Comparing The Efficacy And Safety Of Irinotecan Or Etoposide Based Chemotherapy Among Caucasian And Asian ED-SCLC Patients: A Systematic Review With Meta-analysis

Background:Various systematic reviews have examined the efficacy of irinotican plus cisplatin/carboplatin(IP)and etoposide plus cisplatin/carboplatin(EP)regimens as a first-line therapy for small cell lung cancer(SCLC),but no direct comparison of these regimens has been undertaken in patients of different ethnicities.Thus,in this study we have conducted a meta-analysis to compare the efficacy and safety of these two treatments among Asian and Caucasian patient populations.Method: The relevant studies for analysis were identified by searching various databases and evaluated using Jadad quality scale.The overall response rate(ORR),one-year survival rate and toxicities of regimens were measured as risk ratios(RR),using Review Manager 5.2.Result: A total of 9 studies including 1,847 patients were identified to assess and compare the efficacy of IP and EP regimens.The result indicated that the IP regimen had statistically significant superiority in the Asian subgroup than EP regimen.However,these effects were not observed in the Caucasian population.In addition,markers of toxicity such as severe anemia,thrombocytopenia and diarrhea were more prevalent in Caucasian patients than in the Asian patient population.Conclusion: IP regimen in SCLC improved the survival of Asians patient and displayed weak hematologic side-effects,but significant gastrointestinal toxicity and fatigue.