Tumor mutational burden (TMB) has recently emerged as a significant and independent predictor of ICI treatment response to diverse tumor types. TMB is a measure of number of mutations expressed by cancer cells and can arise due to various factors, such as exposure to environmental carcinogens or errors during DNA replication. Clinical studies have demonstrated that patients with high TMB tend to have better responses to ICIs and improved overall survival rates. These findings have led to the exploration of TMB as a biomarker to guide treatment decisions in immuno-oncology 237 across various cancer types. By assessing a tumor's mutational burden, clinicians can identify patients who are more likely to benefit from ICI therapy, thereby personalizing treatment approaches. Other biomarkers of apparent prognostic significance include -TROP2 a transmembrane glycoprotein overexpressed in many cancers, including breast, lung, colorectal, pancreatic, and bladder cancers ; and LC3B a protein involved in the autophagy pathway. Autophagy is a highly regulated process that plays a critical role in maintaining cellular homeostasis. Higher levels of LC3B expression are associated with better patient outcomes, indicating a n advantageous prognostic value. 239