Scoring system

1. Rows are alternatives, and every field of a row must hold for the whole row. Split a disjunction into rows only when its branches need different values in a field the reference groups or filters on:
    - a different tumour entity ("DLBCL, Burkitt lymphoma or Burkitt-like lymphoma" → one row per entity; "gastric, gastro-oesophageal junction or oesophageal adenocarcinoma" → a gastric/GEJ row and an oesophageal row);
    - a different biomarker, or positive vs negative ("ALK- or ROS1-positive" → two rows);
    - an untreated branch vs a pretreated branch (1L vs a later line);
    - a different treatment phase (rules 12 and 12a);
    - monotherapy vs combination, or a different targeted or immunotherapy partner ("as monotherapy or in combination with trastuzumab" → two rows);
    - a different age group.
   Otherwise keep ONE row and write the alternatives with "or" into the free-text field:
    - alternative chemotherapy or endocrine partners ("in combination with paclitaxel or docetaxel" → combination "+ paclitaxel or docetaxel"; "capecitabine or 5-fluorouracil and cisplatin" → "+ capecitabine or 5-fluorouracil, and cisplatin"; "with or without bevacizumab");
    - sub-sites of one tumour type ("gastric or gastro-oesophageal junction adenocarcinoma"; "ovarian, fallopian tube or primary peritoneal cancer");
    - stage lists ("stage IIB with risk factors, stage III or stage IV Hodgkin lymphoma" → one row, stage per rule 10, the list in patient_eligibility);
    - alternative results of one biomarker ("TC ≥ 50% or IC ≥ 10%"; "dMMR or MSI-H"; "exon 19 deletion or exon 21 L858R"; "HER2-low or HER2-ultralow"; "BRCA mutation and/or genomic instability"): scoring_system takes the first-named leg, diagnostic_criterion holds all of them;
    - alternative prior-therapy routes to the same line ("after ASCT, or after at least two prior therapies when ASCT is not an option" → one row at the lowest line, rule 13).
   A later sentence that moves a biomarker subgroup to a later line ("In patients with EGFR-mutant or ALK-positive NSCLC, X is indicated only after failure of appropriate targeted therapies") changes the first-line row: append "; EGFR/ALK-negative" to its biomarker_detail. Each subgroup then gets its own later-line row, one per biomarker ("EGFR mutation", "ALK-positive").

2. No biomarker in the text (classic chemotherapy, anti-angiogenesis without biomarker gating) → biomarker_name="none", alteration_type="none", biomarker_detail="n/a", diagnostic_criterion="n/a", scoring_system="n/a", test_method=[] (empty list — no diagnostic test applies). Flag "no-biomarker" and "non-targeted-therapy".

2a. A hereditary tumour syndrome named as the population (von Hippel-Lindau disease, neurofibromatosis type 1, tuberous sclerosis complex) is a clinical diagnosis, not a biomarker: biomarker_name="none", alteration_type="none", scoring_system="n/a", test_method=[]. Put the syndrome into tumor_type (e.g. "VHL disease-associated renal cell carcinoma") and patient_eligibility, and flag "no-biomarker" but NOT "non-targeted-therapy". Record a germline biomarker only when the text names the alteration itself (e.g. "germline BRCA1/2 mutations").

5. Do NOT invent thresholds. "Tumours expressing PD-L1" without a cutoff → scoring_system="other", diagnostic_criterion=verbatim phrase, flag "ambiguous-threshold".

5a. scoring_system is a **numeric scored readout**, not a catch-all. Pick "n/a" — NOT "other" — when the biomarker is a categorical status with no score:
    - Mutation/fusion presence ("BRCA1/2 mutation", "ALK rearrangement", "NTRK fusion", "FLT3-ITD positive") → scoring_system="n/a".
    - MMR/MSI status by IHC or PCR (dMMR, pMMR, MSI-H, MSS) → scoring_system="n/a".
    - HRD categorical ("HRD positive", "HRD deficient") without a numeric HRD score in the text → scoring_system="n/a".
    - Wild-type-required (RAS wild-type, EGFR wild-type) → scoring_system="n/a".
    - Secondary biomarker mentions in biomarker_detail (e.g. "; HER2-negative") do NOT promote scoring_system away from the primary biomarker's value.
    Reserve "other" for **assay-specific composite scores** that are quantitative but lack a canonical short name (e.g. zolbetuximab CLDN18.2 "moderate-to-strong membranous staining in ≥ 75% of tumour cells"). Put the verbatim composite in diagnostic_criterion.

5b. HER2 protein status is an IHC score: scoring_system="IHC-score", and diagnostic_criterion gives the standard definition (EU SmPC section 4.2), even when the text names only the category:
    - HER2-positive / "HER2 overexpression or HER2 gene amplification" → "IHC 3+ or IHC 2+/ISH-positive" (keep stricter wording the text gives, e.g. "IHC 3+").
    - HER2-low → "IHC 1+ or IHC 2+/ISH-negative".
    - HER2-ultralow → "IHC 0 with membrane staining (faint, incomplete, ≤10% of tumour cells)".
    "HER2-low or HER2-ultralow" stays one row with both definitions. HER2 (ERBB2) mutation → alteration_type="mutation", scoring_system="n/a". A secondary "HER2-negative" does not change scoring_system.

6. "PD L1" / "PD-L1" are the same — use "PD-L1". PD-L1 scoring_system mapping by SmPC phrasing:
    - "tumour cell PD-L1 expression ≥ X%" / "PD-L1 expression in tumour cells ≥ X%" / "TPS ≥ X" / "tumour proportion score ≥ X%" → scoring_system="TPS" (Tumor Proportion Score = % PD-L1+ tumor cells, pembrolizumab/nivolumab).
    - "combined positive score ≥ X" / "CPS ≥ X" → scoring_system="CPS".
    - "PD-L1 positive immune cells ≥ X%" / "tumour-infiltrating immune cells covering ≥ X%" / "IC ≥ X" → scoring_system="IC" (Immune Cell score, atezolizumab SP142).
    - "TC ≥ X%" / "PD-L1 stained tumour cells ≥ X%" as the SP142-style tumour-cell leg paired with an IC leg → scoring_system="TC" (atezolizumab tumour-cell score, distinct from TPS).
    - "TAP score ≥ X%" / "tumour area positivity ≥ X%" / "PD-L1 expression with a TAP score ≥ X%" → scoring_system="TAP" (tislelizumab SP263).
    - A PD-L1 percentage that names no cells or score ("PD-L1 expression ≥ 1%", "tumours expressing PD-L1 ≥ 1%", "PD-L1 positive cells ≥ X%") → scoring_system="TPS" (tumour-cell expression, as in the pivotal trials). Exception: for atezolizumab (SP142 assay) such a percentage refers to tumour-infiltrating immune cells → scoring_system="IC", unless the text names tumour cells.
    - PD-L1 below a threshold ("tumour cell PD-L1 expression < 1%") is still a PD-L1 expression result → alteration_type="overexpression", with the threshold in diagnostic_criterion.

7. Gene symbols uppercase (BRAF, EGFR, ERBB2). Use "PD-L1" (protein) not CD274. An HLA type is a germline genotype, never a mutation: "HLA-A*02:01-positive" → biomarker_name="HLA-A*02:01", alteration_type="overexpression", biomarker_detail="HLA-A*02:01-positive", scoring_system="n/a", test_method=["molecular"]. Hormone receptors are proteins measured by IHC: "hormone receptor-positive" → biomarker_name="HR", "oestrogen receptor-positive" → "ER", progesterone receptor → "PR"; use "ESR1" only for ESR1 mutations.