Objective: Irinotecan in combination with cisplatin for extensive-stage disease small-cell lung cancer (ED-SCLC) patients has gained wide interest. Varying results for this treatment underpin the need for a synthesis of evidence. Methods: We conducted a literature-based meta-analysis to quantify the magnitude of the benefit comparing irinotecan in combination with cisplatin (IP) with etoposide in combination with cisplatin (EP) in ED-SCLC patients. The primary outcome was overall survival (OS) and progression-free survival (PFS); secondary outcomes included overall response rate, 1- and 2-year survival rates, disease control rate and toxicity. Results: Four trials including 1,541 patients were identified in the analysis. No positive results (P<0.05) were seen: OS (HR=0.85, CI95%=0.71-1.01; P=0.08) with high heterogeneity (Chi 2 =7.76, df=3 P=0.05]; I 2 =61%), PFS (HR=0.91, CI95%=0.74-1.28; P=0.36) with high heterogeneity (Chi 2 =11.96, df=3 P=0.008]; I 2 =75%), overall response rate(OR=1.16; CI95%=0.79-1.70; P=0.45), disease control rate (OR=1.01; CI95%=0.74-1.38; P=0.95), 1-year survival rate (OR = 1.30; CI95%=0.98-1.72; P=0.07) and 2-year survival rate (OR=1.97; CI95%=0.95-4.09; P=0.07). Fewer patients who received IP suffered severe hematologic toxicities (grade≥3), such as neutropenia, thrombocytopenia and leucopenia. However, severe non-hematologic toxicities (grade≥3), such as diarrhea, nausea, vomiting, fatigue, anorexia, and dehydration, were more common among patients who received IP. Conclusion: IP does not lengthen the overall survival or progression-free survival compared with EP in patients with ED-SCLC. Fewer patients receiving IP had grade ≥ 3 hematological toxicities of neutropenia, leucopenia and thrombocytopenia, but more had grade≥3 diarrhea, nausea, vomiting, fatigue, anorexia and dehydration. Objective: Irinotecan in combination with cisplatin for extensive-stage disease small-cell lung cancer (ED-SCLC) patients has gained wide interest. Varying results for this treatment underpin the need for a synthesis of evidence. Methods: We conducted a literature-based meta-analysis to quantify the magnitude of the benefit comparing irinotecan in combination with cisplatin (IP) with etoposide in combination with cisplatin (EP) in ED-SCLC patients. The primary outcome was overall survival (OS) and progression-free survival Results showed that 1,541 patients were identified in the analysis. No positive results (P <0.05) were seen: OS ( HR = 0.85, CI 95% = 0.71-1.01; P = 0.08) with high heterogeneity (Chi 2 = 7.76, df = 3 P = 0.05]; I 2 = 61% 1.28; P = 0.36) with high heterogeneity (Chi 2 = 11.96, df = 3 P = 0.008]; I 2 = 75%), overall response rate = 1.16; CI95% = 0.79-1.70; P = 0.45), disease control rate (OR = 1.01; CI95% = 0.74-1.38; P = 0.95) (OR = 1.97; CI 95% = 0.95-4.09; P = 0.07). Fewer patients who received IP suffered severe hematologic toxicities (grade ≧ 3), such as neutropenia, thrombocytopenia and However, severe non-hematologic toxicities (grade ≧ 3), such as diarrhea, nausea, vomiting, fatigue, anorexia, and dehydration, were more common among patients who received IP. Conclusion: IP does not lengthen the overall survival or progression -free survival compared with EP in patients with ED-SCLC. Fewer patients receiving IP had grade ≥ 3 hematological toxicities of neutropenia, leucopenia and thrombocytopenia, but more had grade≥3 diarrhea, nausea, vomiting, fatigue, anorexia and dehydration.