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Adding-on nivolumab to chemotherapy-stabilized patients is associated with improved survival in advanced pancreatic ductal adenocarcinoma
Background Immune checkpoint inhibitors (ICIs) are rarely used to treat advanced pancreatic ductal adenocarcinoma (PDAC) due to marginal efficacy. Patients and methods This study included 92 consecutive patients diagnosed with advanced or recurrent PDAC who received nivolumab-based treatment. Univar...
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| Published in: | Cancer Immunology, Immunotherapy : CII Immunotherapy : CII, 2024-09, Vol.73 (11), p.227, Article 227 |
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| container_title | Cancer Immunology, Immunotherapy : CII |
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| creator | Yang, Shih-Hung Kuo, Sung-Hsin Lee, Jen-Chieh Chen, Bang-Bin Shan, Yan-Shen Tien, Yu-Wen Chiu, Sz-Chi Cheng, Ann-Lii Yeh, Kun-Huei |
| description | Background
Immune checkpoint inhibitors (ICIs) are rarely used to treat advanced pancreatic ductal adenocarcinoma (PDAC) due to marginal efficacy.
Patients and methods
This study included 92 consecutive patients diagnosed with advanced or recurrent PDAC who received nivolumab-based treatment. Univariate and multivariate analyses were used to identify prognostic factors. A control group of 301 patients with PDAC who achieved disease control with palliative chemotherapy but without ICIs was selected for comparison using propensity score matching (PSM).
Results
The median overall survival (OS) since nivolumab treatment was 15.8 (95% confidence interval [CI], 12.5–19.0), 2.4 (95% CI 1.2–3.6), and 1.1 (95% CI 1.0–1.2) months in patients who received add-on nivolumab after achieving disease control with chemotherapy, in those who received concomitant nivolumab and chemotherapy without prerequisite confirmation of disease control, and in those who received nivolumab without concomitant chemotherapy, respectively (
P
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| doi_str_mv | 10.1007/s00262-024-03821-3 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_11383886</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3102211719</sourcerecordid><originalsourceid>FETCH-LOGICAL-c356t-ae73bb4552b4fc8a3e609e82bd374a5c8a3db30f69c6bc3fb6f1c5d976009d333</originalsourceid><addsrcrecordid>eNp9kcluFDEQhi0EIgu8AAdkiQuXBi-9-YSiCAhSJC7kbJWXnnHUbTe2u1F4A94az0w2cuBku-qrv_zrR-gNJR8oId3HRAhrWUVYXRHeM1rxZ-iY1ryU-oY-f3Q_QicpXRNSMyLES3TEBasFpf0x-nNmjPObKnjs3RrGZQKFc8B6a6eQtzbCfFOlDMqN7rc1eIbsrM8Ju4QhpaAd5FL-5fIWu2mOYS2vtMTVrTBi5zGYFbzeT3odbRnX2Cw6ly4Y64OGqJ0PE7xCLwYYk319e56iqy-ff5xfVJffv347P7usNG_aXIHtuFJ10zBVD7oHblsibM-U4V0Nza5iFCdDK3SrNB9UO1DdGNG1hAjDOT9Fnw6686Ima3RxE2GUc3QTxBsZwMl_O95t5SasklLe875vi8L7W4UYfi42ZTm5pO04grdhSZJTwkjHRcMK-u4Jeh2W6Iu_PcUo7agoFDtQOoaUoh3uf0OJ3EUtD1HLErXcRy13Pt4-9nE_cpdtAfgBSKXlNzY-7P6P7F-oSLi8</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3102211719</pqid></control><display><type>article</type><title>Adding-on nivolumab to chemotherapy-stabilized patients is associated with improved survival in advanced pancreatic ductal adenocarcinoma</title><source>Springer Nature - SpringerLink Journals - Fully Open Access</source><source>Springer Nature</source><source>PubMed Central</source><creator>Yang, Shih-Hung ; Kuo, Sung-Hsin ; Lee, Jen-Chieh ; Chen, Bang-Bin ; Shan, Yan-Shen ; Tien, Yu-Wen ; Chiu, Sz-Chi ; Cheng, Ann-Lii ; Yeh, Kun-Huei</creator><creatorcontrib>Yang, Shih-Hung ; Kuo, Sung-Hsin ; Lee, Jen-Chieh ; Chen, Bang-Bin ; Shan, Yan-Shen ; Tien, Yu-Wen ; Chiu, Sz-Chi ; Cheng, Ann-Lii ; Yeh, Kun-Huei</creatorcontrib><description>Background
Immune checkpoint inhibitors (ICIs) are rarely used to treat advanced pancreatic ductal adenocarcinoma (PDAC) due to marginal efficacy.
Patients and methods
This study included 92 consecutive patients diagnosed with advanced or recurrent PDAC who received nivolumab-based treatment. Univariate and multivariate analyses were used to identify prognostic factors. A control group of 301 patients with PDAC who achieved disease control with palliative chemotherapy but without ICIs was selected for comparison using propensity score matching (PSM).
Results
The median overall survival (OS) since nivolumab treatment was 15.8 (95% confidence interval [CI], 12.5–19.0), 2.4 (95% CI 1.2–3.6), and 1.1 (95% CI 1.0–1.2) months in patients who received add-on nivolumab after achieving disease control with chemotherapy, in those who received concomitant nivolumab and chemotherapy without prerequisite confirmation of disease control, and in those who received nivolumab without concomitant chemotherapy, respectively (
P
< 0.001). After PSM, the median overall survival (OS) since initiation of the concomitant chemotherapy that achieved disease control was significantly longer (
P
= 0.026) in patients who received add-on nivolumab (19.8 months; 95% CI 14.5–25.1) than in those who received chemotherapy alone (13.8 months; 95% CI 10.8–16.9). The immune profiling of the tumors in resected patients revealed higher scores of CD8
+
T cells to Tregs in patients with add-on nivolumab comparing to those who received chemotherapy alone.
Conclusion
Adding-on nivolumab was associated with improved OS in patients with advanced PDAC who achieved disease control following chemotherapy.</description><identifier>ISSN: 1432-0851</identifier><identifier>ISSN: 0340-7004</identifier><identifier>EISSN: 1432-0851</identifier><identifier>DOI: 10.1007/s00262-024-03821-3</identifier><identifier>PMID: 39249118</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adenocarcinoma ; Adult ; Aged ; Aged, 80 and over ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Cancer Research ; Carcinoma, Pancreatic Ductal - drug therapy ; Carcinoma, Pancreatic Ductal - mortality ; Carcinoma, Pancreatic Ductal - pathology ; CD8 antigen ; Chemotherapy ; Disease control ; Female ; Humans ; Immune checkpoint inhibitors ; Immune Checkpoint Inhibitors - therapeutic use ; Immunology ; Immunotherapy ; Lymphocytes T ; Male ; Medical prognosis ; Medicine ; Medicine & Public Health ; Middle Aged ; Monoclonal antibodies ; Nivolumab - administration & dosage ; Nivolumab - therapeutic use ; Oncology ; Pancreas ; Pancreatic cancer ; Pancreatic Neoplasms - drug therapy ; Pancreatic Neoplasms - mortality ; Prognosis ; Retrospective Studies ; Targeted cancer therapy</subject><ispartof>Cancer Immunology, Immunotherapy : CII, 2024-09, Vol.73 (11), p.227, Article 227</ispartof><rights>The Author(s) 2024</rights><rights>2024. The Author(s).</rights><rights>The Author(s) 2024. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>The Author(s) 2024 2024</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c356t-ae73bb4552b4fc8a3e609e82bd374a5c8a3db30f69c6bc3fb6f1c5d976009d333</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/PMC11383886/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11383886/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27922,27923,53789,53791</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39249118$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yang, Shih-Hung</creatorcontrib><creatorcontrib>Kuo, Sung-Hsin</creatorcontrib><creatorcontrib>Lee, Jen-Chieh</creatorcontrib><creatorcontrib>Chen, Bang-Bin</creatorcontrib><creatorcontrib>Shan, Yan-Shen</creatorcontrib><creatorcontrib>Tien, Yu-Wen</creatorcontrib><creatorcontrib>Chiu, Sz-Chi</creatorcontrib><creatorcontrib>Cheng, Ann-Lii</creatorcontrib><creatorcontrib>Yeh, Kun-Huei</creatorcontrib><title>Adding-on nivolumab to chemotherapy-stabilized patients is associated with improved survival in advanced pancreatic ductal adenocarcinoma</title><title>Cancer Immunology, Immunotherapy : CII</title><addtitle>Cancer Immunol Immunother</addtitle><addtitle>Cancer Immunol Immunother</addtitle><description>Background
Immune checkpoint inhibitors (ICIs) are rarely used to treat advanced pancreatic ductal adenocarcinoma (PDAC) due to marginal efficacy.
Patients and methods
This study included 92 consecutive patients diagnosed with advanced or recurrent PDAC who received nivolumab-based treatment. Univariate and multivariate analyses were used to identify prognostic factors. A control group of 301 patients with PDAC who achieved disease control with palliative chemotherapy but without ICIs was selected for comparison using propensity score matching (PSM).
Results
The median overall survival (OS) since nivolumab treatment was 15.8 (95% confidence interval [CI], 12.5–19.0), 2.4 (95% CI 1.2–3.6), and 1.1 (95% CI 1.0–1.2) months in patients who received add-on nivolumab after achieving disease control with chemotherapy, in those who received concomitant nivolumab and chemotherapy without prerequisite confirmation of disease control, and in those who received nivolumab without concomitant chemotherapy, respectively (
P
< 0.001). After PSM, the median overall survival (OS) since initiation of the concomitant chemotherapy that achieved disease control was significantly longer (
P
= 0.026) in patients who received add-on nivolumab (19.8 months; 95% CI 14.5–25.1) than in those who received chemotherapy alone (13.8 months; 95% CI 10.8–16.9). The immune profiling of the tumors in resected patients revealed higher scores of CD8
+
T cells to Tregs in patients with add-on nivolumab comparing to those who received chemotherapy alone.
Conclusion
Adding-on nivolumab was associated with improved OS in patients with advanced PDAC who achieved disease control following chemotherapy.</description><subject>Adenocarcinoma</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Cancer Research</subject><subject>Carcinoma, Pancreatic Ductal - drug therapy</subject><subject>Carcinoma, Pancreatic Ductal - mortality</subject><subject>Carcinoma, Pancreatic Ductal - pathology</subject><subject>CD8 antigen</subject><subject>Chemotherapy</subject><subject>Disease control</subject><subject>Female</subject><subject>Humans</subject><subject>Immune checkpoint inhibitors</subject><subject>Immune Checkpoint Inhibitors - therapeutic use</subject><subject>Immunology</subject><subject>Immunotherapy</subject><subject>Lymphocytes T</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Monoclonal antibodies</subject><subject>Nivolumab - administration & dosage</subject><subject>Nivolumab - therapeutic use</subject><subject>Oncology</subject><subject>Pancreas</subject><subject>Pancreatic cancer</subject><subject>Pancreatic Neoplasms - drug therapy</subject><subject>Pancreatic Neoplasms - mortality</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Targeted cancer therapy</subject><issn>1432-0851</issn><issn>0340-7004</issn><issn>1432-0851</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp9kcluFDEQhi0EIgu8AAdkiQuXBi-9-YSiCAhSJC7kbJWXnnHUbTe2u1F4A94az0w2cuBku-qrv_zrR-gNJR8oId3HRAhrWUVYXRHeM1rxZ-iY1ryU-oY-f3Q_QicpXRNSMyLES3TEBasFpf0x-nNmjPObKnjs3RrGZQKFc8B6a6eQtzbCfFOlDMqN7rc1eIbsrM8Ju4QhpaAd5FL-5fIWu2mOYS2vtMTVrTBi5zGYFbzeT3odbRnX2Cw6ly4Y64OGqJ0PE7xCLwYYk319e56iqy-ff5xfVJffv347P7usNG_aXIHtuFJ10zBVD7oHblsibM-U4V0Nza5iFCdDK3SrNB9UO1DdGNG1hAjDOT9Fnw6686Ima3RxE2GUc3QTxBsZwMl_O95t5SasklLe875vi8L7W4UYfi42ZTm5pO04grdhSZJTwkjHRcMK-u4Jeh2W6Iu_PcUo7agoFDtQOoaUoh3uf0OJ3EUtD1HLErXcRy13Pt4-9nE_cpdtAfgBSKXlNzY-7P6P7F-oSLi8</recordid><startdate>20240909</startdate><enddate>20240909</enddate><creator>Yang, Shih-Hung</creator><creator>Kuo, Sung-Hsin</creator><creator>Lee, Jen-Chieh</creator><creator>Chen, Bang-Bin</creator><creator>Shan, Yan-Shen</creator><creator>Tien, Yu-Wen</creator><creator>Chiu, Sz-Chi</creator><creator>Cheng, Ann-Lii</creator><creator>Yeh, Kun-Huei</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>C6C</scope><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>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20240909</creationdate><title>Adding-on nivolumab to chemotherapy-stabilized patients is associated with improved survival in advanced pancreatic ductal adenocarcinoma</title><author>Yang, Shih-Hung ; Kuo, Sung-Hsin ; Lee, Jen-Chieh ; Chen, Bang-Bin ; Shan, Yan-Shen ; Tien, Yu-Wen ; Chiu, Sz-Chi ; Cheng, Ann-Lii ; Yeh, Kun-Huei</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-ae73bb4552b4fc8a3e609e82bd374a5c8a3db30f69c6bc3fb6f1c5d976009d333</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adenocarcinoma</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</topic><topic>Cancer Research</topic><topic>Carcinoma, Pancreatic Ductal - drug therapy</topic><topic>Carcinoma, Pancreatic Ductal - mortality</topic><topic>Carcinoma, Pancreatic Ductal - pathology</topic><topic>CD8 antigen</topic><topic>Chemotherapy</topic><topic>Disease control</topic><topic>Female</topic><topic>Humans</topic><topic>Immune checkpoint inhibitors</topic><topic>Immune Checkpoint Inhibitors - therapeutic use</topic><topic>Immunology</topic><topic>Immunotherapy</topic><topic>Lymphocytes T</topic><topic>Male</topic><topic>Medical prognosis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Monoclonal antibodies</topic><topic>Nivolumab - administration & dosage</topic><topic>Nivolumab - therapeutic use</topic><topic>Oncology</topic><topic>Pancreas</topic><topic>Pancreatic cancer</topic><topic>Pancreatic Neoplasms - drug therapy</topic><topic>Pancreatic Neoplasms - mortality</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Targeted cancer therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yang, Shih-Hung</creatorcontrib><creatorcontrib>Kuo, Sung-Hsin</creatorcontrib><creatorcontrib>Lee, Jen-Chieh</creatorcontrib><creatorcontrib>Chen, Bang-Bin</creatorcontrib><creatorcontrib>Shan, Yan-Shen</creatorcontrib><creatorcontrib>Tien, Yu-Wen</creatorcontrib><creatorcontrib>Chiu, Sz-Chi</creatorcontrib><creatorcontrib>Cheng, Ann-Lii</creatorcontrib><creatorcontrib>Yeh, Kun-Huei</creatorcontrib><collection>SpringerOpen</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Cancer Immunology, Immunotherapy : CII</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yang, Shih-Hung</au><au>Kuo, Sung-Hsin</au><au>Lee, Jen-Chieh</au><au>Chen, Bang-Bin</au><au>Shan, Yan-Shen</au><au>Tien, Yu-Wen</au><au>Chiu, Sz-Chi</au><au>Cheng, Ann-Lii</au><au>Yeh, Kun-Huei</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Adding-on nivolumab to chemotherapy-stabilized patients is associated with improved survival in advanced pancreatic ductal adenocarcinoma</atitle><jtitle>Cancer Immunology, Immunotherapy : CII</jtitle><stitle>Cancer Immunol Immunother</stitle><addtitle>Cancer Immunol Immunother</addtitle><date>2024-09-09</date><risdate>2024</risdate><volume>73</volume><issue>11</issue><spage>227</spage><pages>227-</pages><artnum>227</artnum><issn>1432-0851</issn><issn>0340-7004</issn><eissn>1432-0851</eissn><abstract>Background
Immune checkpoint inhibitors (ICIs) are rarely used to treat advanced pancreatic ductal adenocarcinoma (PDAC) due to marginal efficacy.
Patients and methods
This study included 92 consecutive patients diagnosed with advanced or recurrent PDAC who received nivolumab-based treatment. Univariate and multivariate analyses were used to identify prognostic factors. A control group of 301 patients with PDAC who achieved disease control with palliative chemotherapy but without ICIs was selected for comparison using propensity score matching (PSM).
Results
The median overall survival (OS) since nivolumab treatment was 15.8 (95% confidence interval [CI], 12.5–19.0), 2.4 (95% CI 1.2–3.6), and 1.1 (95% CI 1.0–1.2) months in patients who received add-on nivolumab after achieving disease control with chemotherapy, in those who received concomitant nivolumab and chemotherapy without prerequisite confirmation of disease control, and in those who received nivolumab without concomitant chemotherapy, respectively (
P
< 0.001). After PSM, the median overall survival (OS) since initiation of the concomitant chemotherapy that achieved disease control was significantly longer (
P
= 0.026) in patients who received add-on nivolumab (19.8 months; 95% CI 14.5–25.1) than in those who received chemotherapy alone (13.8 months; 95% CI 10.8–16.9). The immune profiling of the tumors in resected patients revealed higher scores of CD8
+
T cells to Tregs in patients with add-on nivolumab comparing to those who received chemotherapy alone.
Conclusion
Adding-on nivolumab was associated with improved OS in patients with advanced PDAC who achieved disease control following chemotherapy.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>39249118</pmid><doi>10.1007/s00262-024-03821-3</doi><oa>free_for_read</oa></addata></record> |
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| source | Springer Nature - SpringerLink Journals - Fully Open Access; Springer Nature; PubMed Central |
| subjects | Adenocarcinoma Adult Aged Aged, 80 and over Antineoplastic Combined Chemotherapy Protocols - therapeutic use Cancer Research Carcinoma, Pancreatic Ductal - drug therapy Carcinoma, Pancreatic Ductal - mortality Carcinoma, Pancreatic Ductal - pathology CD8 antigen Chemotherapy Disease control Female Humans Immune checkpoint inhibitors Immune Checkpoint Inhibitors - therapeutic use Immunology Immunotherapy Lymphocytes T Male Medical prognosis Medicine Medicine & Public Health Middle Aged Monoclonal antibodies Nivolumab - administration & dosage Nivolumab - therapeutic use Oncology Pancreas Pancreatic cancer Pancreatic Neoplasms - drug therapy Pancreatic Neoplasms - mortality Prognosis Retrospective Studies Targeted cancer therapy |
| title | Adding-on nivolumab to chemotherapy-stabilized patients is associated with improved survival in advanced pancreatic ductal adenocarcinoma |
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