Integrated clinical, genomic, and transcriptomic profiling of 400 resected stage IA–IIIA EGFR-mutant lung adenocarcinoma (LUAD) patients to develop and validate multi-omic recurrence risk models across one internal and three external cohorts.
A multi-omic model achieved a median concordance index of 75.4% across four independent validation cohorts, outperforming clinical or genomic variables alone, and successfully stratified recurrence risk within individual pathological stages—including stage I—while identifying patients most likely to benefit from adjuvant EGFR TKI therapy.
Retrospective design requiring prospective validation in larger cohorts; real-world data show up to 40% of patients remain disease-free at five years without adjuvant osimertinib, suggesting the baseline comparator population is heterogeneous; external cohort characteristics and follow-up durations are not fully described in the abstract.
Multi-omic profiling (combining genomic and transcriptomic data) can stratify recurrence risk beyond pathological stage in resected EGFR-mutant LUAD and may help identify which stage IB–IIIA patients are most likely to benefit from adjuvant osimertinib—though prospective validation is still needed before routine clinical use.
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