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

Clinical significance of mutations (ESCAT)

Tumor-board context — the engine does not use these tiers to rank tracks
BiomarkerVariantESCATEvidenceClinical significanceDrugsSources
BIO-NTRK-FUSIONNTRK1/3 fusion (rare in PTC, ~1-2%; enriched in radiation-induced PTC)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 papillary thyroid carcinoma (~1-2% sporadic, higher in radiation-induced disease — Chernobyl cohorts). Larotrectinib and entrectinib are FDA tumor-agnostic for NTRK-fusion solid tumors. PTC subset of NAVIGATE / STARTRK-2 demonstrates durable responses in RAI-refractory disease.larotrectinib monotherapy (RAI-refractory advanced disease)
entrectinib monotherapy
  • SRC-FDA-CDS-2026

Treatment options (1 tracks)

Standard plan
★ DEFAULT
Indication
IND-THYROID-PAPILLARY-RAI-REFRACTORY-LENVATINIB
Regimen
Lenvatinib monotherapy (RAI-refractory progressive PTC, 1L systemic)
Drugs + NSZU
  • Lenvatinib (DRUG-LENVATINIB) 24 mg PO daily, continuous · Per regimen schedule · IV ⚠ NSZU — not for this indication
Reason
Engine default per algorithm ALGO-THYROID-PAPILLARY-1L: {'step': None, 'note': 'decision tree fell through; using default_indication', 'result': 'IND-THYROID-PAPILLARY-RAI-REFRACTORY-LENVATINIB', 'fired_red_flags': []}

Timeline

Treatment timeline — derived from regimen + monitoring schedule

Standard plan

Induction · Lenvatinib monotherapy (RAI-re
21-day cycles × 6 cycles or until progression / toxicity

MDT brief

Data quality

  • Unevaluated RedFlags: RF-THYROID-PAPILLARY-FRAILTY-AGE, RF-THYROID-PAPILLARY-HIGH-RISK-BIOLOGY, RF-THYROID-PAPILLARY-INFECTION-SCREENING, RF-THYROID-PAPILLARY-ORGAN-DYSFUNCTION, RF-THYROID-PAPILLARY-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
Lenvatinib monotherapy (RAI-refractory progressive PTC, 1L systemic) (REG-LENVATINIB-THYROID-RAI-REF)
✓ 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-NTRK_FUSION_THYROID_PAPILLAR-V1 | version: 1 | generated: 2026-05-04T14:13:16.656141+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.