Platinum Doublet Lifts 2-Year DFS to 96% in Gene-High Stage I–IIA NSCLC

Platinum-based adjuvant chemotherapy—mainly cisplatin or carboplatin doublets—was tested in the Phase 3 AIM-HIGH trial (NCT01817192), which randomized 200 resected stage IA-IIA non-squamous NSCLC patients flagged as high/intermediate risk by a CLIA-certified 14-gene expression assay to four cycles of chemo (n = 87) or observation (n = 107). At the prespecified interim read-out, 24-month disease-free survival was 96% versus 79% (HR 0.22, p = 0.0087); only six deaths occurred overall, and full grade 3+ toxicity data await maturation, though historical platinum doublets cause ≥G3 neutropenia in roughly 20-30%. The observation arm’s DFS aligns with prior surgery-alone cohorts (~75-85%), making the 17-point absolute gain markedly larger than the ~5-point 5-year benefit seen in earlier LACE meta-analysis of unselected adjuvant cisplatin.