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Treatment plan — Soft tissue sarcoma

PLAN-VERIFIED-SOFT-TISSUE-SARCOMA-L2-STS_ADVANCED_2L_GEMDOC-V1 · v1 · 2026-07-15

Patient

VERIFIED-SOFT-TISSUE-SARCOMA-L2-STS_ADVANCED_2L_GEMDOC · Algorithm: ALGO-STS-ADVANCED-2L

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-2L-GEMDOC

Regimen

Gemcitabine + docetaxel (soft tissue sarcoma)

Drugs + NSZU

Gemcitabine (DRUG-GEMCITABINE) 900 mg/m² IV over 90 min (rate-controlled: 10 mg/m²/min) · Days 1 and 8 q21d · IV ⚠ NSZU — not for this indication
Docetaxel (DRUG-DOCETAXEL) 100 mg/m² IV over 60 min · Day 8 only q21d (after gemcitabine on day 8) · IV ⚠ NSZU — not for this indication

Reason

Provisional current-line default from ALGO-STS-ADVANCED-2L: step 1 did not select a treatment branch. GIST: use imatinib/sunitinib/regorafenib pathway (out of scope). Ewing sarcoma: IE, VIE, high-dose protocols (out of scope — NCCN Ewing). Rhabdomyosarcoma: pediatric/specialized protocols (out of scope).

Other current-line alternatives (1 tracks)

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

Standard plan

Indication

IND-STS-ADVANCED-2L-PAZOPANIB

Regimen

Pazopanib (soft tissue sarcoma, 2L)

Drugs + NSZU

Pazopanib (DRUG-PAZOPANIB) 800 mg PO daily (continuous) · Once daily, at the same time each day · PO ⚠ Out-of-pocket

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-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
TEST-TSH	Thyroid-stimulating hormone	Standard	lab	—	all tracks

What NOT to do

Explicit prohibitive rules, each grounded in a regimen / supportive care / contraindication entity

Standard plan (IND-STS-ADVANCED-2L-GEMDOC)

Не вводити гемцитабін за стандартний 30-хвилинний протокол — потрібна 90-хвилинна контрольована інфузія (10 мг/м²/хв)
Не призначати без G-CSF первинної профілактики
Не використовувати при GIST — інша система TKI
Не призначати при важкій нирковій недостатності (КК <30 мл/хв)

Standard plan (IND-STS-ADVANCED-2L-PAZOPANIB)

НІКОЛИ не призначати при ліпосаркомі — виключена з PALETTE; стандартом є трабектедин або ерибулін
Не призначати без моnoторингу LFT (тижno 3, 5, 7 — гепатотоксичnoсть є найсерйозnoшим ускладненням)
Не застосовувати з інгібіторами CYP3A4 або симвастатином без корекції дози/заміни
Не приймати з їжею — порожnoй шлунок ОБОВ'ЯЗКОВИЙ

Timeline

Treatment timeline — derived from regimen + monitoring schedule

Standard plan

Induction · Gemcitabine + docetaxel (soft tissue sarcoma)

21-day cycles × Continue until progression or unacceptable toxicity; typically 6 cycles initial assessment

Standard plan

Induction · Pazopanib (soft tissue sarcoma, 2L)

28-day cycles × Continue until progression or unacceptable toxicity

MDT brief

MDT talk tree (1 steps)

#	Owner	Topic	Action
1	social_worker_case_manager	Specialist review	Plan includes drugs without NSZU reimbursement — patient access pathway must be assessed.

Skills (recommended) — for consideration (1)

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-CASCADE-LFS-FDR-POSITIVE, RF-COSTELLO-CONFIRMED-CARRIER, RF-DICER1-CONFIRMED-CARRIER, RF-LI-FRAUMENI-FAMILY-HISTORY-SUSPICION, RF-NF1-CONFIRMED-CARRIER, RF-NF1-FAMILY-HISTORY-SUSPICION, RF-ROTHMUND-THOMSON-CONFIRMED-CARRIER, RF-WERNER-CONFIRMED-CARRIER

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-PALETTE-VAN-DER-GRAAF-2012: Pazopanib for metastatic soft-tissue sarcoma (PALETTE): a randomised, double-blind, placebo-controlled phase 3 trial (2012)
SRC-SARC002-MAKI-2007: Randomized phase II study of gemcitabine and docetaxel compared with gemcitabine alone in patients with metastatic soft tissue sarcomas: results of Sarcoma Alliance for Research through Collaboration study 002 [corrected] ()

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: 2026-07-15.

NCT	Title	Phase	Status	Sponsor	UA	Signals
NCT06580002	Repurposing Riluzole for Cancer-Related Cognitive Impairment: A Pilot Trial	PHASE2	RECRUITING	University of California, Irvine	—	Single country
NCT06299553	Study to Evaluate the Effectiveness of Tafasitamab in Combination With Lenalidomide Followed by Tafasitamab Monotherapy in Relapsed or Refractory Diffuse Large B-cell Lymphoma Non-transplant Eligible Patients in Italy (PRO-MIND)	N/A	RECRUITING	Incyte Biosciences Italy S.r.l	—	Surrogate endpoint only Single country
NCT04796012	VITAS: Atezolizumab in Combination With Chemotherapy for Pediatric Relapsed/Refractory Solid Tumors	PHASE1 / PHASE2	RECRUITING	University of Texas Southwestern Medical Center	—	Small N (<50) Surrogate endpoint only Single country
NCT07261657	N-803 in Patients With Progressive Synovial Sarcoma and Myxoid/Round Cell Liposarcoma Previously Treated With Adoptive Cellular Therapy	EARLY_PHASE1	RECRUITING	Seth Pollack	—	Small N (<50) Single country
NCT06753136	Electrochemotherapy (ECT) in Patients With Primary Visceral Tumors and/or Secondary Visceral Localizations, of Any Histotype	NA	RECRUITING	Istituto Oncologico Veneto IRCCS	—	Small N (<50) Single country
NCT03959800	Molecular Basis of Pediatric Liver Cancer	N/A	RECRUITING	University of Pittsburgh	—	Single country
NCT06939855	QL1706 in the Treatment of Advanced Bone and Soft Tissue Sarcoma	PHASE2	RECRUITING	Sun Yat-sen University	—	Small N (<50) Surrogate endpoint only Single country
NCT03458520	Pediatric PET/MR Image Registry	N/A	RECRUITING	Stanford University	—	Single country
NCT04690374	Registry to Collect Health Information About Desmoplastic Small Round Cell Tumor	N/A	RECRUITING	Memorial Sloan Kettering Cancer Center	—	Single country
NCT06721689	PEEL-224, Vincristine and Temozolomide in Pediatric Solid Tumors	PHASE1 / PHASE2	RECRUITING	Theodore Laetsch	—	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 Gemcitabine + docetaxel (soft tissue sarcoma) (REG-GEMCITABINE-DOCETAXEL-STS)	✓ registered	✓ covered	₴-? — verify pathway	NSZU formulary
Standard plan Pazopanib (soft tissue sarcoma, 2L) (REG-PAZOPANIB-STS) 1/1 component drug(s) not on NSZU formulary	✓ registered	✗ out-of-pocket	₴-? — verify pathway	not recorded
Trial · NCT06580002 Repurposing Riluzole for Cancer-Related Cognitive Impairment: A Pilot Trial No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT06299553 Study to Evaluate the Effectiveness of Tafasitamab in Combination With Lenalidomide Followed by Tafasitamab Monotherapy in Relapsed or Refractory Diffuse Large B-cell Lymphoma Non-transplant Eligible Patients in Italy (PRO-MIND) No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT04796012 VITAS: Atezolizumab in Combination With Chemotherapy for Pediatric Relapsed/Refractory Solid Tumors No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT07261657 N-803 in Patients With Progressive Synovial Sarcoma and Myxoid/Round Cell Liposarcoma Previously Treated With Adoptive Cellular Therapy No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT06753136 Electrochemotherapy (ECT) in Patients With Primary Visceral Tumors and/or Secondary Visceral Localizations, of Any Histotype No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT03959800 Molecular Basis of Pediatric Liver Cancer No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT06939855 QL1706 in the Treatment of Advanced Bone and Soft Tissue Sarcoma No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT03458520 Pediatric PET/MR Image Registry No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT04690374 Registry to Collect Health Information About Desmoplastic Small Round Cell Tumor No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT06721689 PEEL-224, Vincristine and Temozolomide in Pediatric 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: 2026-07-15.

plan_id: PLAN-VERIFIED-SOFT-TISSUE-SARCOMA-L2-STS_ADVANCED_2L_GEMDOC-V1 | version: 1 | generated: 2026-07-15T13:33:23.059620+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.