What can platinum offer yet in the treatment of PS2 NSCLC patients? A systematic review and meta-analysis

• Comparison between platinum-based doublets and single-agents in NSCLC PS2 patients.
• Sistematic Review and Meta-analysis to estimate the effectiveness and safety of platinum-based doublets in NSCLC PS2 patients.
• Platinum-combination regimens are superior to single-agent both in terms of ORR and survival-rate with increase of severe hematological toxicities.
• A careful clinical selection among PS2 patients with NSCLC could help to identify those who could better tolerate platinum-based doublets, achieving a greater benefit from this treatment.

BackgroundRandomized phase III trials showed interesting, but conflicting results, regarding the treatment of NSCLC, PS2 population. This meta-analysis aims to review all randomized trials comparing platinum-based doublets and single-agents in NSCLC PS2 patients.Materials and methodsData from all published randomized trials, comparing efficacy and safety of platinum-based doublets to single agents in untreated NSCLC, PS2 patients, were collected. Pooled ORs were calculated for the 1-year Survival-Rate (1y-SR), Overall Response Rate (ORR), and grade 3–4 (G3–4) hematologic toxicities.ResultsSix eligible trials (741 patients) were selected. Pooled analysis showed a significant improvement in ORR (OR: 3.243; 95% CI: 1.883–5.583) and 1y-SR (OR: 1.743; 95% CI: 1.203–2.525) in favor of platinum-based doublets. G3–4 hematological toxicities were also more frequent in this group.ConclusionThis meta-analysis suggests that platinum-combination regimens are superior to singleagent both in terms of ORR and survival-rate with increase of severe hematological toxicities.