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. 2021 Nov 2;12:721409. doi: 10.3389/fimmu.2021.721409

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Copyright © 2021 Shi, Zhang, Yang, Yang, Zhao, Xie, Sheng, Wang and Wang

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Determination of melanoma mutational signatures and their sex biases with respect to ICI efficacy. (A) Heatmap representation of the cosine similarities between the extracted four mutational signatures and 30 COSMIC signatures. (B) Identification of the four mutational signatures with specific etiology according to the COSMIC nomenclature. (C) Distinct activities of the identified four mutational signatures between male and female subgroups. (D) Kaplan–Meier survival curves stratified by signature 4 status in male melanoma patients. Forest plot illustration of the associations of signature 4 with ICI overall survival in (E) male and (F) female patients. Bar plots representation of the associations of signature 4 with ICI response rate in (G) male and (H) female patients. **P < 0.01; ***P < 0.001; NS, not significant.