Division of Hematology and Oncology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
J Immunother Cancer. 2021 Nov;9(11). doi: 10.1136/jitc-2021-003683.
The FDA approval of immune checkpoint inhibitors for cancers with tumor mutation burden (TMB) of at least 10 mut/Mb is postulated to reduce healthcare disparities by broadly expanding treatment eligibility. In a cohort of 39,400 patients with available genomic and race data, black and Asian patients were less likely to have TMB-high cancers in multiple types of malignancies based on the currently approved cut-off. Decreasing TMB thresholds preferentially increased the eligibility of minority patients for immune checkpoint inhibitors while retaining predictive value of treatment benefit in a cohort of immune checkpoint inhibitor treated patients. This study highlights differing distributions of TMB-high cancers between racial groups and provides guidance in developing more rational eligibility criteria for immune checkpoint inhibitors.
FDA 批准肿瘤突变负荷（TMB）至少为 10 mut/Mb 的癌症的免疫检查点抑制剂，旨在通过广泛扩大治疗资格来减少医疗保健差距。在一个有基因组和种族数据的 39400 名患者队列中，基于目前批准的截止值，黑人患者和亚裔患者在多种恶性肿瘤中 TMB 高癌症的可能性较小。降低 TMB 阈值优先增加了少数族裔患者接受免疫检查点抑制剂治疗的资格，同时保留了免疫检查点抑制剂治疗患者队列中治疗获益的预测价值。本研究强调了 TMB 高癌症在不同种族群体之间的分布差异，并为免疫检查点抑制剂的更合理资格标准的制定提供了指导。
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