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MSI-hoch / dMMR oder TMB-hoch (≥10 Mut/Mb) rezidivierende, persistente oder metastasierende Nebenschilddrüse...

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

IDRF-PARATHYROID-CARCINOMA-MSI-TMB-HIGH-ACTIONABILITY
ArtWarnhinweis
Statusreviewed 2026-07-11 | pending_clinical_signoff
ErkrankungenDIS-PARATHYROID-CARCINOMA
QuellenSRC-NCCN-NET-2025 SRC-NCCN-THYROID-2025

Ursprung der Roten Flagge

BegriffsbestimmungMSI-high / dMMR ODER TMB-hift (≥10 Mut/Mb) rezidivierendes, persistentes oder metastasierendes Parathyreoidkarzinom — öffnet die gewebeagnostische Pembrolizumab-Indikation und überschreibt den standardmäßigen Cinacalcet-Only-Supporting-Care-Track mit einer von Biomarker gesteuerten systemischen Option.
Klinische RichtungIntensivierung
Kategoriehigh-risk-biology
Schaltet AlgorithmusALGO-PARATHYROID-CARCINOMA-1L

Logik auslösen

{
  "any_of": [
    {
      "finding": "BIO-MSI-STATUS",
      "value": "MSI-H"
    },
    {
      "finding": "msi_status",
      "value": "MSI-H"
    },
    {
      "finding": "BIO-DMMR-IHC",
      "value": "dMMR"
    },
    {
      "finding": "dmmr_status",
      "value": "deficient"
    },
    {
      "finding": "BIO-TMB-HIGH",
      "value": "positive"
    },
    {
      "finding": "tmb_status",
      "value": "TMB-H"
    }
  ],
  "type": "biomarker"
}

Anmerkungen

Parathyroid carcinoma has no standard cytotoxic regimen with consistent activity; this RF exists to surface the one biomarker- gated systemic option (pembrolizumab, tissue-agnostic MSI-H/dMMR + TMB-high FDA approvals) for the rare recurrent/metastatic case where it applies. No parathyroid-carcinoma-specific prevalence data exists for MSI-H/dMMR or TMB-H given disease rarity — trigger and rationale are extrapolated from general solid-tumor basket-trial eligibility, matching the pattern already used by RF-CRC-MSI-H-ACTIONABILITY and RF-CHOLANGIOCARCINOMA-HIGH-RISK-BIOLOGY for the same biomarkers. STUB — requires clinical co-lead signoff.

Verwendet von

Algorithmen

Erkrankung

Anwendungsgebiet