Advances in Immunotherapy Necessitate Nuanced Understanding of Clinical Application Across Tumor Types

Publication date: Jun 27, 2025

High TMB often occurs in MSI-high patients and carcinogen-driven tumors like melanoma or nonsmall cell lung cancer. Weve found that a higher number of patients than we previously thought have lingering toxicities after stopping immune therapy. I would say one of the [biomarkers] that is most promising, although it unfortunately only applies to a small number of patients, is microsatellite instability [MSI]. Theres probably a sweet spot where patients get AEs, but not too many, that reflects a robust immune system. For many years, physicians and patient advocacy organizations were simply not aware of immunotherapy; it was considered a niche product in melanoma and had not moved beyond that. This has become a cornerstone of cancer treatment, on par with chemotherapy and radiation therapy, and is now being used across many tumor types. Unfortunately, if we still look at the long-term survival rates, we’re still seeing relatively poor outcomes in those patients.

Semantics