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Article History

Received: 27 September 2025

Accepted: 28 April 2026

First Online: 8 June 2026

Competing interests

: H.B. reports research funding from Ono Pharmaceutical and honoraria from Ono Pharmaceutical, Taiho Pharmaceutical and Guardant Health. J.W. reports honoraria for lectures from Johnson & Johnson, Covidien Japan, Eli Lilly, Terumo and Takeda Pharmaceutical, and research funding from Covidien Japan, Terumo and Stryker Japan, all outside the submitted work. Y.T., K.H., Y.M., M.T., D.M., A.K., M.F., I.T. and D.K. declare no competing interests. M.K. reports honoraria from Chugai Pharmaceutical, Eli Lilly Japan and Takeda Pharmaceutical. N.M. reports honoraria from multiple companies, including Abbott, Astellas, AstraZeneca, Bayer, Bristol Myers Squibb, Chugai Pharmaceutical, Daiichi Sankyo, Eisai, Eli Lilly, Guardant Health, Johnson & Johnson, Kyowa Kirin, Merck, MSD, Novartis, Ono Pharmaceutical, Taiho Pharmaceutical, Takeda Pharmaceutical and others, and research funding to the institution from Covidien Japan, Johnson & Johnson, Taiho Pharmaceutical, Terumo and others. E.O. reports research funding from Guardant Health and honoraria from Ono Pharmaceutical, Takeda Pharmaceutical, Bayer, Chugai Pharmaceutical, Taiho Pharmaceutical, Eli Lilly Japan and Bristol Myers Squibb. Y.K. reports research funding from Taiho Pharmaceutical, Ono Pharmaceutical, Chugai Pharmaceutical, Amgen, MSD, Daiichi Sankyo, Eisai, Sysmex and Takeda Pharmaceutical, and honoraria from Bayer, Chugai Pharmaceutical, Taiho Pharmaceutical, Merck, MSD, Ono Pharmaceutical, Daiichi Sankyo, Eisai, Guardant Health, Astellas and Takeda Pharmaceutical. M.S. reports honoraria from Eli Lilly, Takeda Pharmaceutical, Merck Serono, Ono Pharmaceutical and Taiho Pharmaceutical. M.T. reports research funding from Ono Pharmaceutical and Nippon Boehringer Ingelheim, and honoraria from Chugai Pharmaceutical, MSD, Taiho Pharmaceutical, Ono Pharmaceutical and Bristol Myers Squibb. K.Y. reports honoraria from Ono Pharmaceutical, Taiho Pharmaceutical, Chugai Pharmaceutical, Daiichi Sankyo, Takeda Pharmaceutical, Eli Lilly, MSD and Bristol Myers Squibb. Y.-H.L. reports honoraria from Amgen, Bayer, Bristol Myers Squibb, Merck, Ono Pharmaceutical and Takeda Pharmaceutical. K.-H.Y. reports honoraria from Amgen, AstraZeneca, Bayer, Bristol Myers Squibb, Daiichi Sankyo, MSD, Merck, Novartis, Ono Pharmaceutical, Pierre Fabre, Pfizer, Roche and Takeda Pharmaceutical. Y.W. and Y.Y. are employees of EPS Corporation. S.S., V.N.A., A.J., M.R., M.C.L. and A.A. are employees of Natera. A.S reports research funding to the institution from Taiho Pharmaceutical, Boehringer Ingelheim, Bayer, Chugai Pharmaceutical, Ono Pharmaceutical, Takeda Pharmaceutical, Pentax Medical Devices, MSD, Daiichi Sankyo/UCB Japan, Merck Pharmaceutical FerroptoCure and Shionogi Pharmaceutical, all outside the submitted work. Y.N. reports advisory roles for Guardant Health; research funding from Exact Sciences, Pfizer and Shionogi; and speaker fees from MSD, Merck Biopharma, Daiichi Sankyo, Chugai Pharmaceutical and Guardant Health Japan. Q.S. reports consulting or advisory roles for Bayer, Boehringer Ingelheim, Regeneron, Genmab, AbbVie, Exelixis and others, and research funding to the institution from Regeneron, Bristol Myers Squibb, Roche/Genentech, Janssen and Novartis. H.T. reports honoraria from Ono Pharmaceutical, Merck Biopharma, Eli Lilly Japan, Chugai Pharmaceutical and Takeda Pharmaceutical, and research funding from Takeda Pharmaceutical, Daiichi Sankyo and Ono Pharmaceutical. T.Y. reports research funding from Taiho Pharmaceutical, Ono Pharmaceutical, Chugai Pharmaceutical, MSD, Bristol Myers Squibb, Caris MPI, Daiichi Sankyo, Eisai, Exact Sciences, FALCO Biosystems, Medical & Biological Laboratories, Merus N.V., Miyarisan Pharmaceutical, Natera, Nippon Boehringer Ingelheim, Pfizer, Sysmex and Takeda Pharmaceutical; honoraria from Chugai Pharmaceutical, Merck Biopharma, Ono Pharmaceutical and Takeda Pharmaceutical; and consulting fees from Sumitomo and Indivumed. T.K. reports honoraria from Chugai Pharmaceutical, Takeda Pharmaceutical, Ono Pharmaceutical and Eli Lilly.