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. 2023 Nov 14;42:300. doi: 10.1186/s13046-023-02876-x

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© The Author(s) 2023

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

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Fig. 1 — Patient selection diagram. This study was based on the ABCSG-34 trial which included a total of 400 patients. Half of them got a vaccination, which was out of the scope of the current study, and they were therefore excluded. Additionally, we excluded non-vaccinated patients treated with aromatase inhibitors (AI). The remaining 154 patients were randomly assigned to two treatment arms with different sequences of neoadjuvant chemotherapy (NAC): the conventional sequence (CON, n = 76) with 4 cycles of EC followed by 4 cycles of D and the reverse sequence (REV, n = 78) with first D then EC. From this collective (n = 154) we determined lymphocyte function (i.e. PHA-induced IFNγ production of circulating lymphocytes) and infiltration (i.e. TILs). Immunoassays for characterization of lymphocyte subpopulation (e.g. CD3 and CD19) and for quantification of soluble immune mediators were started later and were therefore only determined in a subgroup (n = 81)