ArticleDiscover oncology2026
A prognostic nomogram for overall survival in patients with driver-gene-negative lung adenocarcinoma and its biological basis.
Article in Discover oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesAssessing the prognosis of patients with "driver-gene-negative" lung adenocarcinoma (LUAD patients negative for EGFR, KRAS, BRAF, HER2, MET, ALK, RET and ROS1 were identified as "driver-gene-negative") is of significant clinical importance. We aimed to devise a prognostic nomogram for this LUAD subgroup and to define its biological basis. MATERIALS AND
methodsPrognostic nomogram were established based on a retrospective study of 294 patients with surgical resected "driver-gene-negative" LUAD at The First Affiliated Hospital of Sun Yat-sen University between September 2003 and June 2015. The concordance index (C-index) and calibration curve were used to determine its predictive accuracy and discriminatory capacity. Patients were classified into low- and high-risk subgroups according to nomogram scores. To define the biological basis, gene set enrichment analysis was carried out in an independent dataset of 49 "driver-gene-negative" LUAD patients.
resultsThe nomogram built on the independent factors including CTC, age and stage achieved C-index of 0.785 [95% confidence interval (CI) 0.753-0.817] for predicting OS of "driver-gene-negative" LUAD. The calibration curves for OS probabilities showed a good agreement between the nomogram prediction and actual observation. High-risk patients had shorter OS [hazard ratio (HR) = 7.43, 95% CI 5.20-10.42, p < 0.0001]. The genetic analysis suggested the biological basis for the role of the predictive model may be due to changes in cell proliferation, metabolism and neurological disease, indicating a relationship between increased proliferative potential and preferential poor prognosis.
conclusionsThe prognostic nomogram showed promising prediction efficacy and is expected to predict the prognosis of "driver-gene-negative" LUAD. The easy-to-use nomogram and the enriched pathways can help clinical decision-making, guide follow-up planning, and develop new therapeutic targets.
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