We demonstrated that COL19A1 high expression facilitates anti-PD-1 therapy [COL19A1 high, OR (95% CI): 0.31 (0.1−0.97), p = 0.044]. COL19A1high patients could benefit more from neoadjuvant immunotherapy (p < 0.01), high mortality (63.3%, p < 0.01), and have a trend towards a better RFS....Further analyses confirmed increased B cells infiltration and COL19A1 high expression could be seen in the immune-activated subgroup, which resulted in favorable survival and response to neoadjuvant immunotherapy plus chemotherapy.