{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T20:59:09Z","timestamp":1790197149017,"version":"4.1.0"},"reference-count":39,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"9","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Precis Oncol"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Preoperative chemoradiotherapy (CRT) can reshape the composition of the tumor immune microenvironment (TIME) in locally advanced rectal cancer (LARC), augmenting T-cell density and activation. As TIME may provide predictive insights, we analyzed the association of immune cell distribution and remodeling after CRT with pathologic response and clinical outcomes in patients with LARC derived from the STAR-01 (fluorouracil-based CRT plus\/minus oxaliplatin) trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods<\/jats:title>\n                    <jats:p>Tumor-infiltrating lymphocytes (TILs) were assessed by standard stains and immunostains (CD3, CD20, CD4, CD8, FOXP3, PD-1, and CD68). Immune cell populations in pretreatment biopsies and post-treatment surgical specimens were compared and associated with complete pathological response (ypT0N0) and overall (OS) and event-free (EFS) survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We retrieved 413 samples from 303 patients from the original cohort, including 110 paired pretreatment biopsies and post-treatment surgical tumor specimens. In pretreatment biopsies, CD20\n                      <jats:sup>+<\/jats:sup>\n                      cell counts were associated with improved EFS (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .051), independent of other prognostic factors. After therapy, intermediate-high TILs, CD3\n                      <jats:sup>+<\/jats:sup>\n                      cells, low CD4\n                      <jats:sup>+<\/jats:sup>\n                      \/CD8\n                      <jats:sup>+<\/jats:sup>\n                      ratio, and CD68\n                      <jats:sup>+<\/jats:sup>\n                      macrophage counts significantly increased, whereas FOXP3\n                      <jats:sup>+<\/jats:sup>\n                      and CD20\n                      <jats:sup>+<\/jats:sup>\n                      cells decreased. ypT0N0 was associated with low CD4\n                      <jats:sup>+<\/jats:sup>\n                      \/CD8\n                      <jats:sup>+<\/jats:sup>\n                      ratio (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001), reduced CD68\n                      <jats:sup>+<\/jats:sup>\n                      (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .001), and absence of eosinophils (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001) in post-treatment surgical specimens. In post-treatment specimens, low CD4\n                      <jats:sup>+<\/jats:sup>\n                      \/CD8\n                      <jats:sup>+<\/jats:sup>\n                      ratio and CD20\n                      <jats:sup>+<\/jats:sup>\n                      cell counts were significantly associated with both improved EFS (CD4\n                      <jats:sup>+<\/jats:sup>\n                      \/CD8\n                      <jats:sup>+<\/jats:sup>\n                      :\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .016; CD20\n                      <jats:sup>+<\/jats:sup>\n                      cells:\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .002) and OS (CD4\n                      <jats:sup>+<\/jats:sup>\n                      \/CD8\n                      <jats:sup>+<\/jats:sup>\n                      :\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .005; CD20\n                      <jats:sup>+<\/jats:sup>\n                      cells:\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .014). This prognostic role was confirmed in a multivariable analysis for CD20\n                      <jats:sup>+<\/jats:sup>\n                      cells.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In LARC, CRT reshapes the type and amount of immune cell contents, and the effects on certain immune populations are associated with tumor regression and clinical outcome.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/po-26-00278","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T19:59:13Z","timestamp":1790193553000},"update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":0,"title":["Tumor Immune Microenvironment and Response to Preoperative Chemoradiotherapy in Locally Advanced Rectal Cancer: Results From the STAR-01 Study Cohort"],"prefix":"10.1200","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5847-3623","authenticated-orcid":true,"given":"Francesca","family":"Negri","sequence":"first","affiliation":[{"name":"Gastroenterology and Endoscopy Unit, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorena","family":"Bottarelli","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, Universit\u00e0 Degli Studi di Parma, Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6982-5188","authenticated-orcid":true,"given":"Letizia","family":"Gnetti","sequence":"additional","affiliation":[{"name":"Pathology Unit, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Boni","sequence":"additional","affiliation":[{"name":"U.O. Epidemiologia Clinica, IRCCS Ospedale Policlinico San Martino, Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicoletta","family":"Campanini","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, Universit\u00e0 Degli Studi di Parma, Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cinzia","family":"Azzoni","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, Universit\u00e0 Degli Studi di Parma, Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Tamberi","sequence":"additional","affiliation":[{"name":"Oncology Unit, Ospedale Santa Maria Delle Croci, Ravenna AUSL Romagna, Ravenna, Italy"},{"name":"Department of Medical Science (DIMEC) University of Bologna, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8795-4653","authenticated-orcid":true,"given":"Francesca","family":"Bergamo","sequence":"additional","affiliation":[{"name":"Oncology 1, Department of Oncology, Istituto Oncologico Veneto IOV\u2014IRCCS, Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michela","family":"Frisinghelli","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Ospedale Santa Chiara, Trento, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Germana","family":"Chiaulon","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Azienda Sanitaria Universitaria Integrata, Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8329-8989","authenticated-orcid":true,"given":"Gianluca","family":"Masi","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology, Department of Translational Research and New Technologies in Medicine and Surgery, Azienda Ospedaliero-Universitaria di Pisa, Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angiolo","family":"Tagliagambe","sequence":"additional","affiliation":[{"name":"Radiotherapy Unit, Ospedale Apuane, Azienda USL Toscana Nord Ovest, Massa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marija","family":"Petric","sequence":"additional","affiliation":[{"name":"Oncology Unit, Azienda Sanitaria Dell\u2019Alto Adige, Bozen, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Morabito","sequence":"additional","affiliation":[{"name":"Oncology, ULSS 6 Euganea, Cittadella, Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni Luca Paolo","family":"Frassineti","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura Dei Tumori (I.R.S.T.) 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