OpenOnco · Treatment Plan

Treatment plan — Soft tissue sarcoma

PLAN-COVERAGE-STS-001-V1 · v1 · 2026-05-13

Patient

COVERAGE-STS-001 · Algorithm: ALGO-STS-ADVANCED-1L

DiagnosisSoft tissue sarcoma

MOH / ICD-10C49.9

ICD-O-38800/3

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
No clinically actionable variants matched in this profile.

Primary current-line option

Standard plan

★ DEFAULT

Indication

IND-STS-ADVANCED-1L-DOXORUBICIN

Regimen

Doxorubicin monotherapy (soft tissue sarcoma)

Drugs + NSZU

Doxorubicin (DRUG-DOXORUBICIN) 75 mg/m² IV over 15–60 min (or 25 mg/m²/d × 3d continuous infusion) · Day 1 of each 21-day cycle · IV ✓ NSZU covered

Reason

Provisional current-line default from ALGO-STS-ADVANCED-1L: step 1 did not select a treatment branch. Refer to disease-specific algorithm: - GIST → imatinib (DIS-GIST algorithm) - Ewing sarcoma → VDC-IE - Rhabdomyosarcoma → pediatric oncology - Chondrosarcoma → DIS-CHONDROSARCOMA algorithm (separate entity) - Osteosarcoma / bone sarcomas → DIS-OSTEOSARCOMA algorithm (not yet aut...

Other current-line alternatives (1 tracks)

Same treatment line; review when biomarker, access, contraindication, or patient-context assumptions change.

Aggressive plan

Indication

IND-STS-ADVANCED-1L-AI

Regimen

Doxorubicin + ifosfamide (soft tissue sarcoma, AI regimen)

Drugs + NSZU

Doxorubicin (DRUG-DOXORUBICIN) 75 mg/m² IV over 15–60 min · Day 1 of each 21-day cycle · IV ✓ NSZU covered
Ifosfamide (DRUG-IFOSFAMIDE) 2.5 mg/m²/day IV over 3h on days 1-4 (total 10 g/m² per cycle) · Days 1-4 of each 21-day cycle (concurrent with ifosfamide fractionation) · IV ✓ NSZU covered
Mesna (DRUG-MESNA) 20% of ifosfamide dose as IV bolus immediately before, then 40% at 4h and 8h after each ifosfamide dose · Days 1-4 concurrent with ifosfamide (total mesna = 60-100% of ifosfamide dose) · IV ✗ Not registered in UA

Reason

Current-line alternative presented for HCP consideration

Pre-treatment investigations

Investigations before treatment start · critical / standard / desired · merged across tracks

ID	Name	Priority	Category	Where to order	Needed for
TEST-CBC	Complete Blood Count with Differential	Critical	lab	—	all tracks
TEST-CMP	Comprehensive Metabolic Panel	Critical	lab	—	all tracks
TEST-CREATININE-CL	Creatinine clearance	Critical	lab	—	aggressive
TEST-LFT	Liver Function Tests (ALT, AST, bilirubin, ALP, GGT, albumin)	Critical	lab	—	all tracks
TEST-CT-CAP	CT chest/abdomen/pelvis	Standard	imaging	—	all tracks

What NOT to do

Explicit prohibitive rules, each grounded in a regimen / supportive care / contraindication entity

Standard plan (IND-STS-ADVANCED-1L-DOXORUBICIN)

Не перевищувати кумулятивну дозу доксорубіцину 450-500 мг/м² — кардіоміопатія
Не вводити без підтвердженої прохідності IV доступу — доксорубіцин є везикантом
Не призначати при ФВЛШ <50% — базова ехоКГ/MUGA обов'язкова
Не використовувати для GIST (іматиnoб) або саркоми Юїнга (VDC-IE) — окремі нозології
Не продовжувати при прогресуванno після 2-3 циклів без кліnoчного обґрунтування

Aggressive plan (IND-STS-ADVANCED-1L-AI)

Не застосовувати без мезни — геморагічний цистит
Не застосовувати без G-КСФ — 71% нейтропеnoї Grade 3/4
Не призначати при ECOG ≥2 — токсичnoсть не виправдана при відсутності OS переваги
Не призначати при КК <50 мл/хв без корекції дози іфосфаміду
Не продовжувати іфосфамід при енцефалопатії Grade ≥2 — відміна іфосфаміду, лікування метиленовим сиnoм

Timeline

Treatment timeline — derived from regimen + monitoring schedule

Standard plan

Induction · Doxorubicin monotherapy (soft tissue sarcoma)

21-day cycles × 6 cycles (or until progression, cumulative dose limit, or unacceptable toxicity)

Aggressive plan

Induction · Doxorubicin + ifosfamide (soft tissue sarcoma, AI regimen)

21-day cycles × 4-6 cycles (or until progression, dose limit, or unacceptable toxicity)

MDT brief

Discussion questions (1, 0 blocking)

OQ-LDH-CURRENT
What is the current LDH? Marker of tumor burden and transformation.
LDH is part of the prognostic indices of indolent lymphomas.
→ hematologist

MDT talk tree (2 steps)

#	Owner	Topic	Action
1	hematologist	Staging / disease burden	What is the current LDH? Marker of tumor burden and transformation.
2	clinical_pharmacist	Specialist review	Chemoimmunotherapy regimen — drug-drug interactions, dose adjustments, premedication.

Skills (recommended) — for consideration (1)

Clinical pharmacist recommended
Chemoimmunotherapy regimen — drug-drug interactions, dose adjustments, premedication.

Data quality

Complete for MDT review. Required MDT data checks are complete for the current case profile.

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

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).

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-EORTC62012-JUDSON-2014: Doxorubicin alone versus intensified doxorubicin plus ifosfamide for first-line treatment of advanced or metastatic soft-tissue sarcoma: a randomised controlled phase 3 trial ()
SRC-NCCN-SARCOMA: NCCN Soft Tissue Sarcoma guideline (TODO: confirm year/citation) ()

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: 2026-05-13.

NCT	Title	Phase	Status	Sponsor	UA	Signals
NCT05617859	Lenvatinib for Advanced Bone and Soft Tissue Sarcoma	PHASE2	RECRUITING	Henan Cancer Hospital	—	Surrogate endpoint only Single country
NCT03175718	INPWT on Wound Complications & Clinical Outcomes After Lower Extremity Sarcoma Surgery Preop Radiation Therapy Patients	NA	RECRUITING	Dr. J. Werier	—	Single country
NCT06836505	Safety and Efficacy of CAR-T Cell Therapy for Relapsed/refractory Neuroblastoma and Desmoplastic Small Round Cell Tumors: a Single-arm, Open-label Trial.	PHASE1 / PHASE2	RECRUITING	Sun Yat-Sen University Cancer Center	—	Small N (<50) Single country
NCT04693377	Cryoablation Combined With Stereotactic Body Radiation Therapy for the Treatment of Painful Bone Metastases, the CROME Trial	NA	RECRUITING	M.D. Anderson Cancer Center	—	Small N (<50) Single country
NCT06891157	Chidamide Plus R-CHOP in Newly Diagnosed Double-Expressor Diffuse Large B-Cell Lymphoma With Other Molecular Subtypes	PHASE2	RECRUITING	The First Affiliated Hospital with Nanjing Medical University	—	Surrogate endpoint only Single country
NCT06114225	Pulmonary Resectable Osteosarcoma Treated by Metastasectomy and Pre-operative Immunotherapy and Stereotactic Body Radiotherapy (PROMIS): a Prospective Clinical Trial	PHASE2	RECRUITING	Ruijin Hospital	—	Small N (<50) Surrogate endpoint only Single country
NCT07328425	Clinical Study in Adult and Young Adult Patients With Advanced Desmoplastic Small Round Cell Tumor (DSRCT) ISG-TULIPS	PHASE2	RECRUITING	Italian Sarcoma Group	—	Small N (<50) Surrogate endpoint only Single country
NCT05377307	Long-term Follow-up Study of Lentiviral-based Gene-edited Immune Cell Therapy	N/A	RECRUITING	Pell Bio-Med Technology Co., Ltd.	—	Small N (<50) Single country
NCT07134192	Fluorescence-Guided Optimization of Sarcoma Margins	NA	RECRUITING	University of Aarhus	—	Single country
NCT03465592	Trial of Nivolumab Following Partially Human Leukocyte Antigen (HLA) Mismatched BMT in Children & Adults With Sarcoma	PHASE1 / PHASE2	RECRUITING	Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins	—	Small N (<50) 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 Doxorubicin monotherapy (soft tissue sarcoma) (REG-DOXORUBICIN-STS)	✓ registered	✓ covered	₴-? — verify pathway	NSZU formulary
Aggressive plan Doxorubicin + ifosfamide (soft tissue sarcoma, AI regimen) (REG-DOXORUBICIN-IFOSFAMIDE-STS) 1/3 component drug(s) not registered in Ukraine +1	✗ not registered	✗ out-of-pocket	₴-? — verify pathway	not recorded
Trial · NCT05617859 Lenvatinib for Advanced Bone and Soft Tissue Sarcoma No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT03175718 INPWT on Wound Complications & Clinical Outcomes After Lower Extremity Sarcoma Surgery Preop Radiation Therapy Patients No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT06836505 Safety and Efficacy of CAR-T Cell Therapy for Relapsed/refractory Neuroblastoma and Desmoplastic Small Round Cell Tumors: a Single-arm, Open-label Trial. No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT04693377 Cryoablation Combined With Stereotactic Body Radiation Therapy for the Treatment of Painful Bone Metastases, the CROME Trial No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT06891157 Chidamide Plus R-CHOP in Newly Diagnosed Double-Expressor Diffuse Large B-Cell Lymphoma With Other Molecular Subtypes No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT06114225 Pulmonary Resectable Osteosarcoma Treated by Metastasectomy and Pre-operative Immunotherapy and Stereotactic Body Radiotherapy (PROMIS): a Prospective Clinical Trial No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT07328425 Clinical Study in Adult and Young Adult Patients With Advanced Desmoplastic Small Round Cell Tumor (DSRCT) ISG-TULIPS No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT05377307 Long-term Follow-up Study of Lentiviral-based Gene-edited Immune Cell Therapy No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT07134192 Fluorescence-Guided Optimization of Sarcoma Margins No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT03465592 Trial of Nivolumab Following Partially Human Leukocyte Antigen (HLA) Mismatched BMT in Children & Adults With Sarcoma 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: 2026-05-13.

plan_id: PLAN-COVERAGE-STS-001-V1 | version: 1 | generated: 2026-05-13T10:01:51.351611+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.