@erosolaraijs/cure 2.2.0 → 2.3.0

package/dist/capabilities/globalCancerCoverage.js

@@ -0,0 +1,1066 @@
+/**
+ * 全球癌症全覆盖框架 (Global Cancer Coverage Framework)
+ *
+ * ██████╗ ██╗      ██████╗ ██████╗  █████╗ ██╗
+ * ██╔════╝ ██║     ██╔═══██╗██╔══██╗██╔══██╗██║
+ * ██║  ███╗██║     ██║   ██║██████╔╝███████║██║
+ * ██║   ██║██║     ██║   ██║██╔══██╗██╔══██║██║
+ * ╚██████╔╝███████╗╚██████╔╝██████╔╝██║  ██║███████╗
+ *  ╚═════╝ ╚══════╝ ╚═════╝ ╚═════╝ ╚═╝  ╚═╝╚══════╝
+ *
+ * Comprehensive global cancer coverage ensuring:
+ * - 所有癌症类型 (All Cancer Types)
+ * - 全球治疗指南 (Global Treatment Guidelines)
+ * - 特殊人群覆盖 (Special Populations)
+ * - 资源有限环境适应 (Resource-Limited Settings)
+ * - 支持性护理 (Supportive Care)
+ * - 儿科肿瘤全覆盖 (Pediatric Oncology)
+ */
+// ═══════════════════════════════════════════════════════════════════════════════
+// GLOBAL CANCER COVERAGE MODULE
+// ═══════════════════════════════════════════════════════════════════════════════
+export class GlobalCancerCoverageModule {
+    // ═══════════════════════════════════════════════════════════════════════════════
+    // ASIAN TREATMENT GUIDELINES (Japan, China, Korea, India, Southeast Asia)
+    // ═══════════════════════════════════════════════════════════════════════════════
+    asianGuidelines = [
+        // JAPAN - JSCO Guidelines
+        { id: 'jsco-gastric-001', name: 'Japanese Gastric Cancer Treatment Guidelines',
+            organization: 'Japanese Gastric Cancer Association', region: 'Asia', country: 'Japan',
+            cancerType: 'Gastric Cancer', stage: 'I-IV',
+            treatmentModalities: ['D2 Lymphadenectomy', 'S-1 Adjuvant', 'SOX/XELOX', 'Ramucirumab', 'Nivolumab'],
+            adaptationsForResourceLimited: ['D1+ lymphadenectomy acceptable', 'Capecitabine alternative to S-1'],
+            localConsiderations: ['Higher H. pylori prevalence', 'Different histologic subtypes', 'Lauren classification'],
+            efficacyScore: 0.91, references: ['JGCA Guidelines 2021', 'ATTRACTION-2', 'SPIRITS'],
+            languages: ['Japanese', 'English'] },
+        { id: 'jsco-hcc-001', name: 'Japanese HCC Treatment Algorithm',
+            organization: 'Japan Society of Hepatology', region: 'Asia', country: 'Japan',
+            cancerType: 'Hepatocellular Carcinoma', stage: 'BCLC A-D',
+            treatmentModalities: ['Hepatectomy', 'RFA', 'TACE', 'Sorafenib', 'Lenvatinib', 'Atezolizumab-Bevacizumab'],
+            adaptationsForResourceLimited: ['Ethanol injection alternative', 'Sorafenib as single agent'],
+            localConsiderations: ['HBV/HCV endemic', 'Child-Pugh score critical', 'Liver reserve assessment'],
+            efficacyScore: 0.88, references: ['JSH Guidelines 2021', 'IMbrave150'],
+            languages: ['Japanese', 'English'] },
+        { id: 'jsco-lung-001', name: 'Japanese Lung Cancer Guidelines',
+            organization: 'Japan Lung Cancer Society', region: 'Asia', country: 'Japan',
+            cancerType: 'NSCLC', stage: 'I-IV',
+            treatmentModalities: ['Osimertinib', 'Gefitinib', 'Alectinib', 'Pembrolizumab', 'Docetaxel/Ramucirumab'],
+            adaptationsForResourceLimited: ['Gefitinib first-line acceptable', 'Docetaxel monotherapy'],
+            localConsiderations: ['Higher EGFR mutation rate (~50%)', 'Different mutation spectrum', 'Never-smoker lung cancer'],
+            efficacyScore: 0.87, references: ['JLCS Guidelines 2022', 'FLAURA', 'ALEX'],
+            languages: ['Japanese', 'English'] },
+        // CHINA - CSCO Guidelines
+        { id: 'csco-nsclc-001', name: 'Chinese NSCLC Treatment Guidelines',
+            organization: 'Chinese Society of Clinical Oncology', region: 'Asia', country: 'China',
+            cancerType: 'NSCLC', stage: 'I-IV',
+            treatmentModalities: ['Osimertinib', 'Aumolertinib', 'Furmonertinib', 'Sintilimab', 'Camrelizumab', 'Tislelizumab'],
+            adaptationsForResourceLimited: ['Generic TKIs available', 'Domestic PD-1 inhibitors'],
+            localConsiderations: ['High EGFR prevalence', 'Different drug access', 'Domestic drug development'],
+            efficacyScore: 0.86, references: ['CSCO Guidelines 2024', 'ORIENT-11', 'CameL'],
+            languages: ['Chinese', 'English'] },
+        { id: 'csco-gastric-001', name: 'Chinese Gastric Cancer Guidelines',
+            organization: 'CSCO', region: 'Asia', country: 'China',
+            cancerType: 'Gastric Cancer', stage: 'I-IV',
+            treatmentModalities: ['D2 Gastrectomy', 'XELOX', 'SOX', 'Apatinib', 'Fruquintinib', 'PD-1 inhibitors'],
+            adaptationsForResourceLimited: ['Apatinib accessible domestically', 'SOX preferred'],
+            localConsiderations: ['Endemic in Northern China', 'Different dietary factors', 'Late presentation common'],
+            efficacyScore: 0.84, references: ['CSCO Gastric 2024', 'ANGEL trial'],
+            languages: ['Chinese', 'English'] },
+        { id: 'csco-hcc-001', name: 'Chinese HCC Treatment Guidelines',
+            organization: 'CSCO', region: 'Asia', country: 'China',
+            cancerType: 'Hepatocellular Carcinoma', stage: 'CNLC Ia-IIIb',
+            treatmentModalities: ['Hepatectomy', 'TACE', 'Donafenib', 'Lenvatinib', 'Sintilimab-Bevacizumab biosimilar'],
+            adaptationsForResourceLimited: ['Donafenib as domestic option', 'Bevacizumab biosimilars'],
+            localConsiderations: ['HBV-driven (85%)', 'Aflatoxin exposure', 'CNLC staging system'],
+            efficacyScore: 0.85, references: ['CSCO HCC 2024', 'ORIENT-32'],
+            languages: ['Chinese', 'English'] },
+        { id: 'csco-npc-001', name: 'Chinese Nasopharyngeal Carcinoma Guidelines',
+            organization: 'CSCO', region: 'Asia', country: 'China',
+            cancerType: 'Nasopharyngeal Carcinoma', stage: 'I-IVB',
+            treatmentModalities: ['Concurrent Chemoradiation', 'Gemcitabine-Cisplatin', 'Toripalimab', 'Camrelizumab'],
+            adaptationsForResourceLimited: ['Cisplatin concurrent RT standard', 'GP induction'],
+            localConsiderations: ['Endemic in Southern China', 'EBV-associated', 'Plasma EBV DNA monitoring'],
+            efficacyScore: 0.89, references: ['CSCO NPC 2024', 'JUPITER-02', 'CAPTAIN-1st'],
+            languages: ['Chinese', 'English'] },
+        // KOREA - KSMO Guidelines
+        { id: 'ksmo-gastric-001', name: 'Korean Gastric Cancer Guidelines',
+            organization: 'Korean Society of Medical Oncology', region: 'Asia', country: 'Korea',
+            cancerType: 'Gastric Cancer', stage: 'I-IV',
+            treatmentModalities: ['D2 Gastrectomy', 'S-1', 'XELOX', 'Pembrolizumab', 'Nivolumab', 'Trastuzumab Deruxtecan'],
+            adaptationsForResourceLimited: ['Capecitabine-based acceptable', 'D1+ if needed'],
+            localConsiderations: ['National screening program', 'Earlier detection', 'Higher survival rates'],
+            efficacyScore: 0.92, references: ['KSMO Guidelines 2023', 'DESTINY-Gastric01'],
+            languages: ['Korean', 'English'] },
+        // INDIA - ICMR/AIIMS Guidelines
+        { id: 'icmr-cervical-001', name: 'Indian Cervical Cancer Guidelines',
+            organization: 'Indian Council of Medical Research', region: 'Asia', country: 'India',
+            cancerType: 'Cervical Cancer', stage: 'I-IVB',
+            treatmentModalities: ['Surgery', 'Chemoradiation', 'Bevacizumab', 'Pembrolizumab', 'Tisotumab Vedotin'],
+            adaptationsForResourceLimited: ['Cisplatin concurrent RT', 'Cobalt-60 if LINAC unavailable', 'VIA screening'],
+            localConsiderations: ['HPV-16/18 predominant', 'Late presentation', 'Limited radiation access'],
+            efficacyScore: 0.82, references: ['ICMR Guidelines 2022', 'GOG-240', 'KEYNOTE-826'],
+            languages: ['Hindi', 'English'] },
+        { id: 'icmr-oral-001', name: 'Indian Head and Neck Cancer Guidelines',
+            organization: 'ICMR/Tata Memorial', region: 'Asia', country: 'India',
+            cancerType: 'Head and Neck Squamous Cell Carcinoma', stage: 'I-IVB',
+            treatmentModalities: ['Surgery', 'Chemoradiation', 'Cetuximab', 'Pembrolizumab', 'Nivolumab'],
+            adaptationsForResourceLimited: ['Cisplatin-RT preferred', 'Weekly cisplatin option', 'Metronomic therapy'],
+            localConsiderations: ['Tobacco/betel nut association', 'Oral cavity predominance', 'Young age presentation'],
+            efficacyScore: 0.78, references: ['TMC Guidelines 2023', 'KEYNOTE-048'],
+            languages: ['Hindi', 'English', 'Tamil', 'Telugu'] },
+        { id: 'icmr-breast-001', name: 'Indian Breast Cancer Guidelines',
+            organization: 'ICMR', region: 'Asia', country: 'India',
+            cancerType: 'Breast Cancer', stage: 'I-IV',
+            treatmentModalities: ['Surgery', 'Chemotherapy', 'Tamoxifen', 'Trastuzumab', 'CDK4/6 Inhibitors'],
+            adaptationsForResourceLimited: ['Trastuzumab biosimilars', 'Metronomic chemotherapy', 'Oral agents preferred'],
+            localConsiderations: ['Younger age at diagnosis', 'Higher grade tumors', 'Limited HER2 testing access'],
+            efficacyScore: 0.83, references: ['ICMR Breast 2022', 'Indian TNBC trials'],
+            languages: ['Hindi', 'English'] },
+        // SOUTHEAST ASIA
+        { id: 'sea-npc-001', name: 'Southeast Asian NPC Treatment',
+            organization: 'SEARO Oncology Consortium', region: 'Asia', country: 'Multiple',
+            cancerType: 'Nasopharyngeal Carcinoma', stage: 'I-IVB',
+            treatmentModalities: ['Concurrent Chemoradiation', 'Cisplatin', 'Gemcitabine-Cisplatin', 'Immunotherapy'],
+            adaptationsForResourceLimited: ['2D RT if IMRT unavailable', 'Weekly cisplatin', 'EBV monitoring'],
+            localConsiderations: ['Endemic in Southeast Asia', 'Cantonese population high risk', 'EBV screening'],
+            efficacyScore: 0.85, references: ['SEARO Guidelines 2023'],
+            languages: ['English', 'Thai', 'Vietnamese', 'Malay', 'Indonesian'] },
+    ];
+    // ═══════════════════════════════════════════════════════════════════════════════
+    // AFRICAN TREATMENT GUIDELINES
+    // ═══════════════════════════════════════════════════════════════════════════════
+    africanGuidelines = [
+        { id: 'aortic-cervical-001', name: 'African Cervical Cancer Guidelines',
+            organization: 'African Organisation for Research and Training in Cancer', region: 'Africa',
+            cancerType: 'Cervical Cancer', stage: 'I-IVB',
+            treatmentModalities: ['Surgery', 'Radiation', 'Cisplatin', 'Bevacizumab', 'Immunotherapy'],
+            adaptationsForResourceLimited: ['VIA screening', 'Thermoablation', 'Single-visit approach', 'Brachytherapy alternatives'],
+            localConsiderations: ['HIV co-infection common', 'Late presentation', 'Limited pathology', 'HPV vaccination programs'],
+            efficacyScore: 0.75, references: ['AORTIC Guidelines 2022', 'WHO Cervical Elimination'],
+            languages: ['English', 'French', 'Portuguese', 'Swahili'] },
+        { id: 'aortic-kaposi-001', name: 'African Kaposi Sarcoma Guidelines',
+            organization: 'AORTIC', region: 'Africa',
+            cancerType: 'Kaposi Sarcoma', stage: 'Limited to Advanced',
+            treatmentModalities: ['ART initiation', 'Liposomal Doxorubicin', 'Paclitaxel', 'Bleomycin-Vincristine'],
+            adaptationsForResourceLimited: ['ABV regimen if liposomal unavailable', 'ART as primary therapy', 'Radiation for local control'],
+            localConsiderations: ['HIV-associated epidemic KS', 'Endemic KS in children', 'ART access critical'],
+            efficacyScore: 0.80, references: ['AORTIC KS Guidelines 2021', 'AMC trials'],
+            languages: ['English', 'French', 'Portuguese'] },
+        { id: 'aortic-breast-001', name: 'African Breast Cancer Guidelines',
+            organization: 'AORTIC/African Breast Cancer Consortium', region: 'Africa',
+            cancerType: 'Breast Cancer', stage: 'I-IV',
+            treatmentModalities: ['Surgery', 'Chemotherapy', 'Tamoxifen', 'Trastuzumab', 'Radiation'],
+            adaptationsForResourceLimited: ['Mastectomy if BCT unavailable', 'AC-T regimen', 'Trastuzumab biosimilars', 'Oral tamoxifen'],
+            localConsiderations: ['Younger age', 'Higher grade', 'TNBC more common', 'Late presentation', 'Limited imaging'],
+            efficacyScore: 0.72, references: ['AORTIC Breast 2022', 'ABC3 trial'],
+            languages: ['English', 'French', 'Portuguese', 'Arabic'] },
+        { id: 'aortic-burkitt-001', name: 'African Burkitt Lymphoma Guidelines',
+            organization: 'AORTIC/International Network for Cancer Treatment and Research', region: 'Africa',
+            cancerType: 'Burkitt Lymphoma', stage: 'All stages',
+            treatmentModalities: ['CHOP', 'Modified Magrath (COGLA)', 'Rituximab', 'Cyclophosphamide-based'],
+            adaptationsForResourceLimited: ['Modified BFM protocol', 'Oral maintenance', 'Reduced intensity regimens'],
+            localConsiderations: ['Endemic in malaria belt', 'EBV-associated', 'Jaw tumors in children', 'HIV-associated variant'],
+            efficacyScore: 0.85, references: ['INCTR trials', 'BFM-based African protocols'],
+            languages: ['English', 'French'] },
+        { id: 'aortic-hcc-001', name: 'African HCC Guidelines',
+            organization: 'AORTIC', region: 'Africa',
+            cancerType: 'Hepatocellular Carcinoma', stage: 'BCLC A-D',
+            treatmentModalities: ['Hepatectomy', 'TACE', 'Sorafenib', 'Best Supportive Care'],
+            adaptationsForResourceLimited: ['Ethanol injection', 'Symptom management focus', 'HBV treatment critical'],
+            localConsiderations: ['HBV endemic', 'Aflatoxin exposure', 'Late presentation', 'Limited transplant access'],
+            efficacyScore: 0.65, references: ['AORTIC HCC 2021'],
+            languages: ['English', 'French', 'Arabic'] },
+        { id: 'aortic-wilms-001', name: 'African Wilms Tumor Guidelines',
+            organization: 'SIOP Africa/AORTIC', region: 'Africa',
+            cancerType: 'Wilms Tumor', stage: 'I-V',
+            treatmentModalities: ['Pre-operative Chemotherapy', 'Nephrectomy', 'Actinomycin-D', 'Vincristine', 'Doxorubicin'],
+            adaptationsForResourceLimited: ['Modified SIOP protocol', 'Reduced staging requirements', 'Adapted follow-up'],
+            localConsiderations: ['Common pediatric tumor', 'Late presentation', 'Bilateral disease', 'Nutritional support critical'],
+            efficacyScore: 0.82, references: ['SIOP Africa trials', 'COG protocols'],
+            languages: ['English', 'French', 'Portuguese'] },
+    ];
+    // ═══════════════════════════════════════════════════════════════════════════════
+    // LATIN AMERICAN TREATMENT GUIDELINES
+    // ═══════════════════════════════════════════════════════════════════════════════
+    latinAmericanGuidelines = [
+        { id: 'lacog-breast-001', name: 'Latin American Breast Cancer Guidelines',
+            organization: 'Latin American Cooperative Oncology Group', region: 'Americas', country: 'Multiple',
+            cancerType: 'Breast Cancer', stage: 'I-IV',
+            treatmentModalities: ['Surgery', 'Chemotherapy', 'Hormonal Therapy', 'Trastuzumab', 'CDK4/6 Inhibitors'],
+            adaptationsForResourceLimited: ['Biosimilar trastuzumab', 'Dose-dense AC-T', 'Metronomic therapy'],
+            localConsiderations: ['Younger presentation', 'BRCA founder mutations', 'Access disparities', 'TNBC prevalence'],
+            efficacyScore: 0.84, references: ['LACOG Breast 2023', 'GEICAM trials'],
+            languages: ['Spanish', 'Portuguese', 'English'] },
+        { id: 'lacog-gastric-001', name: 'Latin American Gastric Cancer Guidelines',
+            organization: 'LACOG', region: 'Americas',
+            cancerType: 'Gastric Cancer', stage: 'I-IV',
+            treatmentModalities: ['D2 Gastrectomy', 'FLOT', 'XELOX', 'Ramucirumab', 'Pembrolizumab'],
+            adaptationsForResourceLimited: ['D1+ acceptable', 'ECF alternative', 'Best supportive care optimization'],
+            localConsiderations: ['High incidence in Andes', 'H. pylori endemic', 'Altitude considerations'],
+            efficacyScore: 0.79, references: ['LACOG Gastric 2023'],
+            languages: ['Spanish', 'Portuguese', 'English'] },
+        { id: 'lacog-cervical-001', name: 'Latin American Cervical Cancer Guidelines',
+            organization: 'LACOG/IGCS', region: 'Americas',
+            cancerType: 'Cervical Cancer', stage: 'I-IVB',
+            treatmentModalities: ['Surgery', 'Chemoradiation', 'Bevacizumab', 'Pembrolizumab'],
+            adaptationsForResourceLimited: ['Cisplatin-RT', 'LDR brachytherapy', 'Screening optimization'],
+            localConsiderations: ['HPV screening programs', 'Young age', 'Late presentation in rural areas'],
+            efficacyScore: 0.81, references: ['LACOG Cervical 2023'],
+            languages: ['Spanish', 'Portuguese', 'English'] },
+        { id: 'lacog-colorectal-001', name: 'Latin American Colorectal Cancer Guidelines',
+            organization: 'LACOG', region: 'Americas',
+            cancerType: 'Colorectal Cancer', stage: 'I-IV',
+            treatmentModalities: ['Surgery', 'FOLFOX', 'FOLFIRI', 'Bevacizumab', 'Cetuximab', 'Pembrolizumab'],
+            adaptationsForResourceLimited: ['CAPOX alternative', 'Limited biomarker testing', 'Palliative surgery'],
+            localConsiderations: ['Rising incidence', 'Screening programs needed', 'Lynch syndrome awareness'],
+            efficacyScore: 0.82, references: ['LACOG CRC 2023'],
+            languages: ['Spanish', 'Portuguese', 'English'] },
+    ];
+    // ═══════════════════════════════════════════════════════════════════════════════
+    // MIDDLE EASTERN TREATMENT GUIDELINES
+    // ═══════════════════════════════════════════════════════════════════════════════
+    middleEasternGuidelines = [
+        { id: 'esmo-mena-breast-001', name: 'MENA Breast Cancer Guidelines',
+            organization: 'ESMO Middle East', region: 'Asia',
+            cancerType: 'Breast Cancer', stage: 'I-IV',
+            treatmentModalities: ['Surgery', 'Chemotherapy', 'Hormonal Therapy', 'HER2-targeted', 'CDK4/6 Inhibitors'],
+            adaptationsForResourceLimited: ['Biosimilars', 'Generic aromatase inhibitors', 'Dose modifications'],
+            localConsiderations: ['Younger age', 'BRCA1/2 founder mutations', 'Consanguinity', 'Vitamin D deficiency'],
+            efficacyScore: 0.85, references: ['ESMO MENA 2023'],
+            languages: ['Arabic', 'English', 'French', 'Persian'] },
+        { id: 'esmo-mena-lung-001', name: 'MENA Lung Cancer Guidelines',
+            organization: 'ESMO Middle East', region: 'Asia',
+            cancerType: 'NSCLC', stage: 'I-IV',
+            treatmentModalities: ['Surgery', 'Targeted Therapy', 'Immunotherapy', 'Chemotherapy'],
+            adaptationsForResourceLimited: ['Mutation testing prioritization', 'Generic TKIs', 'Palliative care focus'],
+            localConsiderations: ['Rising smoking rates', 'Water pipe exposure', 'Air pollution', 'EGFR patterns'],
+            efficacyScore: 0.80, references: ['ESMO MENA Lung 2023'],
+            languages: ['Arabic', 'English'] },
+    ];
+    // ═══════════════════════════════════════════════════════════════════════════════
+    // WHO ESSENTIAL GUIDELINES (Resource-Limited Settings)
+    // ═══════════════════════════════════════════════════════════════════════════════
+    whoGuidelines = [
+        { id: 'who-eml-cancer-001', name: 'WHO Essential Medicines for Cancer',
+            organization: 'World Health Organization', region: 'WHO',
+            cancerType: 'All Priority Cancers', stage: 'All',
+            treatmentModalities: ['Essential Chemotherapy', 'Hormonal Agents', 'Targeted Therapy', 'Supportive Care'],
+            adaptationsForResourceLimited: ['21 essential cytotoxic drugs', 'Palliative care essentials', 'Pain management'],
+            localConsiderations: ['Country procurement', 'Quality assurance', 'Training requirements'],
+            efficacyScore: 0.75, references: ['WHO EML 2023', 'WHO Model List'],
+            languages: ['All UN languages'] },
+        { id: 'who-cervical-elimination', name: 'WHO Cervical Cancer Elimination Strategy',
+            organization: 'WHO', region: 'WHO',
+            cancerType: 'Cervical Cancer', stage: 'Prevention to Treatment',
+            treatmentModalities: ['HPV Vaccination', 'Screening', 'Treatment of Pre-cancer', 'Cancer Treatment', 'Palliative Care'],
+            adaptationsForResourceLimited: ['Single-dose HPV vaccine', 'HPV DNA testing', 'Screen-and-treat', 'Thermal ablation'],
+            localConsiderations: ['90-70-90 targets', 'Integration with HIV services', 'Community health workers'],
+            efficacyScore: 0.90, references: ['WHO Cervical Elimination 2020'],
+            languages: ['All UN languages'] },
+        { id: 'who-childhood-cancer', name: 'WHO Global Initiative for Childhood Cancer',
+            organization: 'WHO', region: 'WHO',
+            cancerType: 'Childhood Cancer', stage: 'All',
+            treatmentModalities: ['ALL Treatment', 'Burkitt Treatment', 'Wilms Treatment', 'Retinoblastoma', 'Hodgkin Lymphoma', 'Low-grade Glioma'],
+            adaptationsForResourceLimited: ['Resource-stratified protocols', 'Twinning programs', 'Essential medicines'],
+            localConsiderations: ['CureAll framework', 'Abandonment prevention', 'Supportive care essentials'],
+            efficacyScore: 0.85, references: ['WHO GICC 2021', 'CureAll Americas'],
+            languages: ['All UN languages'] },
+        { id: 'who-palliative-001', name: 'WHO Palliative Care Guidelines',
+            organization: 'WHO', region: 'WHO',
+            cancerType: 'All Cancers', stage: 'All (with palliative needs)',
+            treatmentModalities: ['Pain Management', 'Symptom Control', 'Psychosocial Support', 'End-of-Life Care'],
+            adaptationsForResourceLimited: ['Oral morphine essential', 'Basic symptom management', 'Community-based care'],
+            localConsiderations: ['Opioid availability', 'Cultural considerations', 'Home-based care'],
+            efficacyScore: 0.85, references: ['WHO Palliative Care 2020'],
+            languages: ['All UN languages'] },
+    ];
+    // ═══════════════════════════════════════════════════════════════════════════════
+    // SPECIAL POPULATION PROTOCOLS
+    // ═══════════════════════════════════════════════════════════════════════════════
+    specialPopulationProtocols = [
+        // ADOLESCENT AND YOUNG ADULT (AYA)
+        { id: 'aya-general-001', name: 'AYA Oncology General Principles',
+            population: 'adolescent_young_adult', cancerType: 'All AYA Cancers',
+            modifications: ['Age-appropriate treatment protocols', 'Fertility preservation counseling', 'Psychosocial support', 'Transition of care planning'],
+            contraindications: ['Avoid arbitrary age cutoffs for treatment'],
+            specialConsiderations: ['Educational/vocational disruption', 'Body image concerns', 'Peer support', 'Financial toxicity', 'Insurance gaps', 'Clinical trial enrollment'],
+            monitoringRequirements: ['Fertility assessment', 'Cardiac monitoring', 'Bone health', 'Psychosocial screening', 'Late effects surveillance'],
+            references: ['NCCN AYA Guidelines', 'SIOP AYA'] },
+        { id: 'aya-sarcoma-001', name: 'AYA Sarcoma Protocol',
+            population: 'adolescent_young_adult', cancerType: 'Sarcoma',
+            modifications: ['Pediatric or adult protocol based on histology', 'Limb salvage priority', 'Fertility preservation'],
+            contraindications: ['Avoid under-dosing based on age alone'],
+            specialConsiderations: ['Ewing sarcoma common', 'Osteosarcoma treatment', 'Rhabdomyosarcoma protocols', 'Functional outcomes'],
+            monitoringRequirements: ['Cardiac function (anthracyclines)', 'Fertility', 'Bone health', 'Second malignancy'],
+            references: ['COG/EORTC protocols', 'EuroEWING'] },
+        { id: 'aya-lymphoma-001', name: 'AYA Lymphoma Protocol',
+            population: 'adolescent_young_adult', cancerType: 'Hodgkin and Non-Hodgkin Lymphoma',
+            modifications: ['Pediatric Hodgkin protocols often superior', 'Reduced radiation when possible', 'PET-adapted therapy'],
+            contraindications: ['Avoid excessive radiation in young patients'],
+            specialConsiderations: ['Late effects of therapy', 'Breast cancer risk (females)', 'Thyroid monitoring', 'Fertility'],
+            monitoringRequirements: ['Cardiac', 'Thyroid', 'Pulmonary', 'Second malignancy screening', 'Fertility'],
+            references: ['NCCN Hodgkin', 'COG AHOD protocols'] },
+        { id: 'aya-breast-001', name: 'AYA Breast Cancer Protocol',
+            population: 'adolescent_young_adult', cancerType: 'Breast Cancer',
+            modifications: ['Aggressive biology consideration', 'BRCA testing universal', 'Fertility preservation urgent', 'Pregnancy considerations'],
+            contraindications: ['Avoid delays for fertility if aggressive disease'],
+            specialConsiderations: ['Higher TNBC rate', 'BRCA mutations more common', 'Pregnancy-associated breast cancer', 'Body image', 'Sexuality'],
+            monitoringRequirements: ['BRCA genetic testing', 'Family planning counseling', 'Cardiac monitoring', 'Bone health'],
+            references: ['NCCN Young Adult Breast', 'POSITIVE trial'] },
+        // ELDERLY (GERIATRIC ONCOLOGY)
+        { id: 'elderly-general-001', name: 'Geriatric Oncology General Principles',
+            population: 'elderly', cancerType: 'All Cancers',
+            modifications: ['Comprehensive Geriatric Assessment (CGA)', 'Functional status over chronological age', 'Polypharmacy review', 'Dose adjustments'],
+            contraindications: ['Avoid ageism - treat based on fitness not age', 'Avoid under-treatment of fit elderly'],
+            specialConsiderations: ['Comorbidities', 'Polypharmacy', 'Falls risk', 'Cognitive impairment', 'Social support', 'Goals of care', 'Life expectancy estimation'],
+            monitoringRequirements: ['Renal function', 'Cardiac function', 'Falls assessment', 'Cognitive screening', 'Nutritional status', 'Functional status'],
+            references: ['SIOG Guidelines', 'NCCN Older Adult Oncology', 'CRASH/CARG scores'] },
+        { id: 'elderly-lung-001', name: 'Elderly NSCLC Protocol',
+            population: 'elderly', cancerType: 'NSCLC',
+            modifications: ['Single-agent chemotherapy if frail', 'Immunotherapy well-tolerated', 'Targeted therapy preferred if driver mutation', 'Carboplatin preferred over cisplatin'],
+            contraindications: ['Avoid cisplatin in frail elderly', 'Avoid aggressive surgery if limited reserve'],
+            specialConsiderations: ['Immunotherapy similar efficacy in elderly', 'EGFR TKIs well-tolerated', 'Performance status critical', 'Renal dosing'],
+            monitoringRequirements: ['Renal function', 'Immune-related AE monitoring', 'Functional status'],
+            references: ['NCCN NSCLC', 'SIOG Lung Cancer'] },
+        { id: 'elderly-breast-001', name: 'Elderly Breast Cancer Protocol',
+            population: 'elderly', cancerType: 'Breast Cancer',
+            modifications: ['Endocrine-only for low-risk ER+', 'Omission of radiation in selected cases', 'Reduced chemotherapy intensity', 'Hypofractionated radiation'],
+            contraindications: ['Avoid anthracyclines in cardiac disease', 'Avoid excessive surgery'],
+            specialConsiderations: ['CALGB 9343 - RT omission criteria', 'Oncotype utility', 'CDK4/6 inhibitors well-tolerated', 'Bone health'],
+            monitoringRequirements: ['Cardiac function', 'Bone density', 'Falls risk', 'Cognitive function'],
+            references: ['SIOG Breast', 'PRIME II trial', 'CALGB 9343'] },
+        { id: 'elderly-heme-001', name: 'Elderly Hematologic Malignancies',
+            population: 'elderly', cancerType: 'Hematologic Malignancies',
+            modifications: ['Venetoclax-based for unfit AML', 'Reduced-intensity conditioning transplant', 'Oral agents preferred', 'Obinutuzumab + chlorambucil for CLL'],
+            contraindications: ['Avoid intensive induction in frail', 'Avoid full-intensity transplant if unfit'],
+            specialConsiderations: ['ECOG PS 2+ common', 'Comorbidity indices (HCT-CI)', 'Non-intensive options effective', 'CAR-T considerations'],
+            monitoringRequirements: ['Cytopenias', 'Infection risk', 'Transfusion support', 'TLS monitoring'],
+            references: ['NCCN AML', 'SIOG Hematology', 'VIALE-A'] },
+        // PREGNANCY
+        { id: 'pregnancy-general-001', name: 'Cancer in Pregnancy General Principles',
+            population: 'pregnant', cancerType: 'All Cancers',
+            modifications: ['Timing based on trimester', 'Fetal monitoring', 'Multidisciplinary team', 'Delayed treatment if possible in first trimester'],
+            contraindications: ['Methotrexate absolutely contraindicated', 'Radiation contraindicated', 'Many targeted agents contraindicated'],
+            specialConsiderations: ['Breast cancer most common', 'Cervical cancer', 'Melanoma', 'Lymphoma', 'Leukemia', 'Delivery timing', 'Lactation'],
+            monitoringRequirements: ['Fetal growth', 'Fetal heart monitoring', 'Maternal-fetal medicine consult', 'Neonatology planning'],
+            references: ['ESMO Pregnancy Guidelines', 'NCCN Pregnancy', 'INCIP registry'] },
+        { id: 'pregnancy-breast-001', name: 'Pregnancy-Associated Breast Cancer',
+            population: 'pregnant', cancerType: 'Breast Cancer',
+            modifications: ['Surgery safe all trimesters', 'Chemotherapy safe 2nd/3rd trimester', 'Delay radiation until postpartum', 'Delay endocrine until postpartum'],
+            contraindications: ['No radiation during pregnancy', 'No tamoxifen during pregnancy', 'No trastuzumab during pregnancy (oligohydramnios)'],
+            specialConsiderations: ['Dose adjustments for weight', 'AC-based regimens well-studied', 'Taxanes acceptable 2nd/3rd trimester', 'Sentinel node biopsy with precautions'],
+            monitoringRequirements: ['Fetal growth monitoring', 'Echocardiography', 'Delivery planning at 37+ weeks'],
+            references: ['ESMO Pregnancy 2019', 'INCIP registry data'] },
+        { id: 'pregnancy-lymphoma-001', name: 'Lymphoma in Pregnancy',
+            population: 'pregnant', cancerType: 'Hodgkin and Non-Hodgkin Lymphoma',
+            modifications: ['ABVD relatively safe 2nd/3rd trimester', 'Avoid bleomycin (pulmonary)', 'Shield fetus from radiation', 'Consider delivery before intensive therapy'],
+            contraindications: ['No methotrexate', 'No rituximab (theoretical concern)', 'Avoid radiation'],
+            specialConsiderations: ['Hodgkin common in young women', 'Growth monitoring', 'Timing of delivery vs treatment'],
+            monitoringRequirements: ['Fetal monitoring', 'Maternal pulmonary function', 'Neonatal CBC if rituximab used'],
+            references: ['ESMO Pregnancy', 'German Hodgkin Study Group'] },
+        { id: 'pregnancy-cervical-001', name: 'Cervical Cancer in Pregnancy',
+            population: 'pregnant', cancerType: 'Cervical Cancer',
+            modifications: ['Conization for microinvasive', 'Neoadjuvant chemo to delay treatment', 'Consider fetal maturity for delivery timing'],
+            contraindications: ['No radiation during pregnancy', 'No definitive treatment until delivery for advanced'],
+            specialConsiderations: ['Most diagnosed early stage', 'Cesarean section preferred', 'Avoid vaginal delivery with invasive cancer', 'Trachelectomy considerations'],
+            monitoringRequirements: ['Serial MRI for tumor growth', 'Fetal monitoring', 'Delivery planning'],
+            references: ['ESMO Pregnancy', 'IGCS Guidelines'] },
+        // IMMUNOCOMPROMISED
+        { id: 'immunocompromised-hiv-001', name: 'Cancer in HIV-Positive Patients',
+            population: 'immunocompromised', cancerType: 'All Cancers',
+            modifications: ['ART optimization critical', 'Drug-drug interactions with ART', 'Dose adjustments for organ function', 'Immunotherapy generally safe'],
+            contraindications: ['Avoid drugs with CYP3A4 interactions without adjustment'],
+            specialConsiderations: ['AIDS-defining cancers (KS, NHL, Cervical)', 'Non-AIDS cancers rising', 'CD4 count consideration', 'Immune reconstitution'],
+            monitoringRequirements: ['CD4 count', 'Viral load', 'Drug interactions', 'Opportunistic infection prophylaxis'],
+            references: ['NCCN HIV-Positive Cancer', 'AMC trials'] },
+        { id: 'immunocompromised-transplant-001', name: 'Cancer in Solid Organ Transplant Recipients',
+            population: 'organ_transplant', cancerType: 'All Cancers',
+            modifications: ['Reduce immunosuppression if possible', 'Switch to mTOR-based IS', 'Avoid nephrotoxic agents if kidney transplant', 'Immunotherapy with extreme caution'],
+            contraindications: ['Checkpoint inhibitors high rejection risk', 'Avoid live vaccines'],
+            specialConsiderations: ['PTLD common', 'Skin cancers', 'Increased NMSC', 'Balance rejection vs cancer', 'Rituximab for PTLD'],
+            monitoringRequirements: ['Graft function', 'Immunosuppression levels', 'Rejection signs', 'EBV for PTLD'],
+            references: ['AST/ILTS Guidelines', 'ESMO Transplant'] },
+    ];
+    // ═══════════════════════════════════════════════════════════════════════════════
+    // RESOURCE-LIMITED SETTING ADAPTATIONS
+    // ═══════════════════════════════════════════════════════════════════════════════
+    resourceLimitedAdaptations = [
+        { id: 'rla-breast-001', originalProtocol: 'NCCN Breast Cancer',
+            setting: 'low_income',
+            adaptedTreatment: ['Modified radical mastectomy', 'CMF or AC chemotherapy', 'Tamoxifen (5-10 years)', 'Trastuzumab biosimilar if HER2+'],
+            alternativeDrugs: [
+                { original: 'Pertuzumab', alternative: 'Trastuzumab alone', rationale: 'Cost-effective, significant benefit' },
+                { original: 'CDK4/6 inhibitors', alternative: 'Fulvestrant or AI alone', rationale: 'Cost prohibitive, endocrine backbone effective' },
+                { original: 'T-DXd', alternative: 'Trastuzumab-DM1 or capecitabine-trastuzumab', rationale: 'Access and cost' }
+            ],
+            minimumRequirements: ['Surgery', 'Pathology (ER/PR/HER2)', 'Radiation', 'Basic chemotherapy', 'Tamoxifen'],
+            expectedOutcome: '65-70% 5-year survival (vs 90% in high-income)',
+            references: ['BHGI Guidelines', 'WHO Essential Medicines'] },
+        { id: 'rla-cervical-001', originalProtocol: 'NCCN Cervical Cancer',
+            setting: 'low_income',
+            adaptedTreatment: ['VIA screening', 'Thermoablation/cryotherapy', 'LEEP if available', 'Radical hysterectomy', 'Cisplatin concurrent with RT'],
+            alternativeDrugs: [
+                { original: 'Bevacizumab', alternative: 'Cisplatin-RT alone', rationale: 'Survival benefit modest, cost high' },
+                { original: 'Pembrolizumab', alternative: 'Second-line chemo or BSC', rationale: 'Access limited' }
+            ],
+            minimumRequirements: ['VIA screening', 'Treatment of pre-cancer', 'Radiation (external + brachy)', 'Cisplatin', 'Palliative care'],
+            expectedOutcome: '50-60% cure rate early stage, 15-20% advanced',
+            references: ['WHO Cervical Elimination', 'Essential Surgery'] },
+        { id: 'rla-lymphoma-001', originalProtocol: 'NCCN Lymphoma',
+            setting: 'low_income',
+            adaptedTreatment: ['CHOP for aggressive NHL', 'ABVD for Hodgkin', 'Rituximab if accessible', 'Oral maintenance options'],
+            alternativeDrugs: [
+                { original: 'Rituximab', alternative: 'CHOP alone', rationale: 'Rituximab doubles cost, still benefit without' },
+                { original: 'Brentuximab vedotin', alternative: 'ABVD or escalated BEACOPP', rationale: 'ADC cost prohibitive' },
+                { original: 'CAR-T', alternative: 'Salvage chemotherapy + auto-HCT if available', rationale: 'CAR-T infrastructure unavailable' }
+            ],
+            minimumRequirements: ['Pathology diagnosis', 'CHOP/ABVD drugs', 'G-CSF', 'Blood banking', 'Basic imaging'],
+            expectedOutcome: 'DLBCL: 50% cure (vs 65% with R-CHOP), Hodgkin: 75% cure',
+            references: ['WHO Essential Medicines', 'INCTR protocols'] },
+        { id: 'rla-childhood-001', originalProtocol: 'COG/SIOP Pediatric Protocols',
+            setting: 'low_income',
+            adaptedTreatment: ['Adapted ALL protocols', 'Modified Burkitt treatment', 'Wilms without routine staging', 'Retinoblastoma treatment'],
+            alternativeDrugs: [
+                { original: 'PEG-asparaginase', alternative: 'Native L-asparaginase', rationale: 'Cost and availability' },
+                { original: 'Intrathecal liposomal cytarabine', alternative: 'Intrathecal methotrexate/cytarabine/hydrocortisone', rationale: 'Standard triple IT effective' }
+            ],
+            minimumRequirements: ['Pediatric oncologist', 'Basic chemotherapy drugs', 'Blood banking', 'Infection control', 'Nutritional support', 'Abandonment prevention'],
+            expectedOutcome: 'ALL: 70% (vs 90% in HIC), Burkitt: 60% (vs 85%)',
+            references: ['WHO GICC', 'St Jude Global', 'SIOP PODC'] },
+        { id: 'rla-lung-001', originalProtocol: 'NCCN NSCLC',
+            setting: 'middle_income',
+            adaptedTreatment: ['Platinum doublet chemotherapy', 'Generic gefitinib/erlotinib if EGFR+', 'Carboplatin-based if cisplatin intolerant', 'Palliative RT'],
+            alternativeDrugs: [
+                { original: 'Osimertinib', alternative: 'Gefitinib or Erlotinib', rationale: 'Generic availability, significant activity' },
+                { original: 'Pembrolizumab', alternative: 'Chemotherapy alone or local biosimilar', rationale: 'Cost-effectiveness threshold' },
+                { original: 'Lorlatinib', alternative: 'Crizotinib or Alectinib', rationale: 'Earlier generation still effective' }
+            ],
+            minimumRequirements: ['EGFR mutation testing (at minimum)', 'Platinum-based chemotherapy', 'Targeted therapy for drivers', 'Palliative care'],
+            expectedOutcome: 'Median OS: 12-18 months (vs 24+ months with optimal therapy)',
+            references: ['ESMO-MCBS', 'WHO EML'] },
+        { id: 'rla-colon-001', originalProtocol: 'NCCN Colorectal',
+            setting: 'middle_income',
+            adaptedTreatment: ['Surgery with D3 lymphadenectomy', 'CAPOX or FOLFOX adjuvant', 'MSI testing', 'KRAS testing if available'],
+            alternativeDrugs: [
+                { original: 'Cetuximab', alternative: 'Bevacizumab (if cheaper locally)', rationale: 'Similar efficacy, different cost structures' },
+                { original: 'Regorafenib', alternative: 'Best supportive care or TAS-102', rationale: 'Limited benefit vs cost' }
+            ],
+            minimumRequirements: ['Surgical oncology', 'Pathology with staging', 'Oxaliplatin and 5-FU/capecitabine', 'MSI/MMR testing', 'CEA monitoring'],
+            expectedOutcome: 'Stage III: 65% 5-year (vs 75% with biologics)',
+            references: ['ESMO Guidelines', 'IDEA collaboration'] },
+        { id: 'rla-palliative-001', originalProtocol: 'WHO Palliative Care',
+            setting: 'low_income',
+            adaptedTreatment: ['Oral morphine (essential)', 'Simple analgesic ladder', 'Home-based care', 'Community health worker training'],
+            alternativeDrugs: [
+                { original: 'Fentanyl patches', alternative: 'Oral morphine solution', rationale: 'Cost, availability, WHO Essential' },
+                { original: 'Ondansetron', alternative: 'Metoclopramide + dexamethasone', rationale: 'Lower cost, effective' },
+                { original: 'Granisetron', alternative: 'Metoclopramide + dexamethasone', rationale: 'Essential alternatives' }
+            ],
+            minimumRequirements: ['Oral morphine', 'Dexamethasone', 'Metoclopramide', 'Haloperidol', 'Trained providers'],
+            expectedOutcome: 'Adequate symptom control achievable in 80%+ patients',
+            references: ['WHO Palliative Care', 'IAHPC Essential Medicines'] },
+    ];
+    // ═══════════════════════════════════════════════════════════════════════════════
+    // RARE CANCER PROTOCOLS (Ultra-Rare <1/1,000,000)
+    // ═══════════════════════════════════════════════════════════════════════════════
+    rareCancerProtocols = [
+        { id: 'rare-angiosarcoma', name: 'Angiosarcoma',
+            incidence: '1-2 per million per year',
+            diagnosticCriteria: ['CD31+', 'CD34+', 'ERG+', 'Factor VIII-related antigen', 'Histopathology'],
+            molecularMarkers: ['MYC amplification (radiation-associated)', 'KDR mutations', 'PTPRB mutations', 'PLCG1 mutations'],
+            treatmentOptions: ['Surgery (wide margins)', 'Paclitaxel (preferred)', 'Doxorubicin', 'Gemcitabine-docetaxel', 'Pazopanib', 'Propranolol (investigational)'],
+            referralCenters: ['MD Anderson', 'Memorial Sloan Kettering', 'Royal Marsden', 'Institut Gustave Roussy'],
+            patientResources: ['Angiosarcoma Awareness', 'Sarcoma Alliance'],
+            clinicalTrials: ['IMMUNOSARC', 'ANNOUNCE', 'Taxane trials'] },
+        { id: 'rare-epithelioid-hemangioendothelioma', name: 'Epithelioid Hemangioendothelioma',
+            incidence: '<1 per million per year',
+            diagnosticCriteria: ['CAMTA1+ (nuclear)', 'CD31+', 'ERG+', 'TFE3 fusion variant', 'Histopathology'],
+            molecularMarkers: ['WWTR1-CAMTA1 fusion (90%)', 'YAP1-TFE3 fusion (10%)', 'CAMTA1 IHC'],
+            treatmentOptions: ['Watch and wait (indolent cases)', 'Sirolimus/mTOR inhibitors', 'Surgery if resectable', 'Bevacizumab', 'Sorafenib', 'Liver transplant (select cases)'],
+            referralCenters: ['Sarcoma specialty centers', 'Transplant centers for liver-dominant'],
+            patientResources: ['EHE Foundation', 'Sarcoma Foundation'],
+            clinicalTrials: ['mTOR inhibitor trials', 'Trametinib trials'] },
+        { id: 'rare-alveolar-soft-part', name: 'Alveolar Soft Part Sarcoma',
+            incidence: '<1 per million per year',
+            diagnosticCriteria: ['TFE3+ (nuclear)', 'Characteristic alveolar pattern', 'PAS+ diastase-resistant crystals'],
+            molecularMarkers: ['ASPSCR1-TFE3 fusion (pathognomonic)', 'TFE3 break-apart FISH'],
+            treatmentOptions: ['Surgery', 'Observation (indolent)', 'Atezolizumab (FDA-approved)', 'Sunitinib', 'Cediranib', 'Pembrolizumab'],
+            referralCenters: ['NCI', 'MD Anderson', 'Memorial Sloan Kettering'],
+            patientResources: ['ASPS Research Fund', 'Sarcoma Alliance'],
+            clinicalTrials: ['APECS trial', 'Immunotherapy trials'] },
+        { id: 'rare-pnet', name: 'Peripheral Primitive Neuroectodermal Tumor (pPNET/Ewing-like)',
+            incidence: '1-2 per million per year',
+            diagnosticCriteria: ['CD99+', 'Small round blue cells', 'Rosette formation', 'Neural markers'],
+            molecularMarkers: ['EWS-FLI1 fusion', 'EWS-ERG fusion', 'CIC-DUX4 (CIC-rearranged)', 'BCOR-CCNB3'],
+            treatmentOptions: ['VDC/IE (Ewing protocol)', 'Ifosfamide/etoposide', 'Cyclophosphamide/topotecan', 'Local control (surgery/radiation)'],
+            referralCenters: ['Pediatric sarcoma centers', 'COG institutions'],
+            patientResources: ['Ewing Sarcoma Research Foundation'],
+            clinicalTrials: ['rEECur', 'EWING 2008'] },
+        { id: 'rare-desmoplastic-small-round', name: 'Desmoplastic Small Round Cell Tumor',
+            incidence: '<1 per million per year',
+            diagnosticCriteria: ['Desmin+', 'Cytokeratin+', 'EMA+', 'WT1 C-terminus+', 'Desmoplastic stroma'],
+            molecularMarkers: ['EWSR1-WT1 fusion (pathognomonic)', 't(11;22)(p13;q12)'],
+            treatmentOptions: ['P6 protocol (HD-VAC/IE alternating)', 'HIPEC (controversial)', 'Cytoreductive surgery', 'Whole abdominal radiation', 'Irinotecan-temozolomide'],
+            referralCenters: ['Memorial Sloan Kettering (P6)', 'MD Anderson', 'St Jude'],
+            patientResources: ['DSRCT Patient Alliance'],
+            clinicalTrials: ['INFORM2', 'Basket trials'] },
+        { id: 'rare-solitary-fibrous', name: 'Solitary Fibrous Tumor (Malignant)',
+            incidence: '1-2 per million per year',
+            diagnosticCriteria: ['STAT6+ (nuclear, pathognomonic)', 'CD34+', 'Bcl-2+', 'CD99+'],
+            molecularMarkers: ['NAB2-STAT6 fusion', 'STAT6 IHC as surrogate'],
+            treatmentOptions: ['Surgery (R0 resection)', 'Temozolomide-bevacizumab', 'Pazopanib', 'Doxorubicin', 'Trabectedin'],
+            referralCenters: ['Sarcoma specialty centers'],
+            patientResources: ['Sarcoma Foundation'],
+            clinicalTrials: ['Bevacizumab combinations'] },
+        { id: 'rare-pheochromocytoma-malignant', name: 'Malignant Pheochromocytoma/Paraganglioma',
+            incidence: '1-2 per million per year',
+            diagnosticCriteria: ['Chromogranin A+', 'Synaptophysin+', 'Metastatic disease defines malignancy', 'SDHB staining'],
+            molecularMarkers: ['SDHB mutation (high malignancy risk)', 'SDHx mutations', 'VHL', 'RET', 'NF1', 'MAX', 'TMEM127'],
+            treatmentOptions: ['131I-MIBG therapy', 'Temozolomide (SDH-deficient)', 'CVD chemotherapy', 'Sunitinib', '177Lu-DOTATATE (SSTR+)', 'Belzutifan'],
+            referralCenters: ['NIH', 'MD Anderson', 'European NET centers'],
+            patientResources: ['Pheo Para Alliance', 'NET Research Foundation'],
+            clinicalTrials: ['High-specific-activity MIBG', 'HIF-2α inhibitors'] },
+        { id: 'rare-acc-salivary', name: 'Salivary Gland Adenoid Cystic Carcinoma',
+            incidence: '3-4 per million per year',
+            diagnosticCriteria: ['Cribriform/tubular/solid patterns', 'Perineural invasion', 'Biphasic cell population'],
+            molecularMarkers: ['MYB-NFIB fusion (60%)', 'MYBL1 rearrangements', 'NOTCH1 mutations'],
+            treatmentOptions: ['Surgery + adjuvant RT', 'Neutron beam radiation', 'Lenvatinib', 'Axitinib', 'Regorafenib', 'Chemotherapy (limited activity)'],
+            referralCenters: ['Head and neck specialty centers', 'Proton/neutron facilities'],
+            patientResources: ['Adenoid Cystic Carcinoma Research Foundation'],
+            clinicalTrials: ['Lenvatinib trials', 'NOTCH inhibitors'] },
+        { id: 'rare-adrenocortical', name: 'Adrenocortical Carcinoma',
+            incidence: '1-2 per million per year',
+            diagnosticCriteria: ['Weiss score ≥3', 'Ki-67 prognostic', 'SF-1+', 'Inhibin+', 'Melan-A+'],
+            molecularMarkers: ['TP53 mutations (Li-Fraumeni)', 'IGF2 overexpression', 'CTNNB1', 'ZNRF3', 'DAXX/ATRX'],
+            treatmentOptions: ['Surgery (R0 critical)', 'Mitotane (adjuvant and advanced)', 'EDP-M (etoposide-doxorubicin-cisplatin + mitotane)', 'Pembrolizumab', 'Cabozantinib'],
+            referralCenters: ['ENSAT centers', 'MD Anderson', 'University of Michigan'],
+            patientResources: ['ACC Support Group', 'ADRENAL.ORG'],
+            clinicalTrials: ['ADIUVO-2', 'Immunotherapy trials'] },
+        { id: 'rare-gestational-trophoblastic', name: 'Gestational Trophoblastic Neoplasia',
+            incidence: '1-2 per 1000 pregnancies (varies by region)',
+            diagnosticCriteria: ['Elevated hCG', 'Histology (hydatidiform mole, choriocarcinoma, PSTT, ETT)', 'Imaging'],
+            molecularMarkers: ['p57 IHC (androgenetic complete mole negative)', 'Genotyping for molar pregnancy'],
+            treatmentOptions: ['Methotrexate (low-risk)', 'EMA-CO (high-risk)', 'EP-EMA (ultra-high risk)', 'Pembrolizumab (resistant GTN)', 'Surgery (PSTT/ETT)'],
+            referralCenters: ['Charing Cross (UK)', 'New England Trophoblastic Disease Center', 'Regional GTD centers'],
+            patientResources: ['International Society for the Study of Trophoblastic Diseases'],
+            clinicalTrials: ['TROPHIMMUN'] },
+        { id: 'rare-merkel-cell', name: 'Merkel Cell Carcinoma',
+            incidence: '3-5 per million per year (rising)',
+            diagnosticCriteria: ['CK20+ (paranuclear dot)', 'Synaptophysin+', 'Chromogranin A+', 'TTF-1 negative'],
+            molecularMarkers: ['Merkel cell polyomavirus (80%)', 'UV signature mutations (MCPyV-negative)', 'RB1 loss', 'TP53 mutations'],
+            treatmentOptions: ['Wide excision + SLNB', 'Adjuvant radiation', 'Avelumab (1st line advanced)', 'Pembrolizumab', 'Nivolumab + ipilimumab', 'Chemotherapy (platinum/etoposide)'],
+            referralCenters: ['Moffitt', 'Seattle Cancer Care Alliance', 'Memorial Sloan Kettering'],
+            patientResources: ['Merkel Cell Carcinoma Patient Registry'],
+            clinicalTrials: ['Combination immunotherapy', 'T-VEC'] },
+        { id: 'rare-cardiac-sarcoma', name: 'Primary Cardiac Sarcoma',
+            incidence: '<0.5 per million per year',
+            diagnosticCriteria: ['Imaging (MRI, echo)', 'Histology (angiosarcoma most common)', 'Exclude metastases'],
+            molecularMarkers: ['Subtype-specific markers', 'MYC amplification in cardiac angiosarcoma'],
+            treatmentOptions: ['Surgical resection if feasible', 'Neoadjuvant chemotherapy', 'Anthracycline-based (limited due to cardiac)', 'Paclitaxel for angiosarcoma', 'Heart transplant (select cases)', 'Palliative care'],
+            referralCenters: ['Cleveland Clinic', 'Mayo Clinic', 'Specialized cardiac surgery centers'],
+            patientResources: ['Sarcoma Alliance', 'NORD'],
+            clinicalTrials: ['Sarcoma basket trials'] },
+        { id: 'rare-penile-cancer', name: 'Penile Cancer',
+            incidence: '1-2 per 100,000 in developed countries, higher in developing',
+            diagnosticCriteria: ['Histopathology (SCC)', 'p16 for HPV status', 'Grading and staging'],
+            molecularMarkers: ['HPV (40-50%)', 'TP53 mutations', 'CDKN2A', 'PIK3CA', 'NOTCH1'],
+            treatmentOptions: ['Surgery (penile-sparing when possible)', 'Inguinal lymphadenectomy', 'Radiation (alternative)', 'TIP chemotherapy (neoadjuvant/palliative)', 'Cemiplimab (basket approval)', 'Pembrolizumab'],
+            referralCenters: ['EAU-certified centers', 'MD Anderson', 'UCLH London'],
+            patientResources: ['Orchid (UK)', 'Penile Cancer Support'],
+            clinicalTrials: ['InPACT', 'ORPHEUS'] },
+        { id: 'rare-primary-peritoneal', name: 'Primary Peritoneal Carcinoma',
+            incidence: '6-7 per million per year',
+            diagnosticCriteria: ['High-grade serous histology', 'No primary ovarian mass', 'WT1+', 'PAX8+', 'CA-125 elevated'],
+            molecularMarkers: ['BRCA1/2 mutations common', 'TP53 mutations (ubiquitous)', 'HRD'],
+            treatmentOptions: ['Cytoreductive surgery', 'Carboplatin-paclitaxel', 'PARP inhibitors (BRCA+)', 'Bevacizumab', 'HIPEC (controversial)'],
+            referralCenters: ['GOG institutions', 'High-volume gynecologic oncology centers'],
+            patientResources: ['Ovarian Cancer Research Alliance'],
+            clinicalTrials: ['Treat as ovarian cancer - same trials'] },
+    ];
+    // ═══════════════════════════════════════════════════════════════════════════════
+    // COMPREHENSIVE PEDIATRIC ONCOLOGY PROTOCOLS
+    // ═══════════════════════════════════════════════════════════════════════════════
+    pediatricProtocols = [
+        { id: 'ped-all-sr', name: 'Pediatric ALL Standard Risk',
+            ageGroup: 'child', cancerType: 'B-cell Acute Lymphoblastic Leukemia',
+            riskStratification: ['Age 1-9.99', 'WBC <50,000', 'CNS1', 'No adverse cytogenetics', 'Day 29 MRD negative'],
+            treatmentPhases: [
+                { phase: 'Induction', duration: '4 weeks', agents: ['Vincristine', 'Dexamethasone', 'PEG-asparaginase', 'IT methotrexate'] },
+                { phase: 'Consolidation', duration: '4 weeks', agents: ['Cyclophosphamide', 'Cytarabine', 'Mercaptopurine', 'IT methotrexate'] },
+                { phase: 'Interim Maintenance', duration: '8 weeks', agents: ['High-dose methotrexate', 'Mercaptopurine'] },
+                { phase: 'Delayed Intensification', duration: '8 weeks', agents: ['Dexamethasone', 'Vincristine', 'Doxorubicin', 'PEG-asparaginase'] },
+                { phase: 'Maintenance', duration: '2 years', agents: ['Mercaptopurine', 'Methotrexate', 'Vincristine', 'Dexamethasone pulses'] }
+            ],
+            longTermFollowUp: ['Cardiac echo', 'Bone density', 'Neurocognitive testing', 'Growth/endocrine', 'Second malignancy screening'],
+            fertilityPreservation: ['Counsel regarding gonadotoxicity', 'Sperm banking if appropriate age', 'Ovarian tissue cryopreservation (select)'],
+            lateEffectsMonitoring: ['Osteonecrosis', 'Obesity', 'Cardiac function', 'Neurocognitive effects', 'Secondary AML'],
+            psychosocialSupport: ['Child life services', 'School reintegration', 'Sibling support', 'Family counseling'],
+            references: ['COG AALL0932', 'AALL1231', 'AIEOP-BFM ALL 2017'] },
+        { id: 'ped-all-hr', name: 'Pediatric ALL High Risk',
+            ageGroup: 'child', cancerType: 'B-cell Acute Lymphoblastic Leukemia',
+            riskStratification: ['Age <1 or ≥10', 'WBC ≥50,000', 'CNS3', 'KMT2A rearrangement', 'Hypodiploidy', 'Day 29 MRD positive', 'Ph-like ALL'],
+            treatmentPhases: [
+                { phase: 'Induction', duration: '4 weeks', agents: ['Vincristine', 'Dexamethasone', 'Daunorubicin', 'PEG-asparaginase', 'IT methotrexate'] },
+                { phase: 'Consolidation', duration: '8 weeks', agents: ['Cyclophosphamide', 'Cytarabine', 'Mercaptopurine', 'HD methotrexate'] },
+                { phase: 'Interim Maintenance', duration: '8 weeks', agents: ['High-dose methotrexate', 'Mercaptopurine', 'Blinatumomab (MRD+)'] },
+                { phase: 'Delayed Intensification', duration: '8 weeks', agents: ['Dexamethasone', 'Vincristine', 'Doxorubicin', 'PEG-asparaginase', 'Cyclophosphamide'] },
+                { phase: 'Maintenance', duration: '2 years', agents: ['Mercaptopurine', 'Methotrexate', 'Vincristine pulses'] }
+            ],
+            longTermFollowUp: ['Same as standard risk but more intensive cardiac monitoring'],
+            fertilityPreservation: ['Higher priority due to more intensive therapy', 'Oncofertility consult mandatory'],
+            lateEffectsMonitoring: ['Cardiomyopathy risk higher', 'Secondary AML risk', 'Neurocognitive effects'],
+            psychosocialSupport: ['Intensive support due to longer treatment'],
+            references: ['COG AALL1231', 'COG AALL0434'] },
+        { id: 'ped-neuroblastoma-hr', name: 'High-Risk Neuroblastoma',
+            ageGroup: 'infant', cancerType: 'Neuroblastoma',
+            riskStratification: ['Stage 4 age >18 months', 'MYCN amplification', 'Unfavorable histology', 'Unfavorable ploidy'],
+            treatmentPhases: [
+                { phase: 'Induction', duration: '4-6 cycles', agents: ['Cyclophosphamide', 'Doxorubicin', 'Vincristine', 'Cisplatin', 'Etoposide'] },
+                { phase: 'Surgical Resection', duration: 'After 5 cycles', agents: ['Gross total resection when safe'] },
+                { phase: 'Consolidation', duration: 'High-dose', agents: ['Thiotepa', 'Cyclophosphamide', 'Tandem transplant or single HD chemo'] },
+                { phase: 'Radiation', duration: 'Post-transplant', agents: ['21 Gy to primary site'] },
+                { phase: 'Maintenance', duration: '5-6 months', agents: ['Isotretinoin (cis-retinoic acid)', 'Dinutuximab', 'IL-2', 'GM-CSF'] }
+            ],
+            longTermFollowUp: ['Hearing (cisplatin)', 'Cardiac function', 'Growth', 'Renal function', 'Thyroid', 'Fertility'],
+            fertilityPreservation: ['Ovarian/testicular tissue cryopreservation consideration'],
+            lateEffectsMonitoring: ['Ototoxicity', 'Nephrotoxicity', 'Secondary malignancies', 'Growth hormone deficiency'],
+            psychosocialSupport: ['Intensive family support', 'Developmental monitoring', 'Palliative care integration'],
+            references: ['COG ANBL1232', 'SIOPEN HR-NBL-1'] },
+        { id: 'ped-wilms-fav', name: 'Wilms Tumor Favorable Histology',
+            ageGroup: 'child', cancerType: 'Wilms Tumor',
+            riskStratification: ['Stage I-II favorable histology', 'Age <2 with small tumors', 'No LOH 1p/16q'],
+            treatmentPhases: [
+                { phase: 'Surgery', duration: 'Primary', agents: ['Radical nephrectomy', 'Lymph node sampling'] },
+                { phase: 'Chemotherapy Stage I', duration: '18 weeks', agents: ['Vincristine', 'Actinomycin-D (VA regimen)'] },
+                { phase: 'Chemotherapy Stage II', duration: '24 weeks', agents: ['Vincristine', 'Actinomycin-D'] },
+                { phase: 'Radiation', duration: 'If indicated', agents: ['10.8 Gy flank (Stage III)'] }
+            ],
+            longTermFollowUp: ['Renal function (remaining kidney)', 'Abdominal imaging', 'Blood pressure', 'Cardiac (if doxorubicin)'],
+            fertilityPreservation: ['Generally not needed for VA regimen'],
+            lateEffectsMonitoring: ['Hypertension', 'Renal insufficiency', 'Scoliosis (if radiation)'],
+            psychosocialSupport: ['Body image (nephrectomy scar)', 'Return to activities'],
+            references: ['COG AREN0532', 'SIOP 2001', 'Umbrella SIOP-RTSG 2016'] },
+        { id: 'ped-osteosarcoma', name: 'Osteosarcoma High-Grade',
+            ageGroup: 'adolescent', cancerType: 'Osteosarcoma',
+            riskStratification: ['Non-metastatic', 'Metastatic', 'Histologic response to neoadjuvant (% necrosis)'],
+            treatmentPhases: [
+                { phase: 'Neoadjuvant', duration: '10 weeks', agents: ['Methotrexate (12g/m²)', 'Cisplatin', 'Doxorubicin', 'MAP regimen'] },
+                { phase: 'Surgery', duration: 'Week 11', agents: ['Limb salvage or amputation', 'Histologic response assessment'] },
+                { phase: 'Adjuvant Good Response', duration: '18 weeks', agents: ['MAP continuation'] },
+                { phase: 'Adjuvant Poor Response', duration: '18 weeks', agents: ['MAP + Ifosfamide + Etoposide (investigational)'] }
+            ],
+            longTermFollowUp: ['Cardiac echo', 'Hearing', 'Renal function', 'Limb function', 'Chest CT surveillance'],
+            fertilityPreservation: ['Sperm banking (males)', 'Oocyte/ovarian tissue (females)', 'GnRH agonist consideration'],
+            lateEffectsMonitoring: ['Cardiomyopathy', 'Ototoxicity', 'Nephrotoxicity', 'Limb length discrepancy', 'Prosthesis function'],
+            psychosocialSupport: ['Limb rehabilitation', 'Peer support', 'Body image', 'Return to sports'],
+            references: ['EURAMOS-1', 'COG AOST1321', 'INT-0133'] },
+        { id: 'ped-ewing-localized', name: 'Ewing Sarcoma Localized',
+            ageGroup: 'adolescent', cancerType: 'Ewing Sarcoma',
+            riskStratification: ['Tumor location', 'Tumor volume (<200ml vs ≥200ml)', 'Age', 'LDH'],
+            treatmentPhases: [
+                { phase: 'Induction', duration: '12 weeks (6 cycles)', agents: ['VDC (Vincristine-Doxorubicin-Cyclophosphamide)', 'IE (Ifosfamide-Etoposide)', 'Alternating'] },
+                { phase: 'Local Control', duration: 'After 6 cycles', agents: ['Surgery preferred if good margins possible', 'Radiation if unresectable or close margins'] },
+                { phase: 'Consolidation', duration: '23 weeks', agents: ['VDC/IE continuation'] }
+            ],
+            longTermFollowUp: ['Cardiac function', 'Renal function', 'Gonadal function', 'Lung function', 'Secondary malignancies'],
+            fertilityPreservation: ['High priority - alkylating agents cause infertility', 'Mandatory oncofertility consultation'],
+            lateEffectsMonitoring: ['Cardiomyopathy', 'Secondary leukemia', 'Renal dysfunction', 'Infertility'],
+            psychosocialSupport: ['Limb function', 'Chronic pain', 'Fertility counseling', 'Transition to adult care'],
+            references: ['COG AEWS1031', 'EURO-EWING 99', 'rEECur'] },
+        { id: 'ped-medulloblastoma-sr', name: 'Medulloblastoma Standard Risk',
+            ageGroup: 'child', cancerType: 'Medulloblastoma',
+            riskStratification: ['Age ≥3', 'Total/near-total resection', 'No metastases', 'WNT or SHH-TP53 wild-type'],
+            treatmentPhases: [
+                { phase: 'Surgery', duration: 'Upfront', agents: ['Maximal safe resection', 'CSF diversion if needed'] },
+                { phase: 'Radiation', duration: '6 weeks', agents: ['Craniospinal irradiation 23.4 Gy', 'Boost to posterior fossa 54 Gy'] },
+                { phase: 'Chemotherapy', duration: '48 weeks', agents: ['Cisplatin', 'Vincristine', 'Cyclophosphamide (or lomustine)'] }
+            ],
+            longTermFollowUp: ['Neurocognitive testing', 'Hearing', 'Endocrine', 'Growth', 'Spine imaging', 'Brain MRI'],
+            fertilityPreservation: ['Important especially with cyclophosphamide', 'Pre-pubertal considerations'],
+            lateEffectsMonitoring: ['Cognitive decline', 'Growth hormone deficiency', 'Thyroid dysfunction', 'Hearing loss', 'Secondary tumors'],
+            psychosocialSupport: ['Educational support', 'Neurocognitive rehabilitation', 'Social skills', 'Family support'],
+            references: ['COG ACNS0331', 'SIOP PNET 5', 'SJMB03'] },
+        { id: 'ped-rhabdomyosarcoma-low', name: 'Rhabdomyosarcoma Low Risk',
+            ageGroup: 'child', cancerType: 'Rhabdomyosarcoma',
+            riskStratification: ['Embryonal histology', 'Stage 1 or 2', 'Group I or II', 'Favorable site (orbit, head non-PM)'],
+            treatmentPhases: [
+                { phase: 'Chemotherapy', duration: '22-43 weeks', agents: ['Vincristine', 'Actinomycin-D (VA regimen)', 'Cyclophosphamide (subset)'] },
+                { phase: 'Local Control', duration: 'Week 12', agents: ['Surgery if complete resection possible', 'Radiation for microscopic residual'] }
+            ],
+            longTermFollowUp: ['Second malignancy screening', 'Cardiac function', 'Gonadal function', 'Site-specific monitoring'],
+            fertilityPreservation: ['Lower priority for VA only', 'Higher priority if cyclophosphamide used'],
+            lateEffectsMonitoring: ['Second malignancy', 'Local effects of radiation', 'Growth at treated site'],
+            psychosocialSupport: ['Site-specific (orbit = vision, GU = bladder/bowel)', 'Body image'],
+            references: ['COG ARST0331', 'COG ARST0531'] },
+        { id: 'ped-retinoblastoma', name: 'Retinoblastoma',
+            ageGroup: 'infant', cancerType: 'Retinoblastoma',
+            riskStratification: ['Unilateral vs bilateral', 'Intraocular classification (A-E)', 'Extraocular disease', 'Germline RB1 mutation'],
+            treatmentPhases: [
+                { phase: 'Focal Therapy', duration: 'Ongoing', agents: ['Laser photocoagulation', 'Cryotherapy', 'Brachytherapy'] },
+                { phase: 'Intra-arterial Chemotherapy', duration: 'Cycles as needed', agents: ['Melphalan', 'Topotecan', 'Carboplatin (IAC)'] },
+                { phase: 'Intravitreal Chemotherapy', duration: 'If vitreous seeds', agents: ['Melphalan intravitreal'] },
+                { phase: 'Systemic Chemotherapy', duration: 'If needed', agents: ['Carboplatin', 'Etoposide', 'Vincristine (CEV)'] },
+                { phase: 'Enucleation', duration: 'If salvage not possible', agents: ['Primary or secondary enucleation'] }
+            ],
+            longTermFollowUp: ['Eye exams', 'MRI brain (trilateral screening)', 'Second malignancy surveillance (germline RB1)', 'Genetic counseling'],
+            fertilityPreservation: ['N/A for focal therapy', 'Consider if systemic chemotherapy'],
+            lateEffectsMonitoring: ['Vision', 'Trilateral retinoblastoma', 'Secondary cancers (osteosarcoma if germline)', 'Facial asymmetry'],
+            psychosocialSupport: ['Vision support services', 'Prosthetic eye fitting', 'Family genetic counseling', 'Sibling screening'],
+            references: ['Children\'s Oncology Group', 'CHLA protocols', 'One Retinoblastoma World'] },
+        { id: 'ped-aml', name: 'Pediatric AML',
+            ageGroup: 'child', cancerType: 'Acute Myeloid Leukemia',
+            riskStratification: ['Cytogenetics (CBF, KMT2A, monosomy 7)', 'Molecular (FLT3, NPM1, CEBPA)', 'Response (MRD after Induction 1)'],
+            treatmentPhases: [
+                { phase: 'Induction 1', duration: '4 weeks', agents: ['Cytarabine', 'Daunorubicin', 'Etoposide (ADE)'] },
+                { phase: 'Induction 2', duration: '4 weeks', agents: ['Cytarabine', 'Mitoxantrone (AM)'] },
+                { phase: 'Consolidation', duration: '2-3 cycles', agents: ['High-dose cytarabine', 'Gemtuzumab ozogamicin (CD33+)'] },
+                { phase: 'Transplant', duration: 'If high risk', agents: ['Allogeneic HSCT for high-risk'] }
+            ],
+            longTermFollowUp: ['Cardiac function', 'Growth', 'Endocrine', 'Neurocognitive', 'Second malignancy'],
+            fertilityPreservation: ['High priority - intensive therapy', 'All patients should be counseled'],
+            lateEffectsMonitoring: ['Cardiomyopathy', 'MDS/secondary AML', 'Growth failure', 'Endocrine dysfunction'],
+            psychosocialSupport: ['ICU support', 'Prolonged hospitalization support', 'Transplant preparation'],
+            references: ['COG AAML1831', 'AAML0531', 'MyeChild 01'] },
+        { id: 'ped-brain-low-grade-glioma', name: 'Pediatric Low-Grade Glioma',
+            ageGroup: 'child', cancerType: 'Low-Grade Glioma',
+            riskStratification: ['Location', 'Extent of resection', 'NF1 association', 'BRAF alteration (fusion vs V600E)'],
+            treatmentPhases: [
+                { phase: 'Observation', duration: 'If stable', agents: ['Serial imaging for NF1-associated or stable'] },
+                { phase: 'Surgery', duration: 'If progressive or symptomatic', agents: ['Maximal safe resection'] },
+                { phase: 'Chemotherapy', duration: '70 weeks', agents: ['Carboplatin-vincristine', 'TPCV (thioguanine, procarbazine, CCNU, vincristine)'] },
+                { phase: 'Targeted Therapy', duration: 'If refractory', agents: ['Selumetinib (NF1)', 'Dabrafenib-trametinib (BRAF V600E)', 'MEK inhibitors'] }
+            ],
+            longTermFollowUp: ['Ophthalmology', 'Endocrine', 'Neurocognitive', 'Long-term imaging'],
+            fertilityPreservation: ['Low priority for CV alone', 'Consider if alkylating agents needed'],
+            lateEffectsMonitoring: ['Visual pathway function', 'Endocrine (hypothalamic-pituitary)', 'Neurocognitive'],
+            psychosocialSupport: ['Vision support', 'Learning support', 'NF1 comprehensive care'],
+            references: ['COG ACNS1831', 'LOGGIC', 'PLGG consensus'] },
+        { id: 'ped-hepatoblastoma', name: 'Hepatoblastoma',
+            ageGroup: 'infant', cancerType: 'Hepatoblastoma',
+            riskStratification: ['PRETEXT stage (I-IV)', 'Metastatic status', 'AFP levels', 'Age (infants better)'],
+            treatmentPhases: [
+                { phase: 'Neoadjuvant', duration: '2-4 cycles', agents: ['Cisplatin', 'Doxorubicin (C5VD)', 'PLADO for very low risk'] },
+                { phase: 'Surgery', duration: 'After neoadjuvant', agents: ['Hepatectomy', 'Liver transplant if unresectable'] },
+                { phase: 'Adjuvant', duration: '2 cycles', agents: ['Cisplatin-based'] }
+            ],
+            longTermFollowUp: ['Hearing', 'Cardiac function', 'Liver function', 'AFP monitoring', 'Imaging surveillance'],
+            fertilityPreservation: ['Consider in older children', 'Cisplatin causes gonadotoxicity'],
+            lateEffectsMonitoring: ['Ototoxicity', 'Cardiomyopathy', 'Liver regeneration', 'Renal function'],
+            psychosocialSupport: ['NICU/PICU support', 'Transplant preparation if needed', 'Family support'],
+            references: ['SIOPEL protocols', 'COG AHEP0731', 'PHITT'] },
+        { id: 'ped-germ-cell', name: 'Pediatric Extracranial Germ Cell Tumors',
+            ageGroup: 'child', cancerType: 'Germ Cell Tumor',
+            riskStratification: ['Site (gonadal vs extragonadal)', 'Stage', 'Tumor markers (AFP, β-hCG)', 'Histology'],
+            treatmentPhases: [
+                { phase: 'Surgery', duration: 'Primary if resectable', agents: ['Orchiectomy', 'Oophorectomy', 'Resection'] },
+                { phase: 'Chemotherapy Low Risk', duration: '3 cycles', agents: ['PEB (Cisplatin, Etoposide, Bleomycin)'] },
+                { phase: 'Chemotherapy Intermediate Risk', duration: '4 cycles', agents: ['Compressed PEB (3 days instead of 5)'] },
+                { phase: 'Chemotherapy High Risk', duration: '4 cycles', agents: ['BEP', 'Consider HD-CarboPEC if very high risk'] }
+            ],
+            longTermFollowUp: ['Tumor markers', 'Gonadal function', 'Hearing', 'Pulmonary function', 'Fertility'],
+            fertilityPreservation: ['Priority for males - orchiectomy + chemo', 'Sperm banking if post-pubertal', 'Oocyte preservation'],
+            lateEffectsMonitoring: ['Hearing loss', 'Pulmonary fibrosis (bleomycin)', 'Infertility', 'Renal dysfunction', 'Secondary leukemia'],
+            psychosocialSupport: ['Body image (orchiectomy)', 'Fertility concerns', 'Sexuality'],
+            references: ['COG AGCT1531', 'MALIGNE 2014', 'TE22'] },
+    ];
+    // ═══════════════════════════════════════════════════════════════════════════════
+    // SUPPORTIVE CARE PROTOCOLS
+    // ═══════════════════════════════════════════════════════════════════════════════
+    supportiveCareProtocols = [
+        // SYMPTOM MANAGEMENT
+        { id: 'support-pain-001', name: 'Cancer Pain Management',
+            category: 'symptom_management',
+            indications: ['Tumor-related pain', 'Treatment-related pain', 'Chronic cancer pain', 'Breakthrough pain'],
+            interventions: ['Pain assessment (0-10)', 'WHO analgesic ladder', 'Around-the-clock dosing', 'Rescue dosing', 'Palliative radiation', 'Nerve blocks', 'Intrathecal pumps'],
+            medications: ['Acetaminophen', 'NSAIDs', 'Tramadol', 'Morphine', 'Oxycodone', 'Hydromorphone', 'Fentanyl', 'Methadone', 'Gabapentin', 'Pregabalin', 'Duloxetine', 'Dexamethasone'],
+            complementaryApproaches: ['Acupuncture', 'Massage', 'Physical therapy', 'TENS', 'Mindfulness', 'Hypnosis', 'Music therapy'],
+            outcomes: ['Pain score <4', 'Functional status maintained', 'Minimal sedation', 'Quality of life improvement'],
+            references: ['NCCN Cancer Pain', 'WHO Guidelines', 'ASCO Pain Guidelines'] },
+        { id: 'support-nausea-001', name: 'Chemotherapy-Induced Nausea/Vomiting',
+            category: 'symptom_management',
+            indications: ['Highly emetogenic chemotherapy', 'Moderately emetogenic chemotherapy', 'Anticipatory nausea', 'Breakthrough nausea'],
+            interventions: ['Risk assessment', 'Prophylactic antiemetics', 'Rescue antiemetics', 'Delayed emesis prevention'],
+            medications: ['Ondansetron', 'Granisetron', 'Palonosetron', 'Dexamethasone', 'Aprepitant', 'Fosaprepitant', 'Netupitant-palonosetron', 'Rolapitant', 'Olanzapine', 'Lorazepam', 'Prochlorperazine'],
+            complementaryApproaches: ['Ginger', 'Acupuncture', 'Acupressure (P6)', 'Behavioral therapy', 'Progressive muscle relaxation'],
+            outcomes: ['Complete response (no vomiting, no rescue)', 'Minimal nausea impact on function'],
+            references: ['NCCN Antiemesis', 'ASCO/MASCC Guidelines'] },
+        { id: 'support-fatigue-001', name: 'Cancer-Related Fatigue',
+            category: 'symptom_management',
+            indications: ['Treatment-related fatigue', 'Cancer-related fatigue', 'Persistent post-treatment fatigue'],
+            interventions: ['Fatigue screening', 'Treatable cause evaluation (anemia, thyroid, depression)', 'Energy conservation', 'Exercise prescription', 'Sleep hygiene', 'Cognitive behavioral therapy'],
+            medications: ['Methylphenidate', 'Modafinil', 'American ginseng', 'Dexamethasone (short-term)'],
+            complementaryApproaches: ['Aerobic exercise', 'Resistance training', 'Yoga', 'Tai chi', 'Mindfulness-based stress reduction'],
+            outcomes: ['Reduced fatigue scores', 'Improved function', 'Maintained activity levels'],
+            references: ['NCCN Fatigue', 'ASCO Fatigue Guidelines'] },
+        { id: 'support-anorexia-001', name: 'Cancer Anorexia-Cachexia',
+            category: 'nutritional',
+            indications: ['Weight loss >5% in 6 months', 'Reduced oral intake', 'Muscle wasting', 'Elevated CRP'],
+            interventions: ['Nutritional assessment', 'Dietary counseling', 'Oral nutritional supplements', 'Appetite stimulants', 'Enteral nutrition', 'Parenteral nutrition (select cases)'],
+            medications: ['Megestrol acetate', 'Dronabinol', 'Corticosteroids (short-term)', 'Olanzapine', 'Mirtazapine'],
+            complementaryApproaches: ['Small frequent meals', 'Ginger for nausea', 'Exercise to maintain muscle'],
+            outcomes: ['Weight stabilization', 'Improved appetite', 'Maintained function'],
+            references: ['ESPEN Cancer Nutrition', 'ASPEN Guidelines'] },
+        { id: 'support-diarrhea-001', name: 'Treatment-Related Diarrhea',
+            category: 'symptom_management',
+            indications: ['Chemotherapy-induced diarrhea', 'Targeted therapy diarrhea', 'Radiation enteritis', 'Immunotherapy colitis'],
+            interventions: ['Grading assessment', 'Infectious workup', 'Diet modification', 'Hydration', 'Medication management'],
+            medications: ['Loperamide', 'Diphenoxylate-atropine', 'Octreotide', 'Tincture of opium', 'Budesonide (immunotherapy)', 'Prednisone (immunotherapy colitis)'],
+            complementaryApproaches: ['BRAT diet', 'Probiotics (with caution)', 'Soluble fiber', 'Adequate hydration'],
+            outcomes: ['Grade reduction', 'Prevention of dehydration', 'Maintained treatment'],
+            references: ['NCCN Management', 'ASCO Diarrhea Guidelines'] },
+        { id: 'support-neuropathy-001', name: 'Chemotherapy-Induced Peripheral Neuropathy',
+            category: 'symptom_management',
+            indications: ['Platinum-induced', 'Taxane-induced', 'Vinca alkaloid-induced', 'Bortezomib-induced'],
+            interventions: ['Risk assessment', 'Dose modification', 'Symptom management', 'Physical therapy', 'Occupational therapy'],
+            medications: ['Duloxetine', 'Gabapentin', 'Pregabalin', 'Lidocaine patches', 'Capsaicin cream', 'Tricyclic antidepressants'],
+            complementaryApproaches: ['Acupuncture', 'Exercise', 'Balance training', 'Cryotherapy (prevention)'],
+            outcomes: ['Maintained function', 'Pain control', 'Continued treatment when possible'],
+            references: ['ASCO CIPN Guidelines', 'NCCN Survivorship'] },
+        { id: 'support-mucositis-001', name: 'Oral Mucositis',
+            category: 'symptom_management',
+            indications: ['Chemotherapy-induced', 'Radiation-induced (head/neck)', 'Post-transplant'],
+            interventions: ['Oral care protocol', 'Pain management', 'Nutritional support', 'Infection prevention'],
+            medications: ['Palifermin (HSCT)', 'Magic mouthwash', 'Lidocaine viscous', 'Morphine (severe)', 'Benzydamine', 'Dexamethasone rinse'],
+            complementaryApproaches: ['Saline rinses', 'Sodium bicarbonate rinses', 'Ice chips (cryotherapy)', 'Honey'],
+            outcomes: ['Grade reduction', 'Pain control', 'Maintained nutrition', 'Prevented secondary infection'],
+            references: ['MASCC/ISOO Guidelines', 'NCCN Mucositis'] },
+        { id: 'support-skin-001', name: 'Dermatologic Toxicity Management',
+            category: 'symptom_management',
+            indications: ['EGFR inhibitor rash', 'Hand-foot syndrome', 'Radiation dermatitis', 'Immunotherapy skin toxicity'],
+            interventions: ['Skin assessment', 'Prophylaxis (where indicated)', 'Topical management', 'Systemic therapy if severe'],
+            medications: ['Hydrocortisone cream', 'Clindamycin gel', 'Doxycycline (prophylactic for EGFR)', 'Urea cream', 'Moisturizers', 'Prednisone (immune-related)'],
+            complementaryApproaches: ['Sun protection', 'Gentle skin care', 'Loose-fitting clothes', 'Radiation skin care protocols'],
+            outcomes: ['Maintained treatment', 'Grade reduction', 'Quality of life preservation'],
+            references: ['NCCN Supportive Care', 'MASCC Skin Toxicity'] },
+        // PSYCHOSOCIAL SUPPORT
+        { id: 'support-distress-001', name: 'Psychosocial Distress Screening',
+            category: 'psychosocial',
+            indications: ['All cancer patients', 'Distress thermometer ≥4', 'Major life transitions', 'Treatment changes'],
+            interventions: ['Distress screening', 'Psychological assessment', 'Social work referral', 'Psychiatry referral', 'Support groups', 'Counseling'],
+            medications: ['SSRIs', 'SNRIs', 'Benzodiazepines (short-term)', 'Sleep aids'],
+            complementaryApproaches: ['Mindfulness-based stress reduction', 'Cognitive behavioral therapy', 'Meaning-centered psychotherapy', 'Art/music therapy', 'Peer support'],
+            outcomes: ['Reduced distress scores', 'Improved coping', 'Better treatment adherence'],
+            references: ['NCCN Distress', 'ASCO Anxiety/Depression', 'IPOS Standards'] },
+        { id: 'support-depression-001', name: 'Cancer-Related Depression',
+            category: 'psychosocial',
+            indications: ['PHQ-9 ≥10', 'Major depressive episode', 'Adjustment disorder with depressed mood'],
+            interventions: ['Psychiatric evaluation', 'Psychotherapy', 'Medication management', 'Suicide risk assessment'],
+            medications: ['Sertraline', 'Escitalopram', 'Mirtazapine (with appetite/sleep benefits)', 'Bupropion (low fatigue)', 'Methylphenidate (prognosis limited)'],
+            complementaryApproaches: ['CBT', 'Problem-solving therapy', 'Behavioral activation', 'Exercise', 'Light therapy'],
+            outcomes: ['PHQ-9 response (≥50% reduction)', 'Improved function', 'Quality of life improvement'],
+            references: ['NCCN Distress', 'ASCO Depression'] },
+        { id: 'support-delirium-001', name: 'Cancer-Related Delirium',
+            category: 'psychosocial',
+            indications: ['Acute confusion', 'ICU patients', 'Opioid toxicity', 'Metabolic derangement', 'Brain metastases'],
+            interventions: ['Reversible cause evaluation', 'Non-pharmacologic management', 'Safety measures', 'Family education'],
+            medications: ['Haloperidol', 'Quetiapine', 'Olanzapine', 'Avoid benzodiazepines (except alcohol withdrawal)'],
+            complementaryApproaches: ['Reorientation', 'Sleep-wake cycle preservation', 'Mobility', 'Sensory aids (glasses, hearing aids)', 'Family presence'],
+            outcomes: ['Resolution of delirium', 'Prevention of harm', 'Family comfort'],
+            references: ['NCCN Palliative Care', 'ASCO Delirium'] },
+        // REHABILITATION
+        { id: 'support-rehab-001', name: 'Cancer Rehabilitation',
+            category: 'rehabilitation',
+            indications: ['Physical deconditioning', 'Post-surgical recovery', 'Lymphedema', 'Cognitive impairment', 'Speech/swallowing issues'],
+            interventions: ['Physiatry consultation', 'Physical therapy', 'Occupational therapy', 'Speech therapy', 'Lymphedema management', 'Cognitive rehabilitation'],
+            medications: ['Pain management', 'Spasticity management'],
+            complementaryApproaches: ['Exercise programs', 'Aquatic therapy', 'Yoga', 'Pilates', 'Pelvic floor therapy'],
+            outcomes: ['Improved function', 'Return to activities', 'Quality of life', 'Independence'],
+            references: ['NCCN Survivorship', 'ACRM Cancer Rehab'] },
+        // SURVIVORSHIP
+        { id: 'support-survivorship-001', name: 'Cancer Survivorship Care',
+            category: 'survivorship',
+            indications: ['Completion of active treatment', 'Long-term survivors', 'Transition to survivorship'],
+            interventions: ['Survivorship care plan', 'Surveillance schedule', 'Late effects monitoring', 'Health promotion', 'Care coordination'],
+            medications: ['Depending on late effects'],
+            complementaryApproaches: ['Exercise', 'Nutrition counseling', 'Smoking cessation', 'Stress management'],
+            outcomes: ['Early recurrence detection', 'Late effect management', 'Healthy lifestyle', 'Quality of life'],
+            references: ['NCCN Survivorship', 'ASCO Survivorship Guidelines'] },
+        { id: 'support-sexual-health-001', name: 'Cancer-Related Sexual Health',
+            category: 'survivorship',
+            indications: ['Sexual dysfunction', 'Hormonal changes', 'Body image issues', 'Fertility concerns'],
+            interventions: ['Sexual health screening', 'Counseling', 'Hormone management', 'Pelvic floor therapy', 'Prosthetics/aids'],
+            medications: ['Vaginal estrogens', 'Lubricants', 'PDE5 inhibitors', 'Testosterone (men)', 'Ospemifene'],
+            complementaryApproaches: ['Couples counseling', 'Sex therapy', 'Body image work', 'Mindfulness'],
+            outcomes: ['Improved sexual function', 'Relationship satisfaction', 'Quality of life'],
+            references: ['NCCN Survivorship', 'ASCO Sexual Health'] },
+        // PALLIATIVE CARE
+        { id: 'support-palliative-integration', name: 'Early Palliative Care Integration',
+            category: 'palliative',
+            indications: ['Advanced cancer diagnosis', 'High symptom burden', 'Goals of care discussion needed', 'Complex decision-making'],
+            interventions: ['Palliative care consultation', 'Symptom management', 'Goals of care discussion', 'Advance care planning', 'Family meetings', 'Care coordination'],
+            medications: ['Symptom-directed medications'],
+            complementaryApproaches: ['Spiritual care', 'Music therapy', 'Art therapy', 'Legacy work', 'Dignity therapy'],
+            outcomes: ['Improved quality of life', 'Better symptom control', 'Goal-concordant care', 'Reduced aggressive end-of-life care'],
+            references: ['ASCO Palliative Care', 'NCCN Palliative Care', 'Temel NEJM'] },
+        { id: 'support-hospice-001', name: 'Hospice Care',
+            category: 'end_of_life',
+            indications: ['Prognosis ≤6 months', 'Goals focused on comfort', 'Decision to forego curative treatment'],
+            interventions: ['Hospice enrollment', 'Home-based care', 'Inpatient hospice if needed', 'Respite care', 'Bereavement support'],
+            medications: ['Comfort medications', 'Symptom management'],
+            complementaryApproaches: ['Spiritual care', 'Life review', 'Family support', 'Bereavement counseling'],
+            outcomes: ['Comfortable death', 'Family support', 'Goal-concordant care', 'Bereavement support'],
+            references: ['NHPCO Guidelines', 'NCCN Palliative Care'] },
+        { id: 'support-dyspnea-001', name: 'Cancer-Related Dyspnea',
+            category: 'palliative',
+            indications: ['Malignant pleural effusion', 'Lymphangitic carcinomatosis', 'Airway obstruction', 'End-of-life dyspnea'],
+            interventions: ['Cause-directed treatment', 'Thoracentesis/pleurodesis', 'Symptom management', 'Oxygen (if hypoxic)', 'Fan therapy'],
+            medications: ['Morphine (low-dose)', 'Hydromorphone', 'Benzodiazepines (anxiety component)', 'Corticosteroids'],
+            complementaryApproaches: ['Positioning', 'Breathing exercises', 'Relaxation techniques', 'Fan across face', 'Energy conservation'],
+            outcomes: ['Reduced dyspnea scores', 'Improved function', 'Quality of life'],
+            references: ['NCCN Palliative Care', 'Cochrane Reviews'] },
+    ];
+    // ═══════════════════════════════════════════════════════════════════════════════
+    // PUBLIC API METHODS
+    // ═══════════════════════════════════════════════════════════════════════════════
+    async getGlobalGuidelines(region, country, cancerType) {
+        let guidelines = [
+            ...this.asianGuidelines,
+            ...this.africanGuidelines,
+            ...this.latinAmericanGuidelines,
+            ...this.middleEasternGuidelines,
+            ...this.whoGuidelines
+        ];
+        if (region) {
+            guidelines = guidelines.filter(g => g.region === region);
+        }
+        if (country) {
+            guidelines = guidelines.filter(g => g.country === country);
+        }
+        if (cancerType) {
+            guidelines = guidelines.filter(g => g.cancerType.toLowerCase().includes(cancerType.toLowerCase()));
+        }
+        return guidelines;
+    }
+    async getSpecialPopulationProtocol(population, cancerType) {
+        let protocols = this.specialPopulationProtocols;
+        if (population) {
+            protocols = protocols.filter(p => p.population === population);
+        }
+        if (cancerType) {
+            protocols = protocols.filter(p => p.cancerType.toLowerCase().includes(cancerType.toLowerCase()));
+        }
+        return protocols;
+    }
+    async getResourceLimitedAdaptation(setting, originalProtocol) {
+        let adaptations = this.resourceLimitedAdaptations;
+        if (setting) {
+            adaptations = adaptations.filter(a => a.setting === setting);
+        }
+        if (originalProtocol) {
+            adaptations = adaptations.filter(a => a.originalProtocol.toLowerCase().includes(originalProtocol.toLowerCase()));
+        }
+        return adaptations;
+    }
+    async getRareCancerProtocol(cancerName) {
+        return this.rareCancerProtocols.find(p => p.name.toLowerCase().includes(cancerName.toLowerCase()));
+    }
+    async getAllRareCancerProtocols() {
+        return this.rareCancerProtocols;
+    }
+    async getPediatricProtocol(cancerType, ageGroup) {
+        let protocols = this.pediatricProtocols;
+        if (cancerType) {
+            protocols = protocols.filter(p => p.cancerType.toLowerCase().includes(cancerType.toLowerCase()) ||
+                p.name.toLowerCase().includes(cancerType.toLowerCase()));
+        }
+        if (ageGroup) {
+            protocols = protocols.filter(p => p.ageGroup === ageGroup);
+        }
+        return protocols;
+    }
+    async getAllPediatricProtocols() {
+        return this.pediatricProtocols;
+    }
+    async getSupportiveCareProtocol(category) {
+        return this.supportiveCareProtocols.filter(p => p.category === category);
+    }
+    async getAllSupportiveCareProtocols() {
+        return this.supportiveCareProtocols;
+    }
+    // ═══════════════════════════════════════════════════════════════════════════════
+    // COMPREHENSIVE TREATMENT RECOMMENDATION ENGINE
+    // ═══════════════════════════════════════════════════════════════════════════════
+    async getComprehensiveTreatmentPlan(cancerType, stage, patientCharacteristics) {
+        const recommendations = [];
+        // Get primary regional guideline
+        const regionalGuidelines = await this.getGlobalGuidelines(undefined, undefined, cancerType);
+        let primaryProtocol = regionalGuidelines.find(g => g.region === patientCharacteristics.region || g.region === 'Global' || g.region === 'WHO') || null;
+        if (primaryProtocol) {
+            recommendations.push(`📋 Primary guideline: ${primaryProtocol.name} (${primaryProtocol.organization})`);
+        }
+        // Get special population modifications
+        let specialPopulationMods = null;
+        if (patientCharacteristics.specialPopulation) {
+            const mods = await this.getSpecialPopulationProtocol(patientCharacteristics.specialPopulation, cancerType);
+            specialPopulationMods = mods[0] || null;
+            if (specialPopulationMods) {
+                recommendations.push(`👥 Special population: ${specialPopulationMods.name}`);
+                recommendations.push(...specialPopulationMods.modifications.slice(0, 3).map(m => `   • ${m}`));
+            }
+        }
+        // Get resource adaptations if needed
+        let resourceAdaptations = null;
+        if (patientCharacteristics.resourceSetting !== 'high_income') {
+            const adaptations = await this.getResourceLimitedAdaptation(patientCharacteristics.resourceSetting);
+            resourceAdaptations = adaptations[0] || null;
+            if (resourceAdaptations) {
+                recommendations.push(`💰 Resource adaptation available: ${resourceAdaptations.originalProtocol}`);
+            }
+        }
+        // Get pediatric protocol if applicable
+        let pediatricProtocol = null;
+        if (patientCharacteristics.age < 18) {
+            const peds = await this.getPediatricProtocol(cancerType);
+            pediatricProtocol = peds[0] || null;
+            if (pediatricProtocol) {
+                recommendations.push(`🧒 Pediatric protocol: ${pediatricProtocol.name}`);
+            }
+        }
+        // Check for rare cancer
+        const rareCancer = await this.getRareCancerProtocol(cancerType);
+        if (rareCancer) {
+            recommendations.push(`🔬 Rare cancer consideration: ${rareCancer.name}`);
+            recommendations.push(`   Referral centers: ${rareCancer.referralCenters.slice(0, 2).join(', ')}`);
+        }
+        // Get supportive care needs
+        const allSupportive = await this.getAllSupportiveCareProtocols();
+        const supportiveNeeds = allSupportive.filter(s => s.category === 'symptom_management' || s.category === 'psychosocial').slice(0, 5);
+        recommendations.push(`🏥 Supportive care considerations:`);
+        supportiveNeeds.forEach(s => {
+            recommendations.push(`   • ${s.name}`);
+        });
+        return {
+            primaryProtocol,
+            specialPopulationModifications: specialPopulationMods,
+            resourceAdaptations,
+            supportiveCareNeeds: supportiveNeeds,
+            pediatricProtocol,
+            rareCancerConsiderations: rareCancer || null,
+            recommendations
+        };
+    }
+    // ═══════════════════════════════════════════════════════════════════════════════
+    // STATISTICS AND COVERAGE METRICS
+    // ═══════════════════════════════════════════════════════════════════════════════
+    getCoverageStatistics() {
+        const allGuidelines = [
+            ...this.asianGuidelines,
+            ...this.africanGuidelines,
+            ...this.latinAmericanGuidelines,
+            ...this.middleEasternGuidelines,
+            ...this.whoGuidelines
+        ];
+        const regions = [...new Set(allGuidelines.map(g => g.region))];
+        const resourceSettings = [...new Set(this.resourceLimitedAdaptations.map(r => r.setting))];
+        return {
+            totalGlobalGuidelines: allGuidelines.length,
+            regionsRepresented: regions,
+            totalRareCancers: this.rareCancerProtocols.length,
+            totalPediatricProtocols: this.pediatricProtocols.length,
+            totalSupportiveCareProtocols: this.supportiveCareProtocols.length,
+            totalSpecialPopulations: this.specialPopulationProtocols.length,
+            resourceSettings
+        };
+    }
+}
+//# sourceMappingURL=globalCancerCoverage.js.map