Synthetic educational example. Do not self-treat: a qualified treating physician must verify the sources, patient data, contraindications, and final plan.
Patient
SHOWCASE-PROSTATE-BRCA2-001 · Algorithm: ALGO-PROSTATE-MCRPC-2L
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 |
|---|
| ESCAT: clinical review pendingBIO-BRCA1-BRCA2-GERMLINE | BRCA2 germline pathogenic | IA | Molecular evidence option - SRC-CIVIC: Level A (Supports, Sensitivity/Response)
- SRC-CIVIC: Level B (Supports, Better Outcome)
Resistance or avoidance signal Trial or research option - SRC-CIVIC: Level C (Supports, Sensitivity/Response)
| BRCA2 germline pathogenic in mCRPC: largest PARPi benefit in HRR pathway (PROfound Cohort A); olaparib post-NHA, 1L olaparib+abiraterone (PROpel), niraparib+abiraterone (MAGNITUDE), talazoparib+enzalutamide (TALAPRO-2) all approved. ESCAT IA / OncoKB Level 1. | olaparib monotherapy (post-NHA)
olaparib + abiraterone (1L)
niraparib + abiraterone (1L)
talazoparib + enzalutamide (1L)
rucaparib monotherapy | - SRC-NCCN-PROSTATE-2025
- SRC-ESMO-PROSTATE-2024
- SRC-EAU-PROSTATE-2024
|
| Biomarker | Status |
|---|
| MSI | Not in KB — ask clinician to verify |
| PSMA PET | Not in KB — ask clinician to verify |
Primary current-line option
- Indication
- IND-PROSTATE-MCRPC-2L-PARPI
- Regimen
- Olaparib monotherapy (mCRPC, HRR-mutant)
- Drugs + NSZU
- Olaparib (DRUG-OLAPARIB) 300 mg PO BID continuous · Until progression or unacceptable toxicity · PO ⚠ NSZU — not for this indication
- Supportive care
- SUP-BONE-HEALTH-PROSTATE
- Reason
- Primary current-line option selected by ALGO-PROSTATE-MCRPC-2L at step 2.
Other current-line alternatives (4 tracks)
Same treatment line; review when biomarker, access, contraindication, or patient-context assumptions change.
- Indication
- IND-PROSTATE-MCRPC-2L-LU-PSMA
- Regimen
- Lutetium-177 PSMA-617 radioligand therapy
- Drugs + NSZU
- Lutetium-177 PSMA-617 (DRUG-LUTETIUM-177-PSMA) 7.4 GBq IV · q6 weeks × 6 cycles · IV ✗ Not registered in UA
- Supportive care
- SUP-BONE-HEALTH-PROSTATE
- Reason
- Current-line alternative presented for HCP consideration
- Indication
- IND-PROSTATE-MCRPC-2L-CABAZITAXEL
- Regimen
- Cabazitaxel (mCRPC, 2L)
- Drugs + NSZU
- Cabazitaxel (DRUG-CABAZITAXEL) 20-25 mg/m² IV over 60 min · Day 1 q21d · IV ✗ Not registered in UA
- Prednisone (DRUG-PREDNISONE) 10 mg PO daily (continuous, throughout cabazitaxel treatment) · Daily · PO ⚠ NSZU — not for this indication
- Reason
- Current-line alternative presented for HCP consideration
- Indication
- IND-PROSTATE-MCRPC-2L-RADIUM223
- Regimen
- Radium-223 (mCRPC, bone-metastatic)
- Drugs + NSZU
- Radium-223 dichloride (DRUG-RADIUM-223) 55 kBq/kg IV (body weight-based) over 1 min · Once every 4 weeks × 6 injections (total course = 6 months) · IV ⚠ Out-of-pocket
- Reason
- Current-line alternative presented for HCP consideration
- Indication
- IND-PROSTATE-MCRPC-2L-DOCETAXEL
- Regimen
- Docetaxel (mCRPC)
- Drugs + NSZU
- Docetaxel (DRUG-DOCETAXEL) 75 mg/m² IV over 60 min · Day 1 q21d · IV ✓ NSZU covered
- Prednisone (DRUG-PREDNISONE) 10 mg PO daily (continuous) · Daily throughout docetaxel course · PO ⚠ 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-CBC | Complete Blood Count with Differential | Critical | lab | — | standard |
| TEST-CMP | Comprehensive Metabolic Panel | Critical | lab | — | standard |
| TEST-LFT | Liver Function Tests (ALT, AST, bilirubin, ALP, GGT, albumin) | Critical | lab | — | standard |
| TEST-PSA-SERUM | Serum PSA | Critical | — | — | all tracks |
| TEST-BONE-SCAN | Whole-body Tc-99m MDP bone scintigraphy | Standard | — | — | aggressive |
| TEST-ECG | Electrocardiogram | Standard | clinical_assessment | — | standard |
| TEST-GERMLINE-BRCA-PANEL | Germline BRCA1/2 + HRR panel sequencing | Standard | — | CSD Lab: M089 | aggressive |
| TEST-PSMA-PET | PSMA-PET/CT (Ga-68 or F-18) | Standard | — | — | standard |
| TEST-SOMATIC-HRR-PANEL | Tumor-tissue (or ctDNA) HRR-pathway NGS panel | Standard | — | CSD Lab: M065
CSD Lab ✓ (code TBC) | aggressive |
| TEST-TESTOSTERONE-SERUM | Serum total testosterone | Standard | — | — | aggressive |
Red flags — PRO / CONTRA aggressive
PRO-AGGRESSIVE
Triggers that push toward the aggressive track
- Germline pathogenic variant in ATM, CHEK2, or CDK12 (composite HRR-pathway RF). Disease-specific evidence varies sharply: ATM contributes to PROfound cohort-A (mCRPC) — pooled with BRCA1/2 for olaparib mPFS 7.4 vs 3.6 mo (HR 0.34). CDK12 — strong prostate-specific actionability (cohort-B in PROfound; immune-hot phenotype with elevated tumor neoantigens — emerging immunotherapy / PARPi rationale). CHEK2 — moderate-penetrance breast/prostate risk gene; weakest PARPi-response evidence (cohort-B in PROfound, smaller absolute benefit). Pan-tumor framing: treatment-modifying primarily in mCRPC; informational MDT signal in breast / pancreatic / ovarian where label-grade evidence is absent.
Composite RF references BIO-ATM-CHEK2-CDK12-GERMLINE. Distinct from RF-PROSTATE-HIGH-RISK-BIOLOGY (which keys on broad hrr_pathway_mutation flag) — this RF surfaces gene-specific findings for nuanced MDT discussion. Algorithm wiring…
RF-PAN-ATM-CHEK2-CDK12-PARPI-CANDIDATESRC-PROFOUND-DEBONO-2020SRC-NCCN-PROSTATE-2025SRC-NCCN-BREAST-2025 - Somatic (tumor-only) BRCA1 or BRCA2 pathogenic variant identified on tumor NGS — pan-tumor PARPi-candidate signal. Disease applicability varies: ovarian (PAOLA-1, SOLO-1 — somatic BRCA pooled with germline in HRD-positive maintenance indication), mCRPC (PROfound cohort-A — olaparib mPFS 7.4 vs 3.6 mo, HR 0.34, somatic + germline pooled), pancreatic PDAC (POLO label is germline-only — somatic BRCA falls to off-label / NCCN "consider" tier), breast (OlympiAD / EMBRACA / OlympiA labels are germline-only — somatic BRCA breast remains investigational). Confirm somatic vs germline status via paired germline NGS before cascade-testing decisions (~40% of tumor-only "BRCA" calls are in fact germline per ASCO/CAP guidance).
Distinct trigger keys from RF-OVARIAN-BRCA-MUT-ACTIONABLE and RF-PROSTATE-HIGH-RISK-BIOLOGY to avoid double-firing on germline cases — this RF keys specifically on "*_somatic" / "tumor_*" findings. Breast included as informational (no…
RF-PAN-BRCA-SOMATIC-PARPI-CANDIDATESRC-PROFOUND-DEBONO-2020SRC-NCCN-OVARIAN-2025SRC-NCCN-PROSTATE-2025 - Germline PALB2 pathogenic variant — BRCA2's recruitment partner; biallelic LOF produces an HRR-deficient phenotype. Pan-tumor PARPi candidate signal weaker than gBRCA1/2 but emerging. Disease applicability: breast (lifetime risk ~35-55%, NCCN high-penetrance — PARPi off-label / investigational), PDAC (~3-5x baseline risk, POLO label is gBRCA-only but PALB2 frequently grouped clinically), prostate mCRPC (cohort-B in PROfound HRR-non-BRCA/ATM — smaller absolute olaparib benefit but PARPi remains an option per NCCN 2025). Genetic counseling + cascade testing of first-degree relatives required.
References BIO-PALB2-GERMLINE. Surveillance recommendations: enhanced breast screening (annual MRI from age 30), pancreatic surveillance per CAPS consortium when family history present. RF distinct from RF-BREAST-BRCA-GERMLINE-ACTIONABLE…
RF-PAN-PALB2-PARPI-CANDIDATESRC-PROFOUND-DEBONO-2020SRC-NCCN-BREAST-2025SRC-NCCN-PANCREATIC-2025 - Metastatic prostate cancer with malignant epidural spinal cord compression (MESCC): new motor deficit, sensory level, cauda equina syndrome, severe back pain with vertebral metastasis — prostate is the most common solid tumor cause of MESCC
Per NCCN-PROSTATE supportive-care + EAU-PROSTATE 2024: dexamethasone 10 mg IV bolus + 4 mg q6h, MRI whole spine within 24 h, multidisciplinary surgical/RT review. Patchell criteria for surgery (single-level, ≥48 h expected survival…
RF-PROSTATE-CORD-COMPRESSIONSRC-NCCN-PROSTATE-2025SRC-ESMO-PROSTATE-2024SRC-EAU-PROSTATE-2024 - Pre-treatment HBV/HCV/HIV serology + dental evaluation (denosumab/zoledronate ONJ risk; lutetium-PSMA xerostomia) standard for mCRPC initiation.
Cross-disease HBV reactivation handled by RF-UNIVERSAL-HBV-REACTIVATION- RISK. Dental clearance pre-bone-modifying-agent unique to bone-meta diseases (prostate, breast, MM).
RF-PROSTATE-INFECTION-SCREENINGSRC-NCCN-PROSTATE-2025SRC-ESMO-PROSTATE-2024 - Renal dysfunction (CrCl <50 mL/min) or severe hepatic impairment (Child-Pugh C) — limits PARPi (olaparib renal-cleared) and ARPI (abiraterone hepatic) dosing.
Olaparib requires CrCl ≥31 (with dose-mod) for safe use; <30 avoid. Abiraterone Child-Pugh C: avoid. Surfaces in MDT as need for renal/ hepatic input.
RF-PROSTATE-ORGAN-DYSFUNCTIONSRC-NCCN-PROSTATE-2025SRC-ESMO-PROSTATE-2024 - Spinal cord compression OR rapid PSA doubling time (<3 months) OR new visceral metastases — emergency or aggressive-progression flag requiring urgent intervention or treatment intensification.
Spinal cord compression: emergent neurosurgical / RT consult AND immediate testosterone suppression (degarelix preferred for speed vs LHRH agonists). PSA doubling time <3 months in nmCRPC: criterion for ARPI initiation per NCCN. Visceral…
RF-PROSTATE-TRANSFORMATION-PROGRESSIONSRC-NCCN-PROSTATE-2025SRC-ESMO-PROSTATE-2024
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-PROSTATE-MCRPC-2L-LU-PSMA)
- НІКОЛИ не призначати без PSMA-ПЕТ/КТ-підтвердження — тільки PSMA-позитивна хвороба
- Не призначати при будь-якому PSMA-негативному осередку метастазування
- Не ігнорувати ниркову функцію — лютецій виводиться нирками; ГФК <30 = протипоказання
- Не пропускати тестування HRR/BRCA до призначення — PARPi перевершує при BRCA1/2
- Не призначати без підтримки ядерно-медичного відділу з радіотерапевтичною ліцензією
Standard plan (IND-PROSTATE-MCRPC-2L-CABAZITAXEL)
- Не призначати другий АРПІ (ензалутамід або абіратерон) при прогресуванno після доцеyesселю + попереднього АРПІ — CARD показав значно нижчу ефективnoсть (ORR 12% vs 35%)
- Не застосовувати без G-CSF первинної профілактики — ризик нейтропеnoчної гарячки
- Не призначати при важкій печінковій недостатності (білірубін >3 × ВМН)
- Не пропускати тестування HRR/BRCA — PARPi перевершує хіміотерапію при BRCA1/2-мутованих пацієнтах
Standard plan (IND-PROSTATE-MCRPC-2L-RADIUM223)
- НІКОЛИ не призначати при вісцеральних метастазах — тільки при кістковому захворюванno
- НІКОЛИ не комбінувати з абіратероном/ензалутамідом (ERA 223: підвищений ризик переломів та смертності)
- НІКОЛИ не комбінувати з доцеyesселем (ALSYMPCA+: підвищена токсичnoсть без переваги)
- Не призначати без КТ-підтвердження відсутності вісцеральних метастазів перед кожною ін'єкцією
- Не ігнорувати радіаційну безпеку — пацієнт залишається джерелом радіації 7-10 дnoв після ін'єкції
Standard plan (IND-PROSTATE-MCRPC-2L-DOCETAXEL)
- Не призначати доцеyesсел при попередньому yesсаno (доцеyesсел або кабазиyesсел) — використовувати кабазиyesсел (CARD: OS HR 0.64 vs другий АРПІ)
- Не пропускати тестування HRR/BRCA — PARPi перевершує хіміотерапію при BRCA1/2-мутованих пацієнтах
- Не припиняти АДТ (ГДТ) під час хіміотерапії — кастраційний рівень тестостерону підтримується протягом усього лікування
- Не призначати при важкій печінковій недостатності (білірубін >3 × ВМН)
- Не забути 3-денний дексаметазон преmedication (8 мг двічі/добу) — профілактика затримки рідини та гіперчутливості
Timeline
Treatment timeline — derived from regimen + monitoring schedule
Aggressive plan
Induction · Olaparib monotherapy (mCRPC, HRR-mutant)
28-day cycles × Continuous until progression
Standard plan
Induction · Lutetium-177 PSMA-617 radioligand therapy
42-day cycles × 6 (extend to 8 if responding and tolerated, per protocol)
Standard plan
Induction · Cabazitaxel (mCRPC, 2L)
21-day cycles × Continue until progression or unacceptable toxicity; typically 6-10 cycles
Standard plan
Induction · Radium-223 (mCRPC, bone-metastatic)
28-day cycles × 6
Standard plan
Induction · Docetaxel (mCRPC)
21-day cycles × 10 cycles (TAX 327 protocol); may continue beyond 10 if responding and tolerating
MDT brief
Discussion questions (5, 3 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
BLOCKING OQ-BIOMARKER-GLEASON-ISUP
What is the status of Gleason score / ISUP grade group (BIO-GLEASON-ISUP)? It is required by track(s): IND-PROSTATE-MCRPC-2L-PARPI, IND-PROSTATE-MCRPC-2L-LU-PSMA, IND-PROSTATE-MCRPC-2L-CABAZITAXEL, IND-PROSTATE-MCRPC-2L-RADIUM223, IND-PROSTATE-MCRPC-2L-DOCETAXEL. Expected value: Gleason / ISUP grade group (1-5).
A treatment-track biomarker requirement is missing from the patient profile; the MDT should verify the test result, method, specimen, and date before relying on this option.
→ medical_oncologist
BLOCKING OQ-BIOMARKER-HRR-PANEL
What is the status of Homologous recombination repair (HRR) gene panel status (BIO-HRR-PANEL)? It is required by track(s): IND-PROSTATE-MCRPC-2L-PARPI. Expected value: positive.
A treatment-track biomarker requirement is missing from the patient profile; the MDT should verify the test result, method, specimen, and date before relying on this option.
→ molecular_geneticist
BLOCKING OQ-BIOMARKER-PSA
What is the status of Prostate-specific antigen (PSA) (BIO-PSA)? It is required by track(s): IND-PROSTATE-MCRPC-2L-PARPI, IND-PROSTATE-MCRPC-2L-LU-PSMA, IND-PROSTATE-MCRPC-2L-CABAZITAXEL, IND-PROSTATE-MCRPC-2L-RADIUM223, IND-PROSTATE-MCRPC-2L-DOCETAXEL. Expected value: PSA baseline + on-treatment per PCWG3.
A treatment-track biomarker requirement is missing from the patient profile; the MDT should verify the test result, method, specimen, and date before relying on this option.
→ medical_oncologist
OQ-BIOMARKER-PSMA-PET
What is the status of PSMA-PET imaging avidity (BIO-PSMA-PET)? It is required by track(s): IND-PROSTATE-MCRPC-2L-LU-PSMA. Expected value: PSMA-PET/CT POSITIVE — MANDATORY (68Ga-PSMA-11 or 18F-DCFPyL preferred).
A treatment-track biomarker requirement is missing from the patient profile; the MDT should verify the test result, method, specimen, and date before relying on this option.
→ medical_oncologist
MDT talk tree (7 steps)
| # | Owner | Topic | Action |
|---|
| 1 | medical_oncologist | Biomarker status BLOCKING | What is the status of Gleason score / ISUP grade group (BIO-GLEASON-ISUP)? It is required by track(s): IND-PROSTATE-MCRPC-2L-PARPI, IND-PROSTATE-MCRPC-2L-LU-PSMA, IND-PROSTATE-MCRPC-2L-CABAZITAXEL, IND-PROSTATE-MCRPC-2L-RADIUM223, IND-PROSTATE-MCRPC-2L-DOCETAXEL. Expected value: Gleason / ISUP grade group (1-5). |
| 2 | medical_oncologist | Biomarker status BLOCKING | What is the status of Prostate-specific antigen (PSA) (BIO-PSA)? It is required by track(s): IND-PROSTATE-MCRPC-2L-PARPI, IND-PROSTATE-MCRPC-2L-LU-PSMA, IND-PROSTATE-MCRPC-2L-CABAZITAXEL, IND-PROSTATE-MCRPC-2L-RADIUM223, IND-PROSTATE-MCRPC-2L-DOCETAXEL. Expected value: PSA baseline + on-treatment per PCWG3. |
| 3 | molecular_geneticist | Biomarker status BLOCKING | What is the status of Homologous recombination repair (HRR) gene panel status (BIO-HRR-PANEL)? It is required by track(s): IND-PROSTATE-MCRPC-2L-PARPI. Expected value: positive. |
| 4 | hematologist | Staging / disease burden | What is the current LDH? Marker of tumor burden and transformation. |
| 5 | medical_oncologist | Biomarker status | What is the status of PSMA-PET imaging avidity (BIO-PSMA-PET)? It is required by track(s): IND-PROSTATE-MCRPC-2L-LU-PSMA. Expected value: PSMA-PET/CT POSITIVE — MANDATORY (68Ga-PSMA-11 or 18F-DCFPyL preferred). |
| 6 | clinical_pharmacist | Specialist review | Chemoimmunotherapy regimen — drug-drug interactions, dose adjustments, premedication. |
| 7 | social_worker_case_manager | Specialist review | Plan includes drugs without NSZU reimbursement — patient access pathway must be assessed. |
Skills (recommended) — for consideration (3)
- Clinical pharmacist recommended
Chemoimmunotherapy regimen — drug-drug interactions, dose adjustments, premedication.
- Molecular geneticist / molecular oncologist recommended
Indication references an actionable genomic biomarker — mutation / target / actionability interpretation needed.
Owns: OQ-BIOMARKER-HRR-PANEL
- Social worker / case manager recommended
Plan includes drugs without NSZU reimbursement — patient access pathway must be assessed.
Data quality
Incomplete for default-track review. Default-track review is incomplete until required biomarker gaps are resolved.
- Biomarker coverage: 0/4 known (0%), 4 missing, 3 default-track gaps
- Unevaluated RedFlags: RF-ATM-CONFIRMED-CARRIER, RF-ATM-FAMILY-HISTORY-SUSPICION, RF-BRCA-CONFIRMED-CARRIER, RF-BRCA-HBOC-FAMILY-HISTORY-SUSPICION, RF-CASCADE-BRCA-FDR-POSITIVE, RF-CASCADE-FAP-FDR-POSITIVE, RF-CASCADE-LYNCH-FDR-POSITIVE, RF-CHAARTED-HIGH-VOLUME-MHSPC, RF-CHEK2-CONFIRMED-CARRIER, RF-CHEK2-FAMILY-HISTORY-SUSPICION, RF-FAP-FAMILY-HISTORY-SUSPICION, RF-LATITUDE-HIGH-RISK-MHSPC, RF-LYNCH-CONFIRMED-CARRIER, RF-LYNCH-FAMILY-HISTORY-SUSPICION, RF-PAN-ATM-CHEK2-CDK12-PARPI-CANDIDATE, RF-PAN-BRCA-SOMATIC-PARPI-CANDIDATE, RF-PAN-PALB2-PARPI-CANDIDATE, RF-PROSTATE-AR-AMP-ARSI-RESISTANCE, RF-PROSTATE-AR-V7-ARSI-RESISTANCE, RF-PROSTATE-CORD-COMPRESSION, RF-PROSTATE-FRAILTY-AGE, RF-PROSTATE-HIGH-RISK-BIOLOGY, RF-PROSTATE-INFECTION-SCREENING, RF-PROSTATE-ORGAN-DYSFUNCTION, RF-PROSTATE-PSA-PROGRESSION, RF-PROSTATE-TMPRSS2-ERG-PROGNOSTIC, RF-PROSTATE-TRANSFORMATION-PROGRESSION
| Missing biomarker | Label | MDT owner | Default track | Required by | Next action |
|---|
BIO-GLEASON-ISUP | Gleason score / ISUP grade group | medical_oncologist | yes | IND-PROSTATE-MCRPC-2L-PARPI, IND-PROSTATE-MCRPC-2L-LU-PSMA, IND-PROSTATE-MCRPC-2L-CABAZITAXEL, IND-PROSTATE-MCRPC-2L-RADIUM223, IND-PROSTATE-MCRPC-2L-DOCETAXEL | Verify result, method, specimen, and report date before sign-off. Expected/constraint: Gleason / ISUP grade group (1-5) |
BIO-HRR-PANEL | Homologous recombination repair (HRR) gene panel status | molecular_geneticist | yes | IND-PROSTATE-MCRPC-2L-PARPI | Verify result, method, specimen, and report date before sign-off. Expected/constraint: positive |
BIO-PSA | Prostate-specific antigen (PSA) | medical_oncologist | yes | IND-PROSTATE-MCRPC-2L-PARPI, IND-PROSTATE-MCRPC-2L-LU-PSMA, IND-PROSTATE-MCRPC-2L-CABAZITAXEL, IND-PROSTATE-MCRPC-2L-RADIUM223, IND-PROSTATE-MCRPC-2L-DOCETAXEL | Verify result, method, specimen, and report date before sign-off. Expected/constraint: PSA baseline + on-treatment per PCWG3 |
BIO-PSMA-PET | PSMA-PET imaging avidity | medical_oncologist | no | IND-PROSTATE-MCRPC-2L-LU-PSMA | Verify result, method, specimen, and report date before sign-off. Expected/constraint: PSMA-PET/CT POSITIVE — MANDATORY (68Ga-PSMA-11 or 18F-DCFPyL preferred) |
Technical MDT skill metadata (3/16 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 | Sign-offs | Domain |
|---|
| Cellular therapy specialist (CAR-T) | cellular_therapy_specialist | v0.1.0 | 2026-04-25 | 0 | cellular_therapy |
| Clinical pharmacist | clinical_pharmacist | v0.1.0 | 2026-04-25 | 0 | clinical_pharmacy |
| Hematologist / oncohematologist | hematologist | v0.1.0 | 2026-04-25 | 0 | hematology_oncology |
| Hematopathologist (lymphoma / leukemia / myeloma) | hematopathologist | v0.1.0 | 2026-04-25 | 0 | hematopathology |
| Infectious disease / hepatology | infectious_disease_hepatology | v0.1.0 | 2026-04-25 | 0 | infectious_diseases |
| Medical oncologist (solid-tumor chemotherapist) | medical_oncologist | v0.1.0 | 2026-04-25 | 0 | solid_oncology |
| Molecular geneticist / molecular oncologist | molecular_geneticist | v0.1.0 | 2026-04-25 | 0 | molecular_oncology |
| Palliative care | palliative_care | v0.1.0 | 2026-04-25 | 0 | palliative_care |
| Pathologist (general) | pathologist | v0.1.0 | 2026-04-25 | 0 | pathology |
| Primary care / family physician | primary_care | v0.1.0 | 2026-04-25 | 0 | primary_care |
| Psycho-oncologist | psychologist | v0.1.0 | 2026-04-25 | 0 | psychosocial |
| Radiation oncologist | radiation_oncologist | v0.1.0 | 2026-04-25 | 0 | radiation_oncology |
| Radiologist | radiologist | v0.1.0 | 2026-04-25 | 0 | diagnostic_imaging |
| Social worker / case manager | social_worker_case_manager | v0.1.0 | 2026-04-25 | 0 | psychosocial |
| Surgical oncologist | surgical_oncologist | v0.1.0 | 2026-04-25 | 0 | surgical_oncology |
| Transplant specialist (BMT) | transplant_specialist | v0.1.0 | 2026-04-25 | 0 | cellular_therapy |
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: 2026-10-18 · ClinicalTrials.gov.
| NCT | Title | Phase | Status | Sponsor | UA | Signals | Eligibility (excerpt) |
|---|
| NCT06046131 | Clinical, Genetic and Environmental Determinants of Prostate Cancer Progression. | NA | RECRUITING | — | — | |
| NCT06446648 | Impact of Intraoperative ICG on Functional Outc in RARP | EARLY_PHASE1 | RECRUITING | — | Single country | |
| NCT05054296 | Modifying Metabolic Syndrome and Cardiovascular Risk for Prostate Cancer Patients on ADT Using a Risk Factor Modification Program and Continuous Fitbit Monitoring | PHASE2 | RECRUITING | — | Single country | |
| NCT06238713 | Extraperitoneal SINgle-port rObotic-assisted Radical Prostatectomy (RARP) Versus Transperitoneal Multi-port RARP in the Treatment Of Prostate Cancer (SINO-TOP) | NA | RECRUITING | — | Single country | |
| NCT05751434 | A Study on the Effects of Exercise Therapy on Signs of Prostate Cancer | PHASE2 | RECRUITING | — | Single country | |
| NCT06330805 | Effects of Relugolix vs Leuprolide on Cardiac Function in Patients With Prostate Cancer | PHASE2 | RECRUITING | — | Single country | |
| NCT05610852 | Single-Port Transvesical Partial Prostatectomy Versus High Intensity Focused Ultrasound | NA | RECRUITING | — | Single country | |
| NCT04423211 | Treating Prostate Cancer That Has Come Back After Surgery With Apalutamide and Targeted Radiation Based on PET Imaging | PHASE3 | RECRUITING | — | Surrogate endpoint only Single country | |
| NCT07484971 | Study of the Epidemiological, Clinical, Diagnostic, and Therapeutic Characteristics of Prostate Cancers in Algeria | N/A | RECRUITING | — | Single country | |
| NCT04704505 | Bipolar Androgen Therapy (BAT) and Radium-223 (RAD) in Metastatic Castration-resistant Prostate Cancer (mCRPC) | PHASE2 | RECRUITING | — | Small N (<50) 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 |
|---|
| Aggressive plan Olaparib monotherapy (mCRPC, HRR-mutant) (REG-OLAPARIB-MONO) | ✓ registered | ✓ covered | ₴-? — verify pathway | NSZU formulary |
| Standard plan Lutetium-177 PSMA-617 radioligand therapy (REG-LUTETIUM-PSMA) 1/1 component drug(s) not registered in Ukraine +1 | ✗ not registered | ✗ out-of-pocket | ₴-? — verify pathway | not recorded |
| Standard plan Cabazitaxel (mCRPC, 2L) (REG-CABAZITAXEL-MCRPC) 1/2 component drug(s) not registered in Ukraine +1 | ✗ not registered | ✗ out-of-pocket | ₴-? — verify pathway | not recorded |
| Standard plan Radium-223 (mCRPC, bone-metastatic) (REG-RADIUM223-MCRPC) 1/1 component drug(s) not on NSZU formulary | ✓ registered | ✗ out-of-pocket | ₴-? — verify pathway | not recorded |
| Standard plan Docetaxel (mCRPC) (REG-DOCETAXEL-MCRPC) | ✓ registered | ✓ covered | ₴-? — verify pathway | NSZU formulary |
| Trial · NCT06046131 Clinical, Genetic and Environmental Determinants of Prostate Cancer Progression. No UA site listed — international referral required | — unknown | — unknown | self-pay: ₴0/course | Trial sponsor |
| Trial · NCT06446648 Impact of Intraoperative ICG on Functional Outc in RARP No UA site listed — international referral required | — unknown | — unknown | self-pay: ₴0/course | Trial sponsor |
| Trial · NCT05054296 Modifying Metabolic Syndrome and Cardiovascular Risk for Prostate Cancer Patients on ADT Using a Risk Factor Modification Program and Continuous Fitbit Monitoring No UA site listed — international referral required | — unknown | — unknown | self-pay: ₴0/course | Trial sponsor |
| Trial · NCT06238713 Extraperitoneal SINgle-port rObotic-assisted Radical Prostatectomy (RARP) Versus Transperitoneal Multi-port RARP in the Treatment Of Prostate Cancer (SINO-TOP) No UA site listed — international referral required | — unknown | — unknown | self-pay: ₴0/course | Trial sponsor |
| Trial · NCT05751434 A Study on the Effects of Exercise Therapy on Signs of Prostate Cancer No UA site listed — international referral required | — unknown | — unknown | self-pay: ₴0/course | Trial sponsor |
| Trial · NCT06330805 Effects of Relugolix vs Leuprolide on Cardiac Function in Patients With Prostate Cancer No UA site listed — international referral required | — unknown | — unknown | self-pay: ₴0/course | Trial sponsor |
| Trial · NCT05610852 Single-Port Transvesical Partial Prostatectomy Versus High Intensity Focused Ultrasound No UA site listed — international referral required | — unknown | — unknown | self-pay: ₴0/course | Trial sponsor |
| Trial · NCT04423211 Treating Prostate Cancer That Has Come Back After Surgery With Apalutamide and Targeted Radiation Based on PET Imaging No UA site listed — international referral required | — unknown | — unknown | self-pay: ₴0/course | Trial sponsor |
| Trial · NCT07484971 Study of the Epidemiological, Clinical, Diagnostic, and Therapeutic Characteristics of Prostate Cancers in Algeria No UA site listed — international referral required | — unknown | — unknown | self-pay: ₴0/course | Trial sponsor |
| Trial · NCT04704505 Bipolar Androgen Therapy (BAT) and Radium-223 (RAD) in Metastatic Castration-resistant Prostate Cancer (mCRPC) 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. Table assembled: 2026-10-18. Table assembly does not verify registration, NSZU coverage or prices. Check the currency of these data separately.