Mutations in CARD11 are associated with inferior clinical outcomes after ibrutinib therapy in relapsed or refractory FL patients. (A) The distribution of best response stratified by CARD11 mutation status for patients with available pre-ibrutinib lymph node samples (n = 31). (B) PFS was significantly shorter in patients with CARD11 mutations (n = 5) compared with wild-type patients. (C) Observed CARD11 mutations (n = 8; top) and CARD11 mutations in the Catalogue of Somatic Mutations in Cancer (COSMIC; bottom) found in lymphoid neoplasms (n = 195). Amino acid positions are indicated by numbers within peptide representations. Exon boundaries are indicated by vertical dashed lines. Patients with mutations in the coiled-coil domain had an event in <12 months. Several mutations observed in relapsed or refractory FL patients examined in this study were previously cataloged in COSMIC (eg, G126D and D230N). The protein mutation diagram was created with ProteinPaint.22 HR, hazard ratio.
