EN · OpenOnco · DIS-NSCLC — Auto-stub (88% наповненість)
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OpenOnco · Treatment Plan
Treatment plan — DIS-NSCLC
PLAN-AUTO-NSCLC-001-V1 · v1 · 2026-04-27
Patient
AUTO-NSCLC-001 · Algorithm: ALGO-NSCLC-METASTATIC-1L

Clinical significance of mutations (ESCAT / OncoKB)

Tumor-board context — the engine does not use these tiers to rank tracks
BiomarkerVariantESCATOncoKBClinical significanceDrugsSources
BIO-BRAF-V600EV600EIA1BRAF V600E in advanced NSCLC (≈1-2% of adenocarcinomas): dabrafenib + trametinib gives ORR ~64% in 1L (Planchard et al. Lancet Oncol 2017) and is FDA/EMA-approved across lines. Encorafenib + binimetinib (PHAROS, Riely et al. JCO 2023) ORR 75% in treatment-naïve, 46% pretreated — also FDA-approved 2023.dabrafenib + trametinib
encorafenib + binimetinib
  • SRC-NCCN-NSCLC-2025
  • SRC-ESMO-NSCLC-METASTATIC-2024

Treatment options (5 tracks)

Aggressive plan
★ DEFAULT
Indication
IND-NSCLC-PDL1-LOW-NONSQ-MET-1L
Regimen
Pembrolizumab + carboplatin + pemetrexed (NSCLC non-squamous, 1L)
Drugs + NSZU
  • Pembrolizumab (DRUG-PEMBROLIZUMAB) 200 mg IV q3 weeks · Continuous up to 2 years · IV ⚠ NSZU — not for this indication
  • Carboplatin (DRUG-CARBOPLATIN) AUC 5 IV · Cycles 1-4 · IV ✓ NSZU covered
  • Pemetrexed (DRUG-PEMETREXED) 500 mg/m² IV · Cycles 1-4 + maintenance until progression · IV ✓ NSZU covered
Reason
Engine default per algorithm ALGO-NSCLC-METASTATIC-1L: {'step': 5, 'outcome': False, 'branch': {'result': 'IND-NSCLC-PDL1-LOW-NONSQ-MET-1L'}, 'fired_red_flags': [], 'winner_red_flag': None}
Standard plan
Indication
IND-NSCLC-EGFR-MUT-MET-1L
Regimen
Osimertinib monotherapy (EGFR-mut NSCLC, 1L metastatic OR adjuvant)
Drugs + NSZU
  • Osimertinib (DRUG-OSIMERTINIB) 80 mg PO once daily · Continuous · PO ⚠ NSZU — not for this indication
Reason
Alternative track presented for HCP consideration
Standard plan
Indication
IND-NSCLC-ALK-MET-1L
Regimen
Alectinib monotherapy (ALK+ NSCLC, 1L metastatic OR adjuvant)
Drugs + NSZU
  • Alectinib (DRUG-ALECTINIB) 600 mg PO BID with food · Continuous · PO ⚠ NSZU — not for this indication
Reason
Alternative track presented for HCP consideration
Standard plan
Indication
IND-NSCLC-KRAS-G12C-MET-2L
Regimen
Sotorasib monotherapy (KRAS G12C+ NSCLC, 2L+)
Drugs + NSZU
  • Sotorasib (DRUG-SOTORASIB) 960 mg PO once daily · Continuous · PO ✗ Not registered in UA
Reason
Alternative track presented for HCP consideration
Standard plan
Indication
IND-NSCLC-PDL1-HIGH-MET-1L
Regimen
Pembrolizumab monotherapy (NSCLC PD-L1 ≥50%, driver-negative, 1L)
Drugs + NSZU
  • Pembrolizumab (DRUG-PEMBROLIZUMAB) 200 mg IV q3 weeks (or 400 mg q6 weeks) · Continuous until progression OR 2 years · IV ⚠ NSZU — not for this indication
Reason
Alternative track presented for HCP consideration

Pre-treatment investigations

Investigations before treatment start · critical / standard / desired · merged across tracks
IDNamePriorityCategoryNeeded for
TEST-CECT-CAPКТ органів грудної клітки/черевної порожнини/таза з внутрішньовенним контрастуваннямCriticalimagingall tracks
TEST-NSCLC-NGS-PANELNSCLC комплексна NGS панель (ДНК + РНК-фузії)Critical—all tracks
TEST-PDL1-IHCPD-L1 ІГХ (TPS для НДРЛ)Critical—all tracks
TEST-BRAIN-MRI-CONTRASTМРТ головного мозку з контрастомStandard—standard

Timeline

Treatment timeline — derived from regimen + monitoring schedule

Aggressive plan

Induction · Pembrolizumab + carboplatin +
21-day cycles × 4 cycles induction; then pembro + pemetrexed maintenance until progression OR 2 years total pembro

Standard plan

Induction · Osimertinib monotherapy (EGFR-
28-day cycles × Continuous until progression (metastatic) OR 3 years (ADAURA adjuvant)

Standard plan

Induction · Alectinib monotherapy (ALK+ NS
28-day cycles × Continuous until progression (metastatic) OR 2 years (ALINA adjuvant)

Standard plan

Induction · Sotorasib monotherapy (KRAS G1
28-day cycles × Continuous until progression

Standard plan

Induction · Pembrolizumab monotherapy (NSC
21-day cycles × Up to 2 years (35 cycles q3w) — KEYNOTE-024 protocol

MDT brief

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
  • Молекулярний генетик / молекулярний онколог recommended
    Indication посилається на actionable геномний біомаркер — потрібна інтерпретація мутації / target / actionability.
    skill: molecular_geneticistv0.1.0reviewed 2026-04-25STUBsign-offs: 0lead: TBD

Open questions (1, 0 blocking)

  • OQ-LDH-CURRENT
    Який актуальний LDH? Маркер пухлинного навантаження і трансформації.
    LDH входить у прогностичні індекси індолентних лімфом.
    → hematologist

Data quality

  • Unevaluated RedFlags: RF-NSCLC-ALK-FUSION-ACTIONABLE, RF-NSCLC-BRAF-V600E-ACTIONABLE, RF-NSCLC-BRAIN-METS-EMERGENCY, RF-NSCLC-CORD-COMPRESSION, RF-NSCLC-EGFR-C797S-RESISTANCE, RF-NSCLC-EGFR-EX19DEL-ACTIONABLE, RF-NSCLC-EGFR-EX20INS-ACTIONABLE, RF-NSCLC-EGFR-T790M-ACTIONABLE, RF-NSCLC-FRAILTY-AGE, RF-NSCLC-HER2-MUT-ACTIONABLE, RF-NSCLC-HIGH-RISK-BIOLOGY, RF-NSCLC-INFECTION-SCREENING, RF-NSCLC-KRAS-G12C-ACTIONABLE, RF-NSCLC-MALIGNANT-EFFUSION, RF-NSCLC-MET-EX14-ACTIONABLE, RF-NSCLC-NTRK-FUSION-ACTIONABLE, RF-NSCLC-ORGAN-DYSFUNCTION, RF-NSCLC-PDL1-50-PLUS, RF-NSCLC-RET-FUSION-ACTIONABLE, RF-NSCLC-ROS1-FUSION-ACTIONABLE, RF-NSCLC-SVC-SYNDROME, RF-NSCLC-TRANSFORMATION-PROGRESSION

Skill catalog (2/16 activated in this plan)

All registered virtual specialists. ✓ — activated for this case; ○ — not activated (available for other clinical scenarios).
Specialistskill_idVersionLast reviewedSign-offsDomain
Specialist з клітинної терапії (CAR-T)cellular_therapy_specialistv0.1.02026-04-250cellular_therapy
Клінічний фармацевтclinical_pharmacistv0.1.02026-04-250clinical_pharmacy
Гематолог / онкогематологhematologistv0.1.02026-04-250hematology_oncology
Гематопатолог (специфічно для лімфом / лейкозів / мієломи)hematopathologistv0.1.02026-04-250hematopathology
Інфекціоніст / гепатологinfectious_disease_hepatologyv0.1.02026-04-250infectious_diseases
Медичний онколог (хіміотерапевт солідних пухлин)medical_oncologistv0.1.02026-04-250solid_oncology
Молекулярний генетик / молекулярний онкологmolecular_geneticistv0.1.02026-04-250molecular_oncology
Паліативна допомогаpalliative_carev0.1.02026-04-250palliative_care
Патолог (загальний)pathologistv0.1.02026-04-250pathology
Сімейний лікар / терапевтprimary_carev0.1.02026-04-250primary_care
Психолог / онкопсихологpsychologistv0.1.02026-04-250psychosocial
Радіотерапевт (променева терапія)radiation_oncologistv0.1.02026-04-250radiation_oncology
Лікар-радіологradiologistv0.1.02026-04-250diagnostic_imaging
Соціальний працівник / кейс-менеджерsocial_worker_case_managerv0.1.02026-04-250psychosocial
Хірург-онкологsurgical_oncologistv0.1.02026-04-250surgical_oncology
Specialist з трансплантації (BMT)transplant_specialistv0.1.02026-04-250cellular_therapy

Sources cited

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).
NCTNamePhaseСтатусСпонсорUAВключення (фрагмент)
NCT04429087A Study to Test Different Doses of BI 764532 in Patients With Small Cell Lung Cancer and Other Neuroendocrine Tumours That Are Positive for DLL3PHASE1RECRUITINGBoehringer Ingelheim—
NCT06616584Adding the Immunotherapy Drug Cemiplimab to Usual Treatment for People With Advanced Non-Small Cell Lung Cancer Who Had Previous Treatment With Platinum Chemotherapy and Immunotherapy (An Expanded Lung-MAP Treatment Trial)PHASE2 / PHASE3RECRUITINGSWOG Cancer Research Network—
NCT05306652Exercise in Extended Oncogene Addicted Lung Cancer in Active TreatmentNARECRUITINGAUSL Romagna Rimini—
NCT07016126D-BACE in Combination With Chemotherapy and Carelizumab for Resectable II-IIIA or Potentially Resectable T3-4N2 Stage IIIB NSCLCPHASE3RECRUITINGGuangdong Provincial People's Hospital—
NCT05014464ALK Tyrosine Kinase Inhibitors in ALK-rearranged Advanced Squamous Cell CarcinomaPHASE2RECRUITINGHunan Province Tumor Hospital—
NCT05940532A Trial of Sugemalimab and Chemotherapy in Unresectable Stage III NSCLCPHASE2RECRUITINGHunan Cancer Hospital—
NCT04980716Early Specialized Cardiovascular Intervention Based on Impedance Cardiography in Locally Advanced Non-small Cell Lung Cancer PatientsPHASE3RECRUITINGSun Yat-sen University—
NCT07467863Dual-Target CAR-NK Cells Directed Against MSLN, EGFR, or HER2 in Advanced NSCLCPHASE1 / PHASE2RECRUITINGBeijing Biotech—
NCT05276726A Study of JAB-21822 in Advanced or Metastatic NSCLC With KRAS p.G12C and STK11 Co-mutation and Wild-type KEAP1PHASE1 / PHASE2RECRUITINGAllist Pharmaceuticals, Inc.—
NCT05609578Combination Therapies With Adagrasib in Patients With Advanced NSCLC With KRAS G12C MutationPHASE2RECRUITINGMirati Therapeutics Inc.—

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).
ОпціяРеєстрація UAНСЗУCost orientationAccess pathway
Aggressive plan
Pembrolizumab + carboplatin + pemetrexed (NSCLC non-squamous, 1L) (REG-PEMBRO-CHEMO-NSCLC-NONSQ)
✓ зареєстровано✓ покривається₴-? — verify pathwayНСЗУ formulary
Standard plan
Osimertinib monotherapy (EGFR-mut NSCLC, 1L metastatic OR adjuvant) (REG-OSIMERTINIB-NSCLC)
✓ зареєстровано✓ покривається₴-? — verify pathwayНСЗУ formulary
Standard plan
Alectinib monotherapy (ALK+ NSCLC, 1L metastatic OR adjuvant) (REG-ALECTINIB-NSCLC)
✓ зареєстровано✓ покривається₴-? — verify pathwayНСЗУ formulary
Standard plan
Sotorasib monotherapy (KRAS G12C+ NSCLC, 2L+) (REG-SOTORASIB-KRAS)
1/1 component drug(s) not registered in Ukraine +1
✗ не зареєстровано✗ out-of-pocket₴-? — verify pathwaynot recorded
Standard plan
Pembrolizumab monotherapy (NSCLC PD-L1 ≥50%, driver-negative, 1L) (REG-PEMBRO-MONO-NSCLC)
✓ зареєстровано✓ покривається₴-? — verify pathwayНСЗУ formulary
Trial · NCT04429087
A Study to Test Different Doses of BI 764532 in Patients With Small Cell Lung Cancer and Other Neuroendocrine Tumours That Are Positive for DLL3
No UA site listed — international referral required
— невідомо— невідомо
self-pay: ₴0/course
Trial sponsor
Trial · NCT06616584
Adding the Immunotherapy Drug Cemiplimab to Usual Treatment for People With Advanced Non-Small Cell Lung Cancer Who Had Previous Treatment With Platinum Chemotherapy and Immunotherapy (An Expanded Lung-MAP Treatment Trial)
No UA site listed — international referral required
— невідомо— невідомо
self-pay: ₴0/course
Trial sponsor
Trial · NCT05306652
Exercise in Extended Oncogene Addicted Lung Cancer in Active Treatment
No UA site listed — international referral required
— невідомо— невідомо
self-pay: ₴0/course
Trial sponsor
Trial · NCT07016126
D-BACE in Combination With Chemotherapy and Carelizumab for Resectable II-IIIA or Potentially Resectable T3-4N2 Stage IIIB NSCLC
No UA site listed — international referral required
— невідомо— невідомо
self-pay: ₴0/course
Trial sponsor
Trial · NCT05014464
ALK Tyrosine Kinase Inhibitors in ALK-rearranged Advanced Squamous Cell Carcinoma
No UA site listed — international referral required
— невідомо— невідомо
self-pay: ₴0/course
Trial sponsor
Trial · NCT05940532
A Trial of Sugemalimab and Chemotherapy in Unresectable Stage III NSCLC
No UA site listed — international referral required
— невідомо— невідомо
self-pay: ₴0/course
Trial sponsor
Trial · NCT04980716
Early Specialized Cardiovascular Intervention Based on Impedance Cardiography in Locally Advanced Non-small Cell Lung Cancer Patients
No UA site listed — international referral required
— невідомо— невідомо
self-pay: ₴0/course
Trial sponsor
Trial · NCT07467863
Dual-Target CAR-NK Cells Directed Against MSLN, EGFR, or HER2 in Advanced NSCLC
No UA site listed — international referral required
— невідомо— невідомо
self-pay: ₴0/course
Trial sponsor
Trial · NCT05276726
A Study of JAB-21822 in Advanced or Metastatic NSCLC With KRAS p.G12C and STK11 Co-mutation and Wild-type KEAP1
No UA site listed — international referral required
— невідомо— невідомо
self-pay: ₴0/course
Trial sponsor
Trial · NCT05609578
Combination Therapies With Adagrasib in Patients With Advanced NSCLC With KRAS G12C Mutation
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-NSCLC-001-V1 | version: 1 | generated: 2026-04-27T10:14:01.633956+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.