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. 2023 Dec 30;28(4):175-184.
doi: 10.15430/JCP.2023.28.4.175.

Prognostic Significance of Tumor Mutation Burden among Patients with Non-small Cell Lung Cancer Who Received Platinum-based Adjuvant Chemotherapy: An Exploratory Study

Wei-Xi Shen  1 , Guang-Hua Li  2 , Yu-Jia Li  2 , Peng-Fei Zhang  2 , Jia-Xing Yu  2 , Di Shang  1 , Qiu-Shi Wang  2
Affiliations

Prognostic Significance of Tumor Mutation Burden among Patients with Non-small Cell Lung Cancer Who Received Platinum-based Adjuvant Chemotherapy: An Exploratory Study

Wei-Xi Shen et al. J Cancer Prev. .

Abstract

This study aimed to investigate the prognostic significance of tumor mutation burden (TMB) among patients with non-small cell lung cancer (NSCLC) who received platinum-based adjuvant chemotherapy. Tumor tissue specimens after surgical resection were collected for DNA extraction. Somatic mutation detection and TMB analysis were conducted using next-generation sequencing (NGS). Recurrence status of the patients was assessed in the hospital during the adjuvant chemotherapy period, and long-term survival data of patients were obtained by telephone follow-up. Univariate analysis between TMB status and prognosis was carried out by survival analysis. A retrospective review of 78 patients with non-squamous NSCLC who received platinum-based adjuvant chemotherapy showed a median disease-free survival of 3.6 years and median overall survival (OS) of 5.3 years. NGS analysis exhibited that the most common mutated somatic genes among the 78 patients were tumor suppressor protein p53 (TP53), epidermal growth factor receptor, low-density lipoprotein receptor related protein 1B, DNA methyltransferase 3 alpha and FAT atypical cadherin 3, and their prevalence was 56.4%, 48.7%, 37.2%, 30.7%, and 25.6%, respectively. TMB status was divided into TMB-L (≤ 4.5/Mb) and TMB-H (> 4.5/Mb) based on the median TMB threshold. Relevance of TMB to prognosis suggested that the median OS of patients with TMB-L was significantly longer than that of patients with TMB-H (NR vs. 4.6, P = 0.014). Higher TMB status conferred a worse implication on OS among patients with non-squamous NSCLC who received platinum-based adjuvant chemotherapy.

Keywords: Adjuvant chemotherapy; Non-small cell lung cancer; Platinum; Prognosis.

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Conflict of interest statement

CONFLICTS OF INTEREST No potential conflicts of interest were disclosed.

Figures

Figure 1
Figure 1. Flow chart of our retrospective study with the 78 postoperative non-squamous non-small cell lung cancer (NSCLC) patients who received platinum-based adjuvant chemotherapy.
ECOG, eastern cooperative oncology group; TMB, tumor mutation burden.
Figure 2
Figure 2. The tumor mutation burden (TMB) profile of the 78 postoperative patients with non-squamous non-small cell lung cancer (NSCLC).
Figure 3
Figure 3. The somatic mutation spectrum of the 78 postoperative patients with non-squamous non-small cell lung cancer identified by targeted next generation sequencing.
Figure 4
Figure 4. The disease-free survival (DFS) and overall survival (OS) curve of the 78 patients with non-squamous non-small cell lung cancer.
Figure 5
Figure 5. Comparison of the disease-free survival (DFS) in the 78 patients with non-squamous non-small cell lung cancer according to the tumor mutation burden (TMB) status.
TMB-L, TMB the low level group; TMB-H, TMB the high level group.
Figure 6
Figure 6. Comparison of the overall survival (OS) in the 78 patients with non-squamous NSCLC according to the TMB status.
NSCLC, non-small cell lung cancer; TMB, tumor mutation burden; TMB-L, TMB the low level group; TMB-H, TMB the high level group; NR, not reached; NA, not available.
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