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Article History

Received: 15 December 2025

Revised: 22 April 2026

Accepted: 22 May 2026

First Online: 4 June 2026

Competing interests

: TRJE has received travel expenses from Bristol-Myers Squibb, Merck Sharp & Dohme, Pierre Fabre, Eisai, Nucana, Roche; institution received consulting fees and/or speaker fees/honoraria and/or research funding from Karus Therapeutics, Eisai, Bristol-Myers Squibb, Merck Sharp & Dohme, United Medical, Nucana, Roche/Genentech, Ascelia, AstraZeneca, Bicycle Therapeutics, Medivir, Seagen, CV6 Therapeutics, Ewopharma, iOnctura, Beigene, Basilea, Celgene, MiNA Therapeutics, Lilly, Merck Serono, Janssen, Johnson & Johnson, Verastem, Novartis, Iovance Biotherapeutics, Sanofi/Aventis, Clovis Oncology, Plexxikon, Sierra Pharma, GlaxoSmithKline, Halozyme, CytomX Therapeutics, Vertex, Athenex, Adaptimmune, Immunocore, Modulate Pharma, Berg, Starpharma, BiolineRx, UCB, Sapience Therapeutics, Astellas Pharma, Boehringer Ingelheim, Avacta Life Sciences, Nurix, Codiak BioSciences, T3 Pharmaceuticals, BioNTech, Moderna Therapeutics, Exelixis, Exscientia, Bayer, Amgen, Sotio, Pfizer; institution received honoraria from Genmab for Chair of Independent Data Monitoring Committee for a Phase 1 trial. He is also Editor-in-Chief of the British Journal of Cancer . NC has received consulting fees from Roche Pharmaceuticals, Servier and REDX Pharmaceuticals; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Roche Pharmaceuticals; support for attending meetings and/or travel from Roche Pharmaceuticals; research funding to research team from AstraZeneca, Orion, F. Hoffmann-La Roche Ltd, Taiho, Novartis, Starpharma, Bayer, Eisai, UCB, RedX Pharmaceuticals, LOXO-oncology, Avacta, Boehringer Ingelheim, Merck and Tarveda Therapeutics; participated in data safety monitoring board or advisory board at Roche Pharmaceuticals and Cancer Research UK. AE-K received support from Eisai for preparation of this manuscript; institutional grants from AstraZeneca, Astex, Auransa, and Fulgent; consulting fees from AbbVie, AstraZeneca, BMS, Eisai, Elevar, Exelixis, Jansen, Jazz Pharmaceuticals, Merck, Qurient, Roche/Genentech, and Terumo; honoraria from Daichi Sankyo; support for attending events/travel from Affimed; support for participation on an Advisory Board from Qurient; and served (unpaid) as a part of the Association of American Cancer Institutes Clinical Research Innovation Steering Committee. DJP received lecture fees from ViiV Healthcare, Bayer Healthcare, BMS, Roche, Eisai, Falk Foundation, travel expenses from BMS and Bayer Healthcare; consulting fees for Mina Therapeutics, EISAI, Roche, DaVolterra, Parabilis Medicines, Boston Scientific, GreyWolf, Mursla, Exact Sciences and AstraZeneca; research funding (to institution) from MSD and BMS. NHT has served as a consultant on advisory boards, received research funding, or paid presentations from the following entities (all paid directly to the Mayo Clinic Foundation): AstraZeneca, Exelixis, DAVA Oncology, Elevar Therapeutics, EXACT SCIENCES, Genentech, Ipsen, MD Outlook, QED/Helsinn Therapeutics. DH has nothing to disclose. EM received payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from AbbVie, Eli Lilly, Gilead, Ipsen, Madrigal, and Novo Nordisk, and participated in data safety monitoring board or advisory board at Eli Lilly, Gilead, Ipsen, and Novo Nordisk. TM has served on advisory boards for Roche, AstraZeneca, Guerbet, Ipsen, GreyWolf, Signant Health, Parabilis Medicines, and has Institutional research grants from MSD, Bayer, and Boston Scientific. JW is an employee of Eisai Inc. SMP is an employee of Eisai Ltd. CP is an employee of Eisai Inc. LD is an employee of Eisai Inc. CEO is an employee of Eisai Ltd. JSL received research grant funding to institution from Roche-Genentech, Basilea, Astex, Taiho, Verastem and Janssen; sits on advisory boards for Roche-Genentech, Basilea, Servier, GSK, Ellipses Pharma; is a member of IDMC for Servier and Ascencion Therapeutics; and is co-chair of the Tessa Jowell Brain Tumour Novel Therapeutic Accelerator, advising numerous industry partners as part of the Accelerator.

: The protocol, informed consent form, and appropriate related documents were reviewed and approved by all the applicable local institutional review boards. This study was conducted in accordance with the standard operating procedures of the sponsor, which are designed to ensure adherence to guidelines as required by the Principles of the World Medical Association Declaration of Helsinki and Good Clinical Practice. All patients provided written informed consent.