Tumor mutational load predicts survival after immunotherapy across multiple cancer types
Open accessAbstract
Immune checkpoint inhibitor (ICI) treatments benefit some patients with metastatic cancers, but predictive biomarkers are needed. Findings in selected cancer types suggest that tumor mutational burden (TMB) may predict clinical response to ICI. To examine this association more broadly, we analyzed the clinical and genomic data of 1,662 advanced cancer patients treated with ICI, and 5,371 non-ICI-treated patients, whose tumors underwent targeted next-generation sequencing (MSK-IMPACT). Among all patients, higher somatic TMB (highest 20% in each histology) was associated with better overall survival. For most cancer histologies, an association between higher TMB and improved survival was observed. The TMB cutpoints associated with improved survival varied markedly between cancer types. These data indicate that TMB is associated with improved survival in patients receiving ICI across a wide variety of cancer types, but that there may not be one universal definition of high TMB.
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In some tumour types, tumour mutational burden or neoantigen number correlates with responsiveness to immune-checkpoint inhibitors.
“In certain tumour types, the number of neoantigens in a tumour (or tumour mutational burden (TMB)) is correlated with responsiveness to ICIs67,68.”
From Adjuvant and neoadjuvant immunotherapies in hepatocellular carcinoma (2024) · cites this paper as [68]
The Abstract (page not specified in our copy) reports that higher TMB was associated with better survival among patients treated with immune-checkpoint inhibitors across many cancer types. The paper proposes that higher TMB may mean more tumour neoantigens, but it does not report a direct correlation between neoantigen number and treatment response. (LLM, conf=0.85)
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- Authors
- Samstein, R. M., Lee, C.-H., Shoushtari, A. N., Hellmann, M. D., Shen, R., Janjigian, Y. Y., Barron, D. A., Zehir, A., Jordan, E. J., Omuro, A., Kaley, T. J., Kendall, S. M., Motzer, R. J., Hakimi, A. A., Voss, M. H., Russo, P., Rosenberg, J., Iyer, G., Bochner, B. H., Bajorin, D. F., Al-Ahmadie, H. A., Chaft, J. E., Rudin, C. M., Riely, G. J., Baxi, S., Ho, A. L., Wong, R. J., Pfister, D. G., Wolchok, J. D., Barker, C. A., Gutin, P. H., Brennan, C. W., Tabar, V., Mellinghoff, I. K., DeAngelis, L. M., Ariyan, C. E., Lee, N., Tap, W. D., Gounder, M. M., D’Angelo, S. P., Saltz, L., Stadler, Z. K., Scher, H. I., Baselga, J., Razavi, P., Klebanoff, C. A., Yaeger, R., Segal, N. H., Ku, G. Y., DeMatteo, R. P., Ladanyi, M., Rizvi, N. A., Berger, M. F., Riaz, N., Solit, D. B., Chan, T. A., & Morris, L. G. T.
- Affiliations
- Memorial Sloan Kettering Cancer Center (US)
- Columbia University Irving Medical Center (US)
- Corresponding author
- Solit, David B.
- Chan, Timothy A.
- Morris, Luc G. T.
- ORCID
- Samstein, Robert M.
- Lee, Chung-Han
- Shoushtari, Alexander N.
- Hellmann, Matthew D.
- Shen, Ronglai
- Janjigian, Yelena Y.
- Zehir, Ahmet
- Jordan, Emmet J.
- Omuro, Antonio
- Kaley, Thomas J.
- Kendall, Sviatoslav M.
- Motzer, Robert J.
- Hakimi, A. Ari
- Voss, Martin H.
- Russo, Paul
- Rosenberg, Jonathan
- Iyer, Gopa
- Bochner, Bernard H.
- Bajorin, Dean F.
- Chaft, Jamie E.
- Rudin, Charles M.
- Riely, Gregory J.
- Baxi, Shrujal
- Ho, Alan L.
- Wong, Richard J.
- Pfister, David G.
- Wolchok, Jedd D.
- Barker, Christopher A.
- Gutin, Philip H.
- Brennan, Cameron W.
- Tabar, Viviane
- Mellinghoff, Ingo K.
- DeAngelis, Lisa M.
- Ariyan, Charlotte E.
- Lee, Nancy
- Tap, William D.
- Gounder, Mrinal M.
- D’Angelo, Sandra P.
- Saltz, Leonard
- Stadler, Zsofia K.
- Scher, Howard I.
- Baselga, Jose
- Razavi, Pedram
- Klebanoff, Christopher A.
- Yaeger, Rona
- Segal, Neil H.
- Ku, Geoffrey Y.
- DeMatteo, Ronald P.
- Ladanyi, Marc
- Rizvi, Naiyer A.
- Berger, Michael F.
- Riaz, Nadeem
- Solit, David B.
- Chan, Timothy A.
- Morris, Luc G. T.
- Venue
- Nature Genetics
- Published
- 2019-01-14
- Volume
- 51
- Issue
- 2
- Pages
- 202-206
- ISSN
- 1061-4036 (ISSN-L)
- 1546-1718
- PMC
- PMC6365097
- OpenAlex
- W2909679049
- Cited by
- 4,071
- References
- 34
- Citations by year
- 2026: 250 · 2025: 382 · 2024: 590 · 2023: 664 · 2022: 760 · 2021: 684 · 2020: 518 · 2019: 217 · 2017: 1 · 2012: 1
- FWCI
- 231.09
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Nature Genetics (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Cancer Institute (P50CA221745, R01CA205426, R35CA232097, P30CA008748)
- National Institute of Dental and Craniofacial Research (R01DE027738, K08DE024774)
- Topics
- Health Sciences › Medicine › Oncology › Cancer Immunotherapy and Biomarkers
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Cancer Genomics and Diagnostics
- Life Sciences › Immunology and Microbiology › Immunology › Immunotherapy and Immune Responses
- Keywords
- tumor mutational burden, immune checkpoint inhibitors, immunotherapy response, overall survival, predictive biomarkers, metastatic cancer, somatic mutations, tumor histology, targeted next-generation sequencing
- MeSH terms
- Antineoplastic Agents, Humans, Immunotherapy, Mutation, Neoplasms, Tumor Burden, High-Throughput Nucleotide Sequencing
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