Evidence map›Paper›PMID 42162005›Full record

ArticleNPJ breast cancer2026

Ultra-high tumor mutation burden breast cancer: genomic profiling and real-world immunotherapy results.

Kristina Fanucci, Mariya Rozenblit, Julia C F Quintanilha, Ryon P Graf, Neal Fischbach, Maureen Pelletier, Abirami Sivapiragasam, Prashanth Ashok Kumar, Mansi Kallem, Ethan S Sokol and 5 more

Abstract read
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In one paragraph

Article in NPJ breast cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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

1 citing paper in PubMed.

  1. Toward targeted therapeutics for lobular breast cancer.The Journal of clinical investigation · 2026
    Review
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

15 authors.

Kristina Fanucci *Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
Mariya Rozenblit *Yale Cancer Center, New Haven, CT, USA. mariya.rozenblit@yale.edu.
Julia C F QuintanilhaFoundation Medicine, Cambridge, MA, USA.
Ryon P GrafFoundation Medicine, Cambridge, MA, USA.
Neal FischbachYale Cancer Center, New Haven, CT, USA.
Maureen PelletierFoundation Medicine, Cambridge, MA, USA.
Abirami SivapiragasamMedical University of South Carolina, Charleston, SC, USA.
Prashanth Ashok KumarGeorge Washington University, Washington, D.C, USA.
Mansi KallemFoundation Medicine, Cambridge, MA, USA.
Ethan S SokolFoundation Medicine, Cambridge, MA, USA.
Smruthy SivakumarFoundation Medicine, Cambridge, MA, USA.
Dean C PavlickFoundation Medicine, Cambridge, MA, USA.
Jeffrey S RossFoundation Medicine, Cambridge, MA, USA.
Maryam LustbergYale Cancer Center, New Haven, CT, USA.
Lajos PusztaiYale Cancer Center, New Haven, CT, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Patients with metastatic breast cancer and tumor mutational burden (TMB) ≥10 mutations/megabase are eligible for immunotherapy, but clinical and genomic characteristics and outcomes of patients with ultra-high TMB (UHTMB) ≥20 mutations/megabase remain under-characterized. In this retrospective cohort and comparative effectiveness study we examined comprehensive genomic profiling assessed on tumors as part of routine care. Real-world time to next treatment (TTNT), and overall survival (rwOS) data were collected from the Flatiron Database. 45/2049 (2.2%) patients had UHTMB; patients with UHTMB were more likely to have estrogen receptor-positive disease (86.6% vs. 70.0%), lobular histology (40.0% vs. 14.5%), and PIK3CA mutation (81.8% vs. 37.9%) vs. patients with TMB ≤ 20. Patients with UHTMB who received immunotherapy had longer TTNT (4.9 vs. 2.6 months, hazard ratio (HR) = 0.49, 95% confidence interval (CI):0.26-0.91,p = 0.025) and longer rwOS (14.1 vs. 3.2 months, HR = 0.37, 95%CI:0.18-0.76,p = 0.007) than patients with TMB <10. Single agent immunotherapy is an important treatment option for patients with UHTMB.

Identifiers

PMID42162005
PMCPMC13462879

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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.