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OpenOnco · DIS-SALIVARY · BIO-NTRK-FUSION (ESCAT IA)
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OpenOnco · Treatment Plan
Treatment plan — DIS-SALIVARY
PLAN-BMA-NTRK_ETV6_SALIVARY-V1 · v1 · 2026-05-04
Patient
BMA-NTRK_ETV6_SALIVARY · Algorithm: ALGO-SALIVARY-1L

Clinical significance of mutations (ESCAT)

Tumor-board context — the engine does not use these tiers to rank tracks
BiomarkerVariantESCATEvidenceClinical significanceDrugsSources
BIO-NTRK-FUSIONETV6-NTRK3 fusionIA
  • SRC-FDA-CDS-2026
Evidence cited from clinical guidelines; per-source evidence levels not yet structured. See Phase-2-of-CIViC-pivot for re-cite roadmap.
ETV6-NTRK3 is the defining fusion of mammary analogue secretory carcinoma (MASC) of salivary gland. Larotrectinib and entrectinib are highly active (NAVIGATE / STARTRK-2 pooled — ORR 75-90% in salivary cohort). Treatment is identical to gene-level NTRK fusion.larotrectinib monotherapy
entrectinib monotherapy
  • SRC-FDA-CDS-2026
BIO-NTRK-FUSIONNTRK1/2/3 fusion (ETV6-NTRK3 defines mammary analogue secretory carcinoma, MASC)IA
  • SRC-FDA-CDS-2026
Evidence cited from clinical guidelines; per-source evidence levels not yet structured. See Phase-2-of-CIViC-pivot for re-cite roadmap.
NTRK fusion in salivary gland tumors — virtually 100% of mammary analogue secretory carcinoma (MASC) carry ETV6-NTRK3. Larotrectinib (NAVIGATE / pooled phase 1/2, Drilon NEJM 2018 — ORR 75% across tumor types, salivary subset ORR ~85%) and entrectinib (STARTRK-2 / ALKA / STARTRK-NG) are FDA-approved tumor-agnostic for NTRK-fusion solid tumors. Salivary MASC has among the highest response rates.larotrectinib monotherapy
entrectinib monotherapy (preferred for CNS disease)
  • SRC-FDA-CDS-2026

Treatment options (1 tracks)

Standard plan
★ DEFAULT
Indication
IND-SALIVARY-PALLIATIVE-PACLITAXEL-CARBO
Regimen
Paclitaxel + carboplatin (salivary gland carcinoma, palliative)
Drugs + NSZU
  • Paclitaxel (DRUG-PACLITAXEL) Paclitaxel 175 mg/m² · Per regimen schedule · IV ✓ NSZU covered
  • Carboplatin (DRUG-CARBOPLATIN) carboplatin AUC 5 IV q3w × 6 cycles · Per regimen schedule · IV ⚠ NSZU — not for this indication
Reason
Engine default per algorithm ALGO-SALIVARY-1L: {'step': None, 'note': 'decision tree fell through; using default_indication', 'result': 'IND-SALIVARY-PALLIATIVE-PACLITAXEL-CARBO', 'fired_red_flags': []}

Timeline

Treatment timeline — derived from regimen + monitoring schedule

Standard plan

Induction · Paclitaxel + carboplatin (sali
21-day cycles × 6 cycles or until progression / toxicity

MDT brief

Data quality

  • Unevaluated RedFlags: RF-SALIVARY-ADVANCED-PALLIATIVE, RF-SALIVARY-FRAILTY-AGE, RF-SALIVARY-HIGH-RISK-BIOLOGY, RF-SALIVARY-INFECTION-SCREENING, RF-SALIVARY-ORGAN-DYSFUNCTION, RF-SALIVARY-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)

Third plan track — open-enrollment trials from ClinicalTrials.gov. Render-time metadata; engine selection is not affected by this block (CHARTER §8.3). Last synced: 2026-05-04.
NCTTitlePhaseStatusSponsorUAEligibility (excerpt)
NCT06145308Precision Treatment of Recurrent/Metastatic Salivary Gland Carcinoma Guided by Molecular TypingPHASE2RECRUITINGPeking Union Medical College—

Verify recruitment status directly with the trial site. ctgov data can lag behind current UA-site status.

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
Paclitaxel + carboplatin (salivary gland carcinoma, palliative) (REG-PACLITAXEL-CARBOPLATIN-SALIVARY)
✓ registered✓ covered₴-? — verify pathwayNSZU formulary
Trial · NCT06145308
Precision Treatment of Recurrent/Metastatic Salivary Gland Carcinoma Guided by Molecular Typing
No UA site listed — international referral required
— unknown— unknown
self-pay: ₴0/course
Trial sponsor

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

plan_id: PLAN-BMA-NTRK_ETV6_SALIVARY-V1 | version: 1 | generated: 2026-05-04T14:13:16.642595+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.