JCO precision oncologyPub Date : 2025-01-01Epub Date: 2025-01-09DOI: 10.1200/PO-24-00785
Yoshiyasu Takefuji
{"title":"Addressing Bias in Feature Importance: A Hybrid Approach for Risk Prediction in Prognostic Survival Models.","authors":"Yoshiyasu Takefuji","doi":"10.1200/PO-24-00785","DOIUrl":"https://doi.org/10.1200/PO-24-00785","url":null,"abstract":"","PeriodicalId":14797,"journal":{"name":"JCO precision oncology","volume":"9 ","pages":"e2400785"},"PeriodicalIF":5.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949296","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}
JCO precision oncologyPub Date : 2025-01-01Epub Date: 2025-01-31DOI: 10.1200/PO-24-00380
Nam Nguyen-Hoang, Yaping Liu, N Lynn Henry, Manjunath P Pai, Hao-Jie Zhu, Daniel L Hertz
{"title":"Quantitation of Plasma Proteins to Predict Taxane-Induced Peripheral Neuropathy.","authors":"Nam Nguyen-Hoang, Yaping Liu, N Lynn Henry, Manjunath P Pai, Hao-Jie Zhu, Daniel L Hertz","doi":"10.1200/PO-24-00380","DOIUrl":"10.1200/PO-24-00380","url":null,"abstract":"<p><strong>Purpose: </strong>Taxane-induced peripheral neuropathy (TIPN) is a dose-limiting toxicity of paclitaxel in patients with cancer. TIPN prediction is challenging although patients with higher systemic paclitaxel exposure have higher TIPN risk. This study aimed to identify protein predictors of TIPN and paclitaxel pharmacokinetics (PK).</p><p><strong>Methods: </strong>This is a retrospective analysis of a prospective study of females with early-stage breast cancer receiving weekly paclitaxel. TIPN was assessed using the sensory subscale of the European Organisation for Research and Treatment of Cancer QLQ-Chemotherapy-Induced Peripheral Neuropathy (CIPN)20 (CIPN8). A blood sample was collected within 10 minutes before the end of the first paclitaxel infusion to measure plasma proteins using liquid chromatography-mass spectrometry and to estimate maximum systemic paclitaxel concentration (<i>C</i><sub>max</sub>). A second sample was collected approximately 24 hours after the first infusion to estimate paclitaxel time above threshold (<i>T</i><sub><i>c</i>>0.05</sub>). Linear mixed-effect and regression models were used to identify proteins predictive of TIPN and paclitaxel PK parameters, respectively, using a Bonferroni-adjusted α = .0006.</p><p><strong>Results: </strong>Data from 36 participants were included in the analysis testing associations of 83 proteins with TIPN or PK. Higher levels of complement C3 were associated with more severe TIPN trajectories (<i>P</i> = .0002). No proteins were associated with either <i>C</i><sub>max</sub> or <i>T</i><sub><i>c</i>>0.05</sub> (all <i>P</i> > .0006).</p><p><strong>Conclusion: </strong>Complement C3 concentration at the end of initial paclitaxel infusion may be useful for identifying patients with breast cancer and potentially other tumor types who could benefit from TIPN prevention strategies to improve long-term treatment outcomes.</p>","PeriodicalId":14797,"journal":{"name":"JCO precision oncology","volume":"9 ","pages":"e2400380"},"PeriodicalIF":5.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11790257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070901","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}
JCO precision oncologyPub Date : 2025-01-01Epub Date: 2025-02-21DOI: 10.1200/PO-24-00690
Manlu Liu, Justin C Jagodinsky, S Carson Callahan, Rachel L Minne, D Bryan Johnson, Scott A Tomlins, Gopal Iyer, Andrew M Baschnagel
{"title":"Genomic and Immune Landscape of Non-Small Cell Lung Cancer Brain Metastases.","authors":"Manlu Liu, Justin C Jagodinsky, S Carson Callahan, Rachel L Minne, D Bryan Johnson, Scott A Tomlins, Gopal Iyer, Andrew M Baschnagel","doi":"10.1200/PO-24-00690","DOIUrl":"https://doi.org/10.1200/PO-24-00690","url":null,"abstract":"<p><strong>Purpose: </strong>Metastatic spread of non-small cell lung cancer (NSCLC) to the brain is a commonly occurring and challenging clinical problem, often resulting in patient mortality. Systemic therapies including immunotherapy have modest efficacy in treating brain metastases. Moreover, the local immune environment of brain metastases remains poorly described. This study aims to understand the genomic and immune landscape of NSCLC brain metastases.</p><p><strong>Methods: </strong>A total of 3,060 patients with NSCLC sequenced with the Strata Select assay on the Strata Oncology Platform were analyzed. Genomic alterations, tumor mutation burden (TMB), <i>PD-L1</i> expression, and immune gene expression were compared across different tissue sites and histologies and within brain metastases.</p><p><strong>Results: </strong>A significant increase in TMB was observed in the brain metastasis samples compared with nonbrain metastasis samples. Mutations in <i>TP53</i>, <i>KRAS</i>, and <i>CDKNA2A</i> were more prevalent within the brain metastasis cohort compared with other tissue locations. In addition, <i>PD-L1</i> expression was significantly decreased within brain metastasis samples compared with other sites. The overall immune landscape within the brain metastasis samples was largely reduced compared with primary lung samples. However, an immune-enriched brain metastasis cohort was identified with higher expressions of <i>PD-L1</i> and other immune-related genes.</p><p><strong>Conclusion: </strong>The overall TMB is increased within brain metastases compared with primary lung and other metastasis sites and is associated with a markedly diminished overall immune landscape. The identification of an immune-enriched brain metastasis subgroup suggests potential heterogeneity within the brain metastasis patient cohort, which might have implications for the development of targeted therapies.</p>","PeriodicalId":14797,"journal":{"name":"JCO precision oncology","volume":"9 ","pages":"e2400690"},"PeriodicalIF":5.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472509","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}
JCO precision oncologyPub Date : 2025-01-01Epub Date: 2025-01-07DOI: 10.1200/PO-24-00712
Zishuo Ian Hu, Dean C Pavlick, Jeffrey S Ross, Sunyoung S Lee, Madhulika Eluri, Milind Javle
{"title":"Molecular Profiling of Biliary Tract Cancers in African American and Caucasian Patients.","authors":"Zishuo Ian Hu, Dean C Pavlick, Jeffrey S Ross, Sunyoung S Lee, Madhulika Eluri, Milind Javle","doi":"10.1200/PO-24-00712","DOIUrl":"10.1200/PO-24-00712","url":null,"abstract":"<p><strong>Purpose: </strong>Biliary tract cancers (BTCs) include intrahepatic cholangiocarcinoma (ICC), extrahepatic cholangiocarcinoma (ECC), and gallbladder cancers. BTCs have a number of genomic alterations, including isocitrate dehydrogenase 1 (<i>IDH1</i>) mutations, fibroblast growth factor receptor 2 (<i>FGFR2</i>) rearrangements, and <i>ERBB2</i> amplifications. Therapies targeting these alterations have shown clinical benefit in patients with BTCs in the United States. However, molecular differences between races in BTCs are largely unknown. In particular, the genomic profiles of African American (AA) patients with BTCs have been infrequently reported. We sought to identify key genomic differences between AA and Caucasian patients with BTCs in the United States in the Foundation Medicine and American Association for Cancer Research (AACR) GENIE databases.</p><p><strong>Methods: </strong>BTC patients from AA and Caucasian patients from the Foundation Medicine and AACR GENIE databases were retrospectively reviewed. BTCs were divided into ICC, ECC, and GBCs in the Foundation Medicine database. BTCs were divided into cholangiocarcinomas and GBCs in the AACR GENIE database.</p><p><strong>Results: </strong>The mean age of AA patients with BTCs was lower compared with Caucasians. <i>TP53</i> and <i>FGFR2</i> alterations were significantly more frequent in AA patients compared with Caucasian patients with BTCs. <i>IDH1</i> mutations in Caucasian patients with BTCs were double that of AA patients.</p><p><strong>Conclusion: </strong>The results of this study suggest that significant genomic differences exist between races and warrant further investigation.</p>","PeriodicalId":14797,"journal":{"name":"JCO precision oncology","volume":"9 ","pages":"e2400712"},"PeriodicalIF":5.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11723491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142948846","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":"Artificial Intelligence-Powered Human Epidermal Growth Factor Receptor 2 and Tumor Microenvironment Analysis in Human Epidermal Growth Factor Receptor 2-Amplified Metastatic Colorectal Cancer: Exploratory Analysis of Phase II TRIUMPH Trial.","authors":"Mitsuho Imai, Yoshiaki Nakamura, Sangwon Shin, Wataru Okamoto, Takeshi Kato, Taito Esaki, Ken Kato, Yoshito Komatsu, Satoshi Yuki, Toshiki Masuishi, Tomohiro Nishina, Kentaro Sawada, Akihiro Sato, Takeshi Kuwata, Riu Yamashita, Takao Fujisawa, Hideaki Bando, Chan-Young Ock, Satoshi Fujii, Takayuki Yoshino","doi":"10.1200/PO-24-00385","DOIUrl":"10.1200/PO-24-00385","url":null,"abstract":"<p><strong>Purpose: </strong>Human epidermal growth factor receptor 2 (HER2)-targeted therapies have shown promise in treating <i>HER2</i>-amplified metastatic colorectal cancer (mCRC). Identifying optimal biomarkers for treatment decisions remains challenging. This study explores the potential of artificial intelligence (AI) in predicting treatment responses to trastuzumab plus pertuzumab (TP) in patients with <i>HER2</i>-amplified mCRC from the phase II TRIUMPH trial.</p><p><strong>Materials and methods: </strong>AI-powered HER2 quantification continuous score (QCS) and tumor microenvironment (TME) analysis were applied to the prescreening cohort (n = 143) and the TRIUMPH cohort (n = 30). AI analyzers determined the proportions of tumor cells (TCs) with HER2 staining intensity and the densities of various cells in TME, examining their associations with clinical outcomes of TP.</p><p><strong>Results: </strong>The AI-powered HER2 QCS for HER2 immunohistochemistry (IHC) achieved an accuracy of 86.7% against pathologist evaluations, with a 100% accuracy for HER2 IHC 3+ patients. Patients with ≥50% of TCs showing HER2 3+ staining intensity (AI-H3-high) exhibited significantly prolonged progression-free survival (PFS; median PFS, 4.4 <i>v</i> 1.4 months; hazard ratio [HR], 0.12 [95% CI, 0.04 to 0.38]) and overall survival (OS; median OS, 16.5 <i>v</i> 4.1 months; HR, 0.13 [95% CI, 0.05 to 0.38]) compared with the AI-H3-low (<50% group). Stratification among patients with AI-H3-high included TME-high (all lymphocyte, fibroblast, and macrophage densities in the cancer stroma above the median) and TME-low (anything below the median), showing a median PFS of 1.3 and 5.6 months for TME-high and TME-low respectively, with an HR of 0.04 (95% CI, 0.01 to 0.19) for AI-H3-high with TME-low compared with AI-H3-low.</p><p><strong>Conclusion: </strong>AI-powered HER2 QCS and TME analysis demonstrated potential in enhancing treatment response predictions in patients with <i>HER2</i>-amplified mCRC undergoing TP therapy.</p>","PeriodicalId":14797,"journal":{"name":"JCO precision oncology","volume":"9 ","pages":"e2400385"},"PeriodicalIF":5.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11753463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005782","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":"Actionable Gene Alterations Identified in Patients With Malignant Melanoma by Targeted Sequencing in Japan.","authors":"Takuro Noguchi, Shin Ariga, Rika Moku, Junko Kikuchi, Toraji Amano, Takuya Maeda, Kosuke Ishikawa, Taku Maeda, Akihiko Shiiya, Tomohiro Goda, Yoshihito Ohhara, Kanako Hagio, Yusuke Saito, Kanako C Hatanaka, Yutaka Hatanaka, Jun Taguchi, Satoshi Takeuchi, Yasushi Shimizu, Ichiro Kinoshita","doi":"10.1200/PO-24-00437","DOIUrl":"https://doi.org/10.1200/PO-24-00437","url":null,"abstract":"<p><strong>Purpose: </strong>Precision medicine plays an important role in the treatment of patients with advanced melanoma. Despite its high incidence in White patients, advanced melanoma is rare in Asian countries, hampering prospective clinical trials targeting the Asian population. This retrospective study aimed to elucidate the real-world molecular diagnoses and outcomes of Japanese patients with melanoma using comprehensive genome profiling (CGP).</p><p><strong>Materials and methods: </strong>Patients with melanoma who completed standard anticancer medical treatments (including those expected to complete the treatments) underwent CGP, which is covered by the National Health Insurance. We analyzed the results and clinical annotations of 569 patients registered before August 2023 in a national database.</p><p><strong>Results: </strong>Skin, mucosal, and uveal melanomas accounted for 64%, 28%, and 7% of cases, respectively. Patients with <i>BRAF</i>, <i>NRAS</i>, <i>NF1</i>, and <i>KIT</i> variants represented 25%, 20%, 17%, and 17%, respectively. Eighty-two percent of <i>BRAF</i>, 97% of <i>NRAS</i>, 69% of <i>NF1</i>, and 54% of <i>KIT</i> were actionable alterations (ie, <i>BRAF</i> classes I, II, and III, <i>NRAS</i> Q61, G12, G13, <i>NF1</i> loss-of-function, <i>KIT</i> gain-of-function variants). <i>BRAF</i> V600E/K variants occurred in 22% of skin and 2% of mucosal melanomas, but not in uveal melanomas. The mean tumor mutation burden in cutaneous melanomas was 4.2 variants/Mb. Patients previously treated with BRAF-targeted therapy harbored amplifications of <i>BRAF</i> and cell cycle genes more frequently than therapy-naive patients. Thirty-six patients (6.3%) were treated following the molecular tumor board (MTB) recommendations.</p><p><strong>Conclusion: </strong>Actionable gene alterations in <i>BRAF</i>, <i>NRAS</i>, <i>NF1</i>, and <i>KIT</i> are common in Japanese patients with melanoma. However, few patients were treated according to the MTB recommendations, suggesting that there is an unmet need to increase accessibility to gene-matched clinical trials in Japan.</p>","PeriodicalId":14797,"journal":{"name":"JCO precision oncology","volume":"9 ","pages":"e2400437"},"PeriodicalIF":5.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11753464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143055967","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}
JCO precision oncologyPub Date : 2025-01-01Epub Date: 2025-02-21DOI: 10.1200/PO-24-00491
Yvette A H Matser, Atia Samim, Marta Fiocco, Marieke van de Mheen, Maria van der Ham, Monique G M de Sain-van der Velden, Nanda M Verhoeven-Duif, Martine van Grotel, Kathelijne C J M Kraal, Miranda P Dierselhuis, Natasha K A van Eijkelenburg, Karin P S Langenberg, Max M van Noesel, André B P van Kuilenburg, Godelieve A M Tytgat
{"title":"Urinary Catecholamines Predict Relapse During Complete Remission in High-Risk Neuroblastoma.","authors":"Yvette A H Matser, Atia Samim, Marta Fiocco, Marieke van de Mheen, Maria van der Ham, Monique G M de Sain-van der Velden, Nanda M Verhoeven-Duif, Martine van Grotel, Kathelijne C J M Kraal, Miranda P Dierselhuis, Natasha K A van Eijkelenburg, Karin P S Langenberg, Max M van Noesel, André B P van Kuilenburg, Godelieve A M Tytgat","doi":"10.1200/PO-24-00491","DOIUrl":"10.1200/PO-24-00491","url":null,"abstract":"<p><strong>Purpose: </strong>Urinary catecholamine metabolites are well-known biomarkers for the diagnosis (Dx) of neuroblastoma, but their clinical significance in determining therapy response during treatment is not well established. Therefore, catecholamines are not included in criteria for assessing response and complete remission (CR). This study investigated the use of urinary catecholamines in response monitoring and predicting survival outcomes.</p><p><strong>Methods: </strong>From 2005 to 2021, a panel of eight urinary catecholamines were measured in patients with high-risk neuroblastoma at Dx and at standard evaluation moments during treatment. At the same time points, response and CR were assessed according to the revised International Neuroblastoma Response Criteria.</p><p><strong>Results: </strong>The total cohort consists of 153 high-risk patients, and at least one of the eight metabolites was elevated (ie, catecholamine status positive) in 141 of 146 (97%), 104 of 128 (81%), and 39 of 69 (57%) patients at Dx, postinduction, and at CR, respectively. Primary tumor resection significantly reduced catecholamine levels (<i>P</i> < .01). A positive catecholamine status at Dx, during treatment, and at the end of treatment was not significantly associated with event-free survival (EFS) or overall survival (OS). However, in patients who achieved CR, those with a positive catecholamine status had poor EFS (38% <i>v</i> 80%, respectively; <i>P</i> < .01) and OS (52% <i>v</i> 86%, respectively; <i>P</i> = .01) compared with those with a negative catecholamine status. Notably, 3-methoxytyramine levels at CR seem to be a prognostic marker for poor OS (hazard ratio, 7.5 [95% CI, 2.0 to 28.6]).</p><p><strong>Conclusion: </strong>Catecholamine measurements contribute to the assessment of CR and identifies patients with high-risk neuroblastoma with an increased risk of relapse and death.</p>","PeriodicalId":14797,"journal":{"name":"JCO precision oncology","volume":"9 ","pages":"e2400491"},"PeriodicalIF":5.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472510","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}
JCO precision oncologyPub Date : 2024-12-01Epub Date: 2024-12-23DOI: 10.1200/PO-24-00525
Ying L Liu, Tiffany Y Sia, Nancy Varice, Michelle Wu, Maureen Byrne, Aliya Khurram, Yelena Kemel, Margaret Sheehan, Jesse Galle, Paul Sabbatini, Carol Brown, Kara Long Roche, Dennis Chi, David B Solit, Jennifer Mueller, Zsofia K Stadler, Jada G Hamilton, Carol Aghajanian, Nadeem R Abu-Rustum
{"title":"Optimizing Mainstreaming of Genetic Testing in Parallel With Ovarian and Endometrial Cancer Tumor Testing: How Do We Maximize Our Impact?","authors":"Ying L Liu, Tiffany Y Sia, Nancy Varice, Michelle Wu, Maureen Byrne, Aliya Khurram, Yelena Kemel, Margaret Sheehan, Jesse Galle, Paul Sabbatini, Carol Brown, Kara Long Roche, Dennis Chi, David B Solit, Jennifer Mueller, Zsofia K Stadler, Jada G Hamilton, Carol Aghajanian, Nadeem R Abu-Rustum","doi":"10.1200/PO-24-00525","DOIUrl":"10.1200/PO-24-00525","url":null,"abstract":"<p><strong>Purpose: </strong>Although germline genetic testing (GT) is recommended for all patients with ovarian cancer (OC) and some patients with endometrial cancer (EC), uptake remains low with multiple barriers. Our center performs GT in parallel with somatic testing via a targeted sequencing assay (MSK-IMPACT) and initiates testing in oncology clinics (mainstreaming). We sought to optimize our GT processes for OC/EC.</p><p><strong>Methods: </strong>We performed a quality improvement study to evaluate our GT processes within gynecologic surgery/medical oncology clinics. All eligible patients with newly diagnosed OC/EC were identified for GT and tracked in a REDCap database. Clinical data and GT rates were collected by the study team, who reviewed data for qualitative themes.</p><p><strong>Results: </strong>From February 2023 to April 2023, we identified 116 patients with newly diagnosed OC (n = 57) and EC (n = 59). Patients were mostly White (62%); English was the preferred language for 90%. GT was performed in 52 (91%) patients with OC (seven external, 45 MSK-IMPACT) and in 44 (75%) patients with EC (three external, 41 MSK-IMPACT). GT results were available within 3 months for 100% and 95% of patients with OC and EC, respectively. Reasons for not undergoing GT included being missed by the clinical team where there was no record that GT was recommended, feeling overwhelmed, financial and privacy concerns, and language barriers. In qualitative review, we found that resources were concentrated in the initial visit with little follow-up to encourage GT at subsequent points of care.</p><p><strong>Conclusion: </strong>A mainstreaming approach that couples somatic and germline GT resulted in high testing rates in OC/EC; however, barriers were identified. Processes that encourage GT at multiple care points and allow self-directed, multilingual digital consenting should be piloted.</p>","PeriodicalId":14797,"journal":{"name":"JCO precision oncology","volume":"8 ","pages":"e2400525"},"PeriodicalIF":5.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11670878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882011","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}