{
"info": {
"nct_id": "NCT06610682",
"official_title": "Feasibility of CSF (Cerebrospinal Fluid) and Plasma ctDNA (Circulating Tumor Deoxyribonucleic) in BRAF (V-raf Murine Sarcoma Viral Oncogene Homolog B1)-Altered Glioma During Treatment With Plixorafenib",
"inclusion_criteria": "1. Histologic diagnosis of a primary central nervous system (CNS) tumor with documented BRAF-V600E mutation by a Clinical Laboratory Improvement Amendments (CLIA) approved DNA or RNA (Ribonucleic acid )-based sequencing test (NGS (Next generation sequencing) or RNAseq). Immunohistochemistry alone is insufficient.\n2. Patient must have received prior BRAF and/or Mitogen-activated protein kinase kinase (MEK) inhibitor therapy.\n3. Karnofsky performance status ≥ 70.\n4. Patient is 18 years of older.\n5. Measurable disease by RANO2.0 criteria on screening MRI. Leptomeningeal disease allowed.\n6. Willing to submit archival tumor sample if available.\n7. The following intervals from previous treatments should have elapsed prior to cycle 1 day 1:\n\n * 12 weeks from the completion of radiation.\n * 12 weeks from an anti- vascular endothelial growth factor therapy (VEGF)\n * 4 weeks from a nitrosourea chemotherapy\n * 3 weeks from a non-nitrosourea chemotherapy\n * 2 weeks or 5 half-lives from any investigational (not FDA-approved) agents (whichever is shorter)\n * 2 weeks from administration of a non-cytotoxic, FDA-approved agent (e.g., erlotinib, hydroxychloroquine, dabrafenib, etc.)\n8. Patients must have the following organ and marrow function:\n\n * Absolute neutrophil count >1,000/micro liter (mcL)\n * Platelets >100,000/mcL\n * Hemoglobin > 9 g/dL\n * Total bilirubin </= 1.5 x institutional upper limit of normal (ULN) OR total bilirubin >1.5 × ULN with direct bilirubin <1.5 × ULN\n * (aspartate aminotransferase (AST) and alanine transaminase (ALT) </= 2.5 x institutional ULN\n * prothrombin time (PT) or Partial thromboplastin time (PTT) < 1.5 x institutional ULN\n * Creatinine ≤ 1.5 x institutional ULN OR Creatinine clearance (Cockcroft-Gault Formula) > 50 ml/min/1.73m2\n9. Patient must be able to provide written informed consent.\n10. All adverse events related to prior therapies (chemotherapy; radiotherapy; surgery) must have resolved to Grade 1 or baseline except for\n\n * Alopecia (Grade ≤2)\n * Sensory neuropathy (Grade ≤2)\n * Lymphopenia (Grade 2)\n * Other adverse events that have resolved to Grade ≤2 that, according to the clinical judgment of the investigator, do not constitute a safety risk to the participant.\n11. Patients must be maintained on a stable or decreasing dose of systemic corticosteroid regimen (no increase for 5 days) prior to screening MRI. Topical and inhaled steroid treatment is allowed.\n12. Ability to swallow and retain orally administered medications, including a liquid suspension.\n13. Female participants of childbearing potential must have a negative serum pregnancy test prior to study start. Female participants of childbearing potential must agree to use highly effective contraception and not to donate ova from screening through 30 days after the last dose of study drug. Highly effective contraception is defined as 1) intrauterine device, 2) abstinence, or 3) combined estrogen and progesterone or progesterone only containing implants, injectables, transdermal, or intravaginal contraceptives. Male participants must also agree to use adequate contraception and not to donate sperm from screening until 90 days after the last dose of study drug.\n14. Patients must have no concurrent malignancy except curatively treated basal or squamous cell carcinoma of the skin or carcinoma in situ of the cervix, breast, or bladder. Patients with other malignancies must be disease-free for >/=2 years.\n15. Life expectancy equal or greater than six months.\nHealthy volunteers allowed\nMust have minimum age of 18 Years",
"exclusion_criteria": "1. Current use of any other standard or investigational agents (excepting tumor treating fields).\n2. Known co-occurring NF-1 (Neurofibromatosis type 1) and/or reticular activating system (RAS) -related alteration known to cause resistance.\n3. Prior treatment with any rapidly accelerated fibrosarcoma (RAF) dimer disruptor or pan-RAF inhibitor.\n4. Known hypersensitivity to plixorafenib, cobicistat or excipients.\n5. Current use of a prohibited medication (including herbal medications, supplements, or foods), as described in Section 5.6, or use of a prohibited medication ≤ 7 days prior to surgery date.\n6. Impairment in gastrointestinal function or disease that may significantly alter the absorption of oral plixorafenib or cobicistat (such as ulcerative diseases, uncontrolled nausea, vomiting, diarrhea, malabsorption syndrome, or small bowel resection).\n7. Clinically significant cardiovascular disease including, but not limited to the following:\n\n * History of acute coronary syndromes (including myocardial infarction or unstable angina), coronary artery bypass grafting, coronary angioplasty or stenting ≤ 180 days prior to start date;\n * Congestive heart failure requiring treatment (New York Heart Association Grade > 2);\n * History or presence of clinically significant cardiac arrhythmias (including resting bradycardia, uncontrolled atrial fibrillation or uncontrolled paroxysmal supraventricular tachycardia);\n * Corrected QT interval (QTcF) QT corrected for heart rate by Fridericia's cube root formula) interval ≥ 480 ms.\n8. History of recent (≤ 90 days) thromboembolic or cerebrovascular event such as transient ischemic attack, cerebrovascular accident, or hemodynamically significant (massive or sub-massive) deep vein thrombosis or pulmonary emboli (DVT/PE). Note: Patients with DVT/PE that does not result in hemodynamic instability may enroll as long as participants are anticoagulated for at least 4 weeks. Note: Patients with Deep vein thrombosis (DVT)/pulmonary embolism (PE) related to indwelling catheters or other procedures may enroll.\n9. Patients with uncontrolled intercurrent illness including, but not limited to, ongoing or active infection or psychiatric illness/social situations that would limit compliance with study requirements, are ineligible.\n10. Pregnant women are excluded from this study because the effects of plixorafenib on a fetus are unknown. Because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with plixorafenib or cobicistat, breastfeeding should be discontinued if the mother is treated on study.\n11. No contraindication to clinically-indicated surgery.\n12. No contraindication to ventricular reservoir placement or biospecimen collection.",
"miscellaneous_criteria": ""
},
"inclusion_lines": [
{
"identified_line": {
"line": "2. Patient must have received prior BRAF and/or Mitogen-activated protein kinase kinase (MEK) inhibitor therapy.",
"criterions": [
{
"exact_snippets": "Patient must have received prior BRAF ... inhibitor therapy.",
"criterion": "BRAF inhibitor therapy",
"requirement": {
"requirement_type": "prior treatment",
"expected_value": true
}
},
{
"exact_snippets": "Patient must have received prior ... Mitogen-activated protein kinase kinase (MEK) inhibitor therapy.",
"criterion": "MEK inhibitor therapy",
"requirement": {
"requirement_type": "prior treatment",
"expected_value": true
}
}
]
},
"logical_structure": {
"or_criteria": [
{
"exact_snippets": "Patient must have received prior BRAF ... inhibitor therapy.",
"criterion": "BRAF inhibitor therapy",
"requirement": {
"requirement_type": "prior treatment",
"expected_value": true
}
},
{
"exact_snippets": "Patient must have received prior ... Mitogen-activated protein kinase kinase (MEK) inhibitor therapy.",
"criterion": "MEK inhibitor therapy",
"requirement": {
"requirement_type": "prior treatment",
"expected_value": true
}
}
]
}
},
{
"identified_line": {
"line": "3. Karnofsky performance status ≥ 70.",
"criterions": [
{
"exact_snippets": "Karnofsky performance status ≥ 70",
"criterion": "Karnofsky performance status",
"requirement": {
"requirement_type": "score",
"expected_value": {
"operator": ">=",
"value": 70,
"unit": "N/A"
}
}
}
]
},
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"and_criteria": [
{
"exact_snippets": "Karnofsky performance status ≥ 70",
"criterion": "Karnofsky performance status",
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"expected_value": {
"operator": ">=",
"value": 70,
"unit": "N/A"
}
}
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}
},
{
"identified_line": {
"line": "4. Patient is 18 years of older.",
"criterions": [
{
"exact_snippets": "Patient is 18 years of older.",
"criterion": "age",
"requirement": {
"requirement_type": "minimum age",
"expected_value": {
"operator": ">=",
"value": 18,
"unit": "years"
}
}
}
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},
"logical_structure": {
"and_criteria": [
{
"exact_snippets": "Patient is 18 years of older.",
"criterion": "age",
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"expected_value": {
"operator": ">=",
"value": 18,
"unit": "years"
}
}
}
]
}
},
{
"identified_line": {
"line": "5. Measurable disease by RANO2.0 criteria on screening MRI. Leptomeningeal disease allowed.",
"criterions": [
{
"exact_snippets": "Measurable disease by RANO2.0 criteria",
"criterion": "measurable disease",
"requirement": {
"requirement_type": "criteria",
"expected_value": "RANO2.0"
}
},
{
"exact_snippets": "screening MRI",
"criterion": "screening MRI",
"requirement": {
"requirement_type": "presence",
"expected_value": true
}
},
{
"exact_snippets": "Leptomeningeal disease allowed",
"criterion": "leptomeningeal disease",
"requirement": {
"requirement_type": "allowance",
"expected_value": true
}
}
]
},
"logical_structure": {
"and_criteria": [
{
"and_criteria": [
{
"exact_snippets": "Measurable disease by RANO2.0 criteria",
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"requirement": {
"requirement_type": "criteria",
"expected_value": "RANO2.0"
}
},
{
"exact_snippets": "screening MRI",
"criterion": "screening MRI",
"requirement": {
"requirement_type": "presence",
"expected_value": true
}
}
]
},
{
"exact_snippets": "Leptomeningeal disease allowed",
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"requirement": {
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"expected_value": true
}
}
]
}
},
{
"identified_line": {
"line": "6. Willing to submit archival tumor sample if available.",
"criterions": [
{
"exact_snippets": "Willing to submit archival tumor sample",
"criterion": "archival tumor sample submission",
"requirement": {
"requirement_type": "willingness",
"expected_value": true
}
},
{
"exact_snippets": "if available",
"criterion": "archival tumor sample",
"requirement": {
"requirement_type": "availability",
"expected_value": true
}
}
]
},
"logical_structure": {
"condition": {
"exact_snippets": "if available",
"criterion": "archival tumor sample",
"requirement": {
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"expected_value": true
}
},
"then_criteria": {
"exact_snippets": "Willing to submit archival tumor sample",
"criterion": "archival tumor sample submission",
"requirement": {
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"expected_value": true
}
},
"else_criteria": null
}
},
{
"identified_line": {
"line": "7. The following intervals from previous treatments should have elapsed prior to cycle 1 day 1:",
"criterions": [
{
"exact_snippets": "intervals from previous treatments should have elapsed",
"criterion": "intervals from previous treatments",
"requirement": {
"requirement_type": "elapsed time",
"expected_value": "prior to cycle 1 day 1"
}
}
]
},
"logical_structure": {
"and_criteria": [
{
"exact_snippets": "intervals from previous treatments should have elapsed",
"criterion": "intervals from previous treatments",
"requirement": {
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"expected_value": "prior to cycle 1 day 1"
}
}
]
}
},
{
"identified_line": {
"line": "* 12 weeks from the completion of radiation.",
"criterions": [
{
"exact_snippets": "12 weeks from the completion of radiation.",
"criterion": "time since completion of radiation",
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"expected_value": {
"operator": ">=",
"value": 12,
"unit": "weeks"
}
}
}
]
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"operator": ">=",
"value": 12,
"unit": "weeks"
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}
}
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{
"identified_line": {
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{
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"operator": ">=",
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"unit": "weeks"
}
}
}
]
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"unit": "weeks"
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{
"identified_line": {
"line": "* 4 weeks from a nitrosourea chemotherapy",
"criterions": [
{
"exact_snippets": "4 weeks from a nitrosourea chemotherapy",
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"requirement": {
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"expected_value": {
"operator": ">=",
"value": 4,
"unit": "weeks"
}
}
}
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"operator": ">=",
"value": 4,
"unit": "weeks"
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}
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},
{
"identified_line": {
"line": "* 3 weeks from a non-nitrosourea chemotherapy",
"criterions": [
{
"exact_snippets": "3 weeks from a non-nitrosourea chemotherapy",
"criterion": "time since last non-nitrosourea chemotherapy",
"requirement": {
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"operator": ">=",
"value": 3,
"unit": "weeks"
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}
}
]
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"operator": ">=",
"value": 3,
"unit": "weeks"
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"identified_line": {
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"criterions": [
{
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"unit": "weeks"
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"requirement": {
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"identified_line": {
"line": "* 2 weeks from administration of a non-cytotoxic, FDA-approved agent (e.g., erlotinib, hydroxychloroquine, dabrafenib, etc.)",
"criterions": [
{
"exact_snippets": "administration of a non-cytotoxic, FDA-approved agent (e.g., erlotinib, hydroxychloroquine, dabrafenib, etc.)",
"criterion": "non-cytotoxic, FDA-approved agent administration",
"requirement": {
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"operator": ">=",
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"unit": "weeks"
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"exact_snippets": "administration of a non-cytotoxic, FDA-approved agent (e.g., erlotinib, hydroxychloroquine, dabrafenib, etc.)",
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"operator": ">=",
"value": 2,
"unit": "weeks"
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},
{
"identified_line": {
"line": "8. Patients must have the following organ and marrow function:",
"criterions": [
{
"exact_snippets": "organ and marrow function",
"criterion": "organ and marrow function",
"requirement": {
"requirement_type": "presence",
"expected_value": true
}
}
]
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"logical_structure": {
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"exact_snippets": "organ and marrow function",
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"expected_value": true
}
}
]
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},
{
"identified_line": {
"line": "* Absolute neutrophil count >1,000/micro liter (mcL)",
"criterions": [
{
"exact_snippets": "Absolute neutrophil count >1,000/micro liter (mcL)",
"criterion": "absolute neutrophil count",
"requirement": {
"requirement_type": "quantity",
"expected_value": {
"operator": ">",
"value": 1000,
"unit": "micro liter (mcL)"
}
}
}
]
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"logical_structure": {
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{
"exact_snippets": "Absolute neutrophil count >1,000/micro liter (mcL)",
"criterion": "absolute neutrophil count",
"requirement": {
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"expected_value": {
"operator": ">",
"value": 1000,
"unit": "micro liter (mcL)"
}
}
}
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}
},
{
"identified_line": {
"line": "* Platelets >100,000/mcL",
"criterions": [
{
"exact_snippets": "Platelets >100,000/mcL",
"criterion": "platelets",
"requirement": {
"requirement_type": "quantity",
"expected_value": {
"operator": ">",
"value": 100000,
"unit": "mcL"
}
}
}
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"exact_snippets": "Platelets >100,000/mcL",
"criterion": "platelets",
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"expected_value": {
"operator": ">",
"value": 100000,
"unit": "mcL"
}
}
}
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},
{
"identified_line": {
"line": "* Hemoglobin > 9 g/dL",
"criterions": [
{
"exact_snippets": "Hemoglobin > 9 g/dL",
"criterion": "hemoglobin level",
"requirement": {
"requirement_type": "level",
"expected_value": {
"operator": ">",
"value": 9,
"unit": "g/dL"
}
}
}
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"and_criteria": [
{
"exact_snippets": "Hemoglobin > 9 g/dL",
"criterion": "hemoglobin level",
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"requirement_type": "level",
"expected_value": {
"operator": ">",
"value": 9,
"unit": "g/dL"
}
}
}
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},
{
"identified_line": {
"line": "* Total bilirubin </= 1.5 x institutional upper limit of normal (ULN) OR total bilirubin >1.5 × ULN with direct bilirubin <1.5 × ULN",
"criterions": [
{
"exact_snippets": "Total bilirubin </= 1.5 x institutional upper limit of normal (ULN)",
"criterion": "total bilirubin",
"requirement": {
"requirement_type": "level",
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"operator": "<=",
"value": 1.5,
"unit": "x ULN"
}
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"exact_snippets": "total bilirubin >1.5 × ULN with direct bilirubin <1.5 × ULN",
"criterion": "total bilirubin",
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"comparisons": [
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"operator": ">",
"value": 1.5,
"unit": "x ULN"
}
]
}
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},
{
"exact_snippets": "direct bilirubin <1.5 × ULN",
"criterion": "direct bilirubin",
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"requirement_type": "level",
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"comparisons": [
{
"operator": "<",
"value": 1.5,
"unit": "x ULN"
}
]
}
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{
"and_criteria": [
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"exact_snippets": "total bilirubin >1.5 × ULN with direct bilirubin <1.5 × ULN",
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"identified_line": {
"line": "* (aspartate aminotransferase (AST) and alanine transaminase (ALT) </= 2.5 x institutional ULN",
"criterions": [
{
"exact_snippets": "aspartate aminotransferase (AST) ... </= 2.5 x institutional ULN",
"criterion": "aspartate aminotransferase (AST)",
"requirement": {
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"expected_value": {
"operator": "<=",
"value": 2.5,
"unit": "x institutional ULN"
}
}
},
{
"exact_snippets": "alanine transaminase (ALT) </= 2.5 x institutional ULN",
"criterion": "alanine transaminase (ALT)",
"requirement": {
"requirement_type": "level",
"expected_value": {
"operator": "<=",
"value": 2.5,
"unit": "x institutional ULN"
}
}
}
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"logical_structure": {
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"exact_snippets": "aspartate aminotransferase (AST) ... </= 2.5 x institutional ULN",
"criterion": "aspartate aminotransferase (AST)",
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"requirement_type": "level",
"expected_value": {
"operator": "<=",
"value": 2.5,
"unit": "x institutional ULN"
}
}
},
{
"exact_snippets": "alanine transaminase (ALT) </= 2.5 x institutional ULN",
"criterion": "alanine transaminase (ALT)",
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"requirement_type": "level",
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"operator": "<=",
"value": 2.5,
"unit": "x institutional ULN"
}
}
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},
{
"identified_line": {
"line": "* prothrombin time (PT) or Partial thromboplastin time (PTT) < 1.5 x institutional ULN",
"criterions": [
{
"exact_snippets": "prothrombin time (PT) ... < 1.5 x institutional ULN",
"criterion": "prothrombin time (PT)",
"requirement": {
"requirement_type": "value",
"expected_value": {
"operator": "<",
"value": 1.5,
"unit": "x institutional ULN"
}
}
},
{
"exact_snippets": "Partial thromboplastin time (PTT) < 1.5 x institutional ULN",
"criterion": "Partial thromboplastin time (PTT)",
"requirement": {
"requirement_type": "value",
"expected_value": {
"operator": "<",
"value": 1.5,
"unit": "x institutional ULN"
}
}
}
]
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"expected_value": {
"operator": "<",
"value": 1.5,
"unit": "x institutional ULN"
}
}
},
{
"exact_snippets": "Partial thromboplastin time (PTT) < 1.5 x institutional ULN",
"criterion": "Partial thromboplastin time (PTT)",
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"requirement_type": "value",
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"operator": "<",
"value": 1.5,
"unit": "x institutional ULN"
}
}
}
]
}
},
{
"identified_line": {
"line": "9. Patient must be able to provide written informed consent.",
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{
"exact_snippets": "Patient must be able to provide written informed consent.",
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"requirement_type": "ability",
"expected_value": true
}
}
]
},
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"and_criteria": [
{
"exact_snippets": "Patient must be able to provide written informed consent.",
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}
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]
}
},
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"identified_line": {
"line": "10. All adverse events related to prior therapies (chemotherapy; radiotherapy; surgery) must have resolved to Grade 1 or baseline except for",
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{
"exact_snippets": "adverse events related to prior therapies (chemotherapy; radiotherapy; surgery) must have resolved to Grade 1 or baseline",
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"requirement_type": "severity",
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}
}
]
},
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"and_criteria": [
{
"exact_snippets": "adverse events related to prior therapies (chemotherapy; radiotherapy; surgery) must have resolved to Grade 1 or baseline",
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"requirement_type": "severity",
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}
}
]
}
},
{
"identified_line": {
"line": "* Alopecia (Grade ≤2)",
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{
"exact_snippets": "Alopecia (Grade ≤2)",
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"requirement_type": "severity",
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"operator": "<=",
"value": 2,
"unit": "Grade"
}
}
}
]
},
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"and_criteria": [
{
"exact_snippets": "Alopecia (Grade ≤2)",
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"operator": "<=",
"value": 2,
"unit": "Grade"
}
}
}
]
}
},
{
"identified_line": {
"line": "* Lymphopenia (Grade 2)",
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{
"exact_snippets": "Lymphopenia (Grade 2)",
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}
]
},
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"and_criteria": [
{
"exact_snippets": "Lymphopenia (Grade 2)",
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"requirement_type": "severity",
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}
]
}
},
{
"identified_line": {
"line": "* Other adverse events that have resolved to Grade ≤2 that, according to the clinical judgment of the investigator, do not constitute a safety risk to the participant.",
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{
"exact_snippets": "Other adverse events that have resolved to Grade ≤2",
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"operator": "<=",
"value": 2,
"unit": "Grade"
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}
},
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"requirement_type": "clinical judgment",
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}
}
]
},
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{
"exact_snippets": "Other adverse events that have resolved to Grade ≤2",
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"operator": "<=",
"value": 2,
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}
},
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}
]
}
},
{
"identified_line": {
"line": "11. Patients must be maintained on a stable or decreasing dose of systemic corticosteroid regimen (no increase for 5 days) prior to screening MRI. Topical and inhaled steroid treatment is allowed.",
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{
"exact_snippets": "Patients must be maintained on a stable or decreasing dose of systemic corticosteroid regimen (no increase for 5 days)",
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"requirement_type": "dose stability",
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}
},
{
"exact_snippets": "Patients must be maintained on a stable or decreasing dose of systemic corticosteroid regimen (no increase for 5 days)",
"criterion": "systemic corticosteroid regimen",
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"requirement_type": "duration",
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"operator": ">=",
"value": 5,
"unit": "days"
}
}
},
{
"exact_snippets": "Topical and inhaled steroid treatment is allowed",
"criterion": "topical and inhaled steroid treatment",
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"requirement_type": "allowance",
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}
}
]
},
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"and_criteria": [
{
"and_criteria": [
{
"exact_snippets": "Patients must be maintained on a stable or decreasing dose of systemic corticosteroid regimen (no increase for 5 days)",
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"requirement_type": "dose stability",
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"operator": ">=",
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},
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}
},
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"identified_line": {
"line": "12. Ability to swallow and retain orally administered medications, including a liquid suspension.",
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},
{
"exact_snippets": "Ability to ... retain orally administered medications",
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"requirement_type": "ability",
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}
},
{
"exact_snippets": "including a liquid suspension",
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},
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{
"exact_snippets": "Ability to swallow and retain orally administered medications",
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},
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"exact_snippets": "Ability to ... retain orally administered medications",
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}
},
{
"exact_snippets": "including a liquid suspension",
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}
},
{
"identified_line": {
"line": "13. Female participants of childbearing potential must have a negative serum pregnancy test prior to study start. Female participants of childbearing potential must agree to use highly effective contraception and not to donate ova from screening through 30 days after the last dose of study drug. Highly effective contraception is defined as 1) intrauterine device, 2) abstinence, or 3) combined estrogen and progesterone or progesterone only containing implants, injectables, transdermal, or intravaginal contraceptives. Male participants must also agree to use adequate contraception and not to donate sperm from screening until 90 days after the last dose of study drug.",
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{
"exact_snippets": "Female participants of childbearing potential must have a negative serum pregnancy test",
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},
{
"exact_snippets": "Female participants of childbearing potential must agree to use highly effective contraception",
"criterion": "contraception use (female)",
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"requirement_type": "agreement",
"expected_value": true
}
},
{
"exact_snippets": "Female participants of childbearing potential must agree ... not to donate ova",
"criterion": "ova donation (female)",
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"requirement_type": "agreement",
"expected_value": false
}
},
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"exact_snippets": "Highly effective contraception is defined as 1) intrauterine device, 2) abstinence, or 3) combined estrogen and progesterone or progesterone only containing implants, injectables, transdermal, or intravaginal contraceptives",
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}
},
{
"exact_snippets": "Male participants must also agree to use adequate contraception",
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"requirement_type": "agreement",
"expected_value": true
}
},
{
"exact_snippets": "Male participants must also agree ... not to donate sperm",
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},
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{
"and_criteria": [
{
"and_criteria": [
{
"and_criteria": [
{
"and_criteria": [
{
"and_criteria": [
{
"exact_snippets": "Female participants of childbearing potential must have a negative serum pregnancy test",
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},
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"exact_snippets": "Female participants of childbearing potential must agree to use highly effective contraception",
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},
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]
},
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"exact_snippets": "Highly effective contraception is defined as 1) intrauterine device, 2) abstinence, or 3) combined estrogen and progesterone or progesterone only containing implants, injectables, transdermal, or intravaginal contraceptives",
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}
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},
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]
},
{
"exact_snippets": "Male participants must also agree ... not to donate sperm",
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}
]
}
},
{
"identified_line": {
"line": "14. Patients must have no concurrent malignancy except curatively treated basal or squamous cell carcinoma of the skin or carcinoma in situ of the cervix, breast, or bladder. Patients with other malignancies must be disease-free for >/=2 years.",
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"exact_snippets": "no concurrent malignancy",
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"exact_snippets": "curatively treated basal or squamous cell carcinoma of the skin",
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}
},
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"exact_snippets": "carcinoma in situ of the cervix, breast, or bladder",
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"expected_value": true
}
},
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"exact_snippets": "Patients with other malignancies must be disease-free for >/=2 years",
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"requirement_type": "duration",
"expected_value": {
"operator": ">=",
"value": 2,
"unit": "years"
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}
}
]
},
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{
"not_criteria": {
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"exact_snippets": "curatively treated basal or squamous cell carcinoma of the skin",
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}
},
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"exact_snippets": "carcinoma in situ of the cervix, breast, or bladder",
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"and_criteria": [
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}
},
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"exact_snippets": "carcinoma in situ of the cervix, breast, or bladder",
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}
}
]
},
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"exact_snippets": "Patients with other malignancies must be disease-free for >/=2 years",
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},
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"identified_line": {
"line": "15. Life expectancy equal or greater than six months.",
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"operator": ">=",
"value": 6,
"unit": "months"
}
]
}
}
}
]
},
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"exact_snippets": "Life expectancy equal or greater than six months.",
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{
"operator": ">=",
"value": 6,
"unit": "months"
}
]
}
}
}
]
}
},
{
"identified_line": {
"line": "Healthy volunteers allowed",
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{
"exact_snippets": "Healthy volunteers allowed",
"criterion": "volunteer health status",
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"requirement_type": "status",
"expected_value": "healthy"
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}
]
},
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"and_criteria": [
{
"exact_snippets": "Healthy volunteers allowed",
"criterion": "volunteer health status",
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"requirement_type": "status",
"expected_value": "healthy"
}
}
]
}
},
{
"identified_line": {
"line": "Must have minimum age of 18 Years",
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{
"exact_snippets": "minimum age of 18 Years",
"criterion": "age",
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"requirement_type": "minimum",
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"unit": "Years"
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}
}
]
},
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"and_criteria": [
{
"exact_snippets": "minimum age of 18 Years",
"criterion": "age",
"requirement": {
"requirement_type": "minimum",
"expected_value": {
"operator": ">=",
"value": 18,
"unit": "Years"
}
}
}
]
}
}
],
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{
"exact_snippets": "Known co-occurring NF-1 (Neurofibromatosis type 1)",
"criterion": "NF-1 (Neurofibromatosis type 1)",
"requirement": {
"requirement_type": "presence",
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}
},
{
"exact_snippets": "reticular activating system (RAS) -related alteration known to cause resistance",
"criterion": "RAS-related alteration",
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"requirement_type": "resistance",
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}
}
]
},
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"and_criteria": [
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"exact_snippets": "Known co-occurring NF-1 (Neurofibromatosis type 1)",
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"expected_value": true
}
},
{
"exact_snippets": "reticular activating system (RAS) -related alteration known to cause resistance",
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}
}
]
},
{
"exact_snippets": "Known co-occurring NF-1 (Neurofibromatosis type 1)",
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}
},
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"exact_snippets": "reticular activating system (RAS) -related alteration known to cause resistance",
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}
]
}
},
{
"identified_line": {
"line": "3. Prior treatment with any rapidly accelerated fibrosarcoma (RAF) dimer disruptor or pan-RAF inhibitor.",
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"exact_snippets": "Prior treatment with any rapidly accelerated fibrosarcoma (RAF) dimer disruptor",
"criterion": "prior treatment with RAF dimer disruptor",
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"requirement_type": "presence",
"expected_value": true
}
},
{
"exact_snippets": "Prior treatment with any ... pan-RAF inhibitor",
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"expected_value": true
}
}
]
},
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"exact_snippets": "Prior treatment with any rapidly accelerated fibrosarcoma (RAF) dimer disruptor",
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}
},
{
"exact_snippets": "Prior treatment with any ... pan-RAF inhibitor",
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}
}
]
}
},
{
"identified_line": {
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{
"exact_snippets": "Known hypersensitivity to plixorafenib",
"criterion": "hypersensitivity to plixorafenib",
"requirement": {
"requirement_type": "presence",
"expected_value": true
}
},
{
"exact_snippets": "Known hypersensitivity to ... cobicistat",
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},
{
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"expected_value": true
}
}
]
},
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"exact_snippets": "Known hypersensitivity to plixorafenib",
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}
},
{
"exact_snippets": "Known hypersensitivity to ... cobicistat",
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}
},
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}
]
}
},
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{
"exact_snippets": "Impairment in gastrointestinal function or disease",
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}
},
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},
{
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"requirement": {
"requirement_type": "presence",
"expected_value": true
}
},
{
"exact_snippets": "uncontrolled nausea",
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"requirement": {
"requirement_type": "control",
"expected_value": "uncontrolled"
}
},
{
"exact_snippets": "vomiting",
"criterion": "vomiting",
"requirement": {
"requirement_type": "presence",
"expected_value": true
}
},
{
"exact_snippets": "diarrhea",
"criterion": "diarrhea",
"requirement": {
"requirement_type": "presence",
"expected_value": true
}
},
{
"exact_snippets": "malabsorption syndrome",
"criterion": "malabsorption syndrome",
"requirement": {
"requirement_type": "presence",
"expected_value": true
}
},
{
"exact_snippets": "small bowel resection",
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"expected_value": true
}
}
]
},
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"and_criteria": [
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"exact_snippets": "Impairment in gastrointestinal function or disease",
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}
},
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]
},
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"or_criteria": [
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"expected_value": true
}
},
{
"exact_snippets": "uncontrolled nausea",
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}
},
{
"exact_snippets": "vomiting",
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}
},
{
"exact_snippets": "diarrhea",
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"requirement_type": "presence",
"expected_value": true
}
},
{
"exact_snippets": "malabsorption syndrome",
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"requirement_type": "presence",
"expected_value": true
}
},
{
"exact_snippets": "small bowel resection",
"criterion": "small bowel resection",
"requirement": {
"requirement_type": "presence",
"expected_value": true
}
}
]
}
]
}
},
{
"identified_line": {
"line": "7. Clinically significant cardiovascular disease including, but not limited to the following:",
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{
"exact_snippets": "Clinically significant cardiovascular disease",
"criterion": "cardiovascular disease",
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"requirement_type": "severity",
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}
}
]
},
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{
"exact_snippets": "Clinically significant cardiovascular disease",
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}
}
]
}
},
{
"identified_line": {
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{
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"criterion": "acute coronary syndromes",
"requirement": {
"requirement_type": "history",
"expected_value": true
}
},
{
"exact_snippets": "History of ... coronary artery bypass grafting",
"criterion": "coronary artery bypass grafting",
"requirement": {
"requirement_type": "history",
"expected_value": true
}
},
{
"exact_snippets": "History of ... coronary angioplasty or stenting ≤ 180 days prior to start date",
"criterion": "coronary angioplasty or stenting",
"requirement": {
"requirement_type": "history",
"expected_value": true
}
},
{
"exact_snippets": "History of ... coronary angioplasty or stenting ≤ 180 days prior to start date",
"criterion": "coronary angioplasty or stenting",
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"requirement_type": "time since procedure",
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"operator": "<=",
"value": 180,
"unit": "days"
}
}
}
]
},
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{
"or_criteria": [
{
"exact_snippets": "History of acute coronary syndromes (including myocardial infarction or unstable angina)",
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}
},
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}
},
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}
]
}
]
}
]
}
},
{
"identified_line": {
"line": "* Congestive heart failure requiring treatment (New York Heart Association Grade > 2);",
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{
"exact_snippets": "Congestive heart failure requiring treatment",
"criterion": "congestive heart failure",
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"requirement_type": "treatment requirement",
"expected_value": true
}
},
{
"exact_snippets": "New York Heart Association Grade > 2",
"criterion": "New York Heart Association Grade",
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"requirement_type": "severity",
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"operator": ">",
"value": 2,
"unit": "N/A"
}
}
}
]
},
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{
"exact_snippets": "Congestive heart failure requiring treatment",
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}
},
{
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"operator": ">",
"value": 2,
"unit": "N/A"
}
}
}
]
}
},
{
"identified_line": {
"line": "* History or presence of clinically significant cardiac arrhythmias (including resting bradycardia, uncontrolled atrial fibrillation or uncontrolled paroxysmal supraventricular tachycardia);",
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{
"exact_snippets": "History or presence of clinically significant cardiac arrhythmias",
"criterion": "cardiac arrhythmias",
"requirement": {
"requirement_type": "presence",
"expected_value": false
}
},
{
"exact_snippets": "resting bradycardia",
"criterion": "resting bradycardia",
"requirement": {
"requirement_type": "presence",
"expected_value": false
}
},
{
"exact_snippets": "uncontrolled atrial fibrillation",
"criterion": "atrial fibrillation",
"requirement": {
"requirement_type": "control",
"expected_value": false
}
},
{
"exact_snippets": "uncontrolled paroxysmal supraventricular tachycardia",
"criterion": "paroxysmal supraventricular tachycardia",
"requirement": {
"requirement_type": "control",
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}
}
]
},
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{
"and_criteria": [
{
"exact_snippets": "History or presence of clinically significant cardiac arrhythmias",
"criterion": "cardiac arrhythmias",
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"requirement_type": "presence",
"expected_value": false
}
},
{
"or_criteria": [
{
"exact_snippets": "resting bradycardia",
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"expected_value": false
}
},
{
"exact_snippets": "uncontrolled atrial fibrillation",
"criterion": "atrial fibrillation",
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"requirement_type": "control",
"expected_value": false
}
},
{
"exact_snippets": "uncontrolled paroxysmal supraventricular tachycardia",
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"requirement": {
"requirement_type": "control",
"expected_value": false
}
}
]
}
]
}
]
}
},
{
"identified_line": {
"line": "* Corrected QT interval (QTcF) QT corrected for heart rate by Fridericia's cube root formula) interval ≥ 480 ms.",
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{
"exact_snippets": "Corrected QT interval (QTcF) ... interval ≥ 480 ms.",
"criterion": "Corrected QT interval (QTcF)",
"requirement": {
"requirement_type": "duration",
"expected_value": {
"operator": ">=",
"value": 480,
"unit": "ms"
}
}
}
]
},
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"and_criteria": [
{
"exact_snippets": "Corrected QT interval (QTcF) ... interval ≥ 480 ms.",
"criterion": "Corrected QT interval (QTcF)",
"requirement": {
"requirement_type": "duration",
"expected_value": {
"operator": ">=",
"value": 480,
"unit": "ms"
}
}
}
]
}
},
{
"identified_line": {
"line": "9. Patients with uncontrolled intercurrent illness including, but not limited to, ongoing or active infection or psychiatric illness/social situations that would limit compliance with study requirements, are ineligible.",
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"exact_snippets": "uncontrolled intercurrent illness",
"criterion": "intercurrent illness",
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"expected_value": false
}
},
{
"exact_snippets": "ongoing or active infection",
"criterion": "infection",
"requirement": {
"requirement_type": "status",
"expected_value": [
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"active"
]
}
},
{
"exact_snippets": "psychiatric illness/social situations that would limit compliance with study requirements",
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"requirement_type": "impact on compliance",
"expected_value": "limit"
}
}
]
},
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{
"and_criteria": [
{
"exact_snippets": "uncontrolled intercurrent illness",
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}
},
{
"or_criteria": [
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"exact_snippets": "ongoing or active infection",
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"requirement": {
"requirement_type": "status",
"expected_value": [
"ongoing",
"active"
]
}
},
{
"exact_snippets": "psychiatric illness/social situations that would limit compliance with study requirements",
"criterion": "psychiatric illness/social situations",
"requirement": {
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"expected_value": "limit"
}
}
]
}
]
}
]
}
},
{
"identified_line": {
"line": "10. Pregnant women are excluded from this study because the effects of plixorafenib on a fetus are unknown. Because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with plixorafenib or cobicistat, breastfeeding should be discontinued if the mother is treated on study.",
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{
"exact_snippets": "Pregnant women are excluded",
"criterion": "pregnancy",
"requirement": {
"requirement_type": "presence",
"expected_value": false
}
},
{
"exact_snippets": "breastfeeding should be discontinued if the mother is treated on study",
"criterion": "breastfeeding",
"requirement": {
"requirement_type": "discontinuation",
"expected_value": true
}
}
]
},
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"condition": {
"exact_snippets": "Pregnant women are excluded",
"criterion": "pregnancy",
"requirement": {
"requirement_type": "presence",
"expected_value": false
}
},
"then_criteria": null,
"else_criteria": {
"exact_snippets": "breastfeeding should be discontinued if the mother is treated on study",
"criterion": "breastfeeding",
"requirement": {
"requirement_type": "discontinuation",
"expected_value": true
}
}
}
},
{
"identified_line": {
"line": "11. No contraindication to clinically-indicated surgery.",
"criterions": [
{
"exact_snippets": "No contraindication to clinically-indicated surgery.",
"criterion": "contraindication to surgery",
"requirement": {
"requirement_type": "presence",
"expected_value": false
}
}
]
},
"logical_structure": {
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"exact_snippets": "No contraindication to clinically-indicated surgery.",
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"requirement_type": "presence",
"expected_value": false
}
}
}
},
{
"identified_line": {
"line": "12. No contraindication to ventricular reservoir placement or biospecimen collection.",
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{
"exact_snippets": "No contraindication to ventricular reservoir placement",
"criterion": "ventricular reservoir placement",
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"requirement_type": "contraindication",
"expected_value": false
}
},
{
"exact_snippets": "No contraindication to ... biospecimen collection",
"criterion": "biospecimen collection",
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"expected_value": false
}
}
]
},
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}
},
{
"exact_snippets": "No contraindication to ... biospecimen collection",
"criterion": "biospecimen collection",
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"expected_value": false
}
}
]
}
}
],
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{
"identified_line": {
"line": "1. Histologic diagnosis of a primary central nervous system (CNS) tumor with documented BRAF-V600E mutation by a Clinical Laboratory Improvement Amendments (CLIA) approved DNA or RNA (Ribonucleic acid )-based sequencing test (NGS (Next generation sequencing) or RNAseq). Immunohistochemistry alone is insufficient.",
"criterions": [
{
"exact_snippets": "Histologic diagnosis of a primary central nervous system (CNS) tumor",
"criterion": "primary central nervous system (CNS) tumor",
"requirement": {
"requirement_type": "diagnosis",
"expected_value": true
}
},
{
"exact_snippets": "documented BRAF-V600E mutation by a Clinical Laboratory Improvement Amendments (CLIA) approved DNA or RNA (Ribonucleic acid )-based sequencing test",
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"requirement": {
"requirement_type": "documentation",
"expected_value": true
}
},
{
"exact_snippets": "documented BRAF-V600E mutation by a Clinical Laboratory Improvement Amendments (CLIA) approved DNA or RNA (Ribonucleic acid )-based sequencing test",
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]
}
},
{
"exact_snippets": "Immunohistochemistry alone is insufficient",
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"requirement_type": "sufficiency",
"expected_value": false
}
}
]
},
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"and_criteria": [
{
"and_criteria": [
{
"and_criteria": [
{
"exact_snippets": "Histologic diagnosis of a primary central nervous system (CNS) tumor",
"criterion": "primary central nervous system (CNS) tumor",
"requirement": {
"requirement_type": "diagnosis",
"expected_value": true
}
},
{
"exact_snippets": "documented BRAF-V600E mutation by a Clinical Laboratory Improvement Amendments (CLIA) approved DNA or RNA (Ribonucleic acid )-based sequencing test",
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"requirement_type": "documentation",
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}
}
]
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}
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]
},
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]
}
},
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"identified_line": {
"line": "* Creatinine ≤ 1.5 x institutional ULN OR Creatinine clearance (Cockcroft-Gault Formula) > 50 ml/min/1.73m2",
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{
"exact_snippets": "Creatinine ≤ 1.5 x institutional ULN",
"criterion": "creatinine level",
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"requirement_type": "level",
"expected_value": {
"operator": "<=",
"value": 1.5,
"unit": "x institutional ULN"
}
}
},
{
"exact_snippets": "Creatinine clearance (Cockcroft-Gault Formula) > 50 ml/min/1.73m2",
"criterion": "creatinine clearance",
"requirement": {
"requirement_type": "clearance",
"expected_value": {
"operator": ">",
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"unit": "ml/min/1.73m2"
}
}
}
]
},
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"exact_snippets": "Creatinine \u0010 1.5 x institutional ULN",
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}
}
},
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"exact_snippets": "Creatinine clearance (Cockcroft-Gault Formula) > 50 ml/min/1.73m2",
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"operator": ">",
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}
}
}
]
}
},
{
"identified_line": {
"line": "* Sensory neuropathy (Grade ≤2)",
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{
"exact_snippets": "Sensory neuropathy (Grade ≤2)",
"criterion": "sensory neuropathy",
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"requirement_type": "severity",
"expected_value": {
"operator": "<=",
"value": 2,
"unit": "Grade"
}
}
}
]
},
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"and_criteria": [
{
"exact_snippets": "Sensory neuropathy (Grade \u0010 2)",
"criterion": "sensory neuropathy",
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"requirement_type": "severity",
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"operator": "<=",
"value": 2,
"unit": "Grade"
}
}
}
]
}
}
],
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}
}
]
},
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}
},
{
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}
}
}
]
}
},
{
"identified_line": {
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{
"exact_snippets": "Current use of a prohibited medication (including herbal medications, supplements, or foods)",
"criterion": "use of prohibited medication",
"requirement": {
"requirement_type": "presence",
"expected_value": false
}
},
{
"exact_snippets": "use of a prohibited medication ≤ 7 days prior to surgery date",
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"operator": "<=",
"value": 7,
"unit": "days"
}
}
}
]
},
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{
"and_criteria": [
{
"exact_snippets": "Current use of a prohibited medication (including herbal medications, supplements, or foods)",
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}
}
]
},
{
"and_criteria": [
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"exact_snippets": "use of a prohibited medication \u0010 7 days prior to surgery date",
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}
}
]
}
]
}
},
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"identified_line": {
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"criterions": [
{
"exact_snippets": "History of recent (≤ 90 days) thromboembolic or cerebrovascular event",
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{
"operator": "<=",
"value": 90,
"unit": "days"
}
]
}
}
},
{
"exact_snippets": "transient ischemic attack",
"criterion": "transient ischemic attack",
"requirement": {
"requirement_type": "presence",
"expected_value": true
}
},
{
"exact_snippets": "cerebrovascular accident",
"criterion": "cerebrovascular accident",
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"requirement_type": "presence",
"expected_value": true
}
},
{
"exact_snippets": "hemodynamically significant (massive or sub-massive) deep vein thrombosis or pulmonary emboli (DVT/PE)",
"criterion": "hemodynamically significant DVT/PE",
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"expected_value": true
}
},
{
"exact_snippets": "DVT/PE that does not result in hemodynamic instability",
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"requirement": {
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"expected_value": true
}
},
{
"exact_snippets": "DVT/PE that does not result in hemodynamic instability",
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"requirement_type": "anticoagulation duration",
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{
"operator": ">=",
"value": 4,
"unit": "weeks"
}
]
}
}
},
{
"exact_snippets": "Deep vein thrombosis (DVT)/pulmonary embolism (PE) related to indwelling catheters or other procedures",
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}
}
]
},
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}
}
}
],
"failed_miscellaneous": []
}