Similar Trend in Benefit of Adjuvant Platinum in Lung Cancer Patients Irrespective of Epidermal Growth Factor Receptor Mutation Status
Bibliographic record
Abstract
OBJECTIVES: Adjuvant osimertinib is currently the standard of care after pulmonary resection in patients with non-small cell lung cancer (NSCLC) harbouring an activating epidermal growth factor receptor (EGFR) mutation. Several guidelines recommended up to 4 cycles of adjuvant platinum-doublet before adjuvant osimertinib treatment. However, whether adjuvant platinum-doublet prolongs the overall survival (OS) of patients with EGFR-mutated NSCLC as it did in the unselected LACE meta-analysis cohort is unclear. METHODS: A multicentre retrospective observational study was conducted at 21 centres in Japan, enrolling 4181 patients with lung adenocarcinoma who received pulmonary resection between 2015 through 2018. In this study, we compared the efficacy of adjuvant platinum-doublet between EGFR mutated and EGFR wild-type cohort focusing on 706 patients with pathological stage II-III disease. Propensity score matching (1:1 ratio, caliper = 0.2) was used to balance patient characteristics (age, sex, smoking, preoperative performance status, pathological stage, and EGFR status) between patients who received adjuvant treatment and those who did not. RESULTS: Among the 706 patients, 391 (55%) received adjuvant platinum-doublet. After 1:1 propensity score matching, patient characteristics were well balanced in the 2 groups (201 patients each). In subgroup analysis of overall and recurrence-free survival, the hazard ratios of adjuvant treatment were similar in the EGFR-mutated and EGFR wild-type groups (eg, OS, 0.56 [95% CI, 0.29-1.10] and 0.52 [95% CI, 0.33-0.82] in EGFR-mutated and EGFR wild-type subgroup, respectively). CONCLUSIONS: Adjuvant platinum-doublet chemotherapy showed similar trends of benefit in the EGFR-mutated and EGFR wild-type subgroups.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.003 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".