{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T12:30:24Z","timestamp":1781353824793,"version":"3.54.1"},"reference-count":47,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T00:00:00Z","timestamp":1759968000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Fondazione Policlinico Campus Bio-Medico of Rome"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: Bone metastases are a common complication in patients with advanced cancer. These patients often experience a decline in physical function and autonomy, particularly in the ability to perform Activities of Daily Living, and structured movement-based interventions may represent an important supportive strategy. The aim of this study is to describe the available evidence regarding the impact of physical activity and exercise interventions on functional status and ADL performance in patients with bone metastases. Methods: A systematic literature review was conducted in PubMed, Scopus, Embase, Web of Science, and CINAHL database up to March 2025 and reported according to PRISMA guidelines. Eligible studies included adults (\u226518 years) with confirmed bone metastases who underwent physical activity interventions designed to enhance functional status and ADLs. Studies\u2019 methodological quality was assessed using the Joanna Briggs Institute critical appraisal tools, selected according to study design. Results: Eleven studies were included: four randomized controlled trials, four quasi-experimental studies, one randomized feasibility trial, one cross-sectional observational study, and one case report. Despite heterogeneity in intervention type, duration, and outcome measures, most studies reported improvements in physical function, including mobility, muscle strength, walking capacity, and endurance, as well as enhanced performance in ADLs and reductions in fatigue. No serious adverse events were reported. Conclusions: Structured physical activity appears safe and may improve function and independence in patients with bone metastases. These findings support the integration of individualized exercise programs into multidisciplinary supportive care.<\/jats:p>","DOI":"10.3390\/cancers17193266","type":"journal-article","created":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T09:41:02Z","timestamp":1760002862000},"page":"3266","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Movement-Based Interventions in Patients Affected by Bone Metastases: Impact on Physical Function and Functional Autonomy\u2014A Systematic Review"],"prefix":"10.3390","volume":"17","author":[{"given":"Giorgia","family":"Petrucci","sequence":"first","affiliation":[{"name":"Operative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agnese","family":"Broccolo","sequence":"additional","affiliation":[{"name":"Department of Biomedicine and Prevention, Tor Vergata University, Via Montpellier, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8680-711X","authenticated-orcid":false,"given":"Anna","family":"Marchetti","sequence":"additional","affiliation":[{"name":"Research Unit Nursing in Palliative Care, Department of Medicine and Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro Del Portillo 200, 00128 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Monterosso","sequence":"additional","affiliation":[{"name":"Research Unit Nursing Science, Department of Medicine and Surgery, Campus Bio-Medico di Roma University, Via Alvaro Del Portillo 21, 00128 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Casale","sequence":"additional","affiliation":[{"name":"Research Unit Nursing in Palliative Care, Department of Medicine and Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro Del Portillo 200, 00128 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Timarco","sequence":"additional","affiliation":[{"name":"Research Unit Nursing in Palliative Care, Department of Medicine and Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro Del Portillo 200, 00128 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6139-2480","authenticated-orcid":false,"given":"Tea","family":"Zeppola","sequence":"additional","affiliation":[{"name":"Medical Oncology, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128 Rome, Italy"},{"name":"Research Unit of Oncology, Department of Medicine and Surgery, Universit\u00e0 Campus Bio-Medico di Roma, Via Alvaro del Portillo 21, 00128 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Dsoke","sequence":"additional","affiliation":[{"name":"Department of Biomedicine and Prevention, Tor Vergata University, Via Montpellier, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5770-0719","authenticated-orcid":false,"given":"Elena","family":"Sandri","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Sciences, Catholic University of Valencia San Vicente M\u00e1rtir, C\/Quevedo 2, 46001 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5998-476X","authenticated-orcid":false,"given":"Michela","family":"Piredda","sequence":"additional","affiliation":[{"name":"Research Unit Nursing Science, Department of Medicine and Surgery, Campus Bio-Medico di Roma University, Via Alvaro Del Portillo 21, 00128 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4140-738X","authenticated-orcid":false,"given":"Giuseppe Francesco","family":"Papalia","sequence":"additional","affiliation":[{"name":"Operative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128 Rome, Italy"},{"name":"Oncological Orthopaedics Department, IFO\u2013IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Grazia","family":"De Marinis","sequence":"additional","affiliation":[{"name":"Research Unit Nursing in Palliative Care, Department of Medicine and Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro Del Portillo 200, 00128 Rome, Italy"},{"name":"Research Unit Nursing Science, Department of Medicine and Surgery, Campus Bio-Medico di Roma University, Via Alvaro Del Portillo 21, 00128 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,9]]},"reference":[{"key":"ref_1","unstructured":"(2025, September 18). Terminal Cancer\u2014NCI, Available online: https:\/\/www.cancer.gov\/about-cancer\/advanced-cancer."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"3011","DOI":"10.1158\/0008-5472.CAN-19-0458","article-title":"Defining the Hallmarks of Metastasis","volume":"79","author":"Welch","year":"2019","journal-title":"Cancer Res."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1002\/mco2.100","article-title":"Tumor Metastasis: Mechanistic Insights and Therapeutic Interventions","volume":"2","author":"Liu","year":"2021","journal-title":"MedComm"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e616","DOI":"10.1200\/JOP.19.00004","article-title":"Spending for Advanced Cancer Diagnoses: Comparing Recurrent Versus De Novo Stage IV Disease","volume":"15","author":"Hassett","year":"2019","journal-title":"J. Oncol. Pract."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"4784701","DOI":"10.1155\/2020\/4784701","article-title":"Tumor Primary Location May Affect Metastasis Pattern for Patients with Stage IV NSCLC: A Population-Based Study","volume":"2020","author":"Shan","year":"2020","journal-title":"J. Oncol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"6243s","DOI":"10.1158\/1078-0432.CCR-06-0931","article-title":"Clinical Features of Metastatic Bone Disease and Risk of Skeletal Morbidity","volume":"12","author":"Coleman","year":"2006","journal-title":"Clin. Cancer Res."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Jensen, A.\u00d8., Jacobsen, J.B., N\u00f8rgaard, M., Yong, M., Fryzek, J.P., and S\u00f8rensen, H.T. (2011). Incidence of Bone Metastases and Skeletal-Related Events in Breast Cancer Patients: A Population-Based Cohort Study in Denmark. BMC Cancer, 11.","DOI":"10.1186\/1471-2407-11-29"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Papalia, G.F., Brigato, P., Sisca, L., Maltese, G., Faiella, E., Santucci, D., Pantano, F., Vincenzi, B., Tonini, G., and Papalia, R. (2024). Artificial Intelligence in Detection, Management, and Prognosis of Bone Metastasis: A Systematic Review. Cancers, 16.","DOI":"10.3390\/cancers16152700"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Zhang, J., Cai, D., and Hong, S. (2023). Prevalence and Prognosis of Bone Metastases in Common Solid Cancers at Initial Diagnosis: A Population-Based Study. BMJ Open, 13.","DOI":"10.1136\/bmjopen-2022-069908"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"66","DOI":"10.5603\/NMR.2013.0037","article-title":"Pattern and Distribution of Bone Metastases in Common Malignant Tumors","volume":"16","author":"Kakhki","year":"2013","journal-title":"Nucl. Med. Rev."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1609926","DOI":"10.3389\/pore.2021.1609926","article-title":"Bone-Specific Metastasis Pattern of Advanced-Stage Lung Adenocarcinoma According to the Localization of the Primary Tumor","volume":"27","author":"Radeczky","year":"2021","journal-title":"Pathol. Oncol. Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1016\/j.pmrj.2018.02.006","article-title":"Considerations for Exercise Prescription in Patients With Bone Metastases: A Comprehensive Narrative Review","volume":"10","author":"Sheill","year":"2018","journal-title":"PMR"},{"key":"ref_13","first-page":"3497","article-title":"Pain and Health-Related Quality of Life in Patients with Advanced Solid Tumours and Bone Metastases: Integrated Results from Three Randomized, Double-Blind Studies of Denosumab and Zoledronic Acid","volume":"21","author":"Body","year":"2013","journal-title":"Support. Care Cancer"},{"key":"ref_14","first-page":"3557","article-title":"Burden of Symptoms Associated with Development of Metastatic Bone Disease in Patients with Breast Cancer","volume":"24","author":"Cleeland","year":"2016","journal-title":"Support. Care Cancer"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"694","DOI":"10.1016\/j.ijrobp.2015.06.024","article-title":"Quality of Life in Relation to Pain Response to Radiation Therapy for Painful Bone Metastases","volume":"93","author":"Westhoff","year":"2015","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Ribi, K., Th\u00fcrlimann, B., Sch\u00e4r, C., Dietrich, D., Cathomas, R., Z\u00fcrrer-H\u00e4rdi, U., Von Briel, T., Anchisi, S., Bohanes, P., and Blum, V. (2021). Quality of Life and Pain in Patients with Metastatic Bone Disease from Solid Tumors Treated with Bone-Targeted Agents\u2013 a Real-World Cross-Sectional Study from Switzerland (SAKK 95\/16). BMC Cancer, 21.","DOI":"10.1186\/s12885-021-07903-8"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e411","DOI":"10.1016\/j.clgc.2017.09.015","article-title":"Recognizing Symptom Burden in Advanced Prostate Cancer: A Global Patient and Caregiver Survey","volume":"16","author":"Oh","year":"2018","journal-title":"Clin. Genitourin. Cancer"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1007\/s10585-019-09983-0","article-title":"Factors Related to the Quality of Life in Patients with Bone Metastases","volume":"36","author":"Shinoda","year":"2019","journal-title":"Clin. Exp. Metastasis"},{"key":"ref_19","first-page":"20220022","article-title":"Clinical Outcome of Patients with Bone Metastases in a Convalescent Rehabilitation Ward: A Case Series of Six Patients","volume":"7","author":"Kobayashi","year":"2022","journal-title":"PRM"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Fujii, Y., Yoshikawa, R., Kashima, R., Saho, W., Onishi, H., Matsumoto, T., Harada, R., Takeoka, Y., Sawada, R., and Fukase, N. (2024). Evaluation of Changes in Activities of Daily Living and Quality of Life of Patients with Bone Metastasis Who Underwent Conservative Therapy through Bone Metastasis Cancer Boards. Medicina, 60.","DOI":"10.3390\/medicina60060906"},{"key":"ref_21","first-page":"20220027","article-title":"Effectiveness of Rehabilitation for Cancer Patients with Bone Metastasis","volume":"7","author":"Itokazu","year":"2022","journal-title":"PRM"},{"key":"ref_22","unstructured":"Edemekong, P.F., Bomgaars, D.L., Sukumaran, S., and Schoo, C. (2025). Activities of Daily Living. StatPearls, StatPearls Publishing."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1038\/sj.pcan.4501013","article-title":"Sexual Function Following Radical Prostatectomy: A Prospective Longitudinal Study of Cultural Differences between Japanese and American Men","volume":"11","author":"Namiki","year":"2008","journal-title":"Prostate Cancer Prostatic Dis."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"S22","DOI":"10.1097\/01.mlr.0000250483.85507.04","article-title":"Psychometric Evaluation and Calibration of Health-Related Quality of Life Item Banks: Plans for the Patient-Reported Outcomes Measurement Information System (PROMIS)","volume":"45","author":"Reeve","year":"2007","journal-title":"Med. Care"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Buiting, H., Van Delden, J., Onwuteaka-Philpsen, B., Rietjens, J., Rurup, M., Van Tol, D., Gevers, J., Van Der Maas, P., and Van Der Heide, A. (2009). Reporting of Euthanasia and Physician-Assisted Suicide in the Netherlands: Descriptive Study. BMC Med. Ethics, 10.","DOI":"10.1186\/1472-6939-10-18"},{"key":"ref_26","first-page":"e380","article-title":"Experiences and Perspectives of People Who Pursued Medical Assistance in Dying: Qualitative Study in Vancouver, BC","volume":"64","author":"Nuhn","year":"2018","journal-title":"Can. Fam. Physician"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1097\/AJP.0000000000000255","article-title":"Modern Palliative Treatments for Metastatic Bone Disease: Awareness of Advantages, Disadvantages, and Guidance","volume":"32","author":"Mavrogenis","year":"2016","journal-title":"Clin. J. Pain"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Myrcik, D., Statowski, W., Trzepizur, M., Paladini, A., Corli, O., and Varrassi, G. (2021). Influence of Physical Activity on Pain, Depression and Quality of Life of Patients in Palliative Care: A Proof-of-Concept Study. JCM, 10.","DOI":"10.3390\/jcm10051012"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1007\/s11764-021-01153-0","article-title":"The Effects of Physical Exercise in the Palliative Care Phase for People with Advanced Cancer: A Systematic Review with Meta-Analysis","volume":"17","author":"Toohey","year":"2023","journal-title":"J. Cancer Surviv."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1177\/02692163231162888","article-title":"Exercise Interventions for Advanced Cancer Palliative Care Patients: A Systematic Literature Review and Descriptive Evidence Synthesis of Randomized Controlled Trials","volume":"37","author":"Bhattacharya","year":"2023","journal-title":"Palliat. Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"103433","DOI":"10.1016\/j.critrevonc.2021.103433","article-title":"Exercise for Individuals with Bone Metastases: A Systematic Review","volume":"166","author":"Weller","year":"2021","journal-title":"Crit. Rev. Oncol.\/Hematol."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Rodr\u00edguez-Prat, A., Monforte-Royo, C., Porta-Sales, J., Escribano, X., and Balaguer, A. (2016). Patient Perspectives of Dignity, Autonomy and Control at the End of Life: Systematic Review and Meta-Ethnography. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0151435"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Ozeki, S., Tatematsu, N., and Sugiura, H. (2024). Physical and Emotional Status, Quality of Life and Activities of Daily Living in Terminal Cancer: Prospective Cohort Study. BMJ Support. Palliat. Care.","DOI":"10.1136\/spcare-2024-005032"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Young, J., Lloyd, A., and Haraldsdottir, E. (2024). A Qualitative Meta-Synthesis of Studies of Patients\u2019 Experience of Exercise Interventions in Advanced Cancer. Front. Rehabil. Sci., 4.","DOI":"10.3389\/fresc.2023.1298553"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Schardt, C., Adams, M.B., Owens, T., Keitz, S., and Fontelo, P. (2007). Utilization of the PICO Framework to Improve Searching PubMed for Clinical Questions. BMC Med. Inf. Decis. Mak., 7.","DOI":"10.1186\/1472-6947-7-16"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Page, M.J., McKenzie, J.E., Bossuyt, P.M., Boutron, I., Hoffmann, T.C., Mulrow, C.D., Shamseer, L., Tetzlaff, J.M., Akl, E.A., and Brennan, S.E. (2021). The PRISMA 2020 Statement: An Updated Guideline for Reporting Systematic Reviews. PLoS Med, 18.","DOI":"10.1371\/journal.pmed.1003583"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Rief, H., Omlor, G., Akbar, M., Welzel, T., Bruckner, T., Rieken, S., Haefner, M.F., Schlampp, I., Gioules, A., and Habermehl, D. (2014). Feasibility of Isometric Spinal Muscle Training in Patients with Bone Metastases under Radiation Therapy\u2014First Results of a Randomized Pilot Trial. BMC Cancer, 14.","DOI":"10.1186\/1471-2407-14-67"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1186\/1748-717X-9-151","article-title":"Quality of Life and Fatigue of Patients with Spinal Bone Metastases under Combined Treatment with Resistance Training and Radiation Therapy- a Randomized Pilot Trial","volume":"9","author":"Rief","year":"2014","journal-title":"Radiat. Oncol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"2957","DOI":"10.1038\/s41591-024-03143-y","article-title":"Supervised, Structured and Individualized Exercise in Metastatic Breast Cancer: A Randomized Controlled Trial","volume":"30","author":"Hiensch","year":"2024","journal-title":"Nat. Med."},{"key":"ref_40","first-page":"393","article-title":"Exercise Preserves Physical Function in Prostate Cancer Patients with Bone Metastases","volume":"50","author":"Taaffe","year":"2017","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Pajares, B., Rold\u00e1n-Jim\u00e9nez, C., Alba, E., and Cuesta-Vargas, A.I. (2022). Implementation of a Standard Care Program of Therapeutic Exercise in Metastatic Breast Cancer Patients. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph191811203"},{"key":"ref_42","first-page":"1537","article-title":"Functional Benefits Are Sustained after a Program of Supervised Resistance Exercise in Cancer Patients with Bone Metastases: Longitudinal Results of a Pilot Study","volume":"22","author":"Cormie","year":"2014","journal-title":"Support. Care Cancer"},{"key":"ref_43","first-page":"3287","article-title":"Feasibility and Outcomes of a Goal-Directed Physical Therapy Program for Patients with Metastatic Breast Cancer","volume":"29","author":"Groen","year":"2021","journal-title":"Support. Care Cancer"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1089\/jpm.2015.0345","article-title":"Development of a Method for Transferring Paraplegic Patients with Advanced Cancer from Bed to Wheelchair","volume":"19","author":"Abe","year":"2016","journal-title":"J. Palliat. Med."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"929","DOI":"10.1016\/j.jpainsymman.2019.07.022","article-title":"Physical Activity for Symptom Management in Women With Metastatic Breast Cancer: A Randomized Feasibility Trial on Physical Activity and Breast Metastases","volume":"58","author":"Yee","year":"2019","journal-title":"J. Pain Symptom Manag."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"151274","DOI":"10.1016\/j.soncn.2022.151274","article-title":"Associations Among Physical Activity, Skeletal Related Events, and Patient Reported Outcomes in Patients with Bone Metastases","volume":"38","author":"Guinan","year":"2022","journal-title":"Semin. Oncol. Nurs."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1097\/01893697-201028020-00003","article-title":"The Effect of a Therapeutic Exercise Program \u201cLife In Balance\u201d on the Quality of Life in a Patient with Metastatic Breast Cancer: A Case Report","volume":"28","author":"Born","year":"2010","journal-title":"Rehabil. Oncol."}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/17\/19\/3266\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:50:53Z","timestamp":1760035853000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/17\/19\/3266"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,9]]},"references-count":47,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2025,10]]}},"alternative-id":["cancers17193266"],"URL":"https:\/\/doi.org\/10.3390\/cancers17193266","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,9]]}}}