Carboplatin in non-small cell lung cancer: review of the Eastern Cooperative Oncology Group trial and comparison with other carboplatin trials.

Clinical trials evaluating carboplatin as a single agent or as a component of combination regimens in the treatment of non-small cell lung cancer (NSCLC) patients are reviewed in this report. Response rates for carboplatin varied from 9% to 20% in four trials testing carboplatin 400 mg/m2 as a single daily dose or given over 3 days. In one of these trials carboplatin treatment was associated with a modest but significant survival benefit, and in all of the trials severe toxicity was minimal. In a randomized trial comparing carboplatin/etoposide to cisplatin/etoposide, no significant differences were observed in response rates or survival duration, but there was a trend for less toxicity with carboplatin/etoposide. Other investigators have evaluated carboplatin in two-drug combination therapy with vinblastine, cisplatin, or etoposide in phase II trials. Response rates have ranged from 9% to 17%, suggesting that these particular combinations were not more effective than carboplatin alone. Providing palliation for stage IV NSCLC patients continues to be a major challenge. The low toxicity and modest activity observed with carboplatin suggest that further evaluation of carboplatin is warranted in stage IV NSCLC patients.