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Article History

Received: 11 August 2025

Accepted: 16 February 2026

First Online: 10 March 2026

Declarations

:

: Not applicable.

: Informed consent was obtained for the publication of this case report and accompanying images.

: Y.K., K.O., H.M., GN declare no competing interests.J.T. received personal fees from AstraZeneca K.K., AbbVie G.K., Boehringer-Ingelheim Japan Inc., Bristol-Myers Squibb Co. Ltd., Chugai Pharmaceutical Co. Ltd., Daiichi Sankyo K.K., Eli Lilly Japan K.K., Janssen Pharmaceutical K.K., MSD K.K., Ono pharmaceutical Co. Ltd., Pfizer Japan Inc., Takeda Pharmaceuticals., and Taiho Pharmaceutical Co. Ltd. outside the submitted work.H.K. reports personal fees from AstraZeneca KK, Chugai Pharmaceutical Co. Ltd., Novartis Pharmaceuticals K.K., Takeda Pharmaceutical Company Limited, MSD K.K., and Daiichi Sankyo K.K. Pfizer Japan Inc. outside the submitted work.T.T. reports personal fees from AstraZeneca K.K, Chugai Pharmaceutical Co. Ltd., Daiichi Sankyo Co., Ltd., Eli Lilly Japan K.K., MSD K.K., Novartis Pharma K.K., Takeda Pharmaceutical Co., Ltd., Pfizer R&D Japan G.K.K.T. reports personal fees from AstraZeneca K.K., Chugai Pharmaceutical Co. Ltd., Eisai K.K., Novartis Pharmaceuticals K.K., Ono Pharmaceutical Co. Ltd., Takeda Pharmaceutical Company Limited, Kyowa-Kirin K.K., MSD K.K., and Bristol-Myers Squibb Co. Ltd. outside the submitted work.H.H. received personal fees from Ono Pharmaceutical Co., Ltd., Eli Lilly Japan K.K., AstraZeneca K.K., Bristol-Myers Squibb Company, MSD K.K., Takeda Pharmaceutical Co., Ltd., Sysmex Corporation, Novartis Pharma K.K., Nippon Boehringer Ingelheim Co., Ltd., Pfizer Japan Inc., AbbVie Inc., Chugai Pharmaceutical Co., Ltd., Kyowa Kirin Co., Ltd., Amgen Inc., and Reno. Medical K.K., Eisai Co., Ltd., Nippon Kayaku Co., Ltd., Janssen Pharmaceutical K.K., Hisamitsu Pharmaceutical Co., Inc., Care Net, Inc., Novocure K.K., Taiho Pharmaceutical Co., Ltd., Merck Biopharma Co., Ltd., Daiichi Sankyo Co., Ltd., 3H Clinical Trial Inc., Guardant Health Japan Corp, Ishiyaku Publishers,Inc., Medical Review Co., Ltd., reports grants or contracts from IQVIA Services JAPAN K.K., Eisai Co., Ltd., SYNEOS HEALTH CLINICAL K.K., Shionogi & Co., Ltd., EP-CRSU CO., LTD., Nippon Kayaku Co.,Ltd., EPS Corporation., GlaxoSmithKline K.K., Otsuka Pharmaceutical Co., Ltd., Sanofi K.K., Takeda Pharmaceutical Co.,Ltd., Taiho Pharmaceutical Co.,Ltd., MSD K.K., Bristol-Myers Squibb Company, Amgen Inc., SRL Medisearch Inc., Chugai Pharmaceutical Co.,Ltd., PRA Health Sciences Inc., Nippon Boehringer Ingelheim Co.,Ltd., CMIC CO., Ltd., Janssen Pharmaceutical K.K., Pfizer R&D Japan G.K., Astellas Pharma Inc., Ascent Development Services, Labcorp Development Japan K.K., Eisai Inc., Kobayashi Pharmaceutical Co., Ltd.,Bayer Yakuhin, Ltd, Pfizer Japan Inc., AstraZeneca K.K., AbbVie Inc., Daiichi Sankyo Co., Ltd., A2 Healthcare Corp., Novartis Pharma K.K., Eli Lilly Japan K.K., Merck Biopharma Co., Ltd, Kyowa Kirin Co.,Ltd., Medpace Japan KK., Sysmex Corporation., ICON Japan K.K., Clinical Research Support Center Kyushu PPD-SNBL K.K., Kyushu Study group of Clinical Cancer., Mochida Pharmaceutical Co., Ltd., Public Health Research Foundation.,Japanese Gastric Cancer Association, Thoracic Oncology Research Group, West Japan Oncology Group, Japan Clinical Cancer Research Organization, Comprehensive Support Project for Oncological Research of Breast Cancer.