OpenOnco · Treatment Plan

Treatment plan — Malignant peripheral nerve sheath tumor

PLAN-VAR-MPNST-FRAIL-V1 · v1 · 2026-05-13

Patient

VAR-MPNST-FRAIL · Algorithm: ALGO-MPNST-1L

DiagnosisMalignant peripheral nerve sheath tumor

MOH / ICD-10C47

ICD-O-39540/3; C47

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-MPNST-DOXORUBICIN-IFOSFAMIDE

Regimen

Doxorubicin + ifosfamide (advanced/metastatic MPNST, 1L)

Drugs + NSZU

Doxorubicin (DRUG-DOXORUBICIN) Doxorubicin 75 mg/m² · Per regimen schedule · IV ⚠ NSZU — not for this indication
Ifosfamide (DRUG-IFOSFAMIDE) ifosfamide 10 g/m² over 4d, q3w × 6 cycles · Per regimen schedule · IV ⚠ NSZU — not for this indication

Reason

Primary current-line option selected by ALGO-MPNST-1L at the fallback path.

Timeline

Treatment timeline — derived from regimen + monitoring schedule

Standard plan

Induction · Doxorubicin + ifosfamide (advanced/metastatic MPNST, 1L)

21-day cycles × 6 cycles or until progression / toxicity

MDT brief

MDT talk tree (1 steps)

#	Owner	Topic	Action
1	palliative_care	Specialist review	Reduced performance status / decompensated comorbidity — goals-of-care assessment needed.

Skills (recommended) — for consideration (1)

Palliative care recommended
Reduced performance status / decompensated comorbidity — goals-of-care assessment needed.

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-MPNST-ADVANCED-DOXORUBICIN-UNSUITABLE, RF-MPNST-FRAILTY-AGE, RF-MPNST-HIGH-RISK-BIOLOGY, RF-MPNST-INFECTION-SCREENING, RF-MPNST-ORGAN-DYSFUNCTION, RF-MPNST-TRANSFORMATION-PROGRESSION

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-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
NCT06693284	A Window of Opportunity Trial of Mirdametinib Plus Vorinostat for NF1 Associated, H3K27 Trimethylation Deficient Malignant Peripheral Nerve Sheath Tumor [MPNST]	EARLY_PHASE1	RECRUITING	University of Minnesota	—	Small N (<50) Single country
NCT04222413	Metarrestin (ML-246) in Subjects With Metastatic Solid Tumors	PHASE1	RECRUITING	National Cancer Institute (NCI)	—	Phase 1 only Surrogate endpoint only Single country
NCT05245500	Phase 1 Study of MRTX1719 in Solid Tumors With MTAP Deletion	PHASE1	RECRUITING	Bristol-Myers Squibb	—	Phase 1 only Single country
NCT03141021	Multi-Institutional Registry for Malignant Peripheral Nerve Sheath Tumors	N/A	RECRUITING	Washington University School of Medicine	—	—
NCT06849986	IO Combined With AI as First-line Treatment for Patients With Soft Tissue Sarcoma(TAIS)	PHASE2	RECRUITING	Fudan University	—	Small N (<50) Surrogate endpoint only Single country
NCT06277154	MASCT-I Combined With Doxorubicin and Ifosfamide for First-line Treatment of Advanced Soft Tissue Sarcoma	PHASE2	RECRUITING	HRYZ Biotech Co.	—	Surrogate endpoint only Single country
NCT05642455	SPEARHEAD-3 Pediatric Study	PHASE1 / PHASE2	RECRUITING	USWM CT, LLC	—	Small N (<50) Single country
NCT07244835	A Study of DEG6498 in Participants With Solid Tumors	PHASE1	RECRUITING	Degron Therapeutics Co.	—	Phase 1 only Single country
NCT05985161	A Study of Selinexor in People With Wilms Tumors and Other Solid Tumors	PHASE2	RECRUITING	Memorial Sloan Kettering Cancer Center	—	Small N (<50) Surrogate endpoint only Single country
NCT05732831	Safety and Tolerability of TNG462 in Patients With MTAP-deleted Solid Tumors	PHASE1 / PHASE2	RECRUITING	Tango Therapeutics, Inc.	—	—

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 + ifosfamide (advanced/metastatic MPNST, 1L) (REG-DOXORUBICIN-IFOSFAMIDE-MPNST)	✓ registered	✓ covered	₴-? — verify pathway	NSZU formulary
Trial · NCT06693284 A Window of Opportunity Trial of Mirdametinib Plus Vorinostat for NF1 Associated, H3K27 Trimethylation Deficient Malignant Peripheral Nerve Sheath Tumor [MPNST] No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT04222413 Metarrestin (ML-246) in Subjects With Metastatic Solid Tumors No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT05245500 Phase 1 Study of MRTX1719 in Solid Tumors With MTAP Deletion No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT03141021 Multi-Institutional Registry for Malignant Peripheral Nerve Sheath Tumors No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT06849986 IO Combined With AI as First-line Treatment for Patients With Soft Tissue Sarcoma(TAIS) No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT06277154 MASCT-I Combined With Doxorubicin and Ifosfamide for First-line Treatment of Advanced Soft Tissue Sarcoma No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT05642455 SPEARHEAD-3 Pediatric Study No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT07244835 A Study of DEG6498 in Participants With Solid Tumors No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT05985161 A Study of Selinexor in People With Wilms Tumors and Other Solid Tumors No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT05732831 Safety and Tolerability of TNG462 in Patients With MTAP-deleted 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-VAR-MPNST-FRAIL-V1 | version: 1 | generated: 2026-05-13T10:01:52.360487+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.