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0074) and DCB ( = 0.0008) while low CNA was associated with prolonged PFS ( = 0.006 and DCB ( = 0.0018). However, TMB alone did not distinguish benefits among -mutant patients. Notably, when combining TMB and CNA, low TMB and high CNA revealed worse outcomes of ICI therapy (mPFS 2.20m, = 0.0023; proportion of DCB 24%, = 0.0001). The combination of TMB and CNA provides more sensible and accurate prediction of ICI response than individual factors in -mutant LUAD. Moreover, low TMB and high CNA can be utilized as a potential biomarker to