{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T22:36:01Z","timestamp":1790289361835,"version":"4.1.0"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T00:00:00Z","timestamp":1771891200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The management of advanced cholangiocarcinoma (CCA) remains a clinical challenge. Prognostic biomarkers are needed to guide treatment decisions. The C-reactive protein\u2013albumin\u2013lymphocyte (CALLY) index reflects nutritional, immune, and inflammatory status and has shown prognostic value in other cancers. However, its role in CCA patients receiving chemoimmunotherapy is unexplored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective propensity score-matched (PSM) cohort study involving advanced CCA patients who were treated with chemoimmunotherapy. Participants were stratified into high- or low-CALLY groups based on an optimal cut-off value of 1.42. PSM (1:1) was applied to balance baseline covariates. Overall survival (OS) and progression-free survival (PFS) were compared between groups using Kaplan-Meier analysis, and Cox regression analysis was employed to identify prognostic factors. The prognostic models underwent comprehensive internal validation, including bootstrap resampling (1,000 iterations) for calibration and discrimination assessment. Health-related quality of life (HRQoL) was assessed using a mixed model for repeated measures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>After 1:1 propensity matching, 55 patients were retained in each group, with balanced baseline characteristics. The high-CALLY group exhibited significantly longer median OS (13.00 months vs. 11.50 months; P = 0.019) and PFS (7.50 months vs. 6.00 months; P = 0.020). Cox analysis confirmed the CALLY index as a valuable prognostic factor for both OS (hazard ratio (HR), 0.68; 95% confidence interval (CI), 0.50 to 0.93; P = 0.014) and PFS (HR, 0.70; 95% CI, 0.58 to 0.85; P &amp;lt; 0.001). Internal validation demonstrated good model performance, with optimism-corrected C-indices of 0.704 for OS and 0.716 for PFS. Furthermore, patients with a high CALLY index showed significantly slower deterioration in HRQoL from week 18 onward (P\u2009&amp;lt;\u20090.05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The CALLY index is a robust prognostic biomarker for advanced CCA patients undergoing chemoimmunotherapy, associated with significantly improved survival and better-preserved quality of life. Its integration into clinical practice could enhance risk stratification and facilitate personalized treatment strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1713495","type":"journal-article","created":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T06:46:03Z","timestamp":1771915563000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["A compass in the challenge: the CALLY index as a prognostic biomarker in advanced cholangiocarcinoma treated with chemoimmunotherapy: a retrospective propensity score-matched cohort study"],"prefix":"10.3389","volume":"17","author":[{"given":"Runjia","family":"Fan","sequence":"first","affiliation":[{"name":"Department of Bio-Therapeutic, The First Medical Center, Chinese People\u2019s Liberation Army General Hospital","place":["Beijing, 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