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This personalized chemotherapy approach, evaluated by Guangzhou Medical University, involves the biomarker-driven selection of adjuvant treatment for patients with resected non-small cell lung cancer (NSCLC). The regimen utilizes three established small molecule chemotherapy agents: carboplatin, gemcitabine, and pemetrexed. In this strategy, patients are assigned to either a carboplatin plus gemcitabine or a carboplatin plus pemetrexed doublet based on the tumor's protein expression levels of ERCC1 (excision repair cross-complementation group 1), RRM1 (ribonucleotide reductase M1), and TS (thymidylate synthase). Carboplatin acts as a DNA alkylating agent that induces cross-links, gemcitabine is a nucleoside analog that inhibits ribonucleotide reductase, and pemetrexed is a multi-target antifolate that primarily inhibits thymidylate synthase. The goal of this individualized selection is to optimize efficacy and improve disease-free survival by matching the chemotherapy regimen to the molecular profile of the patient's tumor.
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