Patients with both low MSAF and low bTMB showed a notably better objective response to anlotinib plus TQB2450 (70% vs. 11%, P < 0.001) and a significantly longer median PFS (11.0 vs. 2.9 months, P < 0.001) than patients with other scenarios….To the best of our knowledge, this is the first investigation that establishes bTMB and MSAF as biomarkers associated with treatment response and survival outcomes of pretreated aTNBC patients receiving combined immunotherapy and antiangiogenic therapy.