Helena A Yu, Yasushi Goto, Hidetoshi Hayashi, Enriqueta Felip, James Chih-Hsin Yang, Martin Reck, Kiyotaka Yoh, Se-Hoon Lee, Luis Paz-Ares, Benjamin Besse, Paolo Bironzo, Dong-Wan Kim, Melissa L Johnson, Yi-Long Wu, Thomas John, Steven Kao, Toshiyuki Kozuki, Erminia Massarelli, Jyoti Patel, Egbert Smit, Karen L Reckamp, Qian Dong, Pomy Shrestha, Pang-Dian Fan, Parul Patel, Andrea Sporchia, David W Sternberg, Dalila Sellami, Pasi A Jänne
{"title":"HERTHENA-Lung01, a Phase II Trial of Patritumab Deruxtecan (HER3-DXd) in Epidermal Growth Factor Receptor-Mutated Non-Small-Cell Lung Cancer After Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitor Therapy and Platinum-Based Chemotherapy.","authors":"Helena A Yu, Yasushi Goto, Hidetoshi Hayashi, Enriqueta Felip, James Chih-Hsin Yang, Martin Reck, Kiyotaka Yoh, Se-Hoon Lee, Luis Paz-Ares, Benjamin Besse, Paolo Bironzo, Dong-Wan Kim, Melissa L Johnson, Yi-Long Wu, Thomas John, Steven Kao, Toshiyuki Kozuki, Erminia Massarelli, Jyoti Patel, Egbert Smit, Karen L Reckamp, Qian Dong, Pomy Shrestha, Pang-Dian Fan, Parul Patel, Andrea Sporchia, David W Sternberg, Dalila Sellami, Pasi A Jänne","doi":"10.1200/JCO.23.01476","DOIUrl":"10.1200/JCO.23.01476","url":null,"abstract":"<p><strong>Purpose: </strong>Patritumab deruxtecan, or HER3-DXd, is an antibody-drug conjugate consisting of a fully human monoclonal antibody to human epidermal growth factor receptor 3 (HER3) attached to a topoisomerase I inhibitor payload via a stable tetrapeptide-based cleavable linker. We assessed the efficacy and safety of HER3-DXd in patients with epidermal growth factor receptor (<i>EGFR</i>)-mutated non-small-cell lung cancer (NSCLC).</p><p><strong>Methods: </strong>This phase II study (ClinicalTrials.gov identifier: NCT04619004) was designed to evaluate HER3-DXd in patients with advanced <i>EGFR-</i>mutated NSCLC previously treated with EGFR tyrosine kinase inhibitor (TKI) therapy and platinum-based chemotherapy (PBC). Patients received HER3-DXd 5.6 mg/kg intravenously once every 3 weeks or an uptitration regimen (3.2 → 4.8 → 6.4 mg/kg). The primary end point was confirmed objective response rate (ORR; RECIST 1.1) by blinded independent central review (BICR), with a null hypothesis of 26.4% on the basis of historical data.</p><p><strong>Results: </strong>Enrollment into the uptitration arm closed early on the basis of a prespecified benefit-risk assessment of data from the phase I U31402-A-U102 trial. In total, 225 patients received HER3-DXd 5.6 mg/kg once every 3 weeks. As of May 18, 2023, median study duration was 18.9 (range, 14.9-27.5) months. Confirmed ORR by BICR was 29.8% (95% CI, 23.9 to 36.2); median duration of response, 6.4 months; median progression-free survival, 5.5 months; and median overall survival, 11.9 months. The subgroup of patients with previous osimertinib and PBC had similar outcomes. Efficacy was observed across a broad range of pretreatment tumor HER3 membrane expression levels and across diverse mechanisms of EGFR TKI resistance. In patients with nonirradiated brain metastases at baseline (n = 30), the confirmed CNS ORR by BICR per CNS RECIST was 33.3% (95% CI, 17.3 to 52.8). The safety profile (National Cancer Institute Common Terminology Criteria for Adverse Events v5.0) was manageable and tolerable, consistent with previous observations.</p><p><strong>Conclusion: </strong>After tumor progression with EGFR TKI therapy and PBC in patients with <i>EGFR</i>-mutated NSCLC, HER3-DXd once every 3 weeks demonstrated clinically meaningful efficacy with durable responses, including in CNS metastases. A phase III trial in <i>EGFR-</i>mutated NSCLC after progression on an EGFR TKI is ongoing (HERTHENA-Lung02; ClinicalTrials.gov identifier: NCT05338970).</p>","PeriodicalId":15384,"journal":{"name":"Journal of Clinical Oncology","volume":" ","pages":"5363-5375"},"PeriodicalIF":45.3,"publicationDate":"2023-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10713116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10542724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Systemic Therapy for Small-Cell Lung Cancer: ASCO-Ontario Health (Cancer Care Ontario) Guideline.","authors":"Humera Khurshid, Nofisat Ismaila, Jessica Bian, Raetasha Dabney, Millie Das, Peter Ellis, Jill Feldman, Christine Hann, Swati Kulkarni, Janessa Laskin, Rami Manochakian, Deebya Raj Mishra, Isabel Preeshagul, Pavan Reddy, Ashish Saxena, Frank Weinberg, Gregory P Kalemkerian","doi":"10.1200/JCO.23.01435","DOIUrl":"10.1200/JCO.23.01435","url":null,"abstract":"<p><strong>Purpose: </strong>To provide evidence-based recommendations to practicing clinicians on the management of patients with small-cell lung cancer.</p><p><strong>Methods: </strong>An Expert Panel of medical oncology, thoracic surgery, radiation oncology, pulmonary, community oncology, research methodology, and advocacy experts were convened to conduct a literature search, which included systematic reviews, meta-analyses, and randomized controlled trials published from 1990 through 2022. Outcomes of interest included response rates, overall survival, disease-free survival or recurrence-free survival, and quality of life. Expert Panel members used available evidence and informal consensus to develop evidence-based guideline recommendations.</p><p><strong>Results: </strong>The literature search identified 95 relevant studies to inform the evidence base for this guideline.</p><p><strong>Recommendations: </strong>Evidence-based recommendations were developed to address systemic therapy options, timing of therapy, treatment in patients who are older or with poor performance status, role of biomarkers, and use of myeloid-supporting agents in patients with small-cell lung cancer.Additional information is available at www.asco.org/thoracic-cancer-guidelines.</p>","PeriodicalId":15384,"journal":{"name":"Journal of Clinical Oncology","volume":" ","pages":"5448-5472"},"PeriodicalIF":45.3,"publicationDate":"2023-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41202216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Speeding up Antibody-Drug Conjugate Development in Pretreated <i>EGFR</i>-Mutant Non-Small-Cell Lung Cancer.","authors":"Lizza E L Hendriks, Jordi Remon","doi":"10.1200/JCO.23.01830","DOIUrl":"10.1200/JCO.23.01830","url":null,"abstract":"","PeriodicalId":15384,"journal":{"name":"Journal of Clinical Oncology","volume":" ","pages":"5351-5355"},"PeriodicalIF":45.3,"publicationDate":"2023-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41202215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Isacco Montroni, Giampaolo Ugolini, Nicole M Saur, Siri Rostoft, Antonino Spinelli, Barbara L Van Leeuwen, Nicola De Liguori Carino, Federico Ghignone, Michael T Jaklitsch, Jakub Kenig, Anna Garutti, Chiara Zingaretti, Flavia Foca, Bernadette Vertogen, Oriana Nanni, Steven D Wexner, Riccardo A Audisio
{"title":"Predicting Functional Recovery and Quality of Life in Older Patients Undergoing Colorectal Cancer Surgery: Real-World Data From the International GOSAFE Study.","authors":"Isacco Montroni, Giampaolo Ugolini, Nicole M Saur, Siri Rostoft, Antonino Spinelli, Barbara L Van Leeuwen, Nicola De Liguori Carino, Federico Ghignone, Michael T Jaklitsch, Jakub Kenig, Anna Garutti, Chiara Zingaretti, Flavia Foca, Bernadette Vertogen, Oriana Nanni, Steven D Wexner, Riccardo A Audisio","doi":"10.1200/JCO.22.02195","DOIUrl":"10.1200/JCO.22.02195","url":null,"abstract":"<p><strong>Purpose: </strong>The GOSAFE study evaluates risk factors for failing to achieve good quality of life (QoL) and functional recovery (FR) in older patients undergoing surgery for colon and rectal cancer.</p><p><strong>Methods: </strong>Patients age 70 years and older undergoing major elective colorectal surgery were prospectively enrolled. Frailty assessment was performed and outcomes, including QoL (EQ-5D-3L) recorded (3/6 months postoperatively). Postoperative FR was defined as a combination of Activity of Daily Living ≥5 + Timed Up & Go test <20 seconds + MiniCog >2.</p><p><strong>Results: </strong>Prospective complete data were available for 625/646 consecutive patients (96.9%; 435 colon and 190 rectal cancer), 52.6% men, and median age was 79.0 years (IQR, 74.6-82.9 years). Surgery was minimally invasive in 73% of patients (321/435 colon; 135/190 rectum). At 3-6 months, 68.9%-70.3% patients experienced equal/better QoL (72.8%-72.9% colon, 60.1%-63.9% rectal cancer). At logistic regression analysis, preoperative Flemish Triage Risk Screening Tool ≥2 (3-month odds ratio [OR], 1.68; 95% CI, 1.04 to 2.73; <i>P</i> = .034, 6-month OR, 1.71; 95% CI, 1.06 to 2.75; <i>P</i> = .027) and postoperative complications (3-month OR, 2.03; 95% CI, 1.20 to 3.42; <i>P</i> = .008, 6-month OR, 2.56; 95% CI, 1.15 to 5.68; <i>P</i> = .02) are associated with decreased QoL after colectomy. Eastern Collaborative Oncology Group performance status (ECOG PS) ≥2 is a strong predictor of postoperative QoL decline in the rectal cancer subgroup (OR, 3.81; 95% CI, 1.45 to 9.92; <i>P</i> = .006). FR was reported by 254/323 (78.6%) patients with colon and 94/133 (70.6%) with rectal cancer. Charlson Age Comorbidity Index ≥7 (OR, 2.59; 95% CI, 1.26 to 5.32; <i>P</i> = .009), ECOG ≥2 (OR, 3.12; 95% CI, 1.36 to 7.20; <i>P</i> = .007 colon; OR, 4.61; 95% CI, 1.45 to 14.63; <i>P</i> = .009 rectal surgery), severe complications (OR, 17.33; 95% CI, 7.30 to 40.8; <i>P</i> < .001), fTRST ≥2 (OR, 2.71; 95% CI, 1.40 to 5.25; <i>P</i> = .003), and palliative surgery (OR, 4.11; 95% CI, 1.29 to 13.07; <i>P</i> = .017) are risk factors for not achieving FR.</p><p><strong>Conclusion: </strong>The majority of older patients experience good QoL and stay independent after colorectal cancer surgery. Predictors for failing to achieve these essential outcomes are now defined to guide patients' and families' preoperative counseling.</p>","PeriodicalId":15384,"journal":{"name":"Journal of Clinical Oncology","volume":" ","pages":"5247-5262"},"PeriodicalIF":45.3,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9730681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Restoration of Quality of Life and Functional Recovery After Colorectal Cancer Surgery in Older Adults.","authors":"Anthony Loria, Fergal J Fleming","doi":"10.1200/JCO.23.01066","DOIUrl":"10.1200/JCO.23.01066","url":null,"abstract":"","PeriodicalId":15384,"journal":{"name":"Journal of Clinical Oncology","volume":" ","pages":"5225-5227"},"PeriodicalIF":45.3,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9782899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Five-Year Overall Survival Analysis of the JIPANG Study: Pemetrexed or Vinorelbine Plus Cisplatin for Resected Stage II-IIIA Nonsquamous Non-Small-Cell Lung Cancer.","authors":"Hirotsugu Kenmotsu, Nobuyuki Yamamoto, Toshihiro Misumi, Kiyotaka Yoh, Haruhiro Saito, Shunichi Sugawara, Koji Yamazaki, Kazuhiko Nakagawa, Kenji Sugio, Takashi Seto, Shinichi Toyooka, Hiroshi Date, Tetsuya Mitsudomi, Isamu Okamoto, Kohei Yokoi, Hideo Saka, Hiroaki Okamoto, Yuichi Takiguchi, Toshiaki Takahashi, Masahiro Tsuboi","doi":"10.1200/JCO.23.00179","DOIUrl":"10.1200/JCO.23.00179","url":null,"abstract":"<p><p><i>Clinical trials frequently include multiple end points that mature at different times. The initial report, typically based on the primary end point, may be published when key planned co-primary or secondary analyses are not yet available. Clinical Trial Updates provide an opportunity to disseminate additional results from studies, published in</i> JCO <i>or elsewhere, for which the primary end point has already been reported.</i>The JIPANG study is an open-label phase III trial evaluating the efficacy of pemetrexed plus cisplatin (PemP) versus vinorelbine plus cisplatin (NP) as adjuvant chemotherapy in patients with stage II-IIIA nonsquamous non-small-cell lung cancer (NSCLC). Here, we report the long follow-up overall survival (OS) data. Eligible patients were randomly assigned to receive either PemP or NP. The primary end point was recurrence-free survival (RFS), and the secondary end point included OS. This analysis was performed using data collected 5 years after the last patient enrollment. Among 804 patients enrolled, 783 patients were eligible (384 for NP and 389 for PemP). The updated median RFS was 37.5 months in the NP arm and 43.4 months in the PemP arm with a hazard ratio of 0.95 (95% CI, 0.79 to 1.14). At a median follow-up of 77.3 months, the OS rates at 3 and 5 years were 84.1% and 75.6% versus 87.0% and 75.0% with a hazard ratio of 1.04 (95% CI, 0.81 to 1.34). This long-term follow-up analysis showed that PemP had similar efficacy to NP in both RFS and OS for this population, with one of the longest OS data compared with the historical data.</p>","PeriodicalId":15384,"journal":{"name":"Journal of Clinical Oncology","volume":" ","pages":"5242-5246"},"PeriodicalIF":45.3,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10491911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Initial Panitumumab Plus Fluorouracil, Leucovorin, and Oxaliplatin or Plus Fluorouracil and Leucovorin in Elderly Patients With RAS and BRAF Wild-Type Metastatic Colorectal Cancer: The PANDA Trial by the GONO Foundation.","authors":"Sara Lonardi, Cosimo Rasola, Riccardo Lobefaro, Daniele Rossini, Vincenzo Formica, Mario Scartozzi, Giovanni Luca Frassineti, Giorgia Boscolo, Saverio Cinieri, Samantha Di Donato, Nicoletta Pella, Francesca Bergamo, Alessandra Raimondi, Ermenegildo Arnoldi, Lorenzo Antonuzzo, Cristina Granetto, Fable Zustovich, Monica Ronzoni, Silvana Leo, Federica Morano, Fotios Loupakis, Federica Buggin, Vittorina Zagonel, Matteo Fassan, Chiara Cremolini, Luca Boni, Filippo Pietrantonio","doi":"10.1200/JCO.23.00506","DOIUrl":"10.1200/JCO.23.00506","url":null,"abstract":"<p><strong>Purpose: </strong>To verify whether both doublet chemotherapy with a modified schedule of fluorouracil, leucovorin, and oxaliplatin (mFOLFOX) and monochemotherapy with fluorouracil plus leucovorin (5-FU + LV) achieve satisfactory efficacy when both regimens are combined with panitumumab (PAN) as initial treatment of elderly patients with <i>RAS</i>/<i>BRAF</i> wild-type metastatic colorectal cancer (mCRC).</p><p><strong>Patients and methods: </strong>PANDA (ClinicalTrials.gov identifier: NCT02904031) was an open-label, randomized phase II noncomparative trial in previously untreated patients age 70 years and older with unresectable <i>RAS</i>/<i>BRAF</i> wild-type mCRC. Patients were randomly assigned 1:1 to mFOLFOX + PAN (arm A) or 5-FU + LV + PAN (arm B) for up to 12 cycles, followed by PAN maintenance. The primary end point was progression-free survival (PFS). In each arm, assuming a null hypothesis of median PFS time <b>≤</b>6 months and target PFS ≥9.65, 90 patients per arm were needed to achieve 90% power and 5% type I error (one-sided Brookmeyer-Crowley test).</p><p><strong>Results: </strong>Between July 2016 and April 2019, 91 patients were randomly assigned to arm A and 92 to arm B. At a median follow-up of 50.0 months (IQR, 45.6-56.4), median PFS was 9.6 and 9.0 months for arm A and B, respectively (<i>P</i> < .001 in each arm). Overall response rate was 69% and 52%, whereas median overall survival was 23.5 and 22.0 months in arm A and B, respectively. The overall rate of grade >2 chemotherapy-related adverse events was 60% and 37%, respectively. Baseline G8 and Chemotherapy Risk Assessment Scale for High-Age Patients scores were prognostic, but they were not associated with efficacy and safety of the two arms.</p><p><strong>Conclusion: </strong>Both mFOLFOX and 5-FU + LV + PAN are reasonable options as initial therapy of elderly patients with <i>RAS</i>/<i>BRAF</i> wild-type mCRC. 5-FU + LV + PAN is associated with a better safety profile.</p>","PeriodicalId":15384,"journal":{"name":"Journal of Clinical Oncology","volume":" ","pages":"5263-5273"},"PeriodicalIF":45.3,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9936430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Geoffrey R Oxnard, Ruthia Chen, Jennifer C Pharr, Diane R Koeller, Arrien A Bertram, Suzanne E Dahlberg, Irene Rainville, Kate Shane-Carson, Kelly A Taylor, Alicia Sable-Hunt, Lynette M Sholl, Craig C Teerlink, Alun Thomas, Lisa A Cannon-Albright, André P Fay, Patrícia Ashton-Prolla, Hao Yang, Mary M Salvatore, Bonnie J Addario, Pasi A Jänne, David P Carbone, Georgia L Wiesner, Judy E Garber
{"title":"Germline <i>EGFR</i> Mutations and Familial Lung Cancer.","authors":"Geoffrey R Oxnard, Ruthia Chen, Jennifer C Pharr, Diane R Koeller, Arrien A Bertram, Suzanne E Dahlberg, Irene Rainville, Kate Shane-Carson, Kelly A Taylor, Alicia Sable-Hunt, Lynette M Sholl, Craig C Teerlink, Alun Thomas, Lisa A Cannon-Albright, André P Fay, Patrícia Ashton-Prolla, Hao Yang, Mary M Salvatore, Bonnie J Addario, Pasi A Jänne, David P Carbone, Georgia L Wiesner, Judy E Garber","doi":"10.1200/JCO.23.01372","DOIUrl":"10.1200/JCO.23.01372","url":null,"abstract":"<p><strong>Purpose: </strong>The genomic underpinnings of inherited lung cancer risk are poorly understood. This prospective study characterized the clinical phenotype of patients and families with germline <i>EGFR</i> pathogenic variants (PVs).</p><p><strong>Methods: </strong>The Investigating Hereditary Risk from T790M study (ClinicalTrials.gov identifier: NCT01754025) enrolled patients with lung cancer whose tumor profiling harbored possible germline <i>EGFR</i> PVs and their relatives, either in person or remotely, providing germline testing and follow-up.</p><p><strong>Results: </strong>A total of 141 participants were enrolled over a 5-year period, 100 (71%) remotely. Based upon previous genotyping, 116 participants from 59 kindreds were tested for <i>EGFR</i> T790M, demonstrating a pattern of Mendelian inheritance with variable lung cancer penetrance. In confirmed or obligate carriers of a germline <i>EGFR</i> PV from 39 different kindreds, 50/91 (55%) were affected with lung cancer with 34/65 (52%) diagnosed by age 60 years. Somatic testing of lung cancers in carriers revealed that 35 of 37 (95%) had an <i>EGFR</i> driver comutation. Among 36 germline carriers without a cancer diagnosis, 15 had computed tomography (CT) imaging and nine had lung nodules, including a 28-year-old with >10 lung nodules. Given geographic enrichment of germline <i>EGFR</i> T790M in the southeast United States, genome-wide haplotyping of 46 germline carriers was performed and identified a 4.1-Mb haplotype shared by 41 (89%), estimated to originate 223-279 years ago.</p><p><strong>Conclusion: </strong>To our knowledge, this is the first prospective description of familial <i>EGFR</i>-mutant lung cancer, identifying a recent founder germline <i>EGFR</i> T790M variant enriched in the Southeast United States. The high prevalence of <i>EGFR</i>-driver lung adenocarcinomas and lung nodules in germline carriers supports effort to identify affected patients and family members for investigation of CT-based screening for these high-risk individuals.</p>","PeriodicalId":15384,"journal":{"name":"Journal of Clinical Oncology","volume":" ","pages":"5274-5284"},"PeriodicalIF":42.1,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9997304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}