J Clin Oncol 2016, 34(12):1402-1418 Revised Protocol No.: 04 Date: 31-May-2019 228 Approved 5.0 v Approved 1.0 v Clinical Protocol CA021002 BMS-986226 anti-ICOS APPENDIX 12 REVISED PROTOCOL SUMMARY OF CHANGE HISTORY Overall Rationale for the Revised Protocol 03, 02-Dec-2018 This protocol has been revised in several ways to im prove access to study treatment for par ticipants with incurable cancer, while enhancing the scientific knowledge gained from each enrolled participant. The inclusion criteria in the prot ocol was modified in order to expand the study population that could potentially benefit from BMS- 986226 by adding additional tumor types, as well as increasing the number of prior therapies allowed for participants enrolled on study. The requirement for confirmation of ICOS e xpression by IHC on pre-treatment biopsy samples was removed, in order to expedite the treatment of participants on the study. The integrity of the biopsy sample will be ensured through a new requir ement for the provision of the FFPE block obtained from the core-needle pre -treatment and on-treatment biops ies. The exact timing of tetanus booster administration, to be used as a surrogate meas ure of antigen-specific immune activation, was defined, in order to synchronize the post-booster immune response in the treatment cohorts. Additionally, changes were made in the conten t and timing of clinical, PK, PD analysis, including stool collection for pre-tr eatment microbiota content analysis, in order to enhance the robustness and interpretability of the scie ntific data gathered from every participant enrolled on the study.Sections in the s ynopsis have been updated to align with the protocol section changes listed below.