@erosolaraijs/cure 1.0.0
This diff represents the content of publicly available package versions that have been released to one of the supported registries. The information contained in this diff is provided for informational purposes only and reflects changes between package versions as they appear in their respective public registries.
- package/LICENSE +21 -0
- package/README.md +120 -0
- package/dist/bin/cure.d.ts +10 -0
- package/dist/bin/cure.d.ts.map +1 -0
- package/dist/bin/cure.js +169 -0
- package/dist/bin/cure.js.map +1 -0
- package/dist/capabilities/cancerTreatmentCapability.d.ts +167 -0
- package/dist/capabilities/cancerTreatmentCapability.d.ts.map +1 -0
- package/dist/capabilities/cancerTreatmentCapability.js +912 -0
- package/dist/capabilities/cancerTreatmentCapability.js.map +1 -0
- package/dist/capabilities/index.d.ts +2 -0
- package/dist/capabilities/index.d.ts.map +1 -0
- package/dist/capabilities/index.js +3 -0
- package/dist/capabilities/index.js.map +1 -0
- package/dist/compliance/hipaa.d.ts +337 -0
- package/dist/compliance/hipaa.d.ts.map +1 -0
- package/dist/compliance/hipaa.js +929 -0
- package/dist/compliance/hipaa.js.map +1 -0
- package/dist/examples/cancerTreatmentDemo.d.ts +21 -0
- package/dist/examples/cancerTreatmentDemo.d.ts.map +1 -0
- package/dist/examples/cancerTreatmentDemo.js +216 -0
- package/dist/examples/cancerTreatmentDemo.js.map +1 -0
- package/dist/integrations/clinicalTrials/clinicalTrialsGov.d.ts +265 -0
- package/dist/integrations/clinicalTrials/clinicalTrialsGov.d.ts.map +1 -0
- package/dist/integrations/clinicalTrials/clinicalTrialsGov.js +808 -0
- package/dist/integrations/clinicalTrials/clinicalTrialsGov.js.map +1 -0
- package/dist/integrations/ehr/fhir.d.ts +455 -0
- package/dist/integrations/ehr/fhir.d.ts.map +1 -0
- package/dist/integrations/ehr/fhir.js +859 -0
- package/dist/integrations/ehr/fhir.js.map +1 -0
- package/dist/integrations/genomics/genomicPlatforms.d.ts +362 -0
- package/dist/integrations/genomics/genomicPlatforms.d.ts.map +1 -0
- package/dist/integrations/genomics/genomicPlatforms.js +1079 -0
- package/dist/integrations/genomics/genomicPlatforms.js.map +1 -0
- package/package.json +52 -0
- package/src/bin/cure.ts +182 -0
- package/src/capabilities/cancerTreatmentCapability.ts +1161 -0
- package/src/capabilities/index.ts +2 -0
- package/src/compliance/hipaa.ts +1365 -0
- package/src/examples/cancerTreatmentDemo.ts +241 -0
- package/src/integrations/clinicalTrials/clinicalTrialsGov.ts +1143 -0
- package/src/integrations/ehr/fhir.ts +1304 -0
- package/src/integrations/genomics/genomicPlatforms.ts +1480 -0
- package/src/ml/outcomePredictor.ts +1301 -0
- package/src/safety/drugInteractions.ts +942 -0
- package/src/validation/retrospectiveValidator.ts +887 -0
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/**
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* 癌症治疗能力框架 (Cancer Treatment Capability Framework)
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*
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* ██████╗██╗ ██╗██████╗ ███████╗ ██████╗ █████╗ ███╗ ██╗ ██████╗███████╗██████╗
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* ██╔════╝██║ ██║██╔══██╗██╔════╝ ██╔════╝██╔══██╗████╗ ██║██╔════╝██╔════╝██╔══██╗
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* ██║ ██║ ██║██████╔╝█████╗ ██║ ███████║██╔██╗ ██║██║ █████╗ ██████╔╝
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* ██║ ██║ ██║██╔══██╗██╔══╝ ██║ ██╔══██║██║╚██╗██║██║ ██╔══╝ ██╔══██╗
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* ╚██████╗╚██████╔╝██║ ██║███████╗ ╚██████╗██║ ██║██║ ╚████║╚██████╗███████╗██║ ██║
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* ╚═════╝ ╚═════╝ ╚═╝ ╚═╝╚══════╝ ╚═════╝╚═╝ ╚═╝╚═╝ ╚═══╝ ╚═════╝╚══════╝╚═╝ ╚═╝
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*
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* AI-powered cancer treatment capability module implementing:
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* - 个性化治疗计划 (Personalized Treatment Planning)
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* - 药物发现与设计 (Drug Discovery & Design)
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* - 免疫治疗优化 (Immunotherapy Optimization)
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* - CAR-T细胞疗法 (CAR-T Cell Therapy)
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* - 组合疗法优化 (Combination Therapy Optimization)
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* - 临床试验管理 (Clinical Trial Management)
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* - 患者护理协调 (Patient Care Coordination)
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* - 医疗系统集成 (Medical System Integration)
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*
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* All operations require proper medical authorization and compliance.
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*/
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// Cancer Treatment Operation Types
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export type CancerTreatmentOperationType =
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| 'diagnosis_assessment'
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| 'treatment_planning'
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| 'drug_design'
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| 'clinical_trial'
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| 'patient_monitoring'
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| 'quality_of_life'
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| 'followup_care'
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| 'immunotherapy'
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| 'car_t_therapy'
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| 'combination_optimization'
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| 'cure_cancer';
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export interface CancerPatient {
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id: string;
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type: 'patient' | 'clinical_trial_participant' | 'research_subject';
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identifier: string;
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demographics?: {
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age: number;
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gender: string;
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ethnicity?: string;
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};
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medicalHistory?: Record<string, any>;
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genomics?: {
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mutations: string[];
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biomarkers: string[];
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expressionProfiles?: Record<string, number>;
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};
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}
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export interface CancerTreatmentOperation {
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id: string;
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type: CancerTreatmentOperationType;
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patient: CancerPatient;
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parameters: Record<string, any>;
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authorization: string;
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timestamp: Date;
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}
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export interface CancerTreatmentResult {
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operationId: string;
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success: boolean;
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outcome: string;
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recommendations: string[];
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nextSteps: string[];
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timestamp: Date;
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}
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export interface TreatmentProtocol {
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id: string;
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name: string;
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organization: 'NCCN' | 'ESMO' | 'ASCO' | 'WHO' | 'FDA' | 'Other';
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cancerType: string;
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stage: string;
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treatmentModalities: string[];
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efficacyScore: number;
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sideEffectProfile: string[];
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references: string[];
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}
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// Comprehensive Drug Target Database
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export interface DrugTarget {
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gene: string;
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protein: string;
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pathway: string;
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cancerTypes: string[];
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approvedDrugs: string[];
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mechanismOfAction: string;
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evidenceLevel: 'FDA-Approved' | 'Phase III' | 'Phase II' | 'Phase I' | 'Preclinical';
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biomarker?: string;
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resistanceMechanisms?: string[];
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}
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// Immunotherapy Protocol
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export interface ImmunotherapyProtocol {
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id: string;
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name: string;
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type: 'checkpoint_inhibitor' | 'car_t' | 'cancer_vaccine' | 'cytokine_therapy' | 'oncolytic_virus';
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targets: string[];
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drugs: string[];
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cancerTypes: string[];
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responseRate: number;
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durableResponseRate: number;
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biomarkers: string[];
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}
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// Combination Therapy
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export interface CombinationTherapy {
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id: string;
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name: string;
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components: string[];
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synergisticEffect: number;
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cancerTypes: string[];
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clinicalEvidence: string;
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}
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// Cancer Cure Result
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export interface CancerCureResult {
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patientId: string;
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cancerType: string;
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stage: string;
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cureStrategy: string;
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treatments: {
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primary: string;
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secondary: string[];
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supportive: string[];
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};
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drugTargets: DrugTarget[];
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immunotherapy?: ImmunotherapyProtocol;
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combinationTherapy?: CombinationTherapy;
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projectedOutcome: {
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responseRate: number;
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fiveYearSurvival: number;
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qualityOfLife: number;
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cureConfidence: number;
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};
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timeline: { phase: string; duration: string; activities: string[] }[];
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breakthroughs: string[];
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status: 'CURED' | 'IN_REMISSION' | 'RESPONDING' | 'STABLE';
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}
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export class CancerTreatmentCapabilityModule {
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// ═══════════════════════════════════════════════════════════════════════════════
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// COMPREHENSIVE DRUG TARGET DATABASE - 50+ Validated Targets
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// ═══════════════════════════════════════════════════════════════════════════════
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private drugTargetDatabase: DrugTarget[] = [
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// === RECEPTOR TYROSINE KINASES ===
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{ gene: 'EGFR', protein: 'Epidermal Growth Factor Receptor', pathway: 'EGFR/RAS/MAPK',
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cancerTypes: ['NSCLC', 'Colorectal', 'Head and Neck', 'Glioblastoma'],
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approvedDrugs: ['Erlotinib', 'Gefitinib', 'Osimertinib', 'Afatinib', 'Cetuximab'],
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mechanismOfAction: 'TKI blocks ATP binding, preventing autophosphorylation',
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evidenceLevel: 'FDA-Approved', biomarker: 'EGFR mutation/amplification',
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resistanceMechanisms: ['T790M mutation', 'MET amplification', 'HER2 amplification'] },
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{ gene: 'HER2', protein: 'Human Epidermal Growth Factor Receptor 2', pathway: 'HER2/PI3K/AKT',
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cancerTypes: ['Breast', 'Gastric', 'Esophageal', 'Ovarian'],
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approvedDrugs: ['Trastuzumab', 'Pertuzumab', 'T-DM1', 'Trastuzumab Deruxtecan', 'Lapatinib', 'Neratinib'],
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mechanismOfAction: 'Monoclonal antibody blocks receptor dimerization and signaling',
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evidenceLevel: 'FDA-Approved', biomarker: 'HER2 overexpression/amplification' },
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{ gene: 'ALK', protein: 'Anaplastic Lymphoma Kinase', pathway: 'ALK/RAS/PI3K',
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cancerTypes: ['NSCLC', 'Neuroblastoma', 'Anaplastic Large Cell Lymphoma'],
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approvedDrugs: ['Crizotinib', 'Alectinib', 'Brigatinib', 'Lorlatinib', 'Ceritinib'],
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mechanismOfAction: 'ALK TKI inhibits constitutive kinase activity',
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evidenceLevel: 'FDA-Approved', biomarker: 'ALK rearrangement' },
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{ gene: 'ROS1', protein: 'ROS Proto-Oncogene 1', pathway: 'ROS1/SHP2/MAPK',
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cancerTypes: ['NSCLC', 'Glioblastoma', 'Cholangiocarcinoma'],
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approvedDrugs: ['Crizotinib', 'Entrectinib', 'Lorlatinib'],
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mechanismOfAction: 'Inhibits ROS1 fusion protein kinase activity',
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evidenceLevel: 'FDA-Approved', biomarker: 'ROS1 rearrangement' },
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{ gene: 'RET', protein: 'RET Proto-Oncogene', pathway: 'RET/RAS/MAPK',
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cancerTypes: ['Thyroid', 'NSCLC', 'Colorectal'],
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approvedDrugs: ['Selpercatinib', 'Pralsetinib', 'Cabozantinib'],
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mechanismOfAction: 'Selective RET kinase inhibition',
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evidenceLevel: 'FDA-Approved', biomarker: 'RET mutation/fusion' },
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{ gene: 'MET', protein: 'Hepatocyte Growth Factor Receptor', pathway: 'MET/PI3K/AKT',
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cancerTypes: ['NSCLC', 'Gastric', 'Hepatocellular', 'Renal'],
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approvedDrugs: ['Capmatinib', 'Tepotinib', 'Crizotinib', 'Cabozantinib'],
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mechanismOfAction: 'MET TKI blocks ligand-independent activation',
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evidenceLevel: 'FDA-Approved', biomarker: 'MET exon 14 skipping/amplification' },
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{ gene: 'FGFR1-4', protein: 'Fibroblast Growth Factor Receptors', pathway: 'FGFR/RAS/MAPK',
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cancerTypes: ['Bladder', 'Cholangiocarcinoma', 'Breast', 'Gastric'],
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approvedDrugs: ['Erdafitinib', 'Pemigatinib', 'Infigratinib', 'Futibatinib'],
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mechanismOfAction: 'Pan-FGFR kinase inhibition',
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evidenceLevel: 'FDA-Approved', biomarker: 'FGFR alterations' },
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{ gene: 'NTRK1-3', protein: 'Neurotrophic Tyrosine Receptor Kinases', pathway: 'NTRK/RAS/PI3K',
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cancerTypes: ['Solid Tumors (agnostic)', 'Thyroid', 'Salivary Gland', 'Sarcoma'],
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approvedDrugs: ['Larotrectinib', 'Entrectinib'],
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mechanismOfAction: 'TRK fusion protein inhibition',
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evidenceLevel: 'FDA-Approved', biomarker: 'NTRK gene fusion' },
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{ gene: 'KIT', protein: 'KIT Proto-Oncogene Receptor Tyrosine Kinase', pathway: 'KIT/RAS/MAPK',
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cancerTypes: ['GIST', 'Melanoma', 'AML', 'Mastocytosis'],
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approvedDrugs: ['Imatinib', 'Sunitinib', 'Regorafenib', 'Ripretinib', 'Avapritinib'],
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mechanismOfAction: 'Inhibits KIT kinase activity',
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evidenceLevel: 'FDA-Approved', biomarker: 'KIT mutation' },
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{ gene: 'PDGFRA/B', protein: 'Platelet-Derived Growth Factor Receptor', pathway: 'PDGFR/RAS/PI3K',
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cancerTypes: ['GIST', 'Glioblastoma', 'Dermatofibrosarcoma'],
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approvedDrugs: ['Imatinib', 'Sunitinib', 'Olaratumab'],
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mechanismOfAction: 'PDGFR kinase inhibition',
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evidenceLevel: 'FDA-Approved', biomarker: 'PDGFRA mutation/amplification' },
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// === RAS/MAPK PATHWAY ===
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{ gene: 'KRAS', protein: 'KRAS GTPase', pathway: 'RAS/MAPK',
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cancerTypes: ['Pancreatic', 'Colorectal', 'NSCLC'],
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approvedDrugs: ['Sotorasib', 'Adagrasib'],
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mechanismOfAction: 'Covalent inhibition of KRAS G12C mutant',
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evidenceLevel: 'FDA-Approved', biomarker: 'KRAS G12C mutation',
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resistanceMechanisms: ['Secondary KRAS mutations', 'MET amplification', 'EGFR activation'] },
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{ gene: 'BRAF', protein: 'B-Raf Proto-Oncogene', pathway: 'RAS/MAPK',
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cancerTypes: ['Melanoma', 'Colorectal', 'NSCLC', 'Thyroid', 'Hairy Cell Leukemia'],
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approvedDrugs: ['Vemurafenib', 'Dabrafenib', 'Encorafenib'],
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mechanismOfAction: 'BRAF V600 kinase inhibition',
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evidenceLevel: 'FDA-Approved', biomarker: 'BRAF V600 mutation' },
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{ gene: 'MEK1/2', protein: 'Mitogen-Activated Protein Kinase Kinase', pathway: 'RAS/MAPK',
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cancerTypes: ['Melanoma', 'NSCLC', 'Ovarian'],
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approvedDrugs: ['Trametinib', 'Cobimetinib', 'Binimetinib', 'Selumetinib'],
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mechanismOfAction: 'MEK kinase inhibition downstream of RAS',
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evidenceLevel: 'FDA-Approved', biomarker: 'BRAF/NRAS mutation' },
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{ gene: 'ERK1/2', protein: 'Extracellular Signal-Regulated Kinase', pathway: 'RAS/MAPK',
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cancerTypes: ['Melanoma', 'NSCLC', 'Colorectal'],
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approvedDrugs: ['Ulixertinib (investigational)'],
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mechanismOfAction: 'ERK kinase inhibition',
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evidenceLevel: 'Phase II', biomarker: 'MAPK pathway activation' },
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// === PI3K/AKT/MTOR PATHWAY ===
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{ gene: 'PIK3CA', protein: 'PI3K Catalytic Subunit Alpha', pathway: 'PI3K/AKT/mTOR',
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cancerTypes: ['Breast', 'Colorectal', 'Endometrial', 'Ovarian'],
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approvedDrugs: ['Alpelisib'],
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mechanismOfAction: 'Selective PI3Kα inhibition',
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evidenceLevel: 'FDA-Approved', biomarker: 'PIK3CA mutation' },
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{ gene: 'AKT1-3', protein: 'AKT Serine/Threonine Kinases', pathway: 'PI3K/AKT/mTOR',
|
|
234
|
+
cancerTypes: ['Breast', 'Prostate', 'Endometrial'],
|
|
235
|
+
approvedDrugs: ['Capivasertib'],
|
|
236
|
+
mechanismOfAction: 'Pan-AKT kinase inhibition',
|
|
237
|
+
evidenceLevel: 'FDA-Approved', biomarker: 'AKT/PIK3CA/PTEN alteration' },
|
|
238
|
+
{ gene: 'MTOR', protein: 'Mechanistic Target of Rapamycin', pathway: 'PI3K/AKT/mTOR',
|
|
239
|
+
cancerTypes: ['Renal', 'Breast', 'Neuroendocrine'],
|
|
240
|
+
approvedDrugs: ['Everolimus', 'Temsirolimus'],
|
|
241
|
+
mechanismOfAction: 'mTORC1 allosteric inhibition',
|
|
242
|
+
evidenceLevel: 'FDA-Approved', biomarker: 'mTOR pathway activation' },
|
|
243
|
+
{ gene: 'PTEN', protein: 'Phosphatase and Tensin Homolog', pathway: 'PI3K/AKT/mTOR',
|
|
244
|
+
cancerTypes: ['Prostate', 'Breast', 'Glioblastoma', 'Endometrial'],
|
|
245
|
+
approvedDrugs: ['PI3K/AKT inhibitors (indirect)'],
|
|
246
|
+
mechanismOfAction: 'Loss enables PI3K pathway targeting',
|
|
247
|
+
evidenceLevel: 'FDA-Approved', biomarker: 'PTEN loss' },
|
|
248
|
+
|
|
249
|
+
// === CELL CYCLE REGULATORS ===
|
|
250
|
+
{ gene: 'CDK4/6', protein: 'Cyclin-Dependent Kinases 4 and 6', pathway: 'Cell Cycle',
|
|
251
|
+
cancerTypes: ['Breast', 'Liposarcoma', 'Mantle Cell Lymphoma'],
|
|
252
|
+
approvedDrugs: ['Palbociclib', 'Ribociclib', 'Abemaciclib'],
|
|
253
|
+
mechanismOfAction: 'CDK4/6 kinase inhibition arrests G1/S transition',
|
|
254
|
+
evidenceLevel: 'FDA-Approved', biomarker: 'HR+/HER2- breast cancer, RB1 intact' },
|
|
255
|
+
{ gene: 'CDK2', protein: 'Cyclin-Dependent Kinase 2', pathway: 'Cell Cycle',
|
|
256
|
+
cancerTypes: ['Ovarian', 'Breast'],
|
|
257
|
+
approvedDrugs: ['Investigational agents'],
|
|
258
|
+
mechanismOfAction: 'CDK2 inhibition for CDK4/6 resistance',
|
|
259
|
+
evidenceLevel: 'Phase II', biomarker: 'CDK4/6 inhibitor resistance' },
|
|
260
|
+
|
|
261
|
+
// === DNA DAMAGE REPAIR ===
|
|
262
|
+
{ gene: 'BRCA1/2', protein: 'BRCA1/2 Tumor Suppressors', pathway: 'Homologous Recombination',
|
|
263
|
+
cancerTypes: ['Breast', 'Ovarian', 'Prostate', 'Pancreatic'],
|
|
264
|
+
approvedDrugs: ['Olaparib', 'Rucaparib', 'Niraparib', 'Talazoparib'],
|
|
265
|
+
mechanismOfAction: 'PARP inhibition causes synthetic lethality in HRD cells',
|
|
266
|
+
evidenceLevel: 'FDA-Approved', biomarker: 'BRCA1/2 mutation, HRD' },
|
|
267
|
+
{ gene: 'ATM', protein: 'ATM Serine/Threonine Kinase', pathway: 'DNA Damage Response',
|
|
268
|
+
cancerTypes: ['Prostate', 'Pancreatic', 'CLL'],
|
|
269
|
+
approvedDrugs: ['PARP inhibitors (synthetic lethality)'],
|
|
270
|
+
mechanismOfAction: 'ATM loss sensitizes to PARP inhibition',
|
|
271
|
+
evidenceLevel: 'FDA-Approved', biomarker: 'ATM loss/mutation' },
|
|
272
|
+
{ gene: 'ATR', protein: 'ATR Serine/Threonine Kinase', pathway: 'DNA Damage Response',
|
|
273
|
+
cancerTypes: ['Ovarian', 'Breast', 'SCLC'],
|
|
274
|
+
approvedDrugs: ['Elimusertib (investigational)'],
|
|
275
|
+
mechanismOfAction: 'ATR kinase inhibition',
|
|
276
|
+
evidenceLevel: 'Phase II', biomarker: 'ATM-deficient tumors' },
|
|
277
|
+
|
|
278
|
+
// === IMMUNE CHECKPOINTS ===
|
|
279
|
+
{ gene: 'PD-1', protein: 'Programmed Cell Death Protein 1', pathway: 'Immune Checkpoint',
|
|
280
|
+
cancerTypes: ['Melanoma', 'NSCLC', 'RCC', 'Hodgkin Lymphoma', 'MSI-H Solid Tumors'],
|
|
281
|
+
approvedDrugs: ['Pembrolizumab', 'Nivolumab', 'Cemiplimab', 'Dostarlimab'],
|
|
282
|
+
mechanismOfAction: 'Blocks PD-1/PD-L1 interaction, restores T-cell activity',
|
|
283
|
+
evidenceLevel: 'FDA-Approved', biomarker: 'PD-L1 expression, TMB-H, MSI-H' },
|
|
284
|
+
{ gene: 'PD-L1', protein: 'Programmed Death-Ligand 1', pathway: 'Immune Checkpoint',
|
|
285
|
+
cancerTypes: ['NSCLC', 'Bladder', 'TNBC', 'Merkel Cell'],
|
|
286
|
+
approvedDrugs: ['Atezolizumab', 'Durvalumab', 'Avelumab'],
|
|
287
|
+
mechanismOfAction: 'Blocks PD-L1 on tumor cells',
|
|
288
|
+
evidenceLevel: 'FDA-Approved', biomarker: 'PD-L1 expression ≥1%' },
|
|
289
|
+
{ gene: 'CTLA-4', protein: 'Cytotoxic T-Lymphocyte Antigen 4', pathway: 'Immune Checkpoint',
|
|
290
|
+
cancerTypes: ['Melanoma', 'RCC', 'MSI-H Colorectal'],
|
|
291
|
+
approvedDrugs: ['Ipilimumab', 'Tremelimumab'],
|
|
292
|
+
mechanismOfAction: 'Blocks CTLA-4 inhibitory signal on T-cells',
|
|
293
|
+
evidenceLevel: 'FDA-Approved', biomarker: 'Melanoma, combination with anti-PD-1' },
|
|
294
|
+
{ gene: 'LAG-3', protein: 'Lymphocyte Activation Gene 3', pathway: 'Immune Checkpoint',
|
|
295
|
+
cancerTypes: ['Melanoma'],
|
|
296
|
+
approvedDrugs: ['Relatlimab'],
|
|
297
|
+
mechanismOfAction: 'Blocks LAG-3 inhibitory receptor',
|
|
298
|
+
evidenceLevel: 'FDA-Approved', biomarker: 'Anti-PD-1 combination' },
|
|
299
|
+
{ gene: 'TIGIT', protein: 'T-cell Immunoreceptor with Ig and ITIM Domains', pathway: 'Immune Checkpoint',
|
|
300
|
+
cancerTypes: ['NSCLC', 'Melanoma'],
|
|
301
|
+
approvedDrugs: ['Tiragolumab (investigational)'],
|
|
302
|
+
mechanismOfAction: 'Blocks TIGIT checkpoint receptor',
|
|
303
|
+
evidenceLevel: 'Phase III', biomarker: 'PD-L1 high tumors' },
|
|
304
|
+
|
|
305
|
+
// === EPIGENETIC REGULATORS ===
|
|
306
|
+
{ gene: 'IDH1/2', protein: 'Isocitrate Dehydrogenase 1/2', pathway: 'Epigenetic',
|
|
307
|
+
cancerTypes: ['AML', 'Glioma', 'Cholangiocarcinoma'],
|
|
308
|
+
approvedDrugs: ['Ivosidenib', 'Enasidenib', 'Vorasidenib'],
|
|
309
|
+
mechanismOfAction: 'Inhibits mutant IDH, reduces oncometabolite 2-HG',
|
|
310
|
+
evidenceLevel: 'FDA-Approved', biomarker: 'IDH1/2 mutation' },
|
|
311
|
+
{ gene: 'EZH2', protein: 'Enhancer of Zeste Homolog 2', pathway: 'Epigenetic',
|
|
312
|
+
cancerTypes: ['Follicular Lymphoma', 'Epithelioid Sarcoma'],
|
|
313
|
+
approvedDrugs: ['Tazemetostat'],
|
|
314
|
+
mechanismOfAction: 'EZH2 methyltransferase inhibition',
|
|
315
|
+
evidenceLevel: 'FDA-Approved', biomarker: 'EZH2 mutation or INI1-loss' },
|
|
316
|
+
{ gene: 'HDAC', protein: 'Histone Deacetylases', pathway: 'Epigenetic',
|
|
317
|
+
cancerTypes: ['T-cell Lymphoma', 'Multiple Myeloma'],
|
|
318
|
+
approvedDrugs: ['Vorinostat', 'Romidepsin', 'Belinostat', 'Panobinostat'],
|
|
319
|
+
mechanismOfAction: 'HDAC inhibition increases histone acetylation',
|
|
320
|
+
evidenceLevel: 'FDA-Approved', biomarker: 'T-cell lymphoma' },
|
|
321
|
+
{ gene: 'DNMT', protein: 'DNA Methyltransferases', pathway: 'Epigenetic',
|
|
322
|
+
cancerTypes: ['MDS', 'AML', 'CMML'],
|
|
323
|
+
approvedDrugs: ['Azacitidine', 'Decitabine'],
|
|
324
|
+
mechanismOfAction: 'Hypomethylating agent restores tumor suppressor expression',
|
|
325
|
+
evidenceLevel: 'FDA-Approved', biomarker: 'MDS, AML' },
|
|
326
|
+
|
|
327
|
+
// === BCL-2 FAMILY ===
|
|
328
|
+
{ gene: 'BCL2', protein: 'B-Cell Lymphoma 2', pathway: 'Apoptosis',
|
|
329
|
+
cancerTypes: ['CLL', 'AML', 'NHL'],
|
|
330
|
+
approvedDrugs: ['Venetoclax'],
|
|
331
|
+
mechanismOfAction: 'BH3 mimetic displaces pro-apoptotic proteins',
|
|
332
|
+
evidenceLevel: 'FDA-Approved', biomarker: 'BCL2 overexpression' },
|
|
333
|
+
{ gene: 'MCL1', protein: 'Myeloid Cell Leukemia 1', pathway: 'Apoptosis',
|
|
334
|
+
cancerTypes: ['AML', 'Multiple Myeloma'],
|
|
335
|
+
approvedDrugs: ['Investigational agents'],
|
|
336
|
+
mechanismOfAction: 'MCL1 inhibition for venetoclax resistance',
|
|
337
|
+
evidenceLevel: 'Phase I', biomarker: 'MCL1 amplification' },
|
|
338
|
+
|
|
339
|
+
// === HORMONE RECEPTORS ===
|
|
340
|
+
{ gene: 'ESR1', protein: 'Estrogen Receptor Alpha', pathway: 'Hormone Signaling',
|
|
341
|
+
cancerTypes: ['Breast'],
|
|
342
|
+
approvedDrugs: ['Tamoxifen', 'Fulvestrant', 'Elacestrant'],
|
|
343
|
+
mechanismOfAction: 'ER antagonism/degradation',
|
|
344
|
+
evidenceLevel: 'FDA-Approved', biomarker: 'ER+ breast cancer, ESR1 mutation' },
|
|
345
|
+
{ gene: 'AR', protein: 'Androgen Receptor', pathway: 'Hormone Signaling',
|
|
346
|
+
cancerTypes: ['Prostate'],
|
|
347
|
+
approvedDrugs: ['Enzalutamide', 'Abiraterone', 'Apalutamide', 'Darolutamide'],
|
|
348
|
+
mechanismOfAction: 'AR antagonism/androgen synthesis inhibition',
|
|
349
|
+
evidenceLevel: 'FDA-Approved', biomarker: 'Castration-resistant prostate cancer' },
|
|
350
|
+
|
|
351
|
+
// === PROTEASOME/PROTEIN HOMEOSTASIS ===
|
|
352
|
+
{ gene: 'PSMA', protein: 'Prostate-Specific Membrane Antigen', pathway: 'Targeted Delivery',
|
|
353
|
+
cancerTypes: ['Prostate'],
|
|
354
|
+
approvedDrugs: ['177Lu-PSMA-617 (Pluvicto)'],
|
|
355
|
+
mechanismOfAction: 'Radioligand therapy delivers radiation to PSMA+ cells',
|
|
356
|
+
evidenceLevel: 'FDA-Approved', biomarker: 'PSMA-positive mCRPC' },
|
|
357
|
+
{ gene: 'Proteasome', protein: '26S Proteasome', pathway: 'Protein Homeostasis',
|
|
358
|
+
cancerTypes: ['Multiple Myeloma', 'Mantle Cell Lymphoma'],
|
|
359
|
+
approvedDrugs: ['Bortezomib', 'Carfilzomib', 'Ixazomib'],
|
|
360
|
+
mechanismOfAction: 'Proteasome inhibition causes proteotoxic stress',
|
|
361
|
+
evidenceLevel: 'FDA-Approved', biomarker: 'Multiple myeloma' },
|
|
362
|
+
|
|
363
|
+
// === NOVEL MECHANISMS ===
|
|
364
|
+
{ gene: 'KRASG12D', protein: 'KRAS G12D Mutant', pathway: 'RAS/MAPK',
|
|
365
|
+
cancerTypes: ['Pancreatic', 'Colorectal'],
|
|
366
|
+
approvedDrugs: ['MRTX1133 (investigational)'],
|
|
367
|
+
mechanismOfAction: 'Non-covalent KRAS G12D inhibition',
|
|
368
|
+
evidenceLevel: 'Phase I', biomarker: 'KRAS G12D mutation' },
|
|
369
|
+
{ gene: 'SHP2', protein: 'SH2 Domain-Containing Phosphatase 2', pathway: 'RAS/MAPK',
|
|
370
|
+
cancerTypes: ['NSCLC', 'Colorectal'],
|
|
371
|
+
approvedDrugs: ['RMC-4630 (investigational)'],
|
|
372
|
+
mechanismOfAction: 'SHP2 allosteric inhibition blocks RAS activation',
|
|
373
|
+
evidenceLevel: 'Phase II', biomarker: 'RTK-driven tumors' },
|
|
374
|
+
{ gene: 'SOS1', protein: 'Son of Sevenless Homolog 1', pathway: 'RAS/MAPK',
|
|
375
|
+
cancerTypes: ['NSCLC', 'Colorectal'],
|
|
376
|
+
approvedDrugs: ['BI 1701963 (investigational)'],
|
|
377
|
+
mechanismOfAction: 'SOS1 inhibition blocks RAS-GTP loading',
|
|
378
|
+
evidenceLevel: 'Phase I', biomarker: 'KRAS mutant tumors' },
|
|
379
|
+
{ gene: 'WEE1', protein: 'WEE1 G2 Checkpoint Kinase', pathway: 'Cell Cycle',
|
|
380
|
+
cancerTypes: ['Ovarian', 'Uterine'],
|
|
381
|
+
approvedDrugs: ['Adavosertib (investigational)'],
|
|
382
|
+
mechanismOfAction: 'WEE1 inhibition abrogates G2/M checkpoint',
|
|
383
|
+
evidenceLevel: 'Phase II', biomarker: 'TP53 mutant tumors' },
|
|
384
|
+
{ gene: 'Claudin-18.2', protein: 'Claudin-18 Isoform 2', pathway: 'Cell Adhesion',
|
|
385
|
+
cancerTypes: ['Gastric', 'Pancreatic'],
|
|
386
|
+
approvedDrugs: ['Zolbetuximab (investigational)'],
|
|
387
|
+
mechanismOfAction: 'Anti-CLDN18.2 antibody mediates ADCC/CDC',
|
|
388
|
+
evidenceLevel: 'Phase III', biomarker: 'Claudin-18.2+ gastric cancer' },
|
|
389
|
+
{ gene: 'HER3', protein: 'Human Epidermal Growth Factor Receptor 3', pathway: 'HER/PI3K',
|
|
390
|
+
cancerTypes: ['Breast', 'NSCLC'],
|
|
391
|
+
approvedDrugs: ['Patritumab Deruxtecan (investigational)'],
|
|
392
|
+
mechanismOfAction: 'HER3-targeting ADC',
|
|
393
|
+
evidenceLevel: 'Phase II', biomarker: 'HER3 expressing tumors' },
|
|
394
|
+
{ gene: 'TROP2', protein: 'Trophoblast Cell Surface Antigen 2', pathway: 'Targeted Delivery',
|
|
395
|
+
cancerTypes: ['TNBC', 'Bladder', 'NSCLC'],
|
|
396
|
+
approvedDrugs: ['Sacituzumab Govitecan'],
|
|
397
|
+
mechanismOfAction: 'TROP2-targeting ADC delivers SN-38 payload',
|
|
398
|
+
evidenceLevel: 'FDA-Approved', biomarker: 'TROP2 expression' },
|
|
399
|
+
{ gene: 'Nectin-4', protein: 'Nectin Cell Adhesion Molecule 4', pathway: 'Targeted Delivery',
|
|
400
|
+
cancerTypes: ['Bladder'],
|
|
401
|
+
approvedDrugs: ['Enfortumab Vedotin'],
|
|
402
|
+
mechanismOfAction: 'Nectin-4-targeting ADC delivers MMAE',
|
|
403
|
+
evidenceLevel: 'FDA-Approved', biomarker: 'Nectin-4 expression' },
|
|
404
|
+
{ gene: 'CD19', protein: 'B-Lymphocyte Antigen CD19', pathway: 'CAR-T Target',
|
|
405
|
+
cancerTypes: ['B-ALL', 'DLBCL', 'Follicular Lymphoma'],
|
|
406
|
+
approvedDrugs: ['Tisagenlecleucel', 'Axicabtagene ciloleucel', 'Brexucabtagene autoleucel', 'Lisocabtagene maraleucel'],
|
|
407
|
+
mechanismOfAction: 'CAR-T cells target CD19+ malignant B-cells',
|
|
408
|
+
evidenceLevel: 'FDA-Approved', biomarker: 'CD19+ B-cell malignancy' },
|
|
409
|
+
{ gene: 'BCMA', protein: 'B-Cell Maturation Antigen', pathway: 'CAR-T Target',
|
|
410
|
+
cancerTypes: ['Multiple Myeloma'],
|
|
411
|
+
approvedDrugs: ['Idecabtagene vicleucel', 'Ciltacabtagene autoleucel', 'Teclistamab'],
|
|
412
|
+
mechanismOfAction: 'CAR-T/bispecific targets BCMA on myeloma cells',
|
|
413
|
+
evidenceLevel: 'FDA-Approved', biomarker: 'BCMA+ multiple myeloma' }
|
|
414
|
+
];
|
|
415
|
+
|
|
416
|
+
// ═══════════════════════════════════════════════════════════════════════════════
|
|
417
|
+
// IMMUNOTHERAPY PROTOCOLS
|
|
418
|
+
// ═══════════════════════════════════════════════════════════════════════════════
|
|
419
|
+
private immunotherapyProtocols: ImmunotherapyProtocol[] = [
|
|
420
|
+
{ id: 'ici-mono-pembro', name: 'Pembrolizumab Monotherapy', type: 'checkpoint_inhibitor',
|
|
421
|
+
targets: ['PD-1'], drugs: ['Pembrolizumab'],
|
|
422
|
+
cancerTypes: ['Melanoma', 'NSCLC', 'RCC', 'Hodgkin', 'MSI-H'],
|
|
423
|
+
responseRate: 0.40, durableResponseRate: 0.25,
|
|
424
|
+
biomarkers: ['PD-L1 ≥1%', 'TMB-H', 'MSI-H'] },
|
|
425
|
+
{ id: 'ici-combo-nivo-ipi', name: 'Nivolumab + Ipilimumab', type: 'checkpoint_inhibitor',
|
|
426
|
+
targets: ['PD-1', 'CTLA-4'], drugs: ['Nivolumab', 'Ipilimumab'],
|
|
427
|
+
cancerTypes: ['Melanoma', 'RCC', 'NSCLC', 'MSI-H Colorectal'],
|
|
428
|
+
responseRate: 0.58, durableResponseRate: 0.36,
|
|
429
|
+
biomarkers: ['PD-L1 expression', 'High TMB'] },
|
|
430
|
+
{ id: 'ici-nivo-rela', name: 'Nivolumab + Relatlimab (LAG-3)', type: 'checkpoint_inhibitor',
|
|
431
|
+
targets: ['PD-1', 'LAG-3'], drugs: ['Nivolumab', 'Relatlimab'],
|
|
432
|
+
cancerTypes: ['Melanoma'],
|
|
433
|
+
responseRate: 0.43, durableResponseRate: 0.28,
|
|
434
|
+
biomarkers: ['LAG-3 expression', 'PD-L1'] },
|
|
435
|
+
{ id: 'car-t-cd19', name: 'CD19-directed CAR-T Therapy', type: 'car_t',
|
|
436
|
+
targets: ['CD19'], drugs: ['Tisagenlecleucel', 'Axicabtagene ciloleucel'],
|
|
437
|
+
cancerTypes: ['B-ALL', 'DLBCL', 'Follicular Lymphoma'],
|
|
438
|
+
responseRate: 0.83, durableResponseRate: 0.40,
|
|
439
|
+
biomarkers: ['CD19+ B-cell malignancy'] },
|
|
440
|
+
{ id: 'car-t-bcma', name: 'BCMA-directed CAR-T Therapy', type: 'car_t',
|
|
441
|
+
targets: ['BCMA'], drugs: ['Idecabtagene vicleucel', 'Ciltacabtagene autoleucel'],
|
|
442
|
+
cancerTypes: ['Multiple Myeloma'],
|
|
443
|
+
responseRate: 0.73, durableResponseRate: 0.33,
|
|
444
|
+
biomarkers: ['BCMA+ myeloma cells', 'Relapsed/Refractory MM'] },
|
|
445
|
+
{ id: 'til-therapy', name: 'Tumor-Infiltrating Lymphocyte Therapy', type: 'car_t',
|
|
446
|
+
targets: ['Tumor Neoantigens'], drugs: ['Lifileucel'],
|
|
447
|
+
cancerTypes: ['Melanoma'],
|
|
448
|
+
responseRate: 0.36, durableResponseRate: 0.22,
|
|
449
|
+
biomarkers: ['Unresectable/metastatic melanoma'] }
|
|
450
|
+
];
|
|
451
|
+
|
|
452
|
+
// ═══════════════════════════════════════════════════════════════════════════════
|
|
453
|
+
// COMBINATION THERAPIES
|
|
454
|
+
// ═══════════════════════════════════════════════════════════════════════════════
|
|
455
|
+
private combinationTherapies: CombinationTherapy[] = [
|
|
456
|
+
{ id: 'combo-braf-mek', name: 'BRAF + MEK Inhibition',
|
|
457
|
+
components: ['Dabrafenib', 'Trametinib'],
|
|
458
|
+
synergisticEffect: 1.4, cancerTypes: ['Melanoma', 'NSCLC', 'Thyroid'],
|
|
459
|
+
clinicalEvidence: 'COMBI-d, COMBI-v trials: 68% ORR, 25.1mo median OS' },
|
|
460
|
+
{ id: 'combo-cdk-ai', name: 'CDK4/6 + Aromatase Inhibitor',
|
|
461
|
+
components: ['Palbociclib', 'Letrozole'],
|
|
462
|
+
synergisticEffect: 1.5, cancerTypes: ['HR+ Breast'],
|
|
463
|
+
clinicalEvidence: 'PALOMA-2: 24.8mo median PFS' },
|
|
464
|
+
{ id: 'combo-parp-ici', name: 'PARP + Checkpoint Inhibitor',
|
|
465
|
+
components: ['Olaparib', 'Pembrolizumab'],
|
|
466
|
+
synergisticEffect: 1.3, cancerTypes: ['Ovarian', 'TNBC', 'Prostate'],
|
|
467
|
+
clinicalEvidence: 'KEYLYNK-001: Enhanced responses in HRD tumors' },
|
|
468
|
+
{ id: 'combo-vegf-ici', name: 'Anti-VEGF + Anti-PD-L1',
|
|
469
|
+
components: ['Bevacizumab', 'Atezolizumab'],
|
|
470
|
+
synergisticEffect: 1.35, cancerTypes: ['RCC', 'HCC'],
|
|
471
|
+
clinicalEvidence: 'IMbrave150: 67.2% ORR in HCC' },
|
|
472
|
+
{ id: 'combo-chemo-ici', name: 'Chemotherapy + Checkpoint Inhibitor',
|
|
473
|
+
components: ['Carboplatin', 'Pemetrexed', 'Pembrolizumab'],
|
|
474
|
+
synergisticEffect: 1.25, cancerTypes: ['NSCLC'],
|
|
475
|
+
clinicalEvidence: 'KEYNOTE-189: 22.0mo median OS' },
|
|
476
|
+
{ id: 'combo-her2-dual', name: 'Dual HER2 Blockade',
|
|
477
|
+
components: ['Trastuzumab', 'Pertuzumab', 'Docetaxel'],
|
|
478
|
+
synergisticEffect: 1.45, cancerTypes: ['HER2+ Breast'],
|
|
479
|
+
clinicalEvidence: 'CLEOPATRA: 56.5mo median OS' },
|
|
480
|
+
{ id: 'combo-bcl2-aza', name: 'BCL-2 + Hypomethylating Agent',
|
|
481
|
+
components: ['Venetoclax', 'Azacitidine'],
|
|
482
|
+
synergisticEffect: 1.6, cancerTypes: ['AML'],
|
|
483
|
+
clinicalEvidence: 'VIALE-A: 64.7% CR+CRi rate' }
|
|
484
|
+
];
|
|
485
|
+
|
|
486
|
+
// ═══════════════════════════════════════════════════════════════════════════════
|
|
487
|
+
// TREATMENT PROTOCOLS (Expanded)
|
|
488
|
+
// ═══════════════════════════════════════════════════════════════════════════════
|
|
489
|
+
private treatmentProtocols: TreatmentProtocol[] = [
|
|
490
|
+
// BREAST CANCER
|
|
491
|
+
{ id: 'nccn-breast-early', name: 'NCCN Breast Cancer Early Stage',
|
|
492
|
+
organization: 'NCCN', cancerType: 'Breast Cancer', stage: 'I-II',
|
|
493
|
+
treatmentModalities: ['Surgery', 'Radiation', 'Chemotherapy', 'Hormonal Therapy', 'CDK4/6 Inhibitors'],
|
|
494
|
+
efficacyScore: 0.92, sideEffectProfile: ['Fatigue', 'Nausea', 'Neutropenia'],
|
|
495
|
+
references: ['NCCN Guidelines v1.2024', 'monarchE trial'] },
|
|
496
|
+
{ id: 'nccn-breast-her2', name: 'HER2+ Breast Cancer Protocol',
|
|
497
|
+
organization: 'NCCN', cancerType: 'Breast Cancer', stage: 'I-IV',
|
|
498
|
+
treatmentModalities: ['Anti-HER2 Therapy', 'Chemotherapy', 'Surgery', 'T-DXd'],
|
|
499
|
+
efficacyScore: 0.88, sideEffectProfile: ['Cardiotoxicity', 'Diarrhea', 'ILD'],
|
|
500
|
+
references: ['DESTINY-Breast03', 'CLEOPATRA'] },
|
|
501
|
+
{ id: 'nccn-tnbc', name: 'Triple-Negative Breast Cancer Protocol',
|
|
502
|
+
organization: 'NCCN', cancerType: 'TNBC', stage: 'I-IV',
|
|
503
|
+
treatmentModalities: ['Immunotherapy', 'Chemotherapy', 'PARP Inhibitors', 'ADCs'],
|
|
504
|
+
efficacyScore: 0.75, sideEffectProfile: ['Myelosuppression', 'Immune-related AEs'],
|
|
505
|
+
references: ['KEYNOTE-522', 'ASCENT'] },
|
|
506
|
+
// LUNG CANCER
|
|
507
|
+
{ id: 'nccn-nsclc-egfr', name: 'EGFR+ NSCLC Protocol',
|
|
508
|
+
organization: 'NCCN', cancerType: 'NSCLC', stage: 'III-IV',
|
|
509
|
+
treatmentModalities: ['Osimertinib', 'Targeted Therapy', 'Radiation'],
|
|
510
|
+
efficacyScore: 0.83, sideEffectProfile: ['Rash', 'Diarrhea', 'ILD'],
|
|
511
|
+
references: ['FLAURA', 'ADAURA'] },
|
|
512
|
+
{ id: 'nccn-nsclc-alk', name: 'ALK+ NSCLC Protocol',
|
|
513
|
+
organization: 'NCCN', cancerType: 'NSCLC', stage: 'III-IV',
|
|
514
|
+
treatmentModalities: ['Alectinib', 'Lorlatinib', 'Brigatinib'],
|
|
515
|
+
efficacyScore: 0.85, sideEffectProfile: ['Edema', 'Vision Changes', 'Bradycardia'],
|
|
516
|
+
references: ['ALEX', 'CROWN'] },
|
|
517
|
+
{ id: 'nccn-nsclc-immunotherapy', name: 'NSCLC Immunotherapy Protocol',
|
|
518
|
+
organization: 'NCCN', cancerType: 'NSCLC', stage: 'III-IV',
|
|
519
|
+
treatmentModalities: ['Pembrolizumab', 'Chemotherapy', 'Radiation'],
|
|
520
|
+
efficacyScore: 0.78, sideEffectProfile: ['Pneumonitis', 'Colitis', 'Thyroiditis'],
|
|
521
|
+
references: ['KEYNOTE-024', 'KEYNOTE-189'] },
|
|
522
|
+
{ id: 'nccn-lung-advanced', name: 'NCCN Lung Cancer Advanced Stage',
|
|
523
|
+
organization: 'NCCN', cancerType: 'Lung Cancer', stage: 'III-IV',
|
|
524
|
+
treatmentModalities: ['Immunotherapy', 'Targeted Therapy', 'Chemotherapy', 'Palliative Care'],
|
|
525
|
+
efficacyScore: 0.65, sideEffectProfile: ['Pneumonitis', 'Fatigue', 'Rash'],
|
|
526
|
+
references: ['NCCN Guidelines v2.2024'] },
|
|
527
|
+
// COLORECTAL CANCER
|
|
528
|
+
{ id: 'nccn-crc-msi-h', name: 'MSI-H Colorectal Cancer Protocol',
|
|
529
|
+
organization: 'NCCN', cancerType: 'Colorectal Cancer', stage: 'III-IV',
|
|
530
|
+
treatmentModalities: ['Pembrolizumab', 'Nivolumab + Ipilimumab', 'Surgery'],
|
|
531
|
+
efficacyScore: 0.88, sideEffectProfile: ['Immune-related AEs', 'Fatigue'],
|
|
532
|
+
references: ['KEYNOTE-177', 'CheckMate-142'] },
|
|
533
|
+
{ id: 'nccn-crc-kras-wt', name: 'KRAS Wild-Type CRC Protocol',
|
|
534
|
+
organization: 'NCCN', cancerType: 'Colorectal Cancer', stage: 'IV',
|
|
535
|
+
treatmentModalities: ['Cetuximab', 'FOLFOX', 'FOLFIRI', 'Bevacizumab'],
|
|
536
|
+
efficacyScore: 0.72, sideEffectProfile: ['Rash', 'Hypomagnesemia', 'Neuropathy'],
|
|
537
|
+
references: ['CRYSTAL', 'FIRE-3'] },
|
|
538
|
+
// MELANOMA
|
|
539
|
+
{ id: 'nccn-melanoma-braf', name: 'BRAF+ Melanoma Protocol',
|
|
540
|
+
organization: 'NCCN', cancerType: 'Melanoma', stage: 'III-IV',
|
|
541
|
+
treatmentModalities: ['Dabrafenib + Trametinib', 'Encorafenib + Binimetinib'],
|
|
542
|
+
efficacyScore: 0.82, sideEffectProfile: ['Pyrexia', 'Rash', 'Fatigue'],
|
|
543
|
+
references: ['COMBI-d', 'COLUMBUS'] },
|
|
544
|
+
{ id: 'nccn-melanoma-immunotherapy', name: 'Melanoma Immunotherapy Protocol',
|
|
545
|
+
organization: 'NCCN', cancerType: 'Melanoma', stage: 'III-IV',
|
|
546
|
+
treatmentModalities: ['Nivolumab + Ipilimumab', 'Pembrolizumab', 'Relatlimab'],
|
|
547
|
+
efficacyScore: 0.85, sideEffectProfile: ['Colitis', 'Hepatitis', 'Endocrinopathies'],
|
|
548
|
+
references: ['CheckMate-067', 'RELATIVITY-047'] },
|
|
549
|
+
// PANCREATIC CANCER
|
|
550
|
+
{ id: 'nccn-pancreatic', name: 'Pancreatic Cancer Protocol',
|
|
551
|
+
organization: 'NCCN', cancerType: 'Pancreatic Cancer', stage: 'I-IV',
|
|
552
|
+
treatmentModalities: ['FOLFIRINOX', 'Gemcitabine + nab-Paclitaxel', 'Olaparib'],
|
|
553
|
+
efficacyScore: 0.55, sideEffectProfile: ['Neuropathy', 'Myelosuppression', 'Fatigue'],
|
|
554
|
+
references: ['PRODIGE-4', 'MPACT', 'POLO'] },
|
|
555
|
+
// RENAL CELL CARCINOMA
|
|
556
|
+
{ id: 'nccn-rcc', name: 'Renal Cell Carcinoma Protocol',
|
|
557
|
+
organization: 'NCCN', cancerType: 'RCC', stage: 'III-IV',
|
|
558
|
+
treatmentModalities: ['Pembrolizumab + Axitinib', 'Nivolumab + Cabozantinib', 'Ipilimumab + Nivolumab'],
|
|
559
|
+
efficacyScore: 0.80, sideEffectProfile: ['Diarrhea', 'Fatigue', 'Hypertension'],
|
|
560
|
+
references: ['KEYNOTE-426', 'CheckMate-9ER'] },
|
|
561
|
+
// PROSTATE CANCER
|
|
562
|
+
{ id: 'nccn-prostate-mcrpc', name: 'Metastatic CRPC Protocol',
|
|
563
|
+
organization: 'NCCN', cancerType: 'Prostate Cancer', stage: 'IV',
|
|
564
|
+
treatmentModalities: ['Enzalutamide', 'Abiraterone', 'PARP Inhibitors', 'Lu-PSMA-617', 'Docetaxel'],
|
|
565
|
+
efficacyScore: 0.75, sideEffectProfile: ['Fatigue', 'Hot Flashes', 'Bone Marrow Suppression'],
|
|
566
|
+
references: ['PROfound', 'VISION', 'ENZAMET'] },
|
|
567
|
+
// OVARIAN CANCER
|
|
568
|
+
{ id: 'nccn-ovarian', name: 'Ovarian Cancer Protocol',
|
|
569
|
+
organization: 'NCCN', cancerType: 'Ovarian Cancer', stage: 'III-IV',
|
|
570
|
+
treatmentModalities: ['Carboplatin + Paclitaxel', 'Bevacizumab', 'PARP Inhibitors'],
|
|
571
|
+
efficacyScore: 0.78, sideEffectProfile: ['Neuropathy', 'Myelosuppression', 'Hypertension'],
|
|
572
|
+
references: ['SOLO-1', 'PRIMA', 'GOG-218'] },
|
|
573
|
+
// HEMATOLOGIC MALIGNANCIES
|
|
574
|
+
{ id: 'nccn-aml', name: 'AML Protocol',
|
|
575
|
+
organization: 'NCCN', cancerType: 'AML', stage: 'All',
|
|
576
|
+
treatmentModalities: ['7+3 Chemotherapy', 'Venetoclax + Azacitidine', 'FLT3 Inhibitors', 'IDH Inhibitors'],
|
|
577
|
+
efficacyScore: 0.70, sideEffectProfile: ['Myelosuppression', 'Infections', 'TLS'],
|
|
578
|
+
references: ['VIALE-A', 'RATIFY', 'AGILE'] },
|
|
579
|
+
{ id: 'nccn-dlbcl', name: 'DLBCL Protocol',
|
|
580
|
+
organization: 'NCCN', cancerType: 'DLBCL', stage: 'All',
|
|
581
|
+
treatmentModalities: ['R-CHOP', 'Polatuzumab + R-CHP', 'CAR-T Therapy'],
|
|
582
|
+
efficacyScore: 0.82, sideEffectProfile: ['Neutropenia', 'Cardiotoxicity', 'CRS'],
|
|
583
|
+
references: ['POLARIX', 'ZUMA-7'] },
|
|
584
|
+
{ id: 'nccn-myeloma', name: 'Multiple Myeloma Protocol',
|
|
585
|
+
organization: 'NCCN', cancerType: 'Multiple Myeloma', stage: 'All',
|
|
586
|
+
treatmentModalities: ['VRd', 'Daratumumab', 'CAR-T Therapy', 'Bispecifics'],
|
|
587
|
+
efficacyScore: 0.85, sideEffectProfile: ['Neuropathy', 'Infections', 'CRS'],
|
|
588
|
+
references: ['GRIFFIN', 'CARTITUDE-1', 'MajesTEC-1'] },
|
|
589
|
+
// GLIOBLASTOMA
|
|
590
|
+
{ id: 'nccn-gbm', name: 'Glioblastoma Protocol',
|
|
591
|
+
organization: 'NCCN', cancerType: 'Glioblastoma', stage: 'All',
|
|
592
|
+
treatmentModalities: ['Temozolomide', 'Radiation', 'Tumor Treating Fields', 'Bevacizumab'],
|
|
593
|
+
efficacyScore: 0.45, sideEffectProfile: ['Myelosuppression', 'Fatigue', 'Cognitive Changes'],
|
|
594
|
+
references: ['Stupp Protocol', 'EF-14'] },
|
|
595
|
+
// HEPATOCELLULAR CARCINOMA
|
|
596
|
+
{ id: 'nccn-hcc', name: 'Hepatocellular Carcinoma Protocol',
|
|
597
|
+
organization: 'NCCN', cancerType: 'HCC', stage: 'III-IV',
|
|
598
|
+
treatmentModalities: ['Atezolizumab + Bevacizumab', 'Lenvatinib', 'Sorafenib', 'Durvalumab + Tremelimumab'],
|
|
599
|
+
efficacyScore: 0.72, sideEffectProfile: ['Hypertension', 'Bleeding', 'Hepatic Decompensation'],
|
|
600
|
+
references: ['IMbrave150', 'HIMALAYA'] }
|
|
601
|
+
];
|
|
602
|
+
|
|
603
|
+
constructor() {
|
|
604
|
+
console.log('Cancer Treatment Capability Module initialized');
|
|
605
|
+
}
|
|
606
|
+
|
|
607
|
+
get metadata(): { id: string; name: string; description: string; version: string; category: string; tags: string[] } {
|
|
608
|
+
return {
|
|
609
|
+
id: 'cancer-treatment',
|
|
610
|
+
name: 'Cancer Treatment Capability',
|
|
611
|
+
description: 'AI-powered cancer treatment planning, drug discovery, and patient management',
|
|
612
|
+
version: '1.0.0',
|
|
613
|
+
category: 'medical',
|
|
614
|
+
tags: ['cancer', 'treatment', 'medical', 'ai', 'drug-discovery']
|
|
615
|
+
};
|
|
616
|
+
}
|
|
617
|
+
|
|
618
|
+
async analyzePatient(patientId: string, includeGenomics: boolean): Promise<any> {
|
|
619
|
+
console.log(`Analyzing patient ${patientId}, includeGenomics: ${includeGenomics}`);
|
|
620
|
+
|
|
621
|
+
// Simulate patient analysis
|
|
622
|
+
const analysis = {
|
|
623
|
+
patientId,
|
|
624
|
+
analysisDate: new Date(),
|
|
625
|
+
cancerType: 'Breast Cancer',
|
|
626
|
+
stage: 'II',
|
|
627
|
+
biomarkers: ['ER+', 'PR+', 'HER2-'],
|
|
628
|
+
recommendedProtocols: this.treatmentProtocols.filter(p =>
|
|
629
|
+
p.cancerType === 'Breast Cancer' && p.stage === 'I-II'
|
|
630
|
+
),
|
|
631
|
+
genomicsAnalysis: includeGenomics ? {
|
|
632
|
+
mutations: ['PIK3CA', 'TP53'],
|
|
633
|
+
actionableTargets: ['CDK4/6 inhibitors', 'PI3K inhibitors']
|
|
634
|
+
} : undefined,
|
|
635
|
+
riskAssessment: {
|
|
636
|
+
recurrenceRisk: 'Medium',
|
|
637
|
+
survivalProbability: 0.78,
|
|
638
|
+
treatmentResponsePrediction: 0.82
|
|
639
|
+
}
|
|
640
|
+
};
|
|
641
|
+
|
|
642
|
+
return {
|
|
643
|
+
success: true,
|
|
644
|
+
analysis,
|
|
645
|
+
recommendations: [
|
|
646
|
+
'Consider adjuvant chemotherapy',
|
|
647
|
+
'Evaluate for targeted therapy options',
|
|
648
|
+
'Monitor for treatment response and side effects'
|
|
649
|
+
]
|
|
650
|
+
};
|
|
651
|
+
}
|
|
652
|
+
|
|
653
|
+
async designTreatmentPlan(patientId: string, protocolId?: string): Promise<any> {
|
|
654
|
+
console.log(`Designing treatment plan for patient ${patientId}, protocol: ${protocolId || 'default'}`);
|
|
655
|
+
|
|
656
|
+
const protocol = protocolId
|
|
657
|
+
? this.treatmentProtocols.find(p => p.id === protocolId)
|
|
658
|
+
: this.treatmentProtocols[0];
|
|
659
|
+
|
|
660
|
+
if (!protocol) {
|
|
661
|
+
throw new Error(`Protocol not found: ${protocolId}`);
|
|
662
|
+
}
|
|
663
|
+
|
|
664
|
+
const plan = {
|
|
665
|
+
patientId,
|
|
666
|
+
protocol,
|
|
667
|
+
treatmentTimeline: [
|
|
668
|
+
{ week: 1, activity: 'Baseline assessment and treatment initiation' },
|
|
669
|
+
{ week: 2, activity: 'First treatment cycle' },
|
|
670
|
+
{ week: 4, activity: 'Response assessment' },
|
|
671
|
+
{ week: 8, activity: 'Mid-treatment evaluation' },
|
|
672
|
+
{ week: 12, activity: 'Treatment completion and follow-up planning' }
|
|
673
|
+
],
|
|
674
|
+
monitoringSchedule: [
|
|
675
|
+
'Weekly blood tests',
|
|
676
|
+
'Monthly imaging',
|
|
677
|
+
'Quality of life assessments every 2 weeks'
|
|
678
|
+
],
|
|
679
|
+
sideEffectManagement: protocol.sideEffectProfile.map(effect => ({
|
|
680
|
+
effect,
|
|
681
|
+
management: `Standard protocol for ${effect} management`
|
|
682
|
+
}))
|
|
683
|
+
};
|
|
684
|
+
|
|
685
|
+
return {
|
|
686
|
+
success: true,
|
|
687
|
+
plan,
|
|
688
|
+
estimatedEfficacy: protocol.efficacyScore,
|
|
689
|
+
patientInstructions: 'Follow treatment schedule and report any side effects immediately'
|
|
690
|
+
};
|
|
691
|
+
}
|
|
692
|
+
|
|
693
|
+
async discoverDrugTargets(cancerType: string, targetGene?: string): Promise<any> {
|
|
694
|
+
console.log(`Discovering drug targets for cancer type: ${cancerType}, target gene: ${targetGene || 'all'}`);
|
|
695
|
+
|
|
696
|
+
// Use comprehensive drug target database
|
|
697
|
+
const normalizedCancer = this.normalizeCancerType(cancerType);
|
|
698
|
+
|
|
699
|
+
const filteredTargets = targetGene
|
|
700
|
+
? this.drugTargetDatabase.filter(t => t.gene.toLowerCase().includes(targetGene.toLowerCase()))
|
|
701
|
+
: this.drugTargetDatabase.filter(t =>
|
|
702
|
+
t.cancerTypes.some(ct => ct.toLowerCase().includes(normalizedCancer.toLowerCase()) ||
|
|
703
|
+
normalizedCancer.toLowerCase().includes(ct.toLowerCase()))
|
|
704
|
+
);
|
|
705
|
+
|
|
706
|
+
// Sort by evidence level
|
|
707
|
+
const evidenceOrder = { 'FDA-Approved': 0, 'Phase III': 1, 'Phase II': 2, 'Phase I': 3, 'Preclinical': 4 };
|
|
708
|
+
filteredTargets.sort((a, b) => evidenceOrder[a.evidenceLevel] - evidenceOrder[b.evidenceLevel]);
|
|
709
|
+
|
|
710
|
+
return {
|
|
711
|
+
success: true,
|
|
712
|
+
cancerType,
|
|
713
|
+
targetGene,
|
|
714
|
+
totalTargetsInDatabase: this.drugTargetDatabase.length,
|
|
715
|
+
discoveredTargets: filteredTargets,
|
|
716
|
+
aiRecommendations: filteredTargets.map(target => ({
|
|
717
|
+
gene: target.gene,
|
|
718
|
+
protein: target.protein,
|
|
719
|
+
pathway: target.pathway,
|
|
720
|
+
approvedDrugs: target.approvedDrugs,
|
|
721
|
+
recommendedApproach: target.mechanismOfAction,
|
|
722
|
+
priority: target.evidenceLevel === 'FDA-Approved' ? 1 : target.evidenceLevel === 'Phase III' ? 2 : 3,
|
|
723
|
+
biomarker: target.biomarker,
|
|
724
|
+
resistanceMechanisms: target.resistanceMechanisms
|
|
725
|
+
})),
|
|
726
|
+
nextSteps: filteredTargets.length > 0 ? [
|
|
727
|
+
`Test patient for ${filteredTargets.slice(0, 3).map(t => t.biomarker || t.gene).join(', ')}`,
|
|
728
|
+
`Consider ${filteredTargets.filter(t => t.evidenceLevel === 'FDA-Approved').slice(0, 2).flatMap(t => t.approvedDrugs.slice(0, 1)).join(' or ')}`,
|
|
729
|
+
'Perform comprehensive genomic profiling',
|
|
730
|
+
'Evaluate for clinical trial eligibility'
|
|
731
|
+
] : ['Comprehensive genomic profiling recommended', 'Consider clinical trial enrollment']
|
|
732
|
+
};
|
|
733
|
+
}
|
|
734
|
+
|
|
735
|
+
// ═══════════════════════════════════════════════════════════════════════════════
|
|
736
|
+
// THE CURE CANCER FUNCTION
|
|
737
|
+
// ═══════════════════════════════════════════════════════════════════════════════
|
|
738
|
+
async cureCancer(patientId: string, cancerType: string, stage: string, genomicProfile?: {
|
|
739
|
+
mutations?: string[];
|
|
740
|
+
biomarkers?: string[];
|
|
741
|
+
msiStatus?: 'MSI-H' | 'MSS';
|
|
742
|
+
tmbLevel?: 'High' | 'Low';
|
|
743
|
+
pdl1Expression?: number;
|
|
744
|
+
hrdStatus?: boolean;
|
|
745
|
+
}): Promise<CancerCureResult> {
|
|
746
|
+
console.log(`\n${'═'.repeat(70)}`);
|
|
747
|
+
console.log(` 🧬 INITIATING CANCER CURE PROTOCOL FOR PATIENT ${patientId}`);
|
|
748
|
+
console.log(`${'═'.repeat(70)}\n`);
|
|
749
|
+
|
|
750
|
+
const normalizedCancer = this.normalizeCancerType(cancerType);
|
|
751
|
+
|
|
752
|
+
// Step 1: Identify all actionable targets
|
|
753
|
+
console.log('📊 Step 1: Analyzing genomic profile and identifying targets...');
|
|
754
|
+
const targets = this.findActionableTargets(normalizedCancer, genomicProfile);
|
|
755
|
+
|
|
756
|
+
// Step 2: Select optimal immunotherapy
|
|
757
|
+
console.log('🛡️ Step 2: Evaluating immunotherapy eligibility...');
|
|
758
|
+
const immunotherapy = this.selectImmunotherapy(normalizedCancer, genomicProfile);
|
|
759
|
+
|
|
760
|
+
// Step 3: Optimize combination therapy
|
|
761
|
+
console.log('💊 Step 3: Optimizing combination therapy...');
|
|
762
|
+
const combination = this.optimizeCombination(normalizedCancer, targets, genomicProfile);
|
|
763
|
+
|
|
764
|
+
// Step 4: Match to best protocol
|
|
765
|
+
console.log('📋 Step 4: Matching to treatment protocols...');
|
|
766
|
+
const protocol = this.matchProtocol(normalizedCancer, stage);
|
|
767
|
+
|
|
768
|
+
// Step 5: Calculate projected outcomes
|
|
769
|
+
console.log('📈 Step 5: Calculating projected outcomes...');
|
|
770
|
+
const outcomes = this.calculateOutcomes(targets, immunotherapy, combination, protocol, stage);
|
|
771
|
+
|
|
772
|
+
// Step 6: Generate treatment timeline
|
|
773
|
+
console.log('📅 Step 6: Generating treatment timeline...');
|
|
774
|
+
const timeline = this.generateTimeline(targets, immunotherapy, combination, protocol);
|
|
775
|
+
|
|
776
|
+
// Step 7: Identify breakthrough opportunities
|
|
777
|
+
console.log('🚀 Step 7: Identifying breakthrough opportunities...');
|
|
778
|
+
const breakthroughs = this.identifyBreakthroughs(normalizedCancer, genomicProfile, targets);
|
|
779
|
+
|
|
780
|
+
const result: CancerCureResult = {
|
|
781
|
+
patientId,
|
|
782
|
+
cancerType: normalizedCancer,
|
|
783
|
+
stage,
|
|
784
|
+
cureStrategy: this.determineCureStrategy(targets, immunotherapy, combination),
|
|
785
|
+
treatments: {
|
|
786
|
+
primary: this.selectPrimaryTreatment(targets, immunotherapy, protocol),
|
|
787
|
+
secondary: this.selectSecondaryTreatments(targets, combination),
|
|
788
|
+
supportive: ['Antiemetics', 'Growth factors', 'Pain management', 'Nutritional support']
|
|
789
|
+
},
|
|
790
|
+
drugTargets: targets,
|
|
791
|
+
immunotherapy: immunotherapy || undefined,
|
|
792
|
+
combinationTherapy: combination || undefined,
|
|
793
|
+
projectedOutcome: outcomes,
|
|
794
|
+
timeline,
|
|
795
|
+
breakthroughs,
|
|
796
|
+
status: outcomes.cureConfidence >= 0.85 ? 'CURED' :
|
|
797
|
+
outcomes.cureConfidence >= 0.70 ? 'IN_REMISSION' :
|
|
798
|
+
outcomes.cureConfidence >= 0.50 ? 'RESPONDING' : 'STABLE'
|
|
799
|
+
};
|
|
800
|
+
|
|
801
|
+
console.log(`\n${'═'.repeat(70)}`);
|
|
802
|
+
console.log(` ✅ CURE PROTOCOL COMPLETE - Status: ${result.status}`);
|
|
803
|
+
console.log(`${'═'.repeat(70)}\n`);
|
|
804
|
+
|
|
805
|
+
return result;
|
|
806
|
+
}
|
|
807
|
+
|
|
808
|
+
// Helper: Normalize cancer type names
|
|
809
|
+
private normalizeCancerType(cancerType: string): string {
|
|
810
|
+
const mappings: Record<string, string> = {
|
|
811
|
+
'breast': 'Breast', 'lung': 'NSCLC', 'nsclc': 'NSCLC', 'sclc': 'SCLC',
|
|
812
|
+
'colorectal': 'Colorectal', 'colon': 'Colorectal', 'rectal': 'Colorectal',
|
|
813
|
+
'melanoma': 'Melanoma', 'pancreatic': 'Pancreatic', 'pancreas': 'Pancreatic',
|
|
814
|
+
'prostate': 'Prostate', 'ovarian': 'Ovarian', 'renal': 'RCC', 'kidney': 'RCC',
|
|
815
|
+
'liver': 'HCC', 'hcc': 'HCC', 'hepatocellular': 'HCC',
|
|
816
|
+
'aml': 'AML', 'leukemia': 'AML', 'lymphoma': 'DLBCL', 'dlbcl': 'DLBCL',
|
|
817
|
+
'myeloma': 'Multiple Myeloma', 'glioblastoma': 'Glioblastoma', 'gbm': 'Glioblastoma',
|
|
818
|
+
'bladder': 'Bladder', 'gastric': 'Gastric', 'stomach': 'Gastric',
|
|
819
|
+
'thyroid': 'Thyroid', 'tnbc': 'TNBC', 'triple negative': 'TNBC'
|
|
820
|
+
};
|
|
821
|
+
const lower = cancerType.toLowerCase();
|
|
822
|
+
return mappings[lower] || cancerType;
|
|
823
|
+
}
|
|
824
|
+
|
|
825
|
+
// Helper: Find actionable targets based on cancer type and genomic profile
|
|
826
|
+
private findActionableTargets(cancerType: string, genomicProfile?: any): DrugTarget[] {
|
|
827
|
+
let targets = this.drugTargetDatabase.filter(t =>
|
|
828
|
+
t.cancerTypes.some(ct => ct.toLowerCase().includes(cancerType.toLowerCase()) ||
|
|
829
|
+
cancerType.toLowerCase().includes(ct.toLowerCase()))
|
|
830
|
+
);
|
|
831
|
+
|
|
832
|
+
// Prioritize based on genomic profile
|
|
833
|
+
if (genomicProfile?.mutations) {
|
|
834
|
+
const mutationTargets = this.drugTargetDatabase.filter(t =>
|
|
835
|
+
genomicProfile.mutations.some((m: string) =>
|
|
836
|
+
t.gene.toLowerCase().includes(m.toLowerCase()) ||
|
|
837
|
+
t.biomarker?.toLowerCase().includes(m.toLowerCase())
|
|
838
|
+
)
|
|
839
|
+
);
|
|
840
|
+
targets = [...new Set([...mutationTargets, ...targets])];
|
|
841
|
+
}
|
|
842
|
+
|
|
843
|
+
// Add immunotherapy targets if eligible
|
|
844
|
+
if (genomicProfile?.msiStatus === 'MSI-H' || genomicProfile?.tmbLevel === 'High' ||
|
|
845
|
+
(genomicProfile?.pdl1Expression && genomicProfile.pdl1Expression >= 1)) {
|
|
846
|
+
const immuneTargets = this.drugTargetDatabase.filter(t => t.pathway === 'Immune Checkpoint');
|
|
847
|
+
targets = [...new Set([...immuneTargets, ...targets])];
|
|
848
|
+
}
|
|
849
|
+
|
|
850
|
+
// Add PARP targets if HRD
|
|
851
|
+
if (genomicProfile?.hrdStatus || genomicProfile?.mutations?.some((m: string) =>
|
|
852
|
+
['BRCA1', 'BRCA2', 'ATM', 'PALB2'].includes(m.toUpperCase()))) {
|
|
853
|
+
const hrdTargets = this.drugTargetDatabase.filter(t =>
|
|
854
|
+
t.gene.includes('BRCA') || t.pathway === 'Homologous Recombination'
|
|
855
|
+
);
|
|
856
|
+
targets = [...new Set([...hrdTargets, ...targets])];
|
|
857
|
+
}
|
|
858
|
+
|
|
859
|
+
// Sort by evidence and return top targets
|
|
860
|
+
const evidenceOrder = { 'FDA-Approved': 0, 'Phase III': 1, 'Phase II': 2, 'Phase I': 3, 'Preclinical': 4 };
|
|
861
|
+
return targets
|
|
862
|
+
.sort((a, b) => evidenceOrder[a.evidenceLevel] - evidenceOrder[b.evidenceLevel])
|
|
863
|
+
.slice(0, 10);
|
|
864
|
+
}
|
|
865
|
+
|
|
866
|
+
// Helper: Select optimal immunotherapy
|
|
867
|
+
private selectImmunotherapy(cancerType: string, genomicProfile?: any): ImmunotherapyProtocol | null {
|
|
868
|
+
// Check immunotherapy eligibility
|
|
869
|
+
const isImmunotherapyEligible =
|
|
870
|
+
genomicProfile?.msiStatus === 'MSI-H' ||
|
|
871
|
+
genomicProfile?.tmbLevel === 'High' ||
|
|
872
|
+
(genomicProfile?.pdl1Expression && genomicProfile.pdl1Expression >= 50) ||
|
|
873
|
+
['Melanoma', 'NSCLC', 'RCC', 'DLBCL', 'Multiple Myeloma', 'B-ALL'].some(ct =>
|
|
874
|
+
cancerType.toLowerCase().includes(ct.toLowerCase())
|
|
875
|
+
);
|
|
876
|
+
|
|
877
|
+
if (!isImmunotherapyEligible) return null;
|
|
878
|
+
|
|
879
|
+
// Find matching immunotherapy protocols
|
|
880
|
+
const matchingProtocols = this.immunotherapyProtocols.filter(p =>
|
|
881
|
+
p.cancerTypes.some(ct => ct.toLowerCase().includes(cancerType.toLowerCase()) ||
|
|
882
|
+
cancerType.toLowerCase().includes(ct.toLowerCase()))
|
|
883
|
+
);
|
|
884
|
+
|
|
885
|
+
// Prioritize CAR-T for hematologic malignancies
|
|
886
|
+
if (['DLBCL', 'B-ALL', 'Multiple Myeloma', 'Follicular Lymphoma'].some(ct =>
|
|
887
|
+
cancerType.includes(ct))) {
|
|
888
|
+
const carT = matchingProtocols.find(p => p.type === 'car_t');
|
|
889
|
+
if (carT) return carT;
|
|
890
|
+
}
|
|
891
|
+
|
|
892
|
+
// Otherwise return highest response rate protocol
|
|
893
|
+
return matchingProtocols.sort((a, b) => b.responseRate - a.responseRate)[0] || null;
|
|
894
|
+
}
|
|
895
|
+
|
|
896
|
+
// Helper: Optimize combination therapy
|
|
897
|
+
private optimizeCombination(cancerType: string, targets: DrugTarget[], genomicProfile?: any): CombinationTherapy | null {
|
|
898
|
+
const matchingCombos = this.combinationTherapies.filter(c =>
|
|
899
|
+
c.cancerTypes.some(ct => ct.toLowerCase().includes(cancerType.toLowerCase()) ||
|
|
900
|
+
cancerType.toLowerCase().includes(ct.toLowerCase()))
|
|
901
|
+
);
|
|
902
|
+
|
|
903
|
+
if (matchingCombos.length === 0) return null;
|
|
904
|
+
|
|
905
|
+
// Prioritize based on targets
|
|
906
|
+
for (const combo of matchingCombos) {
|
|
907
|
+
const hasMatchingTarget = targets.some(t =>
|
|
908
|
+
combo.components.some(c =>
|
|
909
|
+
t.approvedDrugs.some(d => d.toLowerCase().includes(c.toLowerCase()))
|
|
910
|
+
)
|
|
911
|
+
);
|
|
912
|
+
if (hasMatchingTarget) return combo;
|
|
913
|
+
}
|
|
914
|
+
|
|
915
|
+
// Return highest synergy combination
|
|
916
|
+
return matchingCombos.sort((a, b) => b.synergisticEffect - a.synergisticEffect)[0];
|
|
917
|
+
}
|
|
918
|
+
|
|
919
|
+
// Helper: Match to treatment protocol
|
|
920
|
+
private matchProtocol(cancerType: string, stage: string): TreatmentProtocol | null {
|
|
921
|
+
const matchingProtocols = this.treatmentProtocols.filter(p =>
|
|
922
|
+
(p.cancerType.toLowerCase().includes(cancerType.toLowerCase()) ||
|
|
923
|
+
cancerType.toLowerCase().includes(p.cancerType.toLowerCase())) &&
|
|
924
|
+
(p.stage === 'All' || p.stage.includes(stage) || stage.includes(p.stage.split('-')[0]))
|
|
925
|
+
);
|
|
926
|
+
|
|
927
|
+
return matchingProtocols.sort((a, b) => b.efficacyScore - a.efficacyScore)[0] || null;
|
|
928
|
+
}
|
|
929
|
+
|
|
930
|
+
// Helper: Calculate outcomes
|
|
931
|
+
private calculateOutcomes(
|
|
932
|
+
targets: DrugTarget[],
|
|
933
|
+
immunotherapy: ImmunotherapyProtocol | null,
|
|
934
|
+
combination: CombinationTherapy | null,
|
|
935
|
+
protocol: TreatmentProtocol | null,
|
|
936
|
+
stage: string
|
|
937
|
+
): { responseRate: number; fiveYearSurvival: number; qualityOfLife: number; cureConfidence: number } {
|
|
938
|
+
let baseResponse = 0.50;
|
|
939
|
+
let baseSurvival = 0.40;
|
|
940
|
+
|
|
941
|
+
// Stage adjustment
|
|
942
|
+
const stageMultiplier = stage === 'I' ? 1.3 : stage === 'II' ? 1.1 : stage === 'III' ? 0.9 : 0.7;
|
|
943
|
+
|
|
944
|
+
// Target bonus
|
|
945
|
+
const fdaApprovedTargets = targets.filter(t => t.evidenceLevel === 'FDA-Approved').length;
|
|
946
|
+
const targetBonus = Math.min(fdaApprovedTargets * 0.08, 0.30);
|
|
947
|
+
|
|
948
|
+
// Immunotherapy bonus
|
|
949
|
+
const immunoBonus = immunotherapy ? immunotherapy.durableResponseRate : 0;
|
|
950
|
+
|
|
951
|
+
// Combination synergy bonus
|
|
952
|
+
const comboBonus = combination ? (combination.synergisticEffect - 1) * 0.3 : 0;
|
|
953
|
+
|
|
954
|
+
// Protocol efficacy
|
|
955
|
+
const protocolEfficacy = protocol ? protocol.efficacyScore : 0.60;
|
|
956
|
+
|
|
957
|
+
const responseRate = Math.min((baseResponse + targetBonus + immunoBonus * 0.5 + comboBonus) * stageMultiplier, 0.95);
|
|
958
|
+
const fiveYearSurvival = Math.min((baseSurvival + targetBonus + immunoBonus + comboBonus) * stageMultiplier * protocolEfficacy, 0.95);
|
|
959
|
+
const qualityOfLife = 0.75 + (immunotherapy ? 0.05 : 0) - (combination ? 0.05 : 0);
|
|
960
|
+
const cureConfidence = Math.min((responseRate + fiveYearSurvival) / 2 + (fdaApprovedTargets >= 3 ? 0.1 : 0), 0.95);
|
|
961
|
+
|
|
962
|
+
return {
|
|
963
|
+
responseRate: Math.round(responseRate * 100) / 100,
|
|
964
|
+
fiveYearSurvival: Math.round(fiveYearSurvival * 100) / 100,
|
|
965
|
+
qualityOfLife: Math.round(qualityOfLife * 100) / 100,
|
|
966
|
+
cureConfidence: Math.round(cureConfidence * 100) / 100
|
|
967
|
+
};
|
|
968
|
+
}
|
|
969
|
+
|
|
970
|
+
// Helper: Generate treatment timeline
|
|
971
|
+
private generateTimeline(
|
|
972
|
+
targets: DrugTarget[],
|
|
973
|
+
immunotherapy: ImmunotherapyProtocol | null,
|
|
974
|
+
combination: CombinationTherapy | null,
|
|
975
|
+
protocol: TreatmentProtocol | null
|
|
976
|
+
): { phase: string; duration: string; activities: string[] }[] {
|
|
977
|
+
const timeline = [
|
|
978
|
+
{
|
|
979
|
+
phase: 'Phase 1: Diagnostic & Staging',
|
|
980
|
+
duration: '1-2 weeks',
|
|
981
|
+
activities: [
|
|
982
|
+
'Comprehensive genomic profiling (CGP)',
|
|
983
|
+
'PD-L1/TMB/MSI testing',
|
|
984
|
+
'Imaging (CT/PET/MRI)',
|
|
985
|
+
'Tumor board review'
|
|
986
|
+
]
|
|
987
|
+
},
|
|
988
|
+
{
|
|
989
|
+
phase: 'Phase 2: Treatment Initiation',
|
|
990
|
+
duration: '2-4 weeks',
|
|
991
|
+
activities: [
|
|
992
|
+
targets.length > 0 ? `Initiate ${targets[0].approvedDrugs[0]}` : 'Initiate standard therapy',
|
|
993
|
+
immunotherapy ? `Add ${immunotherapy.drugs[0]}` : 'Evaluate immunotherapy eligibility',
|
|
994
|
+
'Baseline labs and cardiac assessment',
|
|
995
|
+
'Patient education and consent'
|
|
996
|
+
]
|
|
997
|
+
},
|
|
998
|
+
{
|
|
999
|
+
phase: 'Phase 3: Active Treatment',
|
|
1000
|
+
duration: '12-24 weeks',
|
|
1001
|
+
activities: [
|
|
1002
|
+
protocol ? protocol.treatmentModalities.join(', ') : 'Multi-modal therapy',
|
|
1003
|
+
combination ? `Combination: ${combination.components.join(' + ')}` : 'Sequential therapy',
|
|
1004
|
+
'Regular monitoring every 2-3 weeks',
|
|
1005
|
+
'Side effect management'
|
|
1006
|
+
]
|
|
1007
|
+
},
|
|
1008
|
+
{
|
|
1009
|
+
phase: 'Phase 4: Response Assessment',
|
|
1010
|
+
duration: '4-8 weeks',
|
|
1011
|
+
activities: [
|
|
1012
|
+
'Restaging imaging',
|
|
1013
|
+
'ctDNA monitoring',
|
|
1014
|
+
'Treatment response evaluation (RECIST)',
|
|
1015
|
+
'Adjust therapy based on response'
|
|
1016
|
+
]
|
|
1017
|
+
},
|
|
1018
|
+
{
|
|
1019
|
+
phase: 'Phase 5: Maintenance/Consolidation',
|
|
1020
|
+
duration: '6-24 months',
|
|
1021
|
+
activities: [
|
|
1022
|
+
'Maintenance therapy as indicated',
|
|
1023
|
+
immunotherapy ? 'Continue immunotherapy up to 2 years' : 'Consider maintenance options',
|
|
1024
|
+
'Surveillance imaging every 3 months',
|
|
1025
|
+
'Survivorship care planning'
|
|
1026
|
+
]
|
|
1027
|
+
}
|
|
1028
|
+
];
|
|
1029
|
+
|
|
1030
|
+
return timeline;
|
|
1031
|
+
}
|
|
1032
|
+
|
|
1033
|
+
// Helper: Identify breakthrough opportunities
|
|
1034
|
+
private identifyBreakthroughs(cancerType: string, genomicProfile?: any, targets?: DrugTarget[]): string[] {
|
|
1035
|
+
const breakthroughs: string[] = [];
|
|
1036
|
+
|
|
1037
|
+
// Check for tumor-agnostic approvals
|
|
1038
|
+
if (genomicProfile?.msiStatus === 'MSI-H') {
|
|
1039
|
+
breakthroughs.push('🎯 MSI-H: Eligible for pembrolizumab (tumor-agnostic approval)');
|
|
1040
|
+
}
|
|
1041
|
+
if (targets?.some(t => t.gene.includes('NTRK'))) {
|
|
1042
|
+
breakthroughs.push('🎯 NTRK fusion: Eligible for larotrectinib/entrectinib (tumor-agnostic)');
|
|
1043
|
+
}
|
|
1044
|
+
if (genomicProfile?.tmbLevel === 'High') {
|
|
1045
|
+
breakthroughs.push('🎯 TMB-High: Enhanced immunotherapy response expected');
|
|
1046
|
+
}
|
|
1047
|
+
|
|
1048
|
+
// Check for breakthrough therapies
|
|
1049
|
+
if (cancerType.includes('NSCLC') && genomicProfile?.mutations?.includes('KRAS G12C')) {
|
|
1050
|
+
breakthroughs.push('💊 KRAS G12C: Sotorasib/Adagrasib - first-in-class RAS inhibitors');
|
|
1051
|
+
}
|
|
1052
|
+
if (cancerType.includes('Breast') && genomicProfile?.mutations?.includes('HER2')) {
|
|
1053
|
+
breakthroughs.push('💊 HER2+: T-DXd achieving unprecedented response rates');
|
|
1054
|
+
}
|
|
1055
|
+
if (['DLBCL', 'B-ALL', 'Multiple Myeloma'].some(ct => cancerType.includes(ct))) {
|
|
1056
|
+
breakthroughs.push('🧬 CAR-T eligible: Potential for durable complete remission');
|
|
1057
|
+
}
|
|
1058
|
+
if (genomicProfile?.hrdStatus) {
|
|
1059
|
+
breakthroughs.push('💊 HRD+: PARP inhibitor synthetic lethality strategy');
|
|
1060
|
+
}
|
|
1061
|
+
|
|
1062
|
+
// Add novel approaches
|
|
1063
|
+
breakthroughs.push('🔬 Consider ctDNA-guided therapy for real-time monitoring');
|
|
1064
|
+
breakthroughs.push('🧪 Evaluate clinical trial options for novel combinations');
|
|
1065
|
+
|
|
1066
|
+
return breakthroughs;
|
|
1067
|
+
}
|
|
1068
|
+
|
|
1069
|
+
// Helper: Determine cure strategy
|
|
1070
|
+
private determineCureStrategy(targets: DrugTarget[], immunotherapy: ImmunotherapyProtocol | null, combination: CombinationTherapy | null): string {
|
|
1071
|
+
const strategies: string[] = [];
|
|
1072
|
+
|
|
1073
|
+
if (targets.filter(t => t.evidenceLevel === 'FDA-Approved').length >= 2) {
|
|
1074
|
+
strategies.push('Precision Medicine');
|
|
1075
|
+
}
|
|
1076
|
+
if (immunotherapy) {
|
|
1077
|
+
strategies.push(immunotherapy.type === 'car_t' ? 'Cellular Therapy' : 'Immuno-Oncology');
|
|
1078
|
+
}
|
|
1079
|
+
if (combination) {
|
|
1080
|
+
strategies.push('Synergistic Combination');
|
|
1081
|
+
}
|
|
1082
|
+
if (strategies.length === 0) {
|
|
1083
|
+
strategies.push('Standard of Care');
|
|
1084
|
+
}
|
|
1085
|
+
|
|
1086
|
+
return strategies.join(' + ');
|
|
1087
|
+
}
|
|
1088
|
+
|
|
1089
|
+
// Helper: Select primary treatment
|
|
1090
|
+
private selectPrimaryTreatment(targets: DrugTarget[], immunotherapy: ImmunotherapyProtocol | null, protocol: TreatmentProtocol | null): string {
|
|
1091
|
+
if (immunotherapy?.type === 'car_t') {
|
|
1092
|
+
return `${immunotherapy.drugs[0]} (CAR-T)`;
|
|
1093
|
+
}
|
|
1094
|
+
if (targets.length > 0 && targets[0].evidenceLevel === 'FDA-Approved') {
|
|
1095
|
+
return `${targets[0].approvedDrugs[0]} (${targets[0].gene} inhibitor)`;
|
|
1096
|
+
}
|
|
1097
|
+
if (immunotherapy) {
|
|
1098
|
+
return immunotherapy.drugs.join(' + ');
|
|
1099
|
+
}
|
|
1100
|
+
if (protocol) {
|
|
1101
|
+
return protocol.treatmentModalities[0];
|
|
1102
|
+
}
|
|
1103
|
+
return 'Multi-modal therapy';
|
|
1104
|
+
}
|
|
1105
|
+
|
|
1106
|
+
// Helper: Select secondary treatments
|
|
1107
|
+
private selectSecondaryTreatments(targets: DrugTarget[], combination: CombinationTherapy | null): string[] {
|
|
1108
|
+
const secondary: string[] = [];
|
|
1109
|
+
|
|
1110
|
+
if (combination) {
|
|
1111
|
+
secondary.push(...combination.components);
|
|
1112
|
+
}
|
|
1113
|
+
|
|
1114
|
+
// Add secondary targeted therapies
|
|
1115
|
+
const secondaryTargets = targets.slice(1, 4);
|
|
1116
|
+
for (const target of secondaryTargets) {
|
|
1117
|
+
if (target.evidenceLevel === 'FDA-Approved' && target.approvedDrugs.length > 0) {
|
|
1118
|
+
secondary.push(`${target.approvedDrugs[0]} (${target.gene})`);
|
|
1119
|
+
}
|
|
1120
|
+
}
|
|
1121
|
+
|
|
1122
|
+
return [...new Set(secondary)].slice(0, 5);
|
|
1123
|
+
}
|
|
1124
|
+
|
|
1125
|
+
async listTreatmentProtocols(): Promise<TreatmentProtocol[]> {
|
|
1126
|
+
return this.treatmentProtocols;
|
|
1127
|
+
}
|
|
1128
|
+
|
|
1129
|
+
async listDrugTargets(): Promise<DrugTarget[]> {
|
|
1130
|
+
return this.drugTargetDatabase;
|
|
1131
|
+
}
|
|
1132
|
+
|
|
1133
|
+
async listImmunotherapyProtocols(): Promise<ImmunotherapyProtocol[]> {
|
|
1134
|
+
return this.immunotherapyProtocols;
|
|
1135
|
+
}
|
|
1136
|
+
|
|
1137
|
+
async listCombinationTherapies(): Promise<CombinationTherapy[]> {
|
|
1138
|
+
return this.combinationTherapies;
|
|
1139
|
+
}
|
|
1140
|
+
|
|
1141
|
+
async addTreatmentProtocol(protocol: TreatmentProtocol): Promise<void> {
|
|
1142
|
+
this.treatmentProtocols.push(protocol);
|
|
1143
|
+
console.log(`Added treatment protocol: ${protocol.name}`);
|
|
1144
|
+
}
|
|
1145
|
+
|
|
1146
|
+
// Simple command interface for CLI
|
|
1147
|
+
async executeCommand(command: string, params: any): Promise<any> {
|
|
1148
|
+
switch (command) {
|
|
1149
|
+
case 'analyze_patient':
|
|
1150
|
+
return await this.analyzePatient(params.patientId, params.includeGenomics || false);
|
|
1151
|
+
case 'design_treatment_plan':
|
|
1152
|
+
return await this.designTreatmentPlan(params.patientId, params.protocolId);
|
|
1153
|
+
case 'discover_drug_targets':
|
|
1154
|
+
return await this.discoverDrugTargets(params.cancerType, params.targetGene);
|
|
1155
|
+
case 'cure_cancer':
|
|
1156
|
+
return await this.cureCancer(params.patientId, params.cancerType, params.stage, params.genomicProfile);
|
|
1157
|
+
default:
|
|
1158
|
+
throw new Error(`Unknown command: ${command}`);
|
|
1159
|
+
}
|
|
1160
|
+
}
|
|
1161
|
+
}
|