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OpenOnco · DIS-CHOLANGIOCARCINOMA · BIO-BRAF-V600E (ESCAT IA)
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OpenOnco · Treatment Plan
Treatment plan — DIS-CHOLANGIOCARCINOMA
PLAN-BMA-BRAF_V600E_CHOLANGIO-V1 · v1 · 2026-05-04
Patient
BMA-BRAF_V600E_CHOLANGIO · Algorithm: ALGO-CHOLANGIO-1L

Clinical significance of mutations (ESCAT)

Tumor-board context — the engine does not use these tiers to rank tracks
BiomarkerVariantESCATEvidenceClinical significanceDrugsSources
BIO-BRAF-V600EV600E (exon 15, kinase domain — present in ~5% of intrahepatic cholangiocarcinoma; rarer in extrahepatic)IABRAF V600E in cholangiocarcinoma (mainly intrahepatic, ~5%) is a tumor-agnostic FDA Level-1 actionable target. Dabrafenib + trametinib is recommended for previously-treated BRAF V600E cholangiocarcinoma per SRC-NCCN-HEPATOBILIARY based on the ROAR basket trial (Subbiah Lancet Oncol 2020 — biliary tract cohort ORR 51%, mPFS 9 mo, mOS 14 mo). 1L remains gemcitabine + cisplatin ± durvalumab (TOPAZ-1) for most patients; testing for BRAF V600E is recommended at diagnosis to plan 2L+ in patients without other actionable alterations (FGFR2 fusion, IDH1 mutation) per SRC-NCCN-HEPATOBILIARY.dabrafenib + trametinib (2L+ BRAF V600E cholangio per SRC-NCCN-HEPATOBILIARY)
  • SRC-NCCN-HEPATOBILIARY

Treatment options (1 tracks)

Standard plan
★ DEFAULT
Indication
IND-CHOLANGIO-ADVANCED-GEM-CIS
Regimen
Gemcitabine + cisplatin (advanced biliary tract cancer, 1L — ABC-02)
Drugs + NSZU
  • Gemcitabine (DRUG-GEMCITABINE) Gemcitabine 1000 mg/m² · Per regimen schedule · IV ⚠ NSZU — not for this indication
  • Cisplatin (DRUG-CISPLATIN) cisplatin 25 mg/m² IV d1, d8 q3w × 8 cycles · Per regimen schedule · IV ⚠ NSZU — not for this indication
Reason
Engine default per algorithm ALGO-CHOLANGIO-1L: {'step': None, 'note': 'decision tree fell through; using default_indication', 'result': 'IND-CHOLANGIO-ADVANCED-GEM-CIS', 'fired_red_flags': []}

Timeline

Treatment timeline — derived from regimen + monitoring schedule

Standard plan

Induction · Gemcitabine + cisplatin (advan
21-day cycles × 6 cycles or until progression / toxicity

MDT brief

Data quality

  • Unevaluated RedFlags: RF-CHOLANGIO-FGFR2-FUSION-ACTIONABLE, RF-CHOLANGIOCARCINOMA-FRAILTY-AGE, RF-CHOLANGIOCARCINOMA-HIGH-RISK-BIOLOGY, RF-CHOLANGIOCARCINOMA-INFECTION-SCREENING, RF-CHOLANGIOCARCINOMA-ORGAN-DYSFUNCTION, RF-CHOLANGIOCARCINOMA-TRANSFORMATION-PROGRESSION

Skill catalog (0/16 activated in this plan)

All registered virtual specialists. ✓ — activated for this case; ○ — not activated (available for other clinical scenarios).
Specialistskill_idVersionLast reviewedSign-offsDomain
Cellular therapy specialist (CAR-T)cellular_therapy_specialistv0.1.02026-04-250cellular_therapy
Clinical pharmacistclinical_pharmacistv0.1.02026-04-250clinical_pharmacy
Hematologist / oncohematologisthematologistv0.1.02026-04-250hematology_oncology
Hematopathologist (lymphoma / leukemia / myeloma)hematopathologistv0.1.02026-04-250hematopathology
Infectious disease / hepatologyinfectious_disease_hepatologyv0.1.02026-04-250infectious_diseases
Medical oncologist (solid-tumor chemotherapist)medical_oncologistv0.1.02026-04-250solid_oncology
Molecular geneticist / molecular oncologistmolecular_geneticistv0.1.02026-04-250molecular_oncology
Palliative carepalliative_carev0.1.02026-04-250palliative_care
Pathologist (general)pathologistv0.1.02026-04-250pathology
Primary care / family physicianprimary_carev0.1.02026-04-250primary_care
Psycho-oncologistpsychologistv0.1.02026-04-250psychosocial
Radiation oncologistradiation_oncologistv0.1.02026-04-250radiation_oncology
Radiologistradiologistv0.1.02026-04-250diagnostic_imaging
Social worker / case managersocial_worker_case_managerv0.1.02026-04-250psychosocial
Surgical oncologistsurgical_oncologistv0.1.02026-04-250surgical_oncology
Transplant specialist (BMT)transplant_specialistv0.1.02026-04-250cellular_therapy

Sources cited

Experimental options (clinical trials)

Last synced: 2026-05-04 · ctgov.

No active trials matched this scenario in ctgov.

Option availability in Ukraine

Per-track UA registration · NSZU · cost · access pathway. Render-time metadata; engine selection does not depend on these fields (CHARTER §8.3).
OptionUA registrationNSZUCost orientationAccess pathway
Standard plan
Gemcitabine + cisplatin (advanced biliary tract cancer, 1L — ABC-02) (REG-GEMCITABINE-CISPLATIN-CHOLANGIO)
✓ registered✓ covered₴-? — verify pathwayNSZU formulary

Cost information is orientation. Verify with a specific pharmacy / foundation / trial site. Status updated: 2026-05-04.

plan_id: PLAN-BMA-BRAF_V600E_CHOLANGIO-V1 | version: 1 | generated: 2026-05-04T14:13:16.591179+00:00
Per FDA non-device CDS positioning (CHARTER §15): Outpatient oncology treatment planning to support tumor-board discussion. Not a medical device; not for autonomous clinical decision-making.
Per FDA non-device CDS positioning (CHARTER §15): Both treatment options below are presented for review. The engine's selection of a 'recommended' default does not constitute a clinical decision. Final treatment selection requires HCP judgment incorporating information not available to the system.
This document is an informational resource supporting tumor-board discussion (per CHARTER §11). It is not a system that makes clinical decisions. Every recommendation must be verified by the treating physician.