{
    "info": {
        "nct_id": "NCT00083031",
        "official_title": "Metronomic Chemotherapy With Bevacizumab for Advanced Breast Cancer",
        "inclusion_criteria": "* Patients must have histologically or cytologically confirmed invasive breast cancer, with stage IV disease. Patients without pathologic or cytologic confirmation of metastatic disease should have unequivocal evidence of metastasis by physical exam or radiologic study.\n* Patients must have measurable disease, defined as at least one lesion that can be accurately measured in at least one dimension (longest diameter to be recorded) as ≥ 20 mm with conventional techniques or as ≥ 10 mm with spiral CT scan. The protocol will employ the RECIST criteria.\n* Prior Therapy:\n\n  * Chemotherapy: early stage breast cancer. Patients may have received prior adjuvant chemotherapy and/or hormonal therapy for early stage breast cancer, including cyclophosphamide-based chemotherapy regimens.\n  * Chemotherapy: metastatic breast cancer. Patients may have received 0-1 prior regimens for metastatic breast cancer. No prior oral cyclophosphamideor methotrexate-based therapy for metastatic disease is permitted.\n  * Chemotherapy: anthracyclines. Patients without prior anthraycline (in either the metastatic or adjuvant setting) exposure are eligible provided that they do not have visceral (parenchymal lung or liver) metastases. Patients without prior anthracycline-based therapy are expected to have \"low volume\" tumor burden, deemed appropriate for non-standard chemotherapy in the estimation of the treating clinician.\n  * Trastuzumab. Patients with HER2-positive breast tumors must have received prior trastuzumab therapy for advanced disease, or have had recurrence within 12 months of receiving (neo)adjuvant trastuzumab.\n  * Radiation therapy. Patients may have received prior radiation therapy in either the metastatic or early stage settings. Radiation therapy may not be administered during the study. Lesions progressing after previous irradiation are measurable; lesions not progressing after previous irradiation are not measurable.\n  * Hormonal therapy. Patients with estrogen- or progesterone-receptor positive disease must have received at least one prior hormonal therapy in the adjuvant and/or metastatic setting.\n\n    --- Patients must discontinue chemotherapy and/or hormonal therapy prior to study participation.\n  * Concurrent Therapy. Patients may receive concurrent bisphosphonate therapy and/or erythropoietin growth factor support while on study. Patients may not receive other experimental treatments while on study. Bisphosphonate therapy and/or erythropoietin growth factor support therapy may commence at any point on study.\n* Patients may not have received prior experimental angiogenesis inhibitors.\n* Age ≥18 years.\n* Life expectancy greater than 6 months.\n* ECOG performance status ≤ 1 (Karnofsky ≥70%; see Appendix B).\n* Absence of poorly controlled hypertension (as defined by the treating clinician), proteinuria, prior history of either deep venous or arterial thrombosis, bleeding diatheses (including hemoptysis).\n* Radiologic exclusion of brain metastases (because of concern for potential CNS bleeding with therapy). All patients must have a brain CT or MRI no more than 6 weeks prior to enrollment.\n* Left ventricular function ≥ 45% as assessed by echocardiogram or nuclear medicine gated study.\n* Patients must have normal organ and marrow function as defined below. Labs should be completed within 4 weeks prior to registration.\n\n  * absolute neutrophil count ≥1000/mm3\n  * platelets ≥100,000/mm3\n  * total bilirubin ≤ 2 x institutional upper limit of normal (ULN)\n  * AST(SGOT)/ALT(SGPT) ≤ 4.0 x ULN\n  * Alkaline phosphatase ≤ 5.0 x ULN\n  * creatinine ≤ 2.0 mg/dl\n  * 24 hr urine specimen < 500 mg protein/24 hr\n\n    --- or\n  * Protein on urinalysis < 1+\n  * PT, PTT ≤ institutional upper limit of normal (ULN)\n* Fertility/reproduction. Patients must be neither pregnant nor expect becoming pregnant or conceiving a child while on study. Women of childbearing potential must have a negative pregnancy test. The effects of bevacizumab, methotrexate, and cyclophosphamide on the developing fetus are unknown. For this reason, women of childbearing potential must agree to use adequate contraception prior to study entry and for the duration of study participation. Should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately.\n* Ability to understand and the willingness to sign a written informed consent document.\n* Exclusion Criteria\n* Patients with less than stage IV disease or lack measurable disease.\n* Prior therapy that included any of the following:\n\n  * Chemotherapy for metastatic breast cancer. Patients who have received ≥ 2 prior regimens for metastatic breast cancer; or who have received prior oral cyclophosphamide- or methotrexate-based therapy for metastatic disease.\n  * Patients who have not recovered from reversible adverse events due to prior treatments.\n  * Patients still on hormonal therapy - including LHRH agonist therapy.\n* Current use of anticoagulants or chronic aspirin therapy (> 325 mg/day) - excluding low-dose warfarin used for venous access patency (doses of 1 to 2 mg/d.)\n* History of grade 3 or 4 allergic reactions attributed to compounds of similar chemical or biologic composition to cyclophosphamide (such as other alkylating agents) or methotrexate (such as other antimetabolites.)\n* Patients with recent (within 6 months) arterial thromboembolic events, including transient ischemic attack (TIA), cerebrovascular accident (CVA), unstable angina, or myocardial infarction (MI). Patients with clinically significant peripheral artery disease should also be excluded.\n* Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.\n* Patients with visceral metastases unless they have previously been treated with an anthraycline-based chemotherapy regimen in either the metastatic or adjuvant setting.\n* Patients may not receive other investigational agents while on study.\n* Non-healing wounds or major surgical procedures other than for venous access device or diagnostic study are not permitted within 28 days prior to enrollment (because of rare potential risk of delayed wound healing associated with bevacizumab).\n* Patients with large or rapidly accumulating pleural or abdominal effusions (based on clinician's judgment) because of the theoretical risk for methotrexate accumulation and related toxicity. --- If a patient's condition is deteriorating, laboratory evaluations should be repeated ≤ 48 hours prior to initiation of therapy.\nHealthy volunteers allowed\nMust be FEMALE\nMust have minimum age of 18 Years",
        "exclusion_criteria": "",
        "miscellaneous_criteria": ""
    },
    "inclusion_lines": [
        {
            "identified_line": {
                "line": "* Patients must have measurable disease, defined as at least one lesion that can be accurately measured in at least one dimension (longest diameter to be recorded) as ≥ 20 mm with conventional techniques or as ≥ 10 mm with spiral CT scan. The protocol will employ the RECIST criteria.",
                "criterions": [
                    {
                        "exact_snippets": "measurable disease, defined as at least one lesion that can be accurately measured in at least one dimension (longest diameter to be recorded) as ≥ 20 mm with conventional techniques or as ≥ 10 mm with spiral CT scan",
                        "criterion": "measurable disease",
                        "requirement": {
                            "requirement_type": "definition",
                            "expected_value": "at least one lesion that can be accurately measured in at least one dimension"
                        }
                    },
                    {
                        "exact_snippets": "measurable disease, defined as at least one lesion that can be accurately measured in at least one dimension (longest diameter to be recorded) as ≥ 20 mm with conventional techniques or as ≥ 10 mm with spiral CT scan",
                        "criterion": "measurable disease",
                        "requirement": {
                            "requirement_type": "measurement",
                            "expected_value": {
                                "comparisons": [
                                    {
                                        "operator": ">=",
                                        "value": 20,
                                        "unit": "mm"
                                    }
                                ]
                            }
                        }
                    },
                    {
                        "exact_snippets": "measurable disease, defined as at least one lesion that can be accurately measured in at least one dimension (longest diameter to be recorded) as ≥ 20 mm with conventional techniques or as ≥ 10 mm with spiral CT scan",
                        "criterion": "measurable disease",
                        "requirement": {
                            "requirement_type": "measurement",
                            "expected_value": {
                                "comparisons": [
                                    {
                                        "operator": ">=",
                                        "value": 10,
                                        "unit": "mm"
                                    }
                                ]
                            }
                        }
                    }
                ]
            },
            "logical_structure": {
                "and_criteria": [
                    {
                        "and_criteria": [
                            {
                                "exact_snippets": "measurable disease, defined as at least one lesion that can be accurately measured in at least one dimension (longest diameter to be recorded) as ≥ 20 mm with conventional techniques or as ≥ 10 mm with spiral CT scan",
                                "criterion": "measurable disease",
                                "requirement": {
                                    "requirement_type": "definition",
                                    "expected_value": "at least one lesion that can be accurately measured in at least one dimension"
                                }
                            },
                            {
                                "or_criteria": [
                                    {
                                        "exact_snippets": "measurable disease, defined as at least one lesion that can be accurately measured in at least one dimension (longest diameter to be recorded) as ≥ 20 mm with conventional techniques or as ≥ 10 mm with spiral CT scan",
                                        "criterion": "measurable disease",
                                        "requirement": {
                                            "requirement_type": "measurement",
                                            "expected_value": {
                                                "comparisons": [
                                                    {
                                                        "operator": ">=",
                                                        "value": 20,
                                                        "unit": "mm"
                                                    }
                                                ]
                                            }
                                        }
                                    },
                                    {
                                        "exact_snippets": "measurable disease, defined as at least one lesion that can be accurately measured in at least one dimension (longest diameter to be recorded) as ≥ 20 mm with conventional techniques or as ≥ 10 mm with spiral CT scan",
                                        "criterion": "measurable disease",
                                        "requirement": {
                                            "requirement_type": "measurement",
                                            "expected_value": {
                                                "comparisons": [
                                                    {
                                                        "operator": ">=",
                                                        "value": 10,
                                                        "unit": "mm"
                                                    }
                                                ]
                                            }
                                        }
                                    }
                                ]
                            }
                        ]
                    }
                ]
            }
        },
        {
            "identified_line": {
                "line": "* Prior Therapy:",
                "criterions": [
                    {
                        "exact_snippets": "Prior Therapy",
                        "criterion": "prior therapy",
                        "requirement": {
                            "requirement_type": "presence",
                            "expected_value": true
                        }
                    }
                ]
            },
            "logical_structure": {
                "and_criteria": [
                    {
                        "exact_snippets": "Prior Therapy",
                        "criterion": "prior therapy",
                        "requirement": {
                            "requirement_type": "presence",
                            "expected_value": true
                        }
                    }
                ]
            }
        },
        {
            "identified_line": {
                "line": "* Chemotherapy: early stage breast cancer. Patients may have received prior adjuvant chemotherapy and/or hormonal therapy for early stage breast cancer, including cyclophosphamide-based chemotherapy regimens.",
                "criterions": [
                    {
                        "exact_snippets": "Patients may have received prior adjuvant chemotherapy",
                        "criterion": "prior adjuvant chemotherapy",
                        "requirement": {
                            "requirement_type": "presence",
                            "expected_value": true
                        }
                    },
                    {
                        "exact_snippets": "Patients may have received ... hormonal therapy for early stage breast cancer",
                        "criterion": "prior hormonal therapy",
                        "requirement": {
                            "requirement_type": "presence",
                            "expected_value": true
                        }
                    },
                    {
                        "exact_snippets": "including cyclophosphamide-based chemotherapy regimens",
                        "criterion": "cyclophosphamide-based chemotherapy regimens",
                        "requirement": {
                            "requirement_type": "inclusion",
                            "expected_value": true
                        }
                    }
                ]
            },
            "logical_structure": {
                "or_criteria": [
                    {
                        "and_criteria": [
                            {
                                "exact_snippets": "Patients may have received prior adjuvant chemotherapy",
                                "criterion": "prior adjuvant chemotherapy",
                                "requirement": {
                                    "requirement_type": "presence",
                                    "expected_value": true
                                }
                            },
                            {
                                "exact_snippets": "including cyclophosphamide-based chemotherapy regimens",
                                "criterion": "cyclophosphamide-based chemotherapy regimens",
                                "requirement": {
                                    "requirement_type": "inclusion",
                                    "expected_value": true
                                }
                            }
                        ]
                    },
                    {
                        "exact_snippets": "Patients may have received ... hormonal therapy for early stage breast cancer",
                        "criterion": "prior hormonal therapy",
                        "requirement": {
                            "requirement_type": "presence",
                            "expected_value": true
                        }
                    }
                ]
            }
        },
        {
            "identified_line": {
                "line": "* Chemotherapy: anthracyclines. Patients without prior anthraycline (in either the metastatic or adjuvant setting) exposure are eligible provided that they do not have visceral (parenchymal lung or liver) metastases. Patients without prior anthracycline-based therapy are expected to have \"low volume\" tumor burden, deemed appropriate for non-standard chemotherapy in the estimation of the treating clinician.",
                "criterions": [
                    {
                        "exact_snippets": "Patients without prior anthraycline (in either the metastatic or adjuvant setting) exposure",
                        "criterion": "prior anthracycline exposure",
                        "requirement": {
                            "requirement_type": "presence",
                            "expected_value": false
                        }
                    },
                    {
                        "exact_snippets": "they do not have visceral (parenchymal lung or liver) metastases",
                        "criterion": "visceral metastases",
                        "requirement": {
                            "requirement_type": "presence",
                            "expected_value": false
                        }
                    },
                    {
                        "exact_snippets": "Patients without prior anthracycline-based therapy are expected to have \"low volume\" tumor burden",
                        "criterion": "tumor burden",
                        "requirement": {
                            "requirement_type": "volume",
                            "expected_value": "low"
                        }
                    },
                    {
                        "exact_snippets": "deemed appropriate for non-standard chemotherapy in the estimation of the treating clinician",
                        "criterion": "appropriateness for non-standard chemotherapy",
                        "requirement": {
                            "requirement_type": "estimation",
                            "expected_value": "treating clinician"
                        }
                    }
                ]
            },
            "logical_structure": {
                "condition": {
                    "and_criteria": [
                        {
                            "exact_snippets": "Patients without prior anthraycline (in either the metastatic or adjuvant setting) exposure",
                            "criterion": "prior anthracycline exposure",
                            "requirement": {
                                "requirement_type": "presence",
                                "expected_value": false
                            }
                        },
                        {
                            "exact_snippets": "they do not have visceral (parenchymal lung or liver) metastases",
                            "criterion": "visceral metastases",
                            "requirement": {
                                "requirement_type": "presence",
                                "expected_value": false
                            }
                        }
                    ]
                },
                "then_criteria": {
                    "and_criteria": [
                        {
                            "exact_snippets": "Patients without prior anthracycline-based therapy are expected to have \"low volume\" tumor burden",
                            "criterion": "tumor burden",
                            "requirement": {
                                "requirement_type": "volume",
                                "expected_value": "low"
                            }
                        },
                        {
                            "exact_snippets": "deemed appropriate for non-standard chemotherapy in the estimation of the treating clinician",
                            "criterion": "appropriateness for non-standard chemotherapy",
                            "requirement": {
                                "requirement_type": "estimation",
                                "expected_value": "treating clinician"
                            }
                        }
                    ]
                },
                "else_criteria": null
            }
        },
        {
            "identified_line": {
                "line": "* Trastuzumab. Patients with HER2-positive breast tumors must have received prior trastuzumab therapy for advanced disease, or have had recurrence within 12 months of receiving (neo)adjuvant trastuzumab.",
                "criterions": [
                    {
                        "exact_snippets": "HER2-positive breast tumors",
                        "criterion": "HER2-positive breast tumors",
                        "requirement": {
                            "requirement_type": "presence",
                            "expected_value": true
                        }
                    },
                    {
                        "exact_snippets": "must have received prior trastuzumab therapy for advanced disease",
                        "criterion": "prior trastuzumab therapy for advanced disease",
                        "requirement": {
                            "requirement_type": "receipt",
                            "expected_value": true
                        }
                    },
                    {
                        "exact_snippets": "recurrence within 12 months of receiving (neo)adjuvant trastuzumab",
                        "criterion": "recurrence after (neo)adjuvant trastuzumab",
                        "requirement": {
                            "requirement_type": "time since treatment",
                            "expected_value": {
                                "operator": "<=",
                                "value": 12,
                                "unit": "months"
                            }
                        }
                    }
                ]
            },
            "logical_structure": {
                "and_criteria": [
                    {
                        "and_criteria": [
                            {
                                "exact_snippets": "HER2-positive breast tumors",
                                "criterion": "HER2-positive breast tumors",
                                "requirement": {
                                    "requirement_type": "presence",
                                    "expected_value": true
                                }
                            },
                            {
                                "or_criteria": [
                                    {
                                        "exact_snippets": "must have received prior trastuzumab therapy for advanced disease",
                                        "criterion": "prior trastuzumab therapy for advanced disease",
                                        "requirement": {
                                            "requirement_type": "receipt",
                                            "expected_value": true
                                        }
                                    },
                                    {
                                        "exact_snippets": "recurrence within 12 months of receiving (neo)adjuvant trastuzumab",
                                        "criterion": "recurrence after (neo)adjuvant trastuzumab",
                                        "requirement": {
                                            "requirement_type": "time since treatment",
                                            "expected_value": {
                                                "operator": "<=",
                                                "value": 12,
                                                "unit": "months"
                                            }
                                        }
                                    }
                                ]
                            }
                        ]
                    }
                ]
            }
        },
        {
            "identified_line": {
                "line": "* Radiation therapy. Patients may have received prior radiation therapy in either the metastatic or early stage settings. Radiation therapy may not be administered during the study. Lesions progressing after previous irradiation are measurable; lesions not progressing after previous irradiation are not measurable.",
                "criterions": [
                    {
                        "exact_snippets": "Patients may have received prior radiation therapy",
                        "criterion": "prior radiation therapy",
                        "requirement": {
                            "requirement_type": "presence",
                            "expected_value": true
                        }
                    },
                    {
                        "exact_snippets": "Radiation therapy may not be administered during the study",
                        "criterion": "radiation therapy during the study",
                        "requirement": {
                            "requirement_type": "administration",
                            "expected_value": false
                        }
                    },
                    {
                        "exact_snippets": "Lesions progressing after previous irradiation are measurable",
                        "criterion": "lesions progressing after previous irradiation",
                        "requirement": {
                            "requirement_type": "measurability",
                            "expected_value": true
                        }
                    },
                    {
                        "exact_snippets": "lesions not progressing after previous irradiation are not measurable",
                        "criterion": "lesions not progressing after previous irradiation",
                        "requirement": {
                            "requirement_type": "measurability",
                            "expected_value": false
                        }
                    }
                ]
            },
            "logical_structure": {
                "and_criteria": [
                    {
                        "and_criteria": [
                            {
                                "and_criteria": [
                                    {
                                        "exact_snippets": "Patients may have received prior radiation therapy",
                                        "criterion": "prior radiation therapy",
                                        "requirement": {
                                            "requirement_type": "presence",
                                            "expected_value": true
                                        }
                                    },
                                    {
                                        "exact_snippets": "Radiation therapy may not be administered during the study",
                                        "criterion": "radiation therapy during the study",
                                        "requirement": {
                                            "requirement_type": "administration",
                                            "expected_value": false
                                        }
                                    }
                                ]
                            },
                            {
                                "or_criteria": [
                                    {
                                        "exact_snippets": "Lesions progressing after previous irradiation are measurable",
                                        "criterion": "lesions progressing after previous irradiation",
                                        "requirement": {
                                            "requirement_type": "measurability",
                                            "expected_value": true
                                        }
                                    },
                                    {
                                        "exact_snippets": "lesions not progressing after previous irradiation are not measurable",
                                        "criterion": "lesions not progressing after previous irradiation",
                                        "requirement": {
                                            "requirement_type": "measurability",
                                            "expected_value": false
                                        }
                                    }
                                ]
                            }
                        ]
                    }
                ]
            }
        },
        {
            "identified_line": {
                "line": "* Hormonal therapy. Patients with estrogen- or progesterone-receptor positive disease must have received at least one prior hormonal therapy in the adjuvant and/or metastatic setting.",
                "criterions": [
                    {
                        "exact_snippets": "estrogen- or progesterone-receptor positive disease",
                        "criterion": "hormone receptor status",
                        "requirement": {
                            "requirement_type": "presence",
                            "expected_value": [
                                "estrogen-receptor positive",
                                "progesterone-receptor positive"
                            ]
                        }
                    },
                    {
                        "exact_snippets": "must have received at least one prior hormonal therapy",
                        "criterion": "prior hormonal therapy",
                        "requirement": {
                            "requirement_type": "quantity",
                            "expected_value": {
                                "operator": ">=",
                                "value": 1,
                                "unit": "therapy"
                            }
                        }
                    },
                    {
                        "exact_snippets": "in the adjuvant and/or metastatic setting",
                        "criterion": "treatment setting",
                        "requirement": {
                            "requirement_type": "presence",
                            "expected_value": [
                                "adjuvant",
                                "metastatic"
                            ]
                        }
                    }
                ]
            },
            "logical_structure": {
                "condition": {
                    "exact_snippets": "estrogen- or progesterone-receptor positive disease",
                    "criterion": "hormone receptor status",
                    "requirement": {
                        "requirement_type": "presence",
                        "expected_value": [
                            "estrogen-receptor positive",
                            "progesterone-receptor positive"
                        ]
                    }
                },
                "then_criteria": {
                    "and_criteria": [
                        {
                            "exact_snippets": "must have received at least one prior hormonal therapy",
                            "criterion": "prior hormonal therapy",
                            "requirement": {
                                "requirement_type": "quantity",
                                "expected_value": {
                                    "operator": ">=",
                                    "value": 1,
                                    "unit": "therapy"
                                }
                            }
                        },
                        {
                            "exact_snippets": "in the adjuvant and/or metastatic setting",
                            "criterion": "treatment setting",
                            "requirement": {
                                "requirement_type": "presence",
                                "expected_value": [
                                    "adjuvant",
                                    "metastatic"
                                ]
                            }
                        }
                    ]
                },
                "else_criteria": null
            }
        },
        {
            "identified_line": {
                "line": "--- Patients must discontinue chemotherapy and/or hormonal therapy prior to study participation.",
                "criterions": [
                    {
                        "exact_snippets": "discontinue chemotherapy",
                        "criterion": "chemotherapy",
                        "requirement": {
                            "requirement_type": "discontinuation",
                            "expected_value": true
                        }
                    },
                    {
                        "exact_snippets": "discontinue ... hormonal therapy",
                        "criterion": "hormonal therapy",
                        "requirement": {
                            "requirement_type": "discontinuation",
                            "expected_value": true
                        }
                    }
                ]
            },
            "logical_structure": {
                "or_criteria": [
                    {
                        "exact_snippets": "discontinue chemotherapy",
                        "criterion": "chemotherapy",
                        "requirement": {
                            "requirement_type": "discontinuation",
                            "expected_value": true
                        }
                    },
                    {
                        "exact_snippets": "discontinue ... hormonal therapy",
                        "criterion": "hormonal therapy",
                        "requirement": {
                            "requirement_type": "discontinuation",
                            "expected_value": true
                        }
                    }
                ]
            }
        },
        {
            "identified_line": {
                "line": "* Concurrent Therapy. Patients may receive concurrent bisphosphonate therapy and/or erythropoietin growth factor support while on study. Patients may not receive other experimental treatments while on study. Bisphosphonate therapy and/or erythropoietin growth factor support therapy may commence at any point on study.",
                "criterions": [
                    {
                        "exact_snippets": "Patients may receive concurrent bisphosphonate therapy",
                        "criterion": "bisphosphonate therapy",
                        "requirement": {
                            "requirement_type": "concurrency",
                            "expected_value": true
                        }
                    },
                    {
                        "exact_snippets": "Patients may receive concurrent ... erythropoietin growth factor support",
                        "criterion": "erythropoietin growth factor support",
                        "requirement": {
                            "requirement_type": "concurrency",
                            "expected_value": true
                        }
                    },
                    {
                        "exact_snippets": "Patients may not receive other experimental treatments while on study",
                        "criterion": "other experimental treatments",
                        "requirement": {
                            "requirement_type": "concurrency",
                            "expected_value": false
                        }
                    }
                ]
            },
            "logical_structure": {
                "and_criteria": [
                    {
                        "or_criteria": [
                            {
                                "exact_snippets": "Patients may receive concurrent bisphosphonate therapy",
                                "criterion": "bisphosphonate therapy",
                                "requirement": {
                                    "requirement_type": "concurrency",
                                    "expected_value": true
                                }
                            },
                            {
                                "exact_snippets": "Patients may receive concurrent ... erythropoietin growth factor support",
                                "criterion": "erythropoietin growth factor support",
                                "requirement": {
                                    "requirement_type": "concurrency",
                                    "expected_value": true
                                }
                            }
                        ]
                    },
                    {
                        "exact_snippets": "Patients may not receive other experimental treatments while on study",
                        "criterion": "other experimental treatments",
                        "requirement": {
                            "requirement_type": "concurrency",
                            "expected_value": false
                        }
                    }
                ]
            }
        },
        {
            "identified_line": {
                "line": "* Patients may not have received prior experimental angiogenesis inhibitors.",
                "criterions": [
                    {
                        "exact_snippets": "Patients may not have received prior experimental angiogenesis inhibitors.",
                        "criterion": "prior experimental angiogenesis inhibitors",
                        "requirement": {
                            "requirement_type": "presence",
                            "expected_value": false
                        }
                    }
                ]
            },
            "logical_structure": {
                "not_criteria": {
                    "exact_snippets": "Patients may not have received prior experimental angiogenesis inhibitors.",
                    "criterion": "prior experimental angiogenesis inhibitors",
                    "requirement": {
                        "requirement_type": "presence",
                        "expected_value": false
                    }
                }
            }
        },
        {
            "identified_line": {
                "line": "* Age ≥18 years.",
                "criterions": [
                    {
                        "exact_snippets": "Age ≥18 years.",
                        "criterion": "age",
                        "requirement": {
                            "requirement_type": "N/A",
                            "expected_value": {
                                "operator": ">=",
                                "value": 18,
                                "unit": "years"
                            }
                        }
                    }
                ]
            },
            "logical_structure": {
                "and_criteria": [
                    {
                        "exact_snippets": "Age ≥18 years.",
                        "criterion": "age",
                        "requirement": {
                            "requirement_type": "N/A",
                            "expected_value": {
                                "operator": ">=",
                                "value": 18,
                                "unit": "years"
                            }
                        }
                    }
                ]
            }
        },
        {
            "identified_line": {
                "line": "* Life expectancy greater than 6 months.",
                "criterions": [
                    {
                        "exact_snippets": "Life expectancy greater than 6 months.",
                        "criterion": "life expectancy",
                        "requirement": {
                            "requirement_type": "duration",
                            "expected_value": {
                                "operator": ">",
                                "value": 6,
                                "unit": "months"
                            }
                        }
                    }
                ]
            },
            "logical_structure": {
                "and_criteria": [
                    {
                        "exact_snippets": "Life expectancy greater than 6 months.",
                        "criterion": "life expectancy",
                        "requirement": {
                            "requirement_type": "duration",
                            "expected_value": {
                                "operator": ">",
                                "value": 6,
                                "unit": "months"
                            }
                        }
                    }
                ]
            }
        },
        {
            "identified_line": {
                "line": "* Absence of poorly controlled hypertension (as defined by the treating clinician), proteinuria, prior history of either deep venous or arterial thrombosis, bleeding diatheses (including hemoptysis).",
                "criterions": [
                    {
                        "exact_snippets": "Absence of poorly controlled hypertension",
                        "criterion": "poorly controlled hypertension",
                        "requirement": {
                            "requirement_type": "presence",
                            "expected_value": false
                        }
                    },
                    {
                        "exact_snippets": "Absence of ... proteinuria",
                        "criterion": "proteinuria",
                        "requirement": {
                            "requirement_type": "presence",
                            "expected_value": false
                        }
                    },
                    {
                        "exact_snippets": "Absence of ... prior history of either deep venous or arterial thrombosis",
                        "criterion": "prior history of deep venous thrombosis",
                        "requirement": {
                            "requirement_type": "presence",
                            "expected_value": false
                        }
                    },
                    {
                        "exact_snippets": "Absence of ... prior history of either deep venous or arterial thrombosis",
                        "criterion": "prior history of arterial thrombosis",
                        "requirement": {
                            "requirement_type": "presence",
                            "expected_value": false
                        }
                    },
                    {
                        "exact_snippets": "Absence of ... bleeding diatheses",
                        "criterion": "bleeding diatheses",
                        "requirement": {
                            "requirement_type": "presence",
                            "expected_value": false
                        }
                    },
                    {
                        "exact_snippets": "Absence of ... hemoptysis",
                        "criterion": "hemoptysis",
                        "requirement": {
                            "requirement_type": "presence",
                            "expected_value": false
                        }
                    }
                ]
            },
            "logical_structure": {
                "and_criteria": [
                    {
                        "and_criteria": [
                            {
                                "and_criteria": [
                                    {
                                        "and_criteria": [
                                            {
                                                "and_criteria": [
                                                    {
                                                        "exact_snippets": "Absence of poorly controlled hypertension",
                                                        "criterion": "poorly controlled hypertension",
                                                        "requirement": {
                                                            "requirement_type": "presence",
                                                            "expected_value": false
                                                        }
                                                    },
                                                    {
                                                        "exact_snippets": "Absence of ... proteinuria",
                                                        "criterion": "proteinuria",
                                                        "requirement": {
                                                            "requirement_type": "presence",
                                                            "expected_value": false
                                                        }
                                                    }
                                                ]
                                            },
                                            {
                                                "or_criteria": [
                                                    {
                                                        "exact_snippets": "Absence of ... prior history of either deep venous or arterial thrombosis",
                                                        "criterion": "prior history of deep venous thrombosis",
                                                        "requirement": {
                                                            "requirement_type": "presence",
                                                            "expected_value": false
                                                        }
                                                    },
                                                    {
                                                        "exact_snippets": "Absence of ... prior history of either deep venous or arterial thrombosis",
                                                        "criterion": "prior history of arterial thrombosis",
                                                        "requirement": {
                                                            "requirement_type": "presence",
                                                            "expected_value": false
                                                        }
                                                    }
                                                ]
                                            }
                                        ]
                                    },
                                    {
                                        "exact_snippets": "Absence of ... bleeding diatheses",
                                        "criterion": "bleeding diatheses",
                                        "requirement": {
                                            "requirement_type": "presence",
                                            "expected_value": false
                                        }
                                    }
                                ]
                            },
                            {
                                "exact_snippets": "Absence of ... hemoptysis",
                                "criterion": "hemoptysis",
                                "requirement": {
                                    "requirement_type": "presence",
                                    "expected_value": false
                                }
                            }
                        ]
                    }
                ]
            }
        },
        {
            "identified_line": {
                "line": "* Radiologic exclusion of brain metastases (because of concern for potential CNS bleeding with therapy). All patients must have a brain CT or MRI no more than 6 weeks prior to enrollment.",
                "criterions": [
                    {
                        "exact_snippets": "Radiologic exclusion of brain metastases",
                        "criterion": "brain metastases",
                        "requirement": {
                            "requirement_type": "presence",
                            "expected_value": false
                        }
                    },
                    {
                        "exact_snippets": "All patients must have a brain CT or MRI no more than 6 weeks prior to enrollment",
                        "criterion": "brain CT or MRI",
                        "requirement": {
                            "requirement_type": "timing",
                            "expected_value": {
                                "operator": "<=",
                                "value": 6,
                                "unit": "weeks"
                            }
                        }
                    }
                ]
            },
            "logical_structure": {
                "and_criteria": [
                    {
                        "exact_snippets": "Radiologic exclusion of brain metastases",
                        "criterion": "brain metastases",
                        "requirement": {
                            "requirement_type": "presence",
                            "expected_value": false
                        }
                    },
                    {
                        "exact_snippets": "All patients must have a brain CT or MRI no more than 6 weeks prior to enrollment",
                        "criterion": "brain CT or MRI",
                        "requirement": {
                            "requirement_type": "timing",
                            "expected_value": {
                                "operator": "<=",
                                "value": 6,
                                "unit": "weeks"
                            }
                        }
                    }
                ]
            }
        },
        {
            "identified_line": {
                "line": "* Left ventricular function ≥ 45% as assessed by echocardiogram or nuclear medicine gated study.",
                "criterions": [
                    {
                        "exact_snippets": "Left ventricular function ≥ 45%",
                        "criterion": "left ventricular function",
                        "requirement": {
                            "requirement_type": "functionality",
                            "expected_value": {
                                "operator": ">=",
                                "value": 45,
                                "unit": "%"
                            }
                        }
                    }
                ]
            },
            "logical_structure": {
                "or_criteria": [
                    {
                        "exact_snippets": "Left ventricular function ≥ 45%",
                        "criterion": "left ventricular function",
                        "requirement": {
                            "requirement_type": "functionality",
                            "expected_value": {
                                "operator": ">=",
                                "value": 45,
                                "unit": "%"
                            }
                        }
                    },
                    {
                        "exact_snippets": "Left ventricular function ≥ 45%",
                        "criterion": "left ventricular function",
                        "requirement": {
                            "requirement_type": "functionality",
                            "expected_value": {
                                "operator": ">=",
                                "value": 45,
                                "unit": "%"
                            }
                        }
                    }
                ]
            }
        },
        {
            "identified_line": {
                "line": "* Patients must have normal organ and marrow function as defined below. Labs should be completed within 4 weeks prior to registration.",
                "criterions": [
                    {
                        "exact_snippets": "normal organ and marrow function",
                        "criterion": "organ and marrow function",
                        "requirement": {
                            "requirement_type": "functionality",
                            "expected_value": "normal"
                        }
                    },
                    {
                        "exact_snippets": "Labs should be completed within 4 weeks prior to registration",
                        "criterion": "lab completion timeframe",
                        "requirement": {
                            "requirement_type": "timeframe",
                            "expected_value": {
                                "operator": "<=",
                                "value": 4,
                                "unit": "weeks"
                            }
                        }
                    }
                ]
            },
            "logical_structure": {
                "and_criteria": [
                    {
                        "exact_snippets": "normal organ and marrow function",
                        "criterion": "organ and marrow function",
                        "requirement": {
                            "requirement_type": "functionality",
                            "expected_value": "normal"
                        }
                    },
                    {
                        "exact_snippets": "Labs should be completed within 4 weeks prior to registration",
                        "criterion": "lab completion timeframe",
                        "requirement": {
                            "requirement_type": "timeframe",
                            "expected_value": {
                                "operator": "<=",
                                "value": 4,
                                "unit": "weeks"
                            }
                        }
                    }
                ]
            }
        },
        {
            "identified_line": {
                "line": "* absolute neutrophil count ≥1000/mm3",
                "criterions": [
                    {
                        "exact_snippets": "absolute neutrophil count ≥1000/mm3",
                        "criterion": "absolute neutrophil count",
                        "requirement": {
                            "requirement_type": "quantity",
                            "expected_value": {
                                "operator": ">=",
                                "value": 1000,
                                "unit": "mm3"
                            }
                        }
                    }
                ]
            },
            "logical_structure": {
                "and_criteria": [
                    {
                        "exact_snippets": "absolute neutrophil count ≥1000/mm3",
                        "criterion": "absolute neutrophil count",
                        "requirement": {
                            "requirement_type": "quantity",
                            "expected_value": {
                                "operator": ">=",
                                "value": 1000,
                                "unit": "mm3"
                            }
                        }
                    }
                ]
            }
        },
        {
            "identified_line": {
                "line": "* platelets ≥100,000/mm3",
                "criterions": [
                    {
                        "exact_snippets": "platelets ≥100,000/mm3",
                        "criterion": "platelet count",
                        "requirement": {
                            "requirement_type": "quantity",
                            "expected_value": {
                                "operator": ">=",
                                "value": 100000,
                                "unit": "mm3"
                            }
                        }
                    }
                ]
            },
            "logical_structure": {
                "and_criteria": [
                    {
                        "exact_snippets": "platelets ≥100,000/mm3",
                        "criterion": "platelet count",
                        "requirement": {
                            "requirement_type": "quantity",
                            "expected_value": {
                                "operator": ">=",
                                "value": 100000,
                                "unit": "mm3"
                            }
                        }
                    }
                ]
            }
        },
        {
            "identified_line": {
                "line": "* Alkaline phosphatase ≤ 5.0 x ULN",
                "criterions": [
                    {
                        "exact_snippets": "Alkaline phosphatase ≤ 5.0 x ULN",
                        "criterion": "alkaline phosphatase",
                        "requirement": {
                            "requirement_type": "level",
                            "expected_value": {
                                "operator": "<=",
                                "value": 5.0,
                                "unit": "x ULN"
                            }
                        }
                    }
                ]
            },
            "logical_structure": {
                "and_criteria": [
                    {
                        "exact_snippets": "Alkaline phosphatase ≤ 5.0 x ULN",
                        "criterion": "alkaline phosphatase",
                        "requirement": {
                            "requirement_type": "level",
                            "expected_value": {
                                "operator": "<=",
                                "value": 5.0,
                                "unit": "x ULN"
                            }
                        }
                    }
                ]
            }
        },
        {
            "identified_line": {
                "line": "* creatinine ≤ 2.0 mg/dl",
                "criterions": [
                    {
                        "exact_snippets": "creatinine ≤ 2.0 mg/dl",
                        "criterion": "creatinine",
                        "requirement": {
                            "requirement_type": "level",
                            "expected_value": {
                                "operator": "<=",
                                "value": 2.0,
                                "unit": "mg/dl"
                            }
                        }
                    }
                ]
            },
            "logical_structure": {
                "and_criteria": [
                    {
                        "exact_snippets": "creatinine ≤ 2.0 mg/dl",
                        "criterion": "creatinine",
                        "requirement": {
                            "requirement_type": "level",
                            "expected_value": {
                                "operator": "<=",
                                "value": 2.0,
                                "unit": "mg/dl"
                            }
                        }
                    }
                ]
            }
        },
        {
            "identified_line": {
                "line": "* 24 hr urine specimen < 500 mg protein/24 hr",
                "criterions": [
                    {
                        "exact_snippets": "24 hr urine specimen < 500 mg protein/24 hr",
                        "criterion": "urine protein level",
                        "requirement": {
                            "requirement_type": "quantity",
                            "expected_value": {
                                "operator": "<",
                                "value": 500,
                                "unit": "mg/24 hr"
                            }
                        }
                    }
                ]
            },
            "logical_structure": {
                "and_criteria": [
                    {
                        "exact_snippets": "24 hr urine specimen < 500 mg protein/24 hr",
                        "criterion": "urine protein level",
                        "requirement": {
                            "requirement_type": "quantity",
                            "expected_value": {
                                "operator": "<",
                                "value": 500,
                                "unit": "mg/24 hr"
                            }
                        }
                    }
                ]
            }
        },
        {
            "identified_line": {
                "line": "* Protein on urinalysis < 1+",
                "criterions": [
                    {
                        "exact_snippets": "Protein on urinalysis < 1+",
                        "criterion": "protein on urinalysis",
                        "requirement": {
                            "requirement_type": "quantity",
                            "expected_value": {
                                "operator": "<",
                                "value": 1,
                                "unit": "+"
                            }
                        }
                    }
                ]
            },
            "logical_structure": {
                "and_criteria": [
                    {
                        "exact_snippets": "Protein on urinalysis < 1+",
                        "criterion": "protein on urinalysis",
                        "requirement": {
                            "requirement_type": "quantity",
                            "expected_value": {
                                "operator": "<",
                                "value": 1,
                                "unit": "+"
                            }
                        }
                    }
                ]
            }
        },
        {
            "identified_line": {
                "line": "* PT, PTT ≤ institutional upper limit of normal (ULN)",
                "criterions": [
                    {
                        "exact_snippets": "PT, PTT ≤ institutional upper limit of normal (ULN)",
                        "criterion": "PT",
                        "requirement": {
                            "requirement_type": "value",
                            "expected_value": {
                                "operator": "<=",
                                "value": 1,
                                "unit": "ULN"
                            }
                        }
                    },
                    {
                        "exact_snippets": "PT, PTT ≤ institutional upper limit of normal (ULN)",
                        "criterion": "PTT",
                        "requirement": {
                            "requirement_type": "value",
                            "expected_value": {
                                "operator": "<=",
                                "value": 1,
                                "unit": "ULN"
                            }
                        }
                    }
                ]
            },
            "logical_structure": {
                "and_criteria": [
                    {
                        "exact_snippets": "PT, PTT ≤ institutional upper limit of normal (ULN)",
                        "criterion": "PT",
                        "requirement": {
                            "requirement_type": "value",
                            "expected_value": {
                                "operator": "<=",
                                "value": 1,
                                "unit": "ULN"
                            }
                        }
                    },
                    {
                        "exact_snippets": "PT, PTT ≤ institutional upper limit of normal (ULN)",
                        "criterion": "PTT",
                        "requirement": {
                            "requirement_type": "value",
                            "expected_value": {
                                "operator": "<=",
                                "value": 1,
                                "unit": "ULN"
                            }
                        }
                    }
                ]
            }
        },
        {
            "identified_line": {
                "line": "* Fertility/reproduction. Patients must be neither pregnant nor expect becoming pregnant or conceiving a child while on study. Women of childbearing potential must have a negative pregnancy test. The effects of bevacizumab, methotrexate, and cyclophosphamide on the developing fetus are unknown. For this reason, women of childbearing potential must agree to use adequate contraception prior to study entry and for the duration of study participation. Should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately.",
                "criterions": [
                    {
                        "exact_snippets": "Patients must be neither pregnant nor expect becoming pregnant or conceiving a child while on study.",
                        "criterion": "pregnancy status",
                        "requirement": {
                            "requirement_type": "status",
                            "expected_value": "not pregnant"
                        }
                    },
                    {
                        "exact_snippets": "Women of childbearing potential must have a negative pregnancy test.",
                        "criterion": "pregnancy test",
                        "requirement": {
                            "requirement_type": "result",
                            "expected_value": "negative"
                        }
                    },
                    {
                        "exact_snippets": "women of childbearing potential must agree to use adequate contraception prior to study entry and for the duration of study participation.",
                        "criterion": "contraception use",
                        "requirement": {
                            "requirement_type": "agreement",
                            "expected_value": true
                        }
                    }
                ]
            },
            "logical_structure": {
                "and_criteria": [
                    {
                        "and_criteria": [
                            {
                                "exact_snippets": "Patients must be neither pregnant nor expect becoming pregnant or conceiving a child while on study.",
                                "criterion": "pregnancy status",
                                "requirement": {
                                    "requirement_type": "status",
                                    "expected_value": "not pregnant"
                                }
                            },
                            {
                                "exact_snippets": "Women of childbearing potential must have a negative pregnancy test.",
                                "criterion": "pregnancy test",
                                "requirement": {
                                    "requirement_type": "result",
                                    "expected_value": "negative"
                                }
                            },
                            {
                                "exact_snippets": "women of childbearing potential must agree to use adequate contraception prior to study entry and for the duration of study participation.",
                                "criterion": "contraception use",
                                "requirement": {
                                    "requirement_type": "agreement",
                                    "expected_value": true
                                }
                            }
                        ]
                    }
                ]
            }
        },
        {
            "identified_line": {
                "line": "* Ability to understand and the willingness to sign a written informed consent document.",
                "criterions": [
                    {
                        "exact_snippets": "Ability to understand",
                        "criterion": "ability to understand",
                        "requirement": {
                            "requirement_type": "presence",
                            "expected_value": true
                        }
                    },
                    {
                        "exact_snippets": "willingness to sign a written informed consent document",
                        "criterion": "willingness to sign informed consent",
                        "requirement": {
                            "requirement_type": "presence",
                            "expected_value": true
                        }
                    }
                ]
            },
            "logical_structure": {
                "and_criteria": [
                    {
                        "exact_snippets": "Ability to understand",
                        "criterion": "ability to understand",
                        "requirement": {
                            "requirement_type": "presence",
                            "expected_value": true
                        }
                    },
                    {
                        "exact_snippets": "willingness to sign a written informed consent document",
                        "criterion": "willingness to sign informed consent",
                        "requirement": {
                            "requirement_type": "presence",
                            "expected_value": true
                        }
                    }
                ]
            }
        },
        {
            "identified_line": {
                "line": "* Patients with less than stage IV disease or lack measurable disease.",
                "criterions": [
                    {
                        "exact_snippets": "less than stage IV disease",
                        "criterion": "disease stage",
                        "requirement": {
                            "requirement_type": "severity",
                            "expected_value": {
                                "operator": "<",
                                "value": 4,
                                "unit": "stage"
                            }
                        }
                    },
                    {
                        "exact_snippets": "lack measurable disease",
                        "criterion": "measurable disease",
                        "requirement": {
                            "requirement_type": "presence",
                            "expected_value": false
                        }
                    }
                ]
            },
            "logical_structure": {
                "or_criteria": [
                    {
                        "and_criteria": [
                            {
                                "exact_snippets": "less than stage IV disease",
                                "criterion": "disease stage",
                                "requirement": {
                                    "requirement_type": "severity",
                                    "expected_value": {
                                        "operator": "<",
                                        "value": 4,
                                        "unit": "stage"
                                    }
                                }
                            }
                        ]
                    },
                    {
                        "and_criteria": [
                            {
                                "exact_snippets": "lack measurable disease",
                                "criterion": "measurable disease",
                                "requirement": {
                                    "requirement_type": "presence",
                                    "expected_value": false
                                }
                            }
                        ]
                    }
                ]
            }
        },
        {
            "identified_line": {
                "line": "* Prior therapy that included any of the following:",
                "criterions": [
                    {
                        "exact_snippets": "Prior therapy that included any of the following",
                        "criterion": "prior therapy",
                        "requirement": {
                            "requirement_type": "inclusion",
                            "expected_value": true
                        }
                    }
                ]
            },
            "logical_structure": {
                "and_criteria": [
                    {
                        "exact_snippets": "Prior therapy that included any of the following",
                        "criterion": "prior therapy",
                        "requirement": {
                            "requirement_type": "inclusion",
                            "expected_value": true
                        }
                    }
                ]
            }
        },
        {
            "identified_line": {
                "line": "* Chemotherapy for metastatic breast cancer. Patients who have received ≥ 2 prior regimens for metastatic breast cancer; or who have received prior oral cyclophosphamide- or methotrexate-based therapy for metastatic disease.",
                "criterions": [
                    {
                        "exact_snippets": "Chemotherapy for metastatic breast cancer.",
                        "criterion": "chemotherapy",
                        "requirement": {
                            "requirement_type": "indication",
                            "expected_value": "metastatic breast cancer"
                        }
                    },
                    {
                        "exact_snippets": "Patients who have received ≥ 2 prior regimens for metastatic breast cancer",
                        "criterion": "prior regimens for metastatic breast cancer",
                        "requirement": {
                            "requirement_type": "quantity",
                            "expected_value": {
                                "operator": ">=",
                                "value": 2,
                                "unit": "regimens"
                            }
                        }
                    },
                    {
                        "exact_snippets": "who have received prior oral cyclophosphamide- or methotrexate-based therapy for metastatic disease",
                        "criterion": "prior oral cyclophosphamide- or methotrexate-based therapy",
                        "requirement": {
                            "requirement_type": "indication",
                            "expected_value": "metastatic disease"
                        }
                    }
                ]
            },
            "logical_structure": {
                "or_criteria": [
                    {
                        "and_criteria": [
                            {
                                "exact_snippets": "Chemotherapy for metastatic breast cancer.",
                                "criterion": "chemotherapy",
                                "requirement": {
                                    "requirement_type": "indication",
                                    "expected_value": "metastatic breast cancer"
                                }
                            },
                            {
                                "exact_snippets": "Patients who have received ≥ 2 prior regimens for metastatic breast cancer",
                                "criterion": "prior regimens for metastatic breast cancer",
                                "requirement": {
                                    "requirement_type": "quantity",
                                    "expected_value": {
                                        "operator": ">=",
                                        "value": 2,
                                        "unit": "regimens"
                                    }
                                }
                            }
                        ]
                    },
                    {
                        "and_criteria": [
                            {
                                "exact_snippets": "Chemotherapy for metastatic breast cancer.",
                                "criterion": "chemotherapy",
                                "requirement": {
                                    "requirement_type": "indication",
                                    "expected_value": "metastatic breast cancer"
                                }
                            },
                            {
                                "exact_snippets": "who have received prior oral cyclophosphamide- or methotrexate-based therapy for metastatic disease",
                                "criterion": "prior oral cyclophosphamide- or methotrexate-based therapy",
                                "requirement": {
                                    "requirement_type": "indication",
                                    "expected_value": "metastatic disease"
                                }
                            }
                        ]
                    }
                ]
            }
        },
        {
            "identified_line": {
                "line": "* Patients who have not recovered from reversible adverse events due to prior treatments.",
                "criterions": [
                    {
                        "exact_snippets": "Patients who have not recovered from reversible adverse events due to prior treatments",
                        "criterion": "recovery from reversible adverse events",
                        "requirement": {
                            "requirement_type": "status",
                            "expected_value": true
                        }
                    }
                ]
            },
            "logical_structure": {
                "and_criteria": [
                    {
                        "exact_snippets": "Patients who have not recovered from reversible adverse events due to prior treatments",
                        "criterion": "recovery from reversible adverse events",
                        "requirement": {
                            "requirement_type": "status",
                            "expected_value": true
                        }
                    }
                ]
            }
        },
        {
            "identified_line": {
                "line": "* Patients still on hormonal therapy - including LHRH agonist therapy.",
                "criterions": [
                    {
                        "exact_snippets": "Patients still on hormonal therapy",
                        "criterion": "hormonal therapy",
                        "requirement": {
                            "requirement_type": "presence",
                            "expected_value": true
                        }
                    },
                    {
                        "exact_snippets": "including LHRH agonist therapy",
                        "criterion": "LHRH agonist therapy",
                        "requirement": {
                            "requirement_type": "presence",
                            "expected_value": true
                        }
                    }
                ]
            },
            "logical_structure": {
                "or_criteria": [
                    {
                        "exact_snippets": "Patients still on hormonal therapy",
                        "criterion": "hormonal therapy",
                        "requirement": {
                            "requirement_type": "presence",
                            "expected_value": true
                        }
                    },
                    {
                        "exact_snippets": "including LHRH agonist therapy",
                        "criterion": "LHRH agonist therapy",
                        "requirement": {
                            "requirement_type": "presence",
                            "expected_value": true
                        }
                    }
                ]
            }
        },
        {
            "identified_line": {
                "line": "* Current use of anticoagulants or chronic aspirin therapy (> 325 mg/day) - excluding low-dose warfarin used for venous access patency (doses of 1 to 2 mg/d.)",
                "criterions": [
                    {
                        "exact_snippets": "Current use of anticoagulants",
                        "criterion": "anticoagulant use",
                        "requirement": {
                            "requirement_type": "presence",
                            "expected_value": true
                        }
                    },
                    {
                        "exact_snippets": "chronic aspirin therapy (> 325 mg/day)",
                        "criterion": "aspirin therapy",
                        "requirement": {
                            "requirement_type": "dosage",
                            "expected_value": {
                                "operator": ">",
                                "value": 325,
                                "unit": "mg/day"
                            }
                        }
                    },
                    {
                        "exact_snippets": "excluding low-dose warfarin used for venous access patency (doses of 1 to 2 mg/d.)",
                        "criterion": "low-dose warfarin use",
                        "requirement": {
                            "requirement_type": "dosage",
                            "expected_value": {
                                "comparisons": [
                                    {
                                        "operator": ">=",
                                        "value": 1,
                                        "unit": "mg/d"
                                    },
                                    {
                                        "operator": "<=",
                                        "value": 2,
                                        "unit": "mg/d"
                                    }
                                ]
                            }
                        }
                    }
                ]
            },
            "logical_structure": {
                "or_criteria": [
                    {
                        "and_criteria": [
                            {
                                "exact_snippets": "Current use of anticoagulants",
                                "criterion": "anticoagulant use",
                                "requirement": {
                                    "requirement_type": "presence",
                                    "expected_value": true
                                }
                            },
                            {
                                "not_criteria": {
                                    "exact_snippets": "excluding low-dose warfarin used for venous access patency (doses of 1 to 2 mg/d.)",
                                    "criterion": "low-dose warfarin use",
                                    "requirement": {
                                        "requirement_type": "dosage",
                                        "expected_value": {
                                            "comparisons": [
                                                {
                                                    "operator": ">=",
                                                    "value": 1,
                                                    "unit": "mg/d"
                                                },
                                                {
                                                    "operator": "<=",
                                                    "value": 2,
                                                    "unit": "mg/d"
                                                }
                                            ]
                                        }
                                    }
                                }
                            }
                        ]
                    },
                    {
                        "exact_snippets": "chronic aspirin therapy (> 325 mg/day)",
                        "criterion": "aspirin therapy",
                        "requirement": {
                            "requirement_type": "dosage",
                            "expected_value": {
                                "operator": ">",
                                "value": 325,
                                "unit": "mg/day"
                            }
                        }
                    }
                ]
            }
        },
        {
            "identified_line": {
                "line": "* History of grade 3 or 4 allergic reactions attributed to compounds of similar chemical or biologic composition to cyclophosphamide (such as other alkylating agents) or methotrexate (such as other antimetabolites.)",
                "criterions": [
                    {
                        "exact_snippets": "History of grade 3 or 4 allergic reactions attributed to compounds of similar chemical or biologic composition to cyclophosphamide",
                        "criterion": "allergic reactions to cyclophosphamide",
                        "requirement": {
                            "requirement_type": "severity",
                            "expected_value": [
                                "grade 3",
                                "grade 4"
                            ]
                        }
                    },
                    {
                        "exact_snippets": "History of grade 3 or 4 allergic reactions attributed to compounds of similar chemical or biologic composition to cyclophosphamide",
                        "criterion": "allergic reactions to cyclophosphamide",
                        "requirement": {
                            "requirement_type": "history",
                            "expected_value": true
                        }
                    },
                    {
                        "exact_snippets": "History of grade 3 or 4 allergic reactions attributed to compounds of similar chemical or biologic composition to ... methotrexate",
                        "criterion": "allergic reactions to methotrexate",
                        "requirement": {
                            "requirement_type": "severity",
                            "expected_value": [
                                "grade 3",
                                "grade 4"
                            ]
                        }
                    },
                    {
                        "exact_snippets": "History of grade 3 or 4 allergic reactions attributed to compounds of similar chemical or biologic composition to ... methotrexate",
                        "criterion": "allergic reactions to methotrexate",
                        "requirement": {
                            "requirement_type": "history",
                            "expected_value": true
                        }
                    }
                ]
            },
            "logical_structure": {
                "or_criteria": [
                    {
                        "and_criteria": [
                            {
                                "and_criteria": [
                                    {
                                        "exact_snippets": "History of grade 3 or 4 allergic reactions attributed to compounds of similar chemical or biologic composition to cyclophosphamide",
                                        "criterion": "allergic reactions to cyclophosphamide",
                                        "requirement": {
                                            "requirement_type": "severity",
                                            "expected_value": [
                                                "grade 3",
                                                "grade 4"
                                            ]
                                        }
                                    },
                                    {
                                        "exact_snippets": "History of grade 3 or 4 allergic reactions attributed to compounds of similar chemical or biologic composition to cyclophosphamide",
                                        "criterion": "allergic reactions to cyclophosphamide",
                                        "requirement": {
                                            "requirement_type": "history",
                                            "expected_value": true
                                        }
                                    }
                                ]
                            },
                            {
                                "and_criteria": [
                                    {
                                        "exact_snippets": "History of grade 3 or 4 allergic reactions attributed to compounds of similar chemical or biologic composition to ... methotrexate",
                                        "criterion": "allergic reactions to methotrexate",
                                        "requirement": {
                                            "requirement_type": "severity",
                                            "expected_value": [
                                                "grade 3",
                                                "grade 4"
                                            ]
                                        }
                                    },
                                    {
                                        "exact_snippets": "History of grade 3 or 4 allergic reactions attributed to compounds of similar chemical or biologic composition to ... methotrexate",
                                        "criterion": "allergic reactions to methotrexate",
                                        "requirement": {
                                            "requirement_type": "history",
                                            "expected_value": true
                                        }
                                    }
                                ]
                            }
                        ]
                    }
                ]
            }
        },
        {
            "identified_line": {
                "line": "Healthy volunteers allowed",
                "criterions": [
                    {
                        "exact_snippets": "Healthy volunteers allowed",
                        "criterion": "volunteer health status",
                        "requirement": {
                            "requirement_type": "status",
                            "expected_value": "healthy"
                        }
                    }
                ]
            },
            "logical_structure": {
                "and_criteria": [
                    {
                        "exact_snippets": "Healthy volunteers allowed",
                        "criterion": "volunteer health status",
                        "requirement": {
                            "requirement_type": "status",
                            "expected_value": "healthy"
                        }
                    }
                ]
            }
        },
        {
            "identified_line": {
                "line": "Must be FEMALE",
                "criterions": [
                    {
                        "exact_snippets": "Must be FEMALE",
                        "criterion": "gender",
                        "requirement": {
                            "requirement_type": "N/A",
                            "expected_value": "female"
                        }
                    }
                ]
            },
            "logical_structure": {
                "and_criteria": [
                    {
                        "exact_snippets": "Must be FEMALE",
                        "criterion": "gender",
                        "requirement": {
                            "requirement_type": "N/A",
                            "expected_value": "female"
                        }
                    }
                ]
            }
        },
        {
            "identified_line": {
                "line": "Must have minimum age of 18 Years",
                "criterions": [
                    {
                        "exact_snippets": "minimum age of 18 Years",
                        "criterion": "age",
                        "requirement": {
                            "requirement_type": "minimum",
                            "expected_value": {
                                "operator": ">=",
                                "value": 18,
                                "unit": "Years"
                            }
                        }
                    }
                ]
            },
            "logical_structure": {
                "and_criteria": [
                    {
                        "exact_snippets": "minimum age of 18 Years",
                        "criterion": "age",
                        "requirement": {
                            "requirement_type": "minimum",
                            "expected_value": {
                                "operator": ">=",
                                "value": 18,
                                "unit": "Years"
                            }
                        }
                    }
                ]
            }
        },
        {
            "identified_line": {
                "line": "* Chemotherapy: metastatic breast cancer. Patients may have received 0-1 prior regimens for metastatic breast cancer. No prior oral cyclophosphamideor methotrexate-based therapy for metastatic disease is permitted.",
                "criterions": [
                    {
                        "exact_snippets": "Chemotherapy: metastatic breast cancer.",
                        "criterion": "chemotherapy",
                        "requirement": {
                            "requirement_type": "indication",
                            "expected_value": "metastatic breast cancer"
                        }
                    },
                    {
                        "exact_snippets": "Patients may have received 0-1 prior regimens for metastatic breast cancer.",
                        "criterion": "prior regimens for metastatic breast cancer",
                        "requirement": {
                            "requirement_type": "quantity",
                            "expected_value": {
                                "comparisons": [
                                    {
                                        "operator": ">=",
                                        "value": 0,
                                        "unit": "N/A"
                                    },
                                    {
                                        "operator": "<=",
                                        "value": 1,
                                        "unit": "N/A"
                                    }
                                ]
                            }
                        }
                    },
                    {
                        "exact_snippets": "No prior oral cyclophosphamide or methotrexate-based therapy for metastatic disease is permitted.",
                        "criterion": "prior oral cyclophosphamide or methotrexate-based therapy",
                        "requirement": {
                            "requirement_type": "presence",
                            "expected_value": false
                        }
                    }
                ]
            },
            "logical_structure": {
                "and_criteria": [
                    {
                        "and_criteria": [
                            {
                                "exact_snippets": "Chemotherapy: metastatic breast cancer.",
                                "criterion": "chemotherapy",
                                "requirement": {
                                    "requirement_type": "indication",
                                    "expected_value": "metastatic breast cancer"
                                }
                            },
                            {
                                "exact_snippets": "Patients may have received 0-1 prior regimens for metastatic breast cancer.",
                                "criterion": "prior regimens for metastatic breast cancer",
                                "requirement": {
                                    "requirement_type": "quantity",
                                    "expected_value": {
                                        "comparisons": [
                                            {
                                                "operator": ">=",
                                                "value": 0,
                                                "unit": "N/A"
                                            },
                                            {
                                                "operator": "<=",
                                                "value": 1,
                                                "unit": "N/A"
                                            }
                                        ]
                                    }
                                }
                            }
                        ]
                    },
                    {
                        "exact_snippets": "No prior oral cyclophosphamide or methotrexate-based therapy for metastatic disease is permitted.",
                        "criterion": "prior oral cyclophosphamide or methotrexate-based therapy",
                        "requirement": {
                            "requirement_type": "presence",
                            "expected_value": false
                        }
                    }
                ]
            }
        },
        {
            "identified_line": {
                "line": "--- or",
                "criterions": []
            },
            "logical_structure": {
                "or_criteria": []
            }
        },
        {
            "identified_line": {
                "line": "* Exclusion Criteria",
                "criterions": []
            },
            "logical_structure": {
                "and_criteria": []
            }
        }
    ],
    "exclusion_lines": [],
    "miscellaneous_lines": [],
    "failed_inclusion": [
        {
            "identified_line": {
                "line": "* Patients must have histologically or cytologically confirmed invasive breast cancer, with stage IV disease. Patients without pathologic or cytologic confirmation of metastatic disease should have unequivocal evidence of metastasis by physical exam or radiologic study.",
                "criterions": [
                    {
                        "exact_snippets": "histologically or cytologically confirmed invasive breast cancer",
                        "criterion": "invasive breast cancer",
                        "requirement": {
                            "requirement_type": "confirmation",
                            "expected_value": [
                                "histologically",
                                "cytologically"
                            ]
                        }
                    },
                    {
                        "exact_snippets": "stage IV disease",
                        "criterion": "breast cancer stage",
                        "requirement": {
                            "requirement_type": "stage",
                            "expected_value": "IV"
                        }
                    },
                    {
                        "exact_snippets": "pathologic or cytologic confirmation of metastatic disease",
                        "criterion": "metastatic disease",
                        "requirement": {
                            "requirement_type": "confirmation",
                            "expected_value": [
                                "pathologic",
                                "cytologic"
                            ]
                        }
                    },
                    {
                        "exact_snippets": "unequivocal evidence of metastasis by physical exam or radiologic study",
                        "criterion": "metastasis evidence",
                        "requirement": {
                            "requirement_type": "evidence",
                            "expected_value": [
                                "physical exam",
                                "radiologic study"
                            ]
                        }
                    }
                ]
            },
            "logical_structure": {
                "exact_snippets": "failed",
                "criterion": "failed",
                "requirement": {
                    "requirement_type": "failed",
                    "expected_value": "failed"
                }
            }
        },
        {
            "identified_line": {
                "line": "* ECOG performance status ≤ 1 (Karnofsky ≥70%; see Appendix B).",
                "criterions": [
                    {
                        "exact_snippets": "ECOG performance status ≤ 1",
                        "criterion": "ECOG performance status",
                        "requirement": {
                            "requirement_type": "value",
                            "expected_value": {
                                "operator": "<=",
                                "value": 1,
                                "unit": "N/A"
                            }
                        }
                    },
                    {
                        "exact_snippets": "Karnofsky ≥70%",
                        "criterion": "Karnofsky performance status",
                        "requirement": {
                            "requirement_type": "value",
                            "expected_value": {
                                "operator": ">=",
                                "value": 70,
                                "unit": "%"
                            }
                        }
                    }
                ]
            },
            "logical_structure": {
                "and_criteria": [
                    {
                        "exact_snippets": "ECOG performance status \u0010 1",
                        "criterion": "ECOG performance status",
                        "requirement": {
                            "requirement_type": "value",
                            "expected_value": {
                                "operator": "<=",
                                "value": 1,
                                "unit": "N/A"
                            }
                        }
                    },
                    {
                        "exact_snippets": "Karnofsky \u0010%",
                        "criterion": "Karnofsky performance status",
                        "requirement": {
                            "requirement_type": "value",
                            "expected_value": {
                                "operator": ">=",
                                "value": 70,
                                "unit": "%"
                            }
                        }
                    }
                ]
            }
        },
        {
            "identified_line": {
                "line": "* total bilirubin ≤ 2 x institutional upper limit of normal (ULN)",
                "criterions": [
                    {
                        "exact_snippets": "total bilirubin ≤ 2 x institutional upper limit of normal (ULN)",
                        "criterion": "total bilirubin",
                        "requirement": {
                            "requirement_type": "level",
                            "expected_value": {
                                "operator": "<=",
                                "value": 2,
                                "unit": "x institutional upper limit of normal (ULN)"
                            }
                        }
                    }
                ]
            },
            "logical_structure": {
                "and_criteria": [
                    {
                        "exact_snippets": "total bilirubin \u0010 2 x institutional upper limit of normal (ULN)",
                        "criterion": "total bilirubin",
                        "requirement": {
                            "requirement_type": "level",
                            "expected_value": {
                                "operator": "<=",
                                "value": 2,
                                "unit": "x institutional upper limit of normal (ULN)"
                            }
                        }
                    }
                ]
            }
        },
        {
            "identified_line": {
                "line": "* AST(SGOT)/ALT(SGPT) ≤ 4.0 x ULN",
                "criterions": [
                    {
                        "exact_snippets": "AST(SGOT)/ALT(SGPT) ≤ 4.0 x ULN",
                        "criterion": "AST(SGOT)/ALT(SGPT)",
                        "requirement": {
                            "requirement_type": "level",
                            "expected_value": {
                                "operator": "<=",
                                "value": 4.0,
                                "unit": "x ULN"
                            }
                        }
                    }
                ]
            },
            "logical_structure": {
                "and_criteria": [
                    {
                        "exact_snippets": "AST(SGOT)/ALT(SGPT) \u00104.0 x ULN",
                        "criterion": "AST(SGOT)/ALT(SGPT)",
                        "requirement": {
                            "requirement_type": "level",
                            "expected_value": {
                                "operator": "<=",
                                "value": 4.0,
                                "unit": "x ULN"
                            }
                        }
                    }
                ]
            }
        },
        {
            "identified_line": {
                "line": "* Patients with recent (within 6 months) arterial thromboembolic events, including transient ischemic attack (TIA), cerebrovascular accident (CVA), unstable angina, or myocardial infarction (MI). Patients with clinically significant peripheral artery disease should also be excluded.",
                "criterions": [
                    {
                        "exact_snippets": "recent (within 6 months) arterial thromboembolic events, including transient ischemic attack (TIA), cerebrovascular accident (CVA), unstable angina, or myocardial infarction (MI)",
                        "criterion": "arterial thromboembolic events",
                        "requirement": {
                            "requirement_type": "recency",
                            "expected_value": {
                                "operator": "<=",
                                "value": 6,
                                "unit": "months"
                            }
                        }
                    },
                    {
                        "exact_snippets": "recent (within 6 months) arterial thromboembolic events, including transient ischemic attack (TIA), cerebrovascular accident (CVA), unstable angina, or myocardial infarction (MI)",
                        "criterion": "arterial thromboembolic events",
                        "requirement": {
                            "requirement_type": "types",
                            "expected_value": [
                                "transient ischemic attack (TIA)",
                                "cerebrovascular accident (CVA)",
                                "unstable angina",
                                "myocardial infarction (MI)"
                            ]
                        }
                    },
                    {
                        "exact_snippets": "clinically significant peripheral artery disease",
                        "criterion": "peripheral artery disease",
                        "requirement": {
                            "requirement_type": "clinical significance",
                            "expected_value": true
                        }
                    }
                ]
            },
            "logical_structure": {
                "exact_snippets": "failed",
                "criterion": "failed",
                "requirement": {
                    "requirement_type": "failed",
                    "expected_value": "failed"
                }
            }
        },
        {
            "identified_line": {
                "line": "* Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.",
                "criterions": [
                    {
                        "exact_snippets": "Uncontrolled intercurrent illness ... ongoing or active infection",
                        "criterion": "intercurrent illness",
                        "requirement": {
                            "requirement_type": "control",
                            "expected_value": false
                        }
                    },
                    {
                        "exact_snippets": "Uncontrolled intercurrent illness including, but not limited to, ... ongoing or active infection",
                        "criterion": "infection",
                        "requirement": {
                            "requirement_type": "status",
                            "expected_value": "ongoing or active"
                        }
                    },
                    {
                        "exact_snippets": "Uncontrolled intercurrent illness including, but not limited to, ... symptomatic congestive heart failure",
                        "criterion": "congestive heart failure",
                        "requirement": {
                            "requirement_type": "symptomatic",
                            "expected_value": true
                        }
                    },
                    {
                        "exact_snippets": "Uncontrolled intercurrent illness including, but not limited to, ... unstable angina pectoris",
                        "criterion": "angina pectoris",
                        "requirement": {
                            "requirement_type": "stability",
                            "expected_value": false
                        }
                    },
                    {
                        "exact_snippets": "Uncontrolled intercurrent illness including, but not limited to, ... cardiac arrhythmia",
                        "criterion": "cardiac arrhythmia",
                        "requirement": {
                            "requirement_type": "presence",
                            "expected_value": true
                        }
                    },
                    {
                        "exact_snippets": "Uncontrolled intercurrent illness including, but not limited to, ... psychiatric illness/social situations that would limit compliance with study requirements",
                        "criterion": "psychiatric illness/social situations",
                        "requirement": {
                            "requirement_type": "impact on compliance",
                            "expected_value": true
                        }
                    }
                ]
            },
            "logical_structure": {
                "exact_snippets": "failed",
                "criterion": "failed",
                "requirement": {
                    "requirement_type": "failed",
                    "expected_value": "failed"
                }
            }
        },
        {
            "identified_line": {
                "line": "* Patients with visceral metastases unless they have previously been treated with an anthraycline-based chemotherapy regimen in either the metastatic or adjuvant setting.",
                "criterions": [
                    {
                        "exact_snippets": "Patients with visceral metastases",
                        "criterion": "visceral metastases",
                        "requirement": {
                            "requirement_type": "presence",
                            "expected_value": true
                        }
                    },
                    {
                        "exact_snippets": "unless they have previously been treated with an anthraycline-based chemotherapy regimen",
                        "criterion": "anthraycline-based chemotherapy regimen",
                        "requirement": {
                            "requirement_type": "treatment history",
                            "expected_value": true
                        }
                    },
                    {
                        "exact_snippets": "in either the metastatic or adjuvant setting",
                        "criterion": "treatment setting",
                        "requirement": {
                            "requirement_type": "setting",
                            "expected_value": [
                                "metastatic",
                                "adjuvant"
                            ]
                        }
                    }
                ]
            },
            "logical_structure": {
                "exact_snippets": "failed",
                "criterion": "failed",
                "requirement": {
                    "requirement_type": "failed",
                    "expected_value": "failed"
                }
            }
        },
        {
            "identified_line": {
                "line": "* Patients may not receive other investigational agents while on study.",
                "criterions": [
                    {
                        "exact_snippets": "Patients may not receive other investigational agents",
                        "criterion": "use of investigational agents",
                        "requirement": {
                            "requirement_type": "presence",
                            "expected_value": false
                        }
                    }
                ]
            },
            "logical_structure": {
                "exact_snippets": "failed",
                "criterion": "failed",
                "requirement": {
                    "requirement_type": "failed",
                    "expected_value": "failed"
                }
            }
        },
        {
            "identified_line": {
                "line": "* Non-healing wounds or major surgical procedures other than for venous access device or diagnostic study are not permitted within 28 days prior to enrollment (because of rare potential risk of delayed wound healing associated with bevacizumab).",
                "criterions": [
                    {
                        "exact_snippets": "Non-healing wounds",
                        "criterion": "non-healing wounds",
                        "requirement": {
                            "requirement_type": "presence",
                            "expected_value": false
                        }
                    },
                    {
                        "exact_snippets": "major surgical procedures other than for venous access device or diagnostic study are not permitted within 28 days prior to enrollment",
                        "criterion": "major surgical procedures",
                        "requirement": {
                            "requirement_type": "type",
                            "expected_value": "other than for venous access device or diagnostic study"
                        }
                    },
                    {
                        "exact_snippets": "major surgical procedures other than for venous access device or diagnostic study are not permitted within 28 days prior to enrollment",
                        "criterion": "major surgical procedures",
                        "requirement": {
                            "requirement_type": "time frame",
                            "expected_value": {
                                "operator": "<",
                                "value": 28,
                                "unit": "days"
                            }
                        }
                    }
                ]
            },
            "logical_structure": {
                "exact_snippets": "failed",
                "criterion": "failed",
                "requirement": {
                    "requirement_type": "failed",
                    "expected_value": "failed"
                }
            }
        },
        {
            "identified_line": {
                "line": "* Patients with large or rapidly accumulating pleural or abdominal effusions (based on clinician's judgment) because of the theoretical risk for methotrexate accumulation and related toxicity. --- If a patient's condition is deteriorating, laboratory evaluations should be repeated ≤ 48 hours prior to initiation of therapy.",
                "criterions": [
                    {
                        "exact_snippets": "large or rapidly accumulating pleural or abdominal effusions",
                        "criterion": "pleural or abdominal effusions",
                        "requirement": {
                            "requirement_type": "severity",
                            "expected_value": [
                                "large",
                                "rapidly accumulating"
                            ]
                        }
                    },
                    {
                        "exact_snippets": "If a patient's condition is deteriorating",
                        "criterion": "patient's condition",
                        "requirement": {
                            "requirement_type": "status",
                            "expected_value": "deteriorating"
                        }
                    },
                    {
                        "exact_snippets": "laboratory evaluations should be repeated ≤ 48 hours prior to initiation of therapy",
                        "criterion": "laboratory evaluations",
                        "requirement": {
                            "requirement_type": "timing",
                            "expected_value": {
                                "operator": "<=",
                                "value": 48,
                                "unit": "hours"
                            }
                        }
                    }
                ]
            },
            "logical_structure": {
                "exact_snippets": "failed",
                "criterion": "failed",
                "requirement": {
                    "requirement_type": "failed",
                    "expected_value": "failed"
                }
            }
        }
    ],
    "failed_exclusion": [],
    "failed_miscellaneous": []
}