Importance of driver mutation assessment and driver-targeted therapy for early-stage NSCLC patients with non-R0 resection

This data includes the raw data of EGFR genotyping by MassARRAY MALDI-TOF nucleotide mass spectrometry platform (Agena Bioscience, San Diego, CA) in the recent study. Abstract Objective: Non-small cell lung cancer patients with incomplete resection have a worse outcome. We aim to identify the risk factors for disease progression and death. Methods: Between August 2011 and December 2020, early-stage NSCLC patients who underwent operation but had a non-R0 resection were included. We analyzed their clinicopathological features and driver mutation status. Results: A total of 65 patients were included for analysis. The median follow-up time was 36.2 months. Thirty-nine patients (60.0%) had experienced disease progression and 3 patients (4.6%) died. Twenty-two patients (33.8%) harbored driver mutation. In multivariate analysis, the presence of driver mutation predicted a higher risk of progression (adjusted OR 24.08 [95% CI 2.77-209.01], P = 0.004). ECOG PS 2 (adjusted HR 3.49 [95% CI 1.10-11.03], P = 0.033), higher tumor stage (adjusted HR 2.55 [95% CI 1.06-6.17], P = 0.037), and the presence of driver mutation (adjusted HR 3.28 [95% CI 1.55-6.94], P = 0.002) all predicted a shorter progression-free survival (PFS). Driver-targeted therapy was associated with a longer post-progression survival when patients were documented to have disease progression (adjusted HR 0.38 [95% CI 0.16-0.91], P = 0.030). There was no significant impact of driver mutation status on overall survival. Conclusions: Although the presence of driver mutation was associated with a higher risk of disease progression and a shorter PFS, patients with disease progression can benefit from driver-targeted therapy, which led to a similar overall survival with that of driver negative or unknown population; hence, comprehensive and earlier analyses of driver mutation are recommended.本数据集包含近期一项研究中，采用MassARRAY MALDI-TOF核苷酸质谱平台（Agena Bioscience，美国加利福尼亚州圣地亚哥）开展表皮生长因子受体（EGFR）基因分型的原始数据。 摘要 目的：接受非R0切除的非小细胞肺癌（NSCLC）患者预后较差。本研究旨在明确疾病进展与死亡的危险因素。 方法：2011年8月至2020年12月期间，纳入接受手术治疗但未达到R0切除的早期非小细胞肺癌患者，分析其临床病理特征与驱动基因突变状态。 结果：共计纳入65例患者进行分析，中位随访时间为36.2个月。其中39例（60.0%）出现疾病进展，3例（4.6%）死亡；22例（33.8%）携带驱动基因突变。多因素分析显示，驱动基因突变的存在预示着更高的疾病进展风险（校正后比值比（OR）=24.08，95%置信区间（CI）：2.77~209.01，P=0.004）。东部肿瘤协作组体能状态评分（ECOG PS）2分（校正后风险比（HR）=3.49，95%CI：1.10~11.03，P=0.033）、较高的肿瘤分期（校正后HR=2.55，95%CI：1.06~6.17，P=0.037）以及驱动基因突变的存在（校正后HR=3.28，95%CI：1.55~6.94，P=0.002）均提示无进展生存期（PFS）更短。当患者出现疾病进展后，驱动基因靶向治疗与更长的进展后生存期相关（校正后HR=0.38，95%CI：0.16~0.91，P=0.030）。驱动基因突变状态对总生存期无显著影响。 结论：尽管驱动基因突变的存在与更高的疾病进展风险及更短的无进展生存期相关，但出现疾病进展的患者可从驱动基因靶向治疗中获益，其总生存期与驱动基因阴性或未知状态的患者相当；因此，推荐对驱动基因突变进行全面且早期的检测分析。