Lung cancer is the leading cause of death due to
cancer in the United States, and approximately 178,100 new cases were estimated to occur last year.
Small-cell lung cancer (SCLC) accounts for approximately 17% to 25% of all
lung cancers. Due to its aggressive nature and rapid proliferation rate,
small-cell lung cancer is usually widespread at diagnosis. Therefore,
chemotherapy is the cornerstone of
therapy for this disease.
Cisplatin (
Platinol) is an active chemotherapeutic agent used to treat
small-cell lung cancer, but its toxicity, including
nausea and
vomiting, nephrotoxicity, neurotoxicity, and
ototoxicity, has led to the investigation of combination regimens with different toxicity profiles.
Carboplatin (
Paraplatin), a derivative of
cisplatin, has far less nonhematologic toxicity, although myelosuppression may be slightly greater than that observed with
cisplatin. The reduced toxicity and equivalent efficacy of
carboplatin have resulted in the increased use of
carboplatin-based regimens to treat
small-cell lung cancer. Phase I and II trials of
carboplatin as single-agent treatment for
small-cell lung cancer resulted in overall response rates of approximately 60% for previously untreated patients and 17% for those who had received prior
therapy. New
combination chemotherapy regimens that include
carboplatin may improve survival in patients with
small-cell lung cancer and potentially cure those patients with limited disease. Further investigation of
carboplatin and other new agents is warranted.