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Article History

Received: 18 December 2025

Accepted: 26 March 2026

First Online: 7 May 2026

Declarations

:

: Kensei Yamaguchi reports grants from Astellas and speakers’ bureaus for Astellas, Bristol Myers Squibb, Chugai, Daiichi Sankyo, Eli Lilly Japan K.K., Merck Biopharma, Ono, Taiho, and Takeda. Hirokazu Shoji reports other financial/nonfinancial interests with AbbVie, Astellas, AstraZeneca, Chugai, Daiichi Sankyo, Elevation Oncology, Merck Sharp & Dohme, Metagen, Ono, and Taiho. Hisateru Yasui has no conflicts to disclose. Eiji Oki has received honoraria from Astellas. Daisuke Sakai has received research funding from Astellas, Eisai, Lucyte, and Taiho. Tetsuya Hamaguchi has received grants from Astellas, AstraZeneca, BeiGene, Bristol Myers Squibb, Daiichi Sankyo, Eisai, Incyte Japan, Ono, and Pfizer and honoraria for lectures from Bayer, Bristol Myers Squibb Japan, Chugai, Daiichi Sankyo, Lilly, Merck Serono, Ono, Taiho, and Takeda. Akihito Tsuji has received payment or honoraria from Asahi Kasei Pharma, Astellas, AstraZeneca K.K., Bayer Yakuhin, Bristol-Myers Squibb K.K., Chugai, Daiichi Sankyo, Eisai, Eli Lilly Japan K.K., Guardant Health Japan K.K., Merck Biopharma, Merck Sharp & Dohme K.K., Nippon Zoki, Novartis Pharma K.K., Ono, Pfizer Japan, Sawai, Servier Japan, Shanghai Henlius Biotech, Sun Pharma, Taiho, Takata, Takeda, Terumo, Tsumura & Co., Yakult Honsha, and Zeria Pharmaceutical and reports participation on a data safety monitoring board or advisory board for FeliMedix Co and Shanghai Henlius Biotech. Takashi Oshima has no conflicts to disclose. Masahiro Tsuda has no conflicts to disclose. Keiko Minashi has received research funding (all to institution) from Astellas, BeiGene, Daiichi Sankyo, Merck Sharp & Dohme, Ono, and Taiho. Jianning Yang is an employee of Astellas. Abraham Guerrero is an employee of Astellas. Yoko Ueno is an employee of Astellas and owns stock or stock options in the company. Maria Matsangou is an employee of Astellas. Georgia Gourgioti is an employee of Astellas. Yuka Nakanishi is an employee of Astellas. Satomi Furuki is an employee of Astellas. Kana Kuwamoto is an employee of Astellas. Shunsuke Yamada is an employee of Astellas and owns stock in the company. Kohei Shitara reports advisory roles for ALX Oncology Inc., Amgen, Arcus Biosciences, Inc., Astellas, AstraZeneca, Bayer, Boehringer Ingelheim, Bristol Myers Squibb, Daiichi Sankyo, GlaxoSmithKline K.K., Guardant Health Japan, Healios K.K., Janssen, Merck Sharp & Dohme, Moderna, Novartis, Ono, Takeda, and Zymeworks; honoraria received from Astellas, AstraZeneca, Bristol Myers Squibb, Eli Lilly, Janssen, and Ono; and research funding (all to institution) from Amgen, Astellas, AstraZeneca, Chugai, Daiichi Sankyo, Eisai, Merck Sharp & Dohme, Ono, PPD-SNBL K.K., PRA Health Sciences, Syneos Health, Taiho, and Toray.

: All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions. Informed consent to be included in the study, or the equivalent, was obtained from all patients.