Classification of SCLC tumors on the basis of PD-L1 expression, CD8+ tumor-infiltrating lymphocyte density, immune-related gene expression, and neoantigen status. (A) Change of median gene signature expression in high versus low groups of SCLC tumors (n = 55) classified according to the median values for the predicted number of frameshift neoantigens or tumor mutation burden. The change of median gene signature expression is represented by the color scale, with the highest values illustrated in red, median in white, and lowest in blue. (B) Relation of the predicted number of frameshift neoantigens to the T cell–inflamed GEP score for SCLC tumors (n = 55). The p value was determined with the Spearman correlation test. (C) Kaplan-Meier curves of progression-free survival for the ICI combo-cohort of patients with SCLC classified according to inflamed versus noninflamed status and predicted frameshift neoantigen load (high defined as ≥5 frameshift neoantigens per case). CI, confidence interval; GEP, gene expression profiling; ICI, immune checkpoint inhibitor; NR, not reached.