Clinical targeted sequencing identifies mutation or deletion of immunotherapy targets. (A) Percent of samples at each disease stage with deletion CD38 and number of prior lines of anti-CD38 received. (B) Deletions of chromosome 4 in relapsed patients with prior lines of anti-CD38 treatment. Each line represents a patient and the extent of the deletion. The blue lines depict deletions in patients who were anti-CD38 naive, whereas the green lines were patients who received anti-CD38. The red arrow indicates the position of CD38. (C) Patient treatment timeline for a patient identified with deletion of CD38 after anti-CD38 treatment. The blue arrow indicates sample time point with key genomic features. iChor copy number profile of chromosome 4 (lower). Location of CD38 indicated by the red arrow. (D) Mutations in TNFRSF17 (BCMA) detected after anti-BCMA treatment. The black arrows indicate mutations detected in this study, whereas the gray arrows indicate previously identified mutations. (E) Patient treatment timeline revealing sequencing date from 2-sample time points before and after anti-BCMA treatments. Blenrep, belantamab mafodotin-blmf; CAR-T, chimeric antigen receptor T cell; Chr. 4, chromosome 4; DaKd, daratumumab carfilzomib dexamethasone; DaPd, daratumumab pomalidomide dexamethasone; DaRd, daratumumab lenalidomide dexamethasone; Elo-Rd, elotuzumab lenalidomide dexamethasone; HDM-ASCT, high-dose melphalan autologous stem cell transplant; HRD, hyperdiploidy; Kd, carfilzomib dexamethasone; NK-CAR-d, natural killer cell chimeric antigen receptor dexamethasone; Pd, pomalidomide dexamethasone; Pom-Pred, pomalidomide prednisone; Rd, lenalidomide dexamethasone; Talq, talquetamab; Tec, teclistimab; Vd, bortezomib dexamethasone.