Fig. 1
From: Tumor mutational burden quantification from targeted gene panels: major advancements and challenges
Tumor mutational burden as immunotherapy biomarker. Interaction between tumor mutational burden, neoantigen production and immune checkpoints. Hyper-mutated tumors (bottom) are more likely than hypo-mutated tumors (top) to generate tumor-specific peptides (neoantigens) recognized by the immune system. However, immune surveillance can be restrained by simultaneous high expression of PD-L1, which delivers a suppressive signal to T cells. PD-L1/PD-1 interaction and other immune checkpoints can be inhibited by immune checkpoint inhibitors, restoring immune response