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Article History

Received: 4 December 2025

Accepted: 27 February 2026

First Online: 10 March 2026

Declarations

:

: Competing interestsShingo Hatakeyama received honoraria from Janssen Pharmaceutical K.K., Astellas Pharma Inc., AstraZeneca K.K., Ono Pharmaceutical Co., Ltd., Bayer AG, Pfizer Inc., Bristol-Myers Squibb, Merck Biopharma Co., Ltd., Kaneka Corporation, and Nipro Corporation. Hiroyuki Nishiyama received honoraria from Astellas, BMS, Janssen, MSD, Ono, and Pfizer, and a grant from Chugai and Astellas. The other authors have no conflicts of interest to declare. Tomonori Habuchi received honoraria from Janssen Pharmaceutical K.K., Nippon Kayaku Co., LTD., Takeda Pharmaceutical Company Ltd., Astellas Pharma Inc., Daiichi Sankyo Company, Ltd., AstraZeneca K.K., Sanofi S.A., Novartis Pharmaceuticals and Bayer AG. Tomonori Habuchi also received research funding supports from Mochida Pharmaceutical Co., Novartis Pharmaceuticals Co, LTD., Pharmaceuticals Co, LTD. and Sysmex Co. Wataru Obara received honoraria from Astellas Pharma Inc., AstraZeneca K.K., Ono Pharmaceutical Co., Ltd., Bristol-Myers Squibb, Merck Biopharma Co., Ltd., Takeda Pharmaceutical Company Ltd., Merck Biopharma. Norihiko Tsuchiya received honoraria from Janssen Pharmaceutical K.K., Pfizer Inc., Takeda Pharmaceutical Co. Ltd., Astellas Pharma Inc., Ono Pharmaceuticals Co., Ltd., MSD K.K., Merk & Co., Inc. Other authors have no conflicts of interest to declare.

: This retrospective, multi-institutional study was approved by the Institutional Review Boards or Ethics Committees of all participating centers, based on the central approval granted by the Ethics Committee of the Hirosaki University School of Medicine (approval number: 2023–063–1), which served as the central ethics committee for this study. The requirement for informed consent was waived by the Ethics Committee of the Hirosaki University School of Medicine due to the retrospective nature of the study, and information was disclosed to patients using an opt-out approach. All methods were performed in accordance with the relevant guidelines and regulations, including the Declaration of Helsinki and institutional policies for human research.

: The need for informed consent to participate was waived by the Institutional Review Board of the University of Tsukuba Hospital and all participating hospitals. Written informed consent was not obtained from individual patients due to the use of an opt-out approach.

: All authors approved for the publication.