Advanced systemic mastocytosis (AdvSM) · line 1 · Midostaurin monotherapy (advanced systemic mastocytosis, 1L alternative; D816V- or avapritinib-contraindicated)

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

Knowledge-base record for audit. Provisional clinical content: this is not a prescription. An oncologist must verify original sources, applicability and review status. Full rules and constraints are in the YAML.

Source YAML: complete record

Line of therapy	1
Track	aggressive
Linked regimen	`REG-MIDOSTAURIN-ADVSM-1L`

ID	`IND-ADVSM-1L-MIDOSTAURIN`
Type	Indication
Status	reviewed 2026-04-26 \| pending_clinical_signoff
Diseases	`DIS-MASTOCYTOSIS`
Sources	`SRC-ESMO-AML-2020` `SRC-NCCN-SM-2025`

Notes

Practical 1L in Ukraine (midostaurin НСЗУ-reimbursed for ASM / SM-AHN / MCL; avapritinib unregistered). Rest-of-world fallback for avapritinib-contraindicated or D816V-negative advanced SM.

Used By

Algorithms

ALGO-ADVSM-1L - ALGO-ADVSM-1L

Red flag

RF-ADVSM-KIT-D816V - KIT D816V activating point mutation (exon 17, activation loop) in advanced systemic masto...