The International Association for the Study of Lung Cancer Pleural Mesothelioma Staging Project: Impact of Common Molecular Alterations and Programmed Death-Ligand 1 Expression on Overall Survival in a Select Cohort From the International Association for the Study of Lung Cancer Ninth Edition Staging Database.

Pathogenic alterations in BAP1 were most common (55.0%, 143/260), followed by CDKN2A (36.2%, 94/260), NF2 (23.8%, 62/260), and TP53 (18.1%, 47/260).

Loss of BAP1 expression by immunohistochemistry was detected in 260 of 452 cases (57.5%).

PD-L1 expression was positive (≥1% of tumor cells with membranous staining) in 89 of 200 cases (44.5%).

Although clinical covariates performed better than molecular alterations alone (C-statistic: 0.67 versus 0.65; R 2 : 25.3 versus 20.8), a model including BAP1 alterations plus any pathogenic alteration in CDKN2A, NF2, and TP53, along with clinical covariates, best predicted survival (C-statistic: 0.70; R 2 : 37.0).