OpenOnco · Treatment Plan

Treatment plan — Colorectal carcinoma

PLAN-CRC-MET-3L-REGO-001-V1 · v1 · 2026-05-13

Patient

CRC-MET-3L-REGO-001 · Algorithm: ALGO-CRC-METASTATIC-3L

DiagnosisColorectal carcinoma

MOH / ICD-10C18-C20

ICD-O-38140/3; C18, C19, C20

StageIV

Histologyadenocarcinoma

Clinical significance of mutations (ESCAT)

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

✅ Covered biomarkers (matched in KB)

Biomarker	Variant	ESCAT	Evidence	Clinical significance	Drugs	Sources
BIO-RAS-MUTATION	KRAS A146T	IV	Molecular evidence option SRC-CIVIC: Level B (Supports, Poor Outcome) Resistance or avoidance signal SRC-CIVIC: Level A ⚠ Resistance SRC-CIVIC: Level B ⚠ Resistance SRC-CIVIC: Level C ⚠ Resistance SRC-CIVIC: Level D ⚠ Resistance Trial or research option SRC-CIVIC: Level D (Supports, Sensitivity/Response) SRC-CIVIC: Level E (Supports, Sensitivity/Response)	KRAS A146T — rare, anti-EGFR contraindication marker. No targeted therapy.	—	SRC-NCCN-COLON-2025
BIO-RAS-MUTATION	KRAS exon 3 codon 59/61	IA	Molecular evidence option SRC-CIVIC: Level B (Supports, Poor Outcome) Resistance or avoidance signal SRC-CIVIC: Level A ⚠ Resistance SRC-CIVIC: Level B ⚠ Resistance SRC-CIVIC: Level C ⚠ Resistance SRC-CIVIC: Level D ⚠ Resistance Trial or research option SRC-CIVIC: Level D (Supports, Sensitivity/Response) SRC-CIVIC: Level E (Supports, Sensitivity/Response)	KRAS exon 3 codon 59/61 in mCRC — extended-RAS WT criterion fails; anti-EGFR (cetuximab/panitumumab) contraindicated. Standard chemo ± bevacizumab.	—	SRC-NCCN-COLON-2025 SRC-ESMO-COLON-2024
BIO-RAS-MUTATION	KRAS exon 4 codon 117/146	IA	Molecular evidence option SRC-CIVIC: Level B (Supports, Poor Outcome) Resistance or avoidance signal SRC-CIVIC: Level A ⚠ Resistance SRC-CIVIC: Level B ⚠ Resistance SRC-CIVIC: Level C ⚠ Resistance SRC-CIVIC: Level D ⚠ Resistance Trial or research option SRC-CIVIC: Level D (Supports, Sensitivity/Response) SRC-CIVIC: Level E (Supports, Sensitivity/Response)	KRAS exon 4 codon 117/146 in mCRC — extended-RAS WT criterion fails; anti-EGFR (cetuximab/panitumumab) contraindicated. Standard chemo ± bevacizumab.	—	SRC-NCCN-COLON-2025 SRC-ESMO-COLON-2024
BIO-RAS-MUTATION	KRAS G12D	IV	Molecular evidence option SRC-CIVIC: Level B (Supports, Better Outcome) Resistance or avoidance signal SRC-CIVIC: Level A ⚠ Resistance SRC-CIVIC: Level B ⚠ Resistance SRC-CIVIC: Level C ⚠ Resistance SRC-CIVIC: Level D ⚠ Resistance Trial or research option SRC-CIVIC: Level C (Supports, Sensitivity/Response) SRC-CIVIC: Level D (Supports, Sensitivity/Response) SRC-CIVIC: Level E (Supports, Sensitivity/Response)	KRAS G12D in mCRC predicts anti-EGFR resistance. No approved targeted therapy 2026; trial-only (MRTX1133, RMC-9805 + cetuximab combos).	—	SRC-NCCN-COLON-2025
BIO-RAS-MUTATION	KRAS G12V	IV	Molecular evidence option SRC-CIVIC: Level B (Supports, Poor Outcome) Resistance or avoidance signal SRC-CIVIC: Level A ⚠ Resistance SRC-CIVIC: Level B ⚠ Resistance SRC-CIVIC: Level C ⚠ Resistance SRC-CIVIC: Level D ⚠ Resistance Trial or research option SRC-CIVIC: Level D (Supports, Sensitivity/Response) SRC-CIVIC: Level E (Supports, Sensitivity/Response)	KRAS G12V in mCRC — anti-EGFR contraindication marker, no targeted therapy. Standard chemo ± anti-VEGF.	—	SRC-NCCN-COLON-2025
BIO-RAS-MUTATION	KRAS G12 (any)	IA	Molecular evidence option SRC-CIVIC: Level B (Supports, Poor Outcome) Resistance or avoidance signal SRC-CIVIC: Level A ⚠ Resistance SRC-CIVIC: Level B ⚠ Resistance SRC-CIVIC: Level C ⚠ Resistance SRC-CIVIC: Level D ⚠ Resistance Trial or research option SRC-CIVIC: Level D (Supports, Sensitivity/Response) SRC-CIVIC: Level E (Supports, Sensitivity/Response)	KRAS G12 (any) in mCRC — extended-RAS WT criterion fails; anti-EGFR (cetuximab/panitumumab) contraindicated. Standard chemo ± bevacizumab.	—	SRC-NCCN-COLON-2025 SRC-ESMO-COLON-2024
BIO-RAS-MUTATION	KRAS G13D	IV	Molecular evidence option SRC-CIVIC: Level B (Supports, Poor Outcome) Resistance or avoidance signal SRC-CIVIC: Level A ⚠ Resistance SRC-CIVIC: Level B ⚠ Resistance SRC-CIVIC: Level C ⚠ Resistance SRC-CIVIC: Level D ⚠ Resistance Trial or research option SRC-CIVIC: Level D (Supports, Sensitivity/Response) SRC-CIVIC: Level E (Supports, Sensitivity/Response)	KRAS G13D in mCRC — historical signal of partial cetuximab response (De Roock 2010) was not confirmed prospectively. Treat as RAS-mut, anti-EGFR contraindicated.	—	SRC-NCCN-COLON-2025
BIO-RAS-MUTATION	KRAS G13 (any non-G13C)	IA	Molecular evidence option SRC-CIVIC: Level B (Supports, Poor Outcome) Resistance or avoidance signal SRC-CIVIC: Level A ⚠ Resistance SRC-CIVIC: Level B ⚠ Resistance SRC-CIVIC: Level C ⚠ Resistance SRC-CIVIC: Level D ⚠ Resistance Trial or research option SRC-CIVIC: Level D (Supports, Sensitivity/Response) SRC-CIVIC: Level E (Supports, Sensitivity/Response)	KRAS G13 (any non-G13C) in mCRC — extended-RAS WT criterion fails; anti-EGFR (cetuximab/panitumumab) contraindicated. Standard chemo ± bevacizumab.	—	SRC-NCCN-COLON-2025 SRC-ESMO-COLON-2024
BIO-RAS-MUTATION	KRAS Q61 (any)	IA	Molecular evidence option SRC-CIVIC: Level B (Supports, Poor Outcome) Resistance or avoidance signal SRC-CIVIC: Level A ⚠ Resistance SRC-CIVIC: Level B ⚠ Resistance SRC-CIVIC: Level C ⚠ Resistance SRC-CIVIC: Level D ⚠ Resistance Trial or research option SRC-CIVIC: Level D (Supports, Sensitivity/Response) SRC-CIVIC: Level E (Supports, Sensitivity/Response)	KRAS Q61 (any) in mCRC — extended-RAS WT criterion fails; anti-EGFR (cetuximab/panitumumab) contraindicated. Standard chemo ± bevacizumab.	—	SRC-NCCN-COLON-2025 SRC-ESMO-COLON-2024
BIO-RAS-MUTATION	NRAS G12	IB	Molecular evidence option SRC-CIVIC: Level B (Supports, N/A) Resistance or avoidance signal SRC-CIVIC: Level A ⚠ Resistance SRC-CIVIC: Level B ⚠ Resistance SRC-CIVIC: Level C ⚠ Resistance SRC-CIVIC: Level D ⚠ Resistance Trial or research option SRC-CIVIC: Level D (Supports, Sensitivity/Response)	NRAS codon 12 mutation in mCRC — extended RAS WT criterion fails; anti-EGFR contraindicated.	—	SRC-NCCN-COLON-2025
BIO-RAS-MUTATION	NRAS G13	IB	Molecular evidence option SRC-CIVIC: Level B (Supports, N/A) Resistance or avoidance signal SRC-CIVIC: Level A ⚠ Resistance SRC-CIVIC: Level B ⚠ Resistance SRC-CIVIC: Level C ⚠ Resistance SRC-CIVIC: Level D ⚠ Resistance Trial or research option SRC-CIVIC: Level D (Supports, Sensitivity/Response)	NRAS codon 13 in mCRC — anti-EGFR contraindicated.	—	SRC-NCCN-COLON-2025
BIO-RAS-MUTATION	NRAS Q61K	IB	Molecular evidence option SRC-CIVIC: Level B (Supports, N/A) Resistance or avoidance signal SRC-CIVIC: Level A ⚠ Resistance SRC-CIVIC: Level B ⚠ Resistance SRC-CIVIC: Level C ⚠ Resistance SRC-CIVIC: Level D ⚠ Resistance Trial or research option SRC-CIVIC: Level C (Supports, Sensitivity/Response) SRC-CIVIC: Level D (Supports, Sensitivity/Response)	NRAS Q61K in mCRC — anti-EGFR contraindication.	—	SRC-NCCN-COLON-2025
BIO-RAS-MUTATION	NRAS Q61R	IB	Molecular evidence option SRC-CIVIC: Level B (Supports, N/A) Resistance or avoidance signal SRC-CIVIC: Level A ⚠ Resistance SRC-CIVIC: Level B ⚠ Resistance SRC-CIVIC: Level C ⚠ Resistance SRC-CIVIC: Level D ⚠ Resistance Trial or research option SRC-CIVIC: Level C (Supports, Sensitivity/Response) SRC-CIVIC: Level D (Supports, Sensitivity/Response)	NRAS Q61R in mCRC — anti-EGFR (cetuximab/panitumumab) contraindication. Standard chemo ± bev; no NRAS-selective drug.	—	SRC-NCCN-COLON-2025 SRC-ESMO-COLON-2024

⚠️ Not included in plan

Biomarker	Status
BIO-MSI-STATUS	BIO definition in KB; no ESCAT BMA entry — verify with clinician
BIO-BRAF-V600E	Excluded (negative)
KRAS	Not in KB — ask clinician to verify

Primary current-line option

Standard plan

★ DEFAULT

Indication

IND-CRC-METASTATIC-3L-TAS102-BEV

Regimen

Trifluridine-Tipiracil + Bevacizumab (SUNLIGHT) — 3L+ mCRC

Drugs + NSZU

Trifluridine + Tipiracil (DRUG-TRIFLURIDINE-TIPIRACIL) 35 mg/m² PO BID (based on FTD component) · Days 1-5 + 8-12 of each 28-day cycle (4 doses/week × 2 weeks, then 14-day rest) · PO ⚠ Out-of-pocket
Bevacizumab (DRUG-BEVACIZUMAB) 5 mg/kg · IV days 1, 15 of each 28-day cycle · IV ✓ NSZU covered

Supportive care

SUP-GCSF-NEUTROPENIA

Reason

Primary current-line option selected by ALGO-CRC-METASTATIC-3L at step 1.

Other current-line alternatives (2 tracks)

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

Aggressive plan

Indication

IND-CRC-METASTATIC-3L-REGORAFENIB

Regimen

Regorafenib monotherapy (CORRECT-style; ReDOS escalation preferred)

Drugs + NSZU

Regorafenib (DRUG-REGORAFENIB) ReDOS escalation: 80 mg PO daily week 1 → 120 mg week 2 → 160 mg week 3 if tolerated; days 1-21 of each 28-day cycle (3 weeks on, 1 week off). Standard CORRECT dose: 160 mg PO daily days 1-21. · PO daily days 1-21 of each 28-day cycle · PO ⚠ NSZU — not for this indication

Reason

Current-line alternative presented for HCP consideration

Standard plan

Indication

IND-CRC-METASTATIC-3L-TRIFLURIDINE-TIPIRACIL-MONO

Regimen

Trifluridine-tipiracil monotherapy (RECOURSE, 3L+ mCRC)

Drugs + NSZU

Trifluridine + Tipiracil (DRUG-TRIFLURIDINE-TIPIRACIL) 35 mg/m² PO BID (rounded to nearest 5 mg) · Days 1-5 + days 8-12 of each 28-day cycle · PO ⚠ Out-of-pocket

Supportive care

SUP-GCSF-NEUTROPENIA

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-CT-CHEST-ABDOMEN-PELVIS	CT chest + abdomen + pelvis with IV contrast	Critical	imaging	—	all tracks
TEST-LFT	Liver Function Tests (ALT, AST, bilirubin, ALP, GGT, albumin)	Critical	lab	—	all tracks
TEST-CEA	CEA	Standard	lab	—	all tracks

Red flags — PRO / CONTRA aggressive

PRO-AGGRESSIVE

Triggers that push toward the aggressive track

Frailty/age profile precluding doublet-intensive or triplet chemo: ECOG ≥3, OR (age ≥80 + Charlson ≥3), OR composite (age ≥75 + albumin <3.0 + ≥2 comorbidities). Triggers de-escalation toward 5-FU/LV mono, capecitabine mono, or best supportive care. RF-CRC-FRAILTY-AGE

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-CRC-METASTATIC-3L-TAS102-BEV)

Do NOT prescribe with ANC <1500 or platelets <75K at cycle start — myelosuppression likely Grade 3+.
Do NOT escalate dose without count recovery cycle-to-cycle — neutropenia is dose-limiting.
Do NOT initiate bevacizumab within 28 days of major surgery.
Do NOT continue bevacizumab in uncontrolled HTN.
Do NOT use in active hemoptysis / GI bleeding.
Do NOT prescribe with ECOG 3-4 — toxicity profile exceeds frail patient tolerance.
Do NOT confirm the plan without funding pathway for TAS-102.
Do NOT forget to reduce dose when CrCl 30-59 (20 mg/m² BID).

Aggressive plan (IND-CRC-METASTATIC-3L-REGORAFENIB)

Do NOT start at full 160 mg dose — ReDOS escalation (80→120→160) substantially better tolerability.
Do NOT ignore hepatic surveillance — fatal hepatic failure ~1-2%; weekly LFT cycle 1.
Do NOT skip topical urea prophylaxis for HFSR — Grade 3 HFSR is treatment-limiting.
Do NOT combine with anticoagulants without strict monitoring — bleeding risk.
Do NOT continue with uncontrolled HTN >160/100.
Do NOT use in Child-Pugh C — severe hepatic impairment contraindicated.
Do NOT initiate within 2 weeks of major surgery — wound healing impairment.
Do NOT confirm without funding — drug not NSZU-reimbursed.

Standard plan (IND-CRC-METASTATIC-3L-TRIFLURIDINE-TIPIRACIL-MONO)

Do NOT prescribe with ANC <1500 or platelets <75K at cycle start — myelosuppression Grade 3+.
Do NOT escalate dose without count recovery cycle-to-cycle — neutropenia is dose-limiting.
Do NOT forget to reduce dose when CrCl 30-59 (20 mg/m² BID).
Do NOT prescribe when CrCl <30 — insufficient safety data.
Do NOT prescribe with ECOG 3-4 — toxicity profile exceeds frail tolerance.
Do NOT confirm without funding pathway for TAS-102.

Timeline

Treatment timeline — derived from regimen + monitoring schedule

Standard plan

Induction · Trifluridine-Tipiracil + Bevacizumab (SUNLIGHT) — 3L+ mCRC

28-day cycles × Until progression / unacceptable toxicity

Aggressive plan

Induction · Regorafenib monotherapy (CORRECT-style; ReDOS escalation preferred)

28-day cycles × Until progression / unacceptable toxicity

Standard plan

Induction · Trifluridine-tipiracil monotherapy (RECOURSE, 3L+ mCRC)

28-day cycles × Until progression / 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 (3 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.
3	social_worker_case_manager	Specialist review	Plan includes drugs without NSZU reimbursement — patient access pathway must be assessed.

Skills (recommended) — for consideration (2)

Clinical pharmacist recommended
Chemoimmunotherapy regimen — drug-drug interactions, dose adjustments, premedication.
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: 0/0 known (100%), 0 missing, 0 default-track gaps
Unevaluated RedFlags: RF-ACTIVE-AUTOIMMUNE-DISEASE-ICI-RISK, RF-CRC-EMERGENCY-OBSTRUCTION-PERFORATION, RF-CRC-FRAILTY-AGE, RF-CRC-HER2-AMP-ACTIONABLE, RF-CRC-INFECTION-SCREENING, RF-CRC-OLIGOMET-LIVER-DEFINITION, RF-CRC-RAS-WT, RF-CRC-TRANSFORMATION-PROGRESSION

Technical MDT skill metadata (2/16 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-ESMO-COLON-2024: ESMO CRC Clinical Practice Guideline (2024)
SRC-NCCN-COLON-2025: NCCN Colon / Rectal Cancer (v.4.2025)

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
NCT05727163	FOLFOX Via HAI Plus Intravenous Irinotecan With or Without Bevacizumab Versus Systemic FOLFOXIRI With or Without Bevacizumab in Initially Unresectable RAS-mutated CRLM Patients	PHASE2	RECRUITING	Sun Yat-sen University	—	Surrogate endpoint only Single country
NCT02885753	Systemic Oxaliplatin or Intra-arterial Chemotherapy Combined With LV5FU2 +/- Irinotecan and an Target Therapy in First Line Treatment of Metastatic Colorectal Cancer Restricted to the Liver	PHASE3	RECRUITING	Federation Francophone de Cancerologie Digestive	—	Biomarker: enriched Surrogate endpoint only
NCT06226857	Other Oncogene Mutations for Anti-EGFR Efficacy in Patients With Left-sided RAS-wild Type Metastatic Colorectal Cancer	PHASE3	RECRUITING	City Clinical Oncology Hospital No 1	—	Surrogate endpoint only Single country
NCT06445062	Study of RAS(ON) Inhibitors in Patients With Gastrointestinal Solid Tumors	PHASE1 / PHASE2	RECRUITING	Revolution Medicines, Inc.	—	Biomarker: enriched Single country
NCT06895031	Study of JYP0015 in Patients With Advanced Solid Tumors Harboring Specific Mutations in RAS	PHASE2	RECRUITING	Guangzhou JOYO Pharma Co., Ltd	—	Biomarker: enriched Surrogate endpoint only Single country
NCT06440902	Exploration of Therapeutic Strategies for NeoRAS Wild-type Metastatic Colorectal Cancer Based on Circulating Tumor DNA	PHASE2	RECRUITING	Fudan University	—	Biomarker: enriched Single country
NCT06218810	Cadonilimab in Combination With Bevacizumab and FOLFOX Regimen for the First-Line Treatment of Advanced Unresectable MSS-Type, RAS-Mutated Metastatic Colorectal Cancer	PHASE2	RECRUITING	Fudan University	—	Surrogate endpoint only Single country
NCT06229340	Leflunomide or Combination of MEK Inhibitor and Hydroxychloroquine for Refractory Patients With RAS Mutations	PHASE2	RECRUITING	N.N. Petrov National Medical Research Center of Oncology	—	Biomarker: enriched Small N (<50) Surrogate endpoint only Single country
NCT05861505	COLLISION RELAPSE Trial	PHASE3	RECRUITING	Amsterdam UMC, location VUmc	—	Single country
NCT07349537	Study of RMC-5127 in Patients With Advanced KRAS G12V-Mutant Solid Tumors	PHASE1	RECRUITING	Revolution Medicines, Inc.	—	Biomarker: enriched Phase 1 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 Trifluridine-Tipiracil + Bevacizumab (SUNLIGHT) — 3L+ mCRC (REG-TRIFLURIDINE-TIPIRACIL-BEV) 1/2 component drug(s) not on NSZU formulary	✓ registered	✗ out-of-pocket	₴-? — verify pathway	not recorded
Aggressive plan Regorafenib monotherapy (CORRECT-style; ReDOS escalation preferred) (REG-REGORAFENIB)	✓ registered	✓ covered	₴-? — verify pathway	NSZU formulary
Standard plan Trifluridine-tipiracil monotherapy (RECOURSE, 3L+ mCRC) (REG-TRIFLURIDINE-TIPIRACIL-MONO) 1/1 component drug(s) not on NSZU formulary	✓ registered	✗ out-of-pocket	₴-? — verify pathway	not recorded
Trial · NCT05727163 FOLFOX Via HAI Plus Intravenous Irinotecan With or Without Bevacizumab Versus Systemic FOLFOXIRI With or Without Bevacizumab in Initially Unresectable RAS-mutated CRLM Patients No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT02885753 Systemic Oxaliplatin or Intra-arterial Chemotherapy Combined With LV5FU2 +/- Irinotecan and an Target Therapy in First Line Treatment of Metastatic Colorectal Cancer Restricted to the Liver No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT06226857 Other Oncogene Mutations for Anti-EGFR Efficacy in Patients With Left-sided RAS-wild Type Metastatic Colorectal Cancer No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT06445062 Study of RAS(ON) Inhibitors in Patients With Gastrointestinal Solid Tumors No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT06895031 Study of JYP0015 in Patients With Advanced Solid Tumors Harboring Specific Mutations in RAS No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT06440902 Exploration of Therapeutic Strategies for NeoRAS Wild-type Metastatic Colorectal Cancer Based on Circulating Tumor DNA No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT06218810 Cadonilimab in Combination With Bevacizumab and FOLFOX Regimen for the First-Line Treatment of Advanced Unresectable MSS-Type, RAS-Mutated Metastatic Colorectal Cancer No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT06229340 Leflunomide or Combination of MEK Inhibitor and Hydroxychloroquine for Refractory Patients With RAS Mutations No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT05861505 COLLISION RELAPSE Trial No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT07349537 Study of RMC-5127 in Patients With Advanced KRAS G12V-Mutant Solid Tumors 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-CRC-MET-3L-REGO-001-V1 | version: 1 | generated: 2026-05-13T10:01:52.979754+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.