{
"info": {
"nct_id": "NCT05383482",
"official_title": "A Phase I/II Dose-Escalation and Efficacy/Safety Study of Afuresertib Plus Sintilimab Plus Chemotherapy in Patients With Selected Solid Tumors That Resistance to Prior Anti-PD-1/PD-L1 Treatment",
"inclusion_criteria": "1. Be >=18 years of age on the day of signing the informed consent and be able to provide written informed consent for the trial.\n2. Prior treatments:\n\n * In phase I, patients had at least 1 prior systemic anti-cancer treatment (including neoadjuvant/adjuvant therapy are qualified to be enrolled). Patients who resistant to anti-PD-1/PD-L1 are preferred.\n * In phase II, patients should meet the following 2 criteria simultaneously:\n\n A: resistant to anti-PD-1/PD-L1: previously received at least 6 weeks (2 cycles) anti-PD-1/PD-L1 (including neoadjuvant/adjuvant therapy) and progressed after anti-PD-1/PD-L1 or their combination therapies.\n\n B: received <=3 lines systematic therapy during recurrent/metastatic period.\n3. Tumor diagnosis:\n\n * In phase I, patients had a histology confirmed diagnosis of locally advanced or metastatic solid tumors who had at least 1 prior systemic anti-cancer treatment including neoadjuvant/adjuvant therapy are qualified to be enrolled. The patients with the 5 selected cancer types below who resistant to prior anti-PD-1/PL-1 or its combination therapies will be enrolled with a higher priority.\n * In phase II, the patients have only the following diagnoses will be allowed:\n\n * CC: Patients with histologically confirmed metastatic, recurrent or persistent squamous cell carcinoma, adenosquamous carcinoma, adenocarcinoma of the cervix are allowed. The other histological types of cervical cancer will be excluded.\n * EC: Patients with histologically confirmed metastatic, recurrent or persistent Epithelial Endometrial Carcinoma with endometrioid, high grade serous, or clear cell carcinoma. The other histological types of endometrial cancer will be excluded.\n * EsC: Patients with histologically confirmed local advanced, recurrent or metastasis esophageal squamous cell carcinoma or Her2- adenocarcinoma.\n * NSCLC: Patients with histologically confirmed locally advanced, recurrent, or metastatic Non-Small Cell Lung Cancer (squamous cell carcinoma or adenocarcinoma, adenosquamous carcinoma), who have EGFR wild type status, KRAS wild type status and ALK- negative rearrangement status.\n * GC/GEJC: Patients with histologically confirmed locally advanced, recurrent, or metastatic Her2- gastric adenocarcinoma or gastroesophageal junction adenocarcinoma or squamous cell carcinoma allowed.\n4. Biomarker test:\n\n * In phase I, the biomarker test with tumor sample is optional. However, blood test of cfDNA is required.\n * In phase II, if patient has prior tumor sample PTEN/PI3K/AKT gene alterations or immunohistochemistry test with a report, no further tumor sample biomarker test is needed, but the blood cfDNA test is still required in this study. Otherwise, patient should be able to provide archival or biopsy tumor samples for PTEN immunohistochemistry and PTEN/PI3K/AKT gene alterations, and/or the blood sample for PTEN/PI3K/AKT gene alterations for the cell-free DNA (cfDNA) test. The archival tumor tissue sample obtained better within 2 year from study enrollment or newly obtained core or excisional biopsy of a tumor lesion not previously irradiated will be accepted for IHC test and gene sequencing test. Formalin-fixed, paraffin embedded tissue blocks are preferred to be sectioned on the slides.\n * Please contact sponsor if patient cannot provide archival or biopsy tumor samples.\n5. Patients who are suitable for nab-paclitaxel or docetaxel judged by investigator.\n6. Have measurable disease per RECIST 1.1 as assessed by local radiology. Lesions situated in a previously irradiated area are considered measurable if progression has been demonstrated in such lesions.\n7. Patients must have an Eastern Cooperative Oncology Group (ECOG) Performance Score of 0-2.\n8. Have adequate organ function as defined below. Specimens must be collected within 10 days prior to the start of study treatment.\n\n 1. Hematological:\n\n Absolute neutrophil count (ANC) ≥ 1.5 × 109 /L Platelet count ≥100 × 109 /L Hemoglobin ≥ 90 g/L\n * Criteria must be met without granulocyte-colony stimulating factor, erythropoietin dependency and without packed red blood cell transfusion within last 2 weeks.\n 2. Renal Creatinine ≤1.5 × upper limit of normal (ULN) OR Measured or calculated per institutional standard creatinine clearance (glomerular filtration rate can also be used in place of creatinine or creatinine clearance) ≥30 mL/min for participant with creatinine levels >1.5 × institutional ULN.\n 3. Hepatic Total bilirubin ≤1.5 ×ULN OR direct bilirubin ≤ULN for participants with total bilirubin levels >1.5 × ULN.\n\n AST (SGOT) and ALT (SGPT) ≤2.5 × ULN (≤5 × ULN for participants with liver metastases).\n 4. Coagulation International normalized ratio (INR) OR prothrombin time (PT) and Activated partial thromboplastin time (aPTT) ≤1.5 × ULN unless participant is receiving anticoagulant therapy, as long as PT or aPTT is within therapeutic range of intended use of anticoagulants.\n9. Fasting glucose ≤126 mg/dL or ≤7.0 mmol/L for patients without type 2 diabetes and ≤167 mg/dL or ≤9.3 mmol/L for patients with type 2 diabetes; OR glycosylated hemoglobin (HbA1c) ≤8%.\n10. Life expectancy of 12 weeks or more based on investigator's assessment.\n11. Patients have recovered from adverse events associated with chemotherapy, radiation and surgical operation as pre-treatment to Grade 1 or lower with CTCAE v5.0 excluding stable symptoms (e.g. alopecia, skin hyperpigmentation.).\n12. Patients must agree to use effective contraception during the study and for at least 16 weeks after discontinuation as following:\n\n 1. Total abstinence (if it is their preferred and usual lifestyle)\n 2. An intrauterine device or hormone-releasing system\n 3. A contraceptive implant\n 4. An oral contraceptive (with additional barrier method) OR\n 5. Have a vasectomized partner with confirmed azoospermia.\n 6. Male patients must agree to use an adequate method of contraception.\n13. Patient is able to swallow and retain oral medication without gastrointestinal diseases to interfere with drug absorption.\nHealthy volunteers allowed\nMust have minimum age of 18 Years",
"exclusion_criteria": "1. Pregnancy or lactation. A woman of child-bearing potential, who has a positive urine pregnancy test prior to treatment. If the urine test is cannot be confirmed as negative, a serum pregnancy test will be required.\n2. Prior anti-cancer treatment or any investigational agent within 28 days (or 5 half-lives, whichever is shorter) prior to the first dose of study drugs.\n3. Patients that have previously received AKT or PI3 kinase pathway or mTOR inhibitors will not be enrolled.\n4. Patients that discontinued prior anti PD-1/PD-L1 due to immune related AE.\n5. Has received prior radiotherapy within 2 weeks of start of study treatment. Participants must have recovered from all radiation-related toxicities, not require corticosteroids, and not have had radiation pneumonitis.\n6. With clinically uncontrolled pleural effusion/ascites (patients who do not need effusion drainage or have no significant increase in effusion 3 days after stopping drainage can be enrolled);\n7. With a tumor compressing the surrounding important organs, compressing the superior vena cava, or invading the mediastinal great vessels, heart, etc.;\n8. Has received a live vaccine within 30 days prior to the first dose of study drug. Examples of live vaccines include, but are not limited to, the following: measles, mumps, rubella, varicella/zoster (chicken pox), yellow fever, rabies, Bacillus Calmette-Guérin (BCG), and typhoid vaccine. Seasonal influenza vaccines for injection are generally killed virus vaccines and are allowed; however, intranasal influenza vaccines (e.g., FluMist®) are live attenuated vaccines and are not allowed.\n9. Has a diagnosis of immunodeficiency or is receiving systemic steroid therapy (in dosing exceeding 10 mg daily of prednisone equivalent) or any other form of immunosuppressive therapy within 7 days prior the first dose of study drug.\n10. Has a known additional malignancy that is progressing or has required active treatment within the past 3 years. Participants with basal cell carcinoma of the skin, squamous cell carcinoma of the skin, transitional cell carcinoma of urothelial cancer, or carcinoma in situ (e.g., breast carcinoma, cervical cancer in situ) that have undergone potentially curative therapy are not excluded.\n11. History of seizure of condition that may predispose to seizure that needs anti-epileptic medications; brain arteriovenous malformation; or intracranial masses, such as schwannomas and meningiomas that are causing edema or mass effect.\n12. Has known active CNS metastases and/or carcinomatous meningitis. Participants with previously treated brain metastases may participate provided they are radiologically stable, i.e., without evidence of progression for at least 4 weeks by repeat imaging (note that the repeat imaging should be performed during study screening), clinically stable and without requirement of steroid treatment for at least 14 days prior to first dose of study treatment.\n13. Has severe hypersensitivity (≥Grade 3) to Sintilimab or afuresertib and/or any of their excipients.\n14. Has an active autoimmune disease that has required systemic treatment in past 2 years (i.e., with use of disease modifying agents, corticosteroids or immunosuppressive drugs) prior to the first dose of study treatment. Replacement therapy (e.g., thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency) is not considered a form of systemic treatment and is allowed.\n15. Has a history of (non-infectious) pneumonitis that required steroids or has concurrent interstitial pneumonia.\n16. Has an active infection requiring systemic therapy, active syphilis infection, active pulmonary tuberculosis infection,HIV-infection (i.e., HIV 1 or 2 antibody positive).\n17. New York Heart Association congestive heart failure of grade II or above, unstable angina, myocardial infarction within the past 6 months or serious cardiac arrhythmia associated with significant cardiovascular impairment within the past 6 months.\n18. Prolongation of corrected QTc interval, as corrected by the Fridericia's correction formula to greater than 450 mSec for males and 470 mSec for females: unless prolonged QTc interval due to right bundle branch block or left bundle branch block with a pacemaker.\n19. Presence of uncontrolled hypertension (systolic blood pressure (BP) >160 mmHg or diastolic BP>100 mmHg). Patients with a history of hypertension are allowed, provided that BP is controlled to within these limits by anti-hypertensive treatment.\n20. Has known untreated active Hepatitis B (defined as HBsAg (+) and HBV DNA ≥200 IU/mL (1000 copies/ml)) or active Hepatitis C virus infection (defined as HCV antibody positive and HCV-RNA level above the lower limit of detection).\n\n Note: Subjects with HBV DNA < 200 IU/ml or below the lower limit of detection are eligible. Those on active HBV therapy with viral loads under 200 IU/mL should stay on the same therapy throughout study treatment.\n21. Has a known psychiatric or substance abuse disorder that would interfere with the patient's ability to cooperate with the requirements of the study.\n22. Patients receiving a strong CYP3CA, OATP, BRCP substrate or inducer are not eligible. Please see protocol related section for the list of prohibited medications.\n23. Has had an allogenic tissue/solid organ transplant.\n24. Has a history or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the study, interfere with the patient's participation for the full duration of the study, or is not in the best interest of the patient to participate, in the opinion of the treating investigator.\n25. Patient needs radiotherapy during this study.",
"miscellaneous_criteria": ""
},
"inclusion_lines": [
{
"identified_line": {
"line": "1. Be >=18 years of age on the day of signing the informed consent and be able to provide written informed consent for the trial.",
"criterions": [
{
"exact_snippets": "Be >=18 years of age",
"criterion": "age",
"requirement": {
"requirement_type": "value",
"expected_value": {
"operator": ">=",
"value": 18,
"unit": "years"
}
}
},
{
"exact_snippets": "be able to provide written informed consent",
"criterion": "ability to provide written informed consent",
"requirement": {
"requirement_type": "ability",
"expected_value": true
}
}
]
},
"logical_structure": {
"and_criteria": [
{
"exact_snippets": "Be >=18 years of age",
"criterion": "age",
"requirement": {
"requirement_type": "value",
"expected_value": {
"operator": ">=",
"value": 18,
"unit": "years"
}
}
},
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"exact_snippets": "be able to provide written informed consent",
"criterion": "ability to provide written informed consent",
"requirement": {
"requirement_type": "ability",
"expected_value": true
}
}
]
}
},
{
"identified_line": {
"line": "2. Prior treatments:",
"criterions": [
{
"exact_snippets": "Prior treatments",
"criterion": "prior treatments",
"requirement": {
"requirement_type": "presence",
"expected_value": true
}
}
]
},
"logical_structure": {
"and_criteria": [
{
"exact_snippets": "Prior treatments",
"criterion": "prior treatments",
"requirement": {
"requirement_type": "presence",
"expected_value": true
}
}
]
}
},
{
"identified_line": {
"line": "* In phase I, patients had at least 1 prior systemic anti-cancer treatment (including neoadjuvant/adjuvant therapy are qualified to be enrolled). Patients who resistant to anti-PD-1/PD-L1 are preferred.",
"criterions": [
{
"exact_snippets": "patients had at least 1 prior systemic anti-cancer treatment",
"criterion": "prior systemic anti-cancer treatment",
"requirement": {
"requirement_type": "quantity",
"expected_value": {
"operator": ">=",
"value": 1,
"unit": "treatment"
}
}
},
{
"exact_snippets": "Patients who resistant to anti-PD-1/PD-L1",
"criterion": "resistance to anti-PD-1/PD-L1",
"requirement": {
"requirement_type": "preference",
"expected_value": true
}
}
]
},
"logical_structure": {
"and_criteria": [
{
"and_criteria": [
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"exact_snippets": "patients had at least 1 prior systemic anti-cancer treatment",
"criterion": "prior systemic anti-cancer treatment",
"requirement": {
"requirement_type": "quantity",
"expected_value": {
"operator": ">=",
"value": 1,
"unit": "treatment"
}
}
},
{
"exact_snippets": "including neoadjuvant/adjuvant therapy are qualified to be enrolled",
"criterion": "neoadjuvant/adjuvant therapy",
"requirement": {
"requirement_type": "qualification",
"expected_value": true
}
}
]
},
{
"exact_snippets": "Patients who resistant to anti-PD-1/PD-L1",
"criterion": "resistance to anti-PD-1/PD-L1",
"requirement": {
"requirement_type": "preference",
"expected_value": true
}
}
]
}
},
{
"identified_line": {
"line": "* In phase II, patients should meet the following 2 criteria simultaneously:",
"criterions": [
{
"exact_snippets": "phase II",
"criterion": "trial phase",
"requirement": {
"requirement_type": "phase",
"expected_value": "II"
}
},
{
"exact_snippets": "patients should meet the following 2 criteria simultaneously",
"criterion": "criteria count",
"requirement": {
"requirement_type": "count",
"expected_value": ">= 2"
}
}
]
},
"logical_structure": {
"and_criteria": [
{
"exact_snippets": "phase II",
"criterion": "trial phase",
"requirement": {
"requirement_type": "phase",
"expected_value": "II"
}
},
{
"exact_snippets": "patients should meet the following 2 criteria simultaneously",
"criterion": "criteria count",
"requirement": {
"requirement_type": "count",
"expected_value": ">= 2"
}
}
]
}
},
{
"identified_line": {
"line": "A: resistant to anti-PD-1/PD-L1: previously received at least 6 weeks (2 cycles) anti-PD-1/PD-L1 (including neoadjuvant/adjuvant therapy) and progressed after anti-PD-1/PD-L1 or their combination therapies.",
"criterions": [
{
"exact_snippets": "resistant to anti-PD-1/PD-L1",
"criterion": "resistance to anti-PD-1/PD-L1",
"requirement": {
"requirement_type": "presence",
"expected_value": true
}
},
{
"exact_snippets": "previously received at least 6 weeks (2 cycles) anti-PD-1/PD-L1",
"criterion": "previous anti-PD-1/PD-L1 treatment duration",
"requirement": {
"requirement_type": "duration",
"expected_value": {
"operator": ">=",
"value": 6,
"unit": "weeks"
}
}
},
{
"exact_snippets": "progressed after anti-PD-1/PD-L1 or their combination therapies",
"criterion": "progression after anti-PD-1/PD-L1 therapies",
"requirement": {
"requirement_type": "progression",
"expected_value": true
}
}
]
},
"logical_structure": {
"and_criteria": [
{
"and_criteria": [
{
"exact_snippets": "resistant to anti-PD-1/PD-L1",
"criterion": "resistance to anti-PD-1/PD-L1",
"requirement": {
"requirement_type": "presence",
"expected_value": true
}
},
{
"exact_snippets": "previously received at least 6 weeks (2 cycles) anti-PD-1/PD-L1",
"criterion": "previous anti-PD-1/PD-L1 treatment duration",
"requirement": {
"requirement_type": "duration",
"expected_value": {
"operator": ">=",
"value": 6,
"unit": "weeks"
}
}
}
]
},
{
"exact_snippets": "progressed after anti-PD-1/PD-L1 or their combination therapies",
"criterion": "progression after anti-PD-1/PD-L1 therapies",
"requirement": {
"requirement_type": "progression",
"expected_value": true
}
}
]
}
},
{
"identified_line": {
"line": "B: received <=3 lines systematic therapy during recurrent/metastatic period.",
"criterions": [
{
"exact_snippets": "received <=3 lines systematic therapy during recurrent/metastatic period",
"criterion": "systematic therapy during recurrent/metastatic period",
"requirement": {
"requirement_type": "quantity",
"expected_value": {
"operator": "<=",
"value": 3,
"unit": "lines"
}
}
}
]
},
"logical_structure": {
"and_criteria": [
{
"exact_snippets": "received <=3 lines systematic therapy during recurrent/metastatic period",
"criterion": "systematic therapy during recurrent/metastatic period",
"requirement": {
"requirement_type": "quantity",
"expected_value": {
"operator": "<=",
"value": 3,
"unit": "lines"
}
}
}
]
}
},
{
"identified_line": {
"line": "3. Tumor diagnosis:",
"criterions": [
{
"exact_snippets": "Tumor diagnosis",
"criterion": "tumor diagnosis",
"requirement": {
"requirement_type": "presence",
"expected_value": true
}
}
]
},
"logical_structure": {
"and_criteria": [
{
"exact_snippets": "Tumor diagnosis",
"criterion": "tumor diagnosis",
"requirement": {
"requirement_type": "presence",
"expected_value": true
}
}
]
}
},
{
"identified_line": {
"line": "* In phase I, patients had a histology confirmed diagnosis of locally advanced or metastatic solid tumors who had at least 1 prior systemic anti-cancer treatment including neoadjuvant/adjuvant therapy are qualified to be enrolled. The patients with the 5 selected cancer types below who resistant to prior anti-PD-1/PL-1 or its combination therapies will be enrolled with a higher priority.",
"criterions": [
{
"exact_snippets": "histology confirmed diagnosis of locally advanced or metastatic solid tumors",
"criterion": "solid tumors",
"requirement": {
"requirement_type": "diagnosis",
"expected_value": "histology confirmed"
}
},
{
"exact_snippets": "histology confirmed diagnosis of locally advanced or metastatic solid tumors",
"criterion": "solid tumors",
"requirement": {
"requirement_type": "stage",
"expected_value": [
"locally advanced",
"metastatic"
]
}
},
{
"exact_snippets": "at least 1 prior systemic anti-cancer treatment including neoadjuvant/adjuvant therapy",
"criterion": "prior systemic anti-cancer treatment",
"requirement": {
"requirement_type": "quantity",
"expected_value": {
"operator": ">=",
"value": 1,
"unit": "treatment"
}
}
},
{
"exact_snippets": "resistant to prior anti-PD-1/PL-1 or its combination therapies",
"criterion": "resistance to anti-PD-1/PL-1 therapies",
"requirement": {
"requirement_type": "resistance",
"expected_value": true
}
}
]
},
"logical_structure": {
"and_criteria": [
{
"and_criteria": [
{
"and_criteria": [
{
"exact_snippets": "histology confirmed diagnosis of locally advanced or metastatic solid tumors",
"criterion": "solid tumors",
"requirement": {
"requirement_type": "diagnosis",
"expected_value": "histology confirmed"
}
},
{
"exact_snippets": "histology confirmed diagnosis of locally advanced or metastatic solid tumors",
"criterion": "solid tumors",
"requirement": {
"requirement_type": "stage",
"expected_value": [
"locally advanced",
"metastatic"
]
}
}
]
},
{
"exact_snippets": "at least 1 prior systemic anti-cancer treatment including neoadjuvant/adjuvant therapy",
"criterion": "prior systemic anti-cancer treatment",
"requirement": {
"requirement_type": "quantity",
"expected_value": {
"operator": ">=",
"value": 1,
"unit": "treatment"
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}
}
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},
{
"exact_snippets": "resistant to prior anti-PD-1/PL-1 or its combination therapies",
"criterion": "resistance to anti-PD-1/PL-1 therapies",
"requirement": {
"requirement_type": "resistance",
"expected_value": true
}
}
]
}
},
{
"identified_line": {
"line": "* In phase II, the patients have only the following diagnoses will be allowed:",
"criterions": [
{
"exact_snippets": "patients have only the following diagnoses",
"criterion": "diagnoses",
"requirement": {
"requirement_type": "specificity",
"expected_value": "only the following"
}
}
]
},
"logical_structure": {
"and_criteria": [
{
"exact_snippets": "patients have only the following diagnoses",
"criterion": "diagnoses",
"requirement": {
"requirement_type": "specificity",
"expected_value": "only the following"
}
}
]
}
},
{
"identified_line": {
"line": "* CC: Patients with histologically confirmed metastatic, recurrent or persistent squamous cell carcinoma, adenosquamous carcinoma, adenocarcinoma of the cervix are allowed. The other histological types of cervical cancer will be excluded.",
"criterions": [
{
"exact_snippets": "histologically confirmed metastatic, recurrent or persistent squamous cell carcinoma, adenosquamous carcinoma, adenocarcinoma of the cervix",
"criterion": "cervical cancer type",
"requirement": {
"requirement_type": "presence",
"expected_value": [
"squamous cell carcinoma",
"adenosquamous carcinoma",
"adenocarcinoma"
]
}
},
{
"exact_snippets": "The other histological types of cervical cancer will be excluded",
"criterion": "cervical cancer type",
"requirement": {
"requirement_type": "exclusion",
"expected_value": "other histological types"
}
}
]
},
"logical_structure": {
"or_criteria": [
{
"exact_snippets": "histologically confirmed metastatic, recurrent or persistent squamous cell carcinoma, adenosquamous carcinoma, adenocarcinoma of the cervix",
"criterion": "cervical cancer type",
"requirement": {
"requirement_type": "presence",
"expected_value": [
"squamous cell carcinoma",
"adenosquamous carcinoma",
"adenocarcinoma"
]
}
},
{
"not_criteria": {
"exact_snippets": "The other histological types of cervical cancer will be excluded",
"criterion": "cervical cancer type",
"requirement": {
"requirement_type": "exclusion",
"expected_value": "other histological types"
}
}
}
]
}
},
{
"identified_line": {
"line": "* EC: Patients with histologically confirmed metastatic, recurrent or persistent Epithelial Endometrial Carcinoma with endometrioid, high grade serous, or clear cell carcinoma. The other histological types of endometrial cancer will be excluded.",
"criterions": [
{
"exact_snippets": "histologically confirmed metastatic, recurrent or persistent Epithelial Endometrial Carcinoma",
"criterion": "Epithelial Endometrial Carcinoma",
"requirement": {
"requirement_type": "confirmation",
"expected_value": "histologically confirmed"
}
},
{
"exact_snippets": "histologically confirmed metastatic, recurrent or persistent Epithelial Endometrial Carcinoma",
"criterion": "Epithelial Endometrial Carcinoma",
"requirement": {
"requirement_type": "stage",
"expected_value": [
"metastatic",
"recurrent",
"persistent"
]
}
},
{
"exact_snippets": "endometrioid, high grade serous, or clear cell carcinoma",
"criterion": "histological subtype of Epithelial Endometrial Carcinoma",
"requirement": {
"requirement_type": "subtype",
"expected_value": [
"endometrioid",
"high grade serous",
"clear cell carcinoma"
]
}
}
]
},
"logical_structure": {
"and_criteria": [
{
"and_criteria": [
{
"exact_snippets": "histologically confirmed metastatic, recurrent or persistent Epithelial Endometrial Carcinoma",
"criterion": "Epithelial Endometrial Carcinoma",
"requirement": {
"requirement_type": "confirmation",
"expected_value": "histologically confirmed"
}
},
{
"exact_snippets": "histologically confirmed metastatic, recurrent or persistent Epithelial Endometrial Carcinoma",
"criterion": "Epithelial Endometrial Carcinoma",
"requirement": {
"requirement_type": "stage",
"expected_value": [
"metastatic",
"recurrent",
"persistent"
]
}
}
]
},
{
"exact_snippets": "endometrioid, high grade serous, or clear cell carcinoma",
"criterion": "histological subtype of Epithelial Endometrial Carcinoma",
"requirement": {
"requirement_type": "subtype",
"expected_value": [
"endometrioid",
"high grade serous",
"clear cell carcinoma"
]
}
}
]
}
},
{
"identified_line": {
"line": "* EsC: Patients with histologically confirmed local advanced, recurrent or metastasis esophageal squamous cell carcinoma or Her2- adenocarcinoma.",
"criterions": [
{
"exact_snippets": "histologically confirmed",
"criterion": "histological confirmation",
"requirement": {
"requirement_type": "presence",
"expected_value": true
}
},
{
"exact_snippets": "local advanced, recurrent or metastasis esophageal squamous cell carcinoma",
"criterion": "esophageal squamous cell carcinoma",
"requirement": {
"requirement_type": "stage",
"expected_value": [
"locally advanced",
"recurrent",
"metastatic"
]
}
},
{
"exact_snippets": "Her2- adenocarcinoma",
"criterion": "adenocarcinoma",
"requirement": {
"requirement_type": "Her2 status",
"expected_value": "negative"
}
}
]
},
"logical_structure": {
"and_criteria": [
{
"and_criteria": [
{
"exact_snippets": "histologically confirmed",
"criterion": "histological confirmation",
"requirement": {
"requirement_type": "presence",
"expected_value": true
}
},
{
"or_criteria": [
{
"exact_snippets": "local advanced, recurrent or metastasis esophageal squamous cell carcinoma",
"criterion": "esophageal squamous cell carcinoma",
"requirement": {
"requirement_type": "stage",
"expected_value": [
"locally advanced",
"recurrent",
"metastatic"
]
}
},
{
"exact_snippets": "Her2- adenocarcinoma",
"criterion": "adenocarcinoma",
"requirement": {
"requirement_type": "Her2 status",
"expected_value": "negative"
}
}
]
}
]
}
]
}
},
{
"identified_line": {
"line": "* GC/GEJC: Patients with histologically confirmed locally advanced, recurrent, or metastatic Her2- gastric adenocarcinoma or gastroesophageal junction adenocarcinoma or squamous cell carcinoma allowed.",
"criterions": [
{
"exact_snippets": "histologically confirmed",
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"requirement_type": "confirmation",
"expected_value": true
}
},
{
"exact_snippets": "locally advanced, recurrent, or metastatic",
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"requirement_type": "stage",
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"recurrent",
"metastatic"
]
}
},
{
"exact_snippets": "Her2- gastric adenocarcinoma",
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"requirement_type": "status",
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}
},
{
"exact_snippets": "gastric adenocarcinoma",
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"requirement": {
"requirement_type": "type",
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}
},
{
"exact_snippets": "gastroesophageal junction adenocarcinoma",
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"requirement": {
"requirement_type": "type",
"expected_value": "gastroesophageal junction adenocarcinoma"
}
},
{
"exact_snippets": "squamous cell carcinoma allowed",
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"requirement_type": "type",
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}
}
]
},
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{
"and_criteria": [
{
"exact_snippets": "histologically confirmed",
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},
{
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"metastatic"
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}
},
{
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},
{
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]
},
{
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{
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"requirement_type": "type",
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}
]
},
{
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"requirement_type": "confirmation",
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},
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"requirement_type": "stage",
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"metastatic"
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}
},
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"exact_snippets": "squamous cell carcinoma allowed",
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}
]
}
]
}
},
{
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"line": "4. Biomarker test:",
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{
"exact_snippets": "Biomarker test",
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}
]
},
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{
"exact_snippets": "Biomarker test",
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}
]
}
},
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"identified_line": {
"line": "* In phase I, the biomarker test with tumor sample is optional. However, blood test of cfDNA is required.",
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{
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"exact_snippets": "blood test of cfDNA is required",
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"requirement_type": "requirement",
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}
]
},
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},
{
"identified_line": {
"line": "* In phase II, if patient has prior tumor sample PTEN/PI3K/AKT gene alterations or immunohistochemistry test with a report, no further tumor sample biomarker test is needed, but the blood cfDNA test is still required in this study. Otherwise, patient should be able to provide archival or biopsy tumor samples for PTEN immunohistochemistry and PTEN/PI3K/AKT gene alterations, and/or the blood sample for PTEN/PI3K/AKT gene alterations for the cell-free DNA (cfDNA) test. The archival tumor tissue sample obtained better within 2 year from study enrollment or newly obtained core or excisional biopsy of a tumor lesion not previously irradiated will be accepted for IHC test and gene sequencing test. Formalin-fixed, paraffin embedded tissue blocks are preferred to be sectioned on the slides.",
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{
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},
{
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},
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"exact_snippets": "able to provide archival or biopsy tumor samples",
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},
{
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},
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"exact_snippets": "blood sample for PTEN/PI3K/AKT gene alterations",
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}
},
{
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}
},
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"expected_value": true
}
},
{
"exact_snippets": "Formalin-fixed, paraffin embedded tissue blocks are preferred",
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"requirement_type": "preference",
"expected_value": true
}
}
]
},
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{
"or_criteria": [
{
"and_criteria": [
{
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},
{
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]
}
},
{
"identified_line": {
"line": "7. Patients must have an Eastern Cooperative Oncology Group (ECOG) Performance Score of 0-2.",
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{
"exact_snippets": "Eastern Cooperative Oncology Group (ECOG) Performance Score of 0-2",
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"requirement": {
"requirement_type": "range",
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{
"operator": ">=",
"value": 0,
"unit": "N/A"
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{
"operator": "<=",
"value": 2,
"unit": "N/A"
}
]
}
}
}
]
},
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{
"exact_snippets": "Eastern Cooperative Oncology Group (ECOG) Performance Score of 0-2",
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"operator": ">=",
"value": 0,
"unit": "N/A"
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{
"operator": "<=",
"value": 2,
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}
]
}
}
}
]
}
},
{
"identified_line": {
"line": "8. Have adequate organ function as defined below. Specimens must be collected within 10 days prior to the start of study treatment.",
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"exact_snippets": "adequate organ function",
"criterion": "organ function",
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"requirement_type": "adequacy",
"expected_value": true
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},
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"exact_snippets": "Specimens must be collected within 10 days prior to the start of study treatment",
"criterion": "specimen collection timing",
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"requirement_type": "timing",
"expected_value": "within 10 days prior to the start of study treatment"
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}
]
},
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"and_criteria": [
{
"exact_snippets": "adequate organ function",
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"expected_value": true
}
},
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"exact_snippets": "Specimens must be collected within 10 days prior to the start of study treatment",
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}
},
{
"identified_line": {
"line": "1. Hematological:",
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"exact_snippets": "Hematological:",
"criterion": "hematological",
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"expected_value": "N/A"
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}
]
},
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{
"exact_snippets": "Hematological:",
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"expected_value": "N/A"
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}
]
}
},
{
"identified_line": {
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{
"exact_snippets": "Absolute neutrophil count (ANC) ≥ 1.5 × 109 /L",
"criterion": "absolute neutrophil count (ANC)",
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"requirement_type": "quantity",
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"operator": ">=",
"value": 1.5,
"unit": "× 10^9 /L"
}
}
},
{
"exact_snippets": "Platelet count ≥100 × 109 /L",
"criterion": "platelet count",
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"requirement_type": "quantity",
"expected_value": {
"operator": ">=",
"value": 100,
"unit": "× 10^9 /L"
}
}
},
{
"exact_snippets": "Hemoglobin ≥ 90 g/L",
"criterion": "hemoglobin",
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"requirement_type": "quantity",
"expected_value": {
"operator": ">=",
"value": 90,
"unit": "g/L"
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}
}
]
},
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"and_criteria": [
{
"exact_snippets": "Absolute neutrophil count (ANC) ≥ 1.5 × 109 /L",
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"requirement_type": "quantity",
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"operator": ">=",
"value": 1.5,
"unit": "× 10^9 /L"
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"exact_snippets": "Platelet count ≥100 × 109 /L",
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"value": 100,
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{
"exact_snippets": "Hemoglobin ≥ 90 g/L",
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"value": 90,
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}
}
]
}
},
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"identified_line": {
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"exact_snippets": "without granulocyte-colony stimulating factor",
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},
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"exact_snippets": "erythropoietin dependency",
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},
{
"exact_snippets": "without packed red blood cell transfusion within last 2 weeks",
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]
},
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},
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"exact_snippets": "erythropoietin dependency",
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}
},
{
"identified_line": {
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"criterion": "hepatic total bilirubin",
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"operator": "<=",
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"unit": "× ULN"
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}
},
{
"exact_snippets": "direct bilirubin ≤ULN",
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"operator": "<=",
"value": 1,
"unit": "ULN"
}
}
},
{
"exact_snippets": "total bilirubin levels >1.5 × ULN",
"criterion": "total bilirubin levels",
"requirement": {
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"operator": ">",
"value": 1.5,
"unit": "× ULN"
}
}
}
]
},
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},
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"and_criteria": [
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}
},
{
"exact_snippets": "total bilirubin levels >1.5 × ULN",
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}
}
}
]
}
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}
},
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"identified_line": {
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{
"exact_snippets": "Coagulation International normalized ratio (INR) ... ≤1.5 × ULN unless participant is receiving anticoagulant therapy",
"criterion": "INR",
"requirement": {
"requirement_type": "value",
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"operator": "<=",
"value": 1.5,
"unit": "× ULN"
}
]
}
}
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"operator": "<=",
"value": 1.5,
"unit": "× ULN"
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]
}
}
},
{
"exact_snippets": "Activated partial thromboplastin time (aPTT) ≤1.5 × ULN unless participant is receiving anticoagulant therapy",
"criterion": "aPTT",
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"operator": "<=",
"value": 1.5,
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]
}
}
},
{
"exact_snippets": "unless participant is receiving anticoagulant therapy, as long as PT or aPTT is within therapeutic range of intended use of anticoagulants",
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"expected_value": true
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}
]
},
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{
"or_criteria": [
{
"exact_snippets": "Coagulation International normalized ratio (INR) ... ≤1.5 × ULN unless participant is receiving anticoagulant therapy",
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"comparisons": [
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"operator": "<=",
"value": 1.5,
"unit": "× ULN"
}
]
}
}
},
{
"and_criteria": [
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"exact_snippets": "prothrombin time (PT) ... ≤1.5 × ULN unless participant is receiving anticoagulant therapy",
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},
{
"exact_snippets": "Activated partial thromboplastin time (aPTT) ≤1.5 × ULN unless participant is receiving anticoagulant therapy",
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"operator": "<=",
"value": 1.5,
"unit": "× ULN"
}
]
}
}
}
]
}
]
}
]
},
"then_criteria": null,
"else_criteria": {
"and_criteria": [
{
"exact_snippets": "unless participant is receiving anticoagulant therapy, as long as PT or aPTT is within therapeutic range of intended use of anticoagulants",
"criterion": "anticoagulant therapy",
"requirement": {
"requirement_type": "presence",
"expected_value": true
}
},
{
"or_criteria": [
{
"exact_snippets": "unless participant is receiving anticoagulant therapy, as long as PT or aPTT is within therapeutic range of intended use of anticoagulants",
"criterion": "PT",
"requirement": {
"requirement_type": "value",
"expected_value": "within therapeutic range of intended use of anticoagulants"
}
},
{
"exact_snippets": "unless participant is receiving anticoagulant therapy, as long as PT or aPTT is within therapeutic range of intended use of anticoagulants",
"criterion": "aPTT",
"requirement": {
"requirement_type": "value",
"expected_value": "within therapeutic range of intended use of anticoagulants"
}
}
]
},
{
"not_criteria": {
"exact_snippets": "Coagulation International normalized ratio (INR) ... ≤1.5 × ULN unless participant is receiving anticoagulant therapy",
"criterion": "INR",
"requirement": {
"requirement_type": "value",
"expected_value": {
"comparisons": [
{
"operator": "<=",
"value": 1.5,
"unit": "× ULN"
}
]
}
}
}
}
]
}
}
},
{
"identified_line": {
"line": "10. Life expectancy of 12 weeks or more based on investigator's assessment.",
"criterions": [
{
"exact_snippets": "Life expectancy of 12 weeks or more",
"criterion": "life expectancy",
"requirement": {
"requirement_type": "duration",
"expected_value": {
"operator": ">=",
"value": 12,
"unit": "weeks"
}
}
}
]
},
"logical_structure": {
"and_criteria": [
{
"exact_snippets": "Life expectancy of 12 weeks or more",
"criterion": "life expectancy",
"requirement": {
"requirement_type": "duration",
"expected_value": {
"operator": ">=",
"value": 12,
"unit": "weeks"
}
}
}
]
}
},
{
"identified_line": {
"line": "11. Patients have recovered from adverse events associated with chemotherapy, radiation and surgical operation as pre-treatment to Grade 1 or lower with CTCAE v5.0 excluding stable symptoms (e.g. alopecia, skin hyperpigmentation.).",
"criterions": [
{
"exact_snippets": "recovered from adverse events associated with chemotherapy",
"criterion": "recovery from chemotherapy adverse events",
"requirement": {
"requirement_type": "severity",
"expected_value": {
"operator": "<=",
"value": 1,
"unit": "CTCAE v5.0"
}
}
},
{
"exact_snippets": "recovered from adverse events associated with ... radiation",
"criterion": "recovery from radiation adverse events",
"requirement": {
"requirement_type": "severity",
"expected_value": {
"operator": "<=",
"value": 1,
"unit": "CTCAE v5.0"
}
}
},
{
"exact_snippets": "recovered from adverse events associated with ... surgical operation",
"criterion": "recovery from surgical operation adverse events",
"requirement": {
"requirement_type": "severity",
"expected_value": {
"operator": "<=",
"value": 1,
"unit": "CTCAE v5.0"
}
}
}
]
},
"logical_structure": {
"and_criteria": [
{
"and_criteria": [
{
"and_criteria": [
{
"exact_snippets": "recovered from adverse events associated with chemotherapy",
"criterion": "recovery from chemotherapy adverse events",
"requirement": {
"requirement_type": "severity",
"expected_value": {
"operator": "<=",
"value": 1,
"unit": "CTCAE v5.0"
}
}
},
{
"exact_snippets": "recovered from adverse events associated with ... radiation",
"criterion": "recovery from radiation adverse events",
"requirement": {
"requirement_type": "severity",
"expected_value": {
"operator": "<=",
"value": 1,
"unit": "CTCAE v5.0"
}
}
}
]
},
{
"exact_snippets": "recovered from adverse events associated with ... surgical operation",
"criterion": "recovery from surgical operation adverse events",
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"requirement_type": "severity",
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"operator": "<=",
"value": 1,
"unit": "CTCAE v5.0"
}
}
}
]
}
]
}
},
{
"identified_line": {
"line": "12. Patients must agree to use effective contraception during the study and for at least 16 weeks after discontinuation as following:",
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{
"exact_snippets": "Patients must agree to use effective contraception during the study and for at least 16 weeks after discontinuation",
"criterion": "contraception use",
"requirement": {
"requirement_type": "agreement",
"expected_value": true
}
},
{
"exact_snippets": "Patients must agree to use effective contraception during the study and for at least 16 weeks after discontinuation",
"criterion": "contraception use",
"requirement": {
"requirement_type": "duration",
"expected_value": "during the study and for at least 16 weeks after discontinuation"
}
}
]
},
"logical_structure": {
"and_criteria": [
{
"exact_snippets": "Patients must agree to use effective contraception during the study and for at least 16 weeks after discontinuation",
"criterion": "contraception use",
"requirement": {
"requirement_type": "agreement",
"expected_value": true
}
},
{
"exact_snippets": "Patients must agree to use effective contraception during the study and for at least 16 weeks after discontinuation",
"criterion": "contraception use",
"requirement": {
"requirement_type": "duration",
"expected_value": "during the study and for at least 16 weeks after discontinuation"
}
}
]
}
},
{
"identified_line": {
"line": "1. Total abstinence (if it is their preferred and usual lifestyle)",
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{
"exact_snippets": "Total abstinence (if it is their preferred and usual lifestyle)",
"criterion": "total abstinence",
"requirement": {
"requirement_type": "preference",
"expected_value": true
}
},
{
"exact_snippets": "Total abstinence (if it is their preferred and usual lifestyle)",
"criterion": "total abstinence",
"requirement": {
"requirement_type": "usual lifestyle",
"expected_value": true
}
}
]
},
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"and_criteria": [
{
"condition": {
"exact_snippets": "Total abstinence (if it is their preferred and usual lifestyle)",
"criterion": "total abstinence",
"requirement": {
"requirement_type": "preference",
"expected_value": true
}
},
"then_criteria": {
"exact_snippets": "Total abstinence (if it is their preferred and usual lifestyle)",
"criterion": "total abstinence",
"requirement": {
"requirement_type": "usual lifestyle",
"expected_value": true
}
},
"else_criteria": null
}
]
}
},
{
"identified_line": {
"line": "2. An intrauterine device or hormone-releasing system",
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{
"exact_snippets": "intrauterine device",
"criterion": "intrauterine device",
"requirement": {
"requirement_type": "presence",
"expected_value": true
}
},
{
"exact_snippets": "hormone-releasing system",
"criterion": "hormone-releasing system",
"requirement": {
"requirement_type": "presence",
"expected_value": true
}
}
]
},
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"or_criteria": [
{
"exact_snippets": "intrauterine device",
"criterion": "intrauterine device",
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"requirement_type": "presence",
"expected_value": true
}
},
{
"exact_snippets": "hormone-releasing system",
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"requirement_type": "presence",
"expected_value": true
}
}
]
}
},
{
"identified_line": {
"line": "3. A contraceptive implant",
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{
"exact_snippets": "A contraceptive implant",
"criterion": "contraceptive implant",
"requirement": {
"requirement_type": "presence",
"expected_value": true
}
}
]
},
"logical_structure": {
"and_criteria": [
{
"exact_snippets": "A contraceptive implant",
"criterion": "contraceptive implant",
"requirement": {
"requirement_type": "presence",
"expected_value": true
}
}
]
}
},
{
"identified_line": {
"line": "4. An oral contraceptive (with additional barrier method) OR",
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{
"exact_snippets": "oral contraceptive",
"criterion": "contraceptive method",
"requirement": {
"requirement_type": "type",
"expected_value": "oral"
}
},
{
"exact_snippets": "additional barrier method",
"criterion": "contraceptive method",
"requirement": {
"requirement_type": "type",
"expected_value": "barrier"
}
}
]
},
"logical_structure": {
"or_criteria": [
{
"and_criteria": [
{
"exact_snippets": "oral contraceptive",
"criterion": "contraceptive method",
"requirement": {
"requirement_type": "type",
"expected_value": "oral"
}
},
{
"exact_snippets": "additional barrier method",
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"requirement_type": "type",
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}
]
}
]
}
},
{
"identified_line": {
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{
"exact_snippets": "vasectomized partner",
"criterion": "partner vasectomy status",
"requirement": {
"requirement_type": "status",
"expected_value": "vasectomized"
}
},
{
"exact_snippets": "confirmed azoospermia",
"criterion": "partner azoospermia",
"requirement": {
"requirement_type": "confirmation",
"expected_value": true
}
}
]
},
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"and_criteria": [
{
"exact_snippets": "vasectomized partner",
"criterion": "partner vasectomy status",
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"requirement_type": "status",
"expected_value": "vasectomized"
}
},
{
"exact_snippets": "confirmed azoospermia",
"criterion": "partner azoospermia",
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"requirement_type": "confirmation",
"expected_value": true
}
}
]
}
},
{
"identified_line": {
"line": "6. Male patients must agree to use an adequate method of contraception.",
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{
"exact_snippets": "Male patients must agree to use an adequate method of contraception.",
"criterion": "contraception method",
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"requirement_type": "agreement",
"expected_value": true
}
},
{
"exact_snippets": "Male patients must agree to use an adequate method of contraception.",
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"requirement_type": "adequacy",
"expected_value": true
}
}
]
},
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{
"exact_snippets": "Male patients must agree to use an adequate method of contraception.",
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"requirement": {
"requirement_type": "agreement",
"expected_value": true
}
},
{
"exact_snippets": "Male patients must agree to use an adequate method of contraception.",
"criterion": "contraception method",
"requirement": {
"requirement_type": "adequacy",
"expected_value": true
}
}
]
}
}
],
"exclusion_lines": [
{
"identified_line": {
"line": "4. Patients that discontinued prior anti PD-1/PD-L1 due to immune related AE.",
"criterions": [
{
"exact_snippets": "discontinued prior anti PD-1/PD-L1",
"criterion": "prior anti PD-1/PD-L1 treatment",
"requirement": {
"requirement_type": "discontinuation",
"expected_value": true
}
},
{
"exact_snippets": "due to immune related AE",
"criterion": "immune related adverse event",
"requirement": {
"requirement_type": "cause of discontinuation",
"expected_value": true
}
}
]
},
"logical_structure": {
"and_criteria": [
{
"exact_snippets": "discontinued prior anti PD-1/PD-L1",
"criterion": "prior anti PD-1/PD-L1 treatment",
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"requirement_type": "discontinuation",
"expected_value": true
}
},
{
"exact_snippets": "due to immune related AE",
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}
}
]
}
},
{
"identified_line": {
"line": "5. Has received prior radiotherapy within 2 weeks of start of study treatment. Participants must have recovered from all radiation-related toxicities, not require corticosteroids, and not have had radiation pneumonitis.",
"criterions": [
{
"exact_snippets": "Has received prior radiotherapy within 2 weeks of start of study treatment",
"criterion": "prior radiotherapy",
"requirement": {
"requirement_type": "time since treatment",
"expected_value": {
"operator": "<=",
"value": 2,
"unit": "weeks"
}
}
},
{
"exact_snippets": "Participants must have recovered from all radiation-related toxicities",
"criterion": "radiation-related toxicities",
"requirement": {
"requirement_type": "recovery",
"expected_value": true
}
},
{
"exact_snippets": "not require corticosteroids",
"criterion": "corticosteroids",
"requirement": {
"requirement_type": "requirement",
"expected_value": false
}
},
{
"exact_snippets": "not have had radiation pneumonitis",
"criterion": "radiation pneumonitis",
"requirement": {
"requirement_type": "history",
"expected_value": false
}
}
]
},
"logical_structure": {
"and_criteria": [
{
"and_criteria": [
{
"exact_snippets": "Has received prior radiotherapy within 2 weeks of start of study treatment",
"criterion": "prior radiotherapy",
"requirement": {
"requirement_type": "time since treatment",
"expected_value": {
"operator": "<=",
"value": 2,
"unit": "weeks"
}
}
},
{
"exact_snippets": "Participants must have recovered from all radiation-related toxicities",
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"expected_value": true
}
}
]
},
{
"and_criteria": [
{
"exact_snippets": "not require corticosteroids",
"criterion": "corticosteroids",
"requirement": {
"requirement_type": "requirement",
"expected_value": false
}
},
{
"exact_snippets": "not have had radiation pneumonitis",
"criterion": "radiation pneumonitis",
"requirement": {
"requirement_type": "history",
"expected_value": false
}
}
]
}
]
}
},
{
"identified_line": {
"line": "6. With clinically uncontrolled pleural effusion/ascites (patients who do not need effusion drainage or have no significant increase in effusion 3 days after stopping drainage can be enrolled);",
"criterions": [
{
"exact_snippets": "clinically uncontrolled pleural effusion",
"criterion": "pleural effusion",
"requirement": {
"requirement_type": "control status",
"expected_value": "clinically uncontrolled"
}
},
{
"exact_snippets": "clinically uncontrolled ... ascites",
"criterion": "ascites",
"requirement": {
"requirement_type": "control status",
"expected_value": "clinically uncontrolled"
}
},
{
"exact_snippets": "patients who do not need effusion drainage",
"criterion": "effusion drainage",
"requirement": {
"requirement_type": "necessity",
"expected_value": false
}
},
{
"exact_snippets": "no significant increase in effusion 3 days after stopping drainage",
"criterion": "effusion increase",
"requirement": {
"requirement_type": "significance",
"expected_value": "no significant increase"
}
}
]
},
"logical_structure": {
"and_criteria": [
{
"or_criteria": [
{
"and_criteria": [
{
"and_criteria": [
{
"exact_snippets": "clinically uncontrolled pleural effusion",
"criterion": "pleural effusion",
"requirement": {
"requirement_type": "control status",
"expected_value": "clinically uncontrolled"
}
},
{
"exact_snippets": "clinically uncontrolled ... ascites",
"criterion": "ascites",
"requirement": {
"requirement_type": "control status",
"expected_value": "clinically uncontrolled"
}
}
]
},
{
"not_criteria": {
"or_criteria": [
{
"exact_snippets": "patients who do not need effusion drainage",
"criterion": "effusion drainage",
"requirement": {
"requirement_type": "necessity",
"expected_value": false
}
},
{
"exact_snippets": "no significant increase in effusion 3 days after stopping drainage",
"criterion": "effusion increase",
"requirement": {
"requirement_type": "significance",
"expected_value": "no significant increase"
}
}
]
}
}
]
}
]
},
{
"not_criteria": {
"or_criteria": [
{
"exact_snippets": "patients who do not need effusion drainage",
"criterion": "effusion drainage",
"requirement": {
"requirement_type": "necessity",
"expected_value": false
}
},
{
"exact_snippets": "no significant increase in effusion 3 days after stopping drainage",
"criterion": "effusion increase",
"requirement": {
"requirement_type": "significance",
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}
}
]
}
}
]
}
},
{
"identified_line": {
"line": "7. With a tumor compressing the surrounding important organs, compressing the superior vena cava, or invading the mediastinal great vessels, heart, etc.;",
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{
"exact_snippets": "tumor compressing the surrounding important organs",
"criterion": "tumor compression on surrounding organs",
"requirement": {
"requirement_type": "presence",
"expected_value": true
}
},
{
"exact_snippets": "compressing the superior vena cava",
"criterion": "tumor compression on superior vena cava",
"requirement": {
"requirement_type": "presence",
"expected_value": true
}
},
{
"exact_snippets": "invading the mediastinal great vessels",
"criterion": "tumor invasion of mediastinal great vessels",
"requirement": {
"requirement_type": "presence",
"expected_value": true
}
},
{
"exact_snippets": "invading the ... heart",
"criterion": "tumor invasion of heart",
"requirement": {
"requirement_type": "presence",
"expected_value": true
}
}
]
},
"logical_structure": {
"or_criteria": [
{
"and_criteria": [
{
"exact_snippets": "tumor compressing the surrounding important organs",
"criterion": "tumor compression on surrounding organs",
"requirement": {
"requirement_type": "presence",
"expected_value": true
}
}
]
},
{
"and_criteria": [
{
"exact_snippets": "compressing the superior vena cava",
"criterion": "tumor compression on superior vena cava",
"requirement": {
"requirement_type": "presence",
"expected_value": true
}
}
]
},
{
"and_criteria": [
{
"exact_snippets": "invading the mediastinal great vessels",
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"expected_value": true
}
}
]
},
{
"and_criteria": [
{
"exact_snippets": "invading the ... heart",
"criterion": "tumor invasion of heart",
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"requirement_type": "presence",
"expected_value": true
}
}
]
}
]
}
},
{
"identified_line": {
"line": "8. Has received a live vaccine within 30 days prior to the first dose of study drug. Examples of live vaccines include, but are not limited to, the following: measles, mumps, rubella, varicella/zoster (chicken pox), yellow fever, rabies, Bacillus Calmette-Guérin (BCG), and typhoid vaccine. Seasonal influenza vaccines for injection are generally killed virus vaccines and are allowed; however, intranasal influenza vaccines (e.g., FluMist®) are live attenuated vaccines and are not allowed.",
"criterions": [
{
"exact_snippets": "Has received a live vaccine within 30 days prior to the first dose of study drug.",
"criterion": "live vaccine",
"requirement": {
"requirement_type": "time since administration",
"expected_value": {
"operator": "<=",
"value": 30,
"unit": "days"
}
}
},
{
"exact_snippets": "Seasonal influenza vaccines for injection are generally killed virus vaccines and are allowed; however, intranasal influenza vaccines (e.g., FluMist®) are live attenuated vaccines and are not allowed.",
"criterion": "intranasal influenza vaccine",
"requirement": {
"requirement_type": "administration method",
"expected_value": "intranasal"
}
},
{
"exact_snippets": "Seasonal influenza vaccines for injection are generally killed virus vaccines and are allowed; however, intranasal influenza vaccines (e.g., FluMist®) are live attenuated vaccines and are not allowed.",
"criterion": "intranasal influenza vaccine",
"requirement": {
"requirement_type": "vaccine type",
"expected_value": "live attenuated"
}
}
]
},
"logical_structure": {
"and_criteria": [
{
"and_criteria": [
{
"exact_snippets": "Has received a live vaccine within 30 days prior to the first dose of study drug.",
"criterion": "live vaccine",
"requirement": {
"requirement_type": "time since administration",
"expected_value": {
"operator": "<=",
"value": 30,
"unit": "days"
}
}
},
{
"not_criteria": {
"and_criteria": [
{
"exact_snippets": "Seasonal influenza vaccines for injection are generally killed virus vaccines and are allowed; however, intranasal influenza vaccines (e.g., FluMist®) are live attenuated vaccines and are not allowed.",
"criterion": "intranasal influenza vaccine",
"requirement": {
"requirement_type": "administration method",
"expected_value": "intranasal"
}
},
{
"exact_snippets": "Seasonal influenza vaccines for injection are generally killed virus vaccines and are allowed; however, intranasal influenza vaccines (e.g., FluMist®) are live attenuated vaccines and are not allowed.",
"criterion": "intranasal influenza vaccine",
"requirement": {
"requirement_type": "vaccine type",
"expected_value": "live attenuated"
}
}
]
}
}
]
}
]
}
},
{
"identified_line": {
"line": "9. Has a diagnosis of immunodeficiency or is receiving systemic steroid therapy (in dosing exceeding 10 mg daily of prednisone equivalent) or any other form of immunosuppressive therapy within 7 days prior the first dose of study drug.",
"criterions": [
{
"exact_snippets": "Has a diagnosis of immunodeficiency",
"criterion": "immunodeficiency",
"requirement": {
"requirement_type": "diagnosis",
"expected_value": true
}
},
{
"exact_snippets": "is receiving systemic steroid therapy (in dosing exceeding 10 mg daily of prednisone equivalent)",
"criterion": "systemic steroid therapy",
"requirement": {
"requirement_type": "dosing",
"expected_value": {
"operator": ">",
"value": 10,
"unit": "mg daily of prednisone equivalent"
}
}
},
{
"exact_snippets": "is receiving ... any other form of immunosuppressive therapy within 7 days prior the first dose of study drug",
"criterion": "immunosuppressive therapy",
"requirement": {
"requirement_type": "timing",
"expected_value": "within 7 days prior the first dose of study drug"
}
}
]
},
"logical_structure": {
"or_criteria": [
{
"exact_snippets": "Has a diagnosis of immunodeficiency",
"criterion": "immunodeficiency",
"requirement": {
"requirement_type": "diagnosis",
"expected_value": true
}
},
{
"exact_snippets": "is receiving systemic steroid therapy (in dosing exceeding 10 mg daily of prednisone equivalent)",
"criterion": "systemic steroid therapy",
"requirement": {
"requirement_type": "dosing",
"expected_value": {
"operator": ">",
"value": 10,
"unit": "mg daily of prednisone equivalent"
}
}
},
{
"exact_snippets": "is receiving ... any other form of immunosuppressive therapy within 7 days prior the first dose of study drug",
"criterion": "immunosuppressive therapy",
"requirement": {
"requirement_type": "timing",
"expected_value": "within 7 days prior the first dose of study drug"
}
}
]
}
},
{
"identified_line": {
"line": "10. Has a known additional malignancy that is progressing or has required active treatment within the past 3 years. Participants with basal cell carcinoma of the skin, squamous cell carcinoma of the skin, transitional cell carcinoma of urothelial cancer, or carcinoma in situ (e.g., breast carcinoma, cervical cancer in situ) that have undergone potentially curative therapy are not excluded.",
"criterions": [
{
"exact_snippets": "Has a known additional malignancy that is progressing or has required active treatment within the past 3 years.",
"criterion": "additional malignancy",
"requirement": {
"requirement_type": "progression",
"expected_value": true
}
},
{
"exact_snippets": "Has a known additional malignancy that is progressing or has required active treatment within the past 3 years.",
"criterion": "additional malignancy",
"requirement": {
"requirement_type": "treatment requirement",
"expected_value": {
"operator": "<=",
"value": 3,
"unit": "years"
}
}
},
{
"exact_snippets": "Participants with basal cell carcinoma of the skin, squamous cell carcinoma of the skin, transitional cell carcinoma of urothelial cancer, or carcinoma in situ (e.g., breast carcinoma, cervical cancer in situ) that have undergone potentially curative therapy are not excluded.",
"criterion": "specific cancer types",
"requirement": {
"requirement_type": "types",
"expected_value": [
"basal cell carcinoma of the skin",
"squamous cell carcinoma of the skin",
"transitional cell carcinoma of urothelial cancer",
"carcinoma in situ"
]
}
},
{
"exact_snippets": "Participants with basal cell carcinoma of the skin, squamous cell carcinoma of the skin, transitional cell carcinoma of urothelial cancer, or carcinoma in situ (e.g., breast carcinoma, cervical cancer in situ) that have undergone potentially curative therapy are not excluded.",
"criterion": "specific cancer types",
"requirement": {
"requirement_type": "treatment outcome",
"expected_value": "potentially curative therapy"
}
}
]
},
"logical_structure": {
"condition": {
"and_criteria": [
{
"or_criteria": [
{
"and_criteria": [
{
"exact_snippets": "Has a known additional malignancy that is progressing or has required active treatment within the past 3 years.",
"criterion": "additional malignancy",
"requirement": {
"requirement_type": "progression",
"expected_value": true
}
},
{
"exact_snippets": "Has a known additional malignancy that is progressing or has required active treatment within the past 3 years.",
"criterion": "additional malignancy",
"requirement": {
"requirement_type": "treatment requirement",
"expected_value": {
"operator": "<=",
"value": 3,
"unit": "years"
}
}
}
]
},
{
"and_criteria": [
{
"exact_snippets": "Participants with basal cell carcinoma of the skin, squamous cell carcinoma of the skin, transitional cell carcinoma of urothelial cancer, or carcinoma in situ (e.g., breast carcinoma, cervical cancer in situ) that have undergone potentially curative therapy are not excluded.",
"criterion": "specific cancer types",
"requirement": {
"requirement_type": "types",
"expected_value": [
"basal cell carcinoma of the skin",
"squamous cell carcinoma of the skin",
"transitional cell carcinoma of urothelial cancer",
"carcinoma in situ"
]
}
},
{
"exact_snippets": "Participants with basal cell carcinoma of the skin, squamous cell carcinoma of the skin, transitional cell carcinoma of urothelial cancer, or carcinoma in situ (e.g., breast carcinoma, cervical cancer in situ) that have undergone potentially curative therapy are not excluded.",
"criterion": "specific cancer types",
"requirement": {
"requirement_type": "treatment outcome",
"expected_value": "potentially curative therapy"
}
}
]
}
]
}
]
},
"then_criteria": {
"not_criteria": {
"and_criteria": [
{
"exact_snippets": "Participants with basal cell carcinoma of the skin, squamous cell carcinoma of the skin, transitional cell carcinoma of urothelial cancer, or carcinoma in situ (e.g., breast carcinoma, cervical cancer in situ) that have undergone potentially curative therapy are not excluded.",
"criterion": "specific cancer types",
"requirement": {
"requirement_type": "types",
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"basal cell carcinoma of the skin",
"squamous cell carcinoma of the skin",
"transitional cell carcinoma of urothelial cancer",
"carcinoma in situ"
]
}
},
{
"exact_snippets": "Participants with basal cell carcinoma of the skin, squamous cell carcinoma of the skin, transitional cell carcinoma of urothelial cancer, or carcinoma in situ (e.g., breast carcinoma, cervical cancer in situ) that have undergone potentially curative therapy are not excluded.",
"criterion": "specific cancer types",
"requirement": {
"requirement_type": "treatment outcome",
"expected_value": "potentially curative therapy"
}
}
]
}
},
"else_criteria": null
}
},
{
"identified_line": {
"line": "11. History of seizure of condition that may predispose to seizure that needs anti-epileptic medications; brain arteriovenous malformation; or intracranial masses, such as schwannomas and meningiomas that are causing edema or mass effect.",
"criterions": [
{
"exact_snippets": "History of seizure",
"criterion": "seizure history",
"requirement": {
"requirement_type": "presence",
"expected_value": true
}
},
{
"exact_snippets": "condition that may predispose to seizure",
"criterion": "condition predisposing to seizure",
"requirement": {
"requirement_type": "presence",
"expected_value": true
}
},
{
"exact_snippets": "needs anti-epileptic medications",
"criterion": "anti-epileptic medication requirement",
"requirement": {
"requirement_type": "necessity",
"expected_value": true
}
},
{
"exact_snippets": "brain arteriovenous malformation",
"criterion": "brain arteriovenous malformation",
"requirement": {
"requirement_type": "presence",
"expected_value": true
}
},
{
"exact_snippets": "intracranial masses, such as schwannomas and meningiomas",
"criterion": "intracranial masses",
"requirement": {
"requirement_type": "presence",
"expected_value": true
}
},
{
"exact_snippets": "causing edema or mass effect",
"criterion": "edema or mass effect",
"requirement": {
"requirement_type": "causation",
"expected_value": true
}
}
]
},
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"or_criteria": [
{
"and_criteria": [
{
"and_criteria": [
{
"exact_snippets": "History of seizure",
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"requirement_type": "presence",
"expected_value": true
}
},
{
"exact_snippets": "condition that may predispose to seizure",
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"requirement": {
"requirement_type": "presence",
"expected_value": true
}
}
]
},
{
"exact_snippets": "needs anti-epileptic medications",
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"requirement": {
"requirement_type": "necessity",
"expected_value": true
}
}
]
},
{
"exact_snippets": "brain arteriovenous malformation",
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"requirement_type": "presence",
"expected_value": true
}
},
{
"and_criteria": [
{
"exact_snippets": "intracranial masses, such as schwannomas and meningiomas",
"criterion": "intracranial masses",
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"requirement_type": "presence",
"expected_value": true
}
},
{
"exact_snippets": "causing edema or mass effect",
"criterion": "edema or mass effect",
"requirement": {
"requirement_type": "causation",
"expected_value": true
}
}
]
}
]
}
},
{
"identified_line": {
"line": "12. Has known active CNS metastases and/or carcinomatous meningitis. Participants with previously treated brain metastases may participate provided they are radiologically stable, i.e., without evidence of progression for at least 4 weeks by repeat imaging (note that the repeat imaging should be performed during study screening), clinically stable and without requirement of steroid treatment for at least 14 days prior to first dose of study treatment.",
"criterions": [
{
"exact_snippets": "Has known active CNS metastases",
"criterion": "active CNS metastases",
"requirement": {
"requirement_type": "presence",
"expected_value": true
}
},
{
"exact_snippets": "carcinomatous meningitis",
"criterion": "carcinomatous meningitis",
"requirement": {
"requirement_type": "presence",
"expected_value": true
}
},
{
"exact_snippets": "Participants with previously treated brain metastases may participate provided they are radiologically stable",
"criterion": "previously treated brain metastases",
"requirement": {
"requirement_type": "radiological stability",
"expected_value": true
}
},
{
"exact_snippets": "without evidence of progression for at least 4 weeks by repeat imaging",
"criterion": "brain metastases progression",
"requirement": {
"requirement_type": "progression",
"expected_value": {
"operator": "<",
"value": 1,
"unit": "evidence"
}
}
},
{
"exact_snippets": "clinically stable",
"criterion": "clinical stability",
"requirement": {
"requirement_type": "stability",
"expected_value": true
}
},
{
"exact_snippets": "without requirement of steroid treatment for at least 14 days prior to first dose of study treatment",
"criterion": "steroid treatment requirement",
"requirement": {
"requirement_type": "requirement",
"expected_value": false
}
}
]
},
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"or_criteria": [
{
"or_criteria": [
{
"and_criteria": [
{
"exact_snippets": "Has known active CNS metastases",
"criterion": "active CNS metastases",
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"requirement_type": "presence",
"expected_value": true
}
},
{
"exact_snippets": "carcinomatous meningitis",
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}
}
]
},
{
"and_criteria": [
{
"exact_snippets": "Participants with previously treated brain metastases may participate provided they are radiologically stable",
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"requirement_type": "radiological stability",
"expected_value": true
}
},
{
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"operator": "<",
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}
},
{
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}
},
{
"exact_snippets": "without requirement of steroid treatment for at least 14 days prior to first dose of study treatment",
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"expected_value": false
}
}
]
}
]
}
]
}
},
{
"identified_line": {
"line": "14. Has an active autoimmune disease that has required systemic treatment in past 2 years (i.e., with use of disease modifying agents, corticosteroids or immunosuppressive drugs) prior to the first dose of study treatment. Replacement therapy (e.g., thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency) is not considered a form of systemic treatment and is allowed.",
"criterions": [
{
"exact_snippets": "Has an active autoimmune disease",
"criterion": "active autoimmune disease",
"requirement": {
"requirement_type": "presence",
"expected_value": true
}
},
{
"exact_snippets": "has required systemic treatment in past 2 years",
"criterion": "systemic treatment for autoimmune disease",
"requirement": {
"requirement_type": "time frame",
"expected_value": "past 2 years"
}
},
{
"exact_snippets": "Replacement therapy ... is not considered a form of systemic treatment and is allowed",
"criterion": "replacement therapy",
"requirement": {
"requirement_type": "allowance",
"expected_value": true
}
}
]
},
"logical_structure": {
"and_criteria": [
{
"and_criteria": [
{
"exact_snippets": "Has an active autoimmune disease",
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"requirement_type": "presence",
"expected_value": true
}
},
{
"exact_snippets": "has required systemic treatment in past 2 years",
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"requirement_type": "time frame",
"expected_value": "past 2 years"
}
}
]
},
{
"not_criteria": {
"exact_snippets": "Replacement therapy ... is not considered a form of systemic treatment and is allowed",
"criterion": "replacement therapy",
"requirement": {
"requirement_type": "allowance",
"expected_value": true
}
}
}
]
}
},
{
"identified_line": {
"line": "15. Has a history of (non-infectious) pneumonitis that required steroids or has concurrent interstitial pneumonia.",
"criterions": [
{
"exact_snippets": "Has a history of (non-infectious) pneumonitis that required steroids",
"criterion": "history of non-infectious pneumonitis",
"requirement": {
"requirement_type": "treatment",
"expected_value": "steroids"
}
},
{
"exact_snippets": "has concurrent interstitial pneumonia",
"criterion": "concurrent interstitial pneumonia",
"requirement": {
"requirement_type": "presence",
"expected_value": true
}
}
]
},
"logical_structure": {
"or_criteria": [
{
"and_criteria": [
{
"exact_snippets": "Has a history of (non-infectious) pneumonitis that required steroids",
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"requirement_type": "treatment",
"expected_value": "steroids"
}
}
]
},
{
"exact_snippets": "has concurrent interstitial pneumonia",
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"requirement": {
"requirement_type": "presence",
"expected_value": true
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}
]
}
},
{
"identified_line": {
"line": "16. Has an active infection requiring systemic therapy, active syphilis infection, active pulmonary tuberculosis infection,HIV-infection (i.e., HIV 1 or 2 antibody positive).",
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{
"exact_snippets": "active infection requiring systemic therapy",
"criterion": "active infection",
"requirement": {
"requirement_type": "treatment",
"expected_value": "systemic therapy"
}
},
{
"exact_snippets": "active syphilis infection",
"criterion": "syphilis infection",
"requirement": {
"requirement_type": "activity",
"expected_value": true
}
},
{
"exact_snippets": "active pulmonary tuberculosis infection",
"criterion": "pulmonary tuberculosis infection",
"requirement": {
"requirement_type": "activity",
"expected_value": true
}
},
{
"exact_snippets": "HIV-infection (i.e., HIV 1 or 2 antibody positive)",
"criterion": "HIV-infection",
"requirement": {
"requirement_type": "antibody status",
"expected_value": "positive"
}
}
]
},
"logical_structure": {
"or_criteria": [
{
"and_criteria": [
{
"exact_snippets": "active infection requiring systemic therapy",
"criterion": "active infection",
"requirement": {
"requirement_type": "treatment",
"expected_value": "systemic therapy"
}
},
{
"exact_snippets": "active syphilis infection",
"criterion": "syphilis infection",
"requirement": {
"requirement_type": "activity",
"expected_value": true
}
},
{
"exact_snippets": "active pulmonary tuberculosis infection",
"criterion": "pulmonary tuberculosis infection",
"requirement": {
"requirement_type": "activity",
"expected_value": true
}
}
]
},
{
"exact_snippets": "HIV-infection (i.e., HIV 1 or 2 antibody positive)",
"criterion": "HIV-infection",
"requirement": {
"requirement_type": "antibody status",
"expected_value": "positive"
}
}
]
}
},
{
"identified_line": {
"line": "17. New York Heart Association congestive heart failure of grade II or above, unstable angina, myocardial infarction within the past 6 months or serious cardiac arrhythmia associated with significant cardiovascular impairment within the past 6 months.",
"criterions": [
{
"exact_snippets": "New York Heart Association congestive heart failure of grade II or above",
"criterion": "New York Heart Association congestive heart failure",
"requirement": {
"requirement_type": "grade",
"expected_value": {
"operator": ">=",
"value": 2,
"unit": "N/A"
}
}
},
{
"exact_snippets": "unstable angina",
"criterion": "unstable angina",
"requirement": {
"requirement_type": "presence",
"expected_value": true
}
},
{
"exact_snippets": "myocardial infarction within the past 6 months",
"criterion": "myocardial infarction",
"requirement": {
"requirement_type": "time frame",
"expected_value": "within the past 6 months"
}
},
{
"exact_snippets": "serious cardiac arrhythmia associated with significant cardiovascular impairment within the past 6 months",
"criterion": "serious cardiac arrhythmia associated with significant cardiovascular impairment",
"requirement": {
"requirement_type": "time frame",
"expected_value": "within the past 6 months"
}
}
]
},
"logical_structure": {
"or_criteria": [
{
"and_criteria": [
{
"exact_snippets": "New York Heart Association congestive heart failure of grade II or above",
"criterion": "New York Heart Association congestive heart failure",
"requirement": {
"requirement_type": "grade",
"expected_value": {
"operator": ">=",
"value": 2,
"unit": "N/A"
}
}
}
]
},
{
"and_criteria": [
{
"exact_snippets": "unstable angina",
"criterion": "unstable angina",
"requirement": {
"requirement_type": "presence",
"expected_value": true
}
}
]
},
{
"and_criteria": [
{
"exact_snippets": "myocardial infarction within the past 6 months",
"criterion": "myocardial infarction",
"requirement": {
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}
}
]
},
{
"and_criteria": [
{
"exact_snippets": "serious cardiac arrhythmia associated with significant cardiovascular impairment within the past 6 months",
"criterion": "serious cardiac arrhythmia associated with significant cardiovascular impairment",
"requirement": {
"requirement_type": "time frame",
"expected_value": "within the past 6 months"
}
}
]
}
]
}
},
{
"identified_line": {
"line": "18. Prolongation of corrected QTc interval, as corrected by the Fridericia's correction formula to greater than 450 mSec for males and 470 mSec for females: unless prolonged QTc interval due to right bundle branch block or left bundle branch block with a pacemaker.",
"criterions": [
{
"exact_snippets": "Prolongation of corrected QTc interval, as corrected by the Fridericia's correction formula to greater than 450 mSec for males",
"criterion": "corrected QTc interval for males",
"requirement": {
"requirement_type": "prolongation",
"expected_value": {
"operator": ">",
"value": 450,
"unit": "mSec"
}
}
},
{
"exact_snippets": "Prolongation of corrected QTc interval, as corrected by the Fridericia's correction formula to greater than ... 470 mSec for females",
"criterion": "corrected QTc interval for females",
"requirement": {
"requirement_type": "prolongation",
"expected_value": {
"operator": ">",
"value": 470,
"unit": "mSec"
}
}
},
{
"exact_snippets": "unless prolonged QTc interval due to right bundle branch block",
"criterion": "prolonged QTc interval due to right bundle branch block",
"requirement": {
"requirement_type": "presence",
"expected_value": false
}
},
{
"exact_snippets": "unless prolonged QTc interval due to ... left bundle branch block with a pacemaker",
"criterion": "prolonged QTc interval due to left bundle branch block with a pacemaker",
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"requirement_type": "presence",
"expected_value": false
}
}
]
},
"logical_structure": {
"and_criteria": [
{
"or_criteria": [
{
"and_criteria": [
{
"exact_snippets": "Prolongation of corrected QTc interval, as corrected by the Fridericia's correction formula to greater than 450 mSec for males",
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"requirement_type": "prolongation",
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"operator": ">",
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"unit": "mSec"
}
}
},
{
"not_criteria": {
"exact_snippets": "unless prolonged QTc interval due to right bundle branch block",
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"expected_value": false
}
}
},
{
"not_criteria": {
"exact_snippets": "unless prolonged QTc interval due to ... left bundle branch block with a pacemaker",
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}
]
},
{
"and_criteria": [
{
"exact_snippets": "Prolongation of corrected QTc interval, as corrected by the Fridericia's correction formula to greater than ... 470 mSec for females",
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"requirement_type": "prolongation",
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"value": 470,
"unit": "mSec"
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}
},
{
"not_criteria": {
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"requirement_type": "presence",
"expected_value": false
}
}
},
{
"not_criteria": {
"exact_snippets": "unless prolonged QTc interval due to ... left bundle branch block with a pacemaker",
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"requirement_type": "presence",
"expected_value": false
}
}
}
]
}
]
}
]
}
},
{
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"criterions": [
{
"exact_snippets": "Presence of uncontrolled hypertension",
"criterion": "uncontrolled hypertension",
"requirement": {
"requirement_type": "presence",
"expected_value": true
}
},
{
"exact_snippets": "systolic blood pressure (BP) >160 mmHg",
"criterion": "systolic blood pressure",
"requirement": {
"requirement_type": "value",
"expected_value": {
"operator": ">",
"value": 160,
"unit": "mmHg"
}
}
},
{
"exact_snippets": "diastolic BP>100 mmHg",
"criterion": "diastolic blood pressure",
"requirement": {
"requirement_type": "value",
"expected_value": {
"operator": ">",
"value": 100,
"unit": "mmHg"
}
}
},
{
"exact_snippets": "Patients with a history of hypertension are allowed, provided that BP is controlled to within these limits by anti-hypertensive treatment",
"criterion": "history of hypertension",
"requirement": {
"requirement_type": "allowance",
"expected_value": true
}
}
]
},
"logical_structure": {
"and_criteria": [
{
"or_criteria": [
{
"and_criteria": [
{
"exact_snippets": "systolic blood pressure (BP) >160 mmHg",
"criterion": "systolic blood pressure",
"requirement": {
"requirement_type": "value",
"expected_value": {
"operator": ">",
"value": 160,
"unit": "mmHg"
}
}
},
{
"exact_snippets": "diastolic BP>100 mmHg",
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"requirement_type": "value",
"expected_value": {
"operator": ">",
"value": 100,
"unit": "mmHg"
}
}
}
]
},
{
"exact_snippets": "Presence of uncontrolled hypertension",
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"requirement": {
"requirement_type": "presence",
"expected_value": true
}
}
]
},
{
"not_criteria": {
"exact_snippets": "Patients with a history of hypertension are allowed, provided that BP is controlled to within these limits by anti-hypertensive treatment",
"criterion": "history of hypertension",
"requirement": {
"requirement_type": "allowance",
"expected_value": true
}
}
}
]
}
},
{
"identified_line": {
"line": "20. Has known untreated active Hepatitis B (defined as HBsAg (+) and HBV DNA ≥200 IU/mL (1000 copies/ml)) or active Hepatitis C virus infection (defined as HCV antibody positive and HCV-RNA level above the lower limit of detection).",
"criterions": [
{
"exact_snippets": "known untreated active Hepatitis B (defined as HBsAg (+) and HBV DNA ≥200 IU/mL (1000 copies/ml))",
"criterion": "Hepatitis B",
"requirement": {
"requirement_type": "status",
"expected_value": "untreated"
}
},
{
"exact_snippets": "known untreated active Hepatitis B (defined as HBsAg (+) and HBV DNA ≥200 IU/mL (1000 copies/ml))",
"criterion": "Hepatitis B",
"requirement": {
"requirement_type": "activity",
"expected_value": "active"
}
},
{
"exact_snippets": "known untreated active Hepatitis B (defined as HBsAg (+) and HBV DNA ≥200 IU/mL (1000 copies/ml))",
"criterion": "Hepatitis B",
"requirement": {
"requirement_type": "HBsAg",
"expected_value": "positive"
}
},
{
"exact_snippets": "known untreated active Hepatitis B (defined as HBsAg (+) and HBV DNA ≥200 IU/mL (1000 copies/ml))",
"criterion": "Hepatitis B",
"requirement": {
"requirement_type": "HBV DNA",
"expected_value": {
"operator": ">=",
"value": 200,
"unit": "IU/mL"
}
}
},
{
"exact_snippets": "active Hepatitis C virus infection (defined as HCV antibody positive and HCV-RNA level above the lower limit of detection)",
"criterion": "Hepatitis C virus infection",
"requirement": {
"requirement_type": "activity",
"expected_value": "active"
}
},
{
"exact_snippets": "active Hepatitis C virus infection (defined as HCV antibody positive and HCV-RNA level above the lower limit of detection)",
"criterion": "Hepatitis C virus infection",
"requirement": {
"requirement_type": "HCV antibody",
"expected_value": "positive"
}
},
{
"exact_snippets": "active Hepatitis C virus infection (defined as HCV antibody positive and HCV-RNA level above the lower limit of detection)",
"criterion": "Hepatitis C virus infection",
"requirement": {
"requirement_type": "HCV-RNA level",
"expected_value": "above the lower limit of detection"
}
}
]
},
"logical_structure": {
"or_criteria": [
{
"and_criteria": [
{
"exact_snippets": "known untreated active Hepatitis B (defined as HBsAg (+) and HBV DNA ≥200 IU/mL (1000 copies/ml))",
"criterion": "Hepatitis B",
"requirement": {
"requirement_type": "status",
"expected_value": "untreated"
}
},
{
"exact_snippets": "known untreated active Hepatitis B (defined as HBsAg (+) and HBV DNA ≥200 IU/mL (1000 copies/ml))",
"criterion": "Hepatitis B",
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"requirement_type": "activity",
"expected_value": "active"
}
},
{
"exact_snippets": "known untreated active Hepatitis B (defined as HBsAg (+) and HBV DNA ≥200 IU/mL (1000 copies/ml))",
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"requirement_type": "HBsAg",
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},
{
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"requirement_type": "HBV DNA",
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"operator": ">=",
"value": 200,
"unit": "IU/mL"
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}
}
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},
{
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{
"exact_snippets": "active Hepatitis C virus infection (defined as HCV antibody positive and HCV-RNA level above the lower limit of detection)",
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"requirement_type": "activity",
"expected_value": "active"
}
},
{
"exact_snippets": "active Hepatitis C virus infection (defined as HCV antibody positive and HCV-RNA level above the lower limit of detection)",
"criterion": "Hepatitis C virus infection",
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"requirement_type": "HCV antibody",
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}
},
{
"exact_snippets": "active Hepatitis C virus infection (defined as HCV antibody positive and HCV-RNA level above the lower limit of detection)",
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"requirement_type": "HCV-RNA level",
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}
}
]
}
]
}
},
{
"identified_line": {
"line": "Note: Subjects with HBV DNA < 200 IU/ml or below the lower limit of detection are eligible. Those on active HBV therapy with viral loads under 200 IU/mL should stay on the same therapy throughout study treatment.",
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{
"exact_snippets": "HBV DNA < 200 IU/ml",
"criterion": "HBV DNA level",
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"requirement_type": "quantity",
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"operator": "<",
"value": 200,
"unit": "IU/ml"
}
}
},
{
"exact_snippets": "HBV DNA ... below the lower limit of detection",
"criterion": "HBV DNA level",
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"requirement_type": "quantity",
"expected_value": "below the lower limit of detection"
}
},
{
"exact_snippets": "active HBV therapy",
"criterion": "HBV therapy",
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"requirement_type": "status",
"expected_value": "active"
}
},
{
"exact_snippets": "viral loads under 200 IU/mL",
"criterion": "viral load",
"requirement": {
"requirement_type": "quantity",
"expected_value": {
"operator": "<",
"value": 200,
"unit": "IU/mL"
}
}
}
]
},
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"and_criteria": [
{
"or_criteria": [
{
"and_criteria": [
{
"not_criteria": {
"exact_snippets": "HBV DNA < 200 IU/ml",
"criterion": "HBV DNA level",
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"operator": "<",
"value": 200,
"unit": "IU/ml"
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},
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}
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},
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"exact_snippets": "active HBV therapy",
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"operator": "<",
"value": 200,
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}
}
}
]
}
]
}
},
{
"identified_line": {
"line": "21. Has a known psychiatric or substance abuse disorder that would interfere with the patient's ability to cooperate with the requirements of the study.",
"criterions": [
{
"exact_snippets": "Has a known psychiatric ... disorder",
"criterion": "psychiatric disorder",
"requirement": {
"requirement_type": "presence",
"expected_value": true
}
},
{
"exact_snippets": "Has a known ... substance abuse disorder",
"criterion": "substance abuse disorder",
"requirement": {
"requirement_type": "presence",
"expected_value": true
}
}
]
},
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"or_criteria": [
{
"and_criteria": [
{
"exact_snippets": "Has a known psychiatric ... disorder",
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"requirement_type": "presence",
"expected_value": true
}
},
{
"exact_snippets": "that would interfere with the patient's ability to cooperate with the requirements of the study",
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}
}
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},
{
"and_criteria": [
{
"exact_snippets": "Has a known ... substance abuse disorder",
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"requirement_type": "presence",
"expected_value": true
}
},
{
"exact_snippets": "that would interfere with the patient's ability to cooperate with the requirements of the study",
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"requirement_type": "presence",
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}
}
]
}
]
}
},
{
"identified_line": {
"line": "22. Patients receiving a strong CYP3CA, OATP, BRCP substrate or inducer are not eligible. Please see protocol related section for the list of prohibited medications.",
"criterions": [
{
"exact_snippets": "Patients receiving a strong CYP3CA, OATP, BRCP substrate or inducer are not eligible.",
"criterion": "CYP3CA, OATP, BRCP substrate or inducer",
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"requirement_type": "presence",
"expected_value": false
}
}
]
},
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"and_criteria": [
{
"exact_snippets": "Patients receiving a strong CYP3CA, OATP, BRCP substrate or inducer are not eligible.",
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"requirement": {
"requirement_type": "presence",
"expected_value": false
}
}
]
}
},
{
"identified_line": {
"line": "23. Has had an allogenic tissue/solid organ transplant.",
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{
"exact_snippets": "Has had an allogenic tissue/solid organ transplant",
"criterion": "allogenic tissue/solid organ transplant",
"requirement": {
"requirement_type": "history",
"expected_value": true
}
}
]
},
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"and_criteria": [
{
"exact_snippets": "Has had an allogenic tissue/solid organ transplant",
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"requirement_type": "history",
"expected_value": true
}
}
]
}
},
{
"identified_line": {
"line": "24. Has a history or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the study, interfere with the patient's participation for the full duration of the study, or is not in the best interest of the patient to participate, in the opinion of the treating investigator.",
"criterions": [
{
"exact_snippets": "Has a history or current evidence of any condition",
"criterion": "condition",
"requirement": {
"requirement_type": "presence",
"expected_value": true
}
},
{
"exact_snippets": "therapy",
"criterion": "therapy",
"requirement": {
"requirement_type": "presence",
"expected_value": true
}
},
{
"exact_snippets": "laboratory abnormality",
"criterion": "laboratory abnormality",
"requirement": {
"requirement_type": "presence",
"expected_value": true
}
}
]
},
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"and_criteria": [
{
"or_criteria": [
{
"and_criteria": [
{
"and_criteria": [
{
"exact_snippets": "Has a history or current evidence of any condition",
"criterion": "condition",
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"expected_value": true
}
},
{
"exact_snippets": "therapy",
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},
{
"exact_snippets": "... that might confound the results of the study",
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]
},
{
"exact_snippets": "... interfere with the patient's participation for the full duration of the study",
"criterion": "participation interference",
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"requirement_type": "potential",
"expected_value": true
}
},
{
"exact_snippets": "... is not in the best interest of the patient to participate, in the opinion of the treating investigator",
"criterion": "best interest to participate",
"requirement": {
"requirement_type": "opinion",
"expected_value": false
}
}
]
}
]
}
},
{
"identified_line": {
"line": "25. Patient needs radiotherapy during this study.",
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{
"exact_snippets": "Patient needs radiotherapy during this study.",
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"requirement": {
"requirement_type": "necessity",
"expected_value": true
}
}
]
},
"logical_structure": {
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"exact_snippets": "Patient needs radiotherapy during this study.",
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"expected_value": true
}
}
}
}
],
"miscellaneous_lines": [],
"failed_inclusion": [
{
"identified_line": {
"line": "* NSCLC: Patients with histologically confirmed locally advanced, recurrent, or metastatic Non-Small Cell Lung Cancer (squamous cell carcinoma or adenocarcinoma, adenosquamous carcinoma), who have EGFR wild type status, KRAS wild type status and ALK- negative rearrangement status.",
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{
"exact_snippets": "histologically confirmed locally advanced, recurrent, or metastatic Non-Small Cell Lung Cancer (squamous cell carcinoma or adenocarcinoma, adenosquamous carcinoma)",
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"expected_value": "histologically confirmed"
}
},
{
"exact_snippets": "histologically confirmed locally advanced, recurrent, or metastatic Non-Small Cell Lung Cancer (squamous cell carcinoma or adenocarcinoma, adenosquamous carcinoma)",
"criterion": "Non-Small Cell Lung Cancer",
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]
}
},
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"exact_snippets": "histologically confirmed locally advanced, recurrent, or metastatic Non-Small Cell Lung Cancer (squamous cell carcinoma or adenocarcinoma, adenosquamous carcinoma)",
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}
},
{
"exact_snippets": "EGFR wild type status",
"criterion": "EGFR status",
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}
},
{
"exact_snippets": "KRAS wild type status",
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"requirement_type": "mutation",
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},
{
"exact_snippets": "ALK- negative rearrangement status",
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}
]
},
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}
},
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"identified_line": {
"line": "* Please contact sponsor if patient cannot provide archival or biopsy tumor samples.",
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{
"exact_snippets": "patient cannot provide archival or biopsy tumor samples",
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"requirement_type": "availability",
"expected_value": true
}
}
]
},
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"criterion": "tumor samples",
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"requirement_type": "availability",
"expected_value": false
}
},
"then_criteria": {
"exact_snippets": "Please contact sponsor",
"criterion": "contact sponsor",
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"requirement_type": "action",
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},
"else_criteria": null
}
},
{
"identified_line": {
"line": "2. Renal Creatinine ≤1.5 × upper limit of normal (ULN) OR Measured or calculated per institutional standard creatinine clearance (glomerular filtration rate can also be used in place of creatinine or creatinine clearance) ≥30 mL/min for participant with creatinine levels >1.5 × institutional ULN.",
"criterions": [
{
"exact_snippets": "Renal Creatinine ≤1.5 × upper limit of normal (ULN)",
"criterion": "renal creatinine",
"requirement": {
"requirement_type": "level",
"expected_value": {
"operator": "<=",
"value": 1.5,
"unit": "× ULN"
}
}
},
{
"exact_snippets": "Measured or calculated per institutional standard creatinine clearance ... ≥30 mL/min",
"criterion": "creatinine clearance",
"requirement": {
"requirement_type": "level",
"expected_value": {
"operator": ">=",
"value": 30,
"unit": "mL/min"
}
}
},
{
"exact_snippets": "glomerular filtration rate can also be used in place of creatinine or creatinine clearance",
"criterion": "glomerular filtration rate",
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"requirement_type": "substitution",
"expected_value": "can be used in place of creatinine or creatinine clearance"
}
}
]
},
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"or_criteria": [
{
"and_criteria": [
{
"exact_snippets": "Renal Creatinine \u001f1.5 \u001d upper limit of normal (ULN)",
"criterion": "renal creatinine",
"requirement": {
"requirement_type": "level",
"expected_value": {
"operator": "<=",
"value": 1.5,
"unit": "\u001d ULN"
}
}
}
]
},
{
"and_criteria": [
{
"exact_snippets": "Measured or calculated per institutional standard creatinine clearance ... \u001f30 mL/min",
"criterion": "creatinine clearance",
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"requirement_type": "level",
"expected_value": {
"operator": ">=",
"value": 30,
"unit": "mL/min"
}
}
},
{
"not_criteria": {
"exact_snippets": "Renal Creatinine \u001f1.5 \u001d upper limit of normal (ULN)",
"criterion": "renal creatinine",
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"operator": "<=",
"value": 1.5,
"unit": "\u001d ULN"
}
}
}
}
]
}
]
}
},
{
"identified_line": {
"line": "AST (SGOT) and ALT (SGPT) ≤2.5 × ULN (≤5 × ULN for participants with liver metastases).",
"criterions": [
{
"exact_snippets": "AST (SGOT) ... ≤2.5 × ULN (≤5 × ULN for participants with liver metastases)",
"criterion": "AST (SGOT)",
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"operator": "<=",
"value": 2.5,
"unit": "ULN"
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]
}
}
},
{
"exact_snippets": "ALT (SGPT) ... ≤2.5 × ULN (≤5 × ULN for participants with liver metastases)",
"criterion": "ALT (SGPT)",
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"comparisons": [
{
"operator": "<=",
"value": 2.5,
"unit": "ULN"
}
]
}
}
},
{
"exact_snippets": "AST (SGOT) and ALT (SGPT) ... ≤5 × ULN for participants with liver metastases",
"criterion": "liver metastases",
"requirement": {
"requirement_type": "presence",
"expected_value": true
}
}
]
},
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{
"and_criteria": [
{
"exact_snippets": "AST (SGOT) ... ≤2.5 × ULN (≤5 × ULN for participants with liver metastases)",
"criterion": "AST (SGOT)",
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"operator": "<=",
"value": 2.5,
"unit": "ULN"
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}
}
},
{
"exact_snippets": "ALT (SGPT) ... ≤2.5 × ULN (≤5 × ULN for participants with liver metastases)",
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"operator": "<=",
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"and_criteria": [
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"exact_snippets": "AST (SGOT) ... ≤2.5 × ULN (≤5 × ULN for participants with liver metastases)",
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"operator": "<=",
"value": 5,
"unit": "ULN"
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]
}
}
},
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"exact_snippets": "ALT (SGPT) ... ≤2.5 × ULN (≤5 × ULN for participants with liver metastases)",
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"operator": "<=",
"value": 5,
"unit": "ULN"
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}
}
},
{
"identified_line": {
"line": "9. Fasting glucose ≤126 mg/dL or ≤7.0 mmol/L for patients without type 2 diabetes and ≤167 mg/dL or ≤9.3 mmol/L for patients with type 2 diabetes; OR glycosylated hemoglobin (HbA1c) ≤8%.",
"criterions": [
{
"exact_snippets": "Fasting glucose ≤126 mg/dL or ≤7.0 mmol/L for patients without type 2 diabetes",
"criterion": "fasting glucose",
"requirement": {
"requirement_type": "value",
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{
"operator": "<=",
"value": 126,
"unit": "mg/dL"
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{
"operator": "<=",
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"unit": "mmol/L"
}
]
}
}
},
{
"exact_snippets": "Fasting glucose ≤126 mg/dL or ≤7.0 mmol/L for patients without type 2 diabetes",
"criterion": "fasting glucose",
"requirement": {
"requirement_type": "condition",
"expected_value": "without type 2 diabetes"
}
},
{
"exact_snippets": "Fasting glucose ... ≤167 mg/dL or ≤9.3 mmol/L for patients with type 2 diabetes",
"criterion": "fasting glucose",
"requirement": {
"requirement_type": "value",
"expected_value": {
"comparisons": [
{
"operator": "<=",
"value": 167,
"unit": "mg/dL"
},
{
"operator": "<=",
"value": 9.3,
"unit": "mmol/L"
}
]
}
}
},
{
"exact_snippets": "Fasting glucose ... ≤167 mg/dL or ≤9.3 mmol/L for patients with type 2 diabetes",
"criterion": "fasting glucose",
"requirement": {
"requirement_type": "condition",
"expected_value": "with type 2 diabetes"
}
},
{
"exact_snippets": "glycosylated hemoglobin (HbA1c) ≤8%",
"criterion": "glycosylated hemoglobin (HbA1c)",
"requirement": {
"requirement_type": "value",
"expected_value": {
"operator": "<=",
"value": 8,
"unit": "%"
}
}
}
]
},
"logical_structure": {
"or_criteria": [
{
"or_criteria": [
{
"condition": {
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"exact_snippets": "Fasting glucose \u001f126 mg/dL or \u001f7.0 mmol/L for patients without type 2 diabetes",
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"exact_snippets": "Fasting glucose \u001f126 mg/dL or \u001f7.0 mmol/L for patients without type 2 diabetes",
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"operator": "<=",
"value": 126,
"unit": "mg/dL"
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{
"operator": "<=",
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"unit": "mmol/L"
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]
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},
{
"condition": {
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"exact_snippets": "Fasting glucose ... \u001f167 mg/dL or \u001f9.3 mmol/L for patients with type 2 diabetes",
"criterion": "fasting glucose",
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"expected_value": "with type 2 diabetes"
}
},
{
"exact_snippets": "Fasting glucose ... \u001f167 mg/dL or \u001f9.3 mmol/L for patients with type 2 diabetes",
"criterion": "fasting glucose",
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"expected_value": {
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{
"operator": "<=",
"value": 167,
"unit": "mg/dL"
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{
"operator": "<=",
"value": 9.3,
"unit": "mmol/L"
}
]
}
}
}
]
},
"then_criteria": null,
"else_criteria": null
}
]
},
{
"exact_snippets": "glycosylated hemoglobin (HbA1c) \u001f8%",
"criterion": "glycosylated hemoglobin (HbA1c)",
"requirement": {
"requirement_type": "value",
"expected_value": {
"operator": "<=",
"value": 8,
"unit": "%"
}
}
}
]
}
},
{
"identified_line": {
"line": "13. Patient is able to swallow and retain oral medication without gastrointestinal diseases to interfere with drug absorption.",
"criterions": [
{
"exact_snippets": "Patient is able to swallow",
"criterion": "ability to swallow",
"requirement": {
"requirement_type": "ability",
"expected_value": true
}
},
{
"exact_snippets": "retain oral medication",
"criterion": "ability to retain oral medication",
"requirement": {
"requirement_type": "ability",
"expected_value": true
}
},
{
"exact_snippets": "without gastrointestinal diseases to interfere with drug absorption",
"criterion": "gastrointestinal diseases",
"requirement": {
"requirement_type": "presence",
"expected_value": false
}
}
]
},
"logical_structure": {
"exact_snippets": "failed",
"criterion": "failed",
"requirement": {
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},
{
"identified_line": {
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{
"exact_snippets": "Healthy volunteers allowed",
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"requirement_type": "status",
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}
}
]
},
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}
},
{
"identified_line": {
"line": "Must have minimum age of 18 Years",
"criterions": [
{
"exact_snippets": "minimum age of 18 Years",
"criterion": "age",
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"operator": ">=",
"value": 18,
"unit": "Years"
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}
}
]
},
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],
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{
"identified_line": {
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{
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}
},
{
"exact_snippets": "lactation",
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}
},
{
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"expected_value": true
}
},
{
"exact_snippets": "positive urine pregnancy test",
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}
]
},
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},
{
"identified_line": {
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"exact_snippets": "Prior anti-cancer treatment ... within 28 days (or 5 half-lives, whichever is shorter) prior to the first dose of study drugs.",
"criterion": "prior anti-cancer treatment",
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"operator": "<=",
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{
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]
}
}
}
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}
},
{
"identified_line": {
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{
"exact_snippets": "Patients that have previously received AKT ... inhibitors will not be enrolled.",
"criterion": "previous AKT inhibitor treatment",
"requirement": {
"requirement_type": "presence",
"expected_value": false
}
},
{
"exact_snippets": "Patients that have previously received ... PI3 kinase pathway ... inhibitors will not be enrolled.",
"criterion": "previous PI3 kinase pathway inhibitor treatment",
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"requirement_type": "presence",
"expected_value": false
}
},
{
"exact_snippets": "Patients that have previously received ... mTOR inhibitors will not be enrolled.",
"criterion": "previous mTOR inhibitor treatment",
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"requirement_type": "presence",
"expected_value": false
}
}
]
},
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}
},
{
"identified_line": {
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{
"exact_snippets": "severe hypersensitivity (≥Grade 3) to Sintilimab",
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"operator": ">=",
"value": 3,
"unit": "Grade"
}
}
},
{
"exact_snippets": "severe hypersensitivity (≥Grade 3) to ... afuresertib",
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"unit": "Grade"
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}
},
{
"exact_snippets": "severe hypersensitivity (≥Grade 3) to ... any of their excipients",
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"requirement_type": "severity",
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"operator": ">=",
"value": 3,
"unit": "Grade"
}
}
}
]
},
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{
"and_criteria": [
{
"exact_snippets": "severe hypersensitivity (Grade 3) to Sintilimab",
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]
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}
],
"failed_miscellaneous": []
}