Development and validation of a blood-based genomic mutation signature to predict the clinical outcomes of atezolizumab therapy in NSCLC

•Developed and validated a blood-based genomic mutation signature (bGMS) to predict OS and PFS benefit for patients with NSCLC receiving atezolizumab therapy.•BGMS is superior to blood tumor mutation burden (bTMB), LAF-bTMB, MSAF, and PD-L1 expression in predicting the OS for patients with NSCLC receiving atezolizumab therapy.•Low bGMS is associated with better clinical outcomes from atezolizumab therapy than docetaxel.•BGMS combined with other non-invasive clinical characteristics improved the predictive power further.