Treatment plan — DIS-DLBCL-NOS

OpenOnco · Treatment Plan

PLAN-AUTO-DLBCL-NOS-001-V1 · v1 · 2026-04-27

Patient

AUTO-DLBCL-NOS-001 · Algorithm: ALGO-DLBCL-1L

Clinical significance of mutations (ESCAT / OncoKB)

Tumor-board context — the engine does not use these tiers to rank tracks

Biomarker	Variant	ESCAT	OncoKB	Clinical significance	Drugs	Sources
No clinically actionable variants matched in this profile.

Treatment options (2 tracks)

Standard plan

★ DEFAULT

Indication

IND-DLBCL-1L-RCHOP

Regimen

Rituximab + CHOP (R-CHOP), 6 cycles

Drugs + NSZU

Rituximab (DRUG-RITUXIMAB) 375 mg/m² · IV day 1 of each 21-day cycle · IV ✓ NSZU covered
Cyclophosphamide (DRUG-CYCLOPHOSPHAMIDE) 750 mg/m² · IV day 1 of each 21-day cycle · IV ⚠ NSZU — not for this indication
Doxorubicin (DRUG-DOXORUBICIN) 50 mg/m² · IV day 1 of each 21-day cycle · IV ✓ NSZU covered
Vincristine (DRUG-VINCRISTINE) 1.4 mg/m² (capped at 2 mg total) · IV day 1 of each 21-day cycle · IV ⚠ NSZU — not for this indication
Prednisone (DRUG-PREDNISONE) 100 mg · PO days 1-5 of each 21-day cycle · PO ⚠ NSZU — not for this indication

Supportive care

SUP-PJP-PROPHYLAXIS, SUP-TLS-PROPHYLAXIS, SUP-ANTIEMETIC-PREMED

Hard contraindications

CI-HBV-NO-PROPHYLAXIS, CI-LVEF-LOW-FOR-ANTHRACYCLINE

Reason

Engine default per algorithm ALGO-DLBCL-1L: {'step': 3, 'outcome': False, 'branch': {'result': 'IND-DLBCL-1L-RCHOP'}, 'fired_red_flags': [], 'winner_red_flag': None}

Aggressive plan

Indication

IND-DLBCL-1L-POLA-R-CHP

Regimen

Polatuzumab vedotin + Rituximab + CHP (Pola-R-CHP), 6 cycles + 2× rituximab

Drugs + NSZU

Polatuzumab vedotin (DRUG-POLATUZUMAB-VEDOTIN) 1.8 mg/kg · IV day 1 of each 21-day cycle, cycles 1-6 · IV ✗ Not registered in UA
Rituximab (DRUG-RITUXIMAB) 375 mg/m² · IV day 1 of each 21-day cycle, cycles 1-8 (last 2 cycles rituximab-only) · IV ✓ NSZU covered
Cyclophosphamide (DRUG-CYCLOPHOSPHAMIDE) 750 mg/m² · IV day 1 of each 21-day cycle, cycles 1-6 · IV ⚠ NSZU — not for this indication
Doxorubicin (DRUG-DOXORUBICIN) 50 mg/m² · IV day 1 of each 21-day cycle, cycles 1-6 · IV ✓ NSZU covered
Prednisone (DRUG-PREDNISONE) 100 mg · PO days 1-5 of each 21-day cycle, cycles 1-6 · PO ⚠ NSZU — not for this indication

Supportive care

SUP-PJP-PROPHYLAXIS, SUP-TLS-PROPHYLAXIS, SUP-ANTIEMETIC-PREMED

Hard contraindications

CI-HBV-NO-PROPHYLAXIS, CI-LVEF-LOW-FOR-ANTHRACYCLINE, CI-BORTEZOMIB-SEVERE-NEUROPATHY

Reason

Alternative track presented for HCP consideration

Pre-treatment investigations

Investigations before treatment start · critical / standard / desired · merged across tracks

ID	Name	Priority	Category	Needed for
TEST-BM-ASPIRATE	Аспірат кісткового мозку (цитологія + flow + цитогенетика + молекулярка)	Critical	histology	all tracks
TEST-BM-TREPHINE	Трепанобіопсія кісткового мозку (core-біопсія)	Critical	histology	all tracks
TEST-CBC	Загальний аналіз крові з лейкоцитарною формулою	Critical	lab	all tracks
TEST-CD20-IHC	Імуногістохімія CD20	Critical	histology	all tracks
TEST-CMP	Розширений біохімічний аналіз крові	Critical	lab	all tracks
TEST-FISH-PANEL	FISH-панель (специфічна для нозології)	Critical	genomic	all tracks
TEST-FLOW-CYTOMETRY	Імунофенотипування методом проточної цитометрії	Critical	histology	all tracks
TEST-HBV-SEROLOGY	Серологія HBV: HBsAg, anti-HBc, anti-HBs	Critical	lab	all tracks
TEST-HCV-ANTIBODY	Антитіла до HCV	Critical	lab	all tracks
TEST-HIV-SEROLOGY	Серологія ВІЛ (антитіла HIV-1/2 + p24)	Critical	lab	all tracks
TEST-LDH	Лактатдегідрогеназа (ЛДГ)	Critical	lab	all tracks
TEST-LFT	Печінкові проби (АЛТ, АСТ, білірубін, ЛФ, ГГТП, альбумін)	Critical	lab	all tracks
TEST-LN-EXCISIONAL-BIOPSY	Ексцизійна біопсія лімфатичного вузла	Critical	histology	all tracks
TEST-PREGNANCY	β-ХГЛ (тест на вагітність)	Critical	lab	all tracks
TEST-B2-MICROGLOBULIN	Бета-2-мікроглобулін	Standard	lab	all tracks
TEST-ECHO	Ехокардіографія (ТТЕ) з оцінкою ФВ ЛШ	Standard	imaging	all tracks
TEST-PET-CT	ПЕТ/КТ із 18F-ФДГ	Standard	imaging	all tracks

Red flags — PRO / CONTRA aggressive

PRO-AGGRESSIVE

Triggers that push toward the aggressive track

Age-adjusted IPI ≥2 in patient <60 yo — high-risk young-adult DLBCL; supports DA-EPOCH-R consideration over R-CHOP per CALGB 50303 / Wilson and AYA-DLBCL seriesRF-AAIPI-HIGH
DLBCL with International Prognostic Index ≥2 — selects intensified Pola-R-CHP over R-CHOP per POLARIX evidenceRF-DLBCL-HIGH-IPI
High-risk biology in DLBCL NOS: double-expressor (MYC + BCL2 by IHC, no rearrangement), TP53 mutation, or non-GCB cell-of-origin in elderly / high-IPI context. Distinct from HGBL "double-hit" which is its own entity (DIS-HGBL-DH) — but double-expressor remains DLBCL NOS and shifts toward intensified backbone. RF-DLBCL-HIGH-RISK-BIOLOGY
DLBCL with International Prognostic Index 4-5 (high risk) — supports Pola-R-CHP intensification per POLARIX and triggers CNS-prophylaxis discussion via CNS-IPIRF-IPI-HIGH

CONTRA-AGGRESSIVE

Hard contraindications to escalation

Active or latent HBV without antiviral prophylaxis is an absolute contraindication to starting B-cell-depleting / immunomodulatory monoclonal antibody therapy (anti-CD20, anti-CD30 ADC, anti-CD38). Severe HBV reactivation hepatitis risk including fulminant hepatic failure.CI-HBV-NO-PROPHYLAXIS
Pre-treatment LVEF <50% is an absolute contraindication to anthracycline-containing regimens (R-CHOP, Pola-R-CHP, ABVD, BV-AVD, etc.). Cardiotoxicity from doxorubicin is dose-cumulative and often irreversible; starting with already-impaired function risks acute decompensation.CI-LVEF-LOW-FOR-ANTHRACYCLINE
Severe pre-existing peripheral neuropathy is an absolute contraindication to bortezomib — therapy will likely worsen the neuropathy to a disabling and often permanent extent.CI-BORTEZOMIB-SEVERE-NEUROPATHY

What NOT to do

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

Standard plan (IND-DLBCL-1L-RCHOP)

Не починати без HBV скринінгу + entecavir prophylaxis при HBsAg+ або anti-HBc+ — ризик фатальної реактивації значно підвищений на anti-CD20.
Не призначати без baseline LVEF ≥50% — anthracyclines кардіотоксичні; кардіоміопатія часто незворотна.
Не ігнорувати CNS-IPI — для пацієнтів з ≥4 CNS-IPI або високоризиковими anatomic sites (тестикули, груди, нирки/наднирники, параназальні синуси) додавати CNS prophylaxis (HD-MTX intercalated).
Не пропускати fertility preservation discussion у репродуктивного віку — циклофосфамід викликає азооспермію + amenorrhea.
Не вводити вінкристин інтратекально — ФАТАЛЬНО. WHO/FDA вимагають IV mini-bag packaging.
Не ескалувати дозу при febrile neutropenia без G-CSF — G-CSF prophylaxis для високоризикових пацієнтів (вік >65, prior cytopenia, advanced disease).

Aggressive plan (IND-DLBCL-1L-POLA-R-CHP)

Не призначати при відсутності верифікованого funding pathway — daratumumab... вибач, polatuzumab не реімбурсується НСЗУ; пацієнт має бути попереджений ДО запропонування.
Не починати без HBV скринінгу + entecavir prophylaxis при HBsAg+ або anti-HBc+ — anti-CD20 reactivation ризик не зменшується від polatuzumab.
Не призначати без baseline LVEF ≥50% — anthracycline cardiotoxicity те ж саме як R-CHOP.
Не ігнорувати pre-existing peripheral neuropathy — polatuzumab MMAE викликає neuropathy; Grade ≥2 baseline = absolute CI.
Не пропускати CNS prophylaxis якщо CNS-IPI ≥4 — той же ризик що при R-CHOP.
Не використовувати при concomitant strong CYP3A4 inhibitor без monitoring — підвищена neuropathy + myelosuppression.

Monitoring schedule

Monitoring schedule by treatment phase

Standard plan · MON-R-CHOP-REGIMEN

Phase	Window	Tests	Checkpoints
baseline	Within 2 weeks before cycle 1	TEST-CBC, TEST-CMP, TEST-LFT, TEST-LDH, TEST-B2-MICROGLOBULIN, TEST-HBV-SEROLOGY, TEST-HCV-ANTIBODY, TEST-HIV-SEROLOGY, TEST-PET-CT, TEST-LN-EXCISIONAL-BIOPSY, TEST-FLOW-CYTOMETRY, TEST-CD20-IHC, TEST-ECHO, TEST-PREGNANCY, TEST-BM-ASPIRATE, TEST-BM-TREPHINE	Confirm CD20+ DLBCL histology; rule out double-hit (FISH for MYC/BCL2/BCL6) Confirm HBV status + entecavir prophylaxis plan if HBsAg+ or anti-HBc+ Baseline LVEF ≥50% before doxorubicin IPI calculation documented (age, ECOG, LDH, stage, extranodal sites) CNS-IPI calculation if anatomic risk sites or composite score concerning Fertility preservation discussion (sperm banking / oocyte cryo) for childbearing-age
on_treatment	Day 1 of every 21-day cycle	TEST-CBC, TEST-CMP, TEST-LFT	ANC ≥1500 + platelets ≥100K before each cycle (delay or G-CSF if not) Neuropathy grade documented (CTCAE) — vincristine modification if ≥2 LVEF re-check after cumulative doxorubicin ~300 mg/m²
interim_response_assessment	After cycles 2-4 (interim PET-CT)	TEST-PET-CT, TEST-LDH	Lugano response criteria + Deauville score If Deauville 4-5 with mass progression → consider salvage or trial
end_of_treatment	After cycle 6 (within 6-8 weeks)	TEST-PET-CT, TEST-CBC, TEST-CMP, TEST-LDH	Confirm CR vs PR vs SD vs PD by Lugano/Deauville Begin survivorship plan: cardiac surveillance schedule, vaccination catch-up, second-cancer screening
follow_up_short	Every 3 months × 2 years post-treatment	TEST-CBC, TEST-CMP, TEST-LFT, TEST-LDH	Surveillance for relapse (~40% relapse risk by 2 years overall) HBV reactivation monitoring continues for 12 months post anti-CD20
follow_up_long	Every 6 months years 3-5, then annually	TEST-CBC, TEST-LFT, TEST-ECHO	Late cardiomyopathy screening (LVEF) annually if cumulative dox >300 Annual second-malignancy screening (skin, breast, etc. age-appropriate)

Timeline

Treatment timeline — derived from regimen + monitoring schedule

Standard plan

Baseline

Within 2 weeks before cycle 1

Induction · Rituximab + CHOP (R-CHOP), 6 c

21-day cycles × 6 (with consideration of 2-month interim PET-CT after cycles 2-4)

Response assessment

After cycles 2-4 (interim PET-CT)

Follow-up

Every 3 months × 2 years post-treatment

Aggressive plan

Baseline

Within 2 weeks before cycle 1

Induction · Polatuzumab vedotin + Rituxima

21-day cycles × 6 (Pola-R-CHP) + 2× rituximab consolidation (cycles 7-8)

Response assessment

After cycles 2-4 (interim PET-CT)

Follow-up

Every 3 months × 2 years post-treatment

MDT brief

Skills (required) — mandatory virtual specialists (1)

Гематолог / онкогематолог required
Лімфомний діагноз — провідна спеціальність для терапевтичного ведення.
Owns: OQ-LDH-CURRENT
skill: hematologistv0.1.0reviewed 2026-04-25STUBsign-offs: 0lead: TBD

Skills (recommended) — for consideration (2)

Клінічний фармацевт recommended
Хіміоімунотерапевтичний схема — drug-drug interactions, dose adjustments, premedication.
skill: clinical_pharmacistv0.1.0reviewed 2026-04-25STUBsign-offs: 0lead: TBD
Патолог (загальний) recommended
Підтвердження гістології лімфоми + оцінка ризику трансформації (DLBCL/Richter).
Owns: OQ-CD20-CONFIRMATION
skill: pathologistv0.1.0reviewed 2026-04-25STUBsign-offs: 0lead: TBD

Open questions (3, 1 blocking)

BLOCKING OQ-CD20-CONFIRMATION
Чи підтверджено CD20+ статус гістологією (IHC)? Без CD20+ rituximab/obinutuzumab не показані.
Anti-CD20 терапія — основа для більшості ліній; відсутність експресії CD20 повністю змінює regimen.
→ pathologist
OQ-STAGING-COMPLETE
Чи виконано повне стадіювання (Lugano + PET/CT або CT)?
Прогноз і вибір треку залежать від stage та tumor burden.
→ radiologist
OQ-LDH-CURRENT
Який актуальний LDH? Маркер пухлинного навантаження і трансформації.
LDH входить у прогностичні індекси індолентних лімфом.
→ hematologist

Data quality

Missing critical: cd20_ihc_status, lugano_stage
Missing recommended: ldh_ratio_to_uln, fib4_index, pet_ct_date
Unevaluated RedFlags: RF-AAIPI-HIGH, RF-DLBCL-CNS-RISK, RF-DLBCL-FRAILTY-AGE, RF-DLBCL-HIGH-IPI, RF-DLBCL-HIGH-RISK-BIOLOGY, RF-DLBCL-INFECTION-SCREENING, RF-DLBCL-ORGAN-DYSFUNCTION, RF-DLBCL-TRANSFORMATION-PROGRESSION, RF-IPI-HIGH, RF-IPI-INTERMEDIATE, RF-IPI-LOW

Skill catalog (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	Domain
Specialist з клітинної терапії (CAR-T)	`cellular_therapy_specialist`	v0.1.0	2026-04-25	cellular_therapy
Клінічний фармацевт	`clinical_pharmacist`	v0.1.0	2026-04-25	clinical_pharmacy
Гематолог / онкогематолог	`hematologist`	v0.1.0	2026-04-25	hematology_oncology
Гематопатолог (специфічно для лімфом / лейкозів / мієломи)	`hematopathologist`	v0.1.0	2026-04-25	hematopathology
Інфекціоніст / гепатолог	`infectious_disease_hepatology`	v0.1.0	2026-04-25	infectious_diseases
Медичний онколог (хіміотерапевт солідних пухлин)	`medical_oncologist`	v0.1.0	2026-04-25	solid_oncology
Молекулярний генетик / молекулярний онколог	`molecular_geneticist`	v0.1.0	2026-04-25	molecular_oncology
Паліативна допомога	`palliative_care`	v0.1.0	2026-04-25	palliative_care
Патолог (загальний)	`pathologist`	v0.1.0	2026-04-25	pathology
Сімейний лікар / терапевт	`primary_care`	v0.1.0	2026-04-25	primary_care
Психолог / онкопсихолог	`psychologist`	v0.1.0	2026-04-25	psychosocial
Радіотерапевт (променева терапія)	`radiation_oncologist`	v0.1.0	2026-04-25	radiation_oncology
Лікар-радіолог	`radiologist`	v0.1.0	2026-04-25	diagnostic_imaging
Соціальний працівник / кейс-менеджер	`social_worker_case_manager`	v0.1.0	2026-04-25	psychosocial
Хірург-онколог	`surgical_oncologist`	v0.1.0	2026-04-25	surgical_oncology
Specialist з трансплантації (BMT)	`transplant_specialist`	v0.1.0	2026-04-25	cellular_therapy

Sources cited

SRC-ESMO-DLBCL-2024: ESMO Clinical Practice Guideline on Diffuse Large B-Cell Lymphoma (2024)
SRC-NCCN-BCELL-2025: NCCN Clinical Practice Guidelines in Oncology: B-Cell Lymphomas (v.2.2025)

Експериментальні опції (клінічні дослідження)

Третій трек плану — open-enrollment trials з ClinicalTrials.gov. Останнє оновлення: 2026-04-27. Render-time metadata; engine selection не змінюється цим блоком (CHARTER §8.3).

NCT	Name	Phase	Статус	Спонсор	UA
NCT06806033	A Study to Evaluate the Optimization of the Cytokine Release Syndrome Profile for Glofitamab in Combination With Gemcitabine Plus Oxaliplatin in Participants With Relapsed/Refractory Aggressive B-Cell Non-Hodgkin's Lymphoma	PHASE2	RECRUITING	Hoffmann-La Roche	—
NCT04231877	Polatuzumab Vedotin and Combination Chemotherapy With or Without Glofitamab for the Treatment of Untreated Aggressive Large B-cell Lymphoma	PHASE1	RECRUITING	University of Washington	—
NCT07098364	ST-067 in Combination With CD19-Directed CAR T-Cell Therapy (Liso-cel) in Relapsed/Refractory Large B-Cell Lymphoma	PHASE1 / PHASE2	RECRUITING	Fred Hutchinson Cancer Center	—
NCT06014762	P-CD19CD20-ALLO1 Allogeneic CAR-T Cells in the Treatment of Subjects With B Cell Malignancies	PHASE1	RECRUITING	Poseida Therapeutics, Inc.	—
NCT06238648	Epcoritamab Compared to Observation for Treating B-cell Lymphoma Patients Not in Complete Remission After CD19-directed CAR-T Therapy	PHASE2	RECRUITING	Academic and Community Cancer Research United	—
NCT06536049	Epcoritamab Plus Ibrutinib for the Treatment of Relapsed or Refractory Aggressive B-Cell Non-Hodgkin Lymphoma	PHASE1 / PHASE2	RECRUITING	Yazeed Sawalha	—
NCT06649812	Testing the Effectiveness of a Combination Targeted Therapy (ViPOR) for Patients With Relapsed and/or Refractory Aggressive B-cell Lymphoma	PHASE2	RECRUITING	National Cancer Institute (NCI)	—
NCT06905509	Epcoritamab Plus Standard of Care Platinum-Based Chemotherapy and Autologous Hematopoietic Cell Transplant for the Treatment of Relapsed or Refractory Large B-cell Lymphoma	PHASE2	RECRUITING	Joseph Tuscano	—
NCT06015880	Testing the Combination of Anti-cancer Drugs Mosunetuzumab, Polatuzumab Vedotin, and Lenalidomide for the Treatment of Relapsed/Refractory Diffuse Large B-Cell Lymphoma	PHASE1	RECRUITING	National Cancer Institute (NCI)	—
NCT07365306	Epcoritamab, Rituximab, Gemcitabine and Oxaliplatin (R-GemOx) as Salvage Therapy Before Autologous Stem Cell Transplant for the Treatment of Relapsed/Refractory Diffuse Large B-Cell Lymphoma	PHASE2	RECRUITING	City of Hope Medical Center	—

Перевіряти статус набору безпосередньо у дослідницькому центрі. Дані ctgov можуть відставати від поточного статусу UA-сайтів.

Доступність опцій в Україні

Per-track UA registration · НСЗУ · cost · access pathway. Render-time metadata; engine selection не залежить від цих полів (CHARTER §8.3).

Опція	Реєстрація UA	НСЗУ	Cost orientation	Access pathway
Standard plan Rituximab + CHOP (R-CHOP), 6 cycles (REG-R-CHOP)	✓ зареєстровано	✓ покривається	₴-? — verify pathway	НСЗУ formulary
Aggressive plan Polatuzumab vedotin + Rituximab + CHP (Pola-R-CHP), 6 cycles + 2× rituximab (REG-POLA-R-CHP) 1/5 component drug(s) not registered in Ukraine +1	✗ не зареєстровано	✗ out-of-pocket	₴-? — verify pathway	not recorded
Trial · NCT06806033 A Study to Evaluate the Optimization of the Cytokine Release Syndrome Profile for Glofitamab in Combination With Gemcitabine Plus Oxaliplatin in Participants With Relapsed/Refractory Aggressive B-Cell Non-Hodgkin's Lymphoma No UA site listed — international referral required	— невідомо	— невідомо	self-pay: ₴0/course	Trial sponsor
Trial · NCT04231877 Polatuzumab Vedotin and Combination Chemotherapy With or Without Glofitamab for the Treatment of Untreated Aggressive Large B-cell Lymphoma No UA site listed — international referral required	— невідомо	— невідомо	self-pay: ₴0/course	Trial sponsor
Trial · NCT07098364 ST-067 in Combination With CD19-Directed CAR T-Cell Therapy (Liso-cel) in Relapsed/Refractory Large B-Cell Lymphoma No UA site listed — international referral required	— невідомо	— невідомо	self-pay: ₴0/course	Trial sponsor
Trial · NCT06014762 P-CD19CD20-ALLO1 Allogeneic CAR-T Cells in the Treatment of Subjects With B Cell Malignancies No UA site listed — international referral required	— невідомо	— невідомо	self-pay: ₴0/course	Trial sponsor
Trial · NCT06238648 Epcoritamab Compared to Observation for Treating B-cell Lymphoma Patients Not in Complete Remission After CD19-directed CAR-T Therapy No UA site listed — international referral required	— невідомо	— невідомо	self-pay: ₴0/course	Trial sponsor
Trial · NCT06536049 Epcoritamab Plus Ibrutinib for the Treatment of Relapsed or Refractory Aggressive B-Cell Non-Hodgkin Lymphoma No UA site listed — international referral required	— невідомо	— невідомо	self-pay: ₴0/course	Trial sponsor
Trial · NCT06649812 Testing the Effectiveness of a Combination Targeted Therapy (ViPOR) for Patients With Relapsed and/or Refractory Aggressive B-cell Lymphoma No UA site listed — international referral required	— невідомо	— невідомо	self-pay: ₴0/course	Trial sponsor
Trial · NCT06905509 Epcoritamab Plus Standard of Care Platinum-Based Chemotherapy and Autologous Hematopoietic Cell Transplant for the Treatment of Relapsed or Refractory Large B-cell Lymphoma No UA site listed — international referral required	— невідомо	— невідомо	self-pay: ₴0/course	Trial sponsor
Trial · NCT06015880 Testing the Combination of Anti-cancer Drugs Mosunetuzumab, Polatuzumab Vedotin, and Lenalidomide for the Treatment of Relapsed/Refractory Diffuse Large B-Cell Lymphoma No UA site listed — international referral required	— невідомо	— невідомо	self-pay: ₴0/course	Trial sponsor
Trial · NCT07365306 Epcoritamab, Rituximab, Gemcitabine and Oxaliplatin (R-GemOx) as Salvage Therapy Before Autologous Stem Cell Transplant for the Treatment of Relapsed/Refractory Diffuse Large B-Cell Lymphoma No UA site listed — international referral required	— невідомо	— невідомо	self-pay: ₴0/course	Trial sponsor

Інформація про ціни — orientation. Перевіряти у конкретній аптеці / foundation / трайл-сайті. Status updated: 2026-04-27.

plan_id: PLAN-AUTO-DLBCL-NOS-001-V1 | version: 1 | generated: 2026-04-27T10:14:01.567049+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.