A Meta-Analysis of Randomized Controlled Trials Comparing Irinotecan/Platinum with Etoposide/Platinum in Patients with Previously Untreated Extensive-Stage.

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A Meta-Analysis of Randomized Controlled Trials Comparing Irinotecan/Platinum with Etoposide/Platinum in Patients with Previously Untreated Extensive-Stage Small Cell Lung Cancer Jingwei Jiang, MM, Xiaohua Liang, MD, Xinli Zhou, MD, Lizhen Huang, MS, Ruofan Huang, MD, Zhaohui Chu, MM, Qiong Zhan, MM Journal of Thoracic Oncology Volume 5, Issue 6, Pages 867-873 (June 2010) DOI: 10.1097/JTO.0b013e3181d95c87 Copyright © 2010 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 1 Flow of identifying the trials comparing irinotecan/platinum with etoposide/platinum in patients with previously untreated extensive-stage small cell lung cancer. Journal of Thoracic Oncology 2010 5, 867-873DOI: (10.1097/JTO.0b013e3181d95c87) Copyright © 2010 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 2 The meta-analysis showed that irinotecan/platinum (IP) regimens could acquire more overall response than etoposide/platinum (EP) regimens in patients with previously untreated extensive-stage small cell lung cancer (p = 0.043), but the subgroup meta-analysis and sensitivity analysis after the trial using carboplatin was excluded failed to show an advantage in IP regimens (p = 0.065). CBP, irinotecan/carboplatin compared with etoposide/carboplatin subgroup; DDP, irinotecan/cisplatin compared with etoposide/cisplatin subgroup. Journal of Thoracic Oncology 2010 5, 867-873DOI: (10.1097/JTO.0b013e3181d95c87) Copyright © 2010 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 3 The pooled hazard ratio showed that irinotecan/platinum (IP) could prolong overall survival in patients with previously untreated extensive-stage small cell lung cancer (p = 0.044), but the subgroup meta-analysis and sensitivity analysis after the trial using carboplatin was excluded failed to show an advantage in IP regimens (p = 0.163). CBP, irinotecan/carboplatin compared with etoposide/carboplatin subgroup; DDP, irinotecan/cisplatin compared with etoposide/cisplatin subgroup. Journal of Thoracic Oncology 2010 5, 867-873DOI: (10.1097/JTO.0b013e3181d95c87) Copyright © 2010 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 4 The pooled hazard ratio for progression-free survival failed to display a difference between irinotecan/platinum and etoposide/platinum regimens in patients with previously untreated extensive-stage small cell lung cancer (p = 0.139). CBP, irinotecan/carboplatin compared with etoposide/carboplatin subgroup; DDP, irinotecan/cisplatin compared with etoposide/cisplatin subgroup. Journal of Thoracic Oncology 2010 5, 867-873DOI: (10.1097/JTO.0b013e3181d95c87) Copyright © 2010 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 5 The pooled odds ratios for hematological toxicities showed irinotecan/platinum regimens led to less grade 3 to 4 anemia, neutropenia, and thrombocytopenia than etoposide/platinum regimens (p = 0.000, 0.000, and 0.000, respectively). Journal of Thoracic Oncology 2010 5, 867-873DOI: (10.1097/JTO.0b013e3181d95c87) Copyright © 2010 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 6 The pooled odds ratios for nonhematological toxicities showed irinotecan/platinum regimens led to more grade 3 to 4 vomiting and diarrhea than etoposide/platinum regimens, and treatment related deaths were comparable between two groups (p = 0.044, 0.000, and 0.301, respectively). Journal of Thoracic Oncology 2010 5, 867-873DOI: (10.1097/JTO.0b013e3181d95c87) Copyright © 2010 International Association for the Study of Lung Cancer Terms and Conditions