双铂化疗是不同组织学类型的晚期和转移性肺癌 (LC) 的旧标准治疗方法，对于不适合使用免疫检查点抑制剂的患者来说仍然是一种选择。然而，在低收入和中等收入国家，化疗，无论是单一疗法还是与铂类联合疗法，仍然是公共机构唯一可行的选择。不同铂类化疗对初治 LC 患者的疗效尚不清楚。在这项回顾性研究中，我们选择了晚期和转移性 (IIIB-IVB) 非鳞状非小细胞 LC (NSCLC) 患者年龄超过 18 岁且接受一线化疗（多西他赛、吉西他滨、依托泊苷、紫杉醇、培美曲塞和长春瑞滨）联合铂类治疗的 NSCLC 和肺神经内分泌肿瘤（小细胞 LC (SCLC)、大细胞神经内分泌和非典型类癌） 2013年1月1日和2022年12月31日。在非鳞状NSCLC、鳞状NSCLC和神经内分泌肿瘤人群中，无进展生存期（PFS）和总生存期（OS）是主要评估终点。血液学安全性是次要终点。总共纳入了 611 名患者。在非鳞状 NSCLC 患者组 (n = 390) 中，接受一线铂类化疗的患者亚组之间没有统计学差异。中位 PFS 为 182（95% 置信区间 [CI]，167-208）天（进展风险比：NR [未达到]；p = 0.37），中位 OS 为 446（95% CI，405-559） ) 天（死亡风险比：1.31；95% CI，0.94 - 1.82；p = 0.1）。在鳞状 NSCLC 患者组 (n = 149) 中，我们注意到接受铂类化疗的患者亚组之间不存在统计学意义。中位 PFS 为 195（95% CI，142-238；进展风险比：1.21，95% CI，0.29-5.02；p = 0.27），中位 OS 为 428（95% CI，324-940）天（死亡风险比：1.76；95% CI，0.93 至 3.3；p = 0.32）。在首次接受依托泊苷-铂、长春瑞滨-铂或紫杉醇-铂的神经内分泌亚组患者中，已注意到这种情况不存在显着性（n = 72）。中位 PFS 为 216 天（95% CI，193-277）天；进展风险比：1.74，95% CI，0.41-7.27； p = 0.69，中位 OS 为 273 (95% CI, 241-459) 天（死亡风险比：2.95；95% CI，0.4-21.7；p = 0.51）。 3-4 级中性粒细胞减少症是近 11% 患者中与化疗相关的主要不良事件。展望未来，必须针对患者完善治疗策略，重点是增加可以从紧急方法中受益的患者数量，以便保证更广泛、更深入和更持久的结果。版权所有 © 2024。由 Elsevier Inc. 出版。

Doublet platin-chemotherapy was the old standard treatment for different histology types of advanced and metastatic lung cancer (LC) and is still an option for patients who are not eligible for immune checkpoint inhibitors. However, in low- and middle-income countries, chemotherapy, either in monotherapy or in combination with platinum, is still the only accessible option in public institutions. The efficacy of different platin-based chemotherapy in patients with LC who are treatment-naïve is unknown.In this retrospective study, we selected patients with advanced and metastatic (IIIB-IVB) non-squamous non-small cell LC (NSCLC), squamous NSCLC, and lung neuroendocrine tumours (small cell LC (SCLC), large cell neuroendocrine, and atypical carcinoid) aged beyond 18 years who received first-line chemotherapy (docetaxel, gemcitabine, etoposide, paclitaxel, pemetrexed, and vinorelbine) combined with platinum between January 1, 2013, and December 31, 2022. Within the population with non-squamous NSCLC, squamous NSCLC, and neuroendocrine tumours, progression-free survival (PFS) and overall survival (OS) were the primary assessed endpoints. Hematologic safety was the secondary endpoint.Overall, 611 patients were included. In the group of patients with non-squamous NSCLC (n = 390), there was no statistical difference between subgroups of patients who received first-line platin-chemotherapy. The median PFS was 182 (95 % confidence interval [CI], 167-208) days (hazard ratio for progression: NR [Not Reached]; p = 0.37), and the median OS was 446 (95 % CI, 405-559) days (hazard ratio for death: 1.31; 95 % CI, 0.94 - 1.82; p = 0.1). In the group of patients with squamous NSCLC (n = 149), we note the absence of statistical significance between subgroups of patients who received platin-based chemotherapy. The median PFS was 195 (95 % CI, 142-238; hazard ratio for progression: 1.21, 95 % CI, 0.29-5.02; p = 0.27), while the median OS was 428 (95 % CI, 324-940) days (hazard ratio for death: 1.76; 95 % CI, 0.93 to 3.3; p = 0.32). The absence of significance has been noticed in the neuroendocrine subgroup of patients who received first etoposide-platinum, vinorelbine-platinum, or paclitaxel-platinum (n = 72). The median PFS was 216 (95 % CI, 193-277) days; hazard ratio for progression: 1.74, 95 % CI, 0.41-7.27; p = 0.69, while the median OS was 273 (95 % CI, 241-459) days (hazard ratio for death: 2.95; 95 % CI, 0.4-21.7; p = 0.51). Grade 3-4 neutropenia grade was the predominant adverse event associated with chemotherapy in almost 11 % of patients.Moving forward, treatment strategies must be refined for patients, with an emphasis on increasing the number of patients who can benefit from emergent approaches in order to guarantee a wider, deeper, and longer-lasting outcome.Copyright © 2024. Published by Elsevier Inc.