Real-world data support carboplatin use in malignant pleural mesothelioma
medwireNews: Among people receiving first-line platinum-based chemotherapy for malignant pleural mesothelioma (MPM), carboplatin is associated with similar overall survival (OS) as cisplatin, show findings presented at the IASLC 2020 World Conference on Lung Cancer.
Thus “[c]arboplatin is an effective, and potentially less toxic, alternative therapy in MPM chemotherapy regimens,” presenter Kathleen Kerrigan (Huntsman Cancer Institute, Salt Lake City, Utah, USA) told delegates.
Speaking on behalf of the study investigators she added: “We don’t see any obvious reason to choose cisplatin over carboplatin in the real-world clinic setting.”
The retrospective observational study included data from the Flatiron Health database for 787 patients with untreated MPM who were given carboplatin (n=464) or cisplatin (n=323) combination chemotherapy, with treatment initiated between 2013 and 2019.
“The patients who received cisplatin did tend to be younger, healthier, with fewer comorbidities and also with better performance status,” explained Kerrigan.
For instance, the median age in the carboplatin group was 77 years compared with 70 years in the cisplatin group, while the proportion of patients with an ECOG performance status of 2 or higher was 11.4% and 6.2%, respectively. And the incidence of heart and kidney disease was higher among carboplatin- than cisplatin-treated patients, at 3.0% versus 0.3% and 3.7% versus 0.6%, respectively.
Therefore, the two groups were matched by propensity scoring on the basis of multiple factors including age, asbestos exposure, smoking history, ECOG performance status, and previous heart, kidney, and audiology conditions.
The propensity score-weighted median OS was 8.02 months for patients given carboplatin and a comparable 8.05 months for those given cisplatin, and equated to a nonsignificant hazard ratio for death of 1.08.
In conclusion, Kerrigan said their research “provides added context when choosing between the two agents, given what is known regarding carboplatin’s favorable tolerability and toxicity profile.”
But she added that “more observations are required to determine which of the two treatments is superior for extending survival.”
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