CSMD3 and neoplasm: Additionally, among the top ten genes with higher mutation frequencies in the ITGA4-altered group, TP53, LRP1B, TTN, MUC16, CSMD3, and SOCS2 have been reported to affect tumor progression, drug resistance, and immunotherapy response (47–50, 52), suggesting that ITGA4 may also be involved in these processes through gene mutation, warranting further research.