OpenOnco · Treatment Plan

Treatment plan — Small cell lung cancer

PLAN-SCLC-LS-001-V1 · v1 · 2026-08-17

Patient

SCLC-LS-001 · Algorithm: ALGO-SCLC-1L

DiagnosisSmall cell lung cancer

MOH / ICD-10C34

ICD-O-38041/3; C34.9

Stagelimited

Histologysmall_cell_carcinoma

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-SCLC-EXTENSIVE-1L

Regimen

Etoposide-platinum + durvalumab (extensive SCLC, 1L)

Drugs + NSZU

Carboplatin (DRUG-CARBOPLATIN) AUC 5-6 IV · Day 1 of 21-day cycle x 4 cycles · IV ✓ NSZU covered
Etoposide (DRUG-ETOPOSIDE) 80-100 mg/m² IV · Days 1, 2, 3 of 21-day cycle x 4 cycles · IV ✓ NSZU covered
Durvalumab (DRUG-DURVALUMAB) 1500 mg IV q3 weeks (induction); 1500 mg q4 weeks (maintenance) · From cycle 1; maintenance until progression · IV ⚠ NSZU — not for this indication

Supportive care

SUP-G-CSF-PRIMARY-PROPHYLAXIS-PROSTATE

Reason

Primary current-line option selected by ALGO-SCLC-1L at step 1.

Other current-line alternatives (2 tracks)

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

Standard plan

Indication

IND-SCLC-LIMITED-1L

Regimen

Etoposide-platinum + concurrent thoracic RT (limited SCLC)

Drugs + NSZU

Cisplatin (DRUG-CISPLATIN) 75 mg/m² IV · Day 1 of 21-day cycle x 4 cycles · IV ✓ NSZU covered
Etoposide (DRUG-ETOPOSIDE) 100 mg/m² IV · Days 1, 2, 3 of 21-day cycle x 4 cycles · IV ✓ NSZU covered

Supportive care

SUP-G-CSF-PRIMARY-PROPHYLAXIS-PROSTATE

Reason

Current-line alternative presented for HCP consideration

Standard plan

Indication

IND-SCLC-LS-CONSOLIDATION-DURVA

Regimen

Durvalumab consolidation post-CRT (LS-SCLC)

Drugs + NSZU

Durvalumab (DRUG-DURVALUMAB) 1500 mg IV q4 weeks · Up to 24 months OR until progression / unacceptable toxicity · IV ⚠ NSZU — not for this indication

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-CECT-CAP	CECT chest/abdomen/pelvis	Critical	imaging	—	all tracks
TEST-BRAIN-MRI-CONTRAST	Brain MRI with contrast	Standard	—	—	all tracks

Red flags — PRO / CONTRA aggressive

PRO-AGGRESSIVE

Triggers that push toward the aggressive track

Patient with active or incompletely controlled pre-existing autoimmune or inflammatory disease (sarcoidosis, rheumatoid arthritis, IBD, SLE, autoimmune hepatitis, inflammatory myopathy, myasthenia gravis, or similar) is considered for immune checkpoint inhibitor (ICI) therapy — elevated risk of immune-related adverse events (irAE) flare or de-novo grade 3-4 irAE. Requires specialist (rheumatology / pulmonology / gastroenterology) pre-treatment review; prefer lower-irAE-burden backbone when options exist (pembrolizumab mono > ipilimumab+nivolumab).
Pre-existing autoimmune disease is present in ~10-15% of patients eligible for ICI therapy; historically excluded from pivotal trials. Real-world data (Abdel-Wahab 2018, 3557 pts) shows 55% experienced irAE flare and ~29% required…
RF-ACTIVE-AUTOIMMUNE-DISEASE-ICI-RISKSRC-SITC-ICI-IRAEMANAGEMENT-2021SRC-ESMO-ICI-TOXICITY-2022
Age ≥75 + ECOG ≥2 OR significant comorbidity — concurrent CRT (limited-stage) poorly tolerated; sequential CRT or single-agent palliative chemo considered.
Limited-stage SCLC + frailty: sequential CRT (chemo first, then RT) better tolerated than concurrent. Extensive-stage + frailty: EP + ICI feasible with G-CSF support.
RF-SCLC-FRAILTY-AGESRC-NCCN-SCLC-2025SRC-ESMO-SCLC-2021

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-SCLC-LS-CONSOLIDATION-DURVA)

Do NOT start durvalumab in patients with progression after CRT — ADRIATIC excluded such patients; benefit not shown
Do NOT start consolidation after SEQUENTIAL (not concurrent) CRT — ADRIATIC enrolled only cCRT; no evidence for sCRT
Do NOT continue through Grade ≥3 immune pneumonitis — permanent discontinuation; pneumonitis risk additive on prior thoracic RT
Do NOT delay start beyond 42 days post-CRT completion (protocol upper limit)

Timeline

Treatment timeline — derived from regimen + monitoring schedule

Standard plan

Induction · Etoposide-platinum + durvalumab (extensive SCLC, 1L)

21-day cycles × EP × 4; durva maintenance until progression

Standard plan

Induction · Etoposide-platinum + concurrent thoracic RT (limited SCLC)

21-day cycles × 4-6 cycles concurrent with thoracic RT (60 Gy/30 fx once-daily OR 45 Gy/30 fx BID)

Standard plan

Induction · Durvalumab consolidation post-CRT (LS-SCLC)

28-day cycles × Up to 24 months consolidation post-concurrent CRT

MDT brief

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-LIFESTYLE-TOBACCO-CANCER-PREVENTION, RF-OCC-ASBESTOS-MALIGNANCY-PREVENTION, RF-OCC-DIESEL-EXHAUST-PREVENTION, RF-OCC-FIREFIGHTER-PREVENTION, RF-OCC-IONIZING-RADIATION-PREVENTION, RF-OCC-PAH-PREVENTION, RF-OCC-PAINTERS-PREVENTION, RF-OCC-SILICA-PREVENTION, RF-RADON-MALIGNANCY-PREVENTION, RF-SCLC-BRAIN-METS-EMERGENCY, RF-SCLC-HIGH-RISK-BIOLOGY, RF-SCLC-INFECTION-SCREENING, RF-SCLC-ORGAN-DYSFUNCTION, RF-SCLC-PARANEOPLASTIC, RF-SCLC-SVC-SYNDROME

Technical MDT skill metadata (0/16 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-ADRIATIC-CHENG-2024: Durvalumab after Chemoradiotherapy in Limited-Stage Small-Cell Lung Cancer (2024)
SRC-ESMO-SCLC-2021: ESMO Clinical Practice Guideline on Small Cell Lung Cancer (2021)
SRC-NCCN-SCLC-2025: NCCN Clinical Practice Guidelines — Small Cell Lung Cancer (2025.v3)

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: 2026-08-17.

NCT	Title	Phase	Status	Sponsor	UA	Signals
NCT05352035	Multiomics Tumor Evolution Model of NSCLC	N/A	RECRUITING	Peking University People's Hospital	—	Single country
NCT07629960	A First-in-Human Trial of BLU-924 (SAR449336) in Advanced Solid Tumors Harboring KRAS Mutations	PHASE1 / PHASE2	RECRUITING	Blueprint Medicines Corporation	—	Surrogate endpoint only Single country
NCT07099898	A Study of GSK5764227 in Participants With Relapsed Small Cell Lung Cancer (SCLC)	PHASE3	RECRUITING	GlaxoSmithKline	—	—
NCT07652125	RGL-270 + ICI in Advanced NSCLC	NA	RECRUITING	Guangdong Association of Clinical Trials	—	Small N (<50) Single country
NCT06332755	Study to Evaluate LB-LR1109, Administered Alone for the Treatment of Solid Tumor and in Combination With Atezolizumab for the Treatment of NSCLC	PHASE1	RECRUITING	LG Chem	—	Phase 1 only Single country
NCT06534489	Surgical Strategy of NSCLC Patients After Neo-adjuvant or Induction Treatment	N/A	RECRUITING	Ruijin Hospital	—	Single country
NCT06357533	Phase III, Open-label, Study of First-line Dato-DXd in Combination With Rilvegostomig for Advanced Non-squamous NSCLC With High PD-L1 Expression (TC ≥ 50%) and Without Actionable Genomic Alterations	PHASE3	RECRUITING	AstraZeneca	—	—
NCT05278052	Standard Maintenance Therapy (SMT) vs Local Consolidative Radiation Therapy and SMT in OM-NSCLC	PHASE3	RECRUITING	Tata Memorial Hospital	—	Single country
NCT06362252	A Study of I-DXd in Combination With Atezolizumab With or Without Carboplatin as First-Line Induction or Maintenance in Subjects With Extensive Stage-Small Cell Lung Cancer (IDeate-Lung03)	PHASE1 / PHASE2	RECRUITING	Daiichi Sankyo	—	—
NCT07565532	Establishment of a Prospective Clinical Cohort of Small Cell Lung Cancer Patients Receiving Radiotherapy-Involved Comprehensive Treatment	N/A	RECRUITING	Shanghai Chest Hospital	—	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 Etoposide-platinum + durvalumab (extensive SCLC, 1L) (REG-EP-DURVA-SCLC)	✓ registered	✓ covered	₴-? — verify pathway	NSZU formulary
Standard plan Etoposide-platinum + concurrent thoracic RT (limited SCLC) (REG-EP-CONCURRENT-RT-SCLC-LIMITED)	✓ registered	✓ covered	₴-? — verify pathway	NSZU formulary
Standard plan Durvalumab consolidation post-CRT (LS-SCLC) (REG-DURVA-CONSOLIDATION-SCLC)	✓ registered	✓ covered	₴-? — verify pathway	NSZU formulary
Trial · NCT05352035 Multiomics Tumor Evolution Model of NSCLC No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT07629960 A First-in-Human Trial of BLU-924 (SAR449336) in Advanced Solid Tumors Harboring KRAS Mutations No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT07099898 A Study of GSK5764227 in Participants With Relapsed Small Cell Lung Cancer (SCLC) No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT07652125 RGL-270 + ICI in Advanced NSCLC No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT06332755 Study to Evaluate LB-LR1109, Administered Alone for the Treatment of Solid Tumor and in Combination With Atezolizumab for the Treatment of NSCLC No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT06534489 Surgical Strategy of NSCLC Patients After Neo-adjuvant or Induction Treatment No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT06357533 Phase III, Open-label, Study of First-line Dato-DXd in Combination With Rilvegostomig for Advanced Non-squamous NSCLC With High PD-L1 Expression (TC ≥ 50%) and Without Actionable Genomic Alterations No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT05278052 Standard Maintenance Therapy (SMT) vs Local Consolidative Radiation Therapy and SMT in OM-NSCLC No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT06362252 A Study of I-DXd in Combination With Atezolizumab With or Without Carboplatin as First-Line Induction or Maintenance in Subjects With Extensive Stage-Small Cell Lung Cancer (IDeate-Lung03) No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT07565532 Establishment of a Prospective Clinical Cohort of Small Cell Lung Cancer Patients Receiving Radiotherapy-Involved Comprehensive Treatment 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: 2026-08-17.

plan_id: PLAN-SCLC-LS-001-V1 | version: 1 | generated: 2026-08-17T08:06:31.349281+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.