Cisplatin and Carboplatin Show Similar Survival in Most Tumors

An umbrella meta-analysis published in JAMA Network Open found that high-certainty evidence comparing cisplatin- and carboplatin-based therapy was limited to selected outcomes in advanced urothelial and ovarian cancers. For most other tumor types and survival outcomes, evidence certainty ranged from moderate to very low.

Investigators reviewed meta-analyses directly comparing the 2 platinum agents in solid tumors. A search of Web of Science Core Collection databases from inception through January 11, 2026, identified 11 eligible meta-analyses encompassing 52 unique studies, 12,683 unique patients, and 7 tumor types. Outcomes were pooled as equivalent odds ratios (eORs), and certainty was assessed using an algorithmic Grading of Recommendations, Assessment, Development and Evaluation approach.

High-certainty evidence supported a higher objective response rate with cisplatin in advanced urothelial carcinoma (8 studies; eOR, 1.38; 95% CI, 1.24-1.53). High-certainty evidence also showed no significant difference in progression-free survival between the agents in advanced ovarian carcinoma (3 studies; eOR, 0.91; 95% CI, 0.81-1.03).

Moderate-certainty evidence favored cisplatin for complete response in early-stage cervical carcinoma (3 studies; eOR, 2.03; 95% CI, 1.27-3.24), although 3-year disease-free survival and overall survival did not differ significantly. In advanced non–small cell lung cancer, 1-year overall survival and mortality ratios also showed no differences, with moderate-certainty evidence. Cisplatin was associated with more ototoxicity, nephrotoxicity, and emesis, whereas carboplatin was associated with more hematologic toxicity, particularly thrombocytopenia; certainty for these safety findings was very low.

The authors cautioned that treatment regimens, dosing schedules, response criteria, and follow-up varied across the underlying studies. They concluded that high-certainty comparative evidence remains limited and that most survival estimates suggested no meaningful differences between the agents, with moderate to low certainty.

Source: Jiménez-Labaig P, Mirallas O, Pereira F, et al. Reappraisal of cisplatin vs carboplatin treatment for solid tumors: an umbrella meta-analysis. JAMA Netw Open. 2026;9(9):e2634287. doi:10.1001/jamanetworkopen.2026.34287