Conflict of interest

Takayuki Takahama received lecture fees from AstraZeneca and Chugai, and research funding from Takeda and Pfizer. Kimio Yonesaka received lecture fees from Chugai Pharmaceutical Co., Ltd. and Merck Sharp & Dohme K.K. Hidetoshi Hayashi received lecture fees from Eli Lilly Japan K.K., Chugai Pharmaceutical Co. Ltd., Ono Pharmaceutical Co., Ltd., Daiichi-Sankyo K.K., Bristol Myers Squibb, AstraZeneca K.K, Amgen Inc. and Pfizer Japan Inc, and manuscript fee from Guardant Health Japan Corp, and research funding from MSD K.K., Daiichi Sankyo Co., Ltd., Taiho Pharmaceutical Co., Ltd., Chugai Pharmaceutical Co., Ltd., SYNEOS HEALTH CLINICAL K.K., Japan Clinical Research Operations, AstraZeneca K.K., IQVIA Services JAPAN K.K., Covance Japan Inc., Takeda Pharmaceutical Co., Ltd., GlaxoSmithKline K.K., Sanofi K.K., EPS Corporation, Novartis Pharma K.K., Medical Research Support, Bristol Myers Squibb Company, PRA Health Sciences Inc., Janssen Pharmaceutical K.K., Eisai. Inc, Astellas Pharma Inc., Amgen Inc. Pfizer R&D Japan G.K., CMIC Co., Ltd, AbbVie Inc., A2 Healthcare Corp., Nippon Boehringer Ingelheim Co., Ltd. and WJOG (West Japan Oncology Group), and scholarship donations from Takeda Pharmaceutical Co., Ltd., Chugai Pharmaceutical Co., Ltd. Ono Pharmaceutical Co., Ltd., Eisai Co., Ltd. Kazuto Nishio received lecture fees from Chugai, and research funding from Nichirei Biosciences, WOG, Eli Lilly Japan, Hitachi, Nippon Boehringer Ingelheim, Osakaminami hospital, Otsuka, TORG and University Public Corporation Osaka. Kazuhiko Nakagawa received patent licensing fees from Daiichi Sankyo co., Ltd, and lecture fees from Eli Lilly Japan K.K., Chugai Pharmaceutical Co., Ltd. and Ono Pharmaceutical Co., Ltd., and research funding from MSD, Daiichi Sankyo, Taiho Pharmaceutical, Chugai Pharmaceutical, SYNEOS HEALTH CLINICAL, Japan Clinical Research Operations AstraZeneca, IQVIA Services JAPAN, Covance Japan, Takeda Pharmaceutical, GlaxoSmithKline, Sanofi, EPS Corporation, Novartis Pharma, Medical Research Support, Bristol Myers Squibb, PRA Health Sciences, Janssen Pharmaceutical, Eisai, Astellas Pharma, Amgen and Nippon Boehringer Ingelheim. Noriomi Matsumura received lecture fees from AstraZeneca, Takeda Pharmaceutical and MSD.

Informed consent

The patient provided informed consent.

Research involving human and animals participants

All procedures performed in studies involving human participants were 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.