期刊
NPJ PRECISION ONCOLOGY
卷 5, 期 1, 页码 -出版社
NATURE RESEARCH
DOI: 10.1038/s41698-021-00164-5
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- National Cancer Institute [CCITLA P30 CA015083-45S2, R21CA251923]
- Mayo Clinic's Center for Individualized Medicine
The recent FDA approval of TMB-H status as a biomarker for PD-1 inhibitor treatment highlights the importance of accurate assessment of patient-specific TMB. Research shows that using public databases for TMB estimation without patient-paired germline sequencing may introduce racial bias, with TMB being more inflated in Black patients compared to White patients.
With the recent FDA approval of tumor mutational burden-high (TMB-H) status as a biomarker for treatment with a PD-1 inhibitor regardless of tumor type, accurate assessment of patient-specific TMB is more critical now more than ever. Using paired tumor and germline exome sequencing data from 701 patients newly diagnosed with multiple myeloma, including 575 self-reported White patients and 126 self-reported Black patients, we observed that compared to the gold standard of filtering germline variants with patient-paired germline sequencing data, TMB estimates were significantly higher in both Black and White patients when using public databases for filtering non-somatic mutations; however, TMB was more significantly inflated in Black patients compared to White patients. TMB as a biomarker for patient selection to receive immune checkpoint inhibitors (ICIs) therapy without patient-paired germline sequencing may introduce racial bias due to the under-representation of minority groups in public databases.
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