Test Scenarios - Temodal®

Scenario 1: No Specific Risks Identified (Safe Level)

Patient Description:

Male, 45 years old.

Diagnosis: Newly diagnosed glioblastoma multiforme (GBM), standard therapy planned.

Medical Condition: General condition satisfactory. No significant comorbidities. Non-smoker, moderate alcohol use. No known drug allergies. HBV status negative. Liver and kidney function normal (LFTs within reference range, CLcr > 90 mL/min). Baseline blood counts normal (ANC > 1.5 x 10⁹/L, Platelets > 100 x 10⁹/L).

Concomitant Therapy: Standard anti-nausea prophylaxis planned. Not taking valproic acid, enzyme inducers, or other myelosuppressive agents.

Reproductive Status: Partner is not of childbearing potential.

Input Data (Example):

  • Age: 45
  • Sex: Male
  • CLcr (mL/min): > 90
  • HBV Status: Negative
  • Baseline ANC: Normal (> 1.5)
  • Baseline Platelets: Normal (> 100)
  • Baseline LFTs: Normal
  • Conditions: (none selected)
  • Medications: (none selected)
  • Reproductive: Partner not of childbearing potential

Expected Result:

🟢 Safe Level

Verdict: "No Specific Risks Identified"

Reasons: (list empty)

General Information Block: Visible.

Scenario 2: Medium Risk Level

Patient Description:

Female, 73 years old.

Diagnosis: Recurrent anaplastic astrocytoma after previous therapy.

Medical Condition: Moderate renal impairment (CLcr = 55 mL/min). Mildly elevated ALT (65 U/L, ULN=40), AST normal. History of PJP 5 years ago (not related to RT). Mild anaemia (Hb 10.5 g/dL). HBV status negative.

Concomitant Therapy: Taking valproic acid for tumour-related seizure control. Anti-nausea prophylaxis planned.

Reproductive Status: Postmenopausal.

Input Data (Example):

  • Age: 73
  • Sex: Female
  • CLcr (mL/min): 55
  • Baseline LFTs: ALT 65 (ULN 40)
  • Baseline Blood Counts: Anaemia (mild)
  • Conditions: History of PJP
  • Medications: Valproic acid

Expected Result:

🟡 Medium Risk

Verdict: "Medium Risk"

Reasons:

  • Age > 70 years...
  • Female sex associated with slightly higher risk...
  • Moderate renal impairment (CLcr 55.0 mL/min)...
  • Moderately elevated baseline LFTs...
  • History of PJP...
  • Concomitant use with valproic acid...
  • Baseline anaemia...

General Information Block: Visible.

Scenario 3: High Risk Level

Patient Description:

Male, 38 years old.

Diagnosis: Newly diagnosed GBM, planned standard chemoradiotherapy (TMZ + RT).

Medical Condition: Found to be HBsAg positive (chronic HBV carrier). History of severe allergic reaction (angioedema) to another chemotherapy agent (not dacarbazine). Current symptoms: occasional seizures (controlled by AEDs), sometimes confusion.

Concomitant Therapy: Taking levetiracetam (non-inducer). RT planned.

Reproductive Status: Has partner of childbearing potential, does not consistently use condoms. Cryopreservation not discussed.

Input Data (Example):

  • Age: 38
  • Sex: Male
  • HBV Status: Positive carrier
  • Conditions: History of severe allergy (other drug)
  • Current Symptoms: Seizures, Confusion / Change in mental status
  • Treatment Factors: Concomitant radiotherapy
  • Medications: (Non-inducing AED)
  • Reproductive: Has partner of childbearing potential, No effective contraception (condoms)

Expected Result:

🟠 High Risk

Verdict: "High Risk"

Reasons:

  • Positive HBV status. Very high risk of HBV reactivation...
  • Concomitant radiotherapy significantly increases the risk of PJP...
  • History of severe allergic reactions to other drugs...
  • Male with a female partner of childbearing potential without effective contraception (condoms)...
  • New or worsening neurological symptoms (seizures, confusion) require immediate evaluation...

General Information Block: Visible.

Scenario 4: Contraindicated (Critical Level)

Patient Description:

Female, 32 years old.

Diagnosis: Recurrent high-grade glioma.

Medical Condition: Patient is pregnant, 10 weeks gestation. No significant allergy history. Organ function and blood counts normal.

Concomitant Therapy: No relevant medications.

Reproductive Status: Pregnant.

Input Data (Example):

  • Age: 32
  • Sex: Female
  • Conditions: Pregnancy or suspected pregnancy
  • Medications: (none selected)

Expected Result:

🔴 Contraindicated

Verdict: "Use Contraindicated"

Reasons:

  • Pregnancy is an absolute contraindication.

General Information Block: Not displayed.