Recent studies have shown that EGFR mutations are associated with a low TMB, an uninflamed tumor microenvironment, and weak immunogenicity, which are associated with an inferior response to programmed cell death protein 1 and PD-L1 blockade in NSCLC.25,41,42 We found that patients who had EGFR mutations accompanied by TP53 and ATM comutation still had a high TMB, but whether this small subgroup of patients would benefit from ICIs needs further confirmation in randomized clinical trials. This evidence concerns the gene ATM and neoplasm.