ArticleJournal of thoracic disease2026
Real world comparative outcomes of adjuvant carboplatin versus cisplatin-based chemotherapy in stage IB-IIIA non-small cell lung cancer: a propensity-weighted analysis.
Article in Journal of thoracic disease, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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12 authors.
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Abstract
Background: Platinum-doublet adjuvant chemotherapy is standard of care for resected non-small cell lung cancer (NSCLC). Cisplatin has been historically favored for modest survival benefits, though its substantial toxicity often limits treatment completion in routine practice. Carboplatin is better tolerated and frequently substituted; however, comparative real-world effectiveness and safety remain unclear. We evaluated outcomes of cisplatin- versus carboplatin-based adjuvant therapy within the Veterans Health Administration (VHA). Methods: We conducted a retrospective cohort study of Veterans with resected stage IB-IIIA NSCLC treated with adjuvant cisplatin- or carboplatin-based doublets from 2006-2020 using national VHA data. Inverse probability of treatment weighting (IPTW) balanced demographic, clinical, and surgical characteristics. Outcomes included overall survival (OS), recurrence-free survival (RFS), renal toxicity, hospitalization, adverse event rate and treatment completion. Results: Among 465 Veterans, 242 received cisplatin and 223 carboplatin. Carboplatin recipients were older with more comorbidities. After IPTW adjustment, cisplatin was associated with higher renal toxicity (≥30% eGFR decline: 42.7% Conclusions: Cisplatin-based adjuvant chemotherapy was associated with higher OS and RFS though with significantly greater toxicity, hospitalization, and lower treatment completion. These findings highlight the importance of considering the tradeoff of tolerability and treatment completion with efficacy in real-world populations to allow individualized regimen selection, particularly when cisplatin is not feasible.
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