{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:23:07Z","timestamp":1787026987147,"version":"build-2736575974"},"reference-count":65,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T00:00:00Z","timestamp":1781740800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:p>Pulmonary sarcomatoid carcinoma (PSC) is frequently underdiagnosed or misdiagnosed due to its rarity and complex histological features. To date, no universally recommended treatment regimens have been established for this rare subtype, and clinical management is currently extrapolated primarily from standard non-small cell lung cancer (NSCLC) protocols. Herein, we report a case of PSC initially diagnosed as multiple primary lung cancer, including adenosquamous carcinoma and adenocarcinoma (pT1N0M0, IA stage, EGFR Exon-21 L858R mutation, below the detection limit) and adenocarcinoma (pT2aN0M0, stage IB, EGFR Exon-21 L858R mutation). Despite radical surgical resection followed by targeted therapy with afatinib (30 mg orally once daily), the disease recurred. Repeat biopsy confirmed the diagnosis of PSC secondary to histological transformation. The patient achieved a durable complete response (CR) to combined immunochemotherapy. We further review the existing literature on EGFR-TKI-associated histological transformation in lung cancer, to provide guidance for the clinical management of this challenging clinical scenario.<\/jats:p>","DOI":"10.3389\/fonc.2026.1811812","type":"journal-article","created":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T04:39:07Z","timestamp":1781757547000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Histological transformation into pulmonary sarcomatoid carcinoma from lung adenosquamous carcinoma after radical resection of EGFR gene Exon-21 L858R mutation: a case report and literature review"],"prefix":"10.3389","volume":"16","author":[{"given":"Daxia","family":"Cai","sequence":"first","affiliation":[{"name":"Cancer Center, Lishui Central Hospital, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Hospital of Zhejiang University","place":["Lishui, Zhejiang, China"]},{"name":"Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Jinan University","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Li","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Taihe Hospital, Hubei University of Medicine","place":["Shiyan, Hubei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiyi","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Jinan University","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xingdong","family":"Cai","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Jinan University","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Tian","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Lishui People\u2019s Hospital, the Six Affiliated Hospital of Wenzhou Medical University","place":["Lishui, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanyan","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Lishui Municipal Central Hospital, The Fifth Affiliated Hospital of Wenzhou Medical University","place":["Lishui, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingjing","family":"Cao","sequence":"additional","affiliation":[{"name":"Pathology department, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Hospital of Zhejiang University","place":["Lishui, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianhui","family":"Huang","sequence":"additional","affiliation":[{"name":"Cancer Center, Lishui Central Hospital, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Hospital of Zhejiang University","place":["Lishui, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiu","family":"Lan","sequence":"additional","affiliation":[{"name":"Cancer Center, Lishui Central Hospital, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Hospital of Zhejiang University","place":["Lishui, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhifeng","family":"Tian","sequence":"additional","affiliation":[{"name":"Cancer Center, Lishui Central Hospital, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Hospital of Zhejiang University","place":["Lishui, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianfei","family":"Tu","sequence":"additional","affiliation":[{"name":"Cancer Center, Lishui Central Hospital, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Hospital of Zhejiang University","place":["Lishui, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yonghui","family":"Wang","sequence":"additional","affiliation":[{"name":"Cancer Center, Lishui Central Hospital, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Hospital of Zhejiang University","place":["Lishui, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,18]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2021.11.003","article-title":"The 2021 WHO classification of lung tumors: Impact of advances since 2015","volume":"17","author":"Nicholson","year":"2022"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2021.12.014","article-title":"The 2021 WHO classification of tumors of the pleura: Advances since the 2015 classification","volume":"17","author":"Sauter","year":"2022"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1669","DOI":"10.1016\/j.jtcvs.2021.01.081","article-title":"Adjuvant chemotherapy for pulmonary sarcomatoid carcinoma: A retrospective analysis of the National Cancer Database","volume":"163","author":"Abdallah","year":"2022"},{"key":"B4","article-title":"A modified vimentin histological score helps recognize pulmonary sarcomatoid carcinoma in small biopsy samples","volume":"32","author":"Pelosi","year":"2012"},{"key":"B5","doi-asserted-by":"publisher","first-page":"4878","DOI":"10.1038\/s41467-020-18702-3","article-title":"Integrated molecular characterization reveals potential therapeutic strategies for pulmonary sarcomatoid carcinoma","volume":"11","author":"Yang","year":"2020"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.34137","article-title":"PSC subtyping based on TTF-1 and p40 expression reveals distinct molecular characteristics and therapeutic strategies","volume":"151","author":"Yang","year":"2022"},{"key":"B7","article-title":"The epidermal growth factor receptor ligand amphiregulin protects from cholestatic liver injury and regulates bile acids synthesis","volume":"69","author":"Santamar\u00eda","year":"2019"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2017.03.005","article-title":"Pulmonary sarcomatoid carcinomas commonly harbor either potentially targetable genomic alterations or high tumor mutational burden as observed by comprehensive genomic profiling","volume":"12","author":"Schrock","year":"2017"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2020.02.071","article-title":"Pulmonary sarcomatoid carcinoma: Experience from SEER database and Shanghai Pulmonary Hospital","volume":"110","author":"Sun","year":"2020"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2016.04.020","article-title":"Deep sequencing analysis reveals that KRAS mutation is a marker of poor prognosis in patients with pulmonary sarcomatoid carcinoma","volume":"11","author":"Lococo","year":"2016"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2019.6879","article-title":"Association of survival and immune-related biomarkers with immunotherapy in patients with non-small cell lung cancer: A meta-analysis and individual patient-level analysis","volume":"2","author":"Yu","year":"2019"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2008.10.026","article-title":"New response evaluation criteria in solid tumours: Revised RECIST guideline (version 1.1)","volume":"45","author":"Eisenhauer","year":"2009"},{"key":"B13","article-title":"Practical PERCIST: A simplified guide to PET response criteria in solid tumors 1.0","volume":"280","author":"O","year":"2016"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1002\/anie.202003500","article-title":"Mutant-selective allosteric EGFR degraders are effective against a broad range of drug-resistant mutations","volume":"59","author":"Jang","year":"2020"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1016\/s1470-2045(14)71180-5","article-title":"Transformation from non-small-cell lung cancer to small-cell lung cancer: Molecular drivers and cells of origin","volume":"16","author":"Oser","year":"2015"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.ccr-12-2246","article-title":"Analysis of tumor specimens at the time of acquired resistance to EGFR-TKI therapy in 155 patients with EGFR-mutant lung cancers","volume":"19","author":"Yu","year":"2013"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1007\/s10147-024-02683-0","article-title":"Japan Society of Clinical Oncology position paper on appropriate clinical use of molecular residual disease (MRD) testing","volume":"30","author":"Kobayashi","year":"2025"},{"key":"B18","doi-asserted-by":"publisher","first-page":"108374","DOI":"10.1016\/j.ejso.2024.108374","article-title":"Impact of timing and initial recurrence site on post-recurrence survival in resected non-small cell lung cancer","volume":"50","author":"Akamine","year":"2024"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacr.2025.02.025","article-title":"ACR Appropriateness Criteria\u00ae lung cancer-surveillance after therapy","volume":"22","author":"Madan","year":"2025"},{"key":"B20","doi-asserted-by":"publisher","first-page":"212","DOI":"10.1007\/s00262-024-03800-8","article-title":"Increasing monocytes after lung cancer surgery triggers the outgrowth of distant metastases, causing recurrence","volume":"73","author":"Kawaguchi","year":"2024"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1136\/jitc-2024-010416","article-title":"ALCAM-CD6 axis suppression: A key determinant of immune-mediated metastasis recurrence in stage III non-small cell lung cancer","volume":"13","author":"Wen","year":"2025"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1016\/j.cllc.2020.09.002","article-title":"Early distant recurrence in patients with resected stage I lung cancer: A case series of \"Blast Metastasis","volume":"22","author":"Ekeke","year":"2021"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-023-05729-x","article-title":"The evolution of non-small cell lung cancer metastases in TRACERx","volume":"616","author":"Al Bakir","year":"2023"},{"key":"B24","doi-asserted-by":"publisher","first-page":"942084","DOI":"10.3389\/fonc.2022.942084","article-title":"Transformation of adenocarcinoma to squamous cell carcinoma as a source of EGFR-TKI resistance: A case report and literature review","volume":"2022","author":"Xi","year":"2022"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.2147\/cmar.s349082","article-title":"Serum NSE is early marker of transformed neuroendocrine tumor after EGFR-TKI treatment of lung adenocarcinoma","volume":"2022","author":"Mao","year":"2022"},{"key":"B26","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1016\/j.lungcan.2019.05.024","article-title":"Paired genomic analysis of squamous cell carcinoma transformed from EGFR-mutated lung adenocarcinoma","volume":"2019","author":"Park","year":"2019"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2017.03.022","article-title":"Large cell neuroendocrine carcinoma transformation and EGFR-T790M mutation as coexisting mechanisms of acquired resistance to EGFR-TKIs in lung cancer","volume":"92","author":"Baglivo","year":"2017"},{"key":"B28","article-title":"Squamous cell carcinoma \"transformation\" concurrent with secondary T790M mutation in resistant EGFR-mutated adenocarcinomas","volume":"11","author":"Jukna","year":"2016"},{"key":"B29","doi-asserted-by":"publisher","first-page":"593","DOI":"10.1186\/s12885-016-2623-4","article-title":"Case report: Small cell transformation and metastasis to the breast in a patient with lung adenocarcinoma following maintenance treatment with epidermal growth factor receptor tyrosine kinase inhibitors","volume":"2016","author":"Lin","year":"2016"},{"key":"B30","article-title":"Lung adenocarcinoma with sarcomatoid transformation after tyrosine kinase inhibitor treatment and chemotherapy","volume":"137","author":"Hsieh","year":""},{"key":"B31","doi-asserted-by":"publisher","first-page":"447","DOI":"10.3390\/cells14060447","article-title":"Chromosomal instability is associated with cGAS-STING activation in EGFR-TKI refractory non-small-cell lung cancer","volume":"14","author":"Yonesaka","year":"2025"},{"key":"B32","doi-asserted-by":"publisher","first-page":"189194","DOI":"10.1016\/j.bbcan.2024.189194","article-title":"Perioperative immunotherapy for patients with EGFR mutant non-small cell lung cancer: Unexpected potential benefits","volume":"1879","author":"Teng","year":"2024"},{"key":"B33","doi-asserted-by":"publisher","first-page":"609","DOI":"10.1038\/s41419-024-07011-y","article-title":"EZH2 represses mesenchymal genes and upholds the epithelial state of breast carcinoma cells","volume":"15","author":"Gallardo","year":"2024"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2024.04.019","article-title":"Tracing tumor heterogeneity of pleomorphic carcinoma of the lung","volume":"19","author":"Roma","year":"2024"},{"key":"B35","doi-asserted-by":"publisher","first-page":"156107","DOI":"10.1016\/j.prp.2025.156107","article-title":"Expression of m6A-related factors in pulmonary sarcomatoid carcinoma","volume":"2025","author":"Chen","year":"2025"},{"key":"B36","doi-asserted-by":"publisher","first-page":"2993","DOI":"10.1007\/s12094-024-03823-8","article-title":"Clinical characteristics and survival outcomes in patients with pulmonary sarcomatoid carcinoma: A multicenter retrospective study","volume":"27","author":"Du","year":"2025"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.1007\/s00432-022-04022-0","article-title":"Transformation of invasive lung adenocarcinoma with ALK rearrangement into pulmonary sarcomatoid carcinoma","volume":"148","author":"Xie","year":"2022"},{"key":"B38","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1186\/s12935-026-04280-9","article-title":"MicroRNA-regulated signaling and tumor microenvironment modulation in lung cancer: Mechanistic insights and translational opportunities","volume":"26","author":"Shrestha","year":"2026"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1158\/0008-5472.can-23-1067","article-title":"Lineage plasticity: The new cancer hallmark on the block","volume":"84","author":"Mehta","year":"2024"},{"key":"B40","doi-asserted-by":"publisher","first-page":"4641","DOI":"10.3390\/cancers13184641","article-title":"Histologic transformation in EGFR-mutant lung adenocarcinomas: Mechanisms and therapeutic implications","volume":"13","author":"Pathak","year":"2021"},{"key":"B41","article-title":"Cancer cell plasticity during tumor progression, metastasis and response to therapy","volume":"4","author":"P\u00e9rez-Gonz\u00e1lez","year":"2023"},{"key":"B42","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1038\/s41571-024-00971-2","article-title":"The changing treatment landscape of EGFR-mutant non-small-cell lung cancer","volume":"22","author":"Zhou","year":"2025"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.1515\/jtim-2024-0019","article-title":"Histological transformation in lung adenocarcinoma: Insights of mechanisms and therapeutic windows","volume":"12","author":"Tan","year":"2024"},{"key":"B44","doi-asserted-by":"publisher","first-page":"4164","DOI":"10.3390\/ijms23084164","article-title":"Morphologic-molecular transformation of oncogene addicted non-small cell lung cancer","volume":"23","author":"Calabrese","year":"2022"},{"key":"B45","doi-asserted-by":"publisher","first-page":"3269","DOI":"10.3390\/cancers16193269","article-title":"FBXO11 mediates ubiquitination of ZEB1 and modulates epithelial-to-mesenchymal transition in lung cancer cells","volume":"16","author":"Zhao","year":"2024"},{"key":"B46","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2022.02.011","article-title":"Concurrent TP53 mutations facilitate resistance evolution in EGFR-mutant lung adenocarcinoma","volume":"17","author":"Vokes","year":"2022"},{"key":"B47","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1016\/j.jncc.2024.12.005","article-title":"Rare transformation from lung adenocarcinoma to sarcomatoid carcinoma mediates resistance to inhibitors targeting different driver oncogenes","volume":"5","author":"Pang","year":"2024"},{"key":"B48","doi-asserted-by":"publisher","first-page":"104295","DOI":"10.1016\/j.critrevonc.2024.104295","article-title":"The study of primary and acquired resistance to first-line osimertinib to improve the outcome of EGFR-mutated advanced non-small cell lung cancer patients: The challenge is open for new therapeutic strategies","volume":"2024","author":"Ferro","year":"2024"},{"key":"B49","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2022.02.003","article-title":"ESMO expert consensus statements on the management of EGFR mutant non-small-cell lung cancer","volume":"33","author":"Passaro","year":"2022"},{"key":"B50","doi-asserted-by":"publisher","first-page":"312","DOI":"10.1007\/s00432-024-05778-3","article-title":"Mutant TP53 promotes invasion of lung cancer cells by regulating desmoglein 3","volume":"150","author":"Feng","year":"2024"},{"key":"B51","doi-asserted-by":"publisher","DOI":"10.1038\/s43018-025-01053-7","article-title":"A cellular and spatial atlas of TP53-associated tissue remodeling defines a multicellular tumor ecosystem in lung adenocarcinoma","volume":"6","author":"Zhao","year":"2025"},{"key":"B52","doi-asserted-by":"publisher","first-page":"1274937","DOI":"10.3389\/fimmu.2023.1274937","article-title":"Pembrolizumab combined with anlotinib improves therapeutic efficacy in pulmonary sarcomatoid carcinoma with TMB-H and PD-L1 expression: a case report and literature review","volume":"2023","author":"Wu","year":"2023"},{"key":"B53","doi-asserted-by":"publisher","first-page":"1467755","DOI":"10.3389\/fimmu.2024.1467755","article-title":"Case report: The outcomes of neoadjuvant immunotherapy combined with chemotherapy in pulmonary sarcomatoid carcinoma: case series and literature review","volume":"2024","author":"Guo","year":"2024"},{"key":"B54","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2025.07.121","article-title":"Distinct clinicogenomic features and immunotherapy associations in pulmonary sarcomatoid carcinoma: a multicenter retrospective study","volume":"20","author":"Hong","year":"2025"},{"key":"B55","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1007\/s10555-025-10245-7","article-title":"Immunomodulatory role of oncogenic alterations in non-small cell lung cancer: a review of implications for immunotherapy","volume":"44","author":"Ramos-Ram\u00edrez","year":"2025"},{"key":"B56","doi-asserted-by":"publisher","first-page":"17588359241249041","DOI":"10.1177\/17588359241249041","article-title":"Role of immunotherapy in pulmonary sarcomatoid carcinoma: review of current approaches and related biomarkers","volume":"2024","author":"Ding","year":"2024"},{"key":"B57","doi-asserted-by":"publisher","first-page":"108068","DOI":"10.1016\/j.lungcan.2024.108068","article-title":"Efficacy of immune checkpoint inhibitors in pulmonary sarcomatoid carcinoma and predictive potential of mutated TP53","volume":"2025","author":"Wu","year":"2025"},{"key":"B58","doi-asserted-by":"publisher","first-page":"n2363","DOI":"10.1136\/bmj.n2363","article-title":"Advances in systemic therapy for non-small cell lung cancer","volume":"2021","author":"Miller","year":"2021"},{"key":"B59","doi-asserted-by":"publisher","DOI":"10.1158\/2326-6066.cir-25-0534","article-title":"Tumor-derived complement C3 overexpression in STK11-mutant lung adenocarcinoma drives tumor growth and immune checkpoint inhibitor resistance","volume":"2025","author":"Suzuki","year":"2025"},{"key":"B60","doi-asserted-by":"publisher","first-page":"100554","DOI":"10.1136\/jitc-2021-sitc2021.602","article-title":"AXL targeting restores PD-1 blockade sensitivity of STK11\/LKB1 mutant NSCLC through expansion of TCF1(+) CD8 T cells","volume":"3","author":"Li","year":"2022"},{"key":"B61","doi-asserted-by":"publisher","DOI":"10.1016\/j.cllc.2020.02.003","article-title":"Temporal heterogeneity of resistance mechanisms to EGFR-TKI identified in a patient with lung adenocarcinoma and sarcomatoid transformation","volume":"21","author":"Zheng","year":"2020"},{"key":"B62","doi-asserted-by":"publisher","DOI":"10.1016\/j.cllc.2020.06.026","article-title":"Transformations first into squamous-cell carcinoma and later into sarcomatoid carcinoma after acquired resistance to osimertinib in a patient with EGFR-mutant lung adenocarcinoma: case report","volume":"22","author":"Lee","year":"2021"},{"key":"B63","doi-asserted-by":"publisher","first-page":"101260","DOI":"10.1016\/j.lanwpc.2024.101260","article-title":"Consensus on the lung cancer management after third-generation EGFR-TKI resistance","author":"Zhou","year":"2024"},{"key":"B64","doi-asserted-by":"publisher","first-page":"20848","DOI":"10.1038\/s41598-023-48210-5","article-title":"Predictive significance of circulating tumor DNA against patients with T790M-positive EGFR-mutant NSCLC receiving osimertinib","volume":"13","author":"Yamaguchi","year":"2023"},{"key":"B65","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2024.07.008","article-title":"Longitudinal analyses of circulating tumor DNA for the detection of EGFR mutation-positive advanced NSCLC progression during treatment: data from FLAURA and AURA3","volume":"19","author":"Gray","year":"2024"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1811812\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T04:39:21Z","timestamp":1781757561000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1811812\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,18]]},"references-count":65,"alternative-id":["10.3389\/fonc.2026.1811812"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2026.1811812","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,18]]},"article-number":"1811812"}}