Mutational Burden

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June 9, 2018 at 8:47 am  #1294570    


In my continual education, I learned that the measure of PD-1 is an indication of likelihood of effectiveness of immunotherapy. The anecdotal belief is that immunotherapy is not a viable option for ALK or EGFR patients. Some data is emerging to contradict such belief. I viewed one of the GRACE video with the question: are there better indicator than PD-1 level. The words “mutational burden” is used. In layman’s term….

*what is mutational burden? The different type of mutations one has? So if one has EGFR and then T-790 and then something else…is that 3 different mutation burden?

*as the number of mutation type increases, does PD-1 measure increases? has there been study to show correlation between the “mutation burden” and PD-1 % measures?

June 9, 2018 at 9:15 am  #1294572    
JimC Forum Moderator
JimC Forum Moderator

Hi wadvocator,

Tumor mutational burden encompasses more detail than just whether one’s cancer has an EGFR, ALK or T790M mutation. It’s the total of all of the mutations that a tumor may have acquired over the course of its development. There are a couple of good descriptions of TMB and its potential use as a biomarker for immunotherapy here:

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Jul 2008 Wife Liz (51/never smoker) Dx Stage IV NSCLC EGFR exon 19
4 cycles Carbo/alimta, 65% shrinkage
Tarceva maintenance
Mar 2010 progression, added Alimta, stable
Sep 2010 multiple brain mets, WBR
Oct 2010 large pericardial effusion, tamponade
Jan 2011 progression, start abraxane
Jun 2011-New liver, brain mets, add Tarceva
Oct 2011-Dx Leptomeningeal carcinomatosis; pulsed Tarceva
At rest Nov 4 2011
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