OpenOnco
UA EN
Plan Builder Onco Wiki Tumor Board
OpenOnco · Pancreatic NET - everolimus 1L
← Back to galleryFeedback on this case
OpenOnco · Treatment Plan
Treatment plan — Pancreatic neuroendocrine tumor
PLAN-COVERAGE-PNET-001-V1 · v1 · 2026-05-12
Patient
COVERAGE-PNET-001 · Algorithm: ALGO-PNET-METASTATIC-1L
DiagnosisPancreatic neuroendocrine tumor
MOH / ICD-10C25.4
ICD-O-38240/3; C25

Clinical significance of mutations (ESCAT)

Tumor-board context — the engine does not use these tiers to rank tracks
✅ Covered biomarkers (matched in KB)
BiomarkerVariantESCATEvidenceClinical significanceDrugsSources
No clinically actionable variants matched in this profile.
⚠️ Not included in plan
BiomarkerStatus
BIO-KI67-PROLIFERATIONNot in KB — ask clinician to verify

Primary current-line option

Standard plan
★ DEFAULT
Indication
IND-PNET-METASTATIC-1L-EVEROLIMUS
Regimen
Everolimus monotherapy (advanced/progressive pNET G1/G2; RADIANT-3)
Drugs + NSZU
  • Everolimus (DRUG-EVEROLIMUS) 10 mg PO once daily · Continuous daily dosing until progression or unacceptable toxicity · PO ⚠ Out-of-pocket
Supportive care
SUP-PJP-PROPHYLAXIS
Reason
Primary current-line option selected by ALGO-PNET-METASTATIC-1L at step 2; branch-driving red flag: RF-FITNESS-ECOG-FIT.

Why this branch was chosen

Triggers from the patient profile that fired and drove the chosen branch.
Step 2 → branch IND-PNET-METASTATIC-1L-EVEROLIMUS
  • RF-FITNESS-ECOG-FIT ★ winner: —

Red flags — PRO / CONTRA aggressive

PRO-AGGRESSIVE

Triggers that push toward the aggressive track
  • Poor performance status (ECOG ≥3): patient capable of only limited self-care, confined to bed/chair >50% of waking hours, or completely disabled. Generally palliative/best-supportive-care intent; cytotoxic therapy at full dose contraindicated. Selective targeted-therapy or steroid debulk may be appropriate as bridge to reassessment. RF-FITNESS-ECOG-POOR
  • Well-differentiated or poorly-differentiated neuroendocrine tumor with Ki67 >20% (WHO 2019 G3). High-grade disease is clinically and therapeutically distinct from G1/G2: well-differentiated G3 pNET may still respond to everolimus/sunitinib/SSA but outcomes are inferior; poorly differentiated neuroendocrine carcinoma (NEC, Ki67 typically >55%) requires platinum- etoposide chemotherapy (CAPEOX/EP/IP). Engine flag routes to MDT review. RF-NET-HIGH-GRADE-G3

CONTRA-AGGRESSIVE

Hard contraindications to escalation
  • —

What NOT to do

Explicit prohibitive rules, each grounded in a regimen / supportive care / contraindication entity
Standard plan (IND-PNET-METASTATIC-1L-EVEROLIMUS)
  • Не призначати еверолімус при погано-диференційоваnoй NEC (Ki67 >55%) — потрібна хіміотерапія (EP)
  • Не починати без базового тестування Ki67 — градуювання є вимогою відбору
  • Не застосовувати з сильними інгібіторами CYP3A4 без корекції дози (зниження до 2.5 мг/добу)
  • Уникати живих вакцин на фоno еверолімусу (імуносупресія)

Timeline

Treatment timeline — derived from regimen + monitoring schedule

Standard plan

Induction · Everolimus monotherapy (advanced/progressive pNET G1/G2; RADIANT-3)
28-day cycles × Continuous until progression or unacceptable toxicity

MDT brief

MDT talk tree (1 steps)

#OwnerTopicAction
1social_worker_case_managerSpecialist review Plan includes drugs without NSZU reimbursement — patient access pathway must be assessed.

Skills (recommended) — for consideration (1)

  • Social worker / case manager recommended
    Plan includes drugs without NSZU reimbursement — patient access pathway must be assessed.

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: 1/1 known (100%), 0 missing, 0 default-track gaps
  • Unevaluated RedFlags: RF-NET-CARCINOID-SYNDROME, RF-NET-HIGH-GRADE-G3
Technical MDT skill metadata (1/16 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: 2026-05-12.
NCTTitlePhaseStatusSponsorUASignalsEligibility (excerpt)
NCT07273409Pancreatic Neuroendocrine Tumour - Optimal Surgical Debulking or NotNARECRUITINGUppsala University—Single country
NCT05746182Genetic Predisposition Testing Program for Pancreatic Neuroendocrine NeoplasmsN/ARECRUITINGUniversity of California, San Francisco—Single country
NCT00830557Collecting Medical Information and Tissue Samples From Patients With Pancreatic Cancer or Other Pancreatic DisordersN/ARECRUITINGMayo Clinic—Single country
NCT05086692A Beta-only IL-2 ImmunoTherapY StudyPHASE1 / PHASE2RECRUITINGMedicenna Therapeutics, Inc.——
NCT04895709A Study of BMS-986340 as Monotherapy and in Combination With Nivolumab or Docetaxel in Participants With Advanced Solid TumorsPHASE1 / PHASE2RECRUITINGBristol-Myers Squibb——
NCT06519500Generation of Organoids of Neuroendocrine Neoplasms of the Gastro-Entero-Pancreatic Tract Obtained From Patients Undergoing SurgeryN/ARECRUITINGRegina Elena Cancer Institute—Small N (<50) Single country
NCT06596915Safety and Efficacy of BA1302 in Patients With Advanced Solid TumorsPHASE1RECRUITINGShandong Boan Biotechnology Co., Ltd—Phase 1 only Single country
NCT06735560Study Assessing PET Imaging With Zirconium-labelled Girentuximab in Patients With HCC, ICC or NENNARECRUITINGNantes University Hospital—Single country
NCT07554560Nutrition Intervention for Pancreatic CancerNARECRUITINGChildren's Hospital of Philadelphia—Small N (<50) Single country
NCT06246630In Vitro Organoid Drug Sensitivity-Guided Treatment for Advanced Pancreatic Neuroendocrine TumorNARECRUITINGRuijin Hospital—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).
OptionUA registrationNSZUCost orientationAccess pathway
Standard plan
Everolimus monotherapy (advanced/progressive pNET G1/G2; RADIANT-3) (REG-EVEROLIMUS-MONO-PNET)
1/1 component drug(s) not on NSZU formulary
✓ registered✗ out-of-pocket₴-? — verify pathwaynot recorded
Trial · NCT07273409
Pancreatic Neuroendocrine Tumour - Optimal Surgical Debulking or Not
No UA site listed — international referral required
— unknown— unknown
self-pay: ₴0/course
Trial sponsor
Trial · NCT05746182
Genetic Predisposition Testing Program for Pancreatic Neuroendocrine Neoplasms
No UA site listed — international referral required
— unknown— unknown
self-pay: ₴0/course
Trial sponsor
Trial · NCT00830557
Collecting Medical Information and Tissue Samples From Patients With Pancreatic Cancer or Other Pancreatic Disorders
No UA site listed — international referral required
— unknown— unknown
self-pay: ₴0/course
Trial sponsor
Trial · NCT05086692
A Beta-only IL-2 ImmunoTherapY Study
No UA site listed — international referral required
— unknown— unknown
self-pay: ₴0/course
Trial sponsor
Trial · NCT04895709
A Study of BMS-986340 as Monotherapy and in Combination With Nivolumab or Docetaxel in Participants With Advanced Solid Tumors
No UA site listed — international referral required
— unknown— unknown
self-pay: ₴0/course
Trial sponsor
Trial · NCT06519500
Generation of Organoids of Neuroendocrine Neoplasms of the Gastro-Entero-Pancreatic Tract Obtained From Patients Undergoing Surgery
No UA site listed — international referral required
— unknown— unknown
self-pay: ₴0/course
Trial sponsor
Trial · NCT06596915
Safety and Efficacy of BA1302 in Patients With Advanced Solid Tumors
No UA site listed — international referral required
— unknown— unknown
self-pay: ₴0/course
Trial sponsor
Trial · NCT06735560
Study Assessing PET Imaging With Zirconium-labelled Girentuximab in Patients With HCC, ICC or NEN
No UA site listed — international referral required
— unknown— unknown
self-pay: ₴0/course
Trial sponsor
Trial · NCT07554560
Nutrition Intervention for Pancreatic Cancer
No UA site listed — international referral required
— unknown— unknown
self-pay: ₴0/course
Trial sponsor
Trial · NCT06246630
In Vitro Organoid Drug Sensitivity-Guided Treatment for Advanced Pancreatic Neuroendocrine Tumor
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: 2026-05-12.

plan_id: PLAN-COVERAGE-PNET-001-V1 | version: 1 | generated: 2026-05-12T18:41:26.047406+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.