Comparison of nedaplatin-based versus cisplatin-based chemotherapy for advanced non-small cell lung cancer among East Asian populations: A meta-analysis

Whether nedaplatin and cisplatin are equally effective for advanced non-small cell lung cancer (NSCLC) remains uncertain. Therefore, we performed a meta-analysis of trials to compare nedaplatin-based chemotherapy with cisplatin-based chemotherapy. We conducted a literature search to identify trials that had investigated the substitution of nedaplatin for cisplatin in the treatment of advanced NSCLC. Fourteen randomized controlled trials were included. We found equivalent overall response, overall survival, and survival probability (0.5-year, 1-year). Considering the toxicity profiles, nausea and vomiting were common in the cisplatin group (OR = 0.28, 95% CI = 0.20-0.40, P < 0.001), whereas severe thrombocytopenia was common in the nedaplatin group (OR = 1.68, 95% CI = 1.18-2.40, P = 0.005). A subgroup analysis of grades 1-4 nephrotoxicity showed that cisplatin-based chemotherapy resulted in more renal toxicity (OR = 0.40, 95% CI = 0.24-0.68, P = 0.001). No significant heterogeneity and publication bias were observed. Cumulative analysis found a stable time-dependent trend. Consistent results stratified by age, regimen, and country were observed. Cisplatin-based chemotherapy was associated with non-inferior antitumor efficacy compared with nedaplatin-based therapy. Therefore, the toxicity profile might play an important role in choosing between cisplatin-based or nedaplatin-based regimens.