cfDNA methylation highlights neuro-immune crosstalk as a key correlate of pathological response to neoadjuvant immunotherapy in gastric cancer

neuroactive ligand-receptor interaction and G protein-coupled receptor signaling rather than conventional T-cell pathways.Three CpG sites were prioritized as exploratory candidates.These findings generate a testable hypothesis that baseline neuro-immune signaling may be associated with immunotherapy response through epigenetic mechanisms, offering a new biological perspective and candidate markers for future validation.