A report published in the Journal of the National Cancer Institute has stated that cisplatin has better response rates than carboplatin in the treatment of advanced non-small cell lung cancer.
The two main types of lung cancer, accounting for over 90 percent of all lung cancers, are non-small cell and small cell cancer. Non-small cell lung cancer (NSCLC) accounts for most of that 90 percent.
Advanced NSCLC means that the patient's cancer has spread to other organs or areas of the body. There has been research done to evaluate which drug is better for NSCLC -- cisplatin or carboplatin. Nine clinical trials were analyzed to see what regime is a better treatment option.
The study concluded that 30 percent of patients treated with cisplatin experienced a partial or complete disappearance of detectable cancer, compared with 24 percent for those treated with carboplatin. Both of these treatments have their own unique side effects. Cisplatin resulted in more severe nausea and vomiting plus kidney problems. Carboplatin resulted in a higher risk of low platelet levels.
These results suggest that cisplatin produces slightly better response rates than carboplatin and may also improve survival in some patients.
1. In an accompanying editorial by Christopher Azzoli, M.D., the author writes that equally inadvisable would be the overzealous use of cisplatin in patients with metastatic NSCLC for whom the drug may be poorly tolerated.
Also equally inadvisable would be the overzealous use of cisplatin in patients with metastatic NSCLC for whom the drug combination may be resistant to the cancer cells. A failed attempt at chemotherapy is detrimental to the physical and emotional well being of patients, is financially burdensome, and may promote the onset of clinically acquired multi-drug resistance.
The use of clinical trials to establish prescribing guidelines for evidence-based medicine is highly criticized because such trials have little relevance for the individual patient in the real world, the individuality and uniqueness of each patient. While the evidence obtained from the clinical trial may apply to the sample of trial participants, it may have little relevance for the individual patient in the real world.
Posted at 5:06PM on Jun 27th 2007 by Gregory D. Pawelski