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HS reports grants from Asahi Kasei; grants and personal fees from Daiichi Sankyo, Kyo Diagnostics, MSD, Ono Pharmaceutical, Taiho Pharmaceutical, and Takeda Pharmaceutical; and personal fees from Astellas Pharma, AstraZeneca, Bayer, Bristol Myers Squibb, Chugai Pharmaceutical, Eli Lilly Japan, Merck BioPharma, Sanofi, and Yakult Honsha, all outside the submitted work. All other authors declare no relevant financial or non-financial interests.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study used anonymized data derived from the C-CAT database. Under the Japanese cancer genomic medicine system, patients provide informed consent before registration in C-CAT. The present secondary analysis used anonymized C-CAT analysis data obtained through the C-CAT data-use framework and was conducted in accordance with the governance framework for secondary use of C-CAT data in Japan. This secondary analysis was approved by the Institutional Review Board of Toyama University on May 1, 2024 (Approval No. R2024016) and the Information Utilization Review Board of C-CAT in August 2025 (Approval No. CDU2025-010N). The study was conducted in accordance with the Declaration of Helsinki, as revised in 2013.The anonymized aggregated C-CAT data were accessed for research purposes on 29 January 2026. The authors did not have access to information that could identify individual participants during or after data collection.","order":2,"name":"Ethics","label":"Ethics approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Under the Japanese cancer genomic medicine system, written informed consent was obtained before registration in C-CAT.","order":3,"name":"Ethics","label":"Consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable (no individual identifying data are included).","order":4,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"During the preparation of this manuscript, the authors used ChatGPT (OpenAI) as AI-assisted tools to improve language and readability. After using this tool, the authors reviewed and edited the content as needed and take full responsibility for the content of the published article.","order":5,"name":"Ethics","label":"Generative AI use","group":{"name":"EthicsHeading","label":"Declarations"}}]}}