Infection-screening gate before metastatic gastric/GEJ adenocarcinoma systemic therapy: H...

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

ID	`RF-GASTRIC-INFECTION-SCREENING`
Type	Red flag
Status	reviewed 2026-04-26 \| pending_clinical_signoff
Diseases	`DIS-GASTRIC`
Sources	`SRC-ESMO-GASTRIC-2024` `SRC-NCCN-GASTRIC-2025`

Red Flag Origin

Definition	Infection-screening gate before metastatic gastric/GEJ adenocarcinoma systemic therapy: HBsAg+ / anti-HBc+ (HBV reactivation on pembrolizumab + chemo + dexamethasone), HIV+, active TB, OR active H. pylori (etiologic agent — eradication post-cancer-staging-completion).
Clinical direction	hold
Category	infection-screening

Trigger Logic

{
  "any_of": [
    {
      "finding": "hbsag",
      "value": "positive"
    },
    {
      "finding": "anti_hbc_total",
      "value": "positive"
    },
    {
      "finding": "hiv_status",
      "value": "positive"
    },
    {
      "finding": "active_tb",
      "value": true
    },
    {
      "finding": "h_pylori_active",
      "value": true
    }
  ],
  "type": "lab_value"
}

Notes

H. pylori eradication standard pre/post curative resection (NCCN MS-12). For metastatic, eradication is supportive (lowers bleeding/MALT-recurrence risk) but not delay-mandating.

Used By

No reverse references found in the YAML corpus.