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Frailty profile precluding FOLFIRINOX in PDAC: ECOG ≥2, OR (age ≥75 + Charlson ≥3), OR co...

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

Red Flag Origin

Trigger Logic

{
  "any_of": [
    {
      "comparator": ">=",
      "finding": "ecog",
      "threshold": 2
    },
    {
      "all_of": [
        {
          "comparator": ">=",
          "finding": "age",
          "threshold": 75
        },
        {
          "comparator": ">=",
          "finding": "charlson_score",
          "threshold": 3
        }
      ]
    },
    {
      "all_of": [
        {
          "comparator": ">=",
          "finding": "age",
          "threshold": 70
        },
        {
          "comparator": "<",
          "finding": "albumin_g_dl",
          "threshold": 3.0
        },
        {
          "comparator": ">=",
          "finding": "weight_loss_pct_3mo",
          "threshold": 10
        }
      ]
    }
  ],
  "type": "composite_score"
}

Notes

ACCORD-11 excluded ECOG ≥2; FOLFIRINOX in real-world frail patients has Grade 3-4 toxicity ~75% + early discontinuation. MPACT trial for gem-nab-pac was more permissive (KPS 70-100); better fit for the borderline-fit patient. Pure BSC for ECOG 4 or organ failure.

Used By

Algorithms

• ALGO-PDAC-METASTATIC-1L - ALGO-PDAC-METASTATIC-1L

Indications

• IND-PDAC-METASTATIC-1L-NALIRIFOX - IND-PDAC-METASTATIC-1L-NALIRIFOX
• IND-PDAC-METASTATIC-2L-NAL-IRI - IND-PDAC-METASTATIC-2L-NAL-IRI

Red flag

• RF-PDAC-FIT-FOR-FOLFIRINOX - Fitness for FOLFIRINOX in metastatic PDAC per PRODIGE-4 / ACCORD-11 inclusion criteria (C...