A meta-analysis of cisplatin-based versus carboplatin-based adjuvant chemotherapy for completely resected non-small cell lung cancer.

BACKGROUND: Cisplatin-based adjuvant chemotherapy is the standard of care for patients with completely resected non-small cell lung cancer (NSCLC). However, carboplatin-based regimens are often selected in clinical practice for patients considered unsuitable for cisplatin, although evidence regarding their long-term survival outcomes remains limited. METHODS: We conducted a meta-analysis to compare survival outcomes between cisplatin-based and carboplatin-based adjuvant chemotherapy in patients with completely resected NSCLC. PubMed and the Cochrane CENTRAL database were searched for relevant studies published up to April 7, 2026. Eligible studies included randomized and observational studies reporting hazard ratios (HRs) for overall survival (OS) and/or recurrence-free survival (RFS). RESULTS: A total of eight studies involving 2269 patients were included. The pooled HRs for OS and RFS indicated no significant differences between the two regimens (OS: HR, 1.08; 95% CI 0.92-1.26; RFS: HR, 0.92; 95% CI 0.71-1.20). A sensitivity analysis limited to randomized controlled trials also demonstrated no significant differences between the two regimens (OS: HR, 0.95; 95% CI 0.60-1.51; RFS: HR, 0.96; 95% CI 0.59-1.58). CONCLUSIONS: Carboplatin-based adjuvant chemotherapy may be considered as an alternative in cisplatin-unfit patients with completely resected NSCLC.