ESMO Open最新文献

{"title":"Precision oncology in biliary tract cancer: the emerging role of liquid biopsy","authors":"M. de Scordilli ,&nbsp;M. Bortolot ,&nbsp;S. Torresan ,&nbsp;C. Noto ,&nbsp;S. Rota ,&nbsp;P. Di Nardo ,&nbsp;A. Fumagalli ,&nbsp;M. Guardascione ,&nbsp;E. Ongaro ,&nbsp;L. Foltran ,&nbsp;F. Puglisi","doi":"10.1016/j.esmoop.2025.105079","DOIUrl":"10.1016/j.esmoop.2025.105079","url":null,"abstract":"<div><div>Liquid biopsy has already proven effective in aiding diagnosis, risk stratification and treatment personalization in several malignancies, and it could represent a practice-changing tool also in biliary tract cancer, even though clinical applications are currently still limited. It is promising for early diagnosis, especially in high-risk populations, and several studies on circulating free DNA (cfDNA), circulating tumour cells and differential microRNA (miRNA) profiles in this setting are ongoing. Circulating tumour DNA (ctDNA) also appears as a feasible noninvasive biomarker in the curative setting, in detecting minimal residual disease after resection and in monitoring disease recurrence. As of today, it can be particularly valuable in biliary tract cancer for genomic profiling, with a good concordance with tissue samples for most molecular alterations. CtDNA analysis may especially be considered in clinical practice when the tumour tissue is not sufficient for next-generation sequencing, or when urgent therapeutic decisions are needed. Moreover, it offers the possibility of providing a real-time picture to monitor treatment response and dynamically identify resistance mutations, potentially representing a way to optimize treatment strategies.</div></div>","PeriodicalId":11877,"journal":{"name":"ESMO Open","volume":"10 5","pages":"Article 105079"},"PeriodicalIF":7.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143890586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world comparison of pembrolizumab alone and combined with chemotherapy in metastatic lung adenocarcinoma patients with PD-L1 expression ≥50%","authors":"H.H. Hektoen ,&nbsp;K.M. Tsuruda ,&nbsp;O.T. Brustugun ,&nbsp;K. Neumann ,&nbsp;B.K. Andreassen","doi":"10.1016/j.esmoop.2025.105073","DOIUrl":"10.1016/j.esmoop.2025.105073","url":null,"abstract":"<div><h3>Objectives</h3><div>The frontline treatment of metastatic lung adenocarcinoma with high Programmed death-ligand 1 (PD-L1) expression (≥50%) includes immune checkpoint inhibitors (ICIs) either as monotherapy or combined with chemotherapy. The added benefit of chemotherapy in this context lacks direct comparison in head-to-head trials. We aimed to compare these two ICI treatment modalities both overall and within relevant patient subgroups in a real-world setting.</div></div><div><h3>Materials and methods</h3><div>This retrospective, nationwide study included 410 individuals diagnosed in Norway during 2017 to 2021 with stage IV non-small-cell lung adenocarcinoma, PD-L1 expression ≥50%, and treated first line with the ICI pembrolizumab, either as monotherapy (<em>n</em> = 317) or in combination with platinum-based chemotherapy (<em>n</em> = 93). We analyzed early (6-month) and overall (3-year) risk of death after treatment initiation using Cox regression, adjusted for and stratified by sex, age, stage, PD-L1 expression, performance status, and education.</div></div><div><h3>Results</h3><div>Patients treated with combination therapy had a higher median overall survival compared with monotherapy (22.6 months versus 14.2 months), and reduced risk of overall death, although not statistically significant after adjustment [hazard ratio (HR) 0.74, 95% confidence interval (CI) 0.54-1.00]. However, the risk of early death was significantly lower in patients receiving combination therapy, even after adjustment (HR 0.41, 95% CI 0.23-0.76). Across most subgroups, patients receiving combination therapy had comparable or superior survival outcomes relative to those receiving monotherapy. Particularly noteworthy were the observed benefits from combination therapy over monotherapy among females, individuals with stage IVB disease, and those with PD-L1 expression exceeding 75%.</div></div><div><h3>Conclusion</h3><div>Our real-world study demonstrates that combination therapy with ICI and chemotherapy provides superior early survival benefits over monotherapy in PD-L1-high patients. Additionally, certain subgroups showed enhanced overall survival. These findings challenge current treatment practices and underscore the need for further validation to optimize patient selection for monotherapy versus combination therapy, in particular to reassess the role of PD-L1 in treatment decisions.</div></div>","PeriodicalId":11877,"journal":{"name":"ESMO Open","volume":"10 5","pages":"Article 105073"},"PeriodicalIF":7.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143886248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter re: The prognostic and predictive value of the luminal-like subtype in hormone receptor-positive breast cancer: an analysis of the DATA trial","authors":"Arif Hakan Önder","doi":"10.1016/j.esmoop.2025.105066","DOIUrl":"10.1016/j.esmoop.2025.105066","url":null,"abstract":"","PeriodicalId":11877,"journal":{"name":"ESMO Open","volume":"10 5","pages":"Article 105066"},"PeriodicalIF":7.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143890584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A phase II study of monalizumab and durvalumab in patients with recurrent/metastatic squamous cell carcinoma of the head and neck: results of the I2 cohort of the EORTC-HNCG-1559 trial (UPSTREAM)","authors":"R. Galot ,&nbsp;C. Le Tourneau ,&nbsp;L. Licitra ,&nbsp;J. Guigay ,&nbsp;A. Kong ,&nbsp;I. Tinhofer ,&nbsp;C. Even ,&nbsp;A. Daste ,&nbsp;S. Henry ,&nbsp;C. Borel ,&nbsp;C. Abdeddaim ,&nbsp;E. Seront ,&nbsp;J.B. Prevost ,&nbsp;A. Rutten ,&nbsp;E. Saada-Bouzid ,&nbsp;F. Rolland ,&nbsp;P. Bonomo ,&nbsp;M. Rasschaert ,&nbsp;L. Dirix ,&nbsp;C. Olungu ,&nbsp;J.P. Machiels","doi":"10.1016/j.esmoop.2025.104554","DOIUrl":"10.1016/j.esmoop.2025.104554","url":null,"abstract":"<div><h3>Background</h3><div>Monalizumab (M), targeting the natural killer group 2A (NKG2A) receptor, has limited activity as monotherapy in recurrent/metastatic (R/M) squamous cell carcinoma of the head and neck (SCCHN). Preliminary data of M and durvalumab (D) have shown encouraging activity in other tumor types.</div></div><div><h3>Patients and methods</h3><div>The UPSTREAM trial was an umbrella trial of targeted therapies and immunotherapy for R/M SCCHN. The immunotherapy 2 (I2) cohort was a phase II, randomized, open-label substudy evaluating the efficacy of D + M versus physician’s choice (control). Patients non-eligible for the biomarker-driven cohorts and pretreated with PD(L)1, were included in the I2 cohort. The primary endpoint was the objective response rate (RECIST version 1.1) during the first 16 weeks.</div></div><div><h3>Results</h3><div>Sixty-six patients with R/M SCCHN were included in the I2 cohort, of whom 60 were assessable (D + M: <em>n</em> = 42, control: <em>n</em> = 18): median age 62 years; 87% with two or three previous lines of treatment. In the D + M arm, one partial response (PR) was recorded, and stable disease (SD) was observed in 11 (26%). One PR was reported in the control arm and SD in 8 (44%). The median progression-free survival (PFS) was 2.0 and 3.1 months in the D + M arm and control arm, respectively. The median overall survival (OS) was 4.3 months (95% confidence interval 3.3-8.9 months) and 8.0 months (95% confidence interval 3.1-14.9 months) in the D + M and control arms, respectively. In the D + M arm, 4 (9%) patients reported grade ≥3 treatment-related adverse events.</div></div><div><h3>Conclusion</h3><div>The I2 substudy failed to demonstrate an activity of D + M in heavily pretreated patients with SCCHN previously exposed to anti-PD(L)1. No benefit was seen in PFS and OS.</div></div>","PeriodicalId":11877,"journal":{"name":"ESMO Open","volume":"10 5","pages":"Article 104554"},"PeriodicalIF":7.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143890585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter re: Prognosis, clinicopathological characteristics, and treatment patterns of patients with ER-intermediate-positive breast cancer undergoing long-term follow-up","authors":"H.G. Güzel,&nbsp;A.H. Önder","doi":"10.1016/j.esmoop.2025.105111","DOIUrl":"10.1016/j.esmoop.2025.105111","url":null,"abstract":"","PeriodicalId":11877,"journal":{"name":"ESMO Open","volume":"10 5","pages":"Article 105111"},"PeriodicalIF":7.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143890583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Refining prognostic tools for luminal breast cancer: genetic insights and comprehensive analysis","authors":"L.A. Sinberger ,&nbsp;T. Zahavi ,&nbsp;N. Keren-Khadmy ,&nbsp;Y. Dugach ,&nbsp;A. Sonnenblick ,&nbsp;M. Salmon-Divon","doi":"10.1016/j.esmoop.2025.105080","DOIUrl":"10.1016/j.esmoop.2025.105080","url":null,"abstract":"<div><h3>Background</h3><div>Luminal breast cancer (BC) is generally associated with a lower risk of recurrence compared with other subtypes. However, patients with luminal BC can still experience recurrence, which remains a significant concern and contributes to BC-related mortality. Current clinical practice for recurrence risk prognosis relies on prognostic tests based on tumor gene expression profiles.</div></div><div><h3>Materials and methods</h3><div>In this study, we aimed to investigate the association between different genetic alterations with the likelihood of recurrence and gene expression prognostic prediction (Oncotype DX®, MammaPrint®, and PAM50-ROR) in luminal BC patients. We constructed three transcriptome-based predictive models, based on these widely used clinical tests, to evaluate the recurrence risk of patients with luminal BC, using RNA-seq data from 1527 samples across 11 datasets. We further classified 1780 patients from the TCGA and METABRIC datasets into risk groups and detected distinct recurrence risk patterns.</div></div><div><h3>Results</h3><div>Our analysis revealed that low-risk groups had higher frequencies of mutations in <em>PIK3CA</em>, <em>MAP3K1</em>, <em>CDH1</em>, <em>KMT2C</em>, and <em>CBFB</em>, as well as co-mutations in <em>PIK3CA</em>-<em>MAP3K1</em>, <em>PIK3CA</em>-<em>CBFB</em>, and <em>KMT2C</em>-<em>MAP3K1</em>. In contrast, high-risk groups showed enrichment of <em>TP53</em>, <em>RB1</em>, and <em>PTPN22</em> mutations compared with the whole cohort, with notable co-mutations in <em>TP</em><em>53</em>-<em>PIK</em><em>3CA</em> and <em>TP</em><em>53</em>-<em>KMT</em><em>2C</em>. Furthermore, mutations in <em>TP53</em> and <em>BRCA2</em>, and deletions in the 7p22.3 region were at least threefold more frequent in high-risk patients compared with low-risk patients. Using an independent dataset, we validated our finding of higher frequency of <em>BRCA2</em> mutations in Oncotype DX® high-risk patients. Notably, <em>PIK3CA</em> mutations had an unexpected negative impact on recurrence and survival among high-risk patients.</div></div><div><h3>Conclusion</h3><div>Our study reveals key genetic factors associated with recurrence risk in luminal BC. Identifying these mutations and copy number alterations provides a basis for refined prognostic models and suggests avenues for further research, potentially improving treatment strategies and follow-up care for patients with luminal BC.</div></div>","PeriodicalId":11877,"journal":{"name":"ESMO Open","volume":"10 5","pages":"Article 105080"},"PeriodicalIF":7.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143886247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extended adjuvant endocrine therapy in early breast cancer: finding the individual balance","authors":"S. Lobo-Martins ,&nbsp;L. Arecco ,&nbsp;T.P. Cabral ,&nbsp;E. Agostinetto ,&nbsp;C. Dauccia ,&nbsp;M.A. Franzoi ,&nbsp;L. del Mastro ,&nbsp;M. Lambertini ,&nbsp;M. Piccart ,&nbsp;E. de Azambuja","doi":"10.1016/j.esmoop.2025.105057","DOIUrl":"10.1016/j.esmoop.2025.105057","url":null,"abstract":"<div><div>Endocrine therapy (ET) is a cornerstone in the management of patients with hormone receptor-positive early breast cancer, which accounts for over 70% of cases worldwide. The efficacy of adjuvant ET for 5 years in reducing the risk of recurrence and improving survival outcomes is well documented. However, the risk for late relapses, occurring &gt;5 years after initial treatment, has prompted exploration of longer treatment durations. Extending ET beyond the traditional 5-year period offers additional benefit in reducing the risk of recurrence and improving long-term outcomes. Nevertheless, determining the optimal duration and identifying suitable candidates for extended therapy is often nuanced. This review aims to comprehensively evaluate the current landscape of extended ET in breast cancer management. It provides an overview of the rationale behind extending endocrine treatment in both premenopausal and postmenopausal women, with a focus on clinical trials and observational studies supporting extended therapy. Furthermore, it emphasizes the significance of considering associated toxicities in patient management. It also explores novel strategies involving the combination of ET with new drugs, leading to an evolution of treatment paradigms that may make the need for extended therapy obsolete.</div></div>","PeriodicalId":11877,"journal":{"name":"ESMO Open","volume":"10 5","pages":"Article 105057"},"PeriodicalIF":7.1,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143864917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Olaparib as a rescue treatment in platinum-refractory germ-cell tumors: the IGG-02 phase II trial","authors":"G. Schepisi ,&nbsp;M. Urbini ,&nbsp;C. Casadei ,&nbsp;V. Gallà ,&nbsp;S. Rossetti ,&nbsp;U. Basso ,&nbsp;C. Lolli ,&nbsp;G. Gurioli ,&nbsp;E. Petracci ,&nbsp;S.C. Cecere ,&nbsp;J. Ventriglia ,&nbsp;V. Zampiga ,&nbsp;A. Miserocchi ,&nbsp;I. Cangini ,&nbsp;I. De Santis ,&nbsp;M. Di Napoli ,&nbsp;C. Menna ,&nbsp;G. Mambelli ,&nbsp;S. Pignata ,&nbsp;U. De Giorgi","doi":"10.1016/j.esmoop.2025.105056","DOIUrl":"10.1016/j.esmoop.2025.105056","url":null,"abstract":"<div><h3>Background</h3><div>Therapeutic options for patients with advanced germ-cell tumors (GCTs) after multiple relapses or resistant disease are limited. Olaparib is an inhibitor of poly (ADP-ribose) polymerase (PARP), an enzyme involved in DNA repair.</div></div><div><h3>Patients and methods</h3><div>In this proof-of principle open-label, single-arm, phase II trial of olaparib 300 mg twice daily in patients with relapsed/refractory metastatic germ-cell cancer [IGG-02 study (NCT02533765)], patient eligibility included failure after high-dose chemotherapy or after at least two different cisplatin-based regimens.</div></div><div><h3>Results</h3><div>Between September 2015 and February 2019, 18 patients, with a median age of 39 years (range 22-61 years) were enrolled. Severe adverse events (AEs) were observed in seven patients. There were no partial responses, five cases (27.8%) with stable disease (SD) lasting 3, 4, 4, 7 and 43 months, and 13 (72.2%) progressive disease. A germline DNA repair profile panel showed only a BRCA1-mutated case associated with an SD lasting for 4 months. The long-lasting patient on olaparib (43 months) experienced a myelodisplastic syndrome (MDS) associated with the onset of a pathogenic mutation affecting PPM1D.</div></div><div><h3>Conclusions</h3><div>Olaparib as a single agent demonstrated no activity in heavily pretreated GCT patients. Future studies with PARP inhibitors should be planned in less-pretreated GCT patients based on molecular analysis to support better patient selection.</div></div>","PeriodicalId":11877,"journal":{"name":"ESMO Open","volume":"10 5","pages":"Article 105056"},"PeriodicalIF":7.1,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143864916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tumor-informed ctDNA assay to predict recurrence in locally advanced squamous-cell carcinoma of the head and neck (SCCHN)","authors":"N. Honoré ,&nbsp;G. Laliotis ,&nbsp;V. Aushev ,&nbsp;S. Velichko ,&nbsp;C. Palsuledesai ,&nbsp;H. Dahou ,&nbsp;C. van Marcke ,&nbsp;R. Galot ,&nbsp;M. Liu ,&nbsp;J-P.H. Machiels","doi":"10.1016/j.esmoop.2025.104534","DOIUrl":"10.1016/j.esmoop.2025.104534","url":null,"abstract":"<div><h3>Background</h3><div>Despite multimodal treatment, locally advanced (LA) squamous-cell carcinoma of the head and neck (SCCHN) has a recurrence rate of ∼50%. Circulating tumor DNA (ctDNA) has emerged as a potential biomarker for minimal residual disease detection after curative-intent treatment. This strategy could be used to identify the patients at greater risk of recurrence, for whom extended or intensified therapy and/or surveillance imaging may be considered.</div></div><div><h3>Materials and methods</h3><div>A personalized, tumor-informed 16-plex multiplex PCR-next-generation sequencing assay was used for the detection of ctDNA in banked plasma samples collected pre-treatment (baseline time point) and within 12 weeks from the end of curative-intent treatment (post-treatment time point). The primary and secondary endpoints were recurrence-free-survival (RFS) and overall survival (OS) of post-treatment ctDNA-positive and -negative patients, respectively.</div></div><div><h3>Results</h3><div>Out of a cohort of 50 patients with LA SCCHN, personalized ctDNA assays were successfully designed for 43 patients. Among these 43 patients, ctDNA was detected in 42 of 43 (97.6%) patients at baseline. At the post-treatment time point, ctDNA was detected in 4 of 42 (9.5%) patients, 3 of whom relapsed. Of the 43 patients, 11 (26%) experienced disease recurrence within 2 years of follow-up. Patients with post-treatment ctDNA positivity demonstrated a significantly inferior RFS and OS (<em>P</em> ≤ 0.05), compared with ctDNA-negative patients. The median lead time for ctDNA positivity over clinical recurrence was 7.0 months (range 3.6-7.1 months).</div></div><div><h3>Conclusions</h3><div>The personalized, tumor-informed assay detected pre-treatment ctDNA in the majority of the patients with LA SCCHN. ctDNA positivity within 12 weeks of completing curative-intent treatment was predictive of worse RFS and OS. These results support studies to assess the value of longitudinal testing for surveillance and may open the path to initiating treatment upon molecular recurrence in patients with LA SCCHN.</div></div>","PeriodicalId":11877,"journal":{"name":"ESMO Open","volume":"10 5","pages":"Article 104534"},"PeriodicalIF":7.1,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143864915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to letter re: The prognostic and predictive value of the luminal-like subtype in hormone receptor-positive breast cancer: an analysis of the DATA trial","authors":"S.W.M. Lammers,&nbsp;V.C.G. Tjan-Heijnen,&nbsp;S.M.E. Geurts,&nbsp;I.J.H. Vriens","doi":"10.1016/j.esmoop.2025.105068","DOIUrl":"10.1016/j.esmoop.2025.105068","url":null,"abstract":"","PeriodicalId":11877,"journal":{"name":"ESMO Open","volume":"10 5","pages":"Article 105068"},"PeriodicalIF":7.1,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143839353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}