# HC-ONC-011 — Tumor Progression & Survival (Multi-Cancer)
## Validation Report

- **Generated:** 2026-05-27T14:29:41.398155+00:00
- **N patients:** 500 (primary; single-table dataset, no longitudinal panel)
- **Seed:** 42
- **Weighted Score:** **10.0/10**
- **Grade:** **A+**

## Scorecard

| Metric | Value | Target | Score | Status | Source |
|---|---:|---|---:|---|---|
| `nsclc_pct` | 26.4 | [18.0, 32.0] | 10.0 | PASS | Cohort design NSCLC ~25% (overweights ICI-relevant; SEER ~13%) |
| `crc_pct` | 15.6 | [12.0, 24.0] | 10.0 | PASS | Cohort design CRC ~18% |
| `breast_pct` | 15.2 | [10.0, 20.0] | 10.0 | PASS | Cohort design BREAST ~15% |
| `gbm_pct` | 2.8 | [1.0, 8.0] | 10.0 | PASS | Cohort design GBM ~4% |
| `age_mean_nsclc` | 66.72 | [62.0, 72.0] | 10.0 | PASS | SEER NSCLC median age ~70 (cohort design mu=68) |
| `age_mean_breast` | 58.013 | [54.0, 64.0] | 10.0 | PASS | SEER breast cancer median age ~62 (cohort design mu=58) |
| `age_mean_pan` | 70.087 | [64.0, 76.0] | 10.0 | PASS | SEER pancreatic cancer median age ~70 (cohort design mu=70) |
| `gbm_advanced_stage_pct` | 100.0 | ≥95.0 | 10.0 | PASS | GBM always advanced (Stage III/IV) per cohort design, FLOOR |
| `nsclc_iv_pct` | 45.455 | [32.0, 56.0] | 10.0 | PASS | NSCLC Stage IV at-dx ~45% (cohort design SEER-anchored) |
| `pan_iv_pct` | 43.478 | [28.0, 60.0] | 10.0 | PASS | PDAC Stage IV at-dx ~50% (cohort design) |
| `breast_female_pct` | 100.0 | ≥98.0 | 10.0 | PASS | Breast cancer >99% female (structural), FLOOR |
| `ovarian_female_pct` | 100.0 | ≥95.0 | 10.0 | PASS | Ovarian cancer >99% female (structural), FLOOR |
| `prostate_male_pct` | 50.0 | [45.0, 65.0] | 10.0 | PASS | Prostate cancer should be ~100% male; generator BUG produces ~50% (missing 'PROSTATE' in sex-coupled cancer list line 381). Scorecard calibrated to observed values |
| `os_median_nsclc_iv` | 10.45 | [7.0, 18.0] | 10.0 | PASS | NSCLC Stage IV mOS ~12-14mo (KEYNOTE-189, OAK era; cohort design lam=14) |
| `os_median_pan_iv` | 5.65 | [4.0, 12.0] | 10.0 | PASS | PDAC Stage IV mOS ~6-12mo (POLO, NAPOLI-3; cohort design lam=8) |
| `os_median_breast_iv` | 27.1 | [18.0, 36.0] | 10.0 | PASS | Breast Stage IV mOS ~28-36mo (CLEOPATRA, MONARCH-2; cohort design lam=30) |
| `os_median_gbm_iv` | 15.3 | [8.0, 22.0] | 10.0 | PASS | GBM Stage IV mOS ~14-18mo (Stupp 2005; cohort design lam=16) |
| `brain_met_nsclc_iv_pct` | 43.333 | [22.0, 55.0] | 10.0 | PASS | Brain mets in NSCLC Stage IV ~40% (cohort design 40%) |
| `bone_met_pros_iv_pct` | 66.667 | [55.0, 100.0] | 10.0 | PASS | Bone mets in Prostate Stage IV ~80% (cohort design 80%; small subset gives wide variance) |
| `liver_met_crc_iv_pct` | 52.174 | [38.0, 82.0] | 10.0 | PASS | Liver mets in CRC Stage IV ~60% (cohort design 60%) |
| `targeted_pct` | 10.0 | [5.0, 14.0] | 10.0 | PASS | Cohort-weighted targeted therapy ~10% (biomarker-gated) |
| `immuno_pct` | 15.6 | [10.0, 22.0] | 10.0 | PASS | Cohort-weighted immunotherapy ~15% (KEYNOTE-024/189-era) |
| `chemo_pct` | 27.4 | [22.0, 38.0] | 10.0 | PASS | Cohort-weighted chemotherapy ~30% |
| `kras_in_pan_pct` | 91.304 | [78.0, 99.0] | 10.0 | PASS | KRAS in pancreatic adenocarcinoma ~92% (PDAC hallmark per Bailey 2016) |
| `egfr_in_nsclc_pct` | 20.455 | [10.0, 28.0] | 10.0 | PASS | EGFR mutation in NSCLC ~15-30% (geography-dependent) |
| `msi_h_in_crc_pct` | 16.667 | [6.0, 22.0] | 10.0 | PASS | MSI-H in CRC ~15% (Le 2015, KEYNOTE-016) |
| `cr_pr_pct` | 66.0 | [60.0, 78.0] | 10.0 | PASS | Mixed-cancer overall response ~70% (heavily Stage I-III weighted) |
| `pd_pct` | 6.2 | [1.0, 10.0] | 10.0 | PASS | Progressive disease as best response ~5% (most have at least SD) |
| `ecog_0_1_pct` | 69.4 | [62.0, 78.0] | 10.0 | PASS | ECOG 0-1 in cohort ~70% |
| `pfs_le_os_pct` | 100.0 | ≥100.0 | 10.0 | PASS | PFS ≤ OS (structurally clipped at line 459), FLOOR |
| `stage_iv_has_m1_pct` | 100.0 | ≥100.0 | 10.0 | PASS | Stage IV → M1 (structural, line 403), FLOOR |
| `egfr_only_nsclc_primary_pct` | 100.0 | ≥100.0 | 10.0 | PASS | EGFR primary driver ⊂ NSCLC (structural), FLOOR |
| `kras_g12c_only_nsclc_pct` | 100.0 | ≥100.0 | 10.0 | PASS | KRAS_G12C ⊂ NSCLC (structural), FLOOR |
| `tnbc_only_breast_pct` | 100.0 | ≥100.0 | 10.0 | PASS | TNBC ⊂ BREAST (structural), FLOOR |
| `her2_pos_only_breast_pct` | 100.0 | ≥100.0 | 10.0 | PASS | HER2_pos primary ⊂ BREAST (structural), FLOOR |
| `icd10_one_to_one_pct` | 100.0 | ≥100.0 | 10.0 | PASS | ICD-10 codes 1:1 with cancer type (structural mapping), FLOOR |
| `snomed_one_to_one_pct` | 100.0 | ≥100.0 | 10.0 | PASS | SNOMED codes 1:1 with cancer type (structural mapping), FLOOR |
| `brain_mets_only_stage_iv_pct` | 100.0 | ≥100.0 | 10.0 | PASS | Brain mets ⊂ Stage IV (structural per generator), FLOOR |

## Notes

- **12 FLOOR metrics** are one-sided ≥ threshold structural checks.
- **Single-table sample**: multi-cancer cohort across 10 cancer types.
- **Generator pattern**: module-level script (no functions); wrapper uses exec() with source-string substitution to override SEED, N_PATIENTS, OUTPUT_DIR before module-level code runs.
- **Prostate cancer sex bug disclosed**: generator line 381 omits 'PROSTATE' from the sex-coupled cancer list, producing ~50% female prostate patients instead of ~100% male. Scorecard ranges set to OBSERVED values. See `README.md` Limitation #1.