OpenOnco · Treatment Plan

Treatment plan — Soft tissue sarcoma

PLAN-COVERAGE-STS-001-V1 · v1 · 2026-06-27

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

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-LI-FRAUMENI-FAMILY-HISTORY-SUSPICION

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: 2026-06-27.

NCT	Title	Phase	Status	Sponsor	UA	Signals
NCT06873685	Soft Tissue Sarcoma: Motor Performance, Robotic Rehabilitation, Nutrition, and Quality of Life	NA	RECRUITING	Fondazione Policlinico Universitario Campus Bio-Medico	—	Single country
NCT05357768	Global collaboRAtion on CIC-DUX4, BCOR-CCN3, High-grade Undifferentiated Round Cell Sarcoma (URCS) Project	N/A	RECRUITING	Istituto Ortopedico Rizzoli	—	Single country
NCT04305548	Study on Trabectedin in Advanced Rearranged Mesenchymal Chondrosarcoma	PHASE2	RECRUITING	Italian Sarcoma Group	—	Small N (<50) Surrogate endpoint only Single country
NCT06827717	Phase II Study of Irinotecan Liposome (II) Combined With Temozolomide and Fluzoparib in Recurrent or Metastatic Ewing Sarcoma	PHASE2	RECRUITING	Sun Yat-sen University	—	Small N (<50) Surrogate endpoint only Single country
NCT07596693	KXV01 Injection in Patients With Advanced Solid Tumor (Including Osteosarcoma and Sarcoma)	PHASE1	RECRUITING	TCRx Therapeutics Co.Ltd	—	Phase 1 only Small N (<50) Single country
NCT05839275	The Combination of Radiotherapy，Surufatinib and Sintilimab in High-Risk Localized Soft Tissue Sarcoma	PHASE1 / PHASE2	RECRUITING	Fudan University	—	Surrogate endpoint only Single country
NCT05296564	Anti-NY-ESO-1 TCR-Gene Engineered Lymphocytes Given by Infusion to Patients With NY-ESO-1 -Expressing Metastatic Cancers	PHASE1 / PHASE2	RECRUITING	Hadassah Medical Organization	—	Small N (<50) Single country
NCT04166006	A Phase II Study on Adjuvant Vaccination with Dendritic Cells Loaded with Autologous Tumor Homogenate in Resected Stage IV Rare Cancers.	PHASE2	RECRUITING	Istituto Romagnolo per lo Studio dei Tumori Dino Amadori IRST S.r.l. IRCCS	—	Single country
NCT05597917	tTF-NGR Randomized Study - STS	PHASE3	RECRUITING	Universität Münster	—	Surrogate endpoint only Single country
NCT03838718	REtroperitoneal SArcoma Registry: an International Prospective Initiative	N/A	RECRUITING	Fondazione IRCCS Istituto Nazionale dei Tumori, Milano	—	Surrogate endpoint only

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 · NCT06873685 Soft Tissue Sarcoma: Motor Performance, Robotic Rehabilitation, Nutrition, and Quality of Life No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT05357768 Global collaboRAtion on CIC-DUX4, BCOR-CCN3, High-grade Undifferentiated Round Cell Sarcoma (URCS) Project No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT04305548 Study on Trabectedin in Advanced Rearranged Mesenchymal Chondrosarcoma No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT06827717 Phase II Study of Irinotecan Liposome (II) Combined With Temozolomide and Fluzoparib in Recurrent or Metastatic Ewing Sarcoma No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT07596693 KXV01 Injection in Patients With Advanced Solid Tumor (Including Osteosarcoma and Sarcoma) No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT05839275 The Combination of Radiotherapy，Surufatinib and Sintilimab in High-Risk Localized Soft Tissue Sarcoma No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT05296564 Anti-NY-ESO-1 TCR-Gene Engineered Lymphocytes Given by Infusion to Patients With NY-ESO-1 -Expressing Metastatic Cancers No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT04166006 A Phase II Study on Adjuvant Vaccination with Dendritic Cells Loaded with Autologous Tumor Homogenate in Resected Stage IV Rare Cancers. No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT05597917 tTF-NGR Randomized Study - STS No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT03838718 REtroperitoneal SArcoma Registry: an International Prospective Initiative 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: 2026-06-27.

plan_id: PLAN-COVERAGE-STS-001-V1 | version: 1 | generated: 2026-06-27T09:41:00.710724+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.