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Prognostic value of immuno-inflammatory biomarkers in esophageal squamous cell carcinoma patients receiving immunotherapy combined with chemoradiotherapy and its association with immuno-genomic landscape
The clinical significance of immuno-inflammatory indicators and the underlying biological basis in patients with esophageal squamous cell carcinoma (ESCC) who receive chemoradiotherapy (CRT) combined with immunotherapy remains unclear. This study aims to evaluate the prognostic value of immuno-infla...
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| Published in: | BMC cancer 2024-12, Vol.24 (1), p.1518-12, Article 1518 |
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| creator | Cheng, Xingyuan Meng, Fanjun Wang, Ruixi Liu, Shiliang Li, Qiaoqiao Chen, Baoqing Xi, Mian |
| description | The clinical significance of immuno-inflammatory indicators and the underlying biological basis in patients with esophageal squamous cell carcinoma (ESCC) who receive chemoradiotherapy (CRT) combined with immunotherapy remains unclear. This study aims to evaluate the prognostic value of immuno-inflammatory biomarkers, develop a prognostic model, and explore the underlying mechanisms.
This study included 212 ESCC patients who received CRT and anti-PD-1 immunotherapy. Association between progression-free survival (PFS) and immuno-inflammatory biomarkers, including absolute lymphocyte count (ALC), neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), lymphocyte-monocyte ratio was analyzed. A nomogram was built based on the independent prognostic factors identified using multivariable Cox regression model. Pre-treatment tumor samples from 47 patients were collected for RNA sequencing to investigate the immune-related tumor microenvironment.
Patients experienced significant changes in immuno-inflammatory biomarkers during CRT, which gradually recovered after radiotherapy. Body mass index |
| doi_str_mv | 10.1186/s12885-024-13298-z |
| format | article |
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This study included 212 ESCC patients who received CRT and anti-PD-1 immunotherapy. Association between progression-free survival (PFS) and immuno-inflammatory biomarkers, including absolute lymphocyte count (ALC), neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), lymphocyte-monocyte ratio was analyzed. A nomogram was built based on the independent prognostic factors identified using multivariable Cox regression model. Pre-treatment tumor samples from 47 patients were collected for RNA sequencing to investigate the immune-related tumor microenvironment.
Patients experienced significant changes in immuno-inflammatory biomarkers during CRT, which gradually recovered after radiotherapy. Body mass index < 18.5 (HR, 1.85; P = 0.032), N3 stage (HR, 2.41; P = 0.002), high pre-CRT PLR (HR, 1.53; P = 0.037), low ALC nadir (HR, 1.84; P = 0.006), and high post-CRT NLR (HR, 2.12; P = 0.002) were independent prognostic factors for unfavorable PFS, which were incorporated into a nomogram with a concordance index of 0.70 (95% CI, 0.67-0.72). High-risk patients stratified by the nomogram had worse survival and were associated with lower levels of leukocyte and T cell activation, proliferation, and migration and less intratumoral immune cell infiltration.
Pre-CRT PLR, ALC nadir during CRT, and post-CRT NLR were significantly associated with PFS in patients with ESCC receiving CRT and immunotherapy. A nomogram model with good prognostic ability was developed.</description><identifier>ISSN: 1471-2407</identifier><identifier>EISSN: 1471-2407</identifier><identifier>DOI: 10.1186/s12885-024-13298-z</identifier><identifier>PMID: 39696104</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Aged ; Analysis ; Biological markers ; Biomarkers, Tumor ; Cancer ; Care and treatment ; Chemoradiotherapy ; Chemoradiotherapy - methods ; Chemotherapy ; Development and progression ; Drug therapy ; Esophageal cancer ; Esophageal Neoplasms - immunology ; Esophageal Neoplasms - mortality ; Esophageal Neoplasms - therapy ; Esophageal squamous cell carcinoma ; Esophageal Squamous Cell Carcinoma - immunology ; Esophageal Squamous Cell Carcinoma - mortality ; Esophageal Squamous Cell Carcinoma - pathology ; Esophageal Squamous Cell Carcinoma - therapy ; Female ; Genetic aspects ; Health aspects ; Humans ; Immune system ; Immuno-inflammatory biomarkers ; Immunogenomic landscape ; Immunotherapy ; Immunotherapy - methods ; Inflammation ; Male ; Medical research ; Medicine, Experimental ; Middle Aged ; Neutrophils ; Nomograms ; Physiological aspects ; Prognosis ; Radiotherapy ; Retrospective Studies ; RNA sequencing ; Squamous cell carcinoma ; T cells ; Tumor Microenvironment - immunology</subject><ispartof>BMC cancer, 2024-12, Vol.24 (1), p.1518-12, Article 1518</ispartof><rights>2024. The Author(s).</rights><rights>COPYRIGHT 2024 BioMed Central Ltd.</rights><rights>The Author(s) 2024 2024</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3531-b090d20e33e32324eaa99ae4ec47693ba807df0a7ac7ca2c7031428b56db1113</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11657211/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11657211/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,37013,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39696104$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cheng, Xingyuan</creatorcontrib><creatorcontrib>Meng, Fanjun</creatorcontrib><creatorcontrib>Wang, Ruixi</creatorcontrib><creatorcontrib>Liu, Shiliang</creatorcontrib><creatorcontrib>Li, Qiaoqiao</creatorcontrib><creatorcontrib>Chen, Baoqing</creatorcontrib><creatorcontrib>Xi, Mian</creatorcontrib><title>Prognostic value of immuno-inflammatory biomarkers in esophageal squamous cell carcinoma patients receiving immunotherapy combined with chemoradiotherapy and its association with immuno-genomic landscape</title><title>BMC cancer</title><addtitle>BMC Cancer</addtitle><description>The clinical significance of immuno-inflammatory indicators and the underlying biological basis in patients with esophageal squamous cell carcinoma (ESCC) who receive chemoradiotherapy (CRT) combined with immunotherapy remains unclear. This study aims to evaluate the prognostic value of immuno-inflammatory biomarkers, develop a prognostic model, and explore the underlying mechanisms.
This study included 212 ESCC patients who received CRT and anti-PD-1 immunotherapy. Association between progression-free survival (PFS) and immuno-inflammatory biomarkers, including absolute lymphocyte count (ALC), neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), lymphocyte-monocyte ratio was analyzed. A nomogram was built based on the independent prognostic factors identified using multivariable Cox regression model. Pre-treatment tumor samples from 47 patients were collected for RNA sequencing to investigate the immune-related tumor microenvironment.
Patients experienced significant changes in immuno-inflammatory biomarkers during CRT, which gradually recovered after radiotherapy. Body mass index < 18.5 (HR, 1.85; P = 0.032), N3 stage (HR, 2.41; P = 0.002), high pre-CRT PLR (HR, 1.53; P = 0.037), low ALC nadir (HR, 1.84; P = 0.006), and high post-CRT NLR (HR, 2.12; P = 0.002) were independent prognostic factors for unfavorable PFS, which were incorporated into a nomogram with a concordance index of 0.70 (95% CI, 0.67-0.72). High-risk patients stratified by the nomogram had worse survival and were associated with lower levels of leukocyte and T cell activation, proliferation, and migration and less intratumoral immune cell infiltration.
Pre-CRT PLR, ALC nadir during CRT, and post-CRT NLR were significantly associated with PFS in patients with ESCC receiving CRT and immunotherapy. A nomogram model with good prognostic ability was developed.</description><subject>Aged</subject><subject>Analysis</subject><subject>Biological markers</subject><subject>Biomarkers, Tumor</subject><subject>Cancer</subject><subject>Care and treatment</subject><subject>Chemoradiotherapy</subject><subject>Chemoradiotherapy - methods</subject><subject>Chemotherapy</subject><subject>Development and progression</subject><subject>Drug therapy</subject><subject>Esophageal cancer</subject><subject>Esophageal Neoplasms - immunology</subject><subject>Esophageal Neoplasms - mortality</subject><subject>Esophageal Neoplasms - therapy</subject><subject>Esophageal squamous cell carcinoma</subject><subject>Esophageal Squamous Cell Carcinoma - immunology</subject><subject>Esophageal Squamous Cell Carcinoma - mortality</subject><subject>Esophageal Squamous Cell Carcinoma - pathology</subject><subject>Esophageal Squamous Cell Carcinoma - therapy</subject><subject>Female</subject><subject>Genetic aspects</subject><subject>Health aspects</subject><subject>Humans</subject><subject>Immune system</subject><subject>Immuno-inflammatory biomarkers</subject><subject>Immunogenomic landscape</subject><subject>Immunotherapy</subject><subject>Immunotherapy - methods</subject><subject>Inflammation</subject><subject>Male</subject><subject>Medical research</subject><subject>Medicine, Experimental</subject><subject>Middle Aged</subject><subject>Neutrophils</subject><subject>Nomograms</subject><subject>Physiological aspects</subject><subject>Prognosis</subject><subject>Radiotherapy</subject><subject>Retrospective Studies</subject><subject>RNA sequencing</subject><subject>Squamous cell carcinoma</subject><subject>T cells</subject><subject>Tumor Microenvironment - immunology</subject><issn>1471-2407</issn><issn>1471-2407</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>DOA</sourceid><recordid>eNptkl2L1DAUhoso7rr6B7yQgCB60TUf_bySZfFjYEHRvQ-n6WmbtU1mk3Z09i_6p8xMx2EKEmhC8py3h_e8UfSS0UvGiuy9Z7wo0pjyJGaCl0X88Cg6Z0nOYp7Q_PHJ-Sx65v0dpSwvaPE0OhNlVmaMJufRn2_Otsb6USuygX5CYhuih2EyNtam6WEYYLRuSyptB3A_0XmiDUFv1x20CD3x9xMMdvJEYd8TBU5pE1CyhlGjGT1xqFBvtGkPumOHDtZbouxQaYM1-aXHjqgOB-ug1sd3MDXRoR68t0oHNWtm9NBei-E_oe0-gF7BGp9HTxroPb447BfR7aePt9df4puvn1fXVzexEqlgcUVLWnOKQqDggicIUJaACaokz0pRQUHzuqGQg8oVcJVTwRJeVGlWV4wxcRGtZtnawp1cOx182UoLWu4vrGsluOBnj1KUtMICap7xJBGoSpqniiWsFFmZpIwGrQ-z1nqqBqxVMMxBvxBdvhjdydZuJGNZmvN9N28PCs7eT-hHOWi_GwUYDFORYheC8KE79PWMthB6C9O1QVLtcHlVcJpyTvM8UJf_ocKqMbhtDTY63C8K3i0KAjPi77GFyXu5-vF9yb45YbuQn7Hztp92w_VLkM-gctZ7h83RE0blLv1yTr8M6Zf79MuHUPTq1M1jyb-4i79kcwSQ</recordid><startdate>20241218</startdate><enddate>20241218</enddate><creator>Cheng, Xingyuan</creator><creator>Meng, Fanjun</creator><creator>Wang, Ruixi</creator><creator>Liu, Shiliang</creator><creator>Li, Qiaoqiao</creator><creator>Chen, Baoqing</creator><creator>Xi, Mian</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><general>BMC</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>ISR</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20241218</creationdate><title>Prognostic value of immuno-inflammatory biomarkers in esophageal squamous cell carcinoma patients receiving immunotherapy combined with chemoradiotherapy and its association with immuno-genomic landscape</title><author>Cheng, Xingyuan ; Meng, Fanjun ; Wang, Ruixi ; Liu, Shiliang ; Li, Qiaoqiao ; Chen, Baoqing ; Xi, Mian</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3531-b090d20e33e32324eaa99ae4ec47693ba807df0a7ac7ca2c7031428b56db1113</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Aged</topic><topic>Analysis</topic><topic>Biological markers</topic><topic>Biomarkers, Tumor</topic><topic>Cancer</topic><topic>Care and treatment</topic><topic>Chemoradiotherapy</topic><topic>Chemoradiotherapy - methods</topic><topic>Chemotherapy</topic><topic>Development and progression</topic><topic>Drug therapy</topic><topic>Esophageal cancer</topic><topic>Esophageal Neoplasms - immunology</topic><topic>Esophageal Neoplasms - mortality</topic><topic>Esophageal Neoplasms - therapy</topic><topic>Esophageal squamous cell carcinoma</topic><topic>Esophageal Squamous Cell Carcinoma - immunology</topic><topic>Esophageal Squamous Cell Carcinoma - mortality</topic><topic>Esophageal Squamous Cell Carcinoma - pathology</topic><topic>Esophageal Squamous Cell Carcinoma - therapy</topic><topic>Female</topic><topic>Genetic aspects</topic><topic>Health aspects</topic><topic>Humans</topic><topic>Immune system</topic><topic>Immuno-inflammatory biomarkers</topic><topic>Immunogenomic landscape</topic><topic>Immunotherapy</topic><topic>Immunotherapy - methods</topic><topic>Inflammation</topic><topic>Male</topic><topic>Medical research</topic><topic>Medicine, Experimental</topic><topic>Middle Aged</topic><topic>Neutrophils</topic><topic>Nomograms</topic><topic>Physiological aspects</topic><topic>Prognosis</topic><topic>Radiotherapy</topic><topic>Retrospective Studies</topic><topic>RNA sequencing</topic><topic>Squamous cell carcinoma</topic><topic>T cells</topic><topic>Tumor Microenvironment - immunology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cheng, Xingyuan</creatorcontrib><creatorcontrib>Meng, Fanjun</creatorcontrib><creatorcontrib>Wang, Ruixi</creatorcontrib><creatorcontrib>Liu, Shiliang</creatorcontrib><creatorcontrib>Li, Qiaoqiao</creatorcontrib><creatorcontrib>Chen, Baoqing</creatorcontrib><creatorcontrib>Xi, Mian</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Science</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>BMC cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cheng, Xingyuan</au><au>Meng, Fanjun</au><au>Wang, Ruixi</au><au>Liu, Shiliang</au><au>Li, Qiaoqiao</au><au>Chen, Baoqing</au><au>Xi, Mian</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic value of immuno-inflammatory biomarkers in esophageal squamous cell carcinoma patients receiving immunotherapy combined with chemoradiotherapy and its association with immuno-genomic landscape</atitle><jtitle>BMC cancer</jtitle><addtitle>BMC Cancer</addtitle><date>2024-12-18</date><risdate>2024</risdate><volume>24</volume><issue>1</issue><spage>1518</spage><epage>12</epage><pages>1518-12</pages><artnum>1518</artnum><issn>1471-2407</issn><eissn>1471-2407</eissn><abstract>The clinical significance of immuno-inflammatory indicators and the underlying biological basis in patients with esophageal squamous cell carcinoma (ESCC) who receive chemoradiotherapy (CRT) combined with immunotherapy remains unclear. This study aims to evaluate the prognostic value of immuno-inflammatory biomarkers, develop a prognostic model, and explore the underlying mechanisms.
This study included 212 ESCC patients who received CRT and anti-PD-1 immunotherapy. Association between progression-free survival (PFS) and immuno-inflammatory biomarkers, including absolute lymphocyte count (ALC), neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), lymphocyte-monocyte ratio was analyzed. A nomogram was built based on the independent prognostic factors identified using multivariable Cox regression model. Pre-treatment tumor samples from 47 patients were collected for RNA sequencing to investigate the immune-related tumor microenvironment.
Patients experienced significant changes in immuno-inflammatory biomarkers during CRT, which gradually recovered after radiotherapy. Body mass index < 18.5 (HR, 1.85; P = 0.032), N3 stage (HR, 2.41; P = 0.002), high pre-CRT PLR (HR, 1.53; P = 0.037), low ALC nadir (HR, 1.84; P = 0.006), and high post-CRT NLR (HR, 2.12; P = 0.002) were independent prognostic factors for unfavorable PFS, which were incorporated into a nomogram with a concordance index of 0.70 (95% CI, 0.67-0.72). High-risk patients stratified by the nomogram had worse survival and were associated with lower levels of leukocyte and T cell activation, proliferation, and migration and less intratumoral immune cell infiltration.
Pre-CRT PLR, ALC nadir during CRT, and post-CRT NLR were significantly associated with PFS in patients with ESCC receiving CRT and immunotherapy. A nomogram model with good prognostic ability was developed.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>39696104</pmid><doi>10.1186/s12885-024-13298-z</doi><tpages>12</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Analysis Biological markers Biomarkers, Tumor Cancer Care and treatment Chemoradiotherapy Chemoradiotherapy - methods Chemotherapy Development and progression Drug therapy Esophageal cancer Esophageal Neoplasms - immunology Esophageal Neoplasms - mortality Esophageal Neoplasms - therapy Esophageal squamous cell carcinoma Esophageal Squamous Cell Carcinoma - immunology Esophageal Squamous Cell Carcinoma - mortality Esophageal Squamous Cell Carcinoma - pathology Esophageal Squamous Cell Carcinoma - therapy Female Genetic aspects Health aspects Humans Immune system Immuno-inflammatory biomarkers Immunogenomic landscape Immunotherapy Immunotherapy - methods Inflammation Male Medical research Medicine, Experimental Middle Aged Neutrophils Nomograms Physiological aspects Prognosis Radiotherapy Retrospective Studies RNA sequencing Squamous cell carcinoma T cells Tumor Microenvironment - immunology |
| title | Prognostic value of immuno-inflammatory biomarkers in esophageal squamous cell carcinoma patients receiving immunotherapy combined with chemoradiotherapy and its association with immuno-genomic landscape |
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