Relationship between Tumor Mutational Burden, PD-L1, Patient Characteristics, and Response to Immune Checkpoint Inhibitors in Head and Neck Squamous Cell Carcinoma
Failure to predict response to immunotherapy (IO) limited its benefit in the treatment of head and neck squamous cell cancer (HNSCC) to 20% of patients or less. Biomarkers including tumor mutational burden (TMB) and programmed death ligand-1 (PD-L1) were evaluated as predictors of response to IO, bu...
Gespeichert in:
| Veröffentlicht in: | Cancers 2021-11, Vol.13 (22), p.5733 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | |
|---|---|
| container_issue | 22 |
| container_start_page | 5733 |
| container_title | Cancers |
| container_volume | 13 |
| creator | Burcher, Kimberly M. Lantz, Jeffrey W. Gavrila, Elena Abreu, Arianne Burcher, Jack T. Faucheux, Andrew T. Xie, Amy Jackson, Clayton Song, Alexander H. Hughes, Ryan T. Lycan, Thomas Bunch, Paul M. Furdui, Cristina M. Topaloglu, Umit D’Agostino, Ralph B. Zhang, Wei Porosnicu, Mercedes |
| description | Failure to predict response to immunotherapy (IO) limited its benefit in the treatment of head and neck squamous cell cancer (HNSCC) to 20% of patients or less. Biomarkers including tumor mutational burden (TMB) and programmed death ligand-1 (PD-L1) were evaluated as predictors of response to IO, but the results are inconsistent and with a lack of standardization of their methods. In this retrospective study, TMB and PD-L1 were measured by commercially available methodologies and were correlated to demographics, outcome, and response to PD-1 inhibitors. No correlation was found between TMB and PD-L1 levels. High TMB was associated with smoking and laryngeal primaries. PD-L1 was significantly higher in African Americans, patients with earlier stage tumors, nonsmokers, and nonethanol drinkers. Patients with high TMB fared better in univariate and multivariate survival analysis. No correlation was found between PD-L1 expression and prognosis. There was a statistically significant association between PFS and response to IO and TMB. There was no association between response to ICI and PD-L1 in this study, possibly affected by variations in the reporting method. Further studies are needed to characterize the biomarkers for IO in HNSCC, and this study supports further research into the advancement of TMB in prospective studies. |
| doi_str_mv | 10.3390/cancers13225733 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8616373</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2604028536</sourcerecordid><originalsourceid>FETCH-LOGICAL-c464t-225e6c20855778d8c306a5d20f233a3ed7aac3c8d03392e068244574509db6f43</originalsourceid><addsrcrecordid>eNpdkk1v1DAQhi0EotXSM1dLXDg01PFXvBckSIGutAVUyjmadWZZl8RObQfE7-GP1t1WiNaXsTzPvJp3PIS8rNkbIZbsxIK3GFMtOFeNEE_IIWcNr7Reyqf_3Q_IUUpXrBwh6kY3z8mBkEYwY8wh-XuBA2QXfNq5iW4w_0b09HIeQ6Tnc96nYKDv59ijP6ZfT6t1XUJ5R59pu4MINmN0KTubjin4nl5gmooe0hzoahxnj4VD-3MKrpSs_M5tXA4xUefpGUK_L_pcAPrteoYxzIm2OAy0hWidDyO8IM-2MCQ8uo8L8v3jh8v2rFp_-bRq360rK7XMVZkCasuZUappTG-sYBpUz9mWCwEC-wbACmv6MoclR6YNl1I1UrFlv9FbKRbk7Z3uNG9G7G1xGGHopuhGiH-6AK57mPFu1_0Ivzqjay3KDyzI63uBGK5nTLkbXbLFC3gstjqumWTcKKEL-uoRehXmWEa9pzirG8VVoU7uKBtDShG3_5qpWXe7A92jHRA3bEulmw</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2602017525</pqid></control><display><type>article</type><title>Relationship between Tumor Mutational Burden, PD-L1, Patient Characteristics, and Response to Immune Checkpoint Inhibitors in Head and Neck Squamous Cell Carcinoma</title><source>PubMed Central Open Access</source><source>MDPI - Multidisciplinary Digital Publishing Institute</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><creator>Burcher, Kimberly M. ; Lantz, Jeffrey W. ; Gavrila, Elena ; Abreu, Arianne ; Burcher, Jack T. ; Faucheux, Andrew T. ; Xie, Amy ; Jackson, Clayton ; Song, Alexander H. ; Hughes, Ryan T. ; Lycan, Thomas ; Bunch, Paul M. ; Furdui, Cristina M. ; Topaloglu, Umit ; D’Agostino, Ralph B. ; Zhang, Wei ; Porosnicu, Mercedes</creator><creatorcontrib>Burcher, Kimberly M. ; Lantz, Jeffrey W. ; Gavrila, Elena ; Abreu, Arianne ; Burcher, Jack T. ; Faucheux, Andrew T. ; Xie, Amy ; Jackson, Clayton ; Song, Alexander H. ; Hughes, Ryan T. ; Lycan, Thomas ; Bunch, Paul M. ; Furdui, Cristina M. ; Topaloglu, Umit ; D’Agostino, Ralph B. ; Zhang, Wei ; Porosnicu, Mercedes</creatorcontrib><description>Failure to predict response to immunotherapy (IO) limited its benefit in the treatment of head and neck squamous cell cancer (HNSCC) to 20% of patients or less. Biomarkers including tumor mutational burden (TMB) and programmed death ligand-1 (PD-L1) were evaluated as predictors of response to IO, but the results are inconsistent and with a lack of standardization of their methods. In this retrospective study, TMB and PD-L1 were measured by commercially available methodologies and were correlated to demographics, outcome, and response to PD-1 inhibitors. No correlation was found between TMB and PD-L1 levels. High TMB was associated with smoking and laryngeal primaries. PD-L1 was significantly higher in African Americans, patients with earlier stage tumors, nonsmokers, and nonethanol drinkers. Patients with high TMB fared better in univariate and multivariate survival analysis. No correlation was found between PD-L1 expression and prognosis. There was a statistically significant association between PFS and response to IO and TMB. There was no association between response to ICI and PD-L1 in this study, possibly affected by variations in the reporting method. Further studies are needed to characterize the biomarkers for IO in HNSCC, and this study supports further research into the advancement of TMB in prospective studies.</description><identifier>ISSN: 2072-6694</identifier><identifier>EISSN: 2072-6694</identifier><identifier>DOI: 10.3390/cancers13225733</identifier><identifier>PMID: 34830888</identifier><language>eng</language><publisher>Basel: MDPI AG</publisher><subject>Apoptosis ; Biomarkers ; Chemotherapy ; Clinical trials ; Demography ; FDA approval ; Head & neck cancer ; Head and neck carcinoma ; Immune checkpoint inhibitors ; Immunotherapy ; Medical prognosis ; Metastasis ; Mutation ; Patients ; PD-1 protein ; PD-L1 protein ; Precision medicine ; Risk factors ; Squamous cell carcinoma ; Standardization ; Statistical analysis ; Tumors</subject><ispartof>Cancers, 2021-11, Vol.13 (22), p.5733</ispartof><rights>2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 by the authors. 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c464t-225e6c20855778d8c306a5d20f233a3ed7aac3c8d03392e068244574509db6f43</citedby><cites>FETCH-LOGICAL-c464t-225e6c20855778d8c306a5d20f233a3ed7aac3c8d03392e068244574509db6f43</cites><orcidid>0000-0002-3241-8773 ; 0000-0002-1288-200X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8616373/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8616373/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids></links><search><creatorcontrib>Burcher, Kimberly M.</creatorcontrib><creatorcontrib>Lantz, Jeffrey W.</creatorcontrib><creatorcontrib>Gavrila, Elena</creatorcontrib><creatorcontrib>Abreu, Arianne</creatorcontrib><creatorcontrib>Burcher, Jack T.</creatorcontrib><creatorcontrib>Faucheux, Andrew T.</creatorcontrib><creatorcontrib>Xie, Amy</creatorcontrib><creatorcontrib>Jackson, Clayton</creatorcontrib><creatorcontrib>Song, Alexander H.</creatorcontrib><creatorcontrib>Hughes, Ryan T.</creatorcontrib><creatorcontrib>Lycan, Thomas</creatorcontrib><creatorcontrib>Bunch, Paul M.</creatorcontrib><creatorcontrib>Furdui, Cristina M.</creatorcontrib><creatorcontrib>Topaloglu, Umit</creatorcontrib><creatorcontrib>D’Agostino, Ralph B.</creatorcontrib><creatorcontrib>Zhang, Wei</creatorcontrib><creatorcontrib>Porosnicu, Mercedes</creatorcontrib><title>Relationship between Tumor Mutational Burden, PD-L1, Patient Characteristics, and Response to Immune Checkpoint Inhibitors in Head and Neck Squamous Cell Carcinoma</title><title>Cancers</title><description>Failure to predict response to immunotherapy (IO) limited its benefit in the treatment of head and neck squamous cell cancer (HNSCC) to 20% of patients or less. Biomarkers including tumor mutational burden (TMB) and programmed death ligand-1 (PD-L1) were evaluated as predictors of response to IO, but the results are inconsistent and with a lack of standardization of their methods. In this retrospective study, TMB and PD-L1 were measured by commercially available methodologies and were correlated to demographics, outcome, and response to PD-1 inhibitors. No correlation was found between TMB and PD-L1 levels. High TMB was associated with smoking and laryngeal primaries. PD-L1 was significantly higher in African Americans, patients with earlier stage tumors, nonsmokers, and nonethanol drinkers. Patients with high TMB fared better in univariate and multivariate survival analysis. No correlation was found between PD-L1 expression and prognosis. There was a statistically significant association between PFS and response to IO and TMB. There was no association between response to ICI and PD-L1 in this study, possibly affected by variations in the reporting method. Further studies are needed to characterize the biomarkers for IO in HNSCC, and this study supports further research into the advancement of TMB in prospective studies.</description><subject>Apoptosis</subject><subject>Biomarkers</subject><subject>Chemotherapy</subject><subject>Clinical trials</subject><subject>Demography</subject><subject>FDA approval</subject><subject>Head & neck cancer</subject><subject>Head and neck carcinoma</subject><subject>Immune checkpoint inhibitors</subject><subject>Immunotherapy</subject><subject>Medical prognosis</subject><subject>Metastasis</subject><subject>Mutation</subject><subject>Patients</subject><subject>PD-1 protein</subject><subject>PD-L1 protein</subject><subject>Precision medicine</subject><subject>Risk factors</subject><subject>Squamous cell carcinoma</subject><subject>Standardization</subject><subject>Statistical analysis</subject><subject>Tumors</subject><issn>2072-6694</issn><issn>2072-6694</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNpdkk1v1DAQhi0EotXSM1dLXDg01PFXvBckSIGutAVUyjmadWZZl8RObQfE7-GP1t1WiNaXsTzPvJp3PIS8rNkbIZbsxIK3GFMtOFeNEE_IIWcNr7Reyqf_3Q_IUUpXrBwh6kY3z8mBkEYwY8wh-XuBA2QXfNq5iW4w_0b09HIeQ6Tnc96nYKDv59ijP6ZfT6t1XUJ5R59pu4MINmN0KTubjin4nl5gmooe0hzoahxnj4VD-3MKrpSs_M5tXA4xUefpGUK_L_pcAPrteoYxzIm2OAy0hWidDyO8IM-2MCQ8uo8L8v3jh8v2rFp_-bRq360rK7XMVZkCasuZUappTG-sYBpUz9mWCwEC-wbACmv6MoclR6YNl1I1UrFlv9FbKRbk7Z3uNG9G7G1xGGHopuhGiH-6AK57mPFu1_0Ivzqjay3KDyzI63uBGK5nTLkbXbLFC3gstjqumWTcKKEL-uoRehXmWEa9pzirG8VVoU7uKBtDShG3_5qpWXe7A92jHRA3bEulmw</recordid><startdate>20211116</startdate><enddate>20211116</enddate><creator>Burcher, Kimberly M.</creator><creator>Lantz, Jeffrey W.</creator><creator>Gavrila, Elena</creator><creator>Abreu, Arianne</creator><creator>Burcher, Jack T.</creator><creator>Faucheux, Andrew T.</creator><creator>Xie, Amy</creator><creator>Jackson, Clayton</creator><creator>Song, Alexander H.</creator><creator>Hughes, Ryan T.</creator><creator>Lycan, Thomas</creator><creator>Bunch, Paul M.</creator><creator>Furdui, Cristina M.</creator><creator>Topaloglu, Umit</creator><creator>D’Agostino, Ralph B.</creator><creator>Zhang, Wei</creator><creator>Porosnicu, Mercedes</creator><general>MDPI AG</general><general>MDPI</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T5</scope><scope>7TO</scope><scope>7XB</scope><scope>8FE</scope><scope>8FH</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>HCIFZ</scope><scope>LK8</scope><scope>M2O</scope><scope>M7P</scope><scope>MBDVC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-3241-8773</orcidid><orcidid>https://orcid.org/0000-0002-1288-200X</orcidid></search><sort><creationdate>20211116</creationdate><title>Relationship between Tumor Mutational Burden, PD-L1, Patient Characteristics, and Response to Immune Checkpoint Inhibitors in Head and Neck Squamous Cell Carcinoma</title><author>Burcher, Kimberly M. ; Lantz, Jeffrey W. ; Gavrila, Elena ; Abreu, Arianne ; Burcher, Jack T. ; Faucheux, Andrew T. ; Xie, Amy ; Jackson, Clayton ; Song, Alexander H. ; Hughes, Ryan T. ; Lycan, Thomas ; Bunch, Paul M. ; Furdui, Cristina M. ; Topaloglu, Umit ; D’Agostino, Ralph B. ; Zhang, Wei ; Porosnicu, Mercedes</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c464t-225e6c20855778d8c306a5d20f233a3ed7aac3c8d03392e068244574509db6f43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Apoptosis</topic><topic>Biomarkers</topic><topic>Chemotherapy</topic><topic>Clinical trials</topic><topic>Demography</topic><topic>FDA approval</topic><topic>Head & neck cancer</topic><topic>Head and neck carcinoma</topic><topic>Immune checkpoint inhibitors</topic><topic>Immunotherapy</topic><topic>Medical prognosis</topic><topic>Metastasis</topic><topic>Mutation</topic><topic>Patients</topic><topic>PD-1 protein</topic><topic>PD-L1 protein</topic><topic>Precision medicine</topic><topic>Risk factors</topic><topic>Squamous cell carcinoma</topic><topic>Standardization</topic><topic>Statistical analysis</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Burcher, Kimberly M.</creatorcontrib><creatorcontrib>Lantz, Jeffrey W.</creatorcontrib><creatorcontrib>Gavrila, Elena</creatorcontrib><creatorcontrib>Abreu, Arianne</creatorcontrib><creatorcontrib>Burcher, Jack T.</creatorcontrib><creatorcontrib>Faucheux, Andrew T.</creatorcontrib><creatorcontrib>Xie, Amy</creatorcontrib><creatorcontrib>Jackson, Clayton</creatorcontrib><creatorcontrib>Song, Alexander H.</creatorcontrib><creatorcontrib>Hughes, Ryan T.</creatorcontrib><creatorcontrib>Lycan, Thomas</creatorcontrib><creatorcontrib>Bunch, Paul M.</creatorcontrib><creatorcontrib>Furdui, Cristina M.</creatorcontrib><creatorcontrib>Topaloglu, Umit</creatorcontrib><creatorcontrib>D’Agostino, Ralph B.</creatorcontrib><creatorcontrib>Zhang, Wei</creatorcontrib><creatorcontrib>Porosnicu, Mercedes</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Research Library</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Cancers</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Burcher, Kimberly M.</au><au>Lantz, Jeffrey W.</au><au>Gavrila, Elena</au><au>Abreu, Arianne</au><au>Burcher, Jack T.</au><au>Faucheux, Andrew T.</au><au>Xie, Amy</au><au>Jackson, Clayton</au><au>Song, Alexander H.</au><au>Hughes, Ryan T.</au><au>Lycan, Thomas</au><au>Bunch, Paul M.</au><au>Furdui, Cristina M.</au><au>Topaloglu, Umit</au><au>D’Agostino, Ralph B.</au><au>Zhang, Wei</au><au>Porosnicu, Mercedes</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Relationship between Tumor Mutational Burden, PD-L1, Patient Characteristics, and Response to Immune Checkpoint Inhibitors in Head and Neck Squamous Cell Carcinoma</atitle><jtitle>Cancers</jtitle><date>2021-11-16</date><risdate>2021</risdate><volume>13</volume><issue>22</issue><spage>5733</spage><pages>5733-</pages><issn>2072-6694</issn><eissn>2072-6694</eissn><abstract>Failure to predict response to immunotherapy (IO) limited its benefit in the treatment of head and neck squamous cell cancer (HNSCC) to 20% of patients or less. Biomarkers including tumor mutational burden (TMB) and programmed death ligand-1 (PD-L1) were evaluated as predictors of response to IO, but the results are inconsistent and with a lack of standardization of their methods. In this retrospective study, TMB and PD-L1 were measured by commercially available methodologies and were correlated to demographics, outcome, and response to PD-1 inhibitors. No correlation was found between TMB and PD-L1 levels. High TMB was associated with smoking and laryngeal primaries. PD-L1 was significantly higher in African Americans, patients with earlier stage tumors, nonsmokers, and nonethanol drinkers. Patients with high TMB fared better in univariate and multivariate survival analysis. No correlation was found between PD-L1 expression and prognosis. There was a statistically significant association between PFS and response to IO and TMB. There was no association between response to ICI and PD-L1 in this study, possibly affected by variations in the reporting method. Further studies are needed to characterize the biomarkers for IO in HNSCC, and this study supports further research into the advancement of TMB in prospective studies.</abstract><cop>Basel</cop><pub>MDPI AG</pub><pmid>34830888</pmid><doi>10.3390/cancers13225733</doi><orcidid>https://orcid.org/0000-0002-3241-8773</orcidid><orcidid>https://orcid.org/0000-0002-1288-200X</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 2072-6694 |
| ispartof | Cancers, 2021-11, Vol.13 (22), p.5733 |
| issn | 2072-6694 2072-6694 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8616373 |
| source | PubMed Central Open Access; MDPI - Multidisciplinary Digital Publishing Institute; EZB-FREE-00999 freely available EZB journals; PubMed Central |
| subjects | Apoptosis Biomarkers Chemotherapy Clinical trials Demography FDA approval Head & neck cancer Head and neck carcinoma Immune checkpoint inhibitors Immunotherapy Medical prognosis Metastasis Mutation Patients PD-1 protein PD-L1 protein Precision medicine Risk factors Squamous cell carcinoma Standardization Statistical analysis Tumors |
| title | Relationship between Tumor Mutational Burden, PD-L1, Patient Characteristics, and Response to Immune Checkpoint Inhibitors in Head and Neck Squamous Cell Carcinoma |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-06T13%3A17%3A26IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Relationship%20between%20Tumor%20Mutational%20Burden,%20PD-L1,%20Patient%20Characteristics,%20and%20Response%20to%20Immune%20Checkpoint%20Inhibitors%20in%20Head%20and%20Neck%20Squamous%20Cell%20Carcinoma&rft.jtitle=Cancers&rft.au=Burcher,%20Kimberly%20M.&rft.date=2021-11-16&rft.volume=13&rft.issue=22&rft.spage=5733&rft.pages=5733-&rft.issn=2072-6694&rft.eissn=2072-6694&rft_id=info:doi/10.3390/cancers13225733&rft_dat=%3Cproquest_pubme%3E2604028536%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2602017525&rft_id=info:pmid/34830888&rfr_iscdi=true |