Evidence map›Paper›PMID 39623081›Full record

ArticleCommunications medicine2024

Blood-based tumor mutational burden impacts clinical outcomes of immune checkpoint inhibitor treated breast and prostate cancers.

Reagan M Barnett, Albert Jang, Sree Lanka, PIngfu Fu, Leslie A Bucheit, Hani Babiker, Alan Bryce, Haley M Meyer, Yujin Choi, Casey Moore and 12 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Communications medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Article
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  5. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

22 authors.

Reagan M BarnettGuardant Health, Inc, Palo Alto, California, USA.
Albert JangUniversity Hospitals Seidman Cancer Center, Cleveland, OH, USA.
Sree LankaTulane Cancer Center, New Orleans, LA, USA.
PIngfu FuUniversity Hospitals Seidman Cancer Center, Cleveland, OH, USA.ORCID http://orcid.org/0000-0002-2334-5218
Leslie A BucheitGuardant Health, Inc, Palo Alto, California, USA.ORCID http://orcid.org/0000-0001-8826-0357
Hani BabikerMayo Clinic Jacksonville, Jacksonville, FL, USA.
Alan BryceMayo Clinic Phoenix, Phoenix, AZ, USA.
Haley M MeyerMayo Clinic Phoenix, Phoenix, AZ, USA.
Yujin ChoiEmory University, Atlanta, GA, USA.
Casey MooreUT Southwestern University, Dallas, TX, USA.
Rohan GarjeMiami Cancer Institute Baptist Health, Miami, FL, USA.
Xin GaoMassachuesetts General Hospital Cancer Center, Boston, MA, USA.
Dae Won KimMoffitt Cancer Institute, Tampa, FL, USA.
Richard Y ChangUniversity Hospitals Seidman Cancer Center, Cleveland, OH, USA.
Pat GulhatiRutgers University, New Brunswick, NJ, USA.
Ryne RamakerMayo Clinic, Rochester, MN, USA.
Rani BansalMayo Clinic, Rochester, MN, USA.ORCID http://orcid.org/0000-0002-1342-4692
Tian ZhangUT Southwestern University, Dallas, TX, USA.
A Oliver SartorMayo Clinic, Rochester, MN, USA.
Andrew J ArmstrongDuke Cancer Institute Center for Prostate and Urologic Cancers, Duke University, Durham, NC, USA.
Mehmet A BilenEmory University, Atlanta, GA, USA.
Pedro BarataUniversity Hospitals Seidman Cancer Center, Cleveland, OH, USA. Pedro.Barata@UHhospitals.org.ORCID http://orcid.org/0000-0002-8890-2951

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBreast and prostate tumors are known to be less responsive to immune checkpoint inhibitors (ICIs). Tissue-based tumor mutation burden (tTMB) has emerged as a predictive biomarker of response to ICIs, including in these "cold tumors". In clinical practice, when tTMB is not available, blood-based TMB score (bTMB) can be used to consider treatment with ICIs.

methodsThis retrospective, real-world study included a final cohort of metastatic breast and prostate cancer patients treated with an ICI following a liquid biopsy test. Multiple bTMB-High cut-offs were assessed. Clinical, genomic, and outcomes data were collected. We hypothesized that a cut-off of bTMB ≥10 mut/Mb is not a strong predictor of response to ICIs in this setting. The Guardant Health genomic database (GHGD) was then queried (N = 13,992) for associations of bTMB with genomic alterations.

resultsIn the clinical cohort (N = 48), ICI treatment is offered after a median of 3 (1-9) lines of treatment. The median bTMB is 16.4 (10-186) mut/Mb. The median time on ICI and PFS is 2.1 (0-1.7) and 3.1 months (95%CI, 1.6-4.6) respectively; no difference by MSI/MMR status (p = 0.152). Response rate among eligible patients (n = 36) is 16.7%; only N = 1/6 in bTMB <16 mut/Mb. High bMSI is associated with higher bTMB (correlation test, r = 0.66, p = 0.000). In the GHGD, patients with bTMB high have significantly more alterations than bTMB low and TP53, PIK3CA, ATM, ESR1, NF1, BRCA2, ARID1A, and APC were the most frequently altered genes.

conclusionsIn this study, the practice of offering an ICIs based on bTMB was uncommon and did not independently predict ICI benefits in patients with refractory, advanced breast and prostate cancers.

Identifiers

PMID39623081
PMCPMC11612475

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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.