Necchi A, Madison R, Raggi D, et al. - Researchers designed a comparative comprehensive genomic profiling (CGP) study to analyze genomic alterations (GAs) and immuno-oncology (IO) biomarkers. They searched the Foundation Medicine database to include a sum of 143 cases with centrally reviewed pure ACB, 2,142 with pure urothelial carcinoma (UC), and 83 with pure SCC. They ascertained tumor mutational burden (TMB) on 1.1 Mbp of sequenced DNA and determined microsatellite instability (MSI) on 114 loci. They further determined programmed cell-death ligand-1 (PD-L1) expression by IHC, with > 1% tumor cells (TCs) or tumor-infiltrating lymphocytes (TILs) scoring positive. In IO biomarkers, deep sequencing showed significant differences among the three major subtypes of bladder carcinomas. They found that UC and SCC displayed higher frequencies of PD-L1 expression and higher TMB than ACB, and SCC has the highest frequency of CD274 amplification. In addition, the appearance of pure SCC features should not disqualify individuals for inclusion in IO trials.