Mutational load and mutations in the interferon signaling pathway among patients with advanced melanoma with or without response to anti–PD-1 blockade.

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Mutational load and mutations in the interferon signaling pathway among patients with advanced melanoma with or without response to anti–PD-1 blockade therapy. Mutational load and mutations in the interferon signaling pathway among patients with advanced melanoma with or without response to anti–PD-1 blockade therapy. A, Total nonsynonymous mutations per tumor from biopsies of patients with response (n = 14) or without response (n = 9) to anti–PD-1 per RECIST 1.1 criteria (median 503 vs. 274, P = 0.27 by Mann–Whitney). Median and interquartile range are shown, with value for each individual tumor shown as dots. B–D, Each column corresponds to an individual case from A. B, Depiction of mutational load (bar graph) and mutations in interferon receptor pathway genes. The size of circles and adjacent labels represents the tumor VAF after adjustment for stromal content. Color represents predicted functional effect. Green, missense; orange, nonsense. Red circle highlights amplified JAK1 mutation in one patient who did not respond to anti–PD-1 therapy. All the tumor sequences were compared to normal germline sequences. C, Heat map of the density of CD8 T cells in the invasive margin or intratumor compartment analyzed in baseline tumor biopsies by immunohistochemistry. D, Heat map of density of PD-L1 expression in available tissue samples. E, Genetic amplification of the chr9p24.1 (PD-L1, PD-L2, and JAK2 locus, termed the PDJ amplicon) was noted in one biopsy from a nonresponding patient. Heat map represents average read depth ratio versus paired germline normal. Daniel Sanghoon Shin et al. Cancer Discov 2017;7:188-201 ©2017 by American Association for Cancer Research