Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Cancer
Published in: BMC Cancer 1/2015

Open Access 01-12-2015 | Research article

Comparison of first-line chemotherapy based on irinotecan or other drugs to treat non-small cell lung cancer in stage IIIB/IV: a systematic review and meta-analysis

Authors: Xue-Qin Yang, Chong-Yi Li, Ming-Fang Xu, Hong Zhao, Dong Wang

Published in: BMC Cancer | Issue 1/2015

Login to get access

Abstract

Background

To compare the efficacy and toxicity of irinotecan-based chemotherapy (IBC) and non-irinotecan-based chemotherapy (NIBC) as first-line treatment for stage IIIB/IV non-small cell lung cancer (NSCLC).

Methods

PubMed, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), abstracts from the annual meetings of ASCO and the ESMO up to 2014 were searched for randomized controlled trials (RCTs) that compared IBC with NIBC. Data on overall survival (OS) and progression-free survival (PFS) were meta-analyzed to provide hazard ratios (HRs), while data on overall response rate (ORR) and frequencies of toxicity were meta-analyzed to provide relative risk ratios (RR).

Results

Seven RCTs (6 RCTs from Asian population and 1 from non-Asian population) involving 1473 patients with previously untreated stage IIIB/IV NSCLC were included in the meta-analysis. IBC and NIBC were associated with similar ORR (RR: 1.08, 95 %CI: 0.94 to 1.23, p = 0.30), OS (HR: 0.97, 95 %CI: 0.88 to 1.07, p = 0.56), and PFS (HR: 1.02, 95 %CI: 0.97 to 1.08, p = 0.38). However, the subgroups between Asian and non-Asian patients differed significantly in OS (HR: 0.94 vs 1.87, p = 0.007). There was no significant difference for hematological toxicity (RR: 0.79, 95 %CI: 0.60 to 1.04, p = 0.09) and significant worse for non-hematological toxicity (RR: 2.28, 95 %CI: 1.60 to3.24, p < 0.001), when IBC compared to NIBC.

Conclusions

As the available evidence suggests that IBC and NIBC are equivalent in terms of ORR, PFS, OS, at least in Asian patients, we recommend that IBC be considered as a first-line treatment in Asian patients with stage IIIB/IV NSCLC. However, the non-hematological toxicity of IBC must be considered.
Appendix
Available only for authorised users
Literature
1.
Bulzebruck H, Bopp R, Drings P, Bauer E, Krysa S, Probst G, et al. New aspects in the staging of lung cancer. Prospective validation of the international union against cancer TNM classification. Cancer. 1992;70(5):1102–10.PubMedCrossRef
2.
Yang P, Allen MS, Aubry MC, Wampfler JA, Marks RS, Edell ES, et al. Clinical features of 5,628 primary lung cancer patients: experience at Mayo Clinic from 1997 to 2003. Chest. 2005;128(1):452–62.PubMedCrossRef
3.
Govindan R, Page N, Morgensztern D, Read W, Tierney R, Vlahiotis A, et al. Changing epidemiology of small-cell lung cancer in the United States over the last 30 years: analysis of the surveillance, epidemiologic, and end results database. J Clin Oncol. 2006;24(28):4539–44.PubMedCrossRef
4.
5.
6.
Rothenberg ML, Eckardt JR, Kuhn JG, Burris 3rd HA, Nelson J, Hilsenbeck SG, et al. Phase II trial of irinotecan in patients with progressive or rapidly recurrent colorectal cancer. J Clin Oncol. 1996;14(4):1128–35.PubMed
7.
Lara Jr PN, Natale R, Crowley J, Lenz HJ, Redman MW, Carleton JE, et al. Phase III trial of irinotecan/cisplatin compared with etoposide/cisplatin in extensive-stage small-cell lung cancer: clinical and pharmacogenomic results from SWOG S0124. J Clin Oncol. 2009;27(15):2530–5.PubMedCentralPubMedCrossRef
8.
Lim WT, Lim ST, Wong NS, Koo WH. CPT-11 and cisplatin in the treatment of advanced gastric cancer in Asians. J Chemother. 2003;15(4):400–5.PubMed
9.
Yamamoto K, Kokawa K, Umesaki N, Nishimura R, Hasegawa K, Konishi I, et al. Phase I study of combination chemotherapy with irinotecan hydrochloride and nedaplatin for cervical squamous cell carcinoma: Japanese gynecologic oncology group study. Oncol Rep. 2009;21(4):1005–9.PubMedCrossRef
10.
Tierney JF, Stewart LA, Ghersi D, Burdett S, Sydes MR. Practical methods for incorporating summary time-to-event data into meta-analysis. Trials. 2007;8:16.PubMedCentralPubMedCrossRef
11.
Banares R, Albillos A, Rincon D, Alonso S, Gonzalez M, Ruiz-del-Arbol L, et al. Endoscopic treatment versus endoscopic plus pharmacologic treatment for acute variceal bleeding: a meta-analysis. Hepatology. 2002;35(3):609–15.PubMedCrossRef
12.
13.
Negoro S, Masuda N, Takada Y, Sugiura T, Kudoh S, Katakami N, et al. Randomised phase III trial of irinotecan combined with cisplatin for advanced non-small-cell lung cancer. Br J Cancer. 2003;88(3):335–41.PubMedCentralPubMedCrossRef
14.
Yamamoto N, Fukuoka M, Negoro SI, Nakagawa K, Saito H, Matsui K, et al. Randomised phase II study of docetaxel/cisplatin vs docetaxel/irinotecan in advanced non-small-cell lung cancer: a west Japan thoracic oncology group study (WJTOG9803). Br J Cancer. 2004;90(1):87–92.PubMedCentralPubMedCrossRef
15.
Ohe Y, Ohashi Y, Kubota K, Tamura T, Nakagawa K, Negoro S, et al. Randomized phase III study of cisplatin plus irinotecan versus carboplatin plus paclitaxel, cisplatin plus gemcitabine, and cisplatin plus vinorelbine for advanced non-small-cell lung cancer: four-Arm cooperative study in Japan. Ann Oncol. 2007;18(2):317–23.PubMedCrossRef
16.
Han JY, Lee DH, Song JE, Lee SY, Kim HY, Kim HT, et al. Randomized phase 2 study of irinotecan plus cisplatin versus gemcitabine plus vinorelbine as first-line chemotherapy with second-line crossover in patients with advanced nonsmall cell lung cancer. Cancer. 2008;113(2):388–95.PubMedCrossRef
17.
Zhao WY, Chen DY. [A prospective randomized controlled clinical trial of irinotecan plus cisplatin versus gemcitabine plus cisplatin as a first-line treatment for advanced non-small cell lung cancer]. Zhonghua zhong liu za zhi [Chinese J Oncol. 2012;34(10):775–9.
18.
Takiguchi Y, Nagao K, Nishiwaki Y, Yokoyama A, Saijo N, Ohashi Y, et al. The final results of a randomized phase III trial comparing irinotecan (CPT-11) and cisplatin (CDDP) with vindesine (VDS) and CDDP in advanced non-small cell lung cancer (NSCLC). Lung Cancer (Amsterdam, Netherlands). 2000;29(9 Suppl 1):S 28.CrossRef
19.
Rocha Lima CM, Rizvi NA, Zhang C, Herndon 2nd JE, Crawford J, Govindan R, et al. Randomized phase II trial of gemcitabine plus irinotecan or docetaxel in stage IIIB or stage IV NSCLC. Ann Oncol. 2004;15(3):410–8.PubMedCrossRef
20.
de Forni M, Bugat R, Chabot GG, Culine S, Extra JM, Gouyette A, et al. Phase I and pharmacokinetic study of the camptothecin derivative irinotecan, administered on a weekly schedule in cancer patients. Cancer Res. 1994;54(16):4347–54.PubMed
21.
Noda K, Nishiwaki Y, Kawahara M, Negoro S, Sugiura T, Yokoyama A, et al. Irinotecan plus cisplatin compared with etoposide plus cisplatin for extensive small-cell lung cancer. N Engl J Med. 2002;346(2):85–91.PubMedCrossRef
22.
Sanoff HK, Sargent DJ, Green EM, McLeod HL, Goldberg RM. Racial differences in advanced colorectal cancer outcomes and pharmacogenetics: a subgroup analysis of a large randomized clinical trial. J Clin Oncol. 2009;27(25):4109–15.PubMedCentralPubMedCrossRef
23.
Saito H, Kudoh S, Nakagawa K, Negoro S, Matsui K, Semba H, et al. Phase II study of 3-week scheduling of irinotecan in combination with cisplatin in patients with advanced nonsmall-cell lung cancer. Am J Clin Oncol. 2006;29(5):503–7.PubMedCrossRef
24.
Hino M, Kobayashi K, Yoshimura A, Takeda Y, Hisakatsu S, Yoneda S, et al. Weekly administration of irinotecan (CPT-11) plus cisplatin for non-small cell lung cancer. Anticancer Res. 2006;26(6C):4697–703.PubMed
25.
Zhang XR, Zhu YZ, Xiu QY, Han FC, Liu DQ, Chu DT. [Irinotecan plus cisplatin for the treatment of advanced non-small cell lung cancer]. Zhonghua zhong liu za zhi [Chinese J Oncol]. 2006;28(10):777–9.
26.
Fukuda M, Oka M, Soda H, Kinoshita A, Fukuda M, Nagashima S, et al. Phase II study of irinotecan combined with carboplatin in previously untreated non-small-cell lung cancer. Cancer Chemother Pharmacol. 2004;54(6):573–7.PubMedCrossRef
27.
Ichiki M, Rikimaru T, Gohara R, Koga T, Kawayama T, Matunami M, et al. Phase II study of irinotecan and ifosfamide in patients with advanced non-small cell lung cancer. Oncology. 2003;64(4):306–11.PubMedCrossRef
28.
Takeda K, Takifuji N, Uejima H, Yoshimura N, Terakawa K, Negoro S. Phase II study of irinotecan and carboplatin for advanced non-small cell lung cancer. Lung Cancer. 2002;38(3):303–8.PubMedCrossRef
29.
Nagao K, Fukuoka M, Fujita A, Kurita Y, Saito R, Niitani H, et al. A phase II study of irinotecan combined with cisplatin in non-small cell lung cancer. CPT-11 lung cancer study group. Gan Kagaku ryoho Cancer Chemotherapy. 2000;27(3):413–21.
30.
Ueoka H, Tanimoto M, Kiura K, Tabata M, Takigawa N, Segawa Y, et al. Fractionated administration of irinotecan and cisplatin for treatment of non-small-cell lung cancer: a phase II study of Okayama lung cancer study group. Br J Cancer. 2001;85(1):9–13.PubMedCentralPubMedCrossRef
31.
Masuda N, Fukuoka M, Fujita A, Kurita Y, Tsuchiya S, Nagao K, et al. A phase II trial of combination of CPT-11 and cisplatin for advanced non-small-cell lung cancer. CPT-11 lung cancer study group. Br J Cancer. 1998;78(2):251–6.PubMedCentralPubMedCrossRef
32.
Pillot GA, Read WL, Hennenfent KL, Marsh S, Gao F, Viswanathan A, et al. A phase II study of irinotecan and carboplatin in advanced non-small cell lung cancer with pharmacogenomic analysis: final report. J Thoracic Oncol. 2006;1(9):972–8.CrossRef
33.
Ziotopoulos P, Androulakis N, Mylonaki E, Chandrinos V, Zachariadis E, Boukovinas I, et al. Front-line treatment of advanced non-small cell lung cancer with irinotecan and docetaxel: a multicentre phase II study. Lung Cancer. 2005;50(1):115–22.PubMedCrossRef
34.
Stathopoulos GP, Dimitroulis J, Antoniou D, Katis C, Tsavdaridis D, Armenaki O, et al. Front-line paclitaxel and irinotecan combination chemotherapy in advanced non-small-cell lung cancer: a phase I-II trial. Br J Cancer. 2005;93(10):1106–11.PubMedCentralPubMedCrossRef
35.
Murren JR, Andersen N, Psyrri D, Brandt D, Nadkarni R, Rose M, et al. Evaluation of irinotecan plus paclitaxel in patients with advanced non-small cell lung cancer. Cancer Biol Therapy. 2005;4(12):1311–5.CrossRef
36.
Raez LE, Rosado MF, Santos ES, Reis IM. Irinotecan and docetaxel as first line chemotherapy in patients with stage IIIB/IV non-small cell lung cancer--experience from a prematurely closed phase II study. Lung Cancer. 2004;45(1):131–2.PubMedCrossRef
37.
Cardenal F, Domine M, Massuti B, Carrato A, Felip E, Garrido P, et al. Three-week schedule of irinotecan and cisplatin in advanced non-small cell lung cancer: a multicentre phase II study. Lung Cancer. 2003;39(2):201–7.PubMedCrossRef
38.
Jagasia MH, Langer CJ, Johnson DH, Yunus F, Rodgers JS, Schlabach LL, et al. Weekly irinotecan and cisplatin in advanced non-small cell lung cancer: a multicenter phase II study. Clin Cancer Res. 2001;7(1):68–73.PubMed
39.
DeVore RF, Johnson DH, Crawford J, Garst J, Dimery IW, Eckardt J, et al. Phase II study of irinotecan plus cisplatin in patients with advanced non-small-cell lung cancer. J Clin Oncol. 1999;17(9):2710–20.PubMed
40.
Crino L, Dansin E, Garrido P, Griesinger F, Laskin J, Pavlakis N, et al. Safety and efficacy of first-line bevacizumab-based therapy in advanced non-squamous non-small-cell lung cancer (SAiL, MO19390): a phase 4 study. Lancet Oncol. 2010;11(8):733–40.PubMedCrossRef
41.
Zhou CC, Bai CX, Guan ZZ, Jiang GL, Shi YK, Wang MZ, et al. Safety and efficacy of first-line bevacizumab combination therapy in Chinese population with advanced non-squamous NSCLC: data of subgroup analyses from MO19390 (SAiL) study. Clin Translation Oncol. 2014;16(5):463–8.CrossRef
42.
Liu CY, Chen PM, Chiou TJ, Liu JH, Lin JK, Lin TC, et al. UGT1A1*28 polymorphism predicts irinotecan-induced severe toxicities without affecting treatment outcome and survival in patients with metastatic colorectal carcinoma. Cancer. 2008;112(9):1932–40.PubMedCrossRef
43.
Park SR, Kong SY, Rhee J, Park YI, Ryu KW, Lee JH, et al. Phase II study of a triplet regimen of S-1 combined with irinotecan and oxaliplatin in patients with metastatic gastric cancer: clinical and pharmacogenetic results. Annals of Oncol. 2011;22(4):890–6.CrossRef
44.
Han JY, Lim HS, Shin ES, Yoo YK, Park YH, Lee JE, et al. Comprehensive analysis of UGT1A polymorphisms predictive for pharmacokinetics and treatment outcome in patients with non-small-cell lung cancer treated with irinotecan and cisplatin. J Clin Oncol. 2006;24(15):2237–44.PubMedCrossRef
45.
Oshita F, Honda T, Murakami S, Kondo T, Saito H, Noda K, et al. Comparison of nedaplatin and irinotecan for patients with squamous and nonsquamous cell carcinoma of the lung: meta-analysis of four trials. J Thoracic Oncol. 2011;6(1):128–31.CrossRef
46.
Schiller JH, Harrington D, Belani CP, Langer C, Sandler A, Krook J, et al. Comparison of four chemotherapy regimens for advanced non-small-cell lung cancer. N Engl J Med. 2002;346(2):92–8.PubMedCrossRef
Metadata
Title
Comparison of first-line chemotherapy based on irinotecan or other drugs to treat non-small cell lung cancer in stage IIIB/IV: a systematic review and meta-analysis
Authors
Xue-Qin Yang
Chong-Yi Li
Ming-Fang Xu
Hong Zhao
Dong Wang
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2015
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-015-1978-2

Other articles of this Issue 1/2015

BMC Cancer 1/2015 Go to the issue

Research article

Dual role of CD44 isoforms in ampullary adenocarcinoma: CD44s predicts poor prognosis in early cancer and CD44ν is an indicator for recurrence in advanced cancer

Research article

Are urothelial carcinomas of the upper urinary tract a distinct entity from urothelial carcinomas of the urinary bladder? Behavior of urothelial carcinoma after radical surgery with respect to anatomical location: a case control study

Research article

Concordance analysis of methylation biomarkers detection in self-collected and physician-collected samples in cervical neoplasm

Research article

A qualitative study of women’s views on overdiagnosis and screening for thyroid cancer in Korea

Research article

Reduced toxicity in the treatment of locally advanced rectal cancer: a comparison of volumetric modulated arc therapy and 3D conformal radiotherapy

Research article

The role of histologic subtype, p16INK4a expression, and presence of human papillomavirus DNA in penile squamous cell carcinoma
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine
Image Credits