{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T21:12:45Z","timestamp":1793308365571,"version":"4.5.0"},"reference-count":42,"publisher":"Springer Science and Business Media LLC","issue":"11","license":[{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Med Oncol"],"DOI":"10.1007\/s12032-026-03434-z","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T04:03:13Z","timestamp":1791432193000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Tumor microenvironment and gut microbiome in immunotherapy resistance in gastric cancer: clinical questions, biological mechanisms, and evidence-based therapeutic perspectives"],"prefix":"10.1007","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1994-4795","authenticated-orcid":false,"given":"Tamotsu","family":"Sagawa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Hirakawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Nagashima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koshi","family":"Fujikawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,8]]},"reference":[{"key":"3434_CR1","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1016\/S0140-6736(21)00797-2","volume":"398","author":"YY Janjigian","year":"2021","unstructured":"Janjigian YY, Shitara K, Moehler M, et al. First-line nivolumab plus chemotherapy versus chemotherapy alone for advanced gastric, gastro-oesophageal junction, and oesophageal adenocarcinoma (CheckMate 649): a randomised, open-label, phase 3 trial. Lancet. 2021;398:27\u201340. https:\/\/doi.org\/10.1016\/S0140-6736(21)00797-2.","journal-title":"Lancet"},{"key":"3434_CR2","doi-asserted-by":"publisher","first-page":"234","DOI":"10.1016\/S1470-2045(21)00692-6","volume":"23","author":"YK Kang","year":"2022","unstructured":"Kang YK, Chen LT, Ryu MH, et al. Nivolumab plus chemotherapy versus placebo plus chemotherapy in patients with HER2-negative, untreated, unresectable advanced or recurrent gastric or gastro-oesophageal junction cancer (ATTRACTION-4): a randomised, multicentre, double-blind, placebo-controlled, phase 3 trial. Lancet Oncol. 2022;23:234\u201347. https:\/\/doi.org\/10.1016\/S1470-2045(21)00692-6.","journal-title":"Lancet Oncol"},{"key":"3434_CR3","doi-asserted-by":"publisher","first-page":"1181","DOI":"10.1016\/S1470-2045(23)00515-6","volume":"24","author":"SY Rha","year":"2023","unstructured":"Rha SY, Oh DY, Ya\u00f1ez P, et al. Pembrolizumab plus chemotherapy versus placebo plus chemotherapy for HER2-negative advanced gastric cancer (KEYNOTE-859): a multicentre, randomised, double-blind, phase 3 trial. Lancet Oncol. 2023;24:1181\u201395. https:\/\/doi.org\/10.1016\/S1470-2045(23)00515-6.","journal-title":"Lancet Oncol"},{"key":"3434_CR4","doi-asserted-by":"publisher","first-page":"1330","DOI":"10.1158\/2159-8290.CD-19-1384","volume":"10","author":"Y Kieffer","year":"2020","unstructured":"Kieffer Y, Hocine HR, Gentric G, et al. Single-cell analysis reveals fibroblast clusters linked to immunotherapy resistance in cancer. Cancer Discov. 2020;10:1330\u201351. https:\/\/doi.org\/10.1158\/2159-8290.CD-19-1384.","journal-title":"Cancer Discov"},{"key":"3434_CR5","doi-asserted-by":"publisher","DOI":"10.1186\/s13045-019-0770-1","volume":"12","author":"T Liu","year":"2019","unstructured":"Liu T, Han C, Wang S, et al. Cancer-associated fibroblasts: an emerging target of anti-cancer immunotherapy. J Hematol Oncol. 2019;12:86. https:\/\/doi.org\/10.1186\/s13045-019-0770-1.","journal-title":"J Hematol Oncol"},{"key":"3434_CR6","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2021.668731","volume":"11","author":"H Raskov","year":"2021","unstructured":"Raskov H, Orhan A, Gaggar S, G\u00f6genur I. Cancer-associated fibroblasts and tumor-associated macrophages in cancer and cancer immunotherapy. Front Oncol. 2021;11:668731. https:\/\/doi.org\/10.3389\/fonc.2021.668731.","journal-title":"Front Oncol"},{"key":"3434_CR7","doi-asserted-by":"publisher","DOI":"10.1186\/s12943-023-01731-z","volume":"22","author":"L Pei","year":"2023","unstructured":"Pei L, Liu Y, Liu L, et al. Roles of cancer-associated fibroblasts (CAFs) in anti-PD-1\/PD-L1 immunotherapy for solid cancers. Mol Cancer. 2023;22:29. https:\/\/doi.org\/10.1186\/s12943-023-01731-z.","journal-title":"Mol Cancer"},{"key":"3434_CR8","doi-asserted-by":"publisher","first-page":"350","DOI":"10.1136\/gutjnl-2024-333617","volume":"74","author":"Y Li","year":"2025","unstructured":"Li Y, Zheng Y, Huang J, et al. CAF-macrophage crosstalk in tumour microenvironments governs the response to immune checkpoint blockade in gastric cancer peritoneal metastases. Gut. 2025;74:350\u201363. https:\/\/doi.org\/10.1136\/gutjnl-2024-333617.","journal-title":"Gut"},{"key":"3434_CR9","doi-asserted-by":"publisher","first-page":"38","DOI":"10.20517\/cdr.2025.97","volume":"8","author":"J Wu","year":"2025","unstructured":"Wu J, Zhang PF, Zeng Y, et al. Effects of FAP+ cancer-associated fibroblasts on anti-PD-1 immunotherapy and CD4\u2009+\u2009T cell polarization in gastric cancer. Cancer Drug Resist. 2025;8:38. https:\/\/doi.org\/10.20517\/cdr.2025.97.","journal-title":"Cancer Drug Resist"},{"key":"3434_CR10","doi-asserted-by":"publisher","first-page":"605","DOI":"10.5230\/jgc.2025.25.e46","volume":"25","author":"H Kim","year":"2025","unstructured":"Kim H, Kwon M, Lee SK, et al. Distinct immunosuppressive tumor microenvironment in gastric cancer with peritoneal metastasis. J Gastric Cancer. 2025;25:605\u201320. https:\/\/doi.org\/10.5230\/jgc.2025.25.e46.","journal-title":"J Gastric Cancer"},{"key":"3434_CR11","doi-asserted-by":"publisher","first-page":"665","DOI":"10.1038\/s41577-019-0221-9","volume":"19","author":"CU Blank","year":"2019","unstructured":"Blank CU, Haining WN, Held W, et al. Defining \u2018T cell exhaustion\u2019. Nat Rev Immunol. 2019;19:665\u201374. https:\/\/doi.org\/10.1038\/s41577-019-0221-9.","journal-title":"Nat Rev Immunol"},{"key":"3434_CR12","doi-asserted-by":"publisher","first-page":"202","DOI":"10.1038\/nature13480","volume":"513","author":"Cancer Genome Atlas Research Network","year":"2014","unstructured":"Cancer Genome Atlas Research Network. Comprehensive molecular characterization of gastric adenocarcinoma. Nature. 2014;513:202\u20139. https:\/\/doi.org\/10.1038\/nature13480.","journal-title":"Nature"},{"key":"3434_CR13","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1126\/science.aan3706","volume":"359","author":"B Routy","year":"2018","unstructured":"Routy B, Le Chatelier E, Derosa L, et al. Gut microbiome influences efficacy of PD-1-based immunotherapy against epithelial tumors. Science. 2018;359:91\u20137. https:\/\/doi.org\/10.1126\/science.aan3706.","journal-title":"Science"},{"key":"3434_CR14","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1126\/science.aan4236","volume":"359","author":"V Gopalakrishnan","year":"2018","unstructured":"Gopalakrishnan V, Spencer CN, Nezi L, et al. Gut microbiome modulates response to anti-PD-1 immunotherapy in melanoma patients. Science. 2018;359:97\u2013103. https:\/\/doi.org\/10.1126\/science.aan4236.","journal-title":"Science"},{"key":"3434_CR15","doi-asserted-by":"publisher","first-page":"104","DOI":"10.1126\/science.aao3290","volume":"359","author":"V Matson","year":"2018","unstructured":"Matson V, Fessler J, Bao R, et al. The commensal microbiome is associated with anti-PD-1 efficacy in metastatic melanoma patients. Science. 2018;359:104\u20138. https:\/\/doi.org\/10.1126\/science.aao3290.","journal-title":"Science"},{"key":"3434_CR16","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1038\/s41591-021-01655-5","volume":"28","author":"L Derosa","year":"2022","unstructured":"Derosa L, Routy B, Thomas AM, et al. Intestinal Akkermansia muciniphila predicts clinical response to PD-1 blockade in patients with advanced non-small-cell lung cancer. Nat Med. 2022;28:315\u201324. https:\/\/doi.org\/10.1038\/s41591-021-01655-5.","journal-title":"Nat Med"},{"key":"3434_CR17","doi-asserted-by":"publisher","first-page":"1243","DOI":"10.1158\/2326-6066.CIR-20-0196","volume":"8","author":"T Hakozaki","year":"2020","unstructured":"Hakozaki T, Richard C, Elkrief A, et al. The gut microbiome associates with immune checkpoint inhibition outcomes in patients with advanced non-small cell lung cancer. Cancer Immunol Res. 2020;8:1243\u201350. https:\/\/doi.org\/10.1158\/2326-6066.CIR-20-0196.","journal-title":"Cancer Immunol Res"},{"key":"3434_CR18","doi-asserted-by":"publisher","first-page":"535","DOI":"10.1038\/s41591-022-01695-5","volume":"28","author":"KA Lee","year":"2022","unstructured":"Lee KA, Thomas AM, Bolte LA, et al. Cross-cohort gut microbiome associations with immune checkpoint inhibitor response in advanced melanoma. Nat Med. 2022;28:535\u201344. https:\/\/doi.org\/10.1038\/s41591-022-01695-5.","journal-title":"Nat Med"},{"key":"3434_CR19","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2024.1512683","volume":"15","author":"MY Lim","year":"2025","unstructured":"Lim MY, Hong S, Nam YD. Understanding the role of the gut microbiome in solid tumor responses to immune checkpoint inhibitors for personalized therapeutic strategies: a review. Front Immunol. 2025;15:1512683. https:\/\/doi.org\/10.3389\/fimmu.2024.1512683.","journal-title":"Front Immunol"},{"key":"3434_CR20","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1038\/s41522-025-00786-8","volume":"11","author":"W Lei","year":"2025","unstructured":"Lei W, Zhou K, Lei Y, Li Q, Zhu H. Gut microbiota shapes cancer immunotherapy responses. NPJ Biofilms Microbiomes. 2025;11:143. https:\/\/doi.org\/10.1038\/s41522-025-00786-8.","journal-title":"NPJ Biofilms Microbiomes"},{"key":"3434_CR21","doi-asserted-by":"publisher","first-page":"704","DOI":"10.1038\/s41591-022-01694-6","volume":"28","author":"N Dizman","year":"2022","unstructured":"Dizman N, Meza L, Bergerot P, et al. Nivolumab plus ipilimumab with or without live bacterial supplementation in metastatic renal cell carcinoma: a randomized phase 1 trial. Nat Med. 2022;28:704\u201312. https:\/\/doi.org\/10.1038\/s41591-022-01694-6.","journal-title":"Nat Med"},{"key":"3434_CR22","doi-asserted-by":"publisher","DOI":"10.1002\/cnr2.70308","volume":"8","author":"J Arima","year":"2025","unstructured":"Arima J, Yoshino H, Tatarano S, et al. Prognostic impact of Clostridium butyricum MIYAIRI (CBM588) in combination with pembrolizumab for advanced urothelial carcinoma: a retrospective cohort study. Cancer Rep. 2025;8:e70308. https:\/\/doi.org\/10.1002\/cnr2.70308.","journal-title":"Cancer Rep"},{"key":"3434_CR23","doi-asserted-by":"publisher","first-page":"903","DOI":"10.3892\/ijo.2013.1790","volume":"42","author":"M Shinnoh","year":"2013","unstructured":"Shinnoh M, Horinaka M, Yasuda T, et al. Clostridium butyricum MIYAIRI 588 shows antitumor effects by enhancing the release of TRAIL from neutrophils through MMP-8. Int J Oncol. 2013;42:903\u201311. https:\/\/doi.org\/10.3892\/ijo.2013.1790.","journal-title":"Int J Oncol"},{"key":"3434_CR24","doi-asserted-by":"publisher","first-page":"595","DOI":"10.1126\/science.abf3363","volume":"371","author":"D Davar","year":"2021","unstructured":"Davar D, Dzutsev AK, McCulloch JA, et al. Fecal microbiota transplant overcomes resistance to anti-PD-1 therapy in melanoma patients. Science. 2021;371:595\u2013602. https:\/\/doi.org\/10.1126\/science.abf3363.","journal-title":"Science"},{"key":"3434_CR25","doi-asserted-by":"publisher","first-page":"602","DOI":"10.1126\/science.abb5920","volume":"371","author":"EN Baruch","year":"2021","unstructured":"Baruch EN, Youngster I, Ben-Betzalel G, et al. Fecal microbiota transplant promotes response in immunotherapy-refractory melanoma patients. Science. 2021;371:602\u20139. https:\/\/doi.org\/10.1126\/science.abb5920.","journal-title":"Science"},{"key":"3434_CR26","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-025-04183-y","volume":"23","author":"A Lin","year":"2025","unstructured":"Lin A, Huang L, Jiang A, et al. Microbiota boost immunotherapy? A meta-analysis dives into fecal microbiota transplantation and immune checkpoint inhibitors. BMC Med. 2025;23:341. https:\/\/doi.org\/10.1186\/s12916-025-04183-y.","journal-title":"BMC Med"},{"key":"3434_CR27","doi-asserted-by":"publisher","first-page":"1437","DOI":"10.1093\/annonc\/mdy103","volume":"29","author":"L Derosa","year":"2018","unstructured":"Derosa L, Hellmann MD, Spaziano M, et al. Negative association of antibiotics on clinical activity of immune checkpoint inhibitors in patients with advanced renal cell and non-small-cell lung cancer. Ann Oncol. 2018;29:1437\u201344. https:\/\/doi.org\/10.1093\/annonc\/mdy103.","journal-title":"Ann Oncol"},{"key":"3434_CR28","doi-asserted-by":"publisher","first-page":"1774","DOI":"10.1001\/jamaoncol.2019.2785","volume":"5","author":"DJ Pinato","year":"2019","unstructured":"Pinato DJ, Howlett S, Ottaviani D, et al. Association of prior antibiotic treatment with survival and response to immune checkpoint inhibitor therapy. JAMA Oncol. 2019;5:1774\u20138. https:\/\/doi.org\/10.1001\/jamaoncol.2019.2785.","journal-title":"JAMA Oncol"},{"key":"3434_CR29","doi-asserted-by":"publisher","first-page":"1415093","DOI":"10.3389\/fmed.2024.1415093","volume":"11","author":"FM Alotaibi","year":"2024","unstructured":"Alotaibi FM, Albalawi IAS, Anis AM, et al. The impact of antibiotic use in gastrointestinal tumors treated with immune checkpoint inhibitors: systematic review and meta-analysis. Front Med (Lausanne). 2024;11:1415093. https:\/\/doi.org\/10.3389\/fmed.2024.1415093.","journal-title":"Front Med (Lausanne)"},{"key":"3434_CR30","doi-asserted-by":"publisher","DOI":"10.1080\/2162402X.2021.1929727","volume":"10","author":"BD Qin","year":"2021","unstructured":"Qin BD, Jiao XD, Zhou XC, et al. Effects of concomitant proton pump inhibitor use on immune checkpoint inhibitor efficacy among patients with advanced cancer. Oncoimmunology. 2021;10:1929727. https:\/\/doi.org\/10.1080\/2162402X.2021.1929727.","journal-title":"Oncoimmunology"},{"key":"3434_CR31","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2023.1070076","volume":"14","author":"S Lopes","year":"2023","unstructured":"Lopes S, Pabst L, Dory A, et al. Do proton pump inhibitors alter the response to immune checkpoint inhibitors in cancer patients? A meta-analysis. Front Immunol. 2023;14:1070076. https:\/\/doi.org\/10.3389\/fimmu.2023.1070076.","journal-title":"Front Immunol"},{"key":"3434_CR32","doi-asserted-by":"publisher","DOI":"10.3390\/cancers17132228","volume":"17","author":"G Ciappina","year":"2025","unstructured":"Ciappina G, Ottaiano A, Santorsola M, et al. Impact of proton pump inhibitor use on progression-free and overall survival in cancer patients undergoing immune checkpoint inhibitor therapy: a systematic review and meta-analysis of recent studies. Cancers (Basel). 2025;17:2228. https:\/\/doi.org\/10.3390\/cancers17132228.","journal-title":"Cancers (Basel)"},{"key":"3434_CR33","doi-asserted-by":"publisher","first-page":"331","DOI":"10.1080\/1750743X.2025.2491300","volume":"17","author":"M Shibano","year":"2025","unstructured":"Shibano M, Takahashi M, Nakatsukasa H, et al. Proton pump inhibitors reduce nivolumab efficacy in unresectable advanced or recurrent gastric cancer. Immunotherapy. 2025;17:331\u20138. https:\/\/doi.org\/10.1080\/1750743X.2025.2491300.","journal-title":"Immunotherapy"},{"key":"3434_CR34","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2025.1538969","volume":"16","author":"S Zhao","year":"2025","unstructured":"Zhao S, Lu Z, Zhao F, Tang S, Zhang L, Feng C. Assessing the impact of probiotics on immunotherapy effectiveness and antibiotic-mediated resistance in cancer: a systematic review and meta-analysis. Front Immunol. 2025;16:1538969. https:\/\/doi.org\/10.3389\/fimmu.2025.1538969.","journal-title":"Front Immunol"},{"key":"3434_CR35","doi-asserted-by":"publisher","first-page":"1632","DOI":"10.1126\/science.aaz7015","volume":"374","author":"CN Spencer","year":"2021","unstructured":"Spencer CN, McQuade JL, Gopalakrishnan V, et al. Dietary fiber and probiotics influence the gut microbiome and melanoma immunotherapy response. Science. 2021;374:1632\u201340. https:\/\/doi.org\/10.1126\/science.aaz7015.","journal-title":"Science"},{"key":"3434_CR36","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1038\/s41586-025-09096-7","volume":"643","author":"THH Coorens","year":"2025","unstructured":"Coorens THH, Oh JW, Choi YA, et al. The Somatic Mosaicism across Human Tissues Network. Nature. 2025;643:47\u201359. https:\/\/doi.org\/10.1038\/s41586-025-09096-7.","journal-title":"Nature"},{"key":"3434_CR37","doi-asserted-by":"publisher","first-page":"398","DOI":"10.1038\/s41586-021-03836-1","volume":"597","author":"R Li","year":"2021","unstructured":"Li R, Di L, Li J, et al. A body map of somatic mutagenesis in morphologically normal human tissues. Nature. 2021;597:398\u2013403. https:\/\/doi.org\/10.1038\/s41586-021-03836-1.","journal-title":"Nature"},{"key":"3434_CR38","doi-asserted-by":"publisher","first-page":"644","DOI":"10.1158\/2159-8290.CD-26-0166","volume":"16","author":"LB Alexandrov","year":"2026","unstructured":"Alexandrov LB, Brennan P, Stratton MR. Early-life mutagenesis and the rise of early-onset colorectal cancer. Cancer Discov. 2026;16:644\u20136. https:\/\/doi.org\/10.1158\/2159-8290.CD-26-0166.","journal-title":"Cancer Discov"},{"key":"3434_CR39","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1111\/j.1751-2980.2011.00550.x","volume":"13","author":"P Correa","year":"2012","unstructured":"Correa P, Piazuelo MB. The gastric precancerous cascade. J Dig Dis. 2012;13:2\u20139. https:\/\/doi.org\/10.1111\/j.1751-2980.2011.00550.x.","journal-title":"J Dig Dis"},{"key":"3434_CR40","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1172\/JCI30111","volume":"117","author":"JG Fox","year":"2007","unstructured":"Fox JG, Wang TC. Inflammation, atrophy, and gastric cancer. J Clin Invest. 2007;117:60\u20139. https:\/\/doi.org\/10.1172\/JCI30111.","journal-title":"J Clin Invest"},{"key":"3434_CR41","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1146\/annurev-pathmechdis-012418-012818","volume":"14","author":"S Ogino","year":"2019","unstructured":"Ogino S, Nowak JA, Hamada T, Milner DA Jr, Nishihara R. Insights into pathogenic interactions among environment, host, and tumor at the crossroads of molecular pathology and epidemiology. Annu Rev Pathol. 2019;14:83\u2013103. https:\/\/doi.org\/10.1146\/annurev-pathmechdis-012418-012818.","journal-title":"Annu Rev Pathol"},{"key":"3434_CR42","doi-asserted-by":"publisher","first-page":"101290","DOI":"10.1016\/j.lana.2025.101290","volume":"53","author":"S Ogino","year":"2026","unstructured":"Ogino S, Patel AV, Ugai S, Giannakis M, Ugai T. Unique role of the prospective cohort incident-tumor biobank method in etiological research. Lancet Reg Health Am. 2026;53:101290. https:\/\/doi.org\/10.1016\/j.lana.2025.101290.","journal-title":"Lancet Reg Health Am"}],"container-title":["Medical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s12032-026-03434-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s12032-026-03434-z","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s12032-026-03434-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T04:03:14Z","timestamp":1791432194000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s12032-026-03434-z"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,8]]},"references-count":42,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2026,11]]}},"alternative-id":["3434"],"URL":"https:\/\/doi.org\/10.1007\/s12032-026-03434-z","relation":{},"ISSN":["1559-131X"],"issn-type":[{"value":"1559-131X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,8]]},"assertion":[{"value":"4 June 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 September 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 October 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Ethics approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":3,"name":"Ethics","label":"Consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":4,"name":"Ethics","label":"Consent to publish","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"308"}}