It is new that TMB guides cancer treatment, but it is really exciting. I read the paper that Foundation One’s article has a link to. The paper published on J Gastrointestinal Oncology includes two successful cases.
case 1: a patient with stage 4 rectal cancer, MSS, TMB = 223 mut/Mb, is having partial response to Keytruda. Tumors have shrunk by over 50%.
Case 2: another patient with stage 3 rectal cancer, MSS, TMB=14 mut/Mb, achieved a complete response to nivolumab, having 18 month NED.
If we add Cynthia who also had complete response, we see three good cases, although TMB guiding treatment is so new.
01.24.14 Male, DX @54 Rectosigmoid Cancer, MRI: T3N0M0
03.19.14 Completed 5-week Radia+Xeloda
05.07.14 Had surgery
02.25.15 CT showed stage 4.
03.15 - 08.15, folfox + Avastin
08.15 - 07.17, 5FU+leucovorin+Avastin
07.17 - 01.18, Folfuri + Avastin
02.18 - 03.19, Centuximab + Irinotecan
03.19 - 05.19, Keytruda
05.19 - 9.19, Folfox+Avastin
10.22.19 - rechallenge Centuximab+Irinotecan
110 rounds of chemos received (as of 12.31.19)
MSS, KRAS wt, BRAF wt