Bunn P A
Department of Medicine, University of Colorado Cancer Center, Denver 80262.
Semin Oncol. 1989 Apr;16(2 Suppl 5):27-33.
Carboplatin is a cisplatin analogue that lacks much of the renal toxicity, neurotoxicity, and ototoxicity of the parent compound. The results of trials summarized in this manuscript show that carboplatin is an active agent in small cell lung cancer (SCLC). In combination regimens for SCLC, the activity of carboplatin regimens appears similar to that of cisplatin regimens, though there are no prospective randomized trials to prove this. Future trials exploring dose response relationships and colony-stimulating factors (CSFs) are needed to determine the ultimate role of carboplatin in SCLC. Carboplatin is also active in non-small cell lung cancer (NSCLC), with an overall response rate of just under 10%. As a single agent, it produces survival equivalent to other non-carboplatin-containing combinations. Carboplatin combinations with etoposide and/or ifosfamide produce very high response rates. Future trials need to address dose, schedule, and combinations with CSFs. For SCLC and NSCLC patients with underlying renal, otologic, and neurologic dysfunction, carboplatin may be substituted for cisplatin as standard therapy.
卡铂是一种顺铂类似物，其肾毒性、神经毒性和耳毒性比母体化合物小得多。本手稿总结的试验结果表明，卡铂是小细胞肺癌（SCLC）的一种有效药物。在SCLC的联合治疗方案中，卡铂方案的活性似乎与顺铂方案相似，不过尚无前瞻性随机试验来证实这一点。未来需要进行探索剂量反应关系和集落刺激因子（CSF）的试验，以确定卡铂在SCLC中的最终作用。卡铂在非小细胞肺癌（NSCLC）中也有活性，总体缓解率略低于10%。作为单一药物，它产生的生存率与其他不含卡铂的联合方案相当。卡铂与依托泊苷和/或异环磷酰胺联合使用可产生非常高的缓解率。未来的试验需要解决剂量、给药方案以及与CSF联合使用的问题。对于有潜在肾、耳和神经功能障碍的SCLC和NSCLC患者，卡铂可替代顺铂作为标准治疗。
