Unanswered Questions With the Role of TMB in NSCLC

Umberto Malapelle, PhD, assistant professor, University of Naples Federico II, discusses unanswered questions regarding the role of tumor mutational burden (TMB) in non—small cell lung cancer (NSCLC).

During an interview with OncLive at the 2019 European Lung Cancer Congress in Geneva, Switzerland, Malapelle explained that TMB is a fascinating biomarker. TMB has solid rationale for use in terms of its predictive value of response to immunotherapy. With that being said, Malapelle notes it is not quite ready for primetime use. Notably, researchers need more overall survival data with this approach in NSCLC and other solid tumors. To date, only progression-free survival data has been published.

Additionally, researchers need to harmonize the way they test for TMB in the real-world setting with how it’s tested in clinical trials. In clinical trials, a large panel of specified samples are utilized. In clinical practice, there is less specificity because of more biopsies and a larger number of samples.