Onco Wiki / Regimen

Sirolimus conversion (iatrogenic/transplant-associated Kaposi sarcoma)

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

ComponentsDRUG-SIROLIMUS
IDREG-SIROLIMUS-KAPOSI-CONVERSION
TypeRegimen
Statusreviewed 2026-07-11 | pending_clinical_signoff
DiseasesNone declared
SourcesNone declared

Notes

New Regimen entity -- reuses the existing DRUG-SIROLIMUS Drug entity (already in the KB for the LAM indication) but is authored separately from REG-SIROLIMUS-LAM because the clinical context (transplant immunosuppression-conversion vs. LAM antiproliferative monotherapy), monitoring priorities (graft function vs. pulmonary function), and evidence base differ. Dosing is deliberately described qualitatively ("per transplant-team protocol") rather than with a single asserted mg/target-trough number: no KB-verifiable primary source for a Kaposi-conversion-specific sirolimus target trough was available at authoring time (CHARTER §8.3 -- do not invent a numeric threshold not already stated in a verified source). Conversion from calcineurin- inhibitor-based to mTOR-inhibitor-based immunosuppression for post-transplant Kaposi sarcoma is well described in the transplant literature (documented tumor regression in a meaningful fraction of patients) but must always be transplant-team-directed -- graft rejection is a real risk. INDEPENDENT REVIEW CORRECTION (2026-07-11): an earlier draft cited SRC-NIH-AIDS-2024 as the source for this regimen's dose-adjustment and between-visit-watchpoint items....

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