The Predictive Value Of TMB In Malignancies Treated By Immune Checkpoint Inhibitors: A Metaanalysis

Purpose: Immune checkpoint inhibitors(ICIs)show encouraging prognosis in treating some malignancies by its long duration of efficacy and less side effects.However,the predictive biomarker of the immunotherapy efficacy has been inconclusive.So,exploring a new biomarker is important.Methods: we made a meta-analysis to evaluate whether tumor mutation burden(TMB)could be the predictive biomarker of efficacy of ICIs.We searched the articles about TMB and prognosis of multiple-magnificent patients on PubMed database and The Cochrane Library from 1984 to the October 15,2019.And we performed the meta-analysis to identify the relationship between TMB and the clinical efficacy of ICIs by using Stata 12.1 software.Results: Finally,nine articles with a total of 2471 patients were included in this meta-analysis.The results showed that high-TMB patients had better progression-free survival(PFS)than that of low-TMB patients with cancer treated by ICIs(HR=0.46,95%CI: 0.35-0.61,P=0.003).However,in terms of overall survival(OS),there was significant statistical difference between patients with high or low TMB(HR=0.61,95%CI:0.40-0.92,p=0.000).However,because of high heterogeneity,the result of OS was no clinical significance.Conclusion: Our study indicates that High TMB is associated with better PFS.Thus,TMB can be considered as a marker of PFS of ICIs in the future.