CD274 and neoplasm: While dNLR can reflect systemic inflammation, it does not fully capture other tumor-intrinsic factors, such as PD-L1 expression, microsatellite instability, or tumor mutational burden, which are known to influence the efficacy of immunotherapy.[22,23] This complexity suggests that while dNLR provides a snapshot of systemic inflammation, it may be insufficient as a standalone marker for predicting response rates to ICIs.