Using multivariate analysis on PFS in the multimodal cohort, alterations of EGFR (n = 22/247, 8.9%; adjusted hazard ratio (aHR) = 2.14, 95% CI 1.06–4.31, P = 0.03), STK11 (n = 44/247, 17.8%; aHR = 2.53, 95% CI 1.71–3.74, P < 0.005) and tumor mutation burden (TMB) (median 7 mt per mb, range 0–90; aHR = 0.14, 95% CI 0.02–0.88, P = 0.04) exhibited significant aHR in a multivariable analysis of mutated oncogenes (EGFR, ALK, ROS1, RET, MET, ERBB2 and BRAF), tumor suppressor genes (STK11), transcription regulator (ARID1A) and TMB (Fig. 4a). Here, ALK is linked to neoplasm.