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Article History

Received: 7 November 2025

Revised: 18 April 2026

Accepted: 2 June 2026

First Online: 18 July 2026

Ethics

Competing interests: Tommaso Bosetti and Oliver Kennedy : The authors declare no conflict of interest. Raffaele Califano Stock and Other Ownership Interests - The Christie Private Care. Honoraria - AstraZeneca; Boehringer Ingelheim; Bristol Myers Squibb Foundation; Janssen; Lilly; MSD; Novartis; Pfizer; Roche; Takeda. Consulting or Advisory Role - AstraZeneca; Boehringer Ingelheim; Bristol Myers. Squibb Foundation; Lilly; MSD; Novartis; Pfizer; Roche; Takeda. Speakers’ Bureau - AstraZeneca; Bristol Myers Squibb Foundation; MSD; Novartis; Pfizer; Roche; Takeda. Research Funding - Abbvie; AstraZeneca; Bristol Myers Squibb Foundation; Clovis Oncology; Lilly; MSD; Novartis; Pfizer; Roche; Takeda. Travel, Accommodations, Expenses - Lilly; MSD; Roche; Takeda. Tom Waddell Stock and Other Ownership Interests - The Christie Clinic LLP. Honoraria - Bristol-Myers Squibb; EUSA Pharma; Ipsen; Pfizer. Consulting or Advisory Role - Eisai Europe; Ipsen; Merck; Merck Sharp & Dohme; Pfizer. Research Funding - Bristol-Myers Squibb (Inst); Eisai (Inst); Ipsen (Inst); Merck. Sharp & Dohme (Inst); Pfizer (Inst); Roche (Inst). Travel, Accommodations, Expenses - Bristol-Myers Squibb; EUSA Pharma; Ipsen. Robert Metcalf Consulting or Advisory Role - Avacta Life Sciences. Sophia Kreft Travel, Accommodations, Expenses - Kyowa Kirin International. Rebecca Lee Honoraria - Pierre Fabre. Research Funding - AstraZeneca (Inst); Bristol Myers Squibb Foundation (Inst); Pierre Fabre (Inst). Paul Lorigan Stock and Other Ownership Interests - Supportive Care; The Christie Private Care. Honoraria - BMS; Iovance Biotherapeutics; MLA Dx. Consulting or Advisory Role - Bristol-Myers Squibb; Iovance Biotherapeutics; Merck Sharp & Dohme; NeraCare GmbH. Speakers’ Bureau - Bristol-Myers Squibb. Research Funding - BMS (Inst); Pierre Fabre (Inst). Travel, Accommodations, Expenses - Bristol-Myers Squibb; Merck Sharp & Dohme.

Ethics approval and consent to participate: This study was performed in accordance with the Declaration of Helsinki. The study was approved by the Quality Improvement and Clinical Audit Committee at The Christie NHS Foundation Trust (project approval number: reference 4191). As no patient identifiable data was included in the analysis, individual patient consent was not required for this study.