Transcriptomic and genomic differences between pretreatment samples from patients with durable benefit (never progressed to immunotherapy) and patients with intrinsically resistant tumors. (A) Median pretreatment TMB by benefit. (B) Frequency of mutational signatures according to benefit to immunotherapy. (C) Immune cell populations according to CIBERSORTx by benefit to immunotherapy. Hallmark gene sets (GSEA) of durable responders versus patients with no benefit for (D) PI3K-AKT-mTOR signaling (P = .023), (E) heme metabolism (P = .023), and (F) inflammatory response (P = .046) enriched in durable responders (enrichment plot). AKT, protein kinase B; ES, enrichment score; GSEA, gene set enrichment analyses; HR, homologous recombination; ICI, immune checkpoint inhibitor; mTOR, mammalian target of rapamycin; NK, natural killer; OS, overall survival; PD-1, programmed cell death protein 1; PD-L1, programmed death-ligand 1; PFS, progression-free survival; PI3K, phosphatidylinositol 3-kinase; SBS, single base substitution; TMB, tumor mutational burden.