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Patients received either pemetrexed 500 mg/m2 intravenously in combination with cisplatin 75 mg/m2 intravenously on Day 1 of each 21-day cycle (n=839) or gemcitabine 1250 mg/m2 intravenously on Days 1 and 8 in combination with cisplatin 75 mg/m2 intravenously on Day 1 of each 21-day cycle (n=830)

The mature adipocytes secrete BMP4 that triggers preadipocyte differentiation by inducing the separation of Wnt1 inducible-signaling pathway protein 2 (WISP2) and zinc finger protein 423 (ZNF423), allowing ZNF423 to translocate into the nucleus and activate peroxisome proliferator-activated receptors (PPAR) and downstream cascade including CCAAT/enhancer-binding proteins (C/EBP), , and [41, 42] ( Figure 1 )