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BIOMARKER:

TMB-H

i
Other names: TMB | Tumor Mutational Burden
Related biomarkers:
Related tests:
2d
AlphaMissense pathogenicity scores predict response to immunotherapy and enhances the predictive capability of tumor mutation burden. (PubMed, Transl Oncol)
AlphaTMB improves survival prediction beyond TMB alone, better captures immunogenic tumor profiles, and reflects more accurate patient stratification. This AI derived somatic mutations pathogenicity scoring represents a step toward personalized immuno-oncology and merits further validation in prospective studies.
Journal • Tumor mutational burden • IO biomarker
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TMB (Tumor Mutational Burden) • POLE (DNA Polymerase Epsilon)
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TMB-H • POLE mutation • TMB-L
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MSK-IMPACT
2d
Extreme Tumor Mutational Burden Predicts Near-Curative Outcomes With Checkpoint Immunotherapy in Melanoma: Half the Eligible, Half the Cure. (PubMed, Pigment Cell Melanoma Res)
A super-high TMB threshold of ≥ 25 mut/Mb by MSK-IMPACT identifies a distinct subset of melanoma patients who achieve truly exceptional benefit, with nearly one in two attaining clinical cure following ICB therapy. These data support prospective validation of "hypermutation" as a clinically actionable biomarker, refine patient counseling, and inform trial stratification in the era of personalized cancer immunotherapy.
Journal • Tumor mutational burden • IO biomarker
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TMB (Tumor Mutational Burden)
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TMB-H
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MSK-IMPACT
2d
Molecular Advances in Gastrointestinal Pathology. (PubMed, Semin Diagn Pathol)
Combining biomarker-driven immunotherapy and targeted approaches such as PD-1 blockade in MSI-H or EBV-positive tumors, HER2-directed therapy, and CLDN18.2 inhibition, has demonstrated a paradigm shift in the clinical management. This review highlights a pathologist-centered perspective on molecularly defined subgroups, actionable biomarkers, and evolving therapeutic paradigms in CRC and GEJ carcinoma, advancing precision oncology.
Review • Journal • Tumor mutational burden • MSi-H Biomarker • PD(L)-1 Biomarker • IO biomarker
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KRAS (KRAS proto-oncogene GTPase) • BRAF (B-raf proto-oncogene) • PIK3CA (Phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha) • TMB (Tumor Mutational Burden) • MSI (Microsatellite instability) • CLDN18 (Claudin 18) • NTRK (Neurotrophic receptor tyrosine kinase)
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PD-L1 expression • TMB-H • MSI-H/dMMR • KRAS G12C • HER-2 amplification • PIK3CA mutation • HER-2 expression • KRAS G12
4d
Modelling Immune Dynamics in Locally Advanced MSI-H/dMMR Colorectal Cancer with Neoadjuvant Pembrolizumab Treatment: From Differential Equations to an Agent-Based Framework. (PubMed, Bull Math Biol)
On the other hand, agent-based models (ABMs) naturally capture stochasticity, interactions at an individual level, and discrete events that lie beyond the scope of differential-equation formulations. As such, we also convert our ODE model, with parameters calibrated to experimental data, to an ABM, preserving its dynamics while providing a flexible platform for future mechanistic investigation and modelling.
Journal • Tumor mutational burden • MSi-H Biomarker • PD(L)-1 Biomarker • IO biomarker • MSI-H • dMMR
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PD-L1 (Programmed death ligand 1) • TMB (Tumor Mutational Burden) • MSI (Microsatellite instability)
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TMB-H • MSI-H/dMMR
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Keytruda (pembrolizumab)
4d
Increased immunogenicity of hypermutated SB28 syngeneic glioblastoma is partially mediated by alterations in tumor chemokine expression. (PubMed, Neurooncol Adv)
Clones were injected subcutaneously or intracranially with or without anti-PD-1/anti-CTLA4 and dexamethasone...Rather, rejection depended on increased secretion of pro-inflammatory chemokines. Msh2 and Mlh1 loss was not equivalent, suggesting that additional studies are needed to elucidate germline and somatic mismatch repair gene-specific immune alterations.
Journal • Tumor mutational burden • PD(L)-1 Biomarker • IO biomarker
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TMB (Tumor Mutational Burden) • IFNG (Interferon, gamma) • MLH1 (MutL homolog 1) • MSH2 (MutS Homolog 2) • CXCL10 (Chemokine (C-X-C motif) ligand 10) • RAG1 (Recombination Activating 1)
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TMB-H • MSI-H/dMMR • TMB-L
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dexamethasone
4d
Iparomlimab and tuvonralimab (QL1706) combined definitive chemoradiotherapy in patients with locally advanced esophageal squamous cell carcinoma (QL1706-IIT-02): a single arm, phase 2 trial. (PubMed, EClinicalMedicine)
Patients received radiotherapy (50.4 Gy/28 in fractions on 5 days per week), concurrent chemotherapy (paclitaxel 135 mg/m2 d1+ cisplatin 25 mg/m2 d1-3, q3w, 2 cycles), and QL1706 (5 mg/kg q3w for up to 1 year [total of 18 cycles]). QL1706 combined with chemoradiotherapy demonstrated potential antitumor activity and manageable toxicity, supporting further investigation. National Natural Science Foundation of China, State Key Laboratory of Druggability Evaluation and Systematic Translational Medicine, Tianjin Key Medical Discipline Construction Project, and Tianjin Key Medical Discipline (Specialty) Construction Project.
P2 data • Journal • Tumor mutational burden • PD(L)-1 Biomarker • IO biomarker
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PD-L1 (Programmed death ligand 1) • TMB (Tumor Mutational Burden) • FASLG (Fas ligand) • ZFHX4 (Zinc Finger Homeobox 4)
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TMB-H
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cisplatin • paclitaxel • Qibeian (iparomlimab/tuvonralimab)
6d
A Phase I Clinical Study Evaluating the Safety and Tolerability of CEL001 Injection in the Treatment of Advanced Solid Tumors (ChiCTR2600116105)
P1, N=10, Recruiting, Cancer Hospital Chinese Academy of Medical Sciences; Guangzhou Celling Biological Technology Co., Ltd.
New P1 trial
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EGFR (Epidermal growth factor receptor) • BRAF (B-raf proto-oncogene) • ALK (Anaplastic lymphoma kinase) • TMB (Tumor Mutational Burden) • MSI (Microsatellite instability) • FGFR2 (Fibroblast growth factor receptor 2) • ROS1 (Proto-Oncogene Tyrosine-Protein Kinase ROS)
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BRAF V600E • TMB-H • MSI-H/dMMR • BRAF V600
7d
A real-world evidence of sputum microbiota alterations and their association with oncogenomic changes and response to targeted therapies in patients with lung cancer. (PubMed, BMC Microbiol)
We demonstrated that opportunistic pathogens exhibited higher infection rates in patients with TP53-mutated, TMB-H, and non-EGFR-mutated tumors. Microbial infection in patients with EGFR mutations might be an influencing factor that weakens the therapeutic efficacy.
Journal • HEOR • Real-world evidence • Tumor mutational burden
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EGFR (Epidermal growth factor receptor) • TP53 (Tumor protein P53) • TMB (Tumor Mutational Burden)
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TP53 mutation • EGFR mutation • TMB-H
7d
Refining Tumor Mutational Burden as a Predictive Biomarker for Pembrolizumab: A Real-World Analysis in Japanese Patients. (PubMed, Cancer Sci)
These findings support the clinical utility of TMB as a biomarker for predicting ICI response in routine oncology practice. In particular, excluding hotspot mutations from TMB calculations may improve response prediction in patients whose TMB values are near the threshold.
Journal • Real-world evidence • Tumor mutational burden • PD(L)-1 Biomarker • IO biomarker
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TMB (Tumor Mutational Burden)
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TMB-H • TMB-L
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FoundationOne® CDx • OncoGuide™ NCC Oncopanel System
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Keytruda (pembrolizumab)
7d
Drastic Response to Olaparib in a Patient With Metastatic Castration-Resistant Prostate Cancer Harboring BRCA2 Alterations and Near-Threshold Tumor Mutational Burden. (PubMed, IJU Case Rep)
Over 3 months, MRI showed further regression of the primary lesion and nodal disease, and PSA and SCC decreased. In metastatic CRPC harboring a BRCA2 mutation and near-threshold TMB, olaparib produced clear radiological and serological responses.
Journal • Tumor mutational burden • BRCA Biomarker • PARP Biomarker
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TMB (Tumor Mutational Burden) • BRCA2 (Breast cancer 2, early onset)
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TMB-H
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Lynparza (olaparib)
7d
Prognostic value of ctDNA-derived maximum somatic allele frequency in patients with metastatic gastric cancer. (PubMed, Ther Adv Med Oncol)
Baseline MSAF is an independent prognostic biomarker in metastatic GC and may reflect underlying biological aggressiveness. Incorporating MSAF into risk stratification frameworks could enhance prognostic classification and inform personalized treatment strategies.
Journal • Tumor mutational burden • IO biomarker • Circulating tumor DNA
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TMB (Tumor Mutational Burden)
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TMB-H • MSI-H/dMMR
7d
Exceptional response to chemo-immunotherapy in a patient with HER2-negative, TMB-high metastatic gastric mucinous adenocarcinoma: a case report and literature review. (PubMed, Front Immunol)
Postoperatively, the patient received 4 cycles of XELOX chemotherapy plus nivolumab, followed by consolidative radiotherapy synchronized with capecitabine and nivolumab, and subsequent maintenance therapy with capecitabine and nivolumab until sustained no evidence of disease (NED) was confirmed in January 2023. This exceptional and sustained response may be attributed to the synergistic effect of TMB-H and POLD1 mutation, which enhance neoantigen generation and sensitize tumors to immunotherapy. This case highlights the potential of biomarker-driven chemo-immunotherapy combined with MDT-guided multimodal treatment (surgery + adjuvant therapy + consolidative radiotherapy) to achieve curative intent in patients with metastatic GMC, providing valuable insights for personalized treatment strategies in this poor-prognosis population.
Review • Journal • Tumor mutational burden • PD(L)-1 Biomarker • IO biomarker
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HER-2 (Human epidermal growth factor receptor 2) • TMB (Tumor Mutational Burden) • POLD1 (DNA Polymerase Delta 1)
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TMB-H • HER-2 negative • POLD1 mutation
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Opdivo (nivolumab) • capecitabine • oxaliplatin