{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T22:24:41Z","timestamp":1794003881786,"version":"4.8.0"},"reference-count":36,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:00:00Z","timestamp":1793491200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:00:00Z","timestamp":1793491200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100008658","name":"Deutsches Krebsforschungszentrum","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008658","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","ejcancer.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Cancer"],"published-print":{"date-parts":[[2026,11]]},"DOI":"10.1016\/j.ejca.2026.117037","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T07:08:28Z","timestamp":1789024108000},"page":"117037","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"special_numbering":"C","title":["Biomarker-defined benefit from FLOT plus nivolumab in metastatic gastroesophageal cancer: Extended follow-up and immune-inflammatory markers of the phase II IKF-AIO-moonlight trial"],"prefix":"10.1016","volume":"248","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9639-3472","authenticated-orcid":false,"given":"Michael","family":"Masetti","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6454-8337","authenticated-orcid":false,"given":"Alexander","family":"Nieto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvie","family":"Lorenzen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8633-2748","authenticated-orcid":false,"given":"Thorsten Oliver","family":"Goetze","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter C.","family":"Thuss-Patience","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Riera-Knorrenschild","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eray","family":"Goekkurt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias Nicolaas","family":"Dechow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas Jens","family":"Ettrich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5972-8504","authenticated-orcid":false,"given":"Ralf Dieter","family":"Hofheinz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim Barbara","family":"Luley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7243-7373","authenticated-orcid":false,"given":"Daniel","family":"Pink","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Udo","family":"Lindig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9321-9911","authenticated-orcid":false,"given":"Gunnar","family":"Folprecht","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gunter","family":"Schuch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4463-8263","authenticated-orcid":false,"given":"Michael","family":"Bitzer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Volker","family":"Heinemann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Angermeier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5169-831X","authenticated-orcid":false,"given":"Claus","family":"Bolling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Loose","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine","family":"Junge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Pauligk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salah-Eddin","family":"Al-Batran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9768-0086","authenticated-orcid":false,"given":"Alexander","family":"Stein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4619-9433","authenticated-orcid":false,"given":"Joseph","family":"Tintelnot","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.ejca.2026.117037_bib1","doi-asserted-by":"crossref","DOI":"10.1200\/EDBK_431060","article-title":"State-of-the-art advancements in gastroesophageal cancer treatment: harnessing biomarkers for precision care","volume":"44","author":"Balmaceda","year":"2024","journal-title":"Am Soc Clin Oncol Educ Book"},{"key":"10.1016\/j.ejca.2026.117037_bib2","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1038\/s41586-021-04161-3","article-title":"The KEYNOTE-811 trial of dual PD-1 and HER2 blockade in HER2-positive gastric cancer","volume":"600","author":"Janjigian","year":"2021","journal-title":"Nature"},{"key":"10.1016\/j.ejca.2026.117037_bib3","first-page":"1150","article-title":"Efficacy of ipilimumab vs FOLFOX in combination with nivolumab and trastuzumab in ERBB2-positive oesophagogastric adenocarcinoma: the INTEGA randomized clinical trial","volume":"8","author":"Stein","year":"2022","journal-title":"JAMA Oncol"},{"key":"10.1016\/j.ejca.2026.117037_bib4","doi-asserted-by":"crossref","DOI":"10.1136\/jitc-2023-006678","article-title":"First-line treatment of unresectable or metastatic HER2-positive esophagogastric adenocarcinoma: liquid biomarker analysis of the phase 2 INTEGA trial","volume":"11","author":"Paschold","year":"2023","journal-title":"J Immunother Cancer"},{"key":"10.1016\/j.ejca.2026.117037_bib5","unstructured":"ESMO Gastric Cancer Living Guideline, v1.4 September 2024. Published by European Society For Medical Oncology (2024)."},{"issue":"5","key":"10.1016\/j.ejca.2026.117037_bib6","doi-asserted-by":"crossref","first-page":"169","DOI":"10.6004\/jnccn.2025.0022","article-title":"Gastric cancer, version 2.2025, NCCN clinical practice guidelines in oncology","volume":"23","author":"Ajani","year":"2025","journal-title":"J Natl Compr Canc Netw"},{"key":"10.1016\/j.ejca.2026.117037_bib7","doi-asserted-by":"crossref","first-page":"732","DOI":"10.1016\/S1470-2045(25)00130-5","article-title":"TFOX versus FOLFOX in first-line treatment of HER2-negative gastric or gastro-oesophageal junction adenocarcinoma (PRODIGE 51\u2013GASTFOX)","volume":"26","author":"Zaanan","year":"2025","journal-title":"Lancet Oncol"},{"key":"10.1016\/j.ejca.2026.117037_bib8","doi-asserted-by":"crossref","first-page":"1948","DOI":"10.1016\/S0140-6736(18)32557-1","article-title":"Perioperative chemotherapy with FLOT vs ECF\/ECX for resectable gastric or GEJ adenocarcinoma (FLOT4): a randomized phase 2\/3 trial","volume":"393","author":"Al-Batran","year":"2019","journal-title":"Lancet"},{"key":"10.1016\/j.ejca.2026.117037_bib9","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1038\/s41571-022-00601-9","article-title":"Mechanisms regulating PD-L1 expression in cancers and opportunities for novel therapeutics","volume":"19","author":"Yamaguchi","year":"2022","journal-title":"Nat Rev Clin Oncol"},{"key":"10.1016\/j.ejca.2026.117037_bib10","doi-asserted-by":"crossref","first-page":"1181","DOI":"10.1016\/S1470-2045(23)00515-6","article-title":"Pembrolizumab plus chemotherapy for HER2-negative gastric cancer (KEYNOTE-859)","volume":"24","author":"Rha","year":"2023","journal-title":"Lancet Oncol"},{"key":"10.1016\/j.ejca.2026.117037_bib11","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/S0140-6736(21)00797-2","article-title":"Nivolumab plus chemotherapy for advanced gastric\/GEJ cancer (CheckMate 649)","volume":"398","author":"Janjigian","year":"2021","journal-title":"Lancet"},{"key":"10.1016\/j.ejca.2026.117037_bib12","doi-asserted-by":"crossref","DOI":"10.1136\/bmj-2023-078876","article-title":"Tislelizumab plus chemotherapy versus placebo plus chemotherapy as first line treatment for advanced gastric or gastro-oesophageal junction adenocarcinoma: RATIONALE-305 randomised, double blind, phase 3 trial","volume":"385","author":"Qiu","year":"2024","journal-title":"BMJ"},{"issue":"4","key":"10.1016\/j.ejca.2026.117037_bib13","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1200\/JCO.23.00975","article-title":"Perioperative Atezolizumab Plus Fluorouracil, Leucovorin, Oxaliplatin, and Docetaxel for Resectable Esophagogastric Cancer: Interim Results From the Randomized, Multicenter, Phase II\/III DANTE\/IKF-s633 Trial","volume":"42","author":"Lorenzen","year":"2024","journal-title":"J Clin Oncol"},{"issue":"3","key":"10.1016\/j.ejca.2026.117037_bib14","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1056\/NEJMoa2503701","article-title":"Perioperative Durvalumab in Gastric and Gastroesophageal Junction Cancer","volume":"393","author":"Janjigian","year":"2025","journal-title":"N Engl J Med"},{"key":"10.1016\/j.ejca.2026.117037_bib15","doi-asserted-by":"crossref","first-page":"2072","DOI":"10.1038\/s41467-026-69622-7","article-title":"First-line modified FOLFOX plus\/minus nivolumab and Ipilimumab or FLOT plus nivolumab in advanced gastroesophageal adenocarcinoma: a phase II multi-cohort trial","volume":"17","author":"Lorenzen","year":"2026","journal-title":"Nat Commun"},{"key":"10.1016\/j.ejca.2026.117037_bib16","doi-asserted-by":"crossref","first-page":"763","DOI":"10.3389\/fonc.2020.00763","article-title":"Predictive biomarkers of immune checkpoint inhibition in gastroesophageal cancers","volume":"10","author":"Sundar","year":"2020","journal-title":"Front Oncol"},{"key":"10.1016\/j.ejca.2026.117037_bib17","article-title":"Pembrolizumab monotherapy for previously treated gastric\/GEJ cancer (KEYNOTE-059)","volume":"4","author":"Fuchs","year":"2018","journal-title":"JAMA Oncol"},{"key":"10.1016\/j.ejca.2026.117037_bib18","first-page":"212","article-title":"Advances and challenges in gastric cancer testing: the role of biomarkers","volume":"22","author":"Sun","year":"2025","journal-title":"Cancer Biol Med"},{"key":"10.1016\/j.ejca.2026.117037_bib19","doi-asserted-by":"crossref","first-page":"826","DOI":"10.1111\/his.14869","article-title":"Clinical impact of biomarker testing in gastric cancer: a real-world cohort","volume":"82","author":"van der Sluis","year":"2023","journal-title":"Histopathology"},{"key":"10.1016\/j.ejca.2026.117037_bib20","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1158\/2326-6066.CIR-24-0561","article-title":"Inflammatory stress determines chemotherapy need in HER2-positive esophagogastric cancer during targeted therapy + immunotherapy","volume":"13","author":"Tintelnot","year":"2025","journal-title":"Cancer Immunol Res"},{"key":"10.1016\/j.ejca.2026.117037_bib21","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1038\/s41598-024-84890-3","article-title":"Pretreatment neutrophil-to-lymphocyte ratio and immunotherapy efficacy: systematic review and meta-analysis","volume":"15","author":"Su","year":"2025","journal-title":"Sci Rep"},{"key":"10.1016\/j.ejca.2026.117037_bib22","doi-asserted-by":"crossref","DOI":"10.3389\/fonc.2023.1228076","article-title":"The neutrophil-to-lymphocyte ratio as a prognostic factor in cancers: a narrative review","volume":"13","author":"Heshmat-Ghahdarijani","year":"2023","journal-title":"Front Oncol"},{"issue":"4","key":"10.1016\/j.ejca.2026.117037_bib23","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1093\/annonc\/mdw012","article-title":"Prognostic value of neutrophil-to-lymphocyte ratio in advanced oesophago-gastric cancer: exploratory analysis of the REAL-2 trial","volume":"27","author":"Grenader","year":"2016","journal-title":"Ann Oncol"},{"issue":"11","key":"10.1016\/j.ejca.2026.117037_bib24","doi-asserted-by":"crossref","first-page":"1","DOI":"10.18637\/jss.v098.i11","article-title":"cutpointr: Improved Estimation and Validation of Optimal Cutpoints in R","volume":"98","author":"Thiele","year":"2021","journal-title":"J Stat Softw"},{"key":"10.1016\/j.ejca.2026.117037_bib25","doi-asserted-by":"crossref","DOI":"10.1155\/2017\/3762651","article-title":"Defining an optimal cut-point value in ROC analysis: an alternative approach","volume":"2017","author":"Unal","year":"2017","journal-title":"Comput Math Methods Med"},{"key":"10.1016\/j.ejca.2026.117037_bib26","doi-asserted-by":"crossref","first-page":"869","DOI":"10.1038\/s41591-024-03398-5","article-title":"Prediction of checkpoint inhibitor immunotherapy efficacy for cancer using routine blood tests and clinical data","volume":"31","author":"Yoo","year":"2025","journal-title":"Nat Med"},{"issue":"12","key":"10.1016\/j.ejca.2026.117037_bib27","doi-asserted-by":"crossref","first-page":"4197","DOI":"10.1038\/s41591-025-03979-y","article-title":"Perioperative pembrolizumab, trastuzumab and FLOT in HER2-positive localized esophagogastric adenocarcinoma: a phase 2 trial","volume":"31","author":"Stein","year":"2025","journal-title":"Nat Med"},{"key":"10.1016\/j.ejca.2026.117037_bib28","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1038\/nature07205","article-title":"Cancer-related inflammation","volume":"454","author":"Mantovani","year":"2008","journal-title":"Nature"},{"key":"10.1016\/j.ejca.2026.117037_bib29","article-title":"Chemotherapy reinforces anti-tumor immune response and enhances ICI efficacy","volume":"12","author":"Zhang","year":"2022","journal-title":"Front Oncol"},{"key":"10.1016\/j.ejca.2026.117037_bib30","doi-asserted-by":"crossref","first-page":"2912","DOI":"10.3390\/cancers15112912","article-title":"Chemo-immunotherapy: a new trend in cancer treatment","volume":"15","author":"Sordo-Bahamonde","year":"2023","journal-title":"Cancers"},{"key":"10.1016\/j.ejca.2026.117037_bib31","doi-asserted-by":"crossref","first-page":"2159","DOI":"10.1182\/blood-2018-11-844548","article-title":"Neutrophil plasticity in the tumor microenvironment","volume":"133","author":"Giese","year":"2019","journal-title":"Blood"},{"key":"10.1016\/j.ejca.2026.117037_bib32","doi-asserted-by":"crossref","DOI":"10.3389\/fimmu.2024.1482746","article-title":"Prognostic value of NLR, PLR, LMR, dNLR, ANC in melanoma receiving immune checkpoint inhibitors: meta-analysis","volume":"15","author":"Ou","year":"2024","journal-title":"Front Immunol"},{"key":"10.1016\/j.ejca.2026.117037_bib33","doi-asserted-by":"crossref","DOI":"10.1155\/2022\/3610038","article-title":"Prognostic value of lymphocyte-to-monocyte ratio in patients receiving ICIs","volume":"2022","author":"Wan","year":"2022","journal-title":"Dis Markers"},{"key":"10.1016\/j.ejca.2026.117037_bib34","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.lungcan.2017.01.013","article-title":"Pretreatment neutrophil-to-lymphocyte ratio as a marker of outcomes in nivolumab-treated patients with advanced non-small-cell lung cancer","volume":"106","author":"Bagley","year":"2017","journal-title":"Lung Cancer"},{"key":"10.1016\/j.ejca.2026.117037_bib35","doi-asserted-by":"crossref","first-page":"842","DOI":"10.1002\/kjm2.12694","article-title":"Prognostic value of neutrophil-to-lymphocyte ratio in gastric cancer patients treated with immune checkpoint inhibitors: A meta-analysis","volume":"39","author":"Li","year":"2023","journal-title":"Kaohsiung J Med Sci"},{"key":"10.1016\/j.ejca.2026.117037_bib36","article-title":"Prognostic value of neutrophil to lymphocyte ratio in gastric cancer patients receiving immune checkpoint inhibitors: a systematic review and meta-analysis","volume":"13","author":"Zhang","year":"2023","journal-title":"Front Oncol"}],"container-title":["European Journal of Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S095980492600818X?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S095980492600818X?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T21:31:49Z","timestamp":1794000709000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S095980492600818X"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,11]]},"references-count":36,"alternative-id":["S095980492600818X"],"URL":"https:\/\/doi.org\/10.1016\/j.ejca.2026.117037","relation":{},"ISSN":["0959-8049"],"issn-type":[{"value":"0959-8049","type":"print"}],"subject":[],"published":{"date-parts":[[2026,11]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Biomarker-defined benefit from FLOT plus nivolumab in metastatic gastroesophageal cancer: Extended follow-up and immune-inflammatory markers of the phase II IKF-AIO-moonlight trial","name":"articletitle","label":"Article Title"},{"value":"European Journal of Cancer","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.ejca.2026.117037","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 The Authors. Published by Elsevier Ltd.","name":"copyright","label":"Copyright"}],"article-number":"117037"}}