Surprisingly, the MSK-IMPACT clinical sequencing cohort from the TCGA database (25) showed that TMB levels in the PARP1 altered group were significantly higher than those in the unaltered group, and similar results were verified in two ICI-treated cohorts (26, 27), which indicated that PARP1 alteration could predict ICI treatment effectiveness across tumor types because TMB level is commonly regarded as a notable biomarker associated with the treatment effect in many ICI-treated tumors (27). This evidence concerns the gene PARP1 and neoplasm.