“…Mutations in liver kinase B1 (LKB1) gene, which encodes Serine/Threonine Kinase 11 (STK11), the 3 rd most mutated gene in the mKRAS cohort (after KRAS and TP53), regulates metabolism, energy sensing and modulates the stimulator of interferon genes (STING) pathway (Esteve-Puig et al, 2014;Kim et al, 2019). STK11 mutations are associated with immunologically cold tumors (Schabath et al, 2016), increased neutrophil accumulation (Koyama et al, 2016), high expression of LAG3 ligand, FLG1 (Wang et al, 2019;Lehtiö et al, 2021), and poor outcomes in patients with mKRAS (Skoulidis et al, 2018). Anaplastic Lymphoma Kinase (ALK) mutations, found in 7.7% (24/ 313) of WT tumors, 4% (7/163) of mKRAS tumors, can generate an immunosuppressive microenvironment unresponsive to checkpoint blockade alone (Hellmann et al, 2018;Sankar et al, 2021).…”