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. 2021 Nov 15;13(11):12825-12833.
eCollection 2021.

Etoposide plus cisplatin chemotherapy improves the efficacy and safety of small cell lung cancer

Zhenxing Wang  1 , Shixiong Mai  1 , Peiyun Lv  1 , Li Xu  1 , Yue Wang  1
Affiliations

Etoposide plus cisplatin chemotherapy improves the efficacy and safety of small cell lung cancer

Zhenxing Wang et al. Am J Transl Res. .

Abstract

Background: According to the statistical data of GLOBOCAN in 2020, the incidence of lung cancer ranks third worldwide. Approximately 60%-70% of newly diagnosed patients with small cell lung cancer (SCLC) has already progressed to extensive-stage SCLC (ES-SCLC). SCLC is sensitive to chemotherapy and radiotherapy, but prone to secondary drug resistance. At present, chemotherapy is the mainstay of treatment for ES-SCLC. This study is designed to evaluate the efficacy and safety of etoposide plus platinum in the treatment of SCLC.

Methods: A retrospective analysis was performed on 112 patients with SCLC admitted to the China-Japan Union Hospital of Jilin University from 2016 to 2018. According to treatment methods, the patients were divided into an EL group (etoposide plus lobaplatin, n = 53) and an EP group (etoposide plus cisplatin, n = 59). The short-term efficacy (objective response rates and disease control rates) and 2-year survival rates were observed. The two groups were compared in terms of serum levels of pro-gastrin-releasing peptide (ProGRP), neuron-specific enolase (NSE), vascular endothelial growth factor (VEGF) and matrix metalloproteinase-9 (MMP-9) before and after treatment. The incidence of adverse reactions was also compared. The quality of life (QOL) of patients was compared by measuring the Karnofsky Performance Status (KPS) scale. The risk factors affecting treatment efficacy were analyzed by multivariate Logistics analysis.

Results: Patients in the EL group had similar objective response rate (ORR) and disease control rate (DCR) to those in the EP group. The 2-year survival prognosis (median survival time) between the two groups was not significantly different. After treatment, serum levels of ProGRP, NSE, VEGF and MMP-9 in both groups decreased remarkably, with no remarkable differences between the two groups. The EL group had a remarkably lower incidence of adverse reactions than the EP group. In the EP group, the KPS scores after 6 cycles of treatment were remarkably higher than those after 2 cycles of treatment. ProGRP, NSE, VEGF and MMP-9 were independent risk factors affecting the efficacy of patients with SCLC.

Conclusion: With equivalent efficacy, EP regimen is safer than EL regimen in the treatment of SCLC, which suggests that etoposide plus platinum has better clinical application value for SCLC.

Keywords: Etoposide; adverse reaction; cisplatin; lobaplatin; objective response rate.

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Conflict of interest statement

None.

Figures

Figure 1
Figure 1
Comparison of 2-year survival rates. There was no significant difference in the 2-year OS between EL and EP groups (9.43% VS 8.47%).
Figure 2
Figure 2
Tumor markers in both groups. A. The ProGRP decreased significantly in both groups after treatment, but with no significant difference between the two groups. B. The NSE reduced significantly in both groups after treatment, but with no significant difference between the two groups. Note: ** indicates P < 0.01 vs before treatment.
Figure 3
Figure 3
VEGF and MMP-9 in both groups. A. The VEGF decreased significantly in both groups after treatment, but with no significant difference between the two groups. B. The MMP-9 reduced significantly in both groups after treatment, but with no significant difference between the two groups. Note: ** indicates P < 0.01 vs before treatment.
Figure 4
Figure 4
QOL in both groups. In the EL group, the KPS score at 6 cycles of treatment was significantly higher than that at 2 cycles of treatment. Note: ** indicates P < 0.01 vs before treatment.
See this image and copyright information in PMC

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