Real-world comparison of survival outcomes with cisplatin versus carboplatin in patients with limited-stage small-cell lung cancer
Introduction: Limited-stage small-cell lung cancer (LS-SCLC) is potentially curable with concurrent chemoradiation (CRT). Cisplatin is the preferred platinum for the chemotherapy backbone in national guidelines. Unfortunately, many LS-SCLC patients are elderly, with comorbidities and poor performanc...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-01-01
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| Series: | Cancer Treatment and Research Communications |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2468294223000072 |
| _version_ | 1797828138943643648 |
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| author | Shashank Sama Kathleen Kerrigan Jennifer A. Sinnott Sonam Puri Wallace Akerley Benjamin Haaland Shiven Patel |
| author_facet | Shashank Sama Kathleen Kerrigan Jennifer A. Sinnott Sonam Puri Wallace Akerley Benjamin Haaland Shiven Patel |
| author_sort | Shashank Sama |
| collection | DOAJ |
| description | Introduction: Limited-stage small-cell lung cancer (LS-SCLC) is potentially curable with concurrent chemoradiation (CRT). Cisplatin is the preferred platinum for the chemotherapy backbone in national guidelines. Unfortunately, many LS-SCLC patients are elderly, with comorbidities and poor performance status (PS), which preclude the use of cisplatin. Carboplatin may be a suitable alternative. This analysis evaluates the overall survival (OS) and time to next treatment (TTNT) in LS-SCLC patients receiving concurrent CRT by platinum use. Materials and methods: The study included LS-SCLC patients in the Flatiron Health nationwide de-identified electronic health record-derived database who received CRT in 2013–2019 with follow-up through May 2020. TTNT and OS were compared using both unadjusted and inverse propensity-weighted Cox proportional hazards models. Results: This study included patients treated with carboplatin (n = 600) or cisplatin (n = 572) in combination with etoposide and radiation. Cisplatin patients were younger, had a shorter time from diagnosis to radiation, and had less kidney disease. In an unadjusted analysis, median overall survival (mOS) was greater in the cisplatin group than the carboplatin group with mOS of 22.3 months vs. 19.2 months and Hazard Ratio (HR) of 0.83 (p = 0.01). In the inverse propensity-weighted analysis, this difference was no longer significant (HR 0.93, p = 0.37). No differences were seen in TTNT. Conclusion: When balancing on key clinical factors, we observed no statistical difference in OS or TTNT by platinum choice in real-world LS-SCLC patients treated with CRT. Although observational, the results from this large data set are consistent with the hypothesis that either cisplatin or carboplatin is an appropriate therapy regardless of health status. |
| first_indexed | 2024-04-09T12:59:50Z |
| format | Article |
| id | doaj.art-b8f6b57af00b42188e0b20bc2cf40fd9 |
| institution | Directory Open Access Journal |
| issn | 2468-2942 |
| language | English |
| last_indexed | 2024-04-09T12:59:50Z |
| publishDate | 2023-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Cancer Treatment and Research Communications |
| spelling | doaj.art-b8f6b57af00b42188e0b20bc2cf40fd92023-05-13T04:25:27ZengElsevierCancer Treatment and Research Communications2468-29422023-01-0135100686Real-world comparison of survival outcomes with cisplatin versus carboplatin in patients with limited-stage small-cell lung cancerShashank Sama0Kathleen Kerrigan1Jennifer A. Sinnott2Sonam Puri3Wallace Akerley4Benjamin Haaland5Shiven Patel6Huntsman Cancer Institute at the University of Utah, 2000 Circle of Hope, Salt Lake City, UT 84112, USAHuntsman Cancer Institute at the University of Utah, 2000 Circle of Hope, Salt Lake City, UT 84112, USAStatistics Department, Ohio State University, Columbus, OH, USAHuntsman Cancer Institute at the University of Utah, 2000 Circle of Hope, Salt Lake City, UT 84112, USAHuntsman Cancer Institute at the University of Utah, 2000 Circle of Hope, Salt Lake City, UT 84112, USAHuntsman Cancer Institute at the University of Utah, 2000 Circle of Hope, Salt Lake City, UT 84112, USAHuntsman Cancer Institute at the University of Utah, 2000 Circle of Hope, Salt Lake City, UT 84112, USA; Corresponding author.Introduction: Limited-stage small-cell lung cancer (LS-SCLC) is potentially curable with concurrent chemoradiation (CRT). Cisplatin is the preferred platinum for the chemotherapy backbone in national guidelines. Unfortunately, many LS-SCLC patients are elderly, with comorbidities and poor performance status (PS), which preclude the use of cisplatin. Carboplatin may be a suitable alternative. This analysis evaluates the overall survival (OS) and time to next treatment (TTNT) in LS-SCLC patients receiving concurrent CRT by platinum use. Materials and methods: The study included LS-SCLC patients in the Flatiron Health nationwide de-identified electronic health record-derived database who received CRT in 2013–2019 with follow-up through May 2020. TTNT and OS were compared using both unadjusted and inverse propensity-weighted Cox proportional hazards models. Results: This study included patients treated with carboplatin (n = 600) or cisplatin (n = 572) in combination with etoposide and radiation. Cisplatin patients were younger, had a shorter time from diagnosis to radiation, and had less kidney disease. In an unadjusted analysis, median overall survival (mOS) was greater in the cisplatin group than the carboplatin group with mOS of 22.3 months vs. 19.2 months and Hazard Ratio (HR) of 0.83 (p = 0.01). In the inverse propensity-weighted analysis, this difference was no longer significant (HR 0.93, p = 0.37). No differences were seen in TTNT. Conclusion: When balancing on key clinical factors, we observed no statistical difference in OS or TTNT by platinum choice in real-world LS-SCLC patients treated with CRT. Although observational, the results from this large data set are consistent with the hypothesis that either cisplatin or carboplatin is an appropriate therapy regardless of health status.http://www.sciencedirect.com/science/article/pii/S2468294223000072Real-world outcomesChemoradiationPlatinum therapyRetrospective analysisRadiosensitizer |
| spellingShingle | Shashank Sama Kathleen Kerrigan Jennifer A. Sinnott Sonam Puri Wallace Akerley Benjamin Haaland Shiven Patel Real-world comparison of survival outcomes with cisplatin versus carboplatin in patients with limited-stage small-cell lung cancer Cancer Treatment and Research Communications Real-world outcomes Chemoradiation Platinum therapy Retrospective analysis Radiosensitizer |
| title | Real-world comparison of survival outcomes with cisplatin versus carboplatin in patients with limited-stage small-cell lung cancer |
| title_full | Real-world comparison of survival outcomes with cisplatin versus carboplatin in patients with limited-stage small-cell lung cancer |
| title_fullStr | Real-world comparison of survival outcomes with cisplatin versus carboplatin in patients with limited-stage small-cell lung cancer |
| title_full_unstemmed | Real-world comparison of survival outcomes with cisplatin versus carboplatin in patients with limited-stage small-cell lung cancer |
| title_short | Real-world comparison of survival outcomes with cisplatin versus carboplatin in patients with limited-stage small-cell lung cancer |
| title_sort | real world comparison of survival outcomes with cisplatin versus carboplatin in patients with limited stage small cell lung cancer |
| topic | Real-world outcomes Chemoradiation Platinum therapy Retrospective analysis Radiosensitizer |
| url | http://www.sciencedirect.com/science/article/pii/S2468294223000072 |
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