{"id":"https://openalex.org/W7204689130","doi":"https://doi.org/10.3390/cancers18183065","title":"Treatment-Induced PD-L1 Dynamics and Temporal Heterogeneity in Locally Advanced and Metastatic Gastroesophageal Cancer\u2014A Systematic Review","display_name":"Treatment-Induced PD-L1 Dynamics and Temporal Heterogeneity in Locally Advanced and Metastatic Gastroesophageal Cancer\u2014A Systematic Review","publication_year":2026,"publication_date":"2026-09-21","ids":{"openalex":"https://openalex.org/W7204689130","doi":"https://doi.org/10.3390/cancers18183065","pmid":"https://pubmed.ncbi.nlm.nih.gov/42795031"},"language":"en","primary_location":{"id":"doi:10.3390/cancers18183065","doi":"https://doi.org/10.3390/cancers18183065","is_oa":true,"landing_page_url":"https://doi.org/10.3390/cancers18183065","pdf_url":null,"source":{"id":"https://openalex.org/S168415115","display_name":"Cancers","issn_l":"2072-6694","issn":["2072-6694"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","norway-1"],"host_organization":"https://openalex.org/P4310310987","host_organization_name":"Multidisciplinary Digital Publishing Institute","host_organization_lineage":["https://openalex.org/P4310310987"],"host_organization_lineage_names":["Multidisciplinary Digital Publishing Institute"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Cancers","raw_type":"journal-article"},"volume":null,"type":"review","indexed_in":["crossref","datacite","pubmed"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://doi.org/10.3390/cancers18183065","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5121740109","display_name":"Marharyta Khaustova","orcid":"https://orcid.org/0009-0001-4641-2911","observed_orcids":["https://orcid.org/0009-0001-4641-2911"]},"institutions":[{"id":"https://openalex.org/I4396570597","display_name":"Aziende Socio Sanitarie Territoriale dei Sette Laghi","ror":"https://ror.org/00xanm517","country_code":null,"type":"government","lineage":["https://openalex.org/I4396570597"]}],"countries":[],"is_corresponding":false,"raw_author_name":"Marharyta Khaustova","raw_affiliation_strings":["Medical Oncology Division, ASST Sette Laghi, 21100 Varese, Italy"],"raw_orcid":"https://orcid.org/0009-0001-4641-2911","affiliations":[{"raw_affiliation_string":"Medical Oncology Division, ASST Sette Laghi, 21100 Varese, Italy","institution_ids":["https://openalex.org/I4396570597"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5116822302","display_name":"Elisabetta Liberanome","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I115752224","display_name":"University of Insubria","ror":"https://ror.org/00s409261","country_code":"IT","type":"education","lineage":["https://openalex.org/I115752224"]}],"countries":["IT"],"is_corresponding":false,"raw_author_name":"Elisabetta Liberanome","raw_affiliation_strings":["Department of Medicine and Technological Innovation (DiMIT), University of Insubria, 21100 Varese, Italy"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Medicine and Technological Innovation (DiMIT), University of Insubria, 21100 Varese, Italy","institution_ids":["https://openalex.org/I115752224"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5113811856","display_name":"Annamaria De Giorgi","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4396570597","display_name":"Aziende Socio Sanitarie Territoriale dei Sette Laghi","ror":"https://ror.org/00xanm517","country_code":null,"type":"government","lineage":["https://openalex.org/I4396570597"]}],"countries":[],"is_corresponding":false,"raw_author_name":"Annamaria De Giorgi","raw_affiliation_strings":["Medical Oncology Division, ASST Sette Laghi, 21100 Varese, Italy"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Medical Oncology Division, ASST Sette Laghi, 21100 Varese, Italy","institution_ids":["https://openalex.org/I4396570597"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5088554692","display_name":"Luigi Pio Guerrera","orcid":"https://orcid.org/0000-0002-1475-3252","observed_orcids":["https://orcid.org/0000-0002-1475-3252"]},"institutions":[{"id":"https://openalex.org/I4396570597","display_name":"Aziende Socio Sanitarie Territoriale dei Sette Laghi","ror":"https://ror.org/00xanm517","country_code":null,"type":"government","lineage":["https://openalex.org/I4396570597"]}],"countries":[],"is_corresponding":false,"raw_author_name":"Luigi Pio Guerrera","raw_affiliation_strings":["Medical Oncology Division, ASST Sette Laghi, 21100 Varese, Italy"],"raw_orcid":"https://orcid.org/0000-0002-1475-3252","affiliations":[{"raw_affiliation_string":"Medical Oncology Division, ASST Sette Laghi, 21100 Varese, Italy","institution_ids":["https://openalex.org/I4396570597"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5058439511","display_name":"Fausto Petrelli","orcid":"https://orcid.org/0000-0001-9639-4486","observed_orcids":["https://orcid.org/0000-0001-9639-4486"]},"institutions":[{"id":"https://openalex.org/I4396570529","display_name":"Azienda Socio Sanitaria Territoriale di Bergamo Ovest","ror":"https://ror.org/05ybzbs43","country_code":null,"type":"government","lineage":["https://openalex.org/I4396570529"]}],"countries":["IT"],"is_corresponding":false,"raw_author_name":"Fausto Petrelli","raw_affiliation_strings":["Oncology Unit, ASST Bergamo Ovest, 24047 Treviglio, Italy"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Oncology Unit, ASST Bergamo Ovest, 24047 Treviglio, Italy","institution_ids":["https://openalex.org/I4396570529"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5103727229","display_name":"Gianluca Tomasello","orcid":"https://orcid.org/0009-0005-0941-8547","observed_orcids":["https://orcid.org/0009-0005-0941-8547"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Gianluca Tomasello","raw_affiliation_strings":["Oncology Unit, ASST Crema, Largo Dossena 2, 26013 Crema, Italy"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Oncology Unit, ASST Crema, Largo Dossena 2, 26013 Crema, Italy","institution_ids":[]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5004680827","display_name":"Michele Ghidini","orcid":"https://orcid.org/0000-0001-5435-1218","observed_orcids":["https://orcid.org/0000-0001-5435-1218"]},"institutions":[{"id":"https://openalex.org/I115752224","display_name":"University of Insubria","ror":"https://ror.org/00s409261","country_code":"IT","type":"education","lineage":["https://openalex.org/I115752224"]},{"id":"https://openalex.org/I4396570597","display_name":"Aziende Socio Sanitarie Territoriale dei Sette Laghi","ror":"https://ror.org/00xanm517","country_code":null,"type":"government","lineage":["https://openalex.org/I4396570597"]}],"countries":["IT"],"is_corresponding":false,"raw_author_name":"Michele Ghidini","raw_affiliation_strings":["Department of Medicine and Technological Innovation (DiMIT), University of Insubria, 21100 Varese, Italy","Medical Oncology Division, ASST Sette Laghi, 21100 Varese, Italy"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Medicine and Technological Innovation (DiMIT), University of Insubria, 21100 Varese, Italy","institution_ids":["https://openalex.org/I115752224"]},{"raw_affiliation_string":"Medical Oncology Division, ASST Sette Laghi, 21100 Varese, Italy","institution_ids":["https://openalex.org/I4396570597"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":3,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":{"value":2900,"currency":"CHF","value_usd":3499},"apc_paid":{"value":2900,"currency":"CHF","value_usd":3499},"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.61029412,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"18","issue":"18","first_page":"3065","last_page":"3065"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10158","display_name":"Cancer Immunotherapy and Biomarkers","score":0.9951000213623047,"subfield":{"id":"https://openalex.org/subfields/2730","display_name":"Oncology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10158","display_name":"Cancer Immunotherapy and Biomarkers","score":0.9951000213623047,"subfield":{"id":"https://openalex.org/subfields/2730","display_name":"Oncology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10696","display_name":"Gastric Cancer Management and Outcomes","score":0.0032999999821186066,"subfield":{"id":"https://openalex.org/subfields/2740","display_name":"Pulmonary and Respiratory Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10619","display_name":"Esophageal Cancer Research and Treatment","score":0.0003000000142492354,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/gastroesophageal-cancer","display_name":"gastroesophageal cancer","score":0.8920000195503235},{"id":"https://openalex.org/keywords/gastric-cancer","display_name":"gastric cancer","score":0.7279999852180481},{"id":"https://openalex.org/keywords/gastroesophageal-junction-cancer","display_name":"gastroesophageal junction cancer","score":0.972000002861023},{"id":"https://openalex.org/keywords/tumor-heterogeneity","display_name":"tumor heterogeneity","score":0.6729999780654907},{"id":"https://openalex.org/keywords/neoadjuvant-therapy","display_name":"neoadjuvant therapy","score":0.8859999775886536},{"id":"https://openalex.org/keywords/pd-l1-combined-positive-score","display_name":"PD-L1 combined positive score","score":0.7739999890327454},{"id":"https://openalex.org/keywords/immunotherapy-eligibility","display_name":"immunotherapy eligibility","score":0.7480000257492065},{"id":"https://openalex.org/keywords/repeat-biopsy","display_name":"repeat biopsy","score":0.5260000228881836}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.8075000047683716},{"id":"https://openalex.org/C143998085","wikidata":"https://www.wikidata.org/wiki/Q162555","display_name":"Oncology","level":1,"score":0.5986999869346619},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.5504000186920166},{"id":"https://openalex.org/C121608353","wikidata":"https://www.wikidata.org/wiki/Q12078","display_name":"Cancer","level":2,"score":0.5461000204086304},{"id":"https://openalex.org/C2775934546","wikidata":"https://www.wikidata.org/wiki/Q179991","display_name":"Biopsy","level":2,"score":0.5212000012397766},{"id":"https://openalex.org/C2777701055","wikidata":"https://www.wikidata.org/wiki/Q1427096","display_name":"Immunotherapy","level":3,"score":0.46950000524520874},{"id":"https://openalex.org/C2779742542","wikidata":"https://www.wikidata.org/wiki/Q372701","display_name":"Esophageal cancer","level":3,"score":0.41359999775886536},{"id":"https://openalex.org/C81917197","wikidata":"https://www.wikidata.org/wiki/Q628760","display_name":"Selection (genetic algorithm)","level":2,"score":0.4117000102996826},{"id":"https://openalex.org/C2779529041","wikidata":"https://www.wikidata.org/wiki/Q22349364","display_name":"Liquid biopsy","level":3,"score":0.4059000015258789},{"id":"https://openalex.org/C535046627","wikidata":"https://www.wikidata.org/wiki/Q30612","display_name":"Clinical trial","level":2,"score":0.4041000008583069},{"id":"https://openalex.org/C2778292576","wikidata":"https://www.wikidata.org/wiki/Q6991934","display_name":"Neoadjuvant therapy","level":4,"score":0.36469998955726624},{"id":"https://openalex.org/C145912823","wikidata":"https://www.wikidata.org/wiki/Q113558","display_name":"Dynamics (music)","level":2,"score":0.299699991941452},{"id":"https://openalex.org/C2777819096","wikidata":"https://www.wikidata.org/wiki/Q173710","display_name":"Esophagus","level":2,"score":0.29670000076293945},{"id":"https://openalex.org/C3018877446","wikidata":"https://www.wikidata.org/wiki/Q1421432","display_name":"Disease monitoring","level":3,"score":0.29510000348091125},{"id":"https://openalex.org/C163763905","wikidata":"https://www.wikidata.org/wiki/Q17075943","display_name":"Precision medicine","level":2,"score":0.28790000081062317},{"id":"https://openalex.org/C542804219","wikidata":"https://www.wikidata.org/wiki/Q5526839","display_name":"Gastrointestinal cancer","level":4,"score":0.2827000021934509},{"id":"https://openalex.org/C6856738","wikidata":"https://www.wikidata.org/wiki/Q331672","display_name":"Protein expression","level":3,"score":0.27799999713897705},{"id":"https://openalex.org/C90559484","wikidata":"https://www.wikidata.org/wiki/Q778379","display_name":"Expression (computer science)","level":2,"score":0.27399998903274536},{"id":"https://openalex.org/C2776694085","wikidata":"https://www.wikidata.org/wiki/Q974135","display_name":"Chemotherapy","level":2,"score":0.2655999958515167},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.265500009059906},{"id":"https://openalex.org/C2779974597","wikidata":"https://www.wikidata.org/wiki/Q28448986","display_name":"Clinical Practice","level":2,"score":0.2644999921321869},{"id":"https://openalex.org/C2989236134","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Patient care","level":2,"score":0.2574999928474426}],"mesh":[],"locations_count":6,"locations":[{"id":"doi:10.3390/cancers18183065","doi":"https://doi.org/10.3390/cancers18183065","is_oa":true,"landing_page_url":"https://doi.org/10.3390/cancers18183065","pdf_url":null,"source":{"id":"https://openalex.org/S168415115","display_name":"Cancers","issn_l":"2072-6694","issn":["2072-6694"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","norway-1"],"host_organization":"https://openalex.org/P4310310987","host_organization_name":"Multidisciplinary Digital Publishing Institute","host_organization_lineage":["https://openalex.org/P4310310987"],"host_organization_lineage_names":["Multidisciplinary Digital Publishing Institute"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Cancers","raw_type":"journal-article"},{"id":"pmid:42795031","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/42795031","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Cancers","raw_type":"Journal Article"},{"id":"pmh:doi:10.17605/osf.io/fwja4","doi":null,"is_oa":true,"landing_page_url":"https://osf.io/fwja4","pdf_url":null,"source":null,"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":"StudyRegistration"},{"id":"pmh:oai:pubmedcentral.nih.gov:13605973","doi":null,"is_oa":true,"landing_page_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13605973/","pdf_url":null,"source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Cancers (Basel)","raw_type":"Text"},{"id":"pmh:oai:share.osf.io:2c567439-745a-4b01-9282-0128a21f975d","doi":null,"is_oa":true,"landing_page_url":"https://osf.io/b6u83","pdf_url":null,"source":{"id":"https://openalex.org/S4306401127","display_name":"OSF Preprints (OSF Preprints)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I2799848540","host_organization_name":"Center for Open Science","host_organization_lineage":["https://openalex.org/I2799848540"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":"Project"},{"id":"doi:10.17605/osf.io/fwja4","doi":"https://doi.org/10.17605/osf.io/fwja4","is_oa":true,"landing_page_url":"https://doi.org/10.17605/osf.io/fwja4","pdf_url":null,"source":{"id":"https://openalex.org/S7407050956","display_name":"Open Science Framework","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I2799848540","host_organization_name":"Center for Open Science","host_organization_lineage":["https://openalex.org/I2799848540"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":null,"is_accepted":false,"is_published":null,"raw_source_name":null,"raw_type":"StudyRegistration"}],"best_oa_location":{"id":"doi:10.3390/cancers18183065","doi":"https://doi.org/10.3390/cancers18183065","is_oa":true,"landing_page_url":"https://doi.org/10.3390/cancers18183065","pdf_url":null,"source":{"id":"https://openalex.org/S168415115","display_name":"Cancers","issn_l":"2072-6694","issn":["2072-6694"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","norway-1"],"host_organization":"https://openalex.org/P4310310987","host_organization_name":"Multidisciplinary Digital Publishing Institute","host_organization_lineage":["https://openalex.org/P4310310987"],"host_organization_lineage_names":["Multidisciplinary Digital Publishing Institute"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Cancers","raw_type":"journal-article"},"sustainable_development_goals":[{"display_name":"Good health and well-being","score":1.0,"id":"https://metadata.un.org/sdg/3"}],"sustainable_development_goals_aurora":[{"display_name":"Good health and well-being","score":0.808046817779541,"id":"https://metadata.un.org/sdg/3"}],"study_designs":[{"display_name":"Systematic Review","id":"https://openalex.org/study-designs/systematic-review"}],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":[],"abstract_inverted_index":{"Background/Objectives:":[0],"Standard":[1],"guidelines":[2],"for":[3,21,103],"treating":[4],"locally":[5],"advanced":[6],"and":[7,17,60,76,82,91,108,114,132,172,263,292,298],"metastatic":[8,92,173,233],"gastroesophageal":[9,115,187,247],"cancer":[10,188,248],"(GEC)":[11],"involve":[12],"combination":[13],"regimens":[14],"of":[15,148,211,217,258,267,284,301],"chemotherapy":[16],"immunotherapy.":[18],"Patient":[19],"eligibility":[20],"these":[22,86],"treatments":[23],"is":[24,277],"primarily":[25,278],"guided":[26],"by":[27,58,280],"the":[28,126,139,153,192,206,256,265,299],"programmed":[29],"cell":[30],"death":[31],"ligand":[32],"1":[33],"(PD-L1)":[34],"combined":[35],"positive":[36],"score":[37],"(CPS).":[38],"This":[39,63,118,275],"approach":[40],"assumes":[41],"that":[42,181],"a":[43,49,215],"single":[44],"baseline":[45],"biopsy":[46],"accurately":[47],"reflects":[48],"stable,":[50],"tumor-wide":[51],"PD-L1":[52,72,110,184,201,218,226,244,290],"status,":[53],"an":[54,196],"assumption":[55],"increasingly":[56],"challenged":[57],"spatial":[59],"temporal":[61],"heterogeneity.":[62],"systematic":[64,119,164],"review":[65,120],"aims":[66],"to":[67,83,100,223,241,270],"synthesize":[68],"existing":[69],"data":[70,134],"on":[71,191,260],"expression":[73,185,202],"dynamics":[74],"before":[75],"after":[77,251],"systemic":[78],"therapy":[79],"in":[80,112,123,162,183,186,199,205,246,289],"GEC,":[81],"evaluate":[84],"whether":[85],"changes":[87,182,249],"differ":[88],"between":[89],"neoadjuvant":[90,168,207],"settings.":[93,177],"Methods:":[94],"We":[95],"systematically":[96],"searched":[97],"PubMed/MEDLINE":[98],"(up":[99],"May":[101],"2026)":[102],"studies":[104,159,213],"reporting":[105,144,214],"paired":[106,285],"pre-":[107],"post-treatment":[109,200],"status":[111,245],"gastric":[113],"junction":[116],"cancers.":[117],"was":[121,150,203,228],"conducted":[122],"accordance":[124],"with":[125,209,235],"PRISMA":[127],"2020":[128],"guidelines.":[129],"Narrative":[130],"synthesis":[131],"qualitative":[133],"transformation":[135],"were":[136,160],"structured":[137],"following":[138],"Synthesis":[140],"Without":[141],"Meta-analysis":[142],"(SWiM)":[143],"framework.":[145],"Study-level":[146],"risk":[147],"bias":[149],"assessed":[151],"using":[152],"Newcastle-Ottawa":[154],"Scale":[155],"(NOS).":[156],"Results:":[157],"Eleven":[158],"included":[161],"this":[163],"review,":[165],"stratified":[166],"into":[167],"(n":[169,174],"=":[170,175],"6)":[171],"5)":[176],"Our":[178],"findings":[179,254],"suggest":[180],"depend":[189],"heavily":[190],"clinical":[193],"setting.":[194],"Specifically,":[195],"upward":[197],"trend":[198],"evident":[204],"setting,":[208],"5":[210],"6":[212],"prevalence":[216],"gain":[219],"ranging":[220,238],"from":[221,239],"6.3%":[222],"33.3%.":[224],"Conversely,":[225],"downregulation":[227],"consistently":[229],"reported":[230],"across":[231],"all":[232],"studies,":[234],"loss":[236],"rates":[237],"19.3%":[240],"44.4%.":[242],"Conclusions:":[243],"dynamically":[250],"treatment.":[252],"These":[253],"highlight":[255],"limitations":[257],"relying":[259],"archival":[261],"tissue":[262],"support":[264],"use":[266],"repeat":[268],"biopsies":[269],"track":[271],"evolving":[272],"tumor":[273],"phenotypes.":[274],"study":[276],"limited":[279],"small":[281],"sample":[282],"sizes":[283],"biopsies,":[286],"technical":[287],"heterogeneity":[288],"scoring":[291],"treatment":[293],"regimens,":[294],"potential":[295],"publication":[296],"bias,":[297],"lack":[300],"prospective":[302],"registration.":[303]},"counts_by_year":[],"updated_date":"2026-09-29T14:09:16.559479","created_date":"2026-08-31T00:00:00"}
