OpenOnco · Treatment Plan

Treatment plan — Salivary gland carcinoma

PLAN-BMA-NTRK_ETV6_SALIVARY-V1 · v1 · 2026-08-17

Patient

BMA-NTRK_ETV6_SALIVARY · Algorithm: ALGO-SALIVARY-1L

DiagnosisSalivary gland carcinoma

MOH / ICD-10C07, C08

ICD-O-38500/3; C07, C08

Clinical significance of mutations (ESCAT)

Tumor-board context — the engine does not use these tiers to rank tracks

Biomarker	Variant	ESCAT	Evidence	Clinical significance	Drugs	Sources
ESCAT: clinical review pendingBIO-NTRK-FUSION	ETV6-NTRK3 fusion	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.	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
ESCAT: clinical review pendingBIO-NTRK-FUSION	NTRK1/2/3 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

Primary current-line option

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

Primary current-line option selected by ALGO-SALIVARY-1L at the fallback path.

Timeline

Treatment timeline — derived from regimen + monitoring schedule

Standard plan

Induction · Paclitaxel + carboplatin (salivary gland carcinoma, palliative)

21-day cycles × 6 cycles or until progression / toxicity

MDT brief

Data quality

Usable with caveats. No critical default-track gap was found, but the MDT should review the listed caveats before final sign-off.

Biomarker coverage: 0/0 known (100%), 0 missing, 0 default-track gaps
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

Technical MDT skill metadata (0/16 activated in this plan)

All registered virtual specialists. ✓ — activated for this case; ○ — not activated (available for other clinical scenarios).

Specialist	skill_id	Version	Last reviewed	Domain
Cellular therapy specialist (CAR-T)	`cellular_therapy_specialist`	v0.1.0	2026-04-25	cellular_therapy
Clinical pharmacist	`clinical_pharmacist`	v0.1.0	2026-04-25	clinical_pharmacy
Hematologist / oncohematologist	`hematologist`	v0.1.0	2026-04-25	hematology_oncology
Hematopathologist (lymphoma / leukemia / myeloma)	`hematopathologist`	v0.1.0	2026-04-25	hematopathology
Infectious disease / hepatology	`infectious_disease_hepatology`	v0.1.0	2026-04-25	infectious_diseases
Medical oncologist (solid-tumor chemotherapist)	`medical_oncologist`	v0.1.0	2026-04-25	solid_oncology
Molecular geneticist / molecular oncologist	`molecular_geneticist`	v0.1.0	2026-04-25	molecular_oncology
Palliative care	`palliative_care`	v0.1.0	2026-04-25	palliative_care
Pathologist (general)	`pathologist`	v0.1.0	2026-04-25	pathology
Primary care / family physician	`primary_care`	v0.1.0	2026-04-25	primary_care
Psycho-oncologist	`psychologist`	v0.1.0	2026-04-25	psychosocial
Radiation oncologist	`radiation_oncologist`	v0.1.0	2026-04-25	radiation_oncology
Radiologist	`radiologist`	v0.1.0	2026-04-25	diagnostic_imaging
Social worker / case manager	`social_worker_case_manager`	v0.1.0	2026-04-25	psychosocial
Surgical oncologist	`surgical_oncologist`	v0.1.0	2026-04-25	surgical_oncology
Transplant specialist (BMT)	`transplant_specialist`	v0.1.0	2026-04-25	cellular_therapy

Sources cited

SRC-NCCN-THYROID-2025: NCCN Clinical Practice Guidelines — Thyroid Carcinoma (2025.v2)

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: 2026-08-17.

NCT	Title	Phase	Status	Sponsor	UA	Signals	Eligibility (excerpt)
NCT06145308	Precision Treatment of Recurrent/Metastatic Salivary Gland Carcinoma Guided by Molecular Typing	PHASE2	RECRUITING	Peking Union Medical College	—	Biomarker: enriched Small N (<50) Surrogate endpoint only Single country

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).

Option	UA registration	NSZU	Cost orientation	Access pathway
Standard plan Paclitaxel + carboplatin (salivary gland carcinoma, palliative) (REG-PACLITAXEL-CARBOPLATIN-SALIVARY)	✓ registered	✓ covered	₴-? — verify pathway	NSZU 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: 2026-08-17.

plan_id: PLAN-BMA-NTRK_ETV6_SALIVARY-V1 | version: 1 | generated: 2026-08-17T08:06:32.097211+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.