Review of therapeutic trials of carboplatin in lung cancer.

Carboplatin is a cisplatin analogue that lacks much of the renal toxicity, neurotoxicity, and ototoxicity of the parent compound. The results of trials summarized in this manuscript show that carboplatin is an active agent in small cell lung cancer (SCLC). In combination regimens for SCLC, the activity of carboplatin regimens appears similar to that of cisplatin regimens, though there are no prospective randomized trials to prove this. Future trials exploring dose response relationships and colony-stimulating factors (CSFs) are needed to determine the ultimate role of carboplatin in SCLC. Carboplatin is also active in non-small cell lung cancer (NSCLC), with an overall response rate of just under 10%. As a single agent, it produces survival equivalent to other non-carboplatin-containing combinations. Carboplatin combinations with etoposide and/or ifosfamide produce very high response rates. Future trials need to address dose, schedule, and combinations with CSFs. For SCLC and NSCLC patients with underlying renal, otologic, and neurologic dysfunction, carboplatin may be substituted for cisplatin as standard therapy.