151 research outputs found
The Political Opposition to Alexios I Komnenos (1081–1118)
No full textThe goal of my thesis is to survey the political environment and the power struggles during the reign of Alexios I Komnenos (1081-1118). For a while, the interpretation put forward by George Orstrogorsky strongly influenced how scholarship perceived the reign of Alexios I. This author states that the political scenario in Byzantium in the 11th century was marked by the struggle between the bureaucracy and the military landed aristocracy. The seizure of power by Alexios I was, therefore, the final victory of the latter. Another important view is that, once in power, Alexios I established a family rule in which his relatives by blood and by marriage had a powerful role, for they held the highest offices both in the military and administration and had an informal influence on the emperor. This gave Alexios political strength to remain in power and crush the civil aristocracy that opposed him. Both interpretations have been partially questioned. Although the approaches that perceive a binary division between bureaucrats and the military have been clearly disproven, their echo can yet be heard in recent work. Some recent scholarship on power or intellectual struggles during his reign still resorts to arguments that have a smack of the binary interpretation. Other scholars such as Jean-Claude Cheynet dismiss this binary division, but still see relatively fixed groups within the Byzantine ruling elite. The role of Alexios’ family as a source of political support has also been questioned by scholars, mainly Peter Frankopan, who made extensive research about the power struggles during his reign. Although this recent scholarship has put forward relevant arguments, it was not sufficient to provide a convincing overview of this key-period for Byzantine History. A close look on the political alliances that formed the groups supporting an emperor or making opposition to him demonstrates that the opposition to Alexios I was not formed by clearly delineated blocks with clear goals. It was rather characterized by a wide range of interests depending on the existing political situation. His supposed lack of interest in reconquering Anatolia, which, according to current scholarship, is the greatest source of the opposition to Alexios, can be nuanced as being an important motivation only to a particular oppositional movement observed in one single episode. A similar subtle approach is also important to understand the relations between the emperor and his family. Although the contemporary or near-contemporary reports seem to confirm the important role played by the imperial family, his relatives did not support the emperor automatically, which demands a more nuanced analysis of the sources. They present the emperor in constant negotiation with his relatives, sometimes granting and sometimes curtailing power, at times being autocratic, at other times almost submissive. Besides the ad-hoc strategies adopted by the emperor to create a group of supporters marked by open contradictions, Alexios I adopted and adapted different discourses to project himself publically in order to strengthen the support to his regime and discourage opposition, which dismisses completely the traditional image of Alexios as a crude and brutal soldier-emperor. In spite of his political and discursive strategies to energize his supporters, co-opt adversaries and repress opposition were at times unsuccessful, they were often successful, which allowed a long reign and the establishment of a dynasty: clear signs of political triumph in Byzantium.266 Seite
Encomium to the Monastic Life: An Unedited Poem of Alexios Makrembolites
No full textThis article presents the first critical edition of a metrical Encomium to the monastic life written by the fourteenth-century Byzantine author Alexios Makrembolites. The text is preserved in only one manuscript (Hierosolymitanus Sabbaiticus gr. 417). Makrembolites, after referring to the constant rejuvenation of the nature, wonders why people are drawn towards material goods and not to spiritual ones, distancing themselves from the immortality offered by a life close to God. After apologizing for his sinful life, he praises monastic life which he believes he should follow in order to bring an end to all his pains.
Detection of RAS family and BRAF mutations in circulating tumor cells in patients with metastatic colorectal cancer, with or without mutations at the primary tumor, who undergo treatment with biologic agents
No full text1. Introduction: Approximately 40-50% of patients with colorectal cancer (CRC) harbor KRAS mutations and another 5-10% harbor BRAF mutations. The presence of these mutations is predictive for absence of benefit to anti-EGFR agents. Nevertheless, the emergence of resistance is inevitable due to multiple factors, such as the acquisition of KRAS mutations. As a result, proper patient selection and early therapy adaptation could lead to the optimization of patient management. Circulating tumor cell (CTC) enumeration is prognostic in metastatic CRC (mCRC), while their genotypic analysis carries predictive information. ISET (Rarecells, France) selects CTCs based on their size and it has been shown to capture diverse cellular populations in mCRC. The aim of this study was the genotypic analysis of CTCs captured by ISET. 2. Patients and methods: This prospective observational study, aiming to enumerate and characterize at the genomic level CTCs captured by ISET from patients with mCRC, was conducted at the Medical Oncology department, University Hospital of Heraklion. Following consent, CTC isolation using the ISET system was performed from prospectively collected blood samples obtained from patients with RAS and BRAF WT mCRC prior to first-line therapy initiation, at first imaging assessment and on disease progression. CTCs were enumerated based on previously published morphological criteria, using hematoxylin & eosin and CD45 double stain on a single membrane spot. DNA was extracted from 5 spots and KRAS exon 2 mutations were detected using a custom quantitative Polymerase Chain Reaction (qPCR) assay. 3. Results: In total, 28 patients were enrolled, 15 wild type (WT), 8 with a KRAS exon 2 mutation (6 harbored the G12D and 2 the G12V mutation), 1 with an exon 4 mutation (A146T), 1 NRAS and 3 with a BRAF mutation. 57 samples were collected; in all the samples, at least 1 CTC / 1 ml was identified, with a median of 6 CTCs / 1 ml (range, 1 – 32) and a mean of 8,22 CTCs / 1 ml. Both the number of CTCs and the number of clusters of 2 or more CTCs increased from baseline to response evaluation and then decreased; only differences in CTC clusters were statistically significant. Among the WT patients, 9/15 (60%) had at least one positive for a mutation sample (in total, 11/28 – 39.2% of samples). 3/11 (27%) patients had a positive baseline sample, while 3/8 (37.5%) samples at progression harbored a mutation. Out of these 3 patients, no previous mutations had been detected and 2 of them had been treated with an anti-EGFR agent. The most frequently detected mutations were G13D and G12C (n=3). Out of the 21 samples from patients with RAS mutated tumors, the G13D mutation was detected 6 times and G12V and G12C once. Finally, out of the 6 samples from 3 patients with a BRAF mutation, no such mutation could be detected in CTCs using Sanger sequencing. However, in one patient the STK11 F354L was detected in both CTCs and the primary tumor. The detection of mutations at baseline was not found to be prognostic for patient outcomes. 4. Discussion: In this study, the kinetics of CTCs isolated with ISET did not follow the disease trajectory as assessed by imaging. These results are in accordance with a published study from another group. Possible reasons are the low number of enrolled patients, the subjective nature of CTC characterization, the uncertain relative importance of the CTC populations that are captured by ISET and the phenomenon of CTC mobilization under the effect of systemic chemotherapy. This study serves as a proof-of-principle regarding the possibility for the genomic characterization of CTCs captured b ISET. The detection of mutations concerned patients with both WT and mutated primary tumors and was achieved in all the phases of first line therapy. The same point mutation identified in the primary tumor could not be identified in the patient’s CTC sample. Possible reasons could be methodology-related, due to the different methods used to detect mutations in the primary tumors and the CTCs or, lastly, this could be an accurate representation of the true molecular heterogeneity of the disease. Despite this study’s weaknesses, the genomic characterization of CTCs captured by ISET is feasible and could provide information regarding the heterogeneity and the emergent resistance while under treatment with an anti-EGFR agent before it is clinically detected. The standardization of the methodology is necessary before it is evaluated in larger scale clinical trials.1. Εισαγωγή: Περίπου 40-50% των περιπτώσεων ορθοκολικού καρκίνου (ΟΚΚ) παρουσιάζουν μεταλλάξεις στο γονίδιο KRAS και 5-10% στο γονίδιο BRAF. Η παρουσία ή μη των μεταλλάξεων έχει σημασία: μόνο οι RAS άγριου τύπου (wild type, WT) ασθενείς ωφελούνται από αντι-EGFR θεραπεία. Εντούτοις, η ανάδυση αντίστασης κατά τη θεραπεία με τα αντισώματα αυτά είναι αναπόφευκτη εξαιτίας μιας ποικιλίας μηχανισμών, όπως είναι οι νεοεμφανιζόμενες KRAS μεταλλάξεις. Έτσι, η κατάλληλη επιλογή ασθενών και η έγκαιρη τροποποίηση της θεραπείας ανάλογα με τους μηχανισμούς αντίστασης θα μπορούσε να βελτιστοποιήσει τη θεραπεία των ασθενών. Η μέτρηση των κυκλοφορούντων καρκινικών κυττάρων (ΚΚΚ) έχει σημαντική προγνωστική ισχύ σε ασθενείς με μεταστατικό ΟΚΚ (ΜΟΚΚ), ενώ η γονοτυπική τους ανάλυση παρουσιάζει προβλεπτική ισχύ για τη λήψη αντι-EGFR παραγόντων. Το σύστημα ISET (Rarecells, France) βασίζεται στην απομόνωση βάσει του μεγέθους των κυττάρων και έχει δειχθεί ότι απομονώνει ευρύ πληθυσμό ΚΚΚ από ασθενείς με ΜΟΚΚ. Στόχος της διατριβής ήταν ο γονοτυπικός χαρακτηρισμός των ΚΚΚ που απομονώνονται με το σύστημα ISET. 2. Ασθενείς και μέθοδοι: Επρόκειτο για μια προοπτική μελέτη παρατήρησης με στόχο την καταμέτρηση και μοριακό χαρακτηρισμό των ΚΚΚ που απομονώνονται από ασθενείς με ΜΟΚΚ και η οποία πραγματοποιήθηκε στην Παθολογική – Ογκολογική κλινική του Πανεπιστημιακού Νοσοκομείου Ηρακλείου. Ασθενείς με ιστολογικά επιβεβαιωμένο ΜΟΚΚ και μη προηγούμενη λήψη θεραπείας για μεταστατική νόσο εντάσσονταν κατόπιν έγγραφης συγκατάθεσης. Δείγματα 10 ml αίματος λαμβάνονταν αμέσως πριν την έναρξη θεραπείας, κατά την στιγμή της ακτινολογικής εκτίμησης της νόσου και κατά τη διαπίστωση εξέλιξης της νόσου και η επεξεργασία με το σύστημα ISET γινόταν εντός 2 ωρών. Μία θέση (spot) από τη μεμβράνη του ISET χρησιμοποιήθηκε για την καταμέτρηση των ΚΚΚ με βάση κυτταρομορφολογικά κριτήρια, χρησιμοποιώντας διπλή ανοσοϊστοχημική χρώση με αντι-CD45 αντίσωμα για την αρνητική επιλογή αιμοποιητικών κυττάρων και χρώση αιματοξυλίνης – ηωσίνης. Η απομόνωση του DNA γινόταν από 5 spot της μεμβράνης ISET κάθε δείγματος. Στο απομονωθέν γενετικό υλικό ακολούθησε ποσοτική αντίδραση αλυσωτής πολυμεράσης (qPCR) για την ανίχνευση των μεταλλάξεων KRAS εξώνιο 2. 3. Αποτελέσματα: Συνολικά εντάχθηκαν 28 ασθενείς, 15 ήταν WT, 8 είχαν μετάλλαξη στο εξώνιο 2 του KRAS (6 τη μετάλλαξη G12D και 2 τη G12V), 1 στο εξώνιο 4 (Α146Τ), 1 στο γονίδιο NRAS και 3 στο γονίδιο BRAF. Ελήφθησαν 57 δείγματα ΚΚΚ και σε όλα ανιχνεύθηκε τουλάχιστον 1 ΚΚΚ / 1 ml αίματος, με διάμεση τιμή ΚΚΚ=6 (εύρος, 1 – 32) και μέση τιμή 8.22 ΚΚΚ / 1 ml. Tόσο ο αριθμός των συνολικών ΚΚΚ όσο και των αθροίσεων 2 ή περισσοτέρων κυττάρων (διάμεση και μέση τιμή) έχουν αυξητική τάση από την 1η (baseline) στη 2η αιμοληψία, ενώ στη συνέχεια ο αριθμός τους πέφτει ξανά. Μόνο η αύξηση των αθροίσεων ήταν στατιστικά σημαντική. Μεταξύ των ασθενών με WT πρωτοπαθή όγκο, οι 9/15 (60%) είχαν τουλάχιστον 1 θετικό για μετάλλαξη δείγμα, 11/28 (39.2%) σε επίπεδο δειγμάτων. Κατά την αρχική αιμοληψία, 3/11 ασθενείς (27%) βρέθηκε να έχουν μετάλλαξη KRAS στο εξώνιο 2 ενώ κατά την εξέλιξη της νόσου, 3/8 δείγματα ήταν θετικά για την παρουσία μετάλλαξης (37.5%). Από τους 3 αυτούς ασθενείς, σε κανέναν δεν είχε ανιχνευθεί αντίστοιχη μετάλλαξη σε προηγούμενη αιμοληψία και 2 εξ αυτών είχαν λάβει θεραπεία με αντι-EGFR παράγοντα. Οι συχνότερα εντοπιζόμενες μεταλλάξεις ήταν οι G13D και G12C (n=3). Από τα 21 δείγματα ΚΚΚ από ασθενείς με RAS mutated πρωτοπαθείς, διαπιστώθηκε η μετάλλαξη G13D σε 6 δείγματα και από 1 φορά οι G12V και G12C. Τέλος, ήταν διαθέσιμα 6 δείγματα από 3 ασθενείς με τη BRAF V600E μετάλλαξη. Σε κανένα δεν διαπιστώθηκε η μετάλλαξη με τη χρήση αλληλούχισης κατά Sanger. Όμως, σε έναν ασθενή διαπιστώθηκε στο δείγμα εξέλιξης της νόσου η μετάλλαξη STK11 F354L η οποία επίσης ανευρέθηκε στον πρωτοπαθή όγκο του ασθενούς. Η ανίχνευση μετάλλαξης στο baseline δείγμα δεν προέβλεπε την έκβαση των ασθενών. 4. Συζήτηση: Στην παρούσα μελέτη φάνηκε ότι η κινητική των ΚΚΚ μετά από απομόνωση με τη μέθοδο ISET δεν ακολουθούσε την πορεία των ασθενών με ΜΟΚΚ όπως αυτή εκτιμήθηκε με τις απεικονιστικές μεθόδους. Τα αποτελέσματα αυτά έρχονται σε συμφωνία και με τα αποτελέσματα άλλης ομάδας. Πιθανές ερμηνείες αποτελούν ο μικρός αριθμός των ασθενών που εντάχθηκαν στη μελέτη, η υποκειμενική φύση του χαρακτηρισμού των ΚΚΚ βάσει μορφολογικών κριτηρίων, η αμφίβολη σημασία του ευρέος πληθυσμού ΚΚΚ που απομονώνεται με το ISET και, τέλος, το φαινόμενο της κινητοποίησης των ΚΚΚ από τους όγκους λόγω της χορηγούμενης θεραπείας. Η τρέχουσα μελέτη αποτελεί κατά βάση μία απόδειξη αρχής σχετικά με τη δυνατότητα γονοτυπικής ανάλυσης των ΚΚΚ που απομονώνονται με το σύστημα ISET. Η ανίχνευση μεταλλάξεων αφορούσε τόσο WT όσο και μεταλλαγμένους πρωτοπαθείς όγκους και επιτεύχθηκε σε όλες τις φάσεις της θεραπεία πρώτης γραμμής. Σημειακή μετάλλαξη ανιχνεύσιμη στον πρωτοπαθή όγκο δεν έγινε δυνατό να ανιχνευθεί στα ΚΚΚ. Tο γεγονός αυτό έχει πολλές πιθανές ερμηνείες: μεθοδολογικά θέματα, η ασυμφωνία να οφείλεται στην διαφορετική τεχνική με την οποία έγιναν τα δείγματα των ΚΚΚ με τον πρωτοπαθή όγκο ή, τέλος, η εικόνα αυτή να είναι αντιπροσωπευτική της αληθινής μοριακής ετερογένειας. Παρά τις αδυναμίες της μελέτης, ο μοριακός χαρακτηρισμός των ΚΚΚ που απομονώνονται με το σύστημα ISET είναι εφικτός και μπορεί να δώσει πληροφορίες σχετικά με τη γενετική ετερογένεια της νόσου και την ανάδυση αντίστασης στην αντι-EGFR θεραπεία πριν αυτή να γίνει κλινικά αντιληπτή. Η προτυποποίηση των χρησιμοποιούμενων μεθόδων είναι απαραίτητο βήμα πριν αυτές αξιολογηθούν σε μεγαλύτερης κλίμακας κλινικές μελέτες
Targeting the PD-1/PD-L1 axis in the treatment of lung cancer
No full textIn recent years major advances in the field of molecular profiling of non-small cell lung cancer led to the identification of targetable driver mutations and revolutionized the treatment of specific patient subsets. However, the majority of NSCLC tumors do not harbor these genomic events. On the other hand, current studies have confirmed an expanding role for immunotherapy in lung cancer and new agents, such as inhibitors of the programmed cell death-1 (PD-1)/programmed cell death ligand 1 (PD-L1) axis have been introduced in the treatment armamentarium. The monoclonal antibodies nivolumab and pembrolizumab targeting PD-1 resulted in superior survival when compared to standard second line chemotherapy within the context of randomized trials and received regulatory approval. Moreover, several other anti-PD-L1 antibodies have demonstrated encouraging preliminary efficacy and multiple clinical trials in various settings during the disease trajectory are currently underway. Early immunotherapy trials have also illustrated the potential of PD-1 blockade in small cell lung cancer treatment, a disease for which major advances in systemic therapy are lacking. The currently available clinical data on PD-1/PD-L1 inhibition in lung cancer are summarized in this review
When universal history reaches the present: narrative time and authorial presence in Zonaras' account of Alexios Komnenos' reign
No full textThe paper addresses the issues of Zonaras Epitome’s place within the tradition of Byzantine chronicle, using it as a test-case for the validity and meaning of genre distinction in Byzantine historiography. The discussion focuses on the last section of Zonaras’ work, which recounts the reign of Alexios I Komnenos. The author shows that Zonaras’ choices with respect to the selection of narrative contents, their chronological arrangement, and the handling of narrative time push the boundaries of the chronicle genre in order to provide an ideological interpretation of the recent past
PD-1 protein and gene expression as prognostic factors in early breast cancer
No full textBACKGROUND: There is a paucity of data on the prognostic value of programmed cell death protein 1 (PD-1) protein and gene expression in early breast cancer (BC) and the present study's aim was to comprehensively investigate it. METHODS: The study consisted of three parts: a correlative analysis of PD-1 protein and gene expression from an original patient cohort of 564 patients with early BC; a systematic review and trial-level meta-analysis on the association between PD-1 protein expression and disease-free survival/overall survival (OS) in early BC; and a pooled gene expression analysis from publicly available transcriptomic datasets regarding PDCD1 expression. RESULTS: In the study cohort, PD-1 protein, but not gene expression, was associated with improved OS (HRadj=0.73, 95% CI 0.55 to 0.97, p=0.027 and HRadj=0.88, 95% CI 0.68 to 1.13, p=0.312, respectively). In the trial-level meta-analysis, PD-1 protein expression was not found to be statistically significantly associated with outcomes in the overall population. Finally, in the pooled gene expression analysis, higher PDCD1 expression was associated with better OS in multivariable analysis in the entire population (HRadj=0.89, 95% CI 0.80 to 0.99, p=0.025) and in basal-like tumours. CONCLUSIONS: PD-1 protein and gene expression seem to be promising prognostic factors in early BC. Standardisation of detection and assessment methods is of utmost importance.sponsorship: This study was supported by the Swedish Cancer Society (grant number CAN 2018/846 to TF), the Cancer Society in Stockholm (174113 to TF); the Swedish Breast Cancer Association (IZ, TF); Alexios Matikas was supported by the Stockholm Region (clinical postdoctorial appointment, dnr K 2017-4577); Theodoros Foukakis is recipient of the Senior Clinical Investigator Award from the Swedish Cancer Society (grant number CAN 2017/1043); Jonas Bergh's research group receives funding from the Stockholm region, the Swedish Cancer Society, the funds at Radiumhemmet, the Swedish Research Council, the Knut and Alice Wallenberg fund. (Swedish Cancer Society|CAN 2018/846, Swedish Cancer Society|CAN 2017/1043, Cancer Society in Stockholm|174113, Swedish Breast Cancer Association, Stockholm Region|K 2017-4577, Stockholm region, Radiumhemmet, Swedish Research Council, Knut and Alice Wallenberg fund, Swedish Cancer Society)status: Publishe
Impact of Primary Breast Surgery on Overall Survival of Patients With De Novo Metastatic Breast Cancer: A Systematic Review and Meta-Analysis
No full textBreast surgery; Metastatic; Overall survivalCirurgia de mama; Metastàtic; Supervivència generalCirugía de mama; Metastásico; Supervivencia generalBackground
Breast surgery in cases of de novo metastatic breast cancer (MBC) is associated with improved outcomes in retrospective studies, although the results of randomized controlled trials (RCTs) are conflicting. We aimed to investigate whether surgery in this context prolongs patient survival.
Methods
We performed a systematic review of the literature to identify RCTs comparing surgery of primary breast cancer to no surgery in patients with de novo MBC. Cochrane Library, Embase, Medline (OVID), and Web of Science were searched with latest update in July 2023, while conference proceedings were manually searched. Data concerning patient and tumor characteristics, as well as outcomes, were extracted. A meta-analysis with random effects models was performed considering heterogeneity between trials.
Results
Overall, 3255 entries were identified and 5 RCTs fulfilled all inclusion criteria, which had enrolled 1381 patients. The overall estimation in the intention-to-treat population showed no benefit for patients who had surgical excision of the primary breast tumor (HR = 0.93; 95% CI, 0.76-1.14). No subgroups in terms of receptor status or patterns of metastasis seemed to benefit from surgery, except for younger/premenopausal patients (HR = 0.74, 95% CI, 0.58-0.94). Breast surgery was associated with improved local progression-free survival (HR = 0.37, 95% CI, 0.19-0.74).
Conclusion
Surgery of the primary tumor in patients with de novo MBC does not prolong survival, except possibly in younger/premenopausal patients. Breast surgery should be offered within the context of well-designed clinical trials examining the issue
The Letters of Maximos Planudes to Alexios Philanthropenos and Melchisedek Akropolites: the Problems of Source Studies in the Context of the Politico-Military Situation in Byzantium in the Late 13th C.
No full textThis research work is dedicated to the problem of dating of the Byzantine scholar and monk Maximos Planudes’ letters to the general, pinkernes Alexios Philanthropenos and his companion, monk Melchisedek Akropolites. Our goal is to date these letters on the basis of their content and data from other sources and to reconstruct chronological sequence of their writing.
The period of time when Alexios Philanthropenos was in office of dux of Thrakision (1293–1295) during which he conducted some military operations against the Turks of beyliks Germiyan and Menteєe has a special place in the history of the Byzantine-Turkish wars in the early Palaiologan era. At this time the Byzantine state made some of its last successful military efforts in this struggle. By studying this theme the present article makes a contribution to research the Byzantine wars against the Turks and the military art and military organization of the empire in the late 13th century.
Following the explicit consideration of some disputed items in dating of Maximos Planudes’ letters to the persons mentioned above (42 letters) the author specifies the chronological sequence of their writing and clarifies the stages of the Alexios Philanthropenos’ military activity in Asia Minor. This article also makes a contribution to using of epistolographic data in historical study
Prognostic Implications of PD-L1 Expression in Breast Cancer: Systematic Review and Meta-analysis of Immunohistochemistry and Pooled Analysis of Transcriptomic Data
No full textPURPOSE: Conflicting data have been reported on the prognostic value of PD-L1 protein and gene expression in breast cancer.Experimental Design: Medline, Embase, Cochrane Library, and Web of Science Core Collection were searched, and data were extracted independently by two researchers. Outcomes included pooled PD-L1 protein positivity in tumor cells, immune cells, or both, per subtype and per antibody used, and its prognostic value for disease-free and overall survival. A pooled gene expression analysis of 39 publicly available transcriptomic datasets was also performed. RESULTS: Of the initial 4,184 entries, 38 retrospective studies fulfilled the predefined inclusion criteria. The overall pooled PD-L1 protein positivity rate was 24% (95% CI, 15%-33%) in tumor cells and 33% (95% CI, 14%- 56%) in immune cells. PD-L1 protein expression in tumor cells was prognostic for shorter overall survival (HR, 1.63; 95% CI, 1.07-2.46; P = 0.02); there was significant heterogeneity (I2 = 80%, P heterogeneity < 0.001). In addition, higher PD-L1 gene expression predicted better survival in multivariate analysis in the entire population (HR, 0.82; 95% CI, 0.74-0.90; P < 0.001 for OS) and in basal-like tumors (HR, 0.64; 95% CI, 0.52-0.80; P < 0.001 for OS; P interaction 0.005). CONCLUSIONS: The largest to our knowledge meta-analysis on the subject informs on PD-L1 protein positivity rates and its prognostic value in breast cancer. Standardization is needed prior to routine implementation. PD-L1 gene expression is a promising prognostic factor, especially in basal-like breast cancer. Discrepant prognostic information might be related to PD-L1 gene expression in the stroma.sponsorship: The authors acknowledge the contribution of Magdalena Svanberg, librarian, Karolinska Institutet University Library during the preparation of this manuscript. A. Matikas was supported by the Stockholm Region (clinical postdoctorial appointment). T. Foukakis is a recipient of the Senior Clinical Investigator Award from the Swedish Cancer Society (grant number CAN 2017/1043). J. Bergh's research group receives funding from the Stockholm region, the Swedish Cancer Society, the funds at Radiumhemmet, the Swedish Research Council, and the Knut and Alice Wallenberg fund. This study was supported by the Swedish Cancer Society (grant numbers CAN 2017/1043 and CAN 2018/846, to T. Foukakis), the Cancer Society in Stockholm (174113, to T. Foukakis), and the Stockholm Region (grant number K2017-4577, to A. Matikas). (Stockholm Region|K2017-4577, Swedish Cancer Society|CAN 2017/1043, Swedish Cancer Society|CAN 2018/846, Radiumhemmet, Swedish Research Council, Knut and Alice Wallenberg fund, Cancer Society in Stockholm|174113)status: Publishe
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