Study showed that ORR was higher in patients with tumor mutational burden of at least 10 mutations per megabase and was not dependent on PD-L1 expression (48% in PD-L1≥1% group and 47% in PD-L1≤1% group), and proposed ≥10 mutations per megabase as the cutoff for tumor mutational burden [106]. This evidence concerns the gene CD274 and neoplasm.