2025年 · 第48卷第01期

Please focus on the diagnosis, treatment and prevention of pneumonia in the elderly in this issue.

On December 15, 1952, the national meeting of the Tuberculosis Society of Chinese Medical Association formed a resolution to "set up an editorial board and publish a tuberculosis journal". After half a year's preparation, on July 1, 1953, the Chinese Journal of Tuberculosis was officially launched, which started the journey of coordinated development between the Tuberculosis Branch of Chinese Medical Association and the journal. In December, 1980, during the first national academic conference of internal medicine, the Respiratory Disease Branch of Chinese Medical Association was established, and then the Chinese Journal of Tuberculosis was renamed the Chinese Journal of Tuberculosis and Respiratory Disease. Since then, the history of the two branches running the journal together has officially opened.

Background and PurposePlatinum is the recommended adjuvant therapy for patients with resectable, anaplastic lymphoma kinase (ALK) -positive non-small cell lung cancer (NSCLC). Alectinib is an oral ALK tyrosine kinase inhibitor (TKI) that has shown significant efficacy in phase III clinical trials in patients with advanced ALK-positive NSCLC. For adjuvant therapy in patients with resectable ALK-positive NSCLC, the efficacy and safety of alectinib compared with chemotherapy are unclear. Methods In a global, phase III, open-label, randomized trial, patients with ALK-positive stage IB (tumor ≥4 cm), stage II, or stage IIIA NSCLC after complete resection (according to AJCC/UICC version 7) were randomized to receive alectinib (600 mg each, twice a day for 24 months) and intravenous platinum-based chemotherapy (4 cycles of 21 days each), respectively. The primary endpoint was disease-free survival (DFS), which was stratified in stage II or stage IIIA patients, followed by an intention-to-treat population. Other endpoints included central nervous system (CNS) -DFS, overall survival (OS), and safety. Results 257 patients were randomly divided into two groups, of which 130 received alectinib and 127 received chemotherapy. In stage II or IIIA patients, the 2-year disease-free survival rate was 93.8% in the alectinib group and 63.0% in the chemotherapy group (hazard ratio for disease recurrence or death, 0.24; 95% CI: 0.13-0.45; P<0.001）； In the intention-to-treat population, 2-year disease-free survival was 93.6% in the alectinib group and 63.7% in the chemotherapy group (hazard ratio, 0.24; 95% CI: 0.13 to 0.43; P<0.001）。 Compared with chemotherapy, alectinib showed a clinically meaningful benefit in CNS-DFS (hazard ratio for CNS disease recurrence or death, 0.22; 95% CI: 0.08-0.58). OS has not been obtained and no unexpected safety events have been observed. Conclusion Alectinib significantly improves DFS compared with platinum-based chemotherapy in adjuvant therapy in patients with resected stage IB, II or IIIA ALK-positive NSCLC.