Pemetrexed plus platinum outperforms other platinum-based adjuvant chemotherapy regimens for resected stage II–IIIA lung adenocarcinoma: an open-label, historical-control study

作者：Xumeng Ji, Qiwen Zheng, Bo Jia, Lingdong Kong, Yuling He, Xiaoyu Zhai, Tongtong An, Jianjie Li, Yuyan Wang, Yujia Chi, Jingjing Wang, Lu Ding, Yidi Tai, Reyizha Nuersulitan, Xingsheng Hu, Fan Yang, Ziping Wang · 发表于：Journal of Thoracic Disease · 年份：2025 · DOI：10.21037/jtd-2025-1060 · 研究领域：Lung Cancer Diagnosis and Treatment、Lung Cancer Research Studies、Lung Cancer Treatments and Mutations

Background: Early-stage lung adenocarcinoma has the potential to achieve long-term survival through radical surgery and appropriate adjuvant therapy. Despite rapid advancements in perioperative treatment strategies, postoperative adjuvant chemotherapy remains critically valuable. However, the optimal adjuvant chemotherapy regimen is yet to be established. Therefore, we initiated this study to evaluate the efficacy and safety of pemetrexed (PEM) plus platinum versus other platinum-based regimes as postoperative adjuvant chemotherapy in patients with stage II–IIIA lung adenocarcinoma after radical surgery to provide further clinical practice evidence. Methods: We performed a non-randomized, open-label, historical-control study. Seventy-one patients with pathologic stage II–IIIA lung adenocarcinoma who had undergone complete resection were prospectively enrolled, all of whom received pemetrexed combined with platinum adjuvant chemotherapy every 3 weeks for 4 cycles. In addition, we retrospectively collected the data from 209 patients recorded between January 2003 and December 2021 with pathologic stage II–IIIA lung adenocarcinoma who received radical surgery followed by adjuvant non-PEM (paclitaxel, gemcitabine and vinorelbine) plus platinum as historical control. The primary end point was disease-free survival (DFS). Univariable and multivariable Cox proportional hazards regression analyses were performed to identify independent prognostic factors for DFS. Propensity score matc...