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Journal of Cancer Prevention

Original Article

J Cancer Prev 2023; 28(4): 175-184

Published online December 30, 2023

© Korean Society of Cancer Prevention

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 Shen1 , Guang-Hua Li2 , Yu-Jia Li2 , Peng-Fei Zhang2 , Jia-Xing Yu2 , Di Shang1 , Qiu-Shi Wang2

1Department of Oncology, The Second Affiliated Hospital of Harbin Medical University, Harbin, 2Department of Thoracic Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China

Correspondence to :
Qiu-Shi Wang, E-mail:,

Received: August 14, 2023; Revised: September 24, 2023; Accepted: September 27, 2023

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


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: Non-small cell lung cancer, Platinum, Adjuvant chemotherapy, Prognosis

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