Oncologist最新文献

{"title":"The safety profile of belzutifan in renal tumors: real-world data from a tertiary academic center.","authors":"Aaron Jacob Winer, Paulo Siqueira do Amaral, Elizabeth G Ryan, Morgan A Lambrecht, Chiu-Lan Chen, Brian I Rini, Kathryn E Beckermann","doi":"10.1093/oncolo/oyaf274","DOIUrl":"10.1093/oncolo/oyaf274","url":null,"abstract":"<p><strong>Background: </strong>Belzutifan is a HIF-2ɑ inhibitor approved for the treatment of tumors in von Hippel-Lindau (VHL) syndrome and sporadic metastatic clear cell renal cell carcinoma (spRCC) in the refractory setting. The efficacy and side effects of belzutifan are well-documented from clinical trials; however, real-world data examining the incidence and management of adverse events (AEs) are lacking. Our study aims to describe the AE profiles of belzutifan in spRCC and VHL populations.</p><p><strong>Methods: </strong>A retrospective analysis was conducted at Vanderbilt University Medical Center assessing patients who received belzutifan monotherapy. Primary endpoints were the incidence of anemia and hypoxia. Secondary endpoints included time to onset of anemia and hypoxia, as well as management strategies.</p><p><strong>Results: </strong>Forty-four patients were identified with either spRCC (n = 22) or VHL syndrome (n = 22). Patients with spRCC were older than VHL patients (median 67 vs 41 years) and had higher rates of chronic kidney disease (36.4% vs 4.5%) and prior nephrectomy (77.3% vs 40.9%). The spRCC patients had a median follow-up time of 3.8 months vs 26.8 months in VHL patients. Any-grade anemia occurred in the majority of spRCC and VHL patients (81% and 95.5%, respectively) with a median time of 25 days in spRCC patients and 77 days in VHL patients. While no patient with VHL experienced grade 3 anemia, 41% of spRCC patients developed grade ≥3 anemia. In spRCC, grade ≥3 hypoxia developed in 54.5% and for VHL patients, grade 3 hypoxia occurred in 9%. Median time to grade ≥3 hypoxia was 29 days (range 12-123) in spRCC patients and 225 days (range 105-345) in VHL patients. Supplemental oxygen was required in 52.5% of spRCC patients and 9.5% in VHL patients. Treatment discontinuation due to AEs occurred in 50% of spRCC patients and 13.6% of VHL patients.</p><p><strong>Conclusions: </strong>The time to onset and severity of belzutifan AEs may differ between patients with VHL syndrome and spRCC. These findings suggest the need for a patient-centered approach to monitor and manage toxicity based on disease setting.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12483163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145014470","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":"The global and regional burden of early-onset gastric cancer (15-49 years, 1990-2021): incidence and mortality with projections to 2030.","authors":"Yujuan Jiang, Peng Wang, Haikuo Wang, Jinghua Chen, Dedi Jiang, Jianwei Liang, Yantao Tian","doi":"10.1093/oncolo/oyaf244","DOIUrl":"10.1093/oncolo/oyaf244","url":null,"abstract":"<p><strong>Background: </strong>While global gastric cancer incidence has declined, trends in early-onset gastric cancer (EOGC, age 15-49) remain unclear. This study evaluates EOGC's global burden (1990-2021), projects trends to 2030, and identifies epidemiological drivers.</p><p><strong>Methods: </strong>Using Global Burden of Disease (GBD) 2021 data, we analyzed age-standardized incidence, mortality, disability-adjusted life years (DALYs), and estimated annual percentage change for EOGC globally and by sex, region, and income level. A Bayesian age-period-cohort model and decomposition analysis assessed temporal trends, epidemiological drivers (eg, aging, population growth), and projected burden through 2030.</p><p><strong>Results: </strong>In 2021, EOGC caused 125 120 new cases and 78 871 deaths globally. From 1990 to 2021, age-standardized mortality, incidence, and DALYs declined worldwide. East Asia and high-middle-income regions bore the highest burden. Decomposition identified epidemiological changes as the primary driver of reduced EOGC burden. Males exhibited higher incidence, mortality, and DALYs than females. Projections suggest declining incidence and mortality rates by 2030 for both sexes, yet rising absolute case numbers due to population growth.</p><p><strong>Conclusions: </strong>Early-onset gastric cancer burden shows complex patterns: while rates have decreased over 3 decades, absolute cases and deaths increased due to demographic expansion. Disparities persist across gender, geography, and development levels. These findings highlight the need for targeted interventions in high-risk populations and regions to address inequities. Policymakers should prioritize surveillance and prevention strategies tailored to evolving epidemiological trends.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144838605","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":"Quality or quantity of life? Treatment priorities in older adults with cancer in the community.","authors":"Gabriel Aleixo, Julianne Ani, Ramy Sedhom","doi":"10.1093/oncolo/oyaf261","DOIUrl":"10.1093/oncolo/oyaf261","url":null,"abstract":"<p><p>Older adults with cancer often face decisions about prioritizing quality of life, survival, or both. In this prospective study of 181 patients aged ≥65 at a community cancer center, patients completed a geriatric assessment (GA) that included a validated trade-off question: \"Maintaining my quality of life is more important to me than living longer.\" Preferences were categorized as prioritizing quality of life, quantity of life, or both. Older age (OR 1.06; P = .04) and female sex (Odds Ratio 2.82; P = .01) were associated with prioritizing quality of life. Functional, cognitive, or psychosocial impairments were not. Prioritizing quality of life was not associated with worse overall survival (Hazard Ratio 1.06; P = .89). Receipt of standard treatment improved survival (HR 0.38; P = .04), while Performance status 3-4 predicted worse outcomes. These findings challenge assumptions that prioritizing quality of life compromises survival and support the integration of GA and values-based discussions into cancer care.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12449121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978864","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":"Is molecular testing necessary for squamous cell carcinoma?","authors":"Tadashi Nishimura, Hajime Fujimoto","doi":"10.1093/oncolo/oyaf226","DOIUrl":"10.1093/oncolo/oyaf226","url":null,"abstract":"","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":"30 9","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12445683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088178","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":"Conservative lymph node surgery for patients with stage III melanoma: a prospective longitudinal cohort.","authors":"David Moreno-Ramírez, Almudena Fernández-Orland, Blanca de-Unamuno, Lucía Jiménez-Puñal, Francisco M Almazán-Fernández, Aram Boada, Juan J Ríos-Martín, Rafael Botella-Estrada, Lara Ferrándiz","doi":"10.1093/oncolo/oyaf212","DOIUrl":"10.1093/oncolo/oyaf212","url":null,"abstract":"<p><strong>Background: </strong>Therapeutic lymph node dissection has shown no clear benefits in terms of overall survival. However, appropriate regional control has repeatedly been reported in patients with lymph node metastasis.</p><p><strong>Objective: </strong>The objective of the study was to analyze the outcomes of a conservative surgical approach to patients with melanoma and lymph node metastasis detected either clinically or by imaging tests.</p><p><strong>Methods: </strong>A multicenter, prospective, longitudinal, single-arm cohort was conducted to recruit patients with melanoma who had 1-3 non-matted regional lymph node metastases (N1b, N2b) and were treated with conservative nodal surgery (conservative NS). The surgical procedure entailed resection of the metastatic lymph nodes identified, while preserving uninvolved lymph nodes in the regional basin. The patients received postoperative adjuvant immunotherapy according to routine clinical recommendations. The primary end-point was the 2-year regional lymph node recurrence-free survival (RRFS).</p><p><strong>Results: </strong>A total of 25 patients with lymph node metastasis underwent conservative NS to remove inguinal (44.00%) and axillary (56.00%) lymph node metastasis. During the follow-up, 36.00% (n = 9) of the patients developed recurrence in the regional basin treated with conservative NS. The 2-year RRFS was 65.70% (95% CI 46.30%-85.10%), and MSS was 78.10% (95% CI 60.85%-95.35%) at 2 years. Stage IIIB patients exhibited no statistically significant improvement in 2-year RRFS (83.30%) (log-rank P = .238). The short-term surgical complications reported were seroma (32%, n = 8), hematoma (8%, n = 2), and wound infection (4%, n = 1). No cases of lymphedema were observed.</p><p><strong>Conclusion: </strong>Conservative NS has the potential to prevent unnecessary complete lymph node dissections, particularly in clinical settings where neoadjuvant immunotherapy is not a suitable first-line therapeutic option.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12449619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661022","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":"Dabrafenib and trametinib vs anti-PD(L)1 for the adjuvant treatment of locally advanced BRAF-mutant melanoma: a systematic review and meta-analysis.","authors":"Daniel V Araujo, Bruno Lins Souza, Mariana F Seibel, Aline F Fares, Vitor T Liutti","doi":"10.1093/oncolo/oyaf247","DOIUrl":"10.1093/oncolo/oyaf247","url":null,"abstract":"<p><strong>Background: </strong>Both dabrafenib and trametinib (D + T) and anti-PD(L)1s have been shown to improve recurrence-free survival (RFS) in patients with stage III or resected stage IV BRAF-mutant melanoma. However, no randomized controlled trials (RCTs) have directly compared them in the adjuvant setting, creating uncertainties about the optimal approach. This systematic review and meta-analysis address this knowledge gap.</p><p><strong>Methods: </strong>A comprehensive search of PubMed, Embase, and Scopus was conducted to identify studies comparing D + T with anti-PD(L)1 therapies. Studies with overlapping populations were excluded. Statistical analyses employed a random-effects model, with heterogeneity assessed via I 2 statistics. This study was registered with PROSPERO (CRD42024553421).</p><p><strong>Results: </strong>Eight observational studies (2394 patients) met the inclusion criteria. No eligible RCTs were identified. Median follow-up ranged from 10 to 53 months. Dabrafenib and trametinib improved RFS compared to anti-PD(L)1 therapies (hazard ratio [HR] 0.53, 95% CI, 0.40-0.70, P < .01; I 2 = 55%). However, no significant difference was observed in overall survival (OS) (HR 0.83, 95% CI, 0.60-1.15, P = .27; I 2 = 0%). Subgroup and sensitivity analyses yielded similar results. Dabrafenib and trametinib was associated with a higher rate of treatment discontinuation due to adverse events (AEs), with a relative risk of 1.57 (95% CI, 1.30-1.91, P < .01; I 2 = 0%), corresponding to a risk difference of 8% (95% CI, 5%-12%, P < .01; I 2 = 0%).</p><p><strong>Conclusions: </strong>Dabrafenib and trametinib demonstrated superiority over anti-PD(L)1 therapies in terms of RFS. However, no OS benefit was observed, and D + T was associated with a higher risk of treatment discontinuation. These findings should be considered when counseling patients, as the choice of adjuvant therapy may need to be tailored to individual preferences and tolerability.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12449075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785970","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":"Real-world assessment of clinical outcomes of first-line treatment in metastatic papillary renal cell carcinoma.","authors":"Manon De Vries-Brilland, Zineb Hamilou, Sunita Ghosh, Daniel Y C Heng, Lori A Wood, Naveen S Basappa, Christian K Kollmannsberger, Jeffrey Graham, Bimal Bhindi, Antonio Finelli, Georg A Bjarnason, Dominick Bosse, Frederic Pouliot, Vincent Castonguay, Rodney H Breau, Ramy R Saleh, Eric Winquist, Aly-Khan A Lalani, Denis Soulières","doi":"10.1093/oncolo/oyaf240","DOIUrl":"10.1093/oncolo/oyaf240","url":null,"abstract":"<p><strong>Background: </strong>Papillary renal cell carcinoma (pRCC) is the most common non-clear cell RCC (nccRCC), representing up to 15% of RCC cases. Phase 2 trials have evaluated first-line (1L) immunotherapy (IO)-based treatment in nccRCC, but with heterogeneous cohorts and limited comparative data. The specific value of IO for metastatic pRCC (mpRCC) remains unquantified.</p><p><strong>Methods: </strong>We analyzed prospectively collected data from the Canadian Kidney Cancer Information System to assess the efficacy of 1L systemic therapy in mpRCC with IO-based regimens vs tyrosine kinase inhibitors (TKI). The primary endpoint was time-to-treatment failure (TTF). Secondary endpoints included overall survival (OS), objective response rate (ORR), and treatment-related adverse events (TRAEs). Analyses were adjusted (adj) for IMDC risk groups.</p><p><strong>Results: </strong>From 2011 to 2024, 197 mpRCC patients received 1L therapy: 70 with IO (alone or in combination) and 127 with TKI. Median follow-up was 21.6 months. Median TTF was 9.9 months with IO vs 5.9 months with TKI (adjHR: 0.62 [0.43-0.91], P = .01). Median OS was 36.9 months with IO vs 23.2 months with TKI (adjHR: 0.54 [0.3-0.9], P = .018). Objective response rate was 37% with IO vs 23% with TKI (adjOR: 2.2 [0.95-5.2], P = .07). The TKI-IO subgroup showed the longest TTF (16.9 months, adjHR: 0.47 [0.26-0.85], P = .01) and OS (not reached, adjHR: 0.26 [0.08-0.83], P = .02), compared to TKI. Grade 3-5 TRAEs occurred in 31% (IO) vs 27% (TKI).</p><p><strong>Conclusions: </strong>This real-world study highlights the benefit of IO-based treatment in mpRCC, particularly in the TKI-IO subgroup. Our findings may inform further trials evaluating 1L IO in mpRCC.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12445671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144776929","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":"Contextualizing results of randomized trials in smoldering myeloma.","authors":"Ghulam Rehman Mohyuddin, Aaron M Goodman, Rajshekhar Chakraborty","doi":"10.1093/oncolo/oyaf216","DOIUrl":"10.1093/oncolo/oyaf216","url":null,"abstract":"","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12404295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661089","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":"Clinical response to novel combination of trastuzumab deruxtecan and abiraterone in HER2-expressing metastatic castration-resistant prostate cancer.","authors":"Rithika Rajendran, Coen J Lap, Siddharth Madapoosi, Angela Heiraty, Fayez Estephan, Winnie Hahn, Aarati Poudel, Victor E Nava, Ramesh Subrahmanyam, Maneesh Jain","doi":"10.1093/oncolo/oyaf207","DOIUrl":"10.1093/oncolo/oyaf207","url":null,"abstract":"<p><p>Human Epidermal Growth Factor Receptor 2 (HER2) is expressed in approximately 60%-70% of patients with metastatic castration-resistant prostate cancer (mCRPC) and may contribute to androgen resistance. This case report describes a patient with HER2-expressing mCRPC who progressed on multiple lines of therapy and subsequently had a significant response to combination treatment with the HER2-targeting antibody-drug-conjugate (ADC) trastuzumab deruxtecan (T-DXd) and re--challenge of abiraterone, despite having progressed on this prior. Unlike other HER2-expressing malignancies, HER2 overexpression in prostate cancer (PCa) occurs in the absence of HER2 mutations and amplifications and, as such, is not detected by next--generation sequencing. Therefore, identifying patients with mCRPC who could benefit from T-DXd necessitates HER2 testing by immunohistochemistry (IHC), a practice not routinely performed. As a result, T-DXd remains underutilized in patients with mCRPC, despite a tumor-agnostic approval for patients with advanced HER2-expressing (IHC 3+) solid tumors. This case highlights the potential of combining T-DXd with androgen receptor pathway inhibitors to overcome treatment resistance and underscores the importance of routine HER2 IHC testing in patients with advanced PCa.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602217","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":"Implementation of neoadjuvant immunotherapy in stage III melanoma: a modified Delphi consensus study in a European-accredited cancer center in Ireland.","authors":"Christopher Cronin, Fiachra Martin, James D Martin-Smith, Nadeem Ajmal, Paul Sullivan, Aileen O'Shea, Muireann Roche, Christian Gulmann, Nazmy Elbeltagi, Barry O'Sullivan, Patrick G Morris, Oscar S Breathnach, Liam M Grogan, Bryan T Hennessy, Adrian Murphy, Megan Greally, Jarushka Naidoo","doi":"10.1093/oncolo/oyaf265","DOIUrl":"10.1093/oncolo/oyaf265","url":null,"abstract":"<p><strong>Background: </strong>The landscape of perioperative immune checkpoint inhibitor (ICI) therapy for stage III melanoma is rapidly evolving. We conducted a modified Delphi consensus process to the define at an institutional level the optimal approach to implementation of a neoadjuvant ICI pathway for melanoma, addressing the themes of patient selection, perioperative therapy, response assessment and operative considerations, and follow-up.</p><p><strong>Methods: </strong>We developed 28 consensus statements which were circulated to 24 senior members of an institutional melanoma multidisciplinary meeting (MDM) team at the OECI-accredited Beaumont RCSI Cancer Centre, Ireland. Members were invited to anonymously rate statements using a 5-point Likert score. Statements not reaching pre-determined consensus threshold from the initial round of Delphi process would be amended for subsequent rounds.</p><p><strong>Results: </strong>Two modified Delphi rounds were conducted between May and June 2024, with round 1 results presented locally and at national meeting. Response rates for rounds 1 and 2 were 60% and 46%, respectively. In total, 23 statements of the 28 included (82%) met pre-determined criteria for consensus. Areas where lack of consensus was identified included the use of ICIs to down-stage unresectable disease, response-adapted approaches to adjuvant therapy and the optimal extent of nodal resection.</p><p><strong>Conclusions and revelance: </strong>Our process identified important knowledge gaps regarding the multidisciplinary care of stage III melanoma. The statements generated will be used to develop a local pathway for the implementation of neoadjuvant immunotherapy in melanoma, with plans to further expand the Delphi process to other Irish institutions incorporating up to date published data to refine recommendations.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979197","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}