American Board of Internal Medicine (ABIM) Certification Practice Exam

What type of chemotherapy has shown a clear survival advantage in patients with resected stage II NSCLC?

1. Cisplatin-based combination therapy

2. Single-agent carboplatin

3. Gemcitabine

4. Pemetrexed

The correct answer is: Cisplatin-based combination therapy

Cisplatin-based combination therapy has demonstrated a significant survival advantage in patients with resected stage II non-small cell lung cancer (NSCLC). This type of chemotherapy often involves combining cisplatin with another drug, such as vinorelbine or gemcitabine, which enhances the overall effectiveness of the treatment. Studies have consistently shown that patients who receive cisplatin-based regimens after surgical resection have better outcomes compared to those who do not receive adjuvant chemotherapy, leading to improved overall survival rates. In the context of resected stage II NSCLC, the rationale for employing cisplatin-based combination regimens stems from their ability to address both micrometastatic disease and the potential for disease recurrence, making these regimens an important part of post-operative management. Other options, like single-agent carboplatin, while they are used in oncology, have not shown the same level of survival advantage in this specific patient population. Similarly, drugs like gemcitabine and pemetrexed have their own indications and benefits but do not provide the same clear evidence for improved survival when used as adjuvant therapy in resected stage II NSCLC as the cisplatin-based combinations do.