Cisplatin and carboplatin-based chemotherapy in the first-line treatment of non-small cell lung cancer: Analysis from the European FRAME study

Objectives: To explore patient and disease factors, and reasons behind the physician’s choice of platinumbackbone for the first-line treatment of non-small cell lung cancer (NSCLC), as observed in a Europeanprospective observational study of patients receiving platinum-based chemotherapy as first-line treat-ment for advanced or metastatic NSCLC (the FRAME study). Additionally, overall survival (OS) for patientswho received cisplatin or carboplatin was evaluated.
Materials and methods: A post-hoc analysis of the prospective study population was conducted. Baselinecharacteristics of patients receiving cisplatin versus carboplatin were compared and summarized bypropensity score. Survival for matched patients was summarized using the Kaplan–Meier approach.
Results: Of the 1564 patients who were included in the prospective study, 1520 received either cisplatin or carboplatin in combination with pemetrexed, gemcitabine, taxanes or vinorelbine. Patientstreated with carboplatin were older than patients receiving cisplatin, had poorer performance status, and more comorbidities. Cisplatin wasmost frequently combined with pemetrexed, and carboplatin most frequently with taxanes. Unadjusted median OS estimates for patients from the total prospective study sample were 11.5 months for cisplatin recipients and 9.0 months for carboplatin recipients.
Median (95% CI) overall survival for the matched cohorts was 10.8 months for cisplatinversus 9.5 months for carboplatin.
Conclusion: This post-hoc analysis illustrated real-life differences in patients with NSCLC prescribedplatinum-based first-line treatment, and suggested that baseline patient and disease characteristics wereassociated with physician’s choice of platinum agent, with cisplatin being more frequently prescribed toyounger and fitter patients.