Actionable molecular driver detected (EGFR / ALK / ROS1 / KRAS G12C / BRAF V600E / MET ex...

Vue déterministe de l'entité source de la LJAM. L'autorité clinique demeure avec les ID de la source cités et l'état d'approbation de l ́examinateur.

ID	`RF-NSCLC-HIGH-RISK-BIOLOGY`
Type	Signal d’alerte
État	pending_clinical_signoff
Maladies	`DIS-NSCLC`
Sources	`SRC-ESMO-NSCLC-METASTATIC-2024` `SRC-NCCN-NSCLC-2025`

Origine du drapeau rouge

Définition	Actionable molecular driver detected (EGFR / ALK / ROS1 / KRAS G12C / BRAF V600E / MET ex14 / RET / NTRK / HER2 mut) — driver-targeted TKI / ADC takes precedence over ICI ± chemo regardless of PD-L1 TPS.
Direction clinique	intensifier
Catégorie	high-risk-biology
Algorithme de décalage	ALGO-NSCLC-METASTATIC-1L

Logique de déclenchement

{
  "any_of": [
    {
      "finding": "BIO-EGFR-MUTATION",
      "value": "positive"
    },
    {
      "finding": "BIO-ALK-FUSION",
      "value": "positive"
    },
    {
      "finding": "BIO-ROS1-FUSION",
      "value": "positive"
    },
    {
      "finding": "BIO-KRAS-G12C",
      "value": "positive"
    },
    {
      "finding": "BIO-BRAF-V600E",
      "value": "positive"
    },
    {
      "finding": "met_ex14_skipping",
      "value": true
    },
    {
      "finding": "ret_fusion",
      "value": true
    },
    {
      "finding": "ntrk_fusion",
      "value": true
    },
    {
      "finding": "her2_mutation_nsclc",
      "value": true
    }
  ],
  "type": "biomarker"
}

Notes

Driver-mutant NSCLC patients DO NOT benefit from ICI 1L (poorer responses, hyperprogression risk) — TKIs/ADCs are markedly superior. Universal NGS at diagnosis prevents missed-driver scenarios.

Utilisé par

Algorithmes

ALGO-NSCLC-METASTATIC-1L - ALGO-NSCLC-METASTATIC-1L

Chapitres du manuel

HB-NSCLC-METASTATIC-1L - Metastatic NSCLC: driver-first treatment reasoning

Questions du manuel

HQ-NSCLC-MET-1L-001 - HQ-NSCLC-MET-1L-001