JCO precision oncology最新文献

{"title":"Genomic Risk Classifiers in Localized Prostate Cancer: Precise but Not Standardized.","authors":"Vitor Góes, Yu Jun Li, Alexander Chehrazi-Raffle","doi":"10.1200/PO-25-00690","DOIUrl":"https://doi.org/10.1200/PO-25-00690","url":null,"abstract":"","PeriodicalId":14797,"journal":{"name":"JCO precision oncology","volume":"9 ","pages":"e2500690"},"PeriodicalIF":5.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033254","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":"Genomic Biomarker for Prostate Cancer Focal Therapy: Post Hoc Assessment of a Phase II Clinical Trial.","authors":"Adam B Weiner, James A Proudfoot, Mamdouh Aker, Michelle Cardenas, Samantha Gonzalez, Eileen Kelly, Elai Davicioni, Anthony E Sisk, Wayne G Brisbane, Leonard S Marks","doi":"10.1200/PO-25-00535","DOIUrl":"10.1200/PO-25-00535","url":null,"abstract":"<p><strong>Purpose: </strong>A biomarker to help predict outcomes after prostate cancer (PCa) focal therapy would be of considerable interest. We sought to assess the association between treatment failure after focal therapy and the Decipher score, a tumor-based genomic classifier (GC).</p><p><strong>Materials and methods: </strong>We performed a post hoc analysis of a single-center phase II trial (ClinicalTrials.gov identifier: NCT03503643) in which patients with unilateral grade group (GG) 2-4 PCa (n = 108) underwent hemigland cryoablation of the prostate (2017-2021; n = 108). Pretreatment biopsy tissue was subjected to transcriptomic profiling to generate GC scores. The primary outcome was the association between GC-low (<0.45) versus GC-high (≥0.45) and in-field recurrence (GG ≥2) on magnetic resonance imaging-guided biopsy 6 months post-treatment, evaluated using multivariable logistic regression.</p><p><strong>Results: </strong>In the GC-high group (n = 37), treatment failure occurred in 17 patients (46%). In the GC-low group (n = 71), treatment failure occurred in 15 patients (21%). These differences were statistically significant (odds ratio [OR], 2.61 [95% CI, 1.05 to 6.51]; <i>P</i> = .04). Differences at 18 months were also significant (76% <i>v</i> 44%; OR, 3.58 [95% CI, 1.37 to 9.36], <i>P</i> = .009).</p><p><strong>Conclusion: </strong>In patients with PCa otherwise suitable for management with focal therapy, a high GC score (≥0.45) was independently associated with treatment failure. A GC score derived from diagnostic biopsy can be used to help predict focal therapy outcomes.</p>","PeriodicalId":14797,"journal":{"name":"JCO precision oncology","volume":"9 ","pages":"e2500535"},"PeriodicalIF":5.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12445177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimized Biopsy Strategy for Transition Zone Prostate Cancer With Enhanced Perilesional Sampling: A Retrospective Analysis and Clinical Trial Validation.","authors":"Xin Chen, Chen Huang, Chenchao Zhou, Yu Li, Renpeng Huang, Jie Bao, Yuxin Lin, Michael C Truß, Jianquan Hou, Yuhua Huang, Xuedong Wei","doi":"10.1200/PO-25-00468","DOIUrl":"10.1200/PO-25-00468","url":null,"abstract":"<p><strong>Purpose: </strong>Prostate biopsy (PBx) is crucial for diagnosing prostate cancer (PCa). This study aims to identify potential underdiagnosis of transition zone (TZ) PCa compared with peripheral zone (PZ) tumors and validate a novel PBx strategy to improve TZ tumor detection.</p><p><strong>Materials and methods: </strong>This study comprised two components: a retrospective analysis and a randomized clinical trial. The retrospective study included 217 patients who underwent radical prostatectomy after 8^PZ + 4^TZ + X transperineal transrectal ultrasound-magnetic resonance imaging-fusion PBx between 2018 and 2021. The clinical trial investigated biopsy efficacy in 400 patients who underwent either modified 8^PZ + 10^TZ + X PBx for the TZ lesion or 8^PZ + 4^TZ + X PBx after block random assignment between 2022 and 2023 at our center.</p><p><strong>Results: </strong>Retrospective analysis reveals identical TZ clinically significant prostate cancer (csPCa) detection rates for 8^PZ + 4^TZ + X and 4^TZ + X PBx, both of which were insufficient for detecting TZ csPCa compared with PZ tumors. Based on these findings, 8^PZ + 10^TZ + X PBx was constructed. In the trial, the 10^TZ + X and 8^PZ + 10^TZ + X PBx demonstrated identical TZ csPCa detection rates and biopsy positivity rate, outperforming the 4^TZ + X and 8^PZ + 4^TZ + X PBx without increasing complications. The self-controlled comparison showed equivalent results for 8^TZ + X and 8^PZ + 10^TZ + X PBx.</p><p><strong>Conclusion: </strong>Our study found that PZ biopsies offer no additional benefit for TZ lesion tumors, and increasing the number of cores in the TZ region can compensate for the current limitations of TZ biopsies. These findings provide potential avenues for optimizing biopsy strategies for TZ lesions.</p>","PeriodicalId":14797,"journal":{"name":"JCO precision oncology","volume":"9 ","pages":"e2500468"},"PeriodicalIF":5.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12445182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to: Germline and Somatic <i>BRCA1/2</i> Mutations in Breast Cancer Treatment Strategies.","authors":"Eric Hahnen, Jan Hauke, Karen Gelmon, Frederik Marmé, Corinna Ernst, Miguel Martin, Michael Untch, Hervé Bonnefoi, Erik Knudsen, Seock-Ah Im, Angela DeMichele, Laura Van't Veer, Sung-Bae Kim, Harry Bear, Nicole McCarthy, Kerstin Rhiem, Nicholas Turner, Agnieszka Witkiewicz, Federico Rojo, Martin Filipits, Lesley-Ann Martin, Peter A Fasching, Christian Schem, Kerstin Becker, José A García-Sáenz, Catherine M Kelly, Toralf Reimer, Masakazu Toi, Hope S Rugo, Carsten Denkert, Michael Gnant, Andreas Makris, Yuan Liu, Olga Valota, Bärbel Felder, Karsten Weber, Valentina Nekljudova, Sibylle Loibl","doi":"10.1200/PO-25-00588","DOIUrl":"10.1200/PO-25-00588","url":null,"abstract":"","PeriodicalId":14797,"journal":{"name":"JCO precision oncology","volume":"9 ","pages":"e2500588"},"PeriodicalIF":5.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954989","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":"Beyond the Score: Integrating Hypoxia Signatures Into Risk-Adapted Stereotactic Body Radiation Therapy for Early-Stage Non-Small Cell Lung Cancer.","authors":"Yaqi Luo, Ling Wang, Li Zhu, Rong Li, Xiulin Wen","doi":"10.1200/PO-25-00594","DOIUrl":"https://doi.org/10.1200/PO-25-00594","url":null,"abstract":"","PeriodicalId":14797,"journal":{"name":"JCO precision oncology","volume":"9 ","pages":"e2500594"},"PeriodicalIF":5.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091737","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":"Integrative Multi-Omics Features Stratify Metabolic and Immune Subtypes in Glioma.","authors":"Jinwei Li, Zeya Yan, Yang Zhang, Jie Hu, Xuhui Hui, Jinnan Zhang, Rui Zhang, Tao Xin, Quan Liu, Yinyan Wang","doi":"10.1200/PO-24-00928","DOIUrl":"https://doi.org/10.1200/PO-24-00928","url":null,"abstract":"<p><strong>Purpose: </strong>Gliomas are aggressive CNS tumors with significant heterogeneity, posing challenges for effective treatment. This study aims to enhance glioma classification by integrating multi-omics data, including genomics and magnetic resonance imaging (MRI)-based radiomics, focusing on metabolic and immune subtypes.</p><p><strong>Methods: </strong>Transcriptome data from 1,720 patients with glioma were analyzed to identify key prognostic factors, including 42 metabolism-related genes and 25 immune cells. A metabolism-immune classifier was developed to categorize gliomas into four subgroups: Metabolism^high/tumor microenvironment (TME)^high, Metabolism^low/TME^high, Metabolism^high/TME^low, and Metabolism^low/TME^low. Multicohort MRI radiomics combined with machine learning algorithms were used to predict these subtypes. Single-cell RNA and spatial transcriptome sequencing were used to validate subgroups' metabolic and immunological characterization.</p><p><strong>Results: </strong>The Metabolism^low/TME^low subgroup showed the best prognosis, whereas the Metabolism^high/TME^high subgroup had the worst. Machine learning models can predict glioma subtypes noninvasively based on MRI radiomics. Single-cell RNA sequencing confirmed the distinct metabolic and immune profiles of the glioma subgroups, revealing significant cellular heterogeneity within the TME.</p><p><strong>Conclusion: </strong>This study demonstrates that integrating multi-omics data with MRI radiomics provides a robust framework for glioma classification, enabling more precise and personalized treatment strategies. The findings highlight the critical role of metabolic and immune profiling in understanding glioma heterogeneity and improving clinical outcomes.</p>","PeriodicalId":14797,"journal":{"name":"JCO precision oncology","volume":"9 ","pages":"e2400928"},"PeriodicalIF":5.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145175582","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":"Clinical Utility and Prognostic Implications of Circulating Cell-Free DNA in Biliary Tract Cancer.","authors":"Darren Cowzer, Madison Darmofal, Kenneth Seier, Rohit Thummalapalli, Henry Walch, Imane El Dika, Danny N Khalil, Wungki Park, Aruj Dhyani, Amin Yaqubie, Paul Shin, Sepideh Gholami, Joseph Erinjeri, Alice C Wei, Randy Yeh, Richard K Do, Olca Basturk, Jinru Shia, Andrea Cercek, Alison Schram, Walid K Chatila, Nikolaus Schultz, Eileen M O'Reilly, Mithat Gonen, Michael F Berger, David B Solit, Ghassan K Abou-Alfa, William Jarnagin, James J Harding","doi":"10.1200/PO-25-00355","DOIUrl":"10.1200/PO-25-00355","url":null,"abstract":"<p><strong>Purpose: </strong>An estimated 25% of patients with biliary tract cancer (BTC) do not undergo genotyping, representing a missed opportunity for therapeutic targeting.</p><p><strong>Methods: </strong>Cell-free DNA (cfDNA) and matched tumor sample from patients with BTC were analyzed using targeted next-generation sequencing (NGS) assay and compared. We sought to define the molecular profile of cancer-derived cfDNA, frequency of OncoKB level 1/2 alterations, plasma:tumor genotype concordance, the prognostic impact of cfDNA, and clonal evolution after targeted therapy progression.</p><p><strong>Results: </strong>cfDNA-based genotyping was performed on 297 blood samples from 170 patients with BTC. The most frequently altered genes were <i>TP53</i> (29%), <i>FGFR2</i> (16%), <i>ARID1A</i> (13%), <i>CDKN2A</i> (11%), and <i>KRAS</i> (11%); 25% of patients had OncoKB level 1/2 alterations and 36.2% of potentially actionable alterations were detected in plasma alone. The cfDNA:tissue concordance accuracy was high (96% <i>IDH1</i>, 98% <i>BRAF</i>, 92% <i>KRAS</i> mutations, 99% <i>ERBB2</i> amplifications, and 96% <i>FGFR2</i> fusions). Detectable tumor-derived cfDNA after resection did not predict recurrence. In treatment-naïve metastatic BTC, high variant allele fraction was associated with worse progression-free survival and overall survival. <i>RAS</i> alterations not detected in samples before treatment were identified at progression in 24% of patients who received BRAF-, FGFR-, or HER2-directed therapy, identifying <i>RAS</i> alterations as a convergent mechanism of targeted therapy resistance.</p><p><strong>Conclusion: </strong>Molecular profiling of cfDNA from patients with BTC identified OncoKB level 1/2 gene alterations and putative genomic resistance mechanisms to targeted therapy. Concordance analysis suggests that cfDNA-based NGS is complementary to that of tissue-based sequencing in the identification of potentially actionable alterations.</p>","PeriodicalId":14797,"journal":{"name":"JCO precision oncology","volume":"9 ","pages":"e2500355"},"PeriodicalIF":5.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12443323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunotherapy Resistance in Lethal Prepubescent Spitz Melanoma With <i>TERT</i> Promoter Variant.","authors":"Alissa Groisser, Liny John, A Yasmine Kirkorian, Sam P Gulino, Christopher T Rossi, Pranav K Vyas, Jeffrey Gagan, Mark Raffeld, Kenneth Aldape, Frederic G Barr, Liqiang Xi, Ina Lee, Christina K Ferrone, Svetlana D Pack, Rosandra N Kaplan, Alisa M Goldstein, Raymond Barnhill, Marielle Yohe, Michael R Sargen","doi":"10.1200/PO-25-00407","DOIUrl":"10.1200/PO-25-00407","url":null,"abstract":"","PeriodicalId":14797,"journal":{"name":"JCO precision oncology","volume":"9 ","pages":"e2500407"},"PeriodicalIF":5.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12407240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Next-Generation Sequencing of Intraoperatively Acquired Cerebrospinal Fluid and Matched Tumor Tissue in Patients Undergoing Surgical Resection for Glioblastoma.","authors":"Erica L Carpenter, Jacob E Till, Dominique Ballinger, Camilla Macia, Carlos Leche, Melinda Yin, Arati S Desai, Timothy Prior, Maikel Mansour, Emily McCoy, Thara Patel, Shivani Shah, H Isaac Chen, Eric Zager, Christina Jackson, Steven Brem, Zev A Binder, Donald M O'Rourke, Nduka Amankulor, Nike Beaubier, Stephen J Bagley","doi":"10.1200/PO-25-00456","DOIUrl":"https://doi.org/10.1200/PO-25-00456","url":null,"abstract":"<p><strong>Purpose: </strong>Because of tumor heterogeneity and sampling error, next-generation sequencing (NGS) of glioblastoma (GBM) tumors may provide an incomplete picture of the somatic mutational landscape. We hypothesized that simultaneous targeted NGS of matched tumor tissue and cerebrospinal fluid (CSF), obtained during craniotomy for resection of GBM, would lead to identification of clinically relevant variants not detected by tissue NGS alone.</p><p><strong>Methods: </strong>We enrolled 50 patients undergoing resection of newly diagnosed (n = 15) or recurrent (n = 35) GBM. CSF was collected intraoperatively via the subarachnoid space (n = 25) or lateral ventricle (n = 25) and assayed by NGS using a hybrid capture liquid biopsy panel. Matched tumor tissue also underwent large panel hybrid capture NGS testing.</p><p><strong>Results: </strong>CSF samples from 28 of 50 patients (56%) passed quality control metrics. At least one CSF variant was detected in 25 of 28 patients (89%), and 22 of 28 patients had matched tissue sequencing results available. In these 22 patients (primary analysis cohort), the median number of variants detected in CSF was higher than in tissue (3 <i>v</i> 2 variants, respectively; <i>P</i> = .0035), and 15 of 22 patients (68%) had ≥1 CSF variant not detected in matched tissue, including clinically relevant alterations in <i>EGFR</i>, <i>PMS2</i>, <i>PIK3CA</i>, and <i>TP53</i>.</p><p><strong>Conclusion: </strong>The addition of intraoperatively acquired CSF liquid biopsy to tissue NGS in patients with GBM may improve detection of clinically relevant variants, potentially improving selection of patients for clinical trials.</p>","PeriodicalId":14797,"journal":{"name":"JCO precision oncology","volume":"9 ","pages":"e2500456"},"PeriodicalIF":5.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000665","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":"Longitudinal Evaluation of Circulating Tumor DNA as a Prognostic Biomarker to Detect Molecular Residual Disease in Germ Cell Tumors.","authors":"Rebecca Hassoun, Reuben Ben-David, John P Sfakianos, George Laliotis, Cherry Au, Clint Cary, Timothy A Masterson, Kevin Manage, Punashi Dutta, Neeraja Tillu, Shivaram Cumarasamy, Jennifer King, Jordan Rich, Adam Rock, Tanya Dorff, Mukti Patel, Shruti Sharma, Adam C ElNaggar, Minetta C Liu, Alan Tan, Lawrence H Einhorn, Nabil Adra, Alexander Chehrazi-Raffle","doi":"10.1200/PO-25-00176","DOIUrl":"10.1200/PO-25-00176","url":null,"abstract":"<p><strong>Purpose: </strong>Serum tumor markers (STMs), including alpha-fetoprotein (AFP) and human chorionic gonadotropin (hCG), are currently used in management of patients with germ cell tumors (GCTs). STMs in a substantial proportion of patients are normal or falsely elevated. We evaluated circulating tumor DNA (ctDNA) as a prognostic biomarker in patients with GCTs.</p><p><strong>Patients and methods: </strong>Longitudinal ctDNA testing was performed on a multi-institutional cohort of patients with GCTs using a clinically validated, personalized, tumor-informed 16-plex multiplex PCR-NGS ctDNA assay (Signatera, Natera Inc). ctDNA was evaluated preorchiectomy and during the molecular residual disease (MRD; 1-12 weeks postorchiectomy) and surveillance windows (>12 weeks postorchiectomy, after retroperitoneal lymph node dissection [RPLND], or postchemotherapy). The correlation between ctDNA status and event-free survival (EFS) was assessed.</p><p><strong>Results: </strong>ctDNA testing was performed for 74 patients (324 plasma samples) with clinical stages I to III GCTs. The median age was 34 years (IQR, 27-39), and the median follow-up was 17 months (IQR, 12-25). Disease management postorchiectomy included surveillance in 23% (17/74), RPLND in 7% (5/74), chemotherapy in 41% (30/74), and chemotherapy + RPLND in 29% (22/74) of patients. Preorchiectomy ctDNA was detectable in 14 of 15 patients. During the MRD (N = 42) and surveillance (N = 51) windows, patients who were ctDNA-positive versus ctDNA-negative showed a significantly inferior EFS during MRD (hazard ratio [HR], 5.11 [95% CI, 1.31 to 19.95]; <i>P</i> = .019) and surveillance windows (HR, 12.45 [95% CI, 4.32 to 35.85]; <i>P</i> < .0001). By contrast, elevated versus normal STM was not associated significantly with worse EFS (MRD: HR, 2.97 [95% CI, 0.68 to 13.05]; <i>P</i> = .149. surveillance: HR, 1.74 [95% CI, 0.75 to 4.02]; <i>P</i> = .194).</p><p><strong>Conclusion: </strong>Tumor-informed ctDNA analysis shows promise for MRD detection in patients with GCTs. With further study, ctDNA monitoring may be useful in clinical decision making. Larger prospective trials are planned to establish clinical utility.</p>","PeriodicalId":14797,"journal":{"name":"JCO precision oncology","volume":"9 ","pages":"e2500176"},"PeriodicalIF":5.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137756","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}