PathGene: Benchmarking Driver Gene Mutations and Exon Prediction Using Multicenter Lung Cancer Histopathology Image Dataset

Abstract

Accurately predicting gene mutations, mutation subtypes and their exons in lung cancer is critical for personalized treatment planning and prognostic assessment. Faced with regional disparities in medical resources and the high cost of genomic assays, using artificial intelligence to infer these mutations and exon variants from routine histopathology images could greatly facilitate precision therapy. Although some prior studies have shown that deep learning can accelerate the prediction of key gene mutations from lung cancer pathology slides, their performance remains suboptimal and has so far been limited mainly to early screening tasks. To address these limitations, we have assembled PathGene, which comprises histopathology images paired with next-generation sequencing reports from 1,576 patients at the Second Xiangya Hospital, Central South University, and 448 TCGA-LUAD patients. This multi-center dataset links whole-slide images to driver gene mutation status, mutation subtypes, exon, and tumor mutational burden (TMB) status, with the goal of leveraging pathology images to predict mutations, subtypes, exon locations, and TMB for early genetic screening and to advance precision oncology. Unlike existing datasets, we provide molecular-level information related to histopathology images in PathGene to facilitate the development of biomarker prediction models. We benchmarked 11 multiple-instance learning methods on PathGene for mutation, subtype, exon, and TMB prediction tasks. These experimental methods provide valuable alternatives for early genetic screening of lung cancer patients and assisting clinicians to quickly develop personalized precision targeted treatment plans for patients. Code and data are available at https://github.com/panliangrui/NIPS2025/.