Efficacy in this case was only evaluated by imaging and serum tumor markers (RECIST 1.1 criteria), lacking dynamic biopsy data of the tumor microenvironment (such as immune cell infiltration profiles, PD-L1 expression) before and after treatment, making it difficult to accurately analyze the immune mechanisms by which ACTL induces clinical complete response (such as memory T cell subtype distribution, cytokine network changes). This evidence concerns the gene CD274 and neoplasm.