Gemcitabine and carboplatin in advanced non small-cell lung cancer: a review

Both gemcitabine and carboplatin have demonstrated activity in advanced non small-cell lung cancer. The combination of gemcitabine and cisplatin has demonstrated equivalent or superior efficacy to other commonly used agents and two-drug combinations, and a recent Eastern Cooperative Oncology Group trial suggested that this regimen may have a slight advantage over other regimens in time to progression. The substitution of carboplatin for cisplatin offers the opportunity for a more well-tolerated regimen, and the combination of gemcitabine with carboplatin has now been studied in various clinical phase I and II trials. The administration of gemcitabine on a day-1-and-8 regimen with carboplatin appears to have a more favorable toxicity profile, especially with regard to platelet toxicity. Therefore, a number of ongoing trials, both phase II and phase III, are investigating the activity of this combination in locally advanced and metastatic non small-cell lung cancer. These trials will help define the role of this active and well-tolerated new regimen and, ultimately, its ability to be incorporated into multimodality therapy as well as with the new biologic agents for the treatment of non small-cell lung cancer.