We retrospectively enrolled patients with locally advanced or metastatic EGFR mutation-positive lung adenocarcinoma who received EGFR-TKIs as the frontline therapy....In multivariate analysis, high TMB was independently associated with a shorter PFS (hazard ratio [HR] = 1.80, p = 0.0427) and shorter OS (HR = 2.05, p = 0.0397) than that of the low TMB group.