Nedaplatin vs Cisplatin for Malignancy-Induced MPE: Noninferior, Less Toxicity

Nedaplatin, a second-generation platinum-based antineoplastic drug, was found noninferior to cisplatin in the treatment of malignancy-induced malignant pleural effusion (MPE), a review of clinical data presented in OncoTargets and Therapy has shown.

Malignant pleural effusion, a common complication of advanced cancer, can severely compromise lung and heart function and significantly decrease quality of life for patients. It is usually managed with intrapleural perfusion chemotherapy, most frequently with cisplatin or carboplatin. Although their efficacy is well-established, associated GI adverse effects and myelosuppression caused by these drugs has limited their clinical use. 

In this study, researchers sought to evaluate the efficacy and safety of nedaplatin vs cisplatin in patients with MPE caused by cancers. The clinical data of 219 consecutive patients with MPE treated from January 2013 to December 2016 were retrospectively reviewed. Patients had been treated with nedaplatin 80 mg/m²(n = 110) or with cisplatin 40 mg/m²(n = 109).

No significant difference was seen in the overall response rate in the nedaplatin group vs the cisplatin group (62.73% vs 54.13%, respectively; P=.154). Nor was any significant different seen in treatment efficacy between the 2 drugs in patients with lung, breast, or GI cancer. However, GI adverse effects were significantly lower in the nedaplatin group, and incidence of increased serum creatinine levels were also significantly less compared with the cisplatin group. Overall rate of toxicity was lower in the nedaplatin group vs the cisplatin group (40.00% vs 78.90%, respectively; P<.001).

Based on these findings, the researchers conclude that nedaplatin is noninferior to cisplatin in the treatment of malignancy-induced MPE. However, nedaplatin offers lower associated toxicity.

Reference

Zhong LZ, Xu HY, Zhao ZM, Zhang GM, Lin FW. Comparison of efficacy and toxicity between nedaplatin and cisplatin in treating malignant pleural effusion. Onco Targets Ther.2018;11:5509-5512.