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Article History

Received: 27 January 2026

Accepted: 27 February 2026

First Online: 4 March 2026

Declarations

:

: The protocol was approved by the Ethics Review Committee of Keio University Hospital in May 2019, and similar approvals were obtained from all other participating institutions. This study has been conducted in accordance with the principles outlined in the Declaration of Helsinki, guidelines for the conduct of clinical trials, and the SPIRIT (Standard Protocol Items for Intervention Trials) guidelines. All patients provided written informed consent prior to participation.

: The manuscript contains no images, videos, or other information that could identify individual participants; therefore, consent for publication was not required.

: YN (during the past 3 years) received speaking fees from Ono Pharmaceutical and Maruho Co., Ltd. NY (during the past 3 years) received honoraria for invited lectures from Bristol Myers Squibb, Takeda Pharmaceuticals, Incyte Biosciences, Chugai Pharmaceutical, MSD, Novartis, and Ono Pharmaceutical; served on advisory boards for Chugai Pharmaceutical, MSD, and Ono Pharmaceutical; and received institutional research grants from Astellas Amgen Biopharma, Bristol Myers Squibb Japan, Merck Serono, Novartis, Ono Pharmaceutical, Takara Bio, MSD, and GlaxoSmithKline. KN received honoraria from Ono Pharmaceutical, Novartis, Bristol-Myers Squibb, and MSD, and served on an advisory board for Novartis, MSD, Rakuten Medical, and Chugai Pharmaceutical, and received institutional research grants from Novartis, Bristol-Myers Squibb, GlaxoSmithKline, PAREXEL International, Takara Bio, MSD, and Chugai Pharmaceutical. TT (during the past 3 years) received speaking fees from Ono Pharmaceutical.SY (during the past 3 years) received speaking fees from AstraZeneca and Janssen Pharmaceutical K.K.; and received advisory fees from Mochida Pharmaceutical Co., Ltd and SBI Pharmaceuticals Co., Ltd. Taku F (during the past 3 years) received speaking fees from Ono Pharmaceutical, Novartis,　BMS, MSD, Maruho, Minophagen Pharmaceutical, Esai, Sun Pharmaceutical, and Daiichi-Sankyo. AO (during the past 3 years) received speaking fees from Sanofi, Eli Lilly, Abbvie, LEO Pharma, Ono Pharmaceutical, Novartis,　BMS, MSD, Maruho, and Kyowa Kirin International. Takeru F (during the past 3 years) received speaking fees from Ono Pharmaceutical, Novartis, BMS, MSD, Maruho, and Kyowa Kirin International; and received an institutional grant from Ono Pharmaceutical. All remaining authors have declared no conflicts of interest.