Comparison Of Nedaplatin Versus Cisplatin As First-line Treatment For Advanced Non-small Cell Lung Cancer

Lung cancer is the leading cause of cancer-related deaths worldwide.Non-small cell lung cancer(NSCLC)accounts for about 80%-85% of lung cancer.When the state of EGFR and ALK mutation is unknown or negative,platinum-based combination chemotherapy is the standard first-line treatment for patients with advanced NSCLC.Up to now,the guidelines recommend cisplatin-based combination chemotherapy as first-line treatment for advanced NSCLC.Due to the adverse reactions of cisplatin,many patients are intolerant and the use of cisplatin is limited.As a result,there is an urgent need for new medicines to improve the situation,and nedaplatin emerges as the times require.Background: A randomized,controlled,phase III study(WJOG5208L)in Japan showed that nedaplatin plus docetaxel significantly prolonged overall survival compared with cisplatin plus docetaxel for advanced or relapsed squamous cell lung cancer,and the two joint regimens had different adverse reactions.Objective: Based on the above background,the aim of this study was to compare the efficacy and safety between nedaplatin-based combination chemotherapy and cisplatin-based combination chemotherapy as first-line treatment for advanced non-small cell lung cancer in Chinese population,providing data for first-line treatment.Methods: We retrospectively analyzed advanced NSCLC patients who were treated with nedaplatin or cisplatin in first-line chemotherapy at Shandong Cancer Hospital affiliated to Shandong University from January 1,2014 to December 31,2016,and these patients were included according to nedaplatin : cisplatin = 1:2 ratio.The primary endpoint wasprogression-free survival(PFS).Secondary end points were overall survival(OS),objective response rate(ORR),disease control rate(DCR)and related adverse events.SPSS17.0software was used to process the data and P <0.05 was considered statistically significant.Results: 183 patients were included in the study.Among them,61 patients received nedaplatin-based combination chemotherapy,122 patients received cisplatin-based combination chemotherapy.The final results showed that the median PFS were 5.80 months and 5.57 months(P=0.470)in nedaplatin group and cisplatin group respectively,and the median OS was 14.53 months and 12.83 months(P=0.563)respectively.There were no significant differences,but the nedaplatin-based combination chemotherapy had a certain trend to prolong PFS and OS than the cisplatin-based combination chemotherapy.ORRs were both 39.3% in two groups.The DCR group was 90.2% in nedaplatin group and 88.5% in cisplatin group(P=0.738).The common gastrointestinal reactions,leukopenia,neutropenia were less in nedaplatin group than cisplatin group in all-grades adverse reactions,the difference was statistically significant.Besides,in grade 3 and above adverse reactions,the incidence of leukopenia was lower in nedaplatin group than cisplatin group and the difference was statistically significant.Conclusions: The efficacy of nedaplatin-based combination chemotherapy is comparable to cisplatin-based chemotherapy as first-line treatment for advanced non-small cell lung cancer,but the former has less adverse reactions.As a result,nedaplatin-based combination chemotherapy may be a new option as first-line treatment for advanced non-small cell lung cancer.