ESMO E-Learning: Practical Management of Patients with Advanced NSCLC: Cisplatin or Carboplatin Combination Therapies

Learning Objectives

  • To discuss issues which challenge the equivalence of two platinum compounds (cis- and carboplatin) in the treatment of patients with advanced non-small cell lung cancer (NSCLC)
  • To understand the pharmacology of platinum compounds and how it impacts on the management issues in solid tumours and especially NSCLC
  • To provide clinical practice recommendations for the selection of platinum compound based on expected toxicity profile, patient organ function, patient comorbidities, and companion drug(s)
Title Duration Content CME Points CME Test
Practical Management of Patients in Advanced NSCLC: Cisplatin or Carboplatin Combination Therapies 25 min. 41 slides 1 Take Test
Marina Garassino
Marina Garassino
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antonio rossi
Antonio Rossi
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This E-Learning module discusses an old issue in oncology, whether two platinum compounds (cis- and carboplatin) are equal in the management of patients with advanced non-small cell lung cancer (NSCLC). The question has an important practical aspect, considering an easier carboplatin administration in the daily practice, with no need for pre/post hydration as in case of cisplatin. Introduced in the clinic with similar mechanism of action, but with significantly different toxicity profile, it is unclear whether their clinical efficacy is the same.

The authors discuss this endless issue by covering renewed rivalry from the aspects of pharmacology of platinum compounds, mechanism of action, toxicity profile, and extensively management issues such as platinum compounds vs. best supportive care, platinum compounds vs. single agent therapy, platinum compounds vs. non-platinum based treatment, and thereafter a direct comparison of cis- vs. carboplatin-based chemotherapy, providing very practical conclusions based on findings from randomised clinical trials and meta-analysis.

By discussing findings from the direct comparison of therapies based on these two platinum agents, this E-Learning module provides very practical considerations about which of these two performs better in terms of activity, treatment efficacy, and also in terms of toxicity.

In conclusion, the authors underline that selection of the platinum compound in the first-line treatment of patients with advanced NSCLC should take into account the expected toxicity profile, the patient organ function, the comorbidities, and the companion drug(s). This is a very practice-oriented, educational material, particularly suitable when faced with a simple, but important clinical practice dilemma.

Last update: 13 December 2012

Dr Garassino has reported to be a consultant for Ely Lilly and Boehringer Ingelheim and a member of the speakers' bureau for Ely Lilly. Dr Rossi has reported no conflicts of interest.