This study was performed in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The patient's data in the case presentation was provided from the multicenter retrospective study approved by the institutional review board of the National Cancer Center (2021-440).

Yoshitaka Honma received honoraria from Novartis Pharma and Teijin Pharma. Masafumi Ikeda received honoraria from AbbVie, AstraZeneca, Chugai, Eisai, Eli Lilly Japan, Fujifilm Toyama Chemical, Guardant Health Japan, Incyte Biosciences Japan, MSD, Nihon Servier, Novartis, Nippon Kayaku, Ono, Taisho Pharmaceutical, Teijin, Takeda, Taiho and Yakult. And research funding (institution) from AstraZeneca, Bayer, Bristol-Myers Squibb, Boehringer Ingelheim, Chugai, Chiome Bioscience, Delta-Fly Pharma, Eisai, Eli Lilly Japan, Invitae, MSD, J-Pharma, Merck biopharma, Merus N.V., Novartis, Nihon Servier, Ono, Pfizer, and Syneos Health. And has consulted for AstraZeneca, Chugai, MSD, Nihon Servier, and Novartis. Susumu Hijioka received honoraria from Novartis Pharma and Teijin Pharma. Shigemi Matsumoto: received honoraria from Novartis Pharma and Taiho Pharmaceutical Co. Ltd. Tetsuhide Ito has no conflict of interest directly relevant to the content of this article. Taku Aoki: has no conflict of interest directly relevant to the content of this article. Junji Furuse received honoraria from Ono Pharma, Chugai Pharma, Eisai, Eli Lilly, Astra Zeneca, Yakult, Servier, MSD, Novartis Pharma, Takeda, Bayer, Taiho Pharma, EA Pharma, Teijin pharma, Daiichi Sankyo, Terumo, Incyte Biosciences, J-Pharma, Fuji film, Astellas, Onco Therapy Science, Delta-Fly-Pharma, Merck Bio. And research funding from Astellas, Astra Zeneca, Incyte Biosciences Japan, Eisai, MSD, Ono Pharmaceutical, Sanofy, J-Pharma, Daiichi Sankyo, Sumitomo Dainippon, Taiho Pharmaceutical, Takeda, Delta-Fly-Pharma, Chugai Pharma