Tumor Mutational Burden Poses Challenges as Immunotherapy Biomarker

Wayne Kuznar
Published: Friday, Mar 29, 2019
Natalie Vokes,
MD, MPhil

Natalie Vokes, MD, MPhil

Although tumor mutational burden(TMB) is associated with responses to checkpoint inhibitor therapy, more research is needed to better understand how TMB interacts with other genomic correlates of the immune cycle before the biomarker can be incorporated into clinical practice, according to Natalie Vokes, MD, MPhil.

The findings suggest that the relationship between TMB and outcomes to immune checkpoint therapy is complicated. TMB is likely not associated with response in a vacuum, Vokes said. Rather, it interacts with other features.

Genomic Correlates

In addition to TMB, looking within the tumor microenvironment may also lead to identification of correlates of response. Cancers with high tumor infiltrate and high expression of cytokines and enzymes involved in the tumor immunity cycle represent “hot,” or T cell–inflamed, tumors that appear to be more amenable to checkpoint inhibitor therapy, said Vokes.
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