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Article History

Received: 8 January 2025

Accepted: 22 August 2025

First Online: 6 September 2025

Declarations

:

: Giulia Cursa from Veracyte. Antonio Marra has received support from Menarini Group and served on the speakers’ bureau for Roche and AstraZeneca. Carmen Criscitiello has participated in advisory or consultancy roles and speakers’ bureau engagements for Eli Lilly, Pfizer, Novartis, Roche, AstraZeneca, MSD, Daiichi Sankyo, Gilead, and Seagen. Giuseppe Curi has received honoraria for speaker engagements from Roche, Seattle Genetics, Novartis, Lilly, Pfizer, Foundation Medicine, NanoString, Samsung, Celltrion, BMS, and MSD; honoraria for consultancy from Roche, Seattle Genetics, and NanoString; honoraria for participation in advisory boards from Roche, Lilly, Pfizer, Foundation Medicine, Samsung, Celltrion, and Mylan; honoraria for writing engagements from Novartis and BMS; and honoraria for participation in the Ellipsis Scientific Affairs Group. He has also received institutional research funding for conducting phase I and II clinical trials from Pfizer, Roche, Novartis, Sanofi, Celgene, Servier, Orion, AstraZeneca, Seattle Genetics, AbbVie, Tesaro, BMS, Merck Serono, Merck Sharp & Dohme, Janssen-Cilag, Philogen, Bayer, Medivation, and Medimmune. Konstantinos Venetis has received honoraria for speakers’ bureau participation from Merck Sharp & Dohme (MSD), Roche, and AstraZeneca. Elena Guerini Rocco has received advisory fees, honoraria, travel accommodations/expenses, grants, and/or non-financial support from AstraZeneca, Exact Sciences, GSK, Illumina, MSD, Novartis, Roche, and Thermo Fisher Scientific. Nicola Fusco has received honoraria for consulting, advisory roles, speakers’ bureau participation, travel, and/or research grants from Merck Sharp & Dohme (MSD), Merck, Novartis, AstraZeneca, Roche, Menarini Group, Daiichi Sankyo, GlaxoSmithKline (GSK), Gilead, Sysmex, Veracyte Inc., Sakura, Leica Biosystems, Lilly, Pfizer, and AbbVie. These companies had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, and/or in the decision to publish the results. Alberto Concardi, Mariia Ivanova, Chiara Frascarelli, Eltjona Mane, Elisa Mangione, Stefano Santaguida, Daniela Tosoni, Salvatore Pece, Antonio Marra, and Giuseppe Viale have no conflicts of interest that are directly relevant to the content of this article.

: This study was conducted in accordance with ethical guidelines and approved by the local ethics committee (approval number #UID3472). Informed consent was obtained from all patients for the use of tissue samples. All patient information was pseudoanonymized in compliance with the European Union’s General Data Protection Regulation.

: Not applicable.

: Not applicable.

: All data generated or analyzed during this study are included in this published article.

: Not applicable.

: GC: writing (original draft), methodology. AC: writing (original draft), methodology. MI: writing (original draft), software, methodology. CF: writing (review and editing), methodology, statistical analyses. Eltjona Mane: writing (review and editing), methodology. Elisa Mangione: writing (review and editing). SS: writing (review and editing). DT: writing (review and editing). SP: writing (review and editing). AM: writing (review and editing). CC: writing (review and editing). GC: writing (review and editing). KV: writing (review and editing), project administration. EG-R: writing (review and editing), methodology. NF: writing (review and editing), project administration, conceptualization.