@erosolaraijs/cure 1.0.5 → 2.0.0

package/src/capabilities/cancerTreatmentCapability.ts

@@ -410,7 +410,228 @@ export class CancerTreatmentCapabilityModule {
       cancerTypes: ['Multiple Myeloma'],
       approvedDrugs: ['Idecabtagene vicleucel', 'Ciltacabtagene autoleucel', 'Teclistamab'],
       mechanismOfAction: 'CAR-T/bispecific targets BCMA on myeloma cells',
-      evidenceLevel: 'FDA-Approved', biomarker: 'BCMA+ multiple myeloma' }
+      evidenceLevel: 'FDA-Approved', biomarker: 'BCMA+ multiple myeloma' },
+
+    // === ADDITIONAL BISPECIFIC ANTIBODY TARGETS ===
+    { gene: 'CD20xCD3', protein: 'CD20 x CD3 Bispecific', pathway: 'Bispecific T-cell Engager',
+      cancerTypes: ['DLBCL', 'Follicular Lymphoma', 'CLL', 'Mantle Cell Lymphoma', 'Marginal Zone Lymphoma'],
+      approvedDrugs: ['Mosunetuzumab', 'Epcoritamab', 'Glofitamab'],
+      mechanismOfAction: 'Bispecific engages T-cells to kill CD20+ B-cells',
+      evidenceLevel: 'FDA-Approved', biomarker: 'CD20+ B-cell lymphoma' },
+    { gene: 'GPRCxCD3', protein: 'GPRC5D x CD3 Bispecific', pathway: 'Bispecific T-cell Engager',
+      cancerTypes: ['Multiple Myeloma'],
+      approvedDrugs: ['Talquetamab'],
+      mechanismOfAction: 'Bispecific targets GPRC5D on myeloma cells',
+      evidenceLevel: 'FDA-Approved', biomarker: 'GPRC5D+ myeloma' },
+    { gene: 'FcRHxCD3', protein: 'FcRH5 x CD3 Bispecific', pathway: 'Bispecific T-cell Engager',
+      cancerTypes: ['Multiple Myeloma'],
+      approvedDrugs: ['Cevostamab (investigational)'],
+      mechanismOfAction: 'Bispecific targets FcRH5 on myeloma cells',
+      evidenceLevel: 'Phase II', biomarker: 'FcRH5+ myeloma' },
+    { gene: 'DLL3xCD3', protein: 'DLL3 x CD3 Bispecific', pathway: 'Bispecific T-cell Engager',
+      cancerTypes: ['SCLC', 'Neuroendocrine'],
+      approvedDrugs: ['Tarlatamab'],
+      mechanismOfAction: 'Bispecific targets DLL3 on SCLC cells',
+      evidenceLevel: 'FDA-Approved', biomarker: 'DLL3+ SCLC' },
+    { gene: 'HER2xCD3', protein: 'HER2 x CD3 Bispecific', pathway: 'Bispecific T-cell Engager',
+      cancerTypes: ['Breast', 'Gastric', 'NSCLC'],
+      approvedDrugs: ['Zanidatamab (investigational)'],
+      mechanismOfAction: 'Bispecific targets HER2+ tumors',
+      evidenceLevel: 'Phase II', biomarker: 'HER2+ solid tumors' },
+
+    // === ADDITIONAL ADC TARGETS ===
+    { gene: 'FRa', protein: 'Folate Receptor Alpha', pathway: 'Targeted Delivery',
+      cancerTypes: ['Ovarian', 'NSCLC', 'Endometrial'],
+      approvedDrugs: ['Mirvetuximab Soravtansine'],
+      mechanismOfAction: 'FRα-targeting ADC delivers DM4 payload',
+      evidenceLevel: 'FDA-Approved', biomarker: 'FRα high expression' },
+    { gene: 'CEACAM5', protein: 'Carcinoembryonic Antigen', pathway: 'Targeted Delivery',
+      cancerTypes: ['Colorectal', 'Gastric', 'Pancreatic', 'NSCLC'],
+      approvedDrugs: ['Tusamitamab Ravtansine (investigational)'],
+      mechanismOfAction: 'CEACAM5-targeting ADC',
+      evidenceLevel: 'Phase III', biomarker: 'CEACAM5+ tumors' },
+    { gene: 'B7H4', protein: 'B7 Homolog 4', pathway: 'Targeted Delivery',
+      cancerTypes: ['Breast', 'Ovarian', 'Endometrial'],
+      approvedDrugs: ['AZD8205 (investigational)'],
+      mechanismOfAction: 'B7H4-targeting ADC',
+      evidenceLevel: 'Phase I', biomarker: 'B7H4+ tumors' },
+    { gene: 'c-MET ADC', protein: 'c-MET ADC Target', pathway: 'Targeted Delivery',
+      cancerTypes: ['NSCLC', 'Gastric', 'RCC'],
+      approvedDrugs: ['Telisotuzumab Vedotin (investigational)'],
+      mechanismOfAction: 'c-MET-targeting ADC delivers MMAE',
+      evidenceLevel: 'Phase II', biomarker: 'c-MET high tumors' },
+
+    // === RADIOLIGAND THERAPY TARGETS ===
+    { gene: 'SSTR2', protein: 'Somatostatin Receptor Type 2', pathway: 'Radioligand Therapy',
+      cancerTypes: ['GI NET', 'Pancreatic NET', 'Pheochromocytoma', 'Paraganglioma'],
+      approvedDrugs: ['177Lu-DOTATATE (Lutathera)'],
+      mechanismOfAction: 'Peptide receptor radionuclide therapy',
+      evidenceLevel: 'FDA-Approved', biomarker: 'SSTR+ neuroendocrine tumors' },
+    { gene: 'FAP', protein: 'Fibroblast Activation Protein', pathway: 'Radioligand Therapy',
+      cancerTypes: ['Pancreatic', 'Breast', 'Colorectal', 'Sarcoma', 'All Solid Tumors'],
+      approvedDrugs: ['177Lu-FAP-2286 (investigational)', '225Ac-FAPI (investigational)'],
+      mechanismOfAction: 'FAP-targeted radioligand therapy',
+      evidenceLevel: 'Phase II', biomarker: 'FAP+ tumor stroma' },
+    { gene: 'CXCR4', protein: 'C-X-C Chemokine Receptor Type 4', pathway: 'Radioligand Therapy',
+      cancerTypes: ['Multiple Myeloma', 'AML', 'CLL', 'Lymphoma'],
+      approvedDrugs: ['177Lu-pentixather (investigational)'],
+      mechanismOfAction: 'CXCR4-targeted radioligand therapy',
+      evidenceLevel: 'Phase II', biomarker: 'CXCR4+ hematologic malignancies' },
+
+    // === PEDIATRIC CANCER TARGETS ===
+    { gene: 'GD2', protein: 'Disialoganglioside GD2', pathway: 'Immunotherapy Target',
+      cancerTypes: ['Neuroblastoma', 'Osteosarcoma', 'Ewing Sarcoma', 'Melanoma'],
+      approvedDrugs: ['Dinutuximab', 'Naxitamab'],
+      mechanismOfAction: 'Anti-GD2 antibody mediates ADCC',
+      evidenceLevel: 'FDA-Approved', biomarker: 'GD2+ tumors' },
+    { gene: 'MYCN', protein: 'N-Myc Proto-Oncogene', pathway: 'Transcription Factor',
+      cancerTypes: ['Neuroblastoma', 'Medulloblastoma', 'Rhabdomyosarcoma'],
+      approvedDrugs: ['Aurora A inhibitors (investigational)', 'BET inhibitors (investigational)'],
+      mechanismOfAction: 'Indirect MYCN destabilization',
+      evidenceLevel: 'Phase II', biomarker: 'MYCN amplification' },
+    { gene: 'PAX-FOXO1', protein: 'PAX3/7-FOXO1 Fusion', pathway: 'Fusion Oncoprotein',
+      cancerTypes: ['Rhabdomyosarcoma (alveolar)'],
+      approvedDrugs: ['Investigational agents'],
+      mechanismOfAction: 'Target fusion-driven transcription',
+      evidenceLevel: 'Phase I', biomarker: 'PAX-FOXO1 fusion' },
+    { gene: 'EWS-FLI1', protein: 'EWSR1-FLI1 Fusion', pathway: 'Fusion Oncoprotein',
+      cancerTypes: ['Ewing Sarcoma'],
+      approvedDrugs: ['Lurbinectedin', 'Trabectedin', 'TK216 (investigational)'],
+      mechanismOfAction: 'Target EWS-FLI1 fusion protein activity',
+      evidenceLevel: 'Phase II', biomarker: 'EWS-FLI1 fusion' },
+    { gene: 'SHH', protein: 'Sonic Hedgehog Pathway', pathway: 'Hedgehog',
+      cancerTypes: ['Medulloblastoma', 'Basal Cell Carcinoma'],
+      approvedDrugs: ['Vismodegib', 'Sonidegib'],
+      mechanismOfAction: 'SMO inhibition blocks Hedgehog signaling',
+      evidenceLevel: 'FDA-Approved', biomarker: 'SHH-activated tumors' },
+    { gene: 'WT1', protein: 'Wilms Tumor 1', pathway: 'Transcription Factor',
+      cancerTypes: ['Wilms Tumor', 'AML', 'Mesothelioma'],
+      approvedDrugs: ['WT1 vaccines (investigational)', 'WT1-TCR T-cells (investigational)'],
+      mechanismOfAction: 'Immune targeting of WT1+ cells',
+      evidenceLevel: 'Phase II', biomarker: 'WT1 overexpression' },
+
+    // === ULTRA-RARE CANCER TARGETS ===
+    { gene: 'SS18-SSX', protein: 'SS18-SSX Fusion', pathway: 'Fusion Oncoprotein',
+      cancerTypes: ['Synovial Sarcoma'],
+      approvedDrugs: ['Trabectedin', 'Pazopanib', 'SYD985 (investigational)'],
+      mechanismOfAction: 'Target SS18-SSX driven transcription',
+      evidenceLevel: 'Phase II', biomarker: 'SS18-SSX fusion' },
+    { gene: 'MDM2', protein: 'Mouse Double Minute 2', pathway: 'p53 Pathway',
+      cancerTypes: ['Liposarcoma', 'Glioblastoma', 'AML'],
+      approvedDrugs: ['Milademetan (investigational)', 'Idasanutlin (investigational)'],
+      mechanismOfAction: 'MDM2 inhibition restores p53 activity',
+      evidenceLevel: 'Phase II', biomarker: 'MDM2 amplification, wild-type TP53' },
+    { gene: 'CDK12', protein: 'Cyclin-Dependent Kinase 12', pathway: 'DNA Repair',
+      cancerTypes: ['Prostate', 'Ovarian'],
+      approvedDrugs: ['PARP inhibitors', 'Platinum chemotherapy', 'Immunotherapy'],
+      mechanismOfAction: 'CDK12 loss creates genomic instability',
+      evidenceLevel: 'FDA-Approved', biomarker: 'CDK12 biallelic loss' },
+    { gene: 'NF1', protein: 'Neurofibromin', pathway: 'RAS/MAPK',
+      cancerTypes: ['MPNST', 'Glioma', 'Melanoma', 'NSCLC'],
+      approvedDrugs: ['Selumetinib', 'MEK inhibitors'],
+      mechanismOfAction: 'MEK inhibition for NF1-driven RAS activation',
+      evidenceLevel: 'FDA-Approved', biomarker: 'NF1 loss/mutation' },
+    { gene: 'NF2', protein: 'Merlin/Neurofibromin 2', pathway: 'Hippo Pathway',
+      cancerTypes: ['Meningioma', 'Schwannoma', 'Mesothelioma'],
+      approvedDrugs: ['Bevacizumab', 'FAK inhibitors (investigational)'],
+      mechanismOfAction: 'Target downstream effectors of NF2 loss',
+      evidenceLevel: 'Phase II', biomarker: 'NF2 mutation/loss' },
+    { gene: 'SDH', protein: 'Succinate Dehydrogenase', pathway: 'Metabolic',
+      cancerTypes: ['Pheochromocytoma', 'Paraganglioma', 'GIST', 'RCC'],
+      approvedDrugs: ['Temozolomide', 'Belzutifan'],
+      mechanismOfAction: 'Target pseudohypoxia pathway',
+      evidenceLevel: 'FDA-Approved', biomarker: 'SDH-deficient tumors' },
+    { gene: 'VHL', protein: 'Von Hippel-Lindau', pathway: 'HIF/VEGF',
+      cancerTypes: ['Clear Cell RCC', 'Hemangioblastoma', 'Pheochromocytoma'],
+      approvedDrugs: ['Belzutifan'],
+      mechanismOfAction: 'HIF-2α inhibition for VHL-deficient tumors',
+      evidenceLevel: 'FDA-Approved', biomarker: 'VHL-altered tumors' },
+    { gene: 'TSC1/2', protein: 'Tuberous Sclerosis Complex', pathway: 'mTOR',
+      cancerTypes: ['Subependymal Giant Cell Astrocytoma', 'Angiomyolipoma', 'LAM'],
+      approvedDrugs: ['Everolimus'],
+      mechanismOfAction: 'mTOR inhibition for TSC-driven tumors',
+      evidenceLevel: 'FDA-Approved', biomarker: 'TSC1/2 mutation' },
+    { gene: 'SMARCB1', protein: 'SWI/SNF Related BAF47', pathway: 'Chromatin Remodeling',
+      cancerTypes: ['Rhabdoid Tumor', 'Epithelioid Sarcoma', 'Malignant Rhabdoid Tumor'],
+      approvedDrugs: ['Tazemetostat'],
+      mechanismOfAction: 'EZH2 inhibition for INI1-deficient tumors',
+      evidenceLevel: 'FDA-Approved', biomarker: 'SMARCB1/INI1 loss' },
+    { gene: 'FH', protein: 'Fumarate Hydratase', pathway: 'Metabolic',
+      cancerTypes: ['Hereditary Leiomyomatosis RCC', 'Uterine Leiomyoma'],
+      approvedDrugs: ['Bevacizumab + Erlotinib', 'Belzutifan (investigational)'],
+      mechanismOfAction: 'Target pseudohypoxia in FH-deficient tumors',
+      evidenceLevel: 'Phase II', biomarker: 'FH-deficient tumors' },
+    { gene: 'POLE/POLD1', protein: 'DNA Polymerase Epsilon/Delta', pathway: 'DNA Replication',
+      cancerTypes: ['Endometrial', 'Colorectal'],
+      approvedDrugs: ['Pembrolizumab', 'Checkpoint inhibitors'],
+      mechanismOfAction: 'Hypermutated tumors respond to immunotherapy',
+      evidenceLevel: 'FDA-Approved', biomarker: 'POLE ultramutated' },
+
+    // === RARE FUSION TARGETS ===
+    { gene: 'NRG1', protein: 'Neuregulin 1 Fusion', pathway: 'HER3/HER2',
+      cancerTypes: ['NSCLC', 'Pancreatic', 'Breast', 'Cholangiocarcinoma'],
+      approvedDrugs: ['Zenocutuzumab (investigational)', 'Afatinib'],
+      mechanismOfAction: 'Block NRG1 fusion-driven HER3 signaling',
+      evidenceLevel: 'Phase II', biomarker: 'NRG1 fusion' },
+    { gene: 'FGFR2 Fusion', protein: 'FGFR2 Fusion', pathway: 'FGFR',
+      cancerTypes: ['Cholangiocarcinoma', 'Bladder'],
+      approvedDrugs: ['Pemigatinib', 'Futibatinib', 'Infigratinib'],
+      mechanismOfAction: 'FGFR TKI for fusion-driven tumors',
+      evidenceLevel: 'FDA-Approved', biomarker: 'FGFR2 fusion/rearrangement' },
+    { gene: 'RAF1 Fusion', protein: 'RAF1 Fusion', pathway: 'RAS/MAPK',
+      cancerTypes: ['Pilocytic Astrocytoma', 'Pancreatic', 'Prostate'],
+      approvedDrugs: ['Sorafenib', 'Pan-RAF inhibitors'],
+      mechanismOfAction: 'Inhibit RAF1 fusion kinase activity',
+      evidenceLevel: 'Phase II', biomarker: 'RAF1 fusion' },
+
+    // === IMMUNE MODULATORS ===
+    { gene: 'CD47', protein: 'CD47 "Don\'t Eat Me" Signal', pathway: 'Innate Immunity',
+      cancerTypes: ['AML', 'MDS', 'DLBCL', 'Solid Tumors'],
+      approvedDrugs: ['Magrolimab (investigational)', 'Lemzoparlimab (investigational)'],
+      mechanismOfAction: 'Block CD47-SIRPα to enable macrophage phagocytosis',
+      evidenceLevel: 'Phase III', biomarker: 'CD47+ malignancies' },
+    { gene: 'CD73', protein: 'Ecto-5\'-Nucleotidase', pathway: 'Adenosine Pathway',
+      cancerTypes: ['NSCLC', 'TNBC', 'Colorectal'],
+      approvedDrugs: ['Oleclumab (investigational)'],
+      mechanismOfAction: 'Block adenosine-mediated immunosuppression',
+      evidenceLevel: 'Phase II', biomarker: 'CD73 high tumors' },
+    { gene: 'TIM-3', protein: 'T-cell Immunoglobulin Mucin-3', pathway: 'Immune Checkpoint',
+      cancerTypes: ['AML', 'MDS', 'Solid Tumors'],
+      approvedDrugs: ['Sabatolimab (investigational)'],
+      mechanismOfAction: 'Block TIM-3 checkpoint receptor',
+      evidenceLevel: 'Phase II', biomarker: 'TIM-3 expression' },
+    { gene: 'ICOS', protein: 'Inducible T-cell Costimulator', pathway: 'Immune Costimulation',
+      cancerTypes: ['Solid Tumors', 'Lymphoma'],
+      approvedDrugs: ['ICOS agonists (investigational)'],
+      mechanismOfAction: 'Agonize ICOS to enhance T-cell activation',
+      evidenceLevel: 'Phase II', biomarker: 'ICOS+ T-cells in TME' },
+    { gene: 'OX40', protein: 'OX40 (CD134)', pathway: 'Immune Costimulation',
+      cancerTypes: ['Solid Tumors'],
+      approvedDrugs: ['OX40 agonists (investigational)'],
+      mechanismOfAction: 'Agonize OX40 to enhance effector T-cells',
+      evidenceLevel: 'Phase I', biomarker: 'T-cell infiltrated tumors' },
+    { gene: '4-1BB', protein: '4-1BB (CD137)', pathway: 'Immune Costimulation',
+      cancerTypes: ['Solid Tumors', 'Lymphoma'],
+      approvedDrugs: ['Utomilumab (investigational)'],
+      mechanismOfAction: 'Agonize 4-1BB to enhance T and NK cells',
+      evidenceLevel: 'Phase II', biomarker: '4-1BB+ immune cells' },
+
+    // === METABOLISM TARGETS ===
+    { gene: 'ASNS', protein: 'Asparagine Synthetase', pathway: 'Amino Acid Metabolism',
+      cancerTypes: ['ALL', 'AML', 'Solid Tumors'],
+      approvedDrugs: ['Asparaginase', 'Pegaspargase', 'Calaspargase pegol'],
+      mechanismOfAction: 'Deplete asparagine in ASNS-low tumors',
+      evidenceLevel: 'FDA-Approved', biomarker: 'ASNS-low expression' },
+    { gene: 'DHODH', protein: 'Dihydroorotate Dehydrogenase', pathway: 'Pyrimidine Synthesis',
+      cancerTypes: ['AML', 'Solid Tumors'],
+      approvedDrugs: ['Brequinar (investigational)'],
+      mechanismOfAction: 'Block de novo pyrimidine synthesis',
+      evidenceLevel: 'Phase II', biomarker: 'DHODH-dependent tumors' },
+    { gene: 'MTAP', protein: 'Methylthioadenosine Phosphorylase', pathway: 'Methionine Salvage',
+      cancerTypes: ['Pancreatic', 'Glioblastoma', 'NSCLC', 'Mesothelioma'],
+      approvedDrugs: ['MAT2A inhibitors (investigational)', 'PRMT5 inhibitors (investigational)'],
+      mechanismOfAction: 'Synthetic lethality in MTAP-deleted tumors',
+      evidenceLevel: 'Phase II', biomarker: 'MTAP deletion (co-deleted with CDKN2A)' }
   ];
 
   // ═══════════════════════════════════════════════════════════════════════════════
@@ -446,7 +667,136 @@ export class CancerTreatmentCapabilityModule {
       targets: ['Tumor Neoantigens'], drugs: ['Lifileucel'],
       cancerTypes: ['Melanoma'],
       responseRate: 0.36, durableResponseRate: 0.22,
-      biomarkers: ['Unresectable/metastatic melanoma'] }
+      biomarkers: ['Unresectable/metastatic melanoma'] },
+
+    // === ADDITIONAL CHECKPOINT INHIBITOR COMBINATIONS ===
+    { id: 'ici-durva-treme', name: 'Durvalumab + Tremelimumab', type: 'checkpoint_inhibitor',
+      targets: ['PD-L1', 'CTLA-4'], drugs: ['Durvalumab', 'Tremelimumab'],
+      cancerTypes: ['HCC', 'NSCLC', 'Bladder'],
+      responseRate: 0.45, durableResponseRate: 0.30,
+      biomarkers: ['PD-L1 expression'] },
+    { id: 'ici-atezo-bev', name: 'Atezolizumab + Bevacizumab', type: 'checkpoint_inhibitor',
+      targets: ['PD-L1', 'VEGF'], drugs: ['Atezolizumab', 'Bevacizumab'],
+      cancerTypes: ['HCC', 'RCC'],
+      responseRate: 0.52, durableResponseRate: 0.35,
+      biomarkers: ['Child-Pugh A liver function'] },
+    { id: 'ici-pembro-lenva', name: 'Pembrolizumab + Lenvatinib', type: 'checkpoint_inhibitor',
+      targets: ['PD-1', 'VEGFR/FGFR'], drugs: ['Pembrolizumab', 'Lenvatinib'],
+      cancerTypes: ['Endometrial', 'RCC', 'HCC'],
+      responseRate: 0.48, durableResponseRate: 0.32,
+      biomarkers: ['Non-MSI-H, dMMR endometrial'] },
+    { id: 'ici-nivo-cabo', name: 'Nivolumab + Cabozantinib', type: 'checkpoint_inhibitor',
+      targets: ['PD-1', 'VEGFR/MET/AXL'], drugs: ['Nivolumab', 'Cabozantinib'],
+      cancerTypes: ['RCC'],
+      responseRate: 0.55, durableResponseRate: 0.38,
+      biomarkers: ['Advanced RCC'] },
+
+    // === CAR-T FOR ADDITIONAL TARGETS ===
+    { id: 'car-t-cd22', name: 'CD22-directed CAR-T Therapy', type: 'car_t',
+      targets: ['CD22'], drugs: ['Investigational CD22 CAR-T'],
+      cancerTypes: ['B-ALL (CD19-relapsed)', 'DLBCL'],
+      responseRate: 0.70, durableResponseRate: 0.35,
+      biomarkers: ['CD22+ B-cell malignancy', 'CD19 CAR-T failure'] },
+    { id: 'car-t-cd7', name: 'CD7-directed CAR-T Therapy', type: 'car_t',
+      targets: ['CD7'], drugs: ['Investigational CD7 CAR-T'],
+      cancerTypes: ['T-ALL', 'T-cell Lymphoma'],
+      responseRate: 0.65, durableResponseRate: 0.28,
+      biomarkers: ['CD7+ T-cell malignancy'] },
+    { id: 'car-t-gpc3', name: 'GPC3-directed CAR-T Therapy', type: 'car_t',
+      targets: ['GPC3'], drugs: ['Investigational GPC3 CAR-T'],
+      cancerTypes: ['HCC', 'Hepatoblastoma'],
+      responseRate: 0.45, durableResponseRate: 0.18,
+      biomarkers: ['GPC3+ liver cancer'] },
+    { id: 'car-t-mesothelin', name: 'Mesothelin-directed CAR-T Therapy', type: 'car_t',
+      targets: ['Mesothelin'], drugs: ['Investigational Mesothelin CAR-T'],
+      cancerTypes: ['Mesothelioma', 'Pancreatic', 'Ovarian'],
+      responseRate: 0.35, durableResponseRate: 0.12,
+      biomarkers: ['Mesothelin+ solid tumors'] },
+    { id: 'car-t-gd2', name: 'GD2-directed CAR-T Therapy', type: 'car_t',
+      targets: ['GD2'], drugs: ['Investigational GD2 CAR-T'],
+      cancerTypes: ['Neuroblastoma', 'Osteosarcoma', 'Melanoma'],
+      responseRate: 0.50, durableResponseRate: 0.25,
+      biomarkers: ['GD2+ pediatric solid tumors'] },
+    { id: 'car-t-claudin18', name: 'Claudin 18.2-directed CAR-T Therapy', type: 'car_t',
+      targets: ['Claudin 18.2'], drugs: ['CT041 (investigational)'],
+      cancerTypes: ['Gastric', 'Pancreatic', 'GE Junction'],
+      responseRate: 0.55, durableResponseRate: 0.22,
+      biomarkers: ['Claudin 18.2+ GI cancers'] },
+
+    // === NK CELL THERAPIES ===
+    { id: 'nk-cell-therapy', name: 'Allogeneic NK Cell Therapy', type: 'cytokine_therapy',
+      targets: ['Tumor Cells'], drugs: ['FT516', 'FT596'],
+      cancerTypes: ['AML', 'Lymphoma', 'Solid Tumors'],
+      responseRate: 0.45, durableResponseRate: 0.20,
+      biomarkers: ['Relapsed/Refractory malignancy'] },
+    { id: 'nk-car-therapy', name: 'CAR-NK Cell Therapy', type: 'car_t',
+      targets: ['CD19', 'HER2', 'GD2'], drugs: ['Off-the-shelf CAR-NK'],
+      cancerTypes: ['B-cell Lymphoma', 'Solid Tumors'],
+      responseRate: 0.50, durableResponseRate: 0.22,
+      biomarkers: ['Target antigen positive'] },
+
+    // === BISPECIFIC ANTIBODY THERAPIES ===
+    { id: 'bispec-teclistamab', name: 'Teclistamab (BCMAxCD3)', type: 'checkpoint_inhibitor',
+      targets: ['BCMA', 'CD3'], drugs: ['Teclistamab'],
+      cancerTypes: ['Multiple Myeloma'],
+      responseRate: 0.63, durableResponseRate: 0.35,
+      biomarkers: ['Relapsed/Refractory MM'] },
+    { id: 'bispec-mosunetuzumab', name: 'Mosunetuzumab (CD20xCD3)', type: 'checkpoint_inhibitor',
+      targets: ['CD20', 'CD3'], drugs: ['Mosunetuzumab'],
+      cancerTypes: ['Follicular Lymphoma', 'DLBCL'],
+      responseRate: 0.80, durableResponseRate: 0.45,
+      biomarkers: ['CD20+ B-cell lymphoma'] },
+    { id: 'bispec-glofitamab', name: 'Glofitamab (CD20xCD3)', type: 'checkpoint_inhibitor',
+      targets: ['CD20', 'CD3'], drugs: ['Glofitamab'],
+      cancerTypes: ['DLBCL', 'Aggressive B-cell Lymphoma'],
+      responseRate: 0.52, durableResponseRate: 0.30,
+      biomarkers: ['CD20+ aggressive lymphoma'] },
+    { id: 'bispec-tarlatamab', name: 'Tarlatamab (DLL3xCD3)', type: 'checkpoint_inhibitor',
+      targets: ['DLL3', 'CD3'], drugs: ['Tarlatamab'],
+      cancerTypes: ['SCLC', 'Large Cell Neuroendocrine'],
+      responseRate: 0.40, durableResponseRate: 0.22,
+      biomarkers: ['DLL3+ neuroendocrine tumors'] },
+    { id: 'bispec-talquetamab', name: 'Talquetamab (GPRC5DxCD3)', type: 'checkpoint_inhibitor',
+      targets: ['GPRC5D', 'CD3'], drugs: ['Talquetamab'],
+      cancerTypes: ['Multiple Myeloma'],
+      responseRate: 0.70, durableResponseRate: 0.32,
+      biomarkers: ['GPRC5D+ myeloma'] },
+
+    // === ONCOLYTIC VIRUS THERAPY ===
+    { id: 'ov-tvec', name: 'Talimogene Laherparepvec (T-VEC)', type: 'oncolytic_virus',
+      targets: ['Tumor Cells'], drugs: ['Talimogene laherparepvec'],
+      cancerTypes: ['Melanoma'],
+      responseRate: 0.26, durableResponseRate: 0.16,
+      biomarkers: ['Injectable melanoma lesions'] },
+    { id: 'ov-delytact', name: 'Delytact (Teserpaturev)', type: 'oncolytic_virus',
+      targets: ['Tumor Cells'], drugs: ['Teserpaturev'],
+      cancerTypes: ['Glioblastoma'],
+      responseRate: 0.30, durableResponseRate: 0.15,
+      biomarkers: ['Recurrent glioblastoma'] },
+
+    // === CANCER VACCINES ===
+    { id: 'vaccine-sipuleucel', name: 'Sipuleucel-T (Provenge)', type: 'cancer_vaccine',
+      targets: ['PAP'], drugs: ['Sipuleucel-T'],
+      cancerTypes: ['Prostate'],
+      responseRate: 0.20, durableResponseRate: 0.15,
+      biomarkers: ['Asymptomatic/minimally symptomatic mCRPC'] },
+    { id: 'vaccine-neoantigen', name: 'Personalized Neoantigen Vaccine', type: 'cancer_vaccine',
+      targets: ['Patient-Specific Neoantigens'], drugs: ['mRNA-4157', 'Autogene Cevumeran'],
+      cancerTypes: ['Melanoma', 'NSCLC', 'Pancreatic', 'Colorectal'],
+      responseRate: 0.35, durableResponseRate: 0.25,
+      biomarkers: ['High TMB', 'MSI-H'] },
+
+    // === CYTOKINE THERAPIES ===
+    { id: 'cytokine-il2', name: 'High-Dose IL-2', type: 'cytokine_therapy',
+      targets: ['T-cells', 'NK cells'], drugs: ['Aldesleukin'],
+      cancerTypes: ['Melanoma', 'RCC'],
+      responseRate: 0.15, durableResponseRate: 0.10,
+      biomarkers: ['Good performance status'] },
+    { id: 'cytokine-pegifn', name: 'Pegylated Interferon Alpha', type: 'cytokine_therapy',
+      targets: ['Immune System'], drugs: ['Peginterferon alfa-2b'],
+      cancerTypes: ['Melanoma (adjuvant)', 'MPN'],
+      responseRate: 0.25, durableResponseRate: 0.18,
+      biomarkers: ['Stage III melanoma'] }
   ];
 
   // ═══════════════════════════════════════════════════════════════════════════════
@@ -480,7 +830,129 @@ export class CancerTreatmentCapabilityModule {
     { id: 'combo-bcl2-aza', name: 'BCL-2 + Hypomethylating Agent',
       components: ['Venetoclax', 'Azacitidine'],
       synergisticEffect: 1.6, cancerTypes: ['AML'],
-      clinicalEvidence: 'VIALE-A: 64.7% CR+CRi rate' }
+      clinicalEvidence: 'VIALE-A: 64.7% CR+CRi rate' },
+
+    // === ADDITIONAL COMBINATIONS FOR COMPREHENSIVE COVERAGE ===
+    { id: 'combo-trastuzumab-deruxtecan', name: 'T-DXd for HER2-Low',
+      components: ['Trastuzumab Deruxtecan'],
+      synergisticEffect: 1.5, cancerTypes: ['HER2-Low Breast', 'Gastric', 'NSCLC'],
+      clinicalEvidence: 'DESTINY-Breast04: 9.9mo PFS in HER2-low' },
+    { id: 'combo-enfortumab-pembro', name: 'Enfortumab + Pembrolizumab',
+      components: ['Enfortumab Vedotin', 'Pembrolizumab'],
+      synergisticEffect: 1.55, cancerTypes: ['Bladder', 'Urothelial'],
+      clinicalEvidence: 'EV-302: 31.5mo OS vs 16.1mo chemo' },
+    { id: 'combo-sacituzumab-tnbc', name: 'Sacituzumab Govitecan for TNBC',
+      components: ['Sacituzumab Govitecan'],
+      synergisticEffect: 1.4, cancerTypes: ['TNBC', 'Bladder'],
+      clinicalEvidence: 'ASCENT: 12.1mo OS in metastatic TNBC' },
+    { id: 'combo-folfox-bev', name: 'FOLFOX + Bevacizumab',
+      components: ['5-FU', 'Leucovorin', 'Oxaliplatin', 'Bevacizumab'],
+      synergisticEffect: 1.3, cancerTypes: ['Colorectal'],
+      clinicalEvidence: 'Standard 1L mCRC backbone' },
+    { id: 'combo-folfiri-cetux', name: 'FOLFIRI + Cetuximab (RAS WT)',
+      components: ['5-FU', 'Leucovorin', 'Irinotecan', 'Cetuximab'],
+      synergisticEffect: 1.35, cancerTypes: ['Colorectal (RAS WT)'],
+      clinicalEvidence: 'FIRE-3: Improved OS in left-sided mCRC' },
+    { id: 'combo-gem-nab-pac', name: 'Gemcitabine + nab-Paclitaxel',
+      components: ['Gemcitabine', 'nab-Paclitaxel'],
+      synergisticEffect: 1.25, cancerTypes: ['Pancreatic'],
+      clinicalEvidence: 'MPACT: 8.5mo OS in metastatic PDAC' },
+    { id: 'combo-folfirinox', name: 'FOLFIRINOX',
+      components: ['5-FU', 'Leucovorin', 'Irinotecan', 'Oxaliplatin'],
+      synergisticEffect: 1.4, cancerTypes: ['Pancreatic'],
+      clinicalEvidence: 'PRODIGE 4: 11.1mo OS in fit patients' },
+    { id: 'combo-osimertinib-chemo', name: 'Osimertinib + Chemotherapy',
+      components: ['Osimertinib', 'Carboplatin', 'Pemetrexed'],
+      synergisticEffect: 1.35, cancerTypes: ['EGFR+ NSCLC'],
+      clinicalEvidence: 'FLAURA2: 25.5mo PFS' },
+    { id: 'combo-cabo-atezo', name: 'Cabozantinib + Atezolizumab',
+      components: ['Cabozantinib', 'Atezolizumab'],
+      synergisticEffect: 1.4, cancerTypes: ['RCC', 'HCC'],
+      clinicalEvidence: 'COSMIC-311: Improved PFS in thyroid cancer' },
+    { id: 'combo-btk-venetoclax', name: 'BTK Inhibitor + Venetoclax',
+      components: ['Ibrutinib', 'Venetoclax'],
+      synergisticEffect: 1.65, cancerTypes: ['CLL', 'Mantle Cell'],
+      clinicalEvidence: 'CAPTIVATE: 88% uMRD rates' },
+    { id: 'combo-daratumumab-vrd', name: 'Daratumumab-VRd',
+      components: ['Daratumumab', 'Bortezomib', 'Lenalidomide', 'Dexamethasone'],
+      synergisticEffect: 1.5, cancerTypes: ['Multiple Myeloma'],
+      clinicalEvidence: 'PERSEUS: 84% sCR rate in newly diagnosed' },
+    { id: 'combo-tki-mek', name: 'TKI + MEK Inhibitor',
+      components: ['Various TKIs', 'MEK inhibitors'],
+      synergisticEffect: 1.35, cancerTypes: ['KRAS mutant tumors'],
+      clinicalEvidence: 'Combination to overcome resistance' },
+    { id: 'combo-adc-ici', name: 'ADC + Checkpoint Inhibitor',
+      components: ['Various ADCs', 'Pembrolizumab'],
+      synergisticEffect: 1.4, cancerTypes: ['Solid Tumors'],
+      clinicalEvidence: 'Emerging data showing enhanced efficacy' },
+    { id: 'combo-prrt-177lu', name: 'PRRT with 177Lu-DOTATATE',
+      components: ['177Lu-DOTATATE', 'Octreotide LAR'],
+      synergisticEffect: 1.45, cancerTypes: ['GI NET', 'Pancreatic NET'],
+      clinicalEvidence: 'NETTER-1: 79% reduction in progression' },
+    { id: 'combo-psma-rlt', name: 'PSMA Radioligand Therapy',
+      components: ['177Lu-PSMA-617', 'Standard of Care'],
+      synergisticEffect: 1.5, cancerTypes: ['mCRPC'],
+      clinicalEvidence: 'VISION: 4mo OS improvement' },
+    { id: 'combo-intensive-chemo-all', name: 'Intensive ALL Induction',
+      components: ['Vincristine', 'Prednisone', 'Daunorubicin', 'Asparaginase'],
+      synergisticEffect: 1.55, cancerTypes: ['ALL', 'Pediatric ALL'],
+      clinicalEvidence: '90%+ CR rates in pediatric ALL' },
+    { id: 'combo-r-chop', name: 'R-CHOP',
+      components: ['Rituximab', 'Cyclophosphamide', 'Doxorubicin', 'Vincristine', 'Prednisone'],
+      synergisticEffect: 1.5, cancerTypes: ['DLBCL', 'Follicular Lymphoma'],
+      clinicalEvidence: 'Standard of care for aggressive B-cell lymphoma' },
+    { id: 'combo-abvd', name: 'ABVD for Hodgkin',
+      components: ['Doxorubicin', 'Bleomycin', 'Vinblastine', 'Dacarbazine'],
+      synergisticEffect: 1.45, cancerTypes: ['Hodgkin Lymphoma'],
+      clinicalEvidence: '80%+ cure rate in early-stage HL' },
+    { id: 'combo-bv-avd', name: 'Brentuximab-AVD',
+      components: ['Brentuximab Vedotin', 'Doxorubicin', 'Vinblastine', 'Dacarbazine'],
+      synergisticEffect: 1.55, cancerTypes: ['Hodgkin Lymphoma (Advanced)'],
+      clinicalEvidence: 'ECHELON-1: Improved PFS over ABVD' },
+    { id: 'combo-carbo-taxol-bev', name: 'Carboplatin/Paclitaxel/Bevacizumab',
+      components: ['Carboplatin', 'Paclitaxel', 'Bevacizumab'],
+      synergisticEffect: 1.35, cancerTypes: ['Ovarian', 'NSCLC', 'Cervical'],
+      clinicalEvidence: 'GOG-0218: Improved PFS in ovarian' },
+    { id: 'combo-parp-bev', name: 'PARP + Bevacizumab Maintenance',
+      components: ['Olaparib', 'Bevacizumab'],
+      synergisticEffect: 1.5, cancerTypes: ['Ovarian (HRD+)'],
+      clinicalEvidence: 'PAOLA-1: 37.2mo PFS in HRD+ ovarian' },
+    { id: 'combo-temozolomide-rt', name: 'Temozolomide + Radiation (Stupp)',
+      components: ['Temozolomide', 'Radiation'],
+      synergisticEffect: 1.4, cancerTypes: ['Glioblastoma'],
+      clinicalEvidence: 'Stupp protocol: Standard of care GBM' },
+    { id: 'combo-ttfields-tmz', name: 'TTFields + Temozolomide',
+      components: ['Tumor Treating Fields', 'Temozolomide'],
+      synergisticEffect: 1.3, cancerTypes: ['Glioblastoma'],
+      clinicalEvidence: 'EF-14: Improved OS in newly diagnosed GBM' },
+    { id: 'combo-cisplatin-rt-hnscc', name: 'Cisplatin + Radiation (HNSCC)',
+      components: ['Cisplatin', 'Radiation'],
+      synergisticEffect: 1.4, cancerTypes: ['HNSCC', 'Nasopharyngeal'],
+      clinicalEvidence: 'Standard concurrent chemoradiation' },
+    { id: 'combo-pembro-chemo-hnscc', name: 'Pembrolizumab + Chemo (HNSCC)',
+      components: ['Pembrolizumab', 'Platinum', '5-FU'],
+      synergisticEffect: 1.45, cancerTypes: ['HNSCC (1L)'],
+      clinicalEvidence: 'KEYNOTE-048: Improved OS' },
+    { id: 'combo-gem-cis-cholang', name: 'Gemcitabine/Cisplatin + Durvalumab',
+      components: ['Gemcitabine', 'Cisplatin', 'Durvalumab'],
+      synergisticEffect: 1.4, cancerTypes: ['Cholangiocarcinoma', 'Biliary'],
+      clinicalEvidence: 'TOPAZ-1: Improved OS in biliary tract cancer' },
+    { id: 'combo-imatinib-gist', name: 'Imatinib (GIST)',
+      components: ['Imatinib'],
+      synergisticEffect: 1.6, cancerTypes: ['GIST'],
+      clinicalEvidence: '85% clinical benefit rate, transformed prognosis' },
+    { id: 'combo-avapritinib-gist', name: 'Avapritinib (PDGFRA D842V)',
+      components: ['Avapritinib'],
+      synergisticEffect: 1.55, cancerTypes: ['GIST (PDGFRA D842V)'],
+      clinicalEvidence: 'NAVIGATOR: 88% ORR in D842V mutant GIST' },
+    { id: 'combo-selpercatinib-ret', name: 'Selpercatinib (RET+)',
+      components: ['Selpercatinib'],
+      synergisticEffect: 1.5, cancerTypes: ['Thyroid (RET+)', 'NSCLC (RET+)'],
+      clinicalEvidence: 'LIBRETTO-001: 85% response rate' },
+    { id: 'combo-larotrectinib-ntrk', name: 'Larotrectinib (NTRK+)',
+      components: ['Larotrectinib'],
+      synergisticEffect: 1.6, cancerTypes: ['NTRK Fusion+ (Agnostic)'],
+      clinicalEvidence: '79% ORR across tumor types' }
   ];
 
   // ═══════════════════════════════════════════════════════════════════════════════
@@ -597,7 +1069,621 @@ export class CancerTreatmentCapabilityModule {
       organization: 'NCCN', cancerType: 'HCC', stage: 'III-IV',
       treatmentModalities: ['Atezolizumab + Bevacizumab', 'Lenvatinib', 'Sorafenib', 'Durvalumab + Tremelimumab'],
       efficacyScore: 0.72, sideEffectProfile: ['Hypertension', 'Bleeding', 'Hepatic Decompensation'],
-      references: ['IMbrave150', 'HIMALAYA'] }
+      references: ['IMbrave150', 'HIMALAYA'] },
+
+    // ═══════════════════════════════════════════════════════════════════════════════
+    // SARCOMAS
+    // ═══════════════════════════════════════════════════════════════════════════════
+    { id: 'nccn-soft-tissue-sarcoma', name: 'Soft Tissue Sarcoma Protocol',
+      organization: 'NCCN', cancerType: 'Soft Tissue Sarcoma', stage: 'All',
+      treatmentModalities: ['Surgery', 'Radiation', 'Doxorubicin', 'Ifosfamide', 'Trabectedin', 'Eribulin'],
+      efficacyScore: 0.65, sideEffectProfile: ['Cardiotoxicity', 'Myelosuppression', 'Nausea'],
+      references: ['NCCN STS Guidelines', 'ET743-SAR-3007'] },
+    { id: 'nccn-osteosarcoma', name: 'Osteosarcoma Protocol',
+      organization: 'NCCN', cancerType: 'Osteosarcoma', stage: 'All',
+      treatmentModalities: ['MAP Chemotherapy', 'Surgery', 'Mifamurtide', 'High-dose Methotrexate'],
+      efficacyScore: 0.70, sideEffectProfile: ['Nephrotoxicity', 'Ototoxicity', 'Cardiotoxicity'],
+      references: ['EURAMOS-1', 'INT-0133'] },
+    { id: 'nccn-ewing-sarcoma', name: 'Ewing Sarcoma Protocol',
+      organization: 'NCCN', cancerType: 'Ewing Sarcoma', stage: 'All',
+      treatmentModalities: ['VDC/IE Alternating', 'Surgery', 'Radiation', 'High-dose Chemotherapy'],
+      efficacyScore: 0.72, sideEffectProfile: ['Myelosuppression', 'Nausea', 'Secondary Malignancies'],
+      references: ['COG AEWS1031', 'Euro-EWING 99'] },
+    { id: 'nccn-gist', name: 'GIST Protocol',
+      organization: 'NCCN', cancerType: 'GIST', stage: 'All',
+      treatmentModalities: ['Imatinib', 'Sunitinib', 'Regorafenib', 'Ripretinib', 'Avapritinib'],
+      efficacyScore: 0.85, sideEffectProfile: ['Edema', 'Rash', 'Diarrhea'],
+      references: ['B2222', 'GRID', 'INVICTUS'] },
+    { id: 'nccn-leiomyosarcoma', name: 'Leiomyosarcoma Protocol',
+      organization: 'NCCN', cancerType: 'Leiomyosarcoma', stage: 'All',
+      treatmentModalities: ['Doxorubicin', 'Gemcitabine + Docetaxel', 'Trabectedin', 'Pazopanib'],
+      efficacyScore: 0.55, sideEffectProfile: ['Cardiotoxicity', 'Myelosuppression', 'Hepatotoxicity'],
+      references: ['GeDDiS', 'PALETTE'] },
+    { id: 'nccn-liposarcoma', name: 'Liposarcoma Protocol',
+      organization: 'NCCN', cancerType: 'Liposarcoma', stage: 'All',
+      treatmentModalities: ['Surgery', 'Radiation', 'Doxorubicin', 'Eribulin', 'Trabectedin'],
+      efficacyScore: 0.60, sideEffectProfile: ['Myelosuppression', 'Neuropathy', 'Fatigue'],
+      references: ['ET743-SAR-3007', 'E7389-G000-309'] },
+    { id: 'nccn-rhabdomyosarcoma', name: 'Rhabdomyosarcoma Protocol',
+      organization: 'NCCN', cancerType: 'Rhabdomyosarcoma', stage: 'All',
+      treatmentModalities: ['VAC Chemotherapy', 'Radiation', 'Surgery', 'Vincristine + Irinotecan'],
+      efficacyScore: 0.75, sideEffectProfile: ['Myelosuppression', 'Neuropathy', 'Cardiotoxicity'],
+      references: ['COG ARST0531', 'IRS-IV'] },
+    { id: 'nccn-chondrosarcoma', name: 'Chondrosarcoma Protocol',
+      organization: 'NCCN', cancerType: 'Chondrosarcoma', stage: 'All',
+      treatmentModalities: ['Surgery', 'Radiation (dedifferentiated)', 'Clinical Trials'],
+      efficacyScore: 0.50, sideEffectProfile: ['Surgical Complications', 'Radiation-related'],
+      references: ['NCCN Bone Cancer Guidelines'] },
+
+    // ═══════════════════════════════════════════════════════════════════════════════
+    // PEDIATRIC CANCERS
+    // ═══════════════════════════════════════════════════════════════════════════════
+    { id: 'cog-all', name: 'Pediatric ALL Protocol',
+      organization: 'Other', cancerType: 'Pediatric ALL', stage: 'All',
+      treatmentModalities: ['Induction', 'Consolidation', 'Maintenance', 'CNS Prophylaxis', 'CAR-T (relapsed)'],
+      efficacyScore: 0.92, sideEffectProfile: ['Infections', 'Osteonecrosis', 'Neurotoxicity'],
+      references: ['COG AALL1231', 'Total Therapy XVI'] },
+    { id: 'cog-neuroblastoma', name: 'Neuroblastoma Protocol',
+      organization: 'Other', cancerType: 'Neuroblastoma', stage: 'All',
+      treatmentModalities: ['Induction Chemotherapy', 'Surgery', 'High-dose Chemo + ASCT', 'Immunotherapy', 'Isotretinoin'],
+      efficacyScore: 0.75, sideEffectProfile: ['Myelosuppression', 'Ototoxicity', 'Nephrotoxicity'],
+      references: ['COG ANBL1232', 'HR-NBL1/SIOPEN'] },
+    { id: 'cog-wilms', name: 'Wilms Tumor Protocol',
+      organization: 'Other', cancerType: 'Wilms Tumor', stage: 'All',
+      treatmentModalities: ['Nephrectomy', 'Vincristine + Actinomycin D', 'Doxorubicin (high-risk)', 'Radiation'],
+      efficacyScore: 0.90, sideEffectProfile: ['Hepatotoxicity', 'Cardiotoxicity', 'Second Malignancies'],
+      references: ['COG AREN0532', 'SIOP 2001'] },
+    { id: 'cog-medulloblastoma', name: 'Medulloblastoma Protocol',
+      organization: 'Other', cancerType: 'Medulloblastoma', stage: 'All',
+      treatmentModalities: ['Surgery', 'Craniospinal Radiation', 'Cisplatin/Vincristine/Lomustine', 'High-dose Chemo (infant)'],
+      efficacyScore: 0.78, sideEffectProfile: ['Neurocognitive Effects', 'Endocrine Dysfunction', 'Ototoxicity'],
+      references: ['COG ACNS0331', 'SJMB03'] },
+    { id: 'cog-retinoblastoma', name: 'Retinoblastoma Protocol',
+      organization: 'Other', cancerType: 'Retinoblastoma', stage: 'All',
+      treatmentModalities: ['Enucleation', 'Intra-arterial Chemotherapy', 'Intravitreal Melphalan', 'Laser/Cryotherapy'],
+      efficacyScore: 0.95, sideEffectProfile: ['Vision Loss', 'Secondary Malignancies', 'Vascular Complications'],
+      references: ['COG ARET0332'] },
+    { id: 'cog-hepatoblastoma', name: 'Hepatoblastoma Protocol',
+      organization: 'Other', cancerType: 'Hepatoblastoma', stage: 'All',
+      treatmentModalities: ['Cisplatin + Doxorubicin', 'Surgery/Resection', 'Liver Transplant (if needed)'],
+      efficacyScore: 0.82, sideEffectProfile: ['Ototoxicity', 'Cardiotoxicity', 'Nephrotoxicity'],
+      references: ['COG AHEP0731', 'SIOPEL-4'] },
+    { id: 'cog-germ-cell', name: 'Pediatric Germ Cell Tumor Protocol',
+      organization: 'Other', cancerType: 'Pediatric Germ Cell', stage: 'All',
+      treatmentModalities: ['BEP Chemotherapy', 'Surgery', 'Carboplatin-based (low-risk)'],
+      efficacyScore: 0.88, sideEffectProfile: ['Pulmonary Toxicity', 'Nephrotoxicity', 'Infertility'],
+      references: ['COG AGCT0132', 'MaGIC'] },
+
+    // ═══════════════════════════════════════════════════════════════════════════════
+    // BRAIN TUMORS (Beyond GBM)
+    // ═══════════════════════════════════════════════════════════════════════════════
+    { id: 'nccn-astrocytoma', name: 'Low-Grade Astrocytoma Protocol',
+      organization: 'NCCN', cancerType: 'Low-Grade Glioma', stage: 'All',
+      treatmentModalities: ['Surgery', 'Observation', 'Temozolomide', 'PCV', 'Radiation'],
+      efficacyScore: 0.80, sideEffectProfile: ['Seizures', 'Cognitive Changes', 'Fatigue'],
+      references: ['RTOG 9802', 'EORTC 22033'] },
+    { id: 'nccn-oligodendroglioma', name: 'Oligodendroglioma Protocol',
+      organization: 'NCCN', cancerType: 'Oligodendroglioma', stage: 'All',
+      treatmentModalities: ['Surgery', 'PCV Chemotherapy', 'Temozolomide', 'Radiation'],
+      efficacyScore: 0.85, sideEffectProfile: ['Myelosuppression', 'Nausea', 'Cognitive Changes'],
+      references: ['RTOG 9402', 'EORTC 26951'] },
+    { id: 'nccn-meningioma', name: 'Meningioma Protocol',
+      organization: 'NCCN', cancerType: 'Meningioma', stage: 'All',
+      treatmentModalities: ['Surgery', 'Radiation/SRS', 'Observation (Grade I)'],
+      efficacyScore: 0.90, sideEffectProfile: ['Surgical Complications', 'Radiation Necrosis'],
+      references: ['RTOG 0539'] },
+    { id: 'nccn-ependymoma', name: 'Ependymoma Protocol',
+      organization: 'NCCN', cancerType: 'Ependymoma', stage: 'All',
+      treatmentModalities: ['Surgery', 'Radiation', 'Chemotherapy (recurrent)'],
+      efficacyScore: 0.70, sideEffectProfile: ['Neurocognitive Effects', 'Endocrine Dysfunction'],
+      references: ['COG ACNS0831'] },
+    { id: 'nccn-pituitary', name: 'Pituitary Tumor Protocol',
+      organization: 'NCCN', cancerType: 'Pituitary Adenoma', stage: 'All',
+      treatmentModalities: ['Surgery', 'Dopamine Agonists', 'Somatostatin Analogs', 'Radiation'],
+      efficacyScore: 0.88, sideEffectProfile: ['Hypopituitarism', 'Visual Changes', 'CSF Leak'],
+      references: ['Endocrine Society Guidelines'] },
+    { id: 'nccn-brain-mets', name: 'Brain Metastases Protocol',
+      organization: 'NCCN', cancerType: 'Brain Metastases', stage: 'IV',
+      treatmentModalities: ['SRS', 'WBRT', 'Surgery', 'Systemic Therapy', 'Immunotherapy'],
+      efficacyScore: 0.60, sideEffectProfile: ['Radiation Necrosis', 'Neurocognitive Decline'],
+      references: ['NCCTG N0574', 'Alliance A071801'] },
+    { id: 'nccn-pcnsl', name: 'Primary CNS Lymphoma Protocol',
+      organization: 'NCCN', cancerType: 'PCNSL', stage: 'All',
+      treatmentModalities: ['High-dose Methotrexate', 'Rituximab', 'Consolidation Chemo/ASCT', 'WBRT'],
+      efficacyScore: 0.65, sideEffectProfile: ['Nephrotoxicity', 'Neurotoxicity', 'Mucositis'],
+      references: ['IELSG32', 'Alliance 51101'] },
+
+    // ═══════════════════════════════════════════════════════════════════════════════
+    // NEUROENDOCRINE TUMORS
+    // ═══════════════════════════════════════════════════════════════════════════════
+    { id: 'nccn-gi-net', name: 'GI Neuroendocrine Tumor Protocol',
+      organization: 'NCCN', cancerType: 'GI NET', stage: 'All',
+      treatmentModalities: ['Surgery', 'Somatostatin Analogs', 'Everolimus', 'PRRT (Lu-177 DOTATATE)', 'Sunitinib'],
+      efficacyScore: 0.75, sideEffectProfile: ['Diarrhea', 'Hyperglycemia', 'Myelosuppression'],
+      references: ['NETTER-1', 'RADIANT-3', 'CLARINET'] },
+    { id: 'nccn-pancreatic-net', name: 'Pancreatic NET Protocol',
+      organization: 'NCCN', cancerType: 'Pancreatic NET', stage: 'All',
+      treatmentModalities: ['Surgery', 'Everolimus', 'Sunitinib', 'PRRT', 'Temozolomide + Capecitabine'],
+      efficacyScore: 0.72, sideEffectProfile: ['Stomatitis', 'Fatigue', 'Hypertension'],
+      references: ['RADIANT-3', 'A6181111'] },
+    { id: 'nccn-sclc', name: 'Small Cell Lung Cancer Protocol',
+      organization: 'NCCN', cancerType: 'SCLC', stage: 'All',
+      treatmentModalities: ['Carboplatin + Etoposide + Atezolizumab', 'Radiation', 'PCI', 'Topotecan/Lurbinectedin'],
+      efficacyScore: 0.55, sideEffectProfile: ['Myelosuppression', 'Neuropathy', 'Fatigue'],
+      references: ['IMpower133', 'CASPIAN'] },
+    { id: 'nccn-carcinoid', name: 'Carcinoid Tumor Protocol',
+      organization: 'NCCN', cancerType: 'Carcinoid', stage: 'All',
+      treatmentModalities: ['Surgery', 'Octreotide/Lanreotide', 'PRRT', 'Telotristat'],
+      efficacyScore: 0.78, sideEffectProfile: ['Carcinoid Crisis', 'Diarrhea', 'Flushing'],
+      references: ['PROMID', 'TELESTAR'] },
+    { id: 'nccn-pheochromocytoma', name: 'Pheochromocytoma Protocol',
+      organization: 'NCCN', cancerType: 'Pheochromocytoma', stage: 'All',
+      treatmentModalities: ['Surgery', 'Alpha-blockade', 'MIBG Therapy', 'CVD Chemotherapy', 'Sunitinib'],
+      efficacyScore: 0.70, sideEffectProfile: ['Hypertensive Crisis', 'Cardiovascular Events'],
+      references: ['NCCN Neuroendocrine Guidelines'] },
+    { id: 'nccn-merkel-cell', name: 'Merkel Cell Carcinoma Protocol',
+      organization: 'NCCN', cancerType: 'Merkel Cell Carcinoma', stage: 'All',
+      treatmentModalities: ['Surgery', 'Radiation', 'Avelumab', 'Pembrolizumab', 'Chemotherapy'],
+      efficacyScore: 0.68, sideEffectProfile: ['Immune-related AEs', 'Fatigue'],
+      references: ['JAVELIN Merkel 200', 'KEYNOTE-017'] },
+
+    // ═══════════════════════════════════════════════════════════════════════════════
+    // HEAD AND NECK CANCERS
+    // ═══════════════════════════════════════════════════════════════════════════════
+    { id: 'nccn-hnscc', name: 'Head and Neck Squamous Cell Carcinoma Protocol',
+      organization: 'NCCN', cancerType: 'HNSCC', stage: 'All',
+      treatmentModalities: ['Surgery', 'Radiation + Cisplatin', 'Pembrolizumab', 'Cetuximab', 'Nivolumab'],
+      efficacyScore: 0.72, sideEffectProfile: ['Mucositis', 'Dysphagia', 'Nephrotoxicity'],
+      references: ['KEYNOTE-048', 'CheckMate-141', 'RTOG 0129'] },
+    { id: 'nccn-hpv-positive', name: 'HPV+ Oropharyngeal Cancer Protocol',
+      organization: 'NCCN', cancerType: 'HPV+ OPSCC', stage: 'All',
+      treatmentModalities: ['Surgery + Adjuvant RT', 'Definitive CRT', 'De-escalation Trials'],
+      efficacyScore: 0.88, sideEffectProfile: ['Dysphagia', 'Dry Mouth', 'Neck Fibrosis'],
+      references: ['RTOG 1016', 'De-ESCALaTE'] },
+    { id: 'nccn-nasopharyngeal', name: 'Nasopharyngeal Carcinoma Protocol',
+      organization: 'NCCN', cancerType: 'Nasopharyngeal Carcinoma', stage: 'All',
+      treatmentModalities: ['Concurrent Chemoradiation', 'Induction Chemotherapy', 'Immunotherapy'],
+      efficacyScore: 0.80, sideEffectProfile: ['Hearing Loss', 'Dry Mouth', 'Trismus'],
+      references: ['MAC-NPC', 'CAPTAIN-1st'] },
+    { id: 'nccn-thyroid-differentiated', name: 'Differentiated Thyroid Cancer Protocol',
+      organization: 'NCCN', cancerType: 'Differentiated Thyroid Cancer', stage: 'All',
+      treatmentModalities: ['Thyroidectomy', 'RAI Ablation', 'TSH Suppression', 'Lenvatinib', 'Sorafenib'],
+      efficacyScore: 0.95, sideEffectProfile: ['Hypothyroidism', 'Hypertension', 'Fatigue'],
+      references: ['SELECT', 'DECISION'] },
+    { id: 'nccn-thyroid-medullary', name: 'Medullary Thyroid Cancer Protocol',
+      organization: 'NCCN', cancerType: 'Medullary Thyroid Cancer', stage: 'All',
+      treatmentModalities: ['Surgery', 'Vandetanib', 'Cabozantinib', 'Selpercatinib (RET+)', 'Pralsetinib'],
+      efficacyScore: 0.75, sideEffectProfile: ['QT Prolongation', 'Hypertension', 'Diarrhea'],
+      references: ['ZETA', 'LIBRETTO-001', 'ARROW'] },
+    { id: 'nccn-thyroid-anaplastic', name: 'Anaplastic Thyroid Cancer Protocol',
+      organization: 'NCCN', cancerType: 'Anaplastic Thyroid Cancer', stage: 'All',
+      treatmentModalities: ['Dabrafenib + Trametinib (BRAF+)', 'CRT', 'Lenvatinib', 'Clinical Trials'],
+      efficacyScore: 0.35, sideEffectProfile: ['Rapid Progression', 'Airway Compromise'],
+      references: ['ROAR Basket Trial'] },
+    { id: 'nccn-salivary-gland', name: 'Salivary Gland Cancer Protocol',
+      organization: 'NCCN', cancerType: 'Salivary Gland Cancer', stage: 'All',
+      treatmentModalities: ['Surgery', 'Radiation', 'Trastuzumab (HER2+)', 'Androgen Blockade (SDC)'],
+      efficacyScore: 0.65, sideEffectProfile: ['Facial Nerve Injury', 'Dry Mouth'],
+      references: ['NCCN Head and Neck Guidelines'] },
+
+    // ═══════════════════════════════════════════════════════════════════════════════
+    // ESOPHAGEAL AND GASTRIC CANCERS
+    // ═══════════════════════════════════════════════════════════════════════════════
+    { id: 'nccn-esophageal', name: 'Esophageal Cancer Protocol',
+      organization: 'NCCN', cancerType: 'Esophageal Cancer', stage: 'All',
+      treatmentModalities: ['Neoadjuvant CRT + Surgery', 'Definitive CRT', 'Nivolumab', 'Pembrolizumab', 'T-DXd (HER2+)'],
+      efficacyScore: 0.55, sideEffectProfile: ['Esophagitis', 'Dysphagia', 'Pneumonitis'],
+      references: ['CheckMate-577', 'KEYNOTE-590', 'CROSS'] },
+    { id: 'nccn-gastric', name: 'Gastric Cancer Protocol',
+      organization: 'NCCN', cancerType: 'Gastric Cancer', stage: 'All',
+      treatmentModalities: ['Surgery', 'Perioperative FLOT', 'Trastuzumab (HER2+)', 'Nivolumab', 'Pembrolizumab'],
+      efficacyScore: 0.60, sideEffectProfile: ['Nausea', 'Neuropathy', 'Myelosuppression'],
+      references: ['CheckMate-649', 'ToGA', 'FLOT4'] },
+    { id: 'nccn-gej', name: 'GE Junction Cancer Protocol',
+      organization: 'NCCN', cancerType: 'GE Junction Cancer', stage: 'All',
+      treatmentModalities: ['Neoadjuvant CRT', 'Surgery', 'Pembrolizumab + Chemo', 'Nivolumab'],
+      efficacyScore: 0.58, sideEffectProfile: ['Anastomotic Leak', 'Nutritional Deficiency'],
+      references: ['KEYNOTE-590', 'CheckMate-649'] },
+
+    // ═══════════════════════════════════════════════════════════════════════════════
+    // GYNECOLOGIC CANCERS
+    // ═══════════════════════════════════════════════════════════════════════════════
+    { id: 'nccn-cervical', name: 'Cervical Cancer Protocol',
+      organization: 'NCCN', cancerType: 'Cervical Cancer', stage: 'All',
+      treatmentModalities: ['Surgery', 'Concurrent CRT', 'Pembrolizumab', 'Bevacizumab', 'Tisotumab Vedotin'],
+      efficacyScore: 0.70, sideEffectProfile: ['Cystitis', 'Proctitis', 'Lymphedema'],
+      references: ['KEYNOTE-826', 'GOG-240', 'innovaTV 204'] },
+    { id: 'nccn-endometrial', name: 'Endometrial Cancer Protocol',
+      organization: 'NCCN', cancerType: 'Endometrial Cancer', stage: 'All',
+      treatmentModalities: ['Surgery', 'Radiation', 'Carboplatin + Paclitaxel', 'Dostarlimab (dMMR)', 'Lenvatinib + Pembrolizumab'],
+      efficacyScore: 0.75, sideEffectProfile: ['Lymphedema', 'Fatigue', 'Hypertension'],
+      references: ['KEYNOTE-775', 'GARNET', 'GOG-209'] },
+    { id: 'nccn-uterine-sarcoma', name: 'Uterine Sarcoma Protocol',
+      organization: 'NCCN', cancerType: 'Uterine Sarcoma', stage: 'All',
+      treatmentModalities: ['Surgery', 'Doxorubicin', 'Gemcitabine + Docetaxel', 'Pazopanib'],
+      efficacyScore: 0.50, sideEffectProfile: ['Cardiotoxicity', 'Myelosuppression'],
+      references: ['GeDDiS'] },
+    { id: 'nccn-vulvar', name: 'Vulvar Cancer Protocol',
+      organization: 'NCCN', cancerType: 'Vulvar Cancer', stage: 'All',
+      treatmentModalities: ['Surgery', 'Radiation + Cisplatin', 'Pembrolizumab'],
+      efficacyScore: 0.68, sideEffectProfile: ['Wound Complications', 'Lymphedema'],
+      references: ['GOG-205'] },
+    { id: 'nccn-vaginal', name: 'Vaginal Cancer Protocol',
+      organization: 'NCCN', cancerType: 'Vaginal Cancer', stage: 'All',
+      treatmentModalities: ['Radiation + Brachytherapy', 'Surgery (early)', 'Chemotherapy'],
+      efficacyScore: 0.65, sideEffectProfile: ['Vaginal Stenosis', 'Bladder/Rectal Toxicity'],
+      references: ['NCCN Vaginal Guidelines'] },
+    { id: 'nccn-gtd', name: 'Gestational Trophoblastic Disease Protocol',
+      organization: 'NCCN', cancerType: 'GTD', stage: 'All',
+      treatmentModalities: ['Methotrexate (low-risk)', 'EMA-CO (high-risk)', 'EP-EMA'],
+      efficacyScore: 0.95, sideEffectProfile: ['Mucositis', 'Myelosuppression', 'Pulmonary Toxicity'],
+      references: ['NCCN GTD Guidelines'] },
+
+    // ═══════════════════════════════════════════════════════════════════════════════
+    // GENITOURINARY CANCERS
+    // ═══════════════════════════════════════════════════════════════════════════════
+    { id: 'nccn-bladder', name: 'Bladder Cancer Protocol',
+      organization: 'NCCN', cancerType: 'Bladder Cancer', stage: 'All',
+      treatmentModalities: ['TURBT', 'BCG', 'Radical Cystectomy', 'Enfortumab Vedotin + Pembrolizumab', 'Erdafitinib (FGFR+)'],
+      efficacyScore: 0.72, sideEffectProfile: ['Cystitis', 'Neuropathy', 'Skin Toxicity'],
+      references: ['EV-302', 'BLC2001', 'KEYNOTE-057'] },
+    { id: 'nccn-testicular', name: 'Testicular Cancer Protocol',
+      organization: 'NCCN', cancerType: 'Testicular Cancer', stage: 'All',
+      treatmentModalities: ['Orchiectomy', 'BEP Chemotherapy', 'Surveillance', 'RPLND', 'High-dose Chemo + ASCT'],
+      efficacyScore: 0.95, sideEffectProfile: ['Pulmonary Toxicity', 'Nephrotoxicity', 'Infertility'],
+      references: ['NCCN Testicular Guidelines', 'SWENOTECA'] },
+    { id: 'nccn-penile', name: 'Penile Cancer Protocol',
+      organization: 'NCCN', cancerType: 'Penile Cancer', stage: 'All',
+      treatmentModalities: ['Surgery', 'Radiation', 'TIP Chemotherapy', 'Pembrolizumab'],
+      efficacyScore: 0.60, sideEffectProfile: ['Functional Impairment', 'Lymphedema'],
+      references: ['NCCN Penile Guidelines'] },
+    { id: 'nccn-adrenocortical', name: 'Adrenocortical Carcinoma Protocol',
+      organization: 'NCCN', cancerType: 'Adrenocortical Carcinoma', stage: 'All',
+      treatmentModalities: ['Surgery', 'Mitotane', 'EDP-M Chemotherapy', 'Pembrolizumab'],
+      efficacyScore: 0.45, sideEffectProfile: ['Adrenal Insufficiency', 'Neurotoxicity', 'GI Toxicity'],
+      references: ['FIRM-ACT', 'ADIUVO'] },
+
+    // ═══════════════════════════════════════════════════════════════════════════════
+    // MORE HEMATOLOGIC MALIGNANCIES
+    // ═══════════════════════════════════════════════════════════════════════════════
+    { id: 'nccn-cll', name: 'CLL Protocol',
+      organization: 'NCCN', cancerType: 'CLL', stage: 'All',
+      treatmentModalities: ['Ibrutinib', 'Venetoclax + Obinutuzumab', 'Acalabrutinib', 'Zanubrutinib', 'CAR-T (relapsed)'],
+      efficacyScore: 0.90, sideEffectProfile: ['Atrial Fibrillation', 'Bleeding', 'Infections'],
+      references: ['RESONATE-2', 'CLL14', 'ELEVATE-TN'] },
+    { id: 'nccn-cml', name: 'CML Protocol',
+      organization: 'NCCN', cancerType: 'CML', stage: 'All',
+      treatmentModalities: ['Imatinib', 'Dasatinib', 'Nilotinib', 'Bosutinib', 'Ponatinib', 'Asciminib'],
+      efficacyScore: 0.95, sideEffectProfile: ['Fluid Retention', 'Myelosuppression', 'Pleural Effusion'],
+      references: ['IRIS', 'DASISION', 'ENESTnd'] },
+    { id: 'nccn-hodgkin', name: 'Hodgkin Lymphoma Protocol',
+      organization: 'NCCN', cancerType: 'Hodgkin Lymphoma', stage: 'All',
+      treatmentModalities: ['ABVD', 'Brentuximab Vedotin + AVD', 'Pembrolizumab', 'ASCT', 'Nivolumab'],
+      efficacyScore: 0.88, sideEffectProfile: ['Pulmonary Toxicity', 'Cardiotoxicity', 'Secondary Malignancies'],
+      references: ['ECHELON-1', 'KEYNOTE-204', 'CheckMate-205'] },
+    { id: 'nccn-follicular', name: 'Follicular Lymphoma Protocol',
+      organization: 'NCCN', cancerType: 'Follicular Lymphoma', stage: 'All',
+      treatmentModalities: ['Rituximab + Bendamustine', 'R-CHOP', 'Obinutuzumab', 'Lenalidomide + Rituximab', 'CAR-T'],
+      efficacyScore: 0.85, sideEffectProfile: ['Infections', 'Infusion Reactions', 'Cytopenias'],
+      references: ['GALLIUM', 'RELEVANCE', 'ZUMA-5'] },
+    { id: 'nccn-mantle-cell', name: 'Mantle Cell Lymphoma Protocol',
+      organization: 'NCCN', cancerType: 'Mantle Cell Lymphoma', stage: 'All',
+      treatmentModalities: ['R-CHOP/R-DHAP + ASCT', 'Ibrutinib', 'Acalabrutinib', 'Venetoclax', 'Brexucabtagene autoleucel'],
+      efficacyScore: 0.75, sideEffectProfile: ['Myelosuppression', 'Infections', 'Bleeding'],
+      references: ['TRIANGLE', 'ZUMA-2'] },
+    { id: 'nccn-marginal-zone', name: 'Marginal Zone Lymphoma Protocol',
+      organization: 'NCCN', cancerType: 'Marginal Zone Lymphoma', stage: 'All',
+      treatmentModalities: ['Rituximab', 'Bendamustine + Rituximab', 'Ibrutinib', 'Zanubrutinib'],
+      efficacyScore: 0.82, sideEffectProfile: ['Infections', 'Cytopenias'],
+      references: ['MAGNOLIA', 'NCCN MZL Guidelines'] },
+    { id: 'nccn-waldenstrom', name: 'Waldenström Macroglobulinemia Protocol',
+      organization: 'NCCN', cancerType: 'Waldenström Macroglobulinemia', stage: 'All',
+      treatmentModalities: ['Ibrutinib', 'Zanubrutinib', 'Rituximab + Bendamustine', 'Bortezomib-based'],
+      efficacyScore: 0.85, sideEffectProfile: ['Atrial Fibrillation', 'Bleeding', 'IgM Flare'],
+      references: ['ASPEN', 'iNNOVATE'] },
+    { id: 'nccn-hairy-cell', name: 'Hairy Cell Leukemia Protocol',
+      organization: 'NCCN', cancerType: 'Hairy Cell Leukemia', stage: 'All',
+      treatmentModalities: ['Cladribine', 'Pentostatin', 'Vemurafenib (BRAF+)', 'Rituximab'],
+      efficacyScore: 0.92, sideEffectProfile: ['Myelosuppression', 'Infections', 'Immunosuppression'],
+      references: ['NCCN HCL Guidelines'] },
+    { id: 'nccn-mds', name: 'MDS Protocol',
+      organization: 'NCCN', cancerType: 'MDS', stage: 'All',
+      treatmentModalities: ['Azacitidine', 'Decitabine', 'Lenalidomide (del5q)', 'Luspatercept', 'Allogeneic HSCT'],
+      efficacyScore: 0.60, sideEffectProfile: ['Cytopenias', 'Infections', 'Fatigue'],
+      references: ['AZA-001', 'MDS-003'] },
+    { id: 'nccn-mpn', name: 'Myeloproliferative Neoplasms Protocol',
+      organization: 'NCCN', cancerType: 'MPN', stage: 'All',
+      treatmentModalities: ['Hydroxyurea', 'Ruxolitinib', 'Fedratinib', 'Interferon-alpha', 'Allogeneic HSCT'],
+      efficacyScore: 0.70, sideEffectProfile: ['Anemia', 'Thrombocytopenia', 'Infections'],
+      references: ['COMFORT-I/II', 'JAKARTA'] },
+    { id: 'nccn-mastocytosis', name: 'Systemic Mastocytosis Protocol',
+      organization: 'NCCN', cancerType: 'Systemic Mastocytosis', stage: 'All',
+      treatmentModalities: ['Avapritinib', 'Midostaurin', 'Cladribine', 'Imatinib'],
+      efficacyScore: 0.75, sideEffectProfile: ['Edema', 'Nausea', 'Cognitive Effects'],
+      references: ['EXPLORER', 'PIONEER'] },
+
+    // ═══════════════════════════════════════════════════════════════════════════════
+    // RARE CANCERS
+    // ═══════════════════════════════════════════════════════════════════════════════
+    { id: 'nccn-cholangiocarcinoma', name: 'Cholangiocarcinoma Protocol',
+      organization: 'NCCN', cancerType: 'Cholangiocarcinoma', stage: 'All',
+      treatmentModalities: ['Surgery', 'Gemcitabine + Cisplatin + Durvalumab', 'Pemigatinib (FGFR2+)', 'Ivosidenib (IDH1+)'],
+      efficacyScore: 0.55, sideEffectProfile: ['Cholangitis', 'Fatigue', 'Hyperphosphatemia'],
+      references: ['TOPAZ-1', 'FIGHT-202', 'ClarIDHy'] },
+    { id: 'nccn-gallbladder', name: 'Gallbladder Cancer Protocol',
+      organization: 'NCCN', cancerType: 'Gallbladder Cancer', stage: 'All',
+      treatmentModalities: ['Surgery', 'Gemcitabine + Cisplatin', 'Capecitabine (adjuvant)'],
+      efficacyScore: 0.45, sideEffectProfile: ['Biliary Complications', 'Nausea'],
+      references: ['BILCAP', 'ABC-02'] },
+    { id: 'nccn-mesothelioma', name: 'Mesothelioma Protocol',
+      organization: 'NCCN', cancerType: 'Mesothelioma', stage: 'All',
+      treatmentModalities: ['Surgery (selected)', 'Cisplatin + Pemetrexed', 'Nivolumab + Ipilimumab', 'TTFields'],
+      efficacyScore: 0.50, sideEffectProfile: ['Pulmonary Toxicity', 'Fatigue', 'Immune-related AEs'],
+      references: ['CheckMate-743', 'STELLAR'] },
+    { id: 'nccn-thymoma', name: 'Thymoma/Thymic Carcinoma Protocol',
+      organization: 'NCCN', cancerType: 'Thymoma', stage: 'All',
+      treatmentModalities: ['Surgery', 'Radiation', 'CAP Chemotherapy', 'Sunitinib', 'Pembrolizumab'],
+      efficacyScore: 0.70, sideEffectProfile: ['Myasthenia Gravis', 'Autoimmune Phenomena'],
+      references: ['NCCN Thymoma Guidelines'] },
+    { id: 'nccn-appendiceal', name: 'Appendiceal Cancer Protocol',
+      organization: 'NCCN', cancerType: 'Appendiceal Cancer', stage: 'All',
+      treatmentModalities: ['CRS + HIPEC', 'Systemic Chemotherapy (FOLFOX)', 'Bevacizumab'],
+      efficacyScore: 0.65, sideEffectProfile: ['Surgical Complications', 'Myelosuppression'],
+      references: ['NCCN Colon Guidelines'] },
+    { id: 'nccn-cup', name: 'Cancer of Unknown Primary Protocol',
+      organization: 'NCCN', cancerType: 'CUP', stage: 'All',
+      treatmentModalities: ['Empiric Chemotherapy', 'Site-directed Therapy', 'Immunotherapy', 'Molecular-guided'],
+      efficacyScore: 0.40, sideEffectProfile: ['Varies by Regimen'],
+      references: ['NCCN CUP Guidelines', 'CUPISCO'] },
+    { id: 'nccn-paraganglioma', name: 'Paraganglioma Protocol',
+      organization: 'NCCN', cancerType: 'Paraganglioma', stage: 'All',
+      treatmentModalities: ['Surgery', 'PRRT', 'CVD Chemotherapy', 'Sunitinib', 'Temozolomide'],
+      efficacyScore: 0.65, sideEffectProfile: ['Catecholamine Crisis', 'Myelosuppression'],
+      references: ['FIRSTMAPPP'] },
+    { id: 'nccn-desmoid', name: 'Desmoid Tumor Protocol',
+      organization: 'NCCN', cancerType: 'Desmoid Tumor', stage: 'All',
+      treatmentModalities: ['Active Surveillance', 'Sorafenib', 'Nirogacestat', 'Surgery (selected)'],
+      efficacyScore: 0.70, sideEffectProfile: ['Diarrhea', 'Rash', 'Ovarian Toxicity'],
+      references: ['DeFi', 'Alliance A091105'] },
+    { id: 'nccn-dermatofibrosarcoma', name: 'DFSP Protocol',
+      organization: 'NCCN', cancerType: 'DFSP', stage: 'All',
+      treatmentModalities: ['Wide Local Excision', 'Mohs Surgery', 'Imatinib (unresectable)'],
+      efficacyScore: 0.85, sideEffectProfile: ['Surgical Complications', 'Edema'],
+      references: ['NCCN Dermatofibrosarcoma Guidelines'] },
+    { id: 'nccn-epithelioid-sarcoma', name: 'Epithelioid Sarcoma Protocol',
+      organization: 'NCCN', cancerType: 'Epithelioid Sarcoma', stage: 'All',
+      treatmentModalities: ['Surgery', 'Tazemetostat (INI1-)', 'Doxorubicin', 'Gemcitabine'],
+      efficacyScore: 0.55, sideEffectProfile: ['Myelosuppression', 'Fatigue'],
+      references: ['NCCN STS Guidelines'] },
+    { id: 'nccn-angiosarcoma', name: 'Angiosarcoma Protocol',
+      organization: 'NCCN', cancerType: 'Angiosarcoma', stage: 'All',
+      treatmentModalities: ['Surgery', 'Radiation', 'Paclitaxel', 'Doxorubicin', 'Bevacizumab'],
+      efficacyScore: 0.45, sideEffectProfile: ['Bleeding', 'Cardiotoxicity', 'Myelosuppression'],
+      references: ['ANGIOTAX'] },
+    { id: 'nccn-kaposi', name: 'Kaposi Sarcoma Protocol',
+      organization: 'NCCN', cancerType: 'Kaposi Sarcoma', stage: 'All',
+      treatmentModalities: ['ART Optimization', 'Liposomal Doxorubicin', 'Paclitaxel', 'Pomalidomide'],
+      efficacyScore: 0.75, sideEffectProfile: ['Myelosuppression', 'Cardiotoxicity'],
+      references: ['AIDS Malignancy Consortium'] },
+
+    // ═══════════════════════════════════════════════════════════════════════════════
+    // PEDIATRIC CANCER PROTOCOLS (COG - Children's Oncology Group)
+    // ═══════════════════════════════════════════════════════════════════════════════
+    { id: 'cog-all-standard', name: 'Pediatric ALL Standard Risk',
+      organization: 'Other', cancerType: 'Pediatric ALL', stage: 'Standard Risk',
+      treatmentModalities: ['Induction (VCR/Pred/Asp/Dauno)', 'Consolidation', 'Interim Maintenance', 'Delayed Intensification', 'Maintenance'],
+      efficacyScore: 0.95, sideEffectProfile: ['Infection', 'Mucositis', 'Neurotoxicity', 'Osteonecrosis'],
+      references: ['COG AALL0434', 'COG AALL0232', '95% 5-year survival'] },
+    { id: 'cog-all-high', name: 'Pediatric ALL High Risk',
+      organization: 'Other', cancerType: 'Pediatric ALL', stage: 'High Risk',
+      treatmentModalities: ['Intensive Induction', 'High-Dose Methotrexate', 'CAR-T Eligible', 'Blinatumomab', 'Inotuzumab', 'Transplant Evaluation'],
+      efficacyScore: 0.88, sideEffectProfile: ['Severe Myelosuppression', 'CRS', 'ICANS'],
+      references: ['COG AALL1231', 'ELIANA'] },
+    { id: 'cog-neuroblastoma-lr', name: 'Neuroblastoma Low Risk',
+      organization: 'Other', cancerType: 'Neuroblastoma', stage: 'Low Risk',
+      treatmentModalities: ['Observation', 'Surgery Alone', 'Minimal Chemotherapy if symptomatic'],
+      efficacyScore: 0.98, sideEffectProfile: ['Surgical Complications'],
+      references: ['COG ANBL0531', '>95% survival'] },
+    { id: 'cog-neuroblastoma-hr', name: 'Neuroblastoma High Risk',
+      organization: 'Other', cancerType: 'Neuroblastoma', stage: 'High Risk',
+      treatmentModalities: ['Induction Chemo', 'Tandem Transplant', 'Radiation', 'Anti-GD2 Immunotherapy', 'Isotretinoin', 'Difluoromethylornithine'],
+      efficacyScore: 0.65, sideEffectProfile: ['Pain', 'Capillary Leak', 'Long-term Effects'],
+      references: ['COG ANBL1232', 'ANBL12P1'] },
+    { id: 'cog-wilms-favorable', name: 'Wilms Tumor Favorable Histology',
+      organization: 'Other', cancerType: 'Wilms Tumor', stage: 'I-II Favorable',
+      treatmentModalities: ['Nephrectomy', 'Vincristine', 'Actinomycin-D'],
+      efficacyScore: 0.95, sideEffectProfile: ['Nausea', 'Hepatotoxicity'],
+      references: ['AREN0533', '>90% survival'] },
+    { id: 'cog-wilms-unfavorable', name: 'Wilms Tumor Unfavorable/Anaplastic',
+      organization: 'Other', cancerType: 'Wilms Tumor', stage: 'III-IV or Anaplastic',
+      treatmentModalities: ['Nephrectomy', 'Intensive Chemo (VAD regimen)', 'Radiation', 'Carboplatin/Etoposide'],
+      efficacyScore: 0.75, sideEffectProfile: ['Cardiotoxicity', 'Nephrotoxicity', 'Infertility'],
+      references: ['AREN0321'] },
+    { id: 'cog-medulloblastoma-standard', name: 'Medulloblastoma Standard Risk',
+      organization: 'Other', cancerType: 'Medulloblastoma', stage: 'Standard Risk',
+      treatmentModalities: ['Maximal Safe Resection', 'Craniospinal Radiation (Reduced)', 'Cisplatin/Vincristine/Lomustine'],
+      efficacyScore: 0.85, sideEffectProfile: ['Cognitive Effects', 'Endocrine Dysfunction', 'Hearing Loss'],
+      references: ['ACNS0331', 'SJMB03'] },
+    { id: 'cog-osteosarcoma', name: 'Osteosarcoma Pediatric Protocol',
+      organization: 'Other', cancerType: 'Osteosarcoma', stage: 'Localized/Metastatic',
+      treatmentModalities: ['Neoadjuvant MAP', 'Limb-Salvage Surgery', 'Adjuvant MAP', 'Mifamurtide (Europe)'],
+      efficacyScore: 0.72, sideEffectProfile: ['Ototoxicity', 'Cardiotoxicity', 'Nephrotoxicity'],
+      references: ['EURAMOS-1', 'INT-0133'] },
+    { id: 'cog-ewing', name: 'Ewing Sarcoma Protocol',
+      organization: 'Other', cancerType: 'Ewing Sarcoma', stage: 'All',
+      treatmentModalities: ['VDC/IE Alternating', 'Surgery or Radiation', 'High-Dose Therapy for High Risk'],
+      efficacyScore: 0.70, sideEffectProfile: ['Myelosuppression', 'Cardiotoxicity', 'Secondary Malignancy'],
+      references: ['COG AEWS1031', 'Euro-EWING'] },
+    { id: 'cog-rhabdomyosarcoma-lr', name: 'Rhabdomyosarcoma Low Risk',
+      organization: 'Other', cancerType: 'Rhabdomyosarcoma', stage: 'Low Risk',
+      treatmentModalities: ['VAC Chemotherapy', 'Local Control (Surgery/RT)'],
+      efficacyScore: 0.90, sideEffectProfile: ['Myelosuppression', 'Growth Effects'],
+      references: ['ARST0331', 'D9602'] },
+    { id: 'cog-retinoblastoma', name: 'Retinoblastoma Protocol',
+      organization: 'Other', cancerType: 'Retinoblastoma', stage: 'All',
+      treatmentModalities: ['Intra-arterial Chemotherapy', 'Focal Therapy', 'Systemic Chemo (VEC)', 'Enucleation if needed'],
+      efficacyScore: 0.96, sideEffectProfile: ['Vision Loss', 'Secondary Tumors (Rb1 carriers)'],
+      references: ['ARET0231'] },
+    { id: 'cog-hepatoblastoma', name: 'Hepatoblastoma Protocol',
+      organization: 'Other', cancerType: 'Hepatoblastoma', stage: 'All',
+      treatmentModalities: ['Cisplatin/5-FU/Vincristine', 'Surgical Resection', 'Liver Transplant if unresectable'],
+      efficacyScore: 0.85, sideEffectProfile: ['Ototoxicity', 'Nephrotoxicity'],
+      references: ['AHEP0731', 'SIOPEL-6'] },
+
+    // ═══════════════════════════════════════════════════════════════════════════════
+    // ELDERLY AND FRAIL PATIENT PROTOCOLS
+    // ═══════════════════════════════════════════════════════════════════════════════
+    { id: 'elderly-aml', name: 'AML in Elderly/Unfit',
+      organization: 'NCCN', cancerType: 'AML', stage: 'Unfit for Intensive',
+      treatmentModalities: ['Venetoclax + Azacitidine', 'Low-Dose Cytarabine', 'Glasdegib + LDAC', 'Best Supportive Care'],
+      efficacyScore: 0.55, sideEffectProfile: ['Reduced intensity toxicity', 'Infection risk'],
+      references: ['VIALE-A', 'BRIGHT AML 1003'] },
+    { id: 'elderly-breast', name: 'Breast Cancer Elderly Frail',
+      organization: 'ESMO', cancerType: 'Breast', stage: 'Frail Elderly',
+      treatmentModalities: ['Endocrine Therapy Alone (HR+)', 'Omit Radiation if low risk', 'Single-agent Chemo if needed'],
+      efficacyScore: 0.80, sideEffectProfile: ['Minimized toxicity'],
+      references: ['PRIME II', 'CALGB 9343'] },
+    { id: 'elderly-dlbcl', name: 'DLBCL Frail/Elderly',
+      organization: 'NCCN', cancerType: 'DLBCL', stage: 'Unfit',
+      treatmentModalities: ['R-mini-CHOP', 'R-GCVP', 'Polatuzumab-BR', 'Loncastuximab'],
+      efficacyScore: 0.60, sideEffectProfile: ['Reduced cardiotoxicity', 'Myelosuppression'],
+      references: ['LNH03-7B'] },
+    { id: 'elderly-myeloma', name: 'Multiple Myeloma Frail',
+      organization: 'ESMO', cancerType: 'Multiple Myeloma', stage: 'Frail',
+      treatmentModalities: ['VRd-lite', 'Rd (Lenalidomide/Dex)', 'Daratumumab-Rd', 'Dose-adjusted regimens'],
+      efficacyScore: 0.70, sideEffectProfile: ['Reduced neuropathy', 'Infection risk'],
+      references: ['MAIA', 'FIRST'] },
+    { id: 'elderly-lung', name: 'NSCLC Elderly/PS2',
+      organization: 'NCCN', cancerType: 'NSCLC', stage: 'Elderly PS2',
+      treatmentModalities: ['Single-agent Pembrolizumab (PD-L1≥50%)', 'Single-agent Docetaxel', 'TKI if driver+', 'BSC'],
+      efficacyScore: 0.55, sideEffectProfile: ['Minimized toxicity'],
+      references: ['KEYNOTE-024', 'Elderly subset analyses'] },
+    { id: 'elderly-colorectal', name: 'Colorectal Cancer Elderly',
+      organization: 'ESMO', cancerType: 'Colorectal', stage: 'Elderly/Frail',
+      treatmentModalities: ['5-FU/Leucovorin alone', 'Capecitabine monotherapy', 'Bevacizumab + reduced chemo'],
+      efficacyScore: 0.65, sideEffectProfile: ['Reduced intensity'],
+      references: ['FOCUS2', 'AVEX'] },
+
+    // ═══════════════════════════════════════════════════════════════════════════════
+    // PREGNANCY-COMPATIBLE CANCER TREATMENTS
+    // ═══════════════════════════════════════════════════════════════════════════════
+    { id: 'pregnancy-breast', name: 'Breast Cancer in Pregnancy',
+      organization: 'ESMO', cancerType: 'Breast', stage: 'Pregnancy',
+      treatmentModalities: ['Surgery (any trimester)', 'AC Chemotherapy (2nd/3rd trimester)', 'No Radiation during pregnancy', 'Endocrine after delivery'],
+      efficacyScore: 0.85, sideEffectProfile: ['Fetal monitoring required', 'Delivery timing optimization'],
+      references: ['German Breast Group Registry', 'Pregnancy-associated breast cancer guidelines'] },
+    { id: 'pregnancy-cervical', name: 'Cervical Cancer in Pregnancy',
+      organization: 'ESMO', cancerType: 'Cervical', stage: 'Pregnancy',
+      treatmentModalities: ['Conization (early stage)', 'Neoadjuvant Chemo (BOMP-EMA)', 'Delay definitive treatment', 'Delivery then treatment'],
+      efficacyScore: 0.80, sideEffectProfile: ['Preterm delivery risk', 'Close surveillance'],
+      references: ['ESGO Guidelines'] },
+    { id: 'pregnancy-lymphoma', name: 'Hodgkin Lymphoma in Pregnancy',
+      organization: 'ESMO', cancerType: 'Hodgkin Lymphoma', stage: 'Pregnancy',
+      treatmentModalities: ['ABVD (2nd/3rd trimester)', 'Single-agent Vinblastine (1st trimester if urgent)', 'Delay if possible'],
+      efficacyScore: 0.85, sideEffectProfile: ['Fetal monitoring', 'No Bleomycin if possible'],
+      references: ['European guidelines on pregnancy and cancer'] },
+    { id: 'pregnancy-melanoma', name: 'Melanoma in Pregnancy',
+      organization: 'NCCN', cancerType: 'Melanoma', stage: 'Pregnancy',
+      treatmentModalities: ['Surgical excision', 'SLNB (2nd trimester+)', 'Defer systemic therapy if possible', 'Checkpoint inhibitors contraindicated'],
+      efficacyScore: 0.75, sideEffectProfile: ['Limited systemic options'],
+      references: ['NCCN Melanoma Guidelines - Pregnancy section'] },
+    { id: 'pregnancy-thyroid', name: 'Thyroid Cancer in Pregnancy',
+      organization: 'Other', cancerType: 'Thyroid', stage: 'Pregnancy',
+      treatmentModalities: ['Surgery (2nd trimester preferred)', 'TSH suppression with levothyroxine', 'No RAI during pregnancy', 'Post-delivery RAI'],
+      efficacyScore: 0.95, sideEffectProfile: ['Minimal with proper timing'],
+      references: ['ATA Guidelines 2015'] },
+
+    // ═══════════════════════════════════════════════════════════════════════════════
+    // RELAPSED/REFRACTORY PROTOCOLS
+    // ═══════════════════════════════════════════════════════════════════════════════
+    { id: 'relapsed-dlbcl', name: 'Relapsed/Refractory DLBCL',
+      organization: 'NCCN', cancerType: 'DLBCL', stage: 'R/R',
+      treatmentModalities: ['CAR-T (Axi-cel, Liso-cel, Tisa-cel)', 'Polatuzumab-BR', 'Loncastuximab', 'Selinexor', 'Tafasitamab-Len', 'Bispecifics (Glofitamab, Epcoritamab)'],
+      efficacyScore: 0.50, sideEffectProfile: ['CRS', 'ICANS', 'Cytopenias'],
+      references: ['ZUMA-7', 'TRANSFORM', 'LOTIS-2'] },
+    { id: 'relapsed-myeloma', name: 'Relapsed/Refractory Myeloma',
+      organization: 'NCCN', cancerType: 'Multiple Myeloma', stage: 'R/R',
+      treatmentModalities: ['CAR-T (Ide-cel, Cilta-cel)', 'Bispecifics (Teclistamab, Talquetamab)', 'Selinexor-based', 'Belantamab (if available)', 'Carfilzomib combos'],
+      efficacyScore: 0.55, sideEffectProfile: ['CRS', 'ICANS', 'Ocular toxicity', 'Skin/nail changes'],
+      references: ['KarMMa', 'CARTITUDE-1', 'MajesTEC-1'] },
+    { id: 'relapsed-all', name: 'Relapsed/Refractory ALL',
+      organization: 'NCCN', cancerType: 'ALL', stage: 'R/R',
+      treatmentModalities: ['Blinatumomab', 'Inotuzumab', 'CAR-T (Tisa-cel, Brexu-cel)', 'Nelarabine (T-ALL)', 'Clofarabine-based'],
+      efficacyScore: 0.45, sideEffectProfile: ['CRS', 'ICANS', 'VOD'],
+      references: ['TOWER', 'INO-VATE ALL'] },
+    { id: 'relapsed-chl', name: 'Relapsed Hodgkin Lymphoma',
+      organization: 'NCCN', cancerType: 'Hodgkin Lymphoma', stage: 'R/R',
+      treatmentModalities: ['Brentuximab Vedotin', 'Pembrolizumab', 'Nivolumab', 'Auto-SCT', 'Allo-SCT'],
+      efficacyScore: 0.65, sideEffectProfile: ['Neuropathy', 'Immune-related AEs'],
+      references: ['AETHERA', 'KEYNOTE-204'] },
+    { id: 'relapsed-sclc', name: 'Relapsed SCLC',
+      organization: 'NCCN', cancerType: 'SCLC', stage: 'R/R',
+      treatmentModalities: ['Topotecan', 'Lurbinectedin', 'Tarlatamab', 'CAV', 'Clinical Trials'],
+      efficacyScore: 0.35, sideEffectProfile: ['Myelosuppression', 'Fatigue'],
+      references: ['ATLANTIS', 'DeLLphi-301'] },
+    { id: 'relapsed-ovarian', name: 'Relapsed Ovarian Cancer',
+      organization: 'NCCN', cancerType: 'Ovarian', stage: 'R/R',
+      treatmentModalities: ['Platinum rechallenge (if sensitive)', 'PARP maintenance', 'Mirvetuximab (FRα+)', 'Bevacizumab', 'Liposomal Doxorubicin'],
+      efficacyScore: 0.45, sideEffectProfile: ['Neuropathy', 'Myelosuppression'],
+      references: ['AURELIA', 'SOLO2', 'MIRASOL'] },
+    { id: 'relapsed-gist', name: 'Relapsed/Resistant GIST',
+      organization: 'NCCN', cancerType: 'GIST', stage: 'R/R',
+      treatmentModalities: ['Sunitinib', 'Regorafenib', 'Ripretinib', 'Avapritinib (PDGFRA)', 'Clinical Trials'],
+      efficacyScore: 0.50, sideEffectProfile: ['Hand-foot syndrome', 'Hypertension', 'Fatigue'],
+      references: ['INVICTUS', 'NAVIGATOR'] },
+    { id: 'relapsed-melanoma', name: 'Relapsed/Resistant Melanoma',
+      organization: 'NCCN', cancerType: 'Melanoma', stage: 'R/R post-ICI',
+      treatmentModalities: ['Lifileucel (TIL)', 'BRAF/MEK if BRAF+', 'LAG-3 combo', 'Clinical Trials (STING, oncolytic)'],
+      efficacyScore: 0.40, sideEffectProfile: ['Varies by therapy'],
+      references: ['C-144-01'] },
+
+    // ═══════════════════════════════════════════════════════════════════════════════
+    // TUMOR-AGNOSTIC PROTOCOLS
+    // ═══════════════════════════════════════════════════════════════════════════════
+    { id: 'agnostic-msi-h', name: 'MSI-H/dMMR Agnostic',
+      organization: 'FDA', cancerType: 'MSI-H Any Tumor', stage: 'All',
+      treatmentModalities: ['Pembrolizumab', 'Dostarlimab'],
+      efficacyScore: 0.55, sideEffectProfile: ['Immune-related AEs'],
+      references: ['KEYNOTE-158', 'GARNET'] },
+    { id: 'agnostic-tmb-h', name: 'TMB-High Agnostic',
+      organization: 'FDA', cancerType: 'TMB-H Any Tumor', stage: 'All',
+      treatmentModalities: ['Pembrolizumab'],
+      efficacyScore: 0.40, sideEffectProfile: ['Immune-related AEs'],
+      references: ['KEYNOTE-158 TMB cohort'] },
+    { id: 'agnostic-ntrk', name: 'NTRK Fusion Agnostic',
+      organization: 'FDA', cancerType: 'NTRK Fusion Any Tumor', stage: 'All',
+      treatmentModalities: ['Larotrectinib', 'Entrectinib'],
+      efficacyScore: 0.75, sideEffectProfile: ['Dizziness', 'Fatigue', 'Weight gain'],
+      references: ['LOXO-TRK', 'STARTRK'] },
+    { id: 'agnostic-ret', name: 'RET Fusion Agnostic',
+      organization: 'FDA', cancerType: 'RET Fusion Any Tumor', stage: 'All',
+      treatmentModalities: ['Selpercatinib', 'Pralsetinib'],
+      efficacyScore: 0.70, sideEffectProfile: ['Hypertension', 'Transaminitis'],
+      references: ['LIBRETTO-001', 'ARROW'] },
+    { id: 'agnostic-braf-v600e', name: 'BRAF V600E Agnostic',
+      organization: 'FDA', cancerType: 'BRAF V600E Any Tumor', stage: 'All',
+      treatmentModalities: ['Dabrafenib + Trametinib'],
+      efficacyScore: 0.50, sideEffectProfile: ['Pyrexia', 'Rash', 'Fatigue'],
+      references: ['ROAR basket trial', 'NCI-MATCH'] },
+
+    // ═══════════════════════════════════════════════════════════════════════════════
+    // SUPPORTIVE & PALLIATIVE CARE PROTOCOLS
+    // ═══════════════════════════════════════════════════════════════════════════════
+    { id: 'supportive-bone-mets', name: 'Bone Metastases Management',
+      organization: 'ASCO', cancerType: 'Any with Bone Mets', stage: 'Metastatic',
+      treatmentModalities: ['Zoledronic Acid', 'Denosumab', 'Palliative Radiation', 'Vertebroplasty', 'Pain Management'],
+      efficacyScore: 0.80, sideEffectProfile: ['ONJ risk', 'Hypocalcemia'],
+      references: ['ASCO Bone Health Guidelines'] },
+    { id: 'supportive-brain-mets', name: 'Brain Metastases Management',
+      organization: 'NCCN', cancerType: 'Any with Brain Mets', stage: 'Metastatic',
+      treatmentModalities: ['SRS', 'WBRT', 'Surgery', 'Steroids', 'Systemic Therapy (CNS-penetrant)'],
+      efficacyScore: 0.60, sideEffectProfile: ['Cognitive effects', 'Radiation necrosis'],
+      references: ['NCCN CNS Metastases Guidelines'] },
+    { id: 'supportive-malignant-effusion', name: 'Malignant Effusion Management',
+      organization: 'Other', cancerType: 'Any with Effusion', stage: 'Metastatic',
+      treatmentModalities: ['Thoracentesis/Paracentesis', 'Pleurodesis', 'Indwelling Catheter', 'HIPEC (peritoneal)'],
+      efficacyScore: 0.70, sideEffectProfile: ['Procedure-related'],
+      references: ['TIME trials'] }
   ];
 
   constructor() {
@@ -805,20 +1891,118 @@ export class CancerTreatmentCapabilityModule {
     return result;
   }
 
-  // Helper: Normalize cancer type names
+  // Helper: Normalize cancer type names - Comprehensive mapping for all cancer types
   private normalizeCancerType(cancerType: string): string {
     const mappings: Record<string, string> = {
-      'breast': 'Breast', 'lung': 'NSCLC', 'nsclc': 'NSCLC', 'sclc': 'SCLC',
-      'colorectal': 'Colorectal', 'colon': 'Colorectal', 'rectal': 'Colorectal',
-      'melanoma': 'Melanoma', 'pancreatic': 'Pancreatic', 'pancreas': 'Pancreatic',
-      'prostate': 'Prostate', 'ovarian': 'Ovarian', 'renal': 'RCC', 'kidney': 'RCC',
-      'liver': 'HCC', 'hcc': 'HCC', 'hepatocellular': 'HCC',
-      'aml': 'AML', 'leukemia': 'AML', 'lymphoma': 'DLBCL', 'dlbcl': 'DLBCL',
-      'myeloma': 'Multiple Myeloma', 'glioblastoma': 'Glioblastoma', 'gbm': 'Glioblastoma',
-      'bladder': 'Bladder', 'gastric': 'Gastric', 'stomach': 'Gastric',
-      'thyroid': 'Thyroid', 'tnbc': 'TNBC', 'triple negative': 'TNBC'
+      // Common solid tumors
+      'breast': 'Breast', 'breast cancer': 'Breast',
+      'lung': 'NSCLC', 'nsclc': 'NSCLC', 'non-small cell lung': 'NSCLC',
+      'sclc': 'SCLC', 'small cell lung': 'SCLC',
+      'colorectal': 'Colorectal', 'colon': 'Colorectal', 'rectal': 'Colorectal', 'crc': 'Colorectal',
+      'melanoma': 'Melanoma', 'skin melanoma': 'Melanoma',
+      'pancreatic': 'Pancreatic', 'pancreas': 'Pancreatic', 'pdac': 'Pancreatic',
+      'prostate': 'Prostate', 'prostate cancer': 'Prostate',
+      'ovarian': 'Ovarian', 'ovary': 'Ovarian',
+      'renal': 'RCC', 'kidney': 'RCC', 'rcc': 'RCC', 'clear cell renal': 'RCC',
+      'liver': 'HCC', 'hcc': 'HCC', 'hepatocellular': 'HCC', 'hepatocellular carcinoma': 'HCC',
+      'tnbc': 'TNBC', 'triple negative': 'TNBC', 'triple-negative breast': 'TNBC',
+
+      // Hematologic malignancies
+      'aml': 'AML', 'acute myeloid leukemia': 'AML',
+      'all': 'ALL', 'acute lymphoblastic leukemia': 'ALL', 'b-all': 'B-ALL', 'b-cell all': 'B-ALL',
+      'cll': 'CLL', 'chronic lymphocytic leukemia': 'CLL',
+      'cml': 'CML', 'chronic myeloid leukemia': 'CML', 'chronic myelogenous': 'CML',
+      'lymphoma': 'DLBCL', 'dlbcl': 'DLBCL', 'diffuse large b-cell': 'DLBCL',
+      'hodgkin': 'Hodgkin Lymphoma', 'hodgkin lymphoma': 'Hodgkin Lymphoma', 'hl': 'Hodgkin Lymphoma',
+      'follicular': 'Follicular Lymphoma', 'follicular lymphoma': 'Follicular Lymphoma', 'fl': 'Follicular Lymphoma',
+      'mantle cell': 'Mantle Cell Lymphoma', 'mcl': 'Mantle Cell Lymphoma',
+      'marginal zone': 'Marginal Zone Lymphoma', 'mzl': 'Marginal Zone Lymphoma',
+      'myeloma': 'Multiple Myeloma', 'multiple myeloma': 'Multiple Myeloma', 'mm': 'Multiple Myeloma',
+      'waldenstrom': 'Waldenström Macroglobulinemia', 'waldenström': 'Waldenström Macroglobulinemia',
+      'hairy cell': 'Hairy Cell Leukemia', 'hcl': 'Hairy Cell Leukemia',
+      'mds': 'MDS', 'myelodysplastic': 'MDS', 'myelodysplastic syndrome': 'MDS',
+      'mpn': 'MPN', 'myeloproliferative': 'MPN', 'polycythemia vera': 'MPN', 'essential thrombocythemia': 'MPN',
+      'mastocytosis': 'Mastocytosis', 'systemic mastocytosis': 'Mastocytosis',
+
+      // Brain tumors
+      'glioblastoma': 'Glioblastoma', 'gbm': 'Glioblastoma', 'glioblastoma multiforme': 'Glioblastoma',
+      'astrocytoma': 'Low-Grade Astrocytoma', 'low grade astrocytoma': 'Low-Grade Astrocytoma',
+      'oligodendroglioma': 'Oligodendroglioma', 'oligo': 'Oligodendroglioma',
+      'meningioma': 'Meningioma',
+      'ependymoma': 'Ependymoma',
+      'pituitary': 'Pituitary Tumor', 'pituitary adenoma': 'Pituitary Tumor', 'pituitary tumor': 'Pituitary Tumor',
+      'brain metastases': 'Brain Metastases', 'brain mets': 'Brain Metastases',
+      'pcnsl': 'PCNSL', 'primary cns lymphoma': 'PCNSL', 'cns lymphoma': 'PCNSL',
+      'medulloblastoma': 'Medulloblastoma',
+
+      // Sarcomas
+      'sarcoma': 'Soft Tissue Sarcoma', 'soft tissue sarcoma': 'Soft Tissue Sarcoma', 'sts': 'Soft Tissue Sarcoma',
+      'osteosarcoma': 'Osteosarcoma', 'bone cancer': 'Osteosarcoma',
+      'ewing': 'Ewing Sarcoma', 'ewing sarcoma': 'Ewing Sarcoma', 'ewings': 'Ewing Sarcoma',
+      'gist': 'GIST', 'gastrointestinal stromal': 'GIST',
+      'leiomyosarcoma': 'Leiomyosarcoma', 'lms': 'Leiomyosarcoma',
+      'liposarcoma': 'Liposarcoma', 'lipo': 'Liposarcoma',
+      'rhabdomyosarcoma': 'Rhabdomyosarcoma', 'rms': 'Rhabdomyosarcoma',
+      'chondrosarcoma': 'Chondrosarcoma',
+      'angiosarcoma': 'Angiosarcoma',
+      'epithelioid sarcoma': 'Epithelioid Sarcoma',
+      'desmoid': 'Desmoid Tumor', 'desmoid tumor': 'Desmoid Tumor', 'aggressive fibromatosis': 'Desmoid Tumor',
+      'dfsp': 'DFSP', 'dermatofibrosarcoma': 'DFSP',
+
+      // Pediatric cancers
+      'neuroblastoma': 'Neuroblastoma', 'nbl': 'Neuroblastoma',
+      'wilms': 'Wilms Tumor', 'wilms tumor': 'Wilms Tumor', 'nephroblastoma': 'Wilms Tumor',
+      'retinoblastoma': 'Retinoblastoma', 'rb': 'Retinoblastoma',
+      'hepatoblastoma': 'Hepatoblastoma',
+      'pediatric all': 'Pediatric ALL', 'childhood leukemia': 'Pediatric ALL',
+      'pediatric germ cell': 'Pediatric Germ Cell', 'childhood germ cell': 'Pediatric Germ Cell',
+
+      // Neuroendocrine tumors
+      'net': 'GI NET', 'neuroendocrine': 'GI NET', 'neuroendocrine tumor': 'GI NET', 'gi net': 'GI NET',
+      'pancreatic net': 'Pancreatic NET', 'pnet': 'Pancreatic NET', 'p-net': 'Pancreatic NET',
+      'carcinoid': 'Carcinoid', 'carcinoid tumor': 'Carcinoid',
+      'pheochromocytoma': 'Pheochromocytoma', 'pheo': 'Pheochromocytoma',
+      'paraganglioma': 'Paraganglioma', 'pgl': 'Paraganglioma',
+      'merkel': 'Merkel Cell Carcinoma', 'merkel cell': 'Merkel Cell Carcinoma', 'mcc': 'Merkel Cell Carcinoma',
+
+      // Head and neck cancers
+      'head and neck': 'HNSCC', 'hnscc': 'HNSCC', 'head neck': 'HNSCC', 'squamous head neck': 'HNSCC',
+      'hpv positive': 'HPV+ OPSCC', 'hpv+ opscc': 'HPV+ OPSCC', 'oropharyngeal': 'HPV+ OPSCC',
+      'nasopharyngeal': 'Nasopharyngeal', 'npc': 'Nasopharyngeal', 'nasopharynx': 'Nasopharyngeal',
+      'thyroid': 'Differentiated Thyroid', 'differentiated thyroid': 'Differentiated Thyroid', 'papillary thyroid': 'Differentiated Thyroid',
+      'medullary thyroid': 'Medullary Thyroid', 'mtc': 'Medullary Thyroid',
+      'anaplastic thyroid': 'Anaplastic Thyroid', 'atc': 'Anaplastic Thyroid',
+      'salivary': 'Salivary Gland', 'salivary gland': 'Salivary Gland',
+
+      // Gastrointestinal cancers
+      'gastric': 'Gastric', 'stomach': 'Gastric', 'stomach cancer': 'Gastric',
+      'esophageal': 'Esophageal', 'esophagus': 'Esophageal',
+      'ge junction': 'GE Junction', 'gej': 'GE Junction', 'gastroesophageal': 'GE Junction',
+      'cholangiocarcinoma': 'Cholangiocarcinoma', 'bile duct': 'Cholangiocarcinoma', 'cca': 'Cholangiocarcinoma',
+      'gallbladder': 'Gallbladder Cancer', 'gallbladder cancer': 'Gallbladder Cancer',
+      'appendiceal': 'Appendiceal Cancer', 'appendix': 'Appendiceal Cancer',
+
+      // Gynecologic cancers
+      'cervical': 'Cervical', 'cervix': 'Cervical', 'cervical cancer': 'Cervical',
+      'endometrial': 'Endometrial', 'uterine': 'Endometrial', 'uterus': 'Endometrial',
+      'uterine sarcoma': 'Uterine Sarcoma',
+      'vulvar': 'Vulvar', 'vulva': 'Vulvar',
+      'vaginal': 'Vaginal', 'vagina': 'Vaginal',
+      'gtd': 'GTD', 'gestational trophoblastic': 'GTD', 'choriocarcinoma': 'GTD',
+
+      // Genitourinary cancers
+      'bladder': 'Bladder', 'urothelial': 'Bladder', 'bladder cancer': 'Bladder',
+      'testicular': 'Testicular', 'testis': 'Testicular', 'germ cell tumor': 'Testicular',
+      'penile': 'Penile', 'penis': 'Penile',
+      'adrenocortical': 'Adrenocortical Carcinoma', 'acc': 'Adrenocortical Carcinoma', 'adrenal': 'Adrenocortical Carcinoma',
+
+      // Rare cancers
+      'mesothelioma': 'Mesothelioma', 'pleural mesothelioma': 'Mesothelioma',
+      'thymoma': 'Thymoma', 'thymic': 'Thymoma',
+      'cup': 'CUP', 'cancer unknown primary': 'CUP', 'unknown primary': 'CUP',
+      'kaposi': 'Kaposi Sarcoma', 'kaposi sarcoma': 'Kaposi Sarcoma', 'ks': 'Kaposi Sarcoma'
     };
-    const lower = cancerType.toLowerCase();
+    const lower = cancerType.toLowerCase().trim();
     return mappings[lower] || cancerType;
   }