Fig. 4: Differential outcomes and abscopal site tumor regression with radioimmunotherapy for participants with TMB-low, PDL1-null and Wnt-mutated tumors.
a, Swimmer’s plot showing OS and clinical and pathological features for each participant in the control (left) and SBRT (right) arms. Participants with TMB-low, PDL1-null or Wnt-mutated tumors were observed to attain the longest clinical outcomes in the SBRT arm. NA, not applicable. b, The abscopal (biopsied) tumor sites in the SBRT arm had a notable decrease in RECIST measurements between 0 and 12 weeks (mean: 45.52 mm to 30.44 mm; Mann–Whitney U-test, P = 0.054), whereas rebiopsied tumor sites showed no change in RECIST measurements in the control arm (Mann–Whitney U-test, P = 0.64). Extensive findings can be found in Supplementary Table 21. c, In TMB-low and PDL1-null participants, we observed a notable regression in RECIST measurements of the biopsied abscopal site in the SBRT arm (TMB-low mean: 47.93 mm to 30.44 mm, Mann–Whitney U-test, P = 0.13; PDL1-null mean: 50.78 mm to 32 mm; Mann–Whitney U-test, P = 0.29), which was not evident in the control arm. Interestingly, the SBRT-associated abscopal site tumor regression was not as pronounced in TMB-high and PDL1-positive tumors; these had similar regressions in the SBRT and control arms. Extensive findings can be found in Supplementary Table 21. d, Kaplan–Meier curve of probability of PFS in TMB-low participants (n = 43 participants) treated in the control arm (n = 21 participants) and SBRT arm (n = 22 participants). TMB-low participants had longer PFS in the SBRT arm than in the control arm (median PFS: 5.21 versus 1.81 months; log-rank test, P = 0.029). e, Kaplan–Meier curve of probability of PFS in PDL1-null participants (n = 41 participants) treated in the control arm (n = 23 participants) and SBRT arm (n = 18 participants). PDL1-null participants had longer PFS in the SBRT arm than in the control arm (median PFS: 4.22 versus 1.71 months; log-rank test, P = 0.022). f, Kaplan–Meier curve of probability of PFS in the SBRT arm (n = 28 participants) in the Wnt-mutated (n = 5 participants) and Wnt wild-type (n = 23 participants) groups. In the SBRT arm, participants with Wnt-mutated tumors had longer PFS compared with the wild-type subgroup (median PFS: not reached versus 5.45 months; log-rank test, P = 0.02). Box plots depict the median value and hinges correspond to the first and third quartiles. The whiskers extend from the corresponding hinge to the furthest value within 1.5× the interquartile range from the hinge.
