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Tumor Mutational Burden in Real-World Patients With Pancreatic Cancer: Genomic Alterations and Predictive Value for Immune Checkpoint Inhibitor Effectiveness by Julia C.F. Quintanilha; Michael H. Storandt; Ryon P. Graf; Gerald Li; Rachel Keller; Douglas I. Lin; Jeffrey S. Ross; Richard S.P. Huang; Alexa B. Schrock; Geoffrey R. Oxnard; Sakti Chakrabarti; Amit Mahipal is a Medicine article available to read on EtoBox.
What is Tumor Mutational Burden in Real-World Patients With Pancreatic Cancer: Genomic Alterations and Predictive Value for Immune Checkpoint Inhibitor Effectiveness about?
## PURPOSE Pancreatic ductal adenocarcinoma (PDAC) is largely considered a nonimmunogenic malignancy; however, approximately 1%, of patients may have tumors with deficient mismatch repair, high microsatellite instability, or high tumor mutational burden (TMB ≥10 mutations/Mb), which may be predictive of response to immune checkpoint inhibitor (ICI) therapy. We sought to analyze outcomes of patients with high-TMB and pathogenic genomic alterations observed in this population. ## METHODS This study included patients with PDAC who underwent comprehensive genomic profiling (CGP) at Foundation Medicine (Cambridge, MA). Clinical data were obtained from a US-wide real-world clinicogenomic pancreatic database. We report genomic alterations in those with high and low TMB, and compare outcomes on the basis of receipt of single-agent ICI or therapy regimens not containing ICI. ## RESULTS We evaluated 21,932 patients with PDAC who had tissue CGP data available, including 21,639 (98.7%) with low-TMB and 293 (1.3%) with high-TMB. Among patients with high-TMB, a greater number of alterations were observed in __BRCA2__, __BRAF__, __PALB2__, and genes of the mismatch repair pathway, whereas fewer a
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- Author
- Julia C.F. Quintanilha; Michael H. Storandt; Ryon P. Graf; Gerald Li; Rachel Keller; Douglas I. Lin; Jeffrey S. Ross; Richard S.P. Huang; Alexa B. Schrock; Geoffrey R. Oxnard; Sakti Chakrabarti; Amit Mahipal
- Publisher
- American Society of Clinical Oncology (ASCO)
- Published
- 2023
- Language
- EN
- Field
- Medicine (Health Sciences)