Summary of findings for the main comparison. Carboplatin compared with cisplatin chemotherapy in combination with third‐generation drugs for advanced non‐small cell lung cancer.
| Carboplatin compared with cisplatin chemotherapy in combination with third‐generation drugs for advanced non‐small cell lung cancer | ||||
| Patient or population: combination with third‐generation drugs for advanced non‐small cell lung cancer Setting: outpatient Intervention: carboplatin‐containing chemotherapy Comparison: cisplatin‐containing chemotherapy | ||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Certainty of the evidence (GRADE) |
| Risk with carboplatin | ||||
| Overall survival (baseline risks for low‐ and high‐risk groups in the control arm were estimated at 1 year) |
Low risk of death | HR 0.99 (0.82 to 1.2) | 2515 (10 RCTs) | ⊕⊕⊕⊕ HIGH |
| 297 per 1000 (254 to 348) | ||||
| High risk of death | ||||
| 447 per 1000 (388 to 512) | ||||
| 1‐year survival rate | Study population | RR 0.98 (0.89 to 1.08) | 4004 (11 RCTs) | ⊕⊕⊕⊕ HIGH |
| 363 per 1000 (330 to 400) | ||||
| Response rate | Study population | RR 0.89 (0.79 to 1.00) | 4020 (11 RCTs) | ⊕⊕⊕⊕ HIGH |
| 246 per 1000 (219 to 277) | ||||
| Grade III or IV neurotoxicity | Study population | RR 1.42 (0.91 to 2.23 | 3857 (10 RCTs) | ⊕⊕⊕⊝ MODERATE 1 |
| 83 per 1000 (57 to 122) | ||||
| Grade III or IV thrombocytopenia | Study population | RR 2.46 (1.49 to 4.04) | 3857 (10 RCTs) | ⊕⊕⊕⊝ MODERATE 2 |
| 109 per 1000 (66 to 180) | ||||
| Grade III or IV renal toxicity | Study population | RR 0.52 (0.19 to 1.45) | 1272 (3 RCTs) | ⊕⊕⊕⊝ MODERATE 3 |
| 10 per 1000 (4 to 27) | ||||
| *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; HR: hazard ratio; RCT: randomised clinical trial; RR: risk ratio | ||||
| GRADE Working Group grades of evidence High certainty: We are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: We are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: Our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect. Very low certainty: We have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect. | ||||
1Renal toxicity rates were only reported by five included trials. 2The heterogeneity found in this analysis was due to data from the Ferry 2017 trial, so that when data from this trial were excluded, the result remained similar, but without significant heterogeneity (RR 2.00, 95% CI 1.37 to 2.91; I2 = 21%). 3Renal toxicity rates were only reported by three included trials.