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Article History

Received: 15 January 2026

Accepted: 8 March 2026

First Online: 14 April 2026

Declarations

Ethics approval: This study was conducted in accordance with the Declaration of Helsinki and International Conference on Harmonization Guidelines for Good Clinical Practice. Approval was granted by the appropriate institutional review boards at National Cancer Center Hospital.

Consent to participate: Written informed consent was obtained from all individual participants included in the study.

Consent to publish: All authors approved the final version of the manuscript and the decision to submit it for publication.

Competing interests: Takafumi Koyama 1. All support for the present manuscript, including funding, provision of study materials, medical writing, and article processing charges, was provided by Toray. 2. Research funding, grants or contracts: Astrazeneca, Novartis, Chugai, Lilly, Daiichi-Sankyo, Zymworks, Takeda, Boehringer Ingelheim, Janssen, MSD, Noile, Astrazeneca, Novartis, Chugai and GlaxoSmithKline. 3. Consulting fees: Amgen. 4. Payment or honoraria for lectures, presentations, speakers bureaus or educational events: Sysmex, Chugai and AstraZeneca. 5. Payment for expert testimony: None 6. Support for attending meetings, accommodations and/or travel: None. 7. Participation on a Data Safety Monitoring Board or Advisory Board: None. 8. Leadership or fiduciary role in other board, society, committee, advocacy group or any for-profit health care company, paid or unpaid: None. 9. Employment at any for-profit health care company: None. 10. Patents planned, issued or pending, royalties or license: None. 11. Stock or stock options: None. 12. Receipt of equipment, materials, drugs, medical writing, gifts or other services: None.Kan Yonemori 1. All support for the present manuscript, including funding, provision of study materials, medical writing, and article processing charges, was provided by Toray. 2. Research funding, grants or contracts: MSD, Daiichi-Sankyo, Merk Biopharma, Astrazeneca, Taiho, Pfizer, Novartis, Takeda, Chugai, Ono, Sanofi, Seattle genetics, Eisai, Eli Lilly, Genmab, Boeringer Ingelheim, Kyowa Hakko Kirin, Nihon Kayaku and Haihe. 3. Consulting fees: None. 4. Payment or honoraria for lectures, presentations, speakers bureaus or educational events: Pfizer, Eisai, AstraZeneca, Eli Lilly, Takeda, Chugai, Fuji Film Pharma, PDR Pharma, MSD, Boeringer Ingelheim, Ono, Daiichi-Sankyo, Bayer, Jansen, Asteras, Bristol Myers Squibb, Novartis, Sanofi, Merk Biopharma, Genmab. 5. Payment for expert testimony: None. 6. Support for attending meetings, accommodation and/or travel: None. 7. Participation on a Data Safety Monitoring Board or Advisory Board: Eisai, Astra Zeneca, Sanofi, Genmab, Giliad, OncXerna, Takeda, Novartis, MSD, Henlius, Eli Lilly, Daiichi Sankyo, GSK, Haihe, Genmab, EP Biopharma and Suwanier. 8. Leadership or fiduciary role in other board, society, committee, advocacy group or any for-profit health care company, paid or unpaid: None. 9. Employment at any for-profit health care company: None. 10. Patents planned, issued or pending, royalties or license: None. 11. Stock or stock options: None. 12. Receipt of equipment, materials, drugs, medical writing, gifts or other services: None.Jun Sato 1. All support for the present manuscript, including funding, provision of study materials, medical writing, and article processing charges, was provided by Toray. 2. Research funding, grants or contracts: Ono Pharmaceutical. 3. Consulting fees: Chugai and CMIC. 4. Payment or honoraria for lectures, presentations, speakers bureaus or educational events: Eisai, Chugai, Fuji Film and Olink Proteomics AB. 5. Payment for expert testimony: None. 6. Support for attending meetings, accommodation and/or travel: None. 7. Participation on a Data Safety Monitoring Board or Advisory Board: None. 8. Leadership or fiduciary role in other board, society, committee, advocacy group or any for-profit health care company, paid or unpaid: None. 9. Employment at any for-profit health care company: None. 10. Patents planned, issued or pending, royalties or license: None. 11. Stock or stock options: None. 12. Receipt of equipment, materials, drugs, medical writing, gifts or other services: None.Yuki Katsuya 1. All support for the present manuscript, including funding, provision of study materials, medical writing, and article processing charges, was provided by Toray. 2. Research funding, grants or contracts: None. 3. Consulting fees: None. 4. Payment or honoraria for lectures, presentations, speakers bureaus or educational events: Nihon Kayaku. 5. Payment for expert testimony: None. 6. Support for attending meetings, accommodation and/or travel: Ono Pharma. 7. Participation on a Data Safety Monitoring Board or Advisory Board: None. 8. Leadership or fiduciary role in other board, society, committee, advocacy group or any for-profit health care company, paid or unpaid: None. 9. Employment at any for-profit health care company: None. 10.Patents planned, issued or pending, royalties or license: None. 11. Stock or stock options: None. 12. Receipt of equipment, materials, drugs, medical writing, gifts or other services: None.Mao Okada 1. All support for the present manuscript, including funding, provision of study materials, medical writing, and article processing charges, was provided by Toray. 2. Research funding, grants or contracts: Pfizer. 3. Consulting fees: None. 4. Payment or honoraria for lectures, presentations, speakers bureaus or educational events: None. 5. Payment for expert testimony: None. 6. Support for attending meetings, accommodation and/or travel: None. 7. Participation on a Data Safety Monitoring Board or Advisory Board: None. 8. Leadership or fiduciary role in other board, society, committee, advocacy group or any for-profit health care company, paid or unpaid: None. 9. Employment at any for-profit health care company: None. 10. Patents planned, issued or pending, royalties or license: None. 11. Stock or stock options: None. 12. Receipt of equipment, materials, drugs, medical writing, gifts or other services: None.Tatsuya Yoshida 1. All support for the present manuscript, including funding, provision of study materials, medical writing, and article processing charges, was provided by Toray. 2. Research funding, grants or contracts: Novartis, AbbVie, Amgen, Daiichi-Sankyo, AstraZeneca, MSD, Chugai Pharmaceutical Co. Ltd., Astellas, Boehringer Ingelheim, BMS, Ono Pharmaceutical and Merck Biopharma. 3. Consulting fees: None. 4. Payment or honoraria for lectures, presentations, speakers bureaus or educational events: Novartis, Daiichi-Sankyo, AstraZeneca, MSD, Chugai pharmaceutical co. ltd, BMS, Ono, Takeda, Pfizer, Lilly and Merck Biopharma. 5. Payment for expert testimony: None. 6. Support for attending meetings, accommodation and/or travel: None. 7. Participation on a Data Safety Monitoring Board or Advisory Board: Novartis, MSD, Amgen, Chugai Pharmaceutical Co., Ltd., Daiichi-Sankyo, Pfizer, and Boehringer Ingelheim. 8. Leadership or fiduciary role in other board, society, committee, advocacy group or any for-profit health care company, paid or unpaid: None. 9. Employment at any for-profit health care company: None. 10. Patents planned, issued or pending, royalties or license: None. 11. Stock or stock options: None. 12. Receipt of equipment, materials, drugs, medical writing, gifts or other services: None.Fumiyoshi Okano 1. All support for the present manuscript, including funding, provision of study materials, medical writing, and article processing charges, was provided by Toray. 2. Research funding, grants or contracts: None. 3. Consulting fees: None. 4. Payment or honoraria for lectures, presentations, speakers bureaus or educational events: None. 5. Payment for expert testimony: None. 6. Support for attending meetings, accommodation and/or travel: None. 7. Participation on a Data Safety Monitoring Board or Advisory Board: None. 8. Leadership or fiduciary role in other board, society, committee, advocacy group or any for-profit health care company, paid or unpaid: None. 9. Employment at any for-profit health care company: Toray Industries, Inc. 10. Patents planned, issued or pending, royalties or license: Toray Industries, Inc. 11.Stock or stock options: Toray Industries, Inc. 12. Receipt of equipment, materials, drugs, medical writing, gifts or other services: None.Noboru Yamamoto 1. All support for the present manuscript, including funding, provision of study materials, medical writing, and article processing charges, was provided by Toray. 2. Research funding, grants or contracts: Astellas, Chugai, Eisai, Taiho, Bristol Myers Squibb, Pfizer, Novartis, Eli Lilly and Company, AbbVie, Daiichi Sankyo, Bayer, Boehringer Ingelheim, Kyowa Kirin, Takeda, ONO Pharmaceutical, Janssen Pharmaceuticals, MSD, Merck, GSK, Sumitomo Pharma, Chiome Bioscience, Otsuka, Carna Biosciences, Genmab, Shionogi, Toray, KAKEN, AstraZeneca, InventisBio, Rakuten Medical, and Amgen, Bicycle Therapeutics and Zymeworks. 3. Consulting fees: None. 4. Payment or honoraria for lectures, presentations, speakers bureaus or educational events: None. Chugai, Daiichi-Sankyo, Eisai. 5. Payment for expert testimony: None. 6. Support for attending meetings, accommodation and/or travel: None. Eisai, Boehringer Ingelheim, Cmic, Chugai, MERCK, Healios, Mitsubishi Tanabe, Rakuten Medical, IQVIA, Noile-Immune Biotech and Janssen Pharma. 7. Participation on a Data Safety Monitoring Board or Advisory Board: None. 8. Leadership or fiduciary role in other board, society, committee, advocacy group or any for-profit health care company, paid or unpaid: None. 9. Employment at any for-profit health care company: None. 10. Patents planned, issued or pending, royalties or license: None. 11. Stock or stock options: None. 12. Receipt of equipment, materials, drugs, medical writing, gifts or other services: None.