(A) Total putative neoantigen burden in multiregion sequenced NSCLC tumors. Proportion of clonal neoantigens, identified ubiquitously in every tumor region, are shown in blue; shared subclonal neoantigens, identified as shared in multiple tumor regions but not all, are shown in yellow; and private subclonal neoantigens, identified in only one tumor region, are in red. (B) Total putative neoantigen burden in TCGA LUAD tumors. Proportion of neoantigens arising from clonal (blue) or subclonal (red) mutations is shown. (C) Schematic illustrating use of different neoantigen ITH thresholds, with bar plot showing separation into the two groups.Without an ITH threshold, samples are simply grouped according to upper quartile of total neoantigen burden. For each ITH threshold, the upper quartile of clonal neoantigens is used to separate tumors with high and low clonal neoantigen burden, and the neoantigen ITH threshold further groups samples. For example, an ITH threshold = 0 involves grouping tumors with high clonal neoantigen burden and zero neoantigen heterogeneity separately from those with low clonal neoantigen burden or any neoantigen heterogeneity. (D) Overall survival curves for samples by using different ITH thresholds. Shown are without an ITH threshold [log-rank, P = 0.025, HR = 0.47 (0.24–0.92)]; ITH threshold = 0 [log-rank, P = 0.019, HR = 0.21 (0.051–0.88)]; ITH threshold = 0.01 [log-rank, P = 0.0096, HR = 0.33 (0.14–0.79)]; and ITH threshold = 0.05 [log-rank, P = 0.021, HR = 0.45 (0.22–0.90)].The number of patients in each group is listed below the survival curves.