O7. Advantages and disadvantages of Cisplatin or carboplatin in adjuvant chemotherapy of NSCLC

Background: Adjuvant chemotherapy (AC) of non-small cell lung carcinoma (NSCLC) is used in stages IB, II and III. Platinum based doublets are applied, combination with vinorelbine is a preferable regimen. AC with cisplatin (CDDP) is considered more effective than carboplatin (CBDCA), nevertheless there is not a single head to head study in AC setting and only meta-analyses on inoperable NSCLC exist.

Methods: Patients after complete resection with stage IB, II and IIIA NSCLC, PS 0-1, age of 18 to 75 years were included to four cycles of 21-day regimens. In the first series—SWITCH, vinorelbine 25 mg/m² was applied on the day one intravenously and on the day 8 60 mg/m² orally. In the second study—FONA, vinorelbine was applied on days 1 and 8 fully orally (80 mg/m², in the first cycle 60 mg/m²). CDDP in dose of 80 mg/m² or CBDCA (AUC 5) were chosen individually according to center and patient preference.

Results: In both SWITCH (154 pts) and FONA (214 pts) series, in pts treated with CBDCA, there were higher relative dose delivery (94% vs. 90%, 95.1% vs. 79%) and mean no of cycles/patient (3.83 vs. 3.76, 3.89 vs. 3.77) than in pts treated with CDDP. Toxicities in both series were similar. In SWITCH series, median of overall survival (mOS) was 69.26 months. Pts treated with CBDCA had mOS significantly longer (P=0.0148). Median of disease free interval (mDFI) was 41.68 months. Pts treated with CBDCA had mDFI significantly longer (P=0.0211). Survival in FONA study was not calculated yet.

Conclusions: Combination of CDDP or CBDCA with oral vinorelbine in 21-day regimens appears to be a feasible and tolerable adjuvant therapy in completely resected NSCLC. Therapy with DBDCA gives better comfort, provides higher dose intensity and more of accomplished treatments. Up-to-date survival results are promising and bring positive expectations for longer survival independently on the fact if CDDP or CBDCA are used.

Keywords: Non-small cell lung carcinoma (NSCLC); adjuvant chemotherapy; cisplatin; carboplatin