The study discussant, Elisabeth Quoix, MD, of the University Hospitals of Strasbourg, France, said that this meta-analysis confirmed that platinum-based doublets remain the standard treatment in this setting. Benefit of platinum-based doublets over non–platinum-based chemotherapy is essentially due to cisplatin (only a trend was seen for carboplatin). However, in special populations (patients with performance status 2, elderly patients) a carboplatin-based doublet should be considered and is probably superior to single new agents.

Need for Meta-analyses

Furthermore, Dr. Quoix emphasized that the high number of meta-analyses performed in advanced NSCLC probably reflects the heterogeneity of patients included in randomized controlled trials (regarding age, performance status, and so forth), which lead to conflicting or at least inconclusive results. Thus, meta-analyses are required to answer important questions, but a good question is why repeated results of meta-analyses do not convince doctors to modify their clinical attitude, she noted. ■

Disclosure: Dr. Quoix reported no potential conflicts of interest.