Standard treatment for patients with extensive SCLC include VePesid® (etoposide) plus Platinol, VePesid plus Paraplatin or Camptosar® (irinotecan) plus Platinol. Etoposide and carboplatin is standard chemotherapy, which is supported by the NCCN guideline. VePesid (etoposide) Capsules in combination with other approved chemotherapeutic agents is FDA approved as first line treatment in patients with small cell lung cancer. The IV equivalent, Vepesid and ETOPOPHOS (etoposide phosphate) is also FDA approved for Injection in combination with other approved chemotherapeutic agents as first-line treatment in patients with small cell lung cancer.
Although carboplatin is not specifically FDA approved for small cell lung cancer, it certainly qualifies as an approved chemotherapeutic agent under the FDA definition. This combination has been shown to be equivalent to irinotecan and cisplatin and superior to Alimta based regimens in phase 3 comparative trials.
A number of other drugs was studied with etoposide instead of cisplatin but the results are not clearly superior and cisplatin remains the standard of care.
Socinski M, Weissman C, Hart L, et al. Randomized Phase II Trial of Pemetrexed Combined With Either Cisplatin or Carboplatin in Untreated Extensive-Stage Small Cell Lung Cancer. Journal of Clinical Oncology . 2006;2 4:4840-4847.
ee SM, James LE, Qian W, et al. Comparison of gemcitabine and carboplatin versus cisplatin and etoposide for patients with poor-prognosis small cell lung cancer. Thorax 2009; 64:75.
Andreas Hermes, Bengt Bergman, Roy Bremnes, Lars Ek, Sverre Fluge, Christer Sederholm, Stein Sundstrøm, Lars Thaning, Jan Vilsvik, Ulf Aasebø and Sverre Sörenson, Irinotecan Plus Carboplatin Versus Oral Etoposide Plus Carboplatin in Extensive Small-Cell Lung Cancer: A Randomized Phase III Trial JCO September 10, 2008 vol. 26 no. 26 4261-4267
nccn.org, small cell lung cancer, 2013