Carboplatin in the treatment of non-small cell lung cancer: a review

Cisplatin is among the most active agents available for the therapy of non-small cell lung cancer (NSCLC). Its congener, carboplatin, has been the focus of intense clinical trials over the last several years because of its improved therapeutic index. Results from randomized trials have shown that carboplatin is active in NSCLC, and that it can be effectively integrated into combination chemotherapy programs, with survival benefits comparable to cisplatin-containing regimens. Ongoing trials address critical issues, including: the optimization of platinum dose by either varying the carboplatin dose or combining cisplatin and carboplatin; evaluating the activity of carboplatin-containing programs with stem-cell support; and combining low-dose carboplatin with radiation therapy in an attempt to integrate these effective modalities. Finally, the availability of new active agents such as TAXOL (paclitaxel) and the camptothecin analogs has led to clinical trials to determine the optimal interaction between these agents and carboplatin.