RiskReveal 14-Gene Assay Guides Platinum Adjuvant to 96% 2-Year DFS in Stage IA–IIA NSCLC

RiskReveal, a 14-gene expression panel, stratified 421 resected stage IA–IIA non-squamous NSCLC patients; intermediate/high-risk cases (mITT n=194 [46%]) were randomized to 4 cycles of cisplatin-based adjuvant chemotherapy (n=87) or observation (n=107). At a 19-month median follow-up, adjuvant chemo cut recurrence/death risk by 78% (HR 0.22, 95% CI 0.06–0.76; p=0.0087) and achieved 96% disease-free survival at 24 mo versus 79% with observation, with median DFS unreached in either arm. Standard surgery-alone outcomes for localized NSCLC hover around 65% 5-year survival, and prior unselected stage IB trials (CALGB 9633) showed only modest benefit from chemo, underscoring the assay’s potential to personalize treatment.