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Article History

Received: 11 August 2024

Revised: 31 January 2025

Accepted: 17 February 2025

First Online: 21 March 2025

Competing interests

: C.D. received personal fees from Novartis, Roche, MSD Oncology, Daiichi-Sankyo, AstraZeneca, Molecular Health, and Merck, all outside the submitted work. C.D. is cofounder of Sividon Diagnostics. In addition, C.D. has a patent on VMScope digital pathology software with royalties paid; a patent WO2020109570A1—cancer immunotherapy pending; and patents WO2015114146A1 and WO2010076322A1—therapy response issued. P.J. reports research grants and travel expenses from GILEAD Sciences GmbH outside the submitted work. N.H. declares to be a GBG Forschungs GmbH employee. GBG Forschungs GmbH reports financial funding from AstraZeneca and Myriad during the conduct of the study; received funding for research grants from Abbvie, Amgen, AstraZeneca, BMS, Daiichi-Sankyo, Gilead, Molecular Health, Stemline Menarini, Celgene/BMS, Novartis, Pfizer and Roche (paid to the institution); GBG Forschungs GmbH has licensing fees from VMscope GmbH. In addition, GBG Forschungs GmbH has a patent EP21152186.9 pending, a patent EP19808852.8 pending, and a patent EP14153692.0 pending. S.L. declares to be the CEO of the GBG Forschungs GmbH. GBG Forschungs GmbH receives grants and other from Abbvie, grants from AstraZeneca, grant from Amgen, grants from DSI, grants from Gilead, Grants from Molecular Health, grants from Celgene/BMS, grants from Novartis, grants from Pfizer, grants from Roche, grant from Stemline/Menarini, financial support from Astra Zeneca, Gilead, Myriad, Novartis, Pfizer, BMS, Sanofi, Lilly, MSD; Consulting fees from following: AstraZeneca, Abbvie, Amgen, Cellcuity, DSI, Gilead, Novartis, Incyte, Pfizer, BMC, Sanofi, Lilly, MSD, Esai, Exact Science, Relay, Stemline, GSK, BioNtech, Olema, Roche; Payment Honoria: AZ, Amgen, Agendia, DSI, Gilead, Novartis, Pfizer, BMS, Stemline/Menarini, Lilly, MSD, Seagen, Medscape, Pierre Fabre, Roche; Travel support from: DSI, ESMO, SCGCC. S.L. reports leadership in: ESMO, SBGCC, SABCS, and AGO Kommission Mamma, S.L. reports receipt of drug equipment in trials from: Gilead, AZ, Celgene/BMS, Novartis, Pfizer, and Roche. GBG Forschungs GmbH has licensing fees from VMscope GmbH. In addition, GBG Forschungs GmbH has a patent EP21152186.9 pending, a patent EP19808852.8 pending, and a patent EP14153692.0 pending. The other authors declare no conflicts of interest.

: Immunohistochemical staining and evaluation of breast cancer patient samples was approved by the Ethics Committee of the University of Marburg (Ethics Opinion No 38/20). All xenograft experiments were performed according to the German animal welfare law and the European legislation for the protection of animals used for scientific purposes (2010/63/EU) and were approved by the regional board (RP Giessen).