Moreover, co-alterations showed the clustering of different groups of patients with mutations in BAP1, PBRM1, SETD2; or in MYC, TERT, RB1 and TP53 or in CDKN2A/B, NF2 and BAP1. Despite the occurrence of alterations in several genes and co-mutations, cases with increased tumour mutational burden were rare, but leave the option for immunotherapy with immune checkpoint inhibitors in some patients. This evidence concerns the gene PBRM1 and neoplasm.