carboplatin + cisplatin + pemetrexed + zipalertinib

This is a combination chemotherapy and targeted therapy regimen for the treatment of advanced non-small cell lung cancer (NSCLC), particularly in patients with specific EGFR mutations such as exon 20 insertions. The regimen combines two platinum-based chemotherapies (carboplatin and cisplatin), an antifolate antimetabolite (pemetrexed), and a novel EGFR tyrosine kinase inhibitor (zipalertinib). Carboplatin and cisplatin are both DNA cross-linking agents that induce apoptosis in rapidly dividing cells, while pemetrexed inhibits enzymes involved in folate metabolism, disrupting DNA synthesis. Zipalertinib is an investigational, orally available, irreversible EGFR-TKI designed to target uncommon or resistant EGFR mutations[7][9][10]. This combination aims to maximize antitumor efficacy by leveraging both cytotoxic chemotherapy and targeted inhibition of oncogenic signaling pathways.