Figure 1. The evolution of tumor mutation burden as an immunotherapy biomarker. Major studies that are important in the ... Figure 1. The evolution of.

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Figure 1. The evolution of tumor mutation burden as an immunotherapy biomarker. Major studies that are important in the ... Figure 1. The evolution of tumor mutation burden as an immunotherapy biomarker. Major studies that are important in the development of TMB as a biomarker are shown. Color coding indicates type of study. The studies are ordered as a function of time, with the year indicated in the timeline. ICB, immune checkpoint blockade; 1L, first line; 2L, second line; +, and others; I-O, immune-oncology agent; IPI, ipilimumab; NIVO, nivolumab; NSCLC, non-small cell lung cancer; SCLC, small cell lung cancer; TMB, tumor mutational burden. 1. Snyder A et al. N Engl J Med 2014; 371(23): 2189–2199. 2. Rooney MS et al. Cell 2015; 160(1–2): 48–61. 3. Rizvi NA et al. Science 2015; 348(6230): 124–128. 4. Rosenberg JE et al. Lancet 2016; 387(10031): 1909–1920. 5. Kowanetz M et al. Poster presentation at ESMO 2016. Abstract 77P. 6. Kowanetz M et al. Oral presentation at WCLC 2016. Abstract 6149. 7. Balar AV et al. Lancet 2017; 389(10064): 67–76. 8. Seiwert TW et al. J Clin Oncol 2018; 36(suppl 5S; abstract 25). 9. Chalmers ZR et al. Genome Med 2017; 9(1): 34. 10. Zehir A et al. Nat Med 2017; 23(6): 703–713. 11. Carbone DP et al. N Engl J Med 2017; 376(25): 2415–2426. 12 Galsky MD et al. Poster presentation at ESMO 2017. Abstract 848PD. 13. Gandara DR et al. Oral presentation at ESMO 2017. Abstract 1295O. 14. Fabrizio DA et al. Poster presentation at ESMO 2017. Abstract 102P. 15. Mok T et al. Poster presentation at ESMO 2017. Abstract 1383TiP. 16. Antonia SJ et al. Oral presentation at WCLC 2017. Abstract 11063. 17. Riaz N et al. Cell 2017; 171(4): 934–949. 18. Foundation Medicine. http://investors.foundationmedicine.com/releasedetail.cfm?ReleaseID=1050380 (11 December 2017, date last accessed). 19. US Food and Drug Administration. https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm585347.htm (1 December 2017, date last accessed). 20. Hellmann MD et al. N Engl J Med 2018, doi: 10.1056/NEJMoa1801946. 21. Forde PM et al. N Engl J Med 2018, doi: 10.1056/NEJMoa1716078. 22. Cristescu et al. Science 2018; 362(6411). Unless provided in the caption above, the following copyright applies to the content of this slide: © The Author(s) 2018. Published by Oxford University Press on behalf of the European Society for Medical Oncology.This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com Ann Oncol, Volume 30, Issue 1, 05 November 2018, Pages 44–56, https://doi.org/10.1093/annonc/mdy495 The content of this slide may be subject to copyright: please see the slide notes for details.

Figure 2. Target regions and sizes of four different hypothetical gene panels (P1–P4). Depending on the size and ... Figure 2. Target regions and sizes of four different hypothetical gene panels (P1–P4). Depending on the size and territory of the exome that is captured by P1–P4, respectively, TMB counts will differ. Other parameters, e.g. filtering of germline variants and cut points for allelic frequencies (blue circles), discussed in this review will influence TMB measurement further. Unless provided in the caption above, the following copyright applies to the content of this slide: © The Author(s) 2018. Published by Oxford University Press on behalf of the European Society for Medical Oncology.This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com Ann Oncol, Volume 30, Issue 1, 05 November 2018, Pages 44–56, https://doi.org/10.1093/annonc/mdy495 The content of this slide may be subject to copyright: please see the slide notes for details.

Figure 3. Mutations, neoantigens, and immune checkpoint blockade Figure 3. Mutations, neoantigens, and immune checkpoint blockade. Somatic mutations can generate neopeptides that are ... Figure 3. Mutations, neoantigens, and immune checkpoint blockade. Somatic mutations can generate neopeptides that are presented by MHC molecules. Both inflamed and non-inflamed tumors, as well as PD-L1 positive or negative tumors, can respond to immune checkpoint blockade therapy. TMB, tumor mutation burden; MMR, mismatch repair. Unless provided in the caption above, the following copyright applies to the content of this slide: © The Author(s) 2018. Published by Oxford University Press on behalf of the European Society for Medical Oncology.This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com Ann Oncol, Volume 30, Issue 1, 05 November 2018, Pages 44–56, https://doi.org/10.1093/annonc/mdy495 The content of this slide may be subject to copyright: please see the slide notes for details.

Figure 4. Impact of TMB pan-cancer: percent of solid tumors with TMB ≥10 mut/Mb. Analysis of top 30 solid tumor types ... Figure 4. Impact of TMB pan-cancer: percent of solid tumors with TMB ≥10 mut/Mb. Analysis of top 30 solid tumor types selected from 104,814 total cases sorted by percent of cases with TMB ≥10 mut/Mb according to the Foundation Medicine database. TMB is defined as the number of somatic synonymous and non-synonymous base substitutions and indels divided by the region over which it was counted. Only cancer types with at least 100 total cases are reported. The average across all solid tumor types was 13.3%. Unless provided in the caption above, the following copyright applies to the content of this slide: © The Author(s) 2018. Published by Oxford University Press on behalf of the European Society for Medical Oncology.This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com Ann Oncol, Volume 30, Issue 1, 05 November 2018, Pages 44–56, https://doi.org/10.1093/annonc/mdy495 The content of this slide may be subject to copyright: please see the slide notes for details.