Case Reports in Oncological Medicine最新文献

{"title":"Concurrent Nivolumab-Induced Myocarditis and Myasthenia Gravis: A Case Report.","authors":"Rajat Gupta, Noorine Plumber, Jae Lee, Barath Prashanth Sivasubramanian, Mohammad Eshaq Kyhan, Hardeep Singh, Sonu Gupta","doi":"10.1155/crom/9486566","DOIUrl":"https://doi.org/10.1155/crom/9486566","url":null,"abstract":"<p><strong>Background: </strong>Immune checkpoint inhibitors (ICIs) such as nivolumab have improved 10-year overall survival rates up to 43% in advanced melanoma. They carry a risk of severe immune-related adverse events (irAEs) up to 9%-33%, including cardiotoxicity and neuromuscular complications. Acral melanoma is a rare subtype that is often diagnosed late and requires aggressive therapy with adjunctive immunotherapy. Here, we report a rare case of an elderly male who developed myocarditis and myasthenia gravis 3 weeks after receiving the first dose of nivolumab for stage IIB acral melanoma.</p><p><strong>Case presentation: </strong>A 72-year-old male with a late diagnosis of Stage IIB acral melanoma of the left great toe underwent toe amputation and received adjuvant therapy with nivolumab as per NCCN guidelines. Within 21 days after the first infusion, he developed chest pressure, fatigue, and diplopia. Workup revealed new-onset heart failure with an EF of 45%-50% with Grade 2 diastolic dysfunction, elevated troponin and NT pro-BNP, and cardiac MRI findings consistent with severe Grade 3, immune-related myocarditis. This presentation was complicated by a Mobitz Type 2 AV block, 10-s asystole, and therefore required permanent pacemaker placement. The symptoms of fatigue and diplopia led to a diagnostic workup with electromyography, confirming Grade 3 nivolumab-induced myasthenia gravis. He was treated with dexamethasone followed by a tapering dose of prednisone, and one cycle of IVIG at 0.4 g/kg for 5 days, leading to symptom resolution and improvement of EF to 60%-65%. However, 2 months later, he developed atrial fibrillation with a rapid ventricular rate, with device check showing 100% burden, therefore requiring hospitalization and subsequent cardioversion.</p><p><strong>Conclusion: </strong>Nivolumab-induced myocarditis and myasthenia gravis require high clinical suspicion to make an early diagnosis and ICI discontinuation and aggressive immunosuppressive treatment. Due to early onset and rapid progression to conduction abnormalities and the development of new arrhythmogenic foci, immunotherapy-related myocarditis requires close monitoring. This case also highlights the importance of multidisciplinary management and individualized risk-benefit assessment when considering rechallenge with ICIs.</p>","PeriodicalId":9636,"journal":{"name":"Case Reports in Oncological Medicine","volume":"2026 ","pages":"9486566"},"PeriodicalIF":0.6,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12974633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147430302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First-Line Treatment of Advanced Thoracic SMARCA4-Deficient Undifferentiated Tumor: A Case Report and Review of the Literature.","authors":"Qingyang Wen, Mengle Long, Feng Li, Yaya Peng, Jiarong Yi, Yongjun Wu, Di Wang","doi":"10.1155/crom/7148051","DOIUrl":"https://doi.org/10.1155/crom/7148051","url":null,"abstract":"<p><strong>Background: </strong>Thoracic SMARCA4-deficient undifferentiated tumor (SMARCA4-UT) of the chest is a highly aggressive smoking-related thoracic malignancy with a median overall survival (OS) of only 4-7 months.</p><p><strong>Case presentation: </strong>In this article, we report a case of a 74-year-old male patient who was admitted to the hospital with recurrent cough with sputum and CT suggestive of a right pleural occupying lesion. Admission to the hospital and perfect CT showed right pleural thickening with multiple metastases in the mediastinum and liver, and the diagnosis of SMARCA4-UT (SMARCA4 expression deletion) was confirmed by pathologic biopsy and immunohistochemistry. The genetic test map suggested high PD-L1 expression (TPS 80%) and the patient was treated with sindilizumab (200 mg q3w) combined with bevacizumab (500 mg q3w). Grade 3 immune myocarditis occurred during treatment, and bevacizumab maintenance therapy was continued after discontinuing immunosuppression. During follow-up, the patient achieved a final OS of 18 months.</p><p><strong>Conclusions: </strong>This case suggests that PD-1 inhibitors combined with antiangiogenic therapy may improve the prognosis of SMARCA4-UT, but the adverse effects observed during the treatment course demanded equally critical attention.</p>","PeriodicalId":9636,"journal":{"name":"Case Reports in Oncological Medicine","volume":"2026 ","pages":"7148051"},"PeriodicalIF":0.6,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12969486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147430513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary Mediastinal Seminoma: A Diagnostic and Therapeutic Challenge With an Optimistic Outcome.","authors":"Stephanie Dos Santos Bueno, Roberta Borin Previtale, Mike Rocha Alves, Klinger Soares Faico-Filho","doi":"10.1155/crom/3286934","DOIUrl":"10.1155/crom/3286934","url":null,"abstract":"<p><strong>Introduction: </strong>Primary mediastinal seminoma is a rare germ cell tumor that predominantly affects young men. Clinical presentation is variable, and diagnosis relies on imaging studies, tumor markers, and histopathological confirmation. This case report describes the diagnostic and therapeutic approach in a patient with mediastinal seminoma, in accordance with CARE guidelines.</p><p><strong>Case report: </strong>A 33-year-old man presented with hoarseness, progressive dyspnea, dysphagia, and cough. Diagnostic investigation revealed a large mass in the anterior and middle mediastinum, which was confirmed as seminoma by biopsy and immunohistochemical analysis. Treatment with cisplatin-based chemotherapy (BEP regimen) resulted in a favorable response and significant tumor reduction.</p><p><strong>Conclusion: </strong>Early diagnosis and appropriate treatment of primary mediastinal seminoma are essential for achieving a favorable prognosis.</p>","PeriodicalId":9636,"journal":{"name":"Case Reports in Oncological Medicine","volume":"2026 ","pages":"3286934"},"PeriodicalIF":0.6,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12966336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147376089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Durable Marked Response of Unresectable Esophageal Squamous Cell Carcinoma After Radiotherapy Alone Followed by Combination Immunotherapy.","authors":"Yasuhiro Watanabe, Shin Ichi Miyamoto, Yoichi Asano, Hiroaki Yaku, Kazuhito Ueki, Norio Araki, Taro Ueo","doi":"10.1155/crom/3970015","DOIUrl":"https://doi.org/10.1155/crom/3970015","url":null,"abstract":"<p><p>We report the case of a 70-year-old man with unresectable esophageal squamous cell carcinoma who achieved durable marked response with combined immune checkpoint inhibitor (ICI) therapy following radiotherapy (RT) alone. The patient presented with dysphagia and stridor due to a bulky esophageal tumor and cervical lymph node metastasis compressing the trachea. He was diagnosed with cT3N1M0 (Stage IIIB; 8th edition of the TNM classification) or cT4(101R-Trachea)N1M0 (Stage IVA; 12th edition of the Japanese classification). He underwent RT alone (total dose, 50 Gy), resulting in substantial tumor shrinkage and improvement in Eastern Cooperative Oncology Group performance status from 4 (due to ventilator dependence) to 1. Following confirmation of programmed death-ligand 1 positivity (tumor proportion score ≧ 1%), treatment with nivolumab (anti<b>-</b>programmed cell death<b>-</b>1 antibody) and ipilimumab (anti-cytotoxic T-lymphocyte antigen-4 antibody) was initiated. The therapeutic effect was remarkable, and treatment continued for 14 courses until an immune-related adverse event of secondary adrenal insufficiency interrupted therapy. Thereafter, there was no apparent recurrence on imaging for 31 months after treatment initiation. This case highlights the potential effect of RT followed by ICI combination therapy. Preclinical and clinical data suggest that prior RT may enhance systemic tumor immune responses. This therapeutic approach is currently being prospectively evaluated in the ongoing Phase II trial by the Japan Clinical Oncology Group (JCOG2311).</p>","PeriodicalId":9636,"journal":{"name":"Case Reports in Oncological Medicine","volume":"2026 ","pages":"3970015"},"PeriodicalIF":0.6,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12947768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147324725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epithelioid Hemangioendothelioma With a Novel Chromosomal Deletion and an Aggressive Clinical Course: A Case Report and Literature Review.","authors":"Danielle C Thor, Nowair Hussain, Ada Baisre de Leon","doi":"10.1155/crom/3387413","DOIUrl":"https://doi.org/10.1155/crom/3387413","url":null,"abstract":"<p><p>Epithelioid hemangioendothelioma (EHE) is a rare neoplastic process arising from the endothelial lining of virtually any blood vessel, with varying degrees of metastatic spread. In the following case report, the clinical course and treatment stratification are detailed for a 59-year-old female who originally presented with cervical radiculopathy and was found to have aggressive-type EHE refractory to multiple lines of therapy. In doing so, a novel deletion of the long arm of Chromosome 16 at Position 24, in all cells analyzed, ISCN Karyotype: 46,XX,del(16)(q24)[10] is also identified and may contribute to a more aggressive disease presentation. Ultimately, further scientific contribution is provided by this report to the otherwise limited understanding of this unique malignancy.</p>","PeriodicalId":9636,"journal":{"name":"Case Reports in Oncological Medicine","volume":"2026 ","pages":"3387413"},"PeriodicalIF":0.6,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12947769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147324710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paraneoplastic Pulmonary Embolism Revealing Metastatic Uterine Carcinosarcoma.","authors":"Elias Tayar, Amira Bitar, Maroun Ibrahim","doi":"10.1155/crom/5340586","DOIUrl":"https://doi.org/10.1155/crom/5340586","url":null,"abstract":"<p><strong>Background: </strong>Venous thromboembolism (VTE) can be a paraneoplastic phenomenon and may occasionally be the first manifestation of an occult malignancy. We present the case of an elderly woman whose \"unprovoked\" pulmonary embolism (PE) led to the diagnosis of metastatic uterine carcinosarcoma, an aggressive endometrial cancer subtype.</p><p><strong>Case: </strong>A 74-year-old postmenopausal woman with a history of uterine fibroids and prior breast ductal carcinoma in situ developed progressive dyspnea. She was found to have bilateral PEs with right heart strain and extensive bilateral deep vein thromboses (DVTs). Imaging also revealed ascites, widespread lymphadenopathy, and an 8-cm uterine mass. Tumor marker evaluation showed a markedly elevated CA-125 level. Diagnostic procedures including endometrial biopsy, ascitic fluid cytology, and lymph node biopsy confirmed Stage IVB uterine carcinosarcoma. She was managed with anticoagulation for VTE and initiated on systemic chemotherapy (carboplatin plus paclitaxel), given that surgical cure was not feasible due to metastases.</p><p><strong>Outcome: </strong>After treatment initiation, the patient's respiratory status improved, and she was discharged on long-term anticoagulation and chemotherapy, with plans for outpatient oncology follow-up.</p><p><strong>Conclusion: </strong>This case highlights that an unexplained (unprovoked) PE in an older adult can be the harbinger of an underlying malignancy. In women, especially those with additional red flags such as abdominal distension or abnormal uterine bleeding, prompt evaluation for gynecologic cancers is warranted. Early identification of the occult cancer allowed appropriate therapy; however, uterine carcinosarcoma carries a poor prognosis once metastatic. Clinicians should maintain a high index of suspicion for hidden malignancy in cases of idiopathic VTE, as timely diagnosis can guide life-saving interventions.</p>","PeriodicalId":9636,"journal":{"name":"Case Reports in Oncological Medicine","volume":"2026 ","pages":"5340586"},"PeriodicalIF":0.6,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12949080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147324764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scleromyxedema Managed With High-Dose Intravenous Immunoglobulin and Bortezomib-Dexamethasone: A Case Report.","authors":"Darren Wijaya, Zachary Hanson, Eric K Lau, Mojtaba Akhtari","doi":"10.1155/crom/3773160","DOIUrl":"https://doi.org/10.1155/crom/3773160","url":null,"abstract":"<p><p>Scleromyxedema is a rare, chronic cutaneous mucinosis marked by widespread waxy papules and potential extracutaneous involvement. This case report discusses the management of a 48-year-old female diagnosed with scleromyxedema, who initially partially responded to high-dose intravenous immunoglobulin (HDIVIG) therapy. After partial relapse, she was induced with bortezomib, a proteasome inhibitor, and dexamethasone, achieving significant clinical improvement. Long-term maintenance with IVIG was utilized to prevent recurrence of symptoms. This case highlights the effectiveness of both HDIVIG and bortezomib-dexamethasone dual therapy as viable treatment options for scleromyxedema, emphasizing the importance of maintenance therapy to prevent relapse.</p>","PeriodicalId":9636,"journal":{"name":"Case Reports in Oncological Medicine","volume":"2026 ","pages":"3773160"},"PeriodicalIF":0.6,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12943466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147324743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sustained Drug-Drug Interaction Between Cyclosporine and Apalutamide in a Patient With Metastatic Hormone-Sensitive Prostate Cancer: A Case Report and Evaluation of CYP3A4 Induction via Pregnane X Receptor Activation by Apalutamide.","authors":"Yoshihisa Mimura, Takaomi Sanda, Rei Unno, Yuki Furukawa, Ryota Shizu, Kotona Motokatsu, Yuusuke Tashiro, Yoshihiko Tasaki, Yosuke Sugiyama, Tomoya Yasujima, Taku Naiki, Yasuhiro Horita, Yuji Hotta, Hiroaki Yuasa, Kouichi Yoshinari, Takahiro Yasui, Shinsuke Iida, Yoko Furukawa-Hibi","doi":"10.1155/crom/3539500","DOIUrl":"https://doi.org/10.1155/crom/3539500","url":null,"abstract":"<p><strong>Background: </strong>Apalutamide (Apa) is a key therapeutic agent for prostate cancer. Despite its efficacy, Apa is known to induce several drug-metabolizing enzymes including cytochrome P450 3A4 (CYP3A4), raising concerns about drug-drug interactions (DDIs). This study reports a rare case of a sustained DDI between Apa and cyclosporine (CsA)-a CYP3A4 substrate-in a patient with metastatic hormone-sensitive prostate cancer (mHSPC) and primary pure red cell aplasia (PRCA). We further investigated whether Apa could activate pregnane X receptor (PXR), a key nuclear receptor that regulates CYP3A4 expression.</p><p><strong>Methods: </strong>With informed consent, residual blood samples were used to measure serum Apa concentration. To assess the potential of Apa in activating PXR, a reporter gene assay and a CYP3A4 mRNA induction test were performed.</p><p><strong>Case presentation: </strong>A 75-year-old man with mHSPC was treated with Apa and leuprorelin. He developed PRCA and was administered CsA (5 mg/kg/day) on Day 1. Despite a target trough concentration (<i>C</i> _trough) of 150-200 ng/mL, the <i>C</i> _trough of CsA remained subtherapeutic (34 ng/mL on Day 5), even after dose escalation to 10 mg/kg/day (<i>C</i> _trough: 66 ng/mL on Day 7), suspecting a DDI with Apa. On Day 8, Apa was discontinued and the CsA dosage was reduced to 5 mg/kg/day. The Apa concentrations measured on Days 13, 26, and 34 were 1.1, 0.15, and 0.07 <i>μ</i>g/mL, respectively, and the <i>C</i> _trough of CsA increased to 45, 82, and 134 ng/mL, respectively. In vitro experiments demonstrated that Apa was a strong activator of PXR and capable of inducing <i>CYP3A4</i>.</p><p><strong>Conclusion: </strong>Apa induced CYP3A4 via the PXR pathway, leading to a sustained DDI with CsA. Careful monitoring is necessary when Apa is coadministered with CYP3A4 substrates.</p>","PeriodicalId":9636,"journal":{"name":"Case Reports in Oncological Medicine","volume":"2026 ","pages":"3539500"},"PeriodicalIF":0.6,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12930205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147289374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Rare Case of TFE3-Rearranged and SMARCB1-Mutated Renal Cell Carcinoma: Diagnostic and Therapeutic Complexities.","authors":"Paul J Pecorin, Nyembezi Dhliwayo, Trevor Christ, Thomas Westbrook","doi":"10.1155/crom/6909249","DOIUrl":"https://doi.org/10.1155/crom/6909249","url":null,"abstract":"<p><p>Renal cell carcinoma (RCC) represents the majority of kidney malignancies, with clear cell RCC being the most common subtype. However, recent advances in tumor genomics have refined RCC classification, highlighting rare molecular subtypes such as TFE3-rearranged and SMARCB1-deficient RCCs. These entities pose unique diagnostic and therapeutic challenges due to their aggressive nature and limited treatment data. We present a rare case of metastatic RCC with concurrent TFE3 translocation and SMARCB1 mutation in a 39-year-old patient. The patient underwent multiple systemic therapies, including immune checkpoint inhibitors (ICIs) and tyrosine kinase inhibitors (TKIs), alongside surgical and radiation interventions. Despite disease progression, a combination of lenvatinib and pembrolizumab has shown recent stabilization. This case underscores the importance of genomic profiling in identifying rare RCC subtypes and guiding treatment decisions. Given the aggressive course and lack of established guidelines, further research is needed to optimize therapeutic strategies for these molecularly defined RCC variants.</p>","PeriodicalId":9636,"journal":{"name":"Case Reports in Oncological Medicine","volume":"2026 ","pages":"6909249"},"PeriodicalIF":0.6,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12930201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147289439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sustained Complete Response to Brigatinib in a Young Patient With ALK-Positive NSCLC Harboring I1171N Mutation Post-Alectinib Resistance.","authors":"Akhil Kapoor, Ajay Kumar Singh, Mahesh Chaudhary, Anuj Gupta, Bipinesh Sansar, Bal Krishna Mishra, Shashikant Patne, Arvind Suresh","doi":"10.1155/crom/7372418","DOIUrl":"https://doi.org/10.1155/crom/7372418","url":null,"abstract":"<p><p>ALK-rearranged non-small cell lung cancer (NSCLC) represents a paradigm of precision oncology, but acquired resistance to second-generation ALK tyrosine kinase inhibitors (TKIs) such as alectinib remains inevitable. We report a young, nonsmoker male with ALK-positive metastatic NSCLC who achieved a sustained complete response (CR) to brigatinib following alectinib resistance mediated by the ALK I1171N mutation. After 22 months of response to alectinib, disease progression prompted repeat molecular profiling, which identified the I1171N alteration. Brigatinib was initiated, and a complete radiologic response was documented within 3 months and has been sustained for over 12 months, including durable intracranial disease control. Sustained CR in I1171N-mediated alectinib resistance is rare and highlights the critical role of repeat molecular testing to guide ALK TKI sequencing.</p>","PeriodicalId":9636,"journal":{"name":"Case Reports in Oncological Medicine","volume":"2026 ","pages":"7372418"},"PeriodicalIF":0.6,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12920669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147269563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}