Treatment plan — DIS-ESOPHAGEAL

OpenOnco · Treatment Plan

PLAN-AUTO-ESOPHAGEAL-001-V1 · v1 · 2026-04-27

Patient

AUTO-ESOPHAGEAL-001 · Algorithm: ALGO-ESOPH-RESECTABLE-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 (1 tracks)

Standard plan

★ DEFAULT

Indication

IND-ESOPH-RESECTABLE-CROSS-NEOADJUVANT

Regimen

Weekly carboplatin + paclitaxel (CROSS-style chemo backbone)

Drugs + NSZU

Carboplatin (DRUG-CARBOPLATIN) AUC 2 · IV weekly × 5 · IV ⚠ NSZU — not for this indication
Paclitaxel (DRUG-PACLITAXEL) 50 mg/m² · IV weekly × 5 · IV ✓ NSZU covered

Reason

Engine default per algorithm ALGO-ESOPH-RESECTABLE-1L: {'step': 1, 'outcome': False, 'branch': {'result': 'IND-ESOPH-RESECTABLE-CROSS-NEOADJUVANT'}, 'fired_red_flags': [], 'winner_red_flag': None}

Pre-treatment investigations

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

ID	Name	Priority	Category	Needed for
TEST-CT-CHEST-ABDOMEN-PELVIS	КТ грудна клітка + черевна порожнина + малий таз з контрастом	Critical	imaging	all tracks
TEST-EGD-VARICES-SCREENING	ФГДС з оцінкою варикозу стравоходу	Critical	imaging	all tracks
TEST-CT-PET	ПЕТ-КТ з ФДГ	Desired	imaging	all tracks

Red flags — PRO / CONTRA aggressive

PRO-AGGRESSIVE

Triggers that push toward the aggressive track

Severe dysphagia with weight loss / aspiration risk in esophageal cancer: inability to swallow saliva, recurrent aspiration pneumonia, >10% weight loss in 3 months, OR malignant tracheoesophageal fistula. Mandates urgent palliative intervention (stenting OR dilation OR diversion) BEFORE any definitive systemic / RT therapy. RF-ESOPH-SEVERE-DYSPHAGIA-ASPIRATION

CONTRA-AGGRESSIVE

Hard contraindications to escalation

What NOT to do

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

Standard plan (IND-ESOPH-RESECTABLE-CROSS-NEOADJUVANT)

Do NOT proceed to surgery without restaging post-CRT (occult progression detection)
Do NOT initiate RT without addressing severe dysphagia / aspiration risk first
Do NOT skip CheckMate-577 nivolumab adjuvant for residual ypT+ or ypN+ post-CROSS

Timeline

Treatment timeline — derived from regimen + monitoring schedule

Standard plan

Induction · Weekly carboplatin + paclitaxe

7-day cycles × 5 weekly cycles concurrent with RT 41.4 Gy in 23 fractions (CROSS protocol)

MDT brief

Data quality

Unevaluated RedFlags: RF-ESOPH-FRAILTY-AGE, RF-ESOPH-HIGH-RISK-BIOLOGY, RF-ESOPH-INFECTION-SCREENING, RF-ESOPH-SEVERE-DYSPHAGIA-ASPIRATION, RF-ESOPH-TRANSFORMATION-PROGRESSION

Skill catalog (0/16 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-ESOPHAGEAL-2024: ESMO Esophageal Cancer (2024)
SRC-NCCN-ESOPHAGEAL-2025: NCCN Esophageal and EGJ Cancers (v.3.2025)

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
NCT06065371	Sacituzumab Govitecan in Combination With Capecitabine for Advanced Gastrointestinal Cancers After Progression on Standard Therapy	PHASE1	RECRUITING	Henry Ford Health System	—
NCT05688176	Barrett's Esophagus and Esophageal Adenocarcinoma, Searching for Reliable Diagnostic RNA Plasma-based Biomarkers	N/A	RECRUITING	University Hospital, Ghent	—
NCT02838836	Tumor Cell and DNA Detection in the Blood, Urine and Bone Marrow of Patients With Solid Cancers	N/A	RECRUITING	University of Missouri-Columbia	—
NCT06138028	Sintilimab and Chemotherapy Sequential Radiotherapy in Advanced Esophageal Cancer	PHASE2 / PHASE3	RECRUITING	Qingdao Central Hospital	—
NCT04871412	The Thoracic Peri-Operative Integrative Surgical Care Evaluation Trial - Stage III	PHASE3	RECRUITING	Ottawa Hospital Research Institute	—
NCT06869213	A Single-arm, Open, Single-center Exploratory Study of Adebrelimab (SHR-1316) in Combination With Chemotherapy for the Perioperative Treatment of Locally Advanced Resectable Esophageal Squamous Carcinoma	PHASE2	RECRUITING	Peking University Cancer Hospital & Institute	—
NCT04513418	Effects of Preoperative Enteral Immunonutrition for Esophageal Cancer Patients Given Neoadjuvant Chemoradiotherapy	PHASE3	RECRUITING	Hecheng Li M.D., Ph.D	—
NCT07016724	Neoadjuvant Radiochemotherapy Combined With Cadonilizumab for Local Advanced Esophageal Squamous Cell Cancer	PHASE2	RECRUITING	The First Affiliated Hospital of Zhengzhou University	—
NCT06084897	Radiotherapy in Patients With Metastatic Esophageal Cancer Responding to PD-1 Inhibitor Plus Chemotherapy	PHASE2	RECRUITING	Cancer Institute and Hospital, Chinese Academy of Medical Sciences	—
NCT07266363	Integrated Cf-miRNA and Exosomal miRNA Signature for Early Detection of Esophageal Squamous Cell Carcinoma	N/A	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 Weekly carboplatin + paclitaxel (CROSS-style chemo backbone) (REG-CARBOPLATIN-PACLITAXEL-WEEKLY)	✓ зареєстровано	✓ покривається	₴-? — verify pathway	НСЗУ formulary
Trial · NCT06065371 Sacituzumab Govitecan in Combination With Capecitabine for Advanced Gastrointestinal Cancers After Progression on Standard Therapy No UA site listed — international referral required	— невідомо	— невідомо	self-pay: ₴0/course	Trial sponsor
Trial · NCT05688176 Barrett's Esophagus and Esophageal Adenocarcinoma, Searching for Reliable Diagnostic RNA Plasma-based Biomarkers No UA site listed — international referral required	— невідомо	— невідомо	self-pay: ₴0/course	Trial sponsor
Trial · NCT02838836 Tumor Cell and DNA Detection in the Blood, Urine and Bone Marrow of Patients With Solid Cancers No UA site listed — international referral required	— невідомо	— невідомо	self-pay: ₴0/course	Trial sponsor
Trial · NCT06138028 Sintilimab and Chemotherapy Sequential Radiotherapy in Advanced Esophageal Cancer No UA site listed — international referral required	— невідомо	— невідомо	self-pay: ₴0/course	Trial sponsor
Trial · NCT04871412 The Thoracic Peri-Operative Integrative Surgical Care Evaluation Trial - Stage III No UA site listed — international referral required	— невідомо	— невідомо	self-pay: ₴0/course	Trial sponsor
Trial · NCT06869213 A Single-arm, Open, Single-center Exploratory Study of Adebrelimab (SHR-1316) in Combination With Chemotherapy for the Perioperative Treatment of Locally Advanced Resectable Esophageal Squamous Carcinoma No UA site listed — international referral required	— невідомо	— невідомо	self-pay: ₴0/course	Trial sponsor
Trial · NCT04513418 Effects of Preoperative Enteral Immunonutrition for Esophageal Cancer Patients Given Neoadjuvant Chemoradiotherapy No UA site listed — international referral required	— невідомо	— невідомо	self-pay: ₴0/course	Trial sponsor
Trial · NCT07016724 Neoadjuvant Radiochemotherapy Combined With Cadonilizumab for Local Advanced Esophageal Squamous Cell Cancer No UA site listed — international referral required	— невідомо	— невідомо	self-pay: ₴0/course	Trial sponsor
Trial · NCT06084897 Radiotherapy in Patients With Metastatic Esophageal Cancer Responding to PD-1 Inhibitor Plus Chemotherapy No UA site listed — international referral required	— невідомо	— невідомо	self-pay: ₴0/course	Trial sponsor
Trial · NCT07266363 Integrated Cf-miRNA and Exosomal miRNA Signature for Early Detection of Esophageal Squamous Cell Carcinoma 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-ESOPHAGEAL-001-V1 | version: 1 | generated: 2026-04-27T10:14:01.610324+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.