{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T06:59:15Z","timestamp":1785135555598,"version":"3.55.0"},"reference-count":31,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T00:00:00Z","timestamp":1784937600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Italian Ministry of Health Ricerca Corrente"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: Germline and somatic variants in DNA Damage Repair (DDR) genes are found in approximately one-fourth of patients with metastatic prostate cancer (PC). However, their precise prognostic role and predictive impact on standard therapies remain controversial. Methods: This retrospective, single-center study evaluated the prevalence of germline\/somatic DDR aberrations in 287 eligible patients with metastatic prostate cancer (mPC), treated between 2017 and 2022. Clinical characteristics and treatment outcomes (PFS and OS) for chemotherapy (taxanes) or next-generation hormonal therapies (NHT) were compared between DDR-mutated (DDRmut) and wild-type (DDRwt) cohorts. Results: Sixty-three patients (21.9%) were DDRmut, with BRCA2 (12.5%), ATM (3.1%), and BRCA1 (1.39%) being the most common alterations. A family history of breast, ovarian, or prostate cancer strongly predicted DDRmut status (47.0% vs. 14.0%, p = 0.0001). Tissue samples remained evaluable for sequencing up to 180 months from collection. Overall baseline characteristics were similar between cohorts, and BRCA1\/2- and ATM-mutated patients treated with first-line taxanes for mCRPC presented with non significantly highermedian OS compared to DDRwt patients (70 vs. 36 months; p = 0.30). On the contrary, the DDRmut subgroup showed a trend toward shorter PFS (12 vs. 18 months; p = 0.04) when treated with first-line NHT. No significant differences were observed with third-line Cabazitaxel. Conclusions: Formalin-fixed paraffin-embedded (FFPE) prostate tissue is highly reliable for DDR, possibly integrating novel liquid biopsy approaches for DDR evaluation. In a real-world setting, BRCA1\/2 and ATM variants identify a distinct molecular subgroup that derives preferential survival benefit from first-line taxanes over standard hormonal intensification.<\/jats:p>","DOI":"10.3390\/cancers18152400","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T05:49:27Z","timestamp":1785131367000},"page":"2400","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Real-World Outcomes of DNA Damage Repair Altered Metastatic Castration-Resistant Prostate Cancer: Insights from FFPE-Based Genomic Profiling"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7726-1864","authenticated-orcid":false,"given":"Eleonora","family":"Lai","sequence":"first","affiliation":[{"name":"Oncology Unit 3, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Pierantoni","sequence":"additional","affiliation":[{"name":"Oncology Unit 3, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilaria","family":"Zampiva","sequence":"additional","affiliation":[{"name":"Oncology Unit 1, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8177-5374","authenticated-orcid":false,"given":"Davide","family":"Bimbatti","sequence":"additional","affiliation":[{"name":"Oncology Unit 1, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-3167-0525","authenticated-orcid":false,"given":"Melissa","family":"Ballestrin","sequence":"additional","affiliation":[{"name":"Oncology Unit 3, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greta","family":"Pretto","sequence":"additional","affiliation":[{"name":"Oncology Unit 3, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy"},{"name":"School of Specialization in Medical Oncology, Department of Oncology, University of Padua, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Milani","sequence":"additional","affiliation":[{"name":"Oncology Unit 3, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy"},{"name":"School of Specialization in Medical Oncology, Department of Oncology, University of Padua, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Erbetta","sequence":"additional","affiliation":[{"name":"Oncology Unit 1, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy"},{"name":"Oncology Unit, ASST Mantova-Carlo Poma Hospital, 46100 Mantova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salim","family":"Jubran","sequence":"additional","affiliation":[{"name":"Oncology Unit 1, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy"},{"name":"Medical Oncology Unit, Azienda ULSS 3 Serenissima, Chioggia Hospital, 30015 Chioggia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6821-9338","authenticated-orcid":false,"given":"Chiara","family":"Pittarello","sequence":"additional","affiliation":[{"name":"Oncology Unit 1, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy"},{"name":"School of Specialization in Medical Oncology, Department of Oncology, University of Padua, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Di Marco","sequence":"additional","affiliation":[{"name":"Oncology Unit 1, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy"},{"name":"School of Specialization in Medical Oncology, Department of Oncology, University of Padua, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicol\u00f2","family":"Cavasin","sequence":"additional","affiliation":[{"name":"Oncology Unit 1, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy"},{"name":"Department of Medical Oncology, Azienda Unit\u00e0 Locale Socio-Sanitaria 2 Marca Trevigiana, 31100 Treviso, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0554-5846","authenticated-orcid":false,"given":"Carolina","family":"Zamuner","sequence":"additional","affiliation":[{"name":"Oncology Unit 3, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4946-5621","authenticated-orcid":false,"given":"Aichi","family":"Msaki","sequence":"additional","affiliation":[{"name":"Oncology Unit 1, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9066-6786","authenticated-orcid":false,"given":"Lidia","family":"Moserle","sequence":"additional","affiliation":[{"name":"Immunology and Molecular Oncology Diagnostics, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3133-4807","authenticated-orcid":false,"given":"Matteo","family":"Curtarello","sequence":"additional","affiliation":[{"name":"Immunology and Molecular Oncology Diagnostics, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7898-5845","authenticated-orcid":false,"given":"Elisa","family":"Boldrin","sequence":"additional","affiliation":[{"name":"Immunology and Molecular Oncology Diagnostics, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Montagna","sequence":"additional","affiliation":[{"name":"Immunology and Molecular Oncology Diagnostics, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5082-1160","authenticated-orcid":false,"given":"Veronica","family":"Varano","sequence":"additional","affiliation":[{"name":"Department of Pathology, Azienda Ospedaliera Universitaria Integrata di Verona, 37134 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-6399-2043","authenticated-orcid":false,"given":"Vasileios","family":"Mourmouras","sequence":"additional","affiliation":[{"name":"Anatomy and Pathological Histology, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2032-2085","authenticated-orcid":false,"given":"Ivana","family":"Cataldo","sequence":"additional","affiliation":[{"name":"Anatomy and Pathological Histology, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2812-5553","authenticated-orcid":false,"given":"Francesco","family":"Claps","sequence":"additional","affiliation":[{"name":"Oncological Urology, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2730-0402","authenticated-orcid":false,"given":"Antonio","family":"Amodeo","sequence":"additional","affiliation":[{"name":"Oncological Urology, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Stragliotto","sequence":"additional","affiliation":[{"name":"Oncology Unit 3, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6256-9249","authenticated-orcid":false,"given":"Marco","family":"Maruzzo","sequence":"additional","affiliation":[{"name":"Oncology Unit 3, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5075-2177","authenticated-orcid":false,"given":"Umberto","family":"Basso","sequence":"additional","affiliation":[{"name":"Oncology Unit 1, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1038\/s41585-018-0060-7","article-title":"Landmarks in prostate cancer","volume":"15","author":"Sathianathen","year":"2018","journal-title":"Nat. Rev. Urol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"4986365","DOI":"10.1155\/2020\/4986365","article-title":"BRCA Mutations in Prostate Cancer: Prognostic and Predictive Implications","volume":"2020","author":"Messina","year":"2020","journal-title":"J. Oncol."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Shah, S., Rachmat, R., Enyioma, S., Ghose, A., Revythis, A., and Boussios, S. (2021). BRCA Mutations in Prostate Cancer: Assessment, Implications and Treatment Considerations. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms222312628"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"155803","DOI":"10.1016\/j.prp.2024.155803","article-title":"BRCA1 and BRCA2 mutations testing in prostate cancer: Detection in formalin fixed paraffin embedded (FFPE) and blood samples","volume":"266","author":"Zannini","year":"2025","journal-title":"Pathol. Res. Pract."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1158\/1078-0432.CCR-22-0931","article-title":"Detection of BRCA1, BRCA2, and ATM Alterations in Matched Tumor Tissue and Circulating Tumor DNA in Patients with Prostate Cancer Screened in PROfound","volume":"29","author":"Chi","year":"2023","journal-title":"Clin. Cancer Res."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Crocetto, F., Russo, G., Di Zazzo, E., Pisapia, P., Mirto, B.F., Palmieri, A., Pepe, F., Bellevicine, C., Russo, A., and La Civita, E. (2022). Liquid biopsy in prostate cancer management\u2014Current challenges and future perspectives. Cancers, 14.","DOI":"10.3390\/cancers14133272"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1056\/NEJMoa1603144","article-title":"Inherited DNA-Repair Gene Mutations in Men with Metastatic Prostate Cancer","volume":"375","author":"Pritchard","year":"2016","journal-title":"N. Engl. J. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.eururo.2017.02.023","article-title":"Treatment Outcomes and Tumor Loss of Heterozygosity in Germline DNA Repair-deficient Prostate Cancer","volume":"72","author":"Annala","year":"2017","journal-title":"Eur. Urol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1016\/j.annonc.2023.02.015","article-title":"Updated treatment recommendations for prostate cancer from the ESMO Clinical Practice Guideline considering treatment intensification and use of novel systemic agents","volume":"34","author":"Fizazi","year":"2023","journal-title":"Ann. Oncol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1518","DOI":"10.1158\/1078-0432.CCR-21-3940","article-title":"Tumor genomic testing for >4000 men with metastatic castration-resistant prostate cancer in the phase III trial PROfound (Olaparib)","volume":"28","author":"Hussain","year":"2022","journal-title":"Clin. Cancer Res."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1136\/jmg-2025-110755","article-title":"Integration of genetic counselling into a multidisciplinary urological oncology programme enhances access and detection of hereditary prostate cancer syndromes","volume":"62","author":"Byrne","year":"2025","journal-title":"J. Med. Genet."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"100459","DOI":"10.1016\/j.esmoop.2022.100459","article-title":"Implementation of preventive and predictive BRCA testing in patients with breast, ovarian, pancreatic, and prostate cancer: A position paper of Italian Scientific Societies","volume":"7","author":"Russo","year":"2022","journal-title":"ESMO Open"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2776","DOI":"10.3390\/curroncol29040226","article-title":"Outcomes of patients with metastatic castration-resistant prostate cancer according to somatic damage DNA repair gene alterations","volume":"29","author":"Neviere","year":"2022","journal-title":"Curr. Oncol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1394","DOI":"10.1038\/s41416-022-01881-9","article-title":"Blood-based liquid biopsies for prostate cancer: Clinical opportunities and challenges","volume":"127","author":"Trujillo","year":"2022","journal-title":"Br. J. Cancer"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Di Santo, R., Niccolini, B., Rosa, E., De Spirito, M., Pizzolante, F., Pitocco, D., Tartaglione, L., Rizzi, A., Basile, U., and Petito, V. (2025). Artificial Intelligence for Liquid Biopsy: FTIR Spectroscopy and Autoencoder-Based Detection of Cancer Biomarkers in Extracellular Vesicles. Cells, 14.","DOI":"10.3390\/cells14231909"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Vescovo, M., Raspollini, M.R., Nibid, L., Castiglione, F., Nardi, E., de Biase, D., Massari, F., Giunchi, F., Pepe, F., and Troncone, G. (2025). Storage Time and DNA Quality Determine BRCA1\/2 Sequencing Success in Prostate Cancer: A Multicentre Analysis with Therapeutic Implications. Cancers, 17.","DOI":"10.3390\/cancers17101705"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1200\/JCO.23.00339","article-title":"Olaparib for the treatment of patients with metastatic castration-resistant prostate cancer and alterations in BRCA1 and\/or BRCA2 in the PROfound trial","volume":"42","author":"Mateo","year":"2024","journal-title":"J. Clin. Oncol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1186\/s13000-023-01431-8","article-title":"A novel targeted NGS panel identifies numerous homologous recombination deficiency (HRD)-associated gene mutations in addition to known BRCA mutations","volume":"19","author":"Vogel","year":"2024","journal-title":"Diagn. Pathol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"v619","DOI":"10.1093\/annonc\/mdx440.025","article-title":"PROREPAIR-B: A prospective cohort study of DNA repair defects in metastatic castration resistant prostate cancer (mCRPC)","volume":"28","author":"Marcos","year":"2017","journal-title":"Ann. Oncol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1016\/j.eururo.2018.01.035","article-title":"Germline DNA-repair Gene Mutations and Outcomes in Men with Metastatic Castration-resistant Prostate Cancer Receiving First-line Abiraterone and Enzalutamide","volume":"74","author":"Antonarakis","year":"2018","journal-title":"Eur. Urol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.ejca.2021.09.029","article-title":"Cabazitaxel activity in men with metastatic castration-resistant prostate cancer with and without DNA damage repair defects","volume":"159","author":"Aldea","year":"2021","journal-title":"Eur. J. Cancer"},{"key":"ref_22","first-page":"45","article-title":"Association of prior PARP inhibitor exposure with clinical outcomes after 177Lu-PSMA-617 in men with castration-resistant prostate cancer and mutations in DNA homologous recombination repair genes","volume":"8","author":"Raychaudhuri","year":"2025","journal-title":"Eur. Urol. Oncol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"5005","DOI":"10.1200\/JCO.2023.41.16_suppl.5005","article-title":"LuPARP: Phase 1 trial of 177Lu-PSMA-617 and olaparib in patients with metastatic castration resistant prostate cancer (mCRPC)","volume":"41","author":"Sandhu","year":"2023","journal-title":"J. Clin. Oncol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1038\/s41467-017-00393-y","article-title":"Synthetic lethality between androgen receptor signalling and the PARP pathway in prostate cancer","volume":"8","author":"Asim","year":"2017","journal-title":"Nat. Commun."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"LBA17","DOI":"10.1200\/JCO.2023.41.6_suppl.LBA17","article-title":"TALAPRO-2: Phase 3 study of talazoparib (TALA) + enzalutamide (ENZA) versus placebo (PBO) + ENZA as first-line (1L) treatment in patients (pts) with metastatic castration-resistant prostate cancer (mCRPC)","volume":"41","author":"Agarwal","year":"2023","journal-title":"J. Clin. Oncol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"S1495","DOI":"10.1016\/j.annonc.2022.07.1945","article-title":"Biomarker analysis and updated results from the phase III PROpel trial of abiraterone (abi) and olaparib (ola) vs. abi and placebo (pbo) as first-line (1L) therapy for patients (pts) with metastatic castration-resistant prostate cancer (mCRPC)","volume":"33","author":"Saad","year":"2022","journal-title":"Ann. Oncol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"772","DOI":"10.1016\/j.annonc.2023.06.009","article-title":"Niraparib plus abiraterone acetate with prednisone in patients with metastatic castration-resistant prostate cancer and homologous recombination repair gene alterations: Second interim analysis of the randomized phase III MAGNITUDE trial","volume":"34","author":"Chi","year":"2023","journal-title":"Ann. Oncol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"LBA5006","DOI":"10.1200\/JCO.2025.43.17_suppl.LBA5006","article-title":"Phase 3 AMPLITUDE trial: Niraparib (NIRA) and abiraterone acetate plus prednisone (AAP) for metastatic castration-sensitive prostate cancer (mCSPC) patients (pts) with alterations in homologous recombination repair (HRR) genes","volume":"43","author":"Attard","year":"2025","journal-title":"J. Clin. Oncol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/j.euo.2023.07.013","article-title":"Combining PARP inhibitors and androgen receptor signalling inhibitors in metastatic prostate cancer: A quantitative synthesis and meta-analysis","volume":"7","author":"Messina","year":"2024","journal-title":"Eur. Urol. Oncol."},{"key":"ref_30","first-page":"12","article-title":"Prostate irradiation in men with de novo, low-volume, metastatic, castration-sensitive prostate cancer (mCSPC): Results of PEACE-1, a phase 3 randomized trial with a 2\u00d72 design","volume":"182","author":"Bossi","year":"2023","journal-title":"Eur. J. Cancer"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"2585","DOI":"10.2217\/fon-2022-0433","article-title":"Darolutamide and survival in metastatic, hormone-sensitive prostate cancer: A patient and caregiver perspective and plain language summary of the ARASENS trial","volume":"18","author":"Smith","year":"2022","journal-title":"Future Oncol."}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/18\/15\/2400\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T06:03:17Z","timestamp":1785132197000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/18\/15\/2400"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,25]]},"references-count":31,"journal-issue":{"issue":"15","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["cancers18152400"],"URL":"https:\/\/doi.org\/10.3390\/cancers18152400","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,25]]}}}