SynthesisESMO open2021
The prognostic impact of tumor mutational burden (TMB) in the first-line management of advanced non-oncogene addicted non-small-cell lung cancer (NSCLC): a systematic review and meta-analysis of randomized controlled trials.
Synthesis in ESMO open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 76 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
76 citing papers in PubMed, 3 syntheses or guidelines pooled it, 121 citations in OpenAlex.
- Predictive Efficacy of Blood-Based Tumor Mutation Burden Assay for Immune Checkpoint Inhibitors Therapy in Non-Small Cell Lung Cancer: A Systematic Review and Meta-Analysis.Frontiers in oncology · 2022Pooled it
- Effect of histology on the efficacy of immune checkpoint inhibitors in advanced non-small cell lung cancer: A systematic review and meta-analysis.Frontiers in oncology · 2022Pooled it
- Pooled it
- Systematic identification of genomic nonresponse biomarkers to cancer therapies.ESMO real world data and digital oncology · 2026Article
- Second Line Treatment Decision as Per Standard of Care or Foundation Medicine in Patients With Locally Advanced or Metastatic Non-Small Cell Lung Cancer.Cancer medicine · 2026Article
- Expert consensus on the detection and clinical application of tumor mutational burden.Cancer biology & medicine · 2026Article
- Tumour mutation burden drives survival outcomes in pancreatic ductal adenocarcinoma and enables noninvasive prediction via dual-layer spectral CT.Insights into imaging · 2026Article
- ctDNA-derived copy-number signatures associated with immune checkpoint inhibitor resistance beyond PD-L1 and TMB in advanced NSCLC.Frontiers in oncology · 2026Article
- Emerging Concepts in Immuno-Oncology: Insights from Natural Language Processing-Driven Co-Occurrence Analysis.ACS omega · 2025Review
- Epithelial zinc finger protein in lung adenocarcinoma: prognostic biomarker with molecular and clinical implications.Hereditas · 2025Article
- On-treatment dynamics of circulating extracellular vesicles in the first-line setting of patients with advanced non-small cell lung cancer: the LEXOVE prospective study.Molecular oncology · 2025Article
- Utilizing multi-omics analysis, a new signature has been identified and validated for predicting prognosis and response to immunotherapy in lung squamous cell carcinoma, which is based on tumor mutation burden.Discover oncology · 2025Article
- Delta-He as a Novel Predictive and Prognostic Biomarker in Patients With NSCLC Treated With PD-1/PD-L1 Inhibitors.Cancer medicine · 2025Article
- Different NGS identification methods of somatic mutation sites in solid tumors impact TMB results.BMC cancer · 2025Article
- Current Biomarkers in Non-Small Cell Lung Cancer-The Molecular Pathologist's Perspective.Diagnostics (Basel, Switzerland) · 2025Review
- Predictive value of ENLIGHT-DP in patients with metastatic lung adenocarcinoma treated with immune checkpoint inhibitors and platinum chemotherapy directly from histopathology slides using inferred transcriptomics.Journal for immunotherapy of cancer · 2025Article
- Integrated single-cell and spatial transcriptomics combined with whole-exome sequencing reveal key hub genes and epithelial heterogeneity in bladder cancer.Frontiers in oncology · 2025Article
- Case Report: A small cell lung cancer transformed from anFrontiers in oncology · 2025Article
- The value ofFrontiers in oncology · 2025Article
- Comprehensive Pan-Cancer Analysis Identifies IGFL1 as an Oncogenic Biomarker and Immunotherapeutic Target with Experimental Validation in Bladder Cancer.International journal of general medicine · 2025Article
16 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe role of tumor mutational burden (TMB) is still debated for selecting advanced non-oncogene addicted non-small-cell lung cancer (NSCLC) patients who might benefit from immune checkpoint inhibitors (ICIs). Of note, TMB failed to predict a benefit in overall survival (OS) among such patients. MATERIALS AND
methodsThe purpose of this meta-analysis was to compare efficacy outcomes among first-line immune-oncology (IO) agents versus standard platinum-based chemotherapy (CT) within two subgroups (TMB-low and TMB-high on either tissue or blood). We collected hazard ratios (HRs) to evaluate the association for progression-free survival (PFS) and OS, with the relative 95% confidence intervals (CIs). Risk ratios (RRs) were used as an association measure for objective response rate (ORR).
resultsEight different cohorts of five randomized controlled phase III studies (3848 patients) were analyzed. In TMB-high patients, IO agents were associated with improved ORR (RRs 1.37, 95% CI 1.13-1.66), PFS (HR 0.69, 95% CI 0.61-0.79) and OS (HR 0.67, 95% CI 0.59-0.77) when compared with CT, thus suggesting a possible predictive role of high TMB for IO regimens. In TMB-low patients, the IO strategy did not lead to any significant benefit in survival and activity, whereas the pooled results of both ORR and PFS were intriguingly associated with a statistical significance in favor of CT.
conclusionsThis meta-analysis resulted in a proven benefit in OS in favor of IO agents in the TMB-high population. Although more prospective data are warranted, we postulated the hypothesis that monitoring TMB, in addition to the existing programmed death-ligand 1 (PD-L1) expression level, could represent the preferable option for future clinical research in the first-line management of advanced non-oncogene addicted NSCLC patients.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.