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Article History

Received: 4 February 2026

Accepted: 11 March 2026

First Online: 11 May 2026

Declarations

:

: MR, JW, JS, HT, JRR, TM, Bradley H, JH, GWS, DM, and DS are employees of Caris Life Sciences and disclose stock and/or stock options in the company. MA reports research grants from Pfizer and Incyte; consulting for Bayer, Xoft, Apollomics, Autem therapeutics, GT Medical Technologies, Modifi biosciences, Bugworks, Allovir, EquilliumBio, VBI Vaccines, Servier Pharmaceuticals, Incyte, Recordati, Novocure, and Abbvie; and stock options in Mimivax, MedInnovate Advisors LLC, Trisalus Lifesciences, and LiveAI. SL reports advisory Board / consultant role with Abbvie, Amgen, AstraZeneca, Boehringer Ingelheim, Bristol-Myers Squibb, Daiichi Sankyo, Genentech/Roche, Gilead, GSK, Guardant Health, Johnson & Johnson, Jazz Pharmaceuticals, Merck, Merus, Natera, Novartis, Nuvalent, OSE Immunotherapeutics, Pfizer, PharmaMar, Regeneron, Revolution Medicines, SystImmune, Takeda, and Yuhan; and research grants (to institution) from Abbvie, Alkermes, AstraZeneca, Avenzo, BioNTech, Bristol-Myers Squibb, Cogent Biosciences, Duality, Ellipses, Genentech, Gilead, Medilink, Merck, Merus, Nuvalent, Nuvation, OSE Immunotherapeutics, Puma, Synthekine, SystImmune. EL reports support and research grants from the American Cancer Society (RSG-22–022-01-CDP) 2022–2026 and from the University of Minnesota Clinical Center for the Study of Pancreatic Disease, part of The Chronic Pancreatitis Diabetes Pancreatic Cancer research (CPDPC) consortium funded by the NIDDK (5U01DK126300-03); financial interests in Ryght, Inc.; consultant and advisor for Myer Research, Inc.; paid consultant for Primum; honoraria from Medscape; compensation for scientific review of proposed printed content, Elsevier Publishing and Johns Hopkins Press; Institutional Principal Investigator for clinical trials sponsored by Celgene, Novocure, Ltd, Intima Bioscience, Inc., the National Cancer Institute, and University of Minnesota membership in the Caris Life Sciences Precision Oncology Alliance (no financial compensation). VS reports research funding for clinical trials paid to institution from AbbVie, Agensys, Alfasigma, Altum, Amgen, Bayer, BERG Health, Blueprint Medicine, Boston Biomedical, Boston Pharmaceuticals, D3 Bio, Dragonfly Therapeutics, Exelixis, Fujifilm, GSK, Idera Pharmaceuticals, Incyte, Inhibrix, Eli Lilly/Loxo Oncology, MedImmune, NanoCarrier, Novartis, PharmaMar, Pfizer, Relay Therapeutics, Roche/Genentech, Takeda, Turning Point Therapeutics, and Vegenics; consulting/advisory role (paid to institution) from AbbVie, Astex Pharmaceuticals, AstraZeneca, Bayer, Genmab, Incyte, Lilly/Loxo Oncology, Novartis, Obsidian Therapeutics, Pfizer, Pheon Therapeutics, Regeneron, Relay Therapeutics, Roche, Endeavor Biomedicines, RevMed, and LabGenius Therapeutics; and other consulting/advisory role/continuing medical education from Helsinn Healthcare, Jazz Pharmaceuticals, Incyte, Loxo Oncology/Lilly, Novartis, Relay Therapeutics, Daiichi Sankyo, Illumina, Bayer, Medscape, OncLive, Clinical Care Communications, Physicians' Education Resource, and Med Learning Group. Balazs H reports research grants (paid to institution) from Boehringer Ingelheim, Astra Zeneca, Merck, BMS, Advaxis, Amgen, AbbVie, Daiichi, Pfizer, GSK, Beigene, Janssen, Black Diamond Therapeutics, Forward Pharma, Numab, and Arrivent; consulting for Astra Zeneca, Boehringer Ingelheim, Apollomics, Johnson & Johnson, Takeda, Merck, BMS, Genentech, Pfizer, Eli-Lilly, Daiichi, GSK; and data safety monitoring board participation with BMS, TPT, Apollomics, eFECTOR, City of Hope, and Nuvalent.

: This study was conducted in accordance with guidelines of the Declaration of Helsinki, Belmont report, and U.S. Common rule. As this study was performed utilizing retrospective, de-identified clinical data, it is considered IRB exempt per 45 CFR 46.104(d)(4). A waiver of patient informed consent was also granted due to the retrospective, de-identified nature of the data. Waiver of patient consent and exempt status were determined by WCG IRB.