Aktive oder latente Infektion, die Auflösung / Prophylaxe vor Beginn der Gemcitab...

Deterministische Ansicht der Quelle YAML Entität. Klinische Autorität bleibt mit den zitierten Quell-IDs und Rezensenten Sign-off Zustand.

ID	`RF-CHOLANGIOCARCINOMA-INFECTION-SCREENING`
Art	Warnhinweis
Status	reviewed 2026-04-27 \| pending_clinical_signoff
Erkrankungen	`DIS-CHOLANGIOCARCINOMA`
Quellen	`SRC-ESMO-BTC-2023` `SRC-NCCN-HEPATOBILIARY`

Ursprung der Roten Flagge

Begriffsbestimmung	Active or latent infection requiring resolution / prophylaxis before initiating gemcitabine + cisplatin + durvalumab or FGFR2/IDH1-targeted therapy: HBsAg-positive (HBV reactivation risk on chemoimmunotherapy + durvalumab), anti-HBc-positive (occult HBV), HIV-positive (ART coordination required), or active TB. Cholangitis from biliary obstruction is also addressed in transformation-progression flag.
Klinische Richtung	Halten
Kategorie	Infektionsuntersuchungen

Logik auslösen

{
  "any_of": [
    {
      "finding": "hbsag",
      "value": "positive"
    },
    {
      "finding": "anti_hbc_total",
      "value": "positive"
    },
    {
      "finding": "hiv_status",
      "value": "positive"
    },
    {
      "finding": "active_tb",
      "value": true
    }
  ],
  "type": "lab_value"
}

Anmerkungen

HBsAg+: entecavir / tenofovir prophylaxis before durvalumab + gem-cis (immune-checkpoint inhibitors carry HBV reactivation signal even in HBsAg-negative / anti-HBc-positive patients). HIV+ biliary cancer manageable with TOPAZ-1 regimen but requires ART coordination — avoid ritonavir-boosted PIs with TKIs (CYP3A4 interactions with FGFR / IDH inhibitors). Active TB: anti-TB completion preferred before chemoimmunotherapy. This flag operationalizes the hold via parallel supportive-care workup rather than indication switch.

Verwendet von

Keine Rückverweise im YAML-Korpus gefunden.