Several studies showed that up to 60% of real-life patients would be ineligible for clinical trials because of inability to meet the strict eligibility criteria.20 In our cohort, 45.5% of patients would not be eligible for clinical trials because of multiple factors, such as low KPS, CNS metastasis, Hb < 9 g/dL, and previous cardiovascular conditions within the past 12 months (such as myocardial infarction, unstable angina, class III or IV congestive heart failure, and pulmonary embolism). The gene discussed is GSTM1; the disease is pulmonary embolism.