Cholangiocarcinoma (bile duct cancer) · line 1 · Pembrolizumab + gemcitabine + cisplatin (KEYNOTE-966) — 1L advanced biliary tract cancer
Vista determinista de la entidad fuente YAML. La autoridad clínica sigue con los ID de fuente citados y estado de firma del revisor.
Registro de base de conocimiento para la auditoría. Contenido clínico provisional: esto no es una prescripción. Un oncólogo debe verificar fuentes originales, aplicabilidad y estado de revisión.
Fuente YAML: registro completo
| Línea de tratamiento | 1 |
|---|---|
| Track | estándar |
| Régimen vinculado | REG-PEMBRO-GEM-CIS-CHOLANGIO |
| ID | IND-CHOLANGIO-METASTATIC-1L-PEMBRO-CHEMO |
|---|---|
| Tipo | Indicación |
| Situación | reviewed 2026-05-08 | pending_clinical_signoff |
| Enfermedades | DIS-CHOLANGIOCARCINOMA |
| Fuentes | SRC-ESMO-BTC-2023 SRC-KEYNOTE-966-KELLEY-2023 SRC-NCCN-HEPATOBILIARY |
Notas
STUB scaffold — KEYNOTE-966 1L IO+chemo for advanced BTC, NCCN category 1 alternative. Auto-generated minimal indication so engine can route end-to-end with new 2024+ standard-of-care; pending Clinical Co-Lead review per CHARTER §6.1 dev-mode signoff exemption. Clinical contraindications (free-text, pending Contraindication-entity authoring): active autoimmune disease requiring systemic immunosuppression (pembrolizumab); prior solid-organ transplant (rejection risk); ECOG PS ≥ 2 (not enrolled in KEYNOTE-966 — gem+cis monotherapy preferred via existing IND-CHOLANGIO-ADVANCED-GEM-CIS); severe renal impairment CrCl <50 mL/min (cisplatin contraindication — carboplatin substitution case-by-case). Required tests (free-text, pending Test-entity authoring): histologic confirmation of BTC; baseline LFTs/CBC/CMP/CrCl; TSH baseline (IO thyroiditis monitoring); CT C/A/P or MRI staging. Desired tests: MSI/MMR (rare MSI-H in BTC); CGP for FGFR2 fusions, IDH1, BRAF, HER2, NTRK (2L+ planning per existing FGFR2-fusion 2L indications); PD-L1 CPS (informational — KEYNOTE-966 benefit subgroup-independent). Protocol differs from TOPAZ-1: gemcitabine continues past 8 cycles as maintenance with pembroli...
Utilizado por
Algoritmos
ALGO-CHOLANGIO-1L- ALGO-CHOLANGIO-1L
Indicación
IND-CHOLANGIO-ADVANCED-GEM-CIS- IND-CHOLANGIO-ADVANCED-GEM-CIS