tooluniverse-clinical-trial-matching

What the source does

• FilesystemNone observedNo reads or writes in the source
• NetworkNone observedNo outbound calls in the source
• ShellNone observedNo commands run in the source
• DependenciesPinnedNothing floats
• SecretsNone foundNo keys in source

Five audit layers

Gates applied: no behavioural pass.

Audit 0.4.1 · source sha 43be0fac747b · 31 Oct 2026Report an issue or request a re-scan

• Publishermims-harvard GitHub organizationOwner of the repository this skill is read from
• Source foldermims-harvard/tooluniverse/skills/tooluniverse-clinical-trial-matchingThe exact folder we audited
• LicenceApache-2.0As the repository states it
• Commit pinned for this verdict43be0fac747bA new audit runs when the source changes
• Repository statusNot archivedPushed today
• Sandboxed runNot runSkills are read, not executed; layer L4 is skipped

Its description: AI-driven patient-to-trial matching for precision oncology and rare-disease care. Transforms a patient's molecular profile (mutations, biomarkers, expression) and clinical state into ranked clinical-trial…

---
name: tooluniverse-clinical-trial-matching
description: AI-driven patient-to-trial matching for precision oncology and rare-disease care. Transforms a patient's molecular profile (mutations, biomarkers, expression) and clinical state into ranked clinical-trial recommendations with evidence tiers. Searches ClinicalTrials.gov, the EU CTIS register (European/EEA trials), AND the ISRCTN registry (UK/international) plus cross-references CIViC, OpenTargets, ChEMBL, and FDA labels. Use for matching patients to trials by genotype, biomarker-driven trial selection, trial-eligibility scoring, and finding trials across the US, Europe, and the UK.
disable-model-invocation: true
---

# Clinical Trial Matching for Precision Medicine

Transform patient molecular profiles and clinical characteristics into prioritized clinical trial recommendations. Searches ClinicalTrials.gov and cross-references with molecular databases (CIViC, OpenTargets, ChEMBL, FDA) to produce evidence-graded, scored trial matches.

**KEY PRINCIPLES**:
1. **Report-first approach** - Create report file FIRST, then populate progressively
2. **Patient-centric** - Every recommendation considers the individual patient's profile
3. **Molecular-first matching** - Prioritize trials targeting patient's specific biomarkers

## Molecular Matching Priority

Match patients to trials by molecular profile FIRST (specific mutations), then by disease stage, then by prior treatments. A patient with EGFR L858R should match to EGFR-targeted trials regardless of other factors.
4. **Evidence-graded** - Every recommendation has an evidence tier (T1-T4)
5. **Quantitative scoring** - Trial Match Score (0-100) for every trial
6. **Eligibility-aware** - Parse and evaluate inclusion/exclusion criteria
7. **Actionable output** - Clear next steps, contact info, enrollment status
8. **Source-referenced** - Every statement cites the tool/database source
9. **Completeness checklist** - Mandatory section showing analysis coverage
10. **English-first queries** - Always use English terms in tool calls. Respond in user's language

## LOOK UP, DON'T GUESS
When uncertain about any scientific fact, SEARCH databases first rather than reasoning from memory. A database-verified answer is always more reliable than a guess.

---

## COMPUTE, DON'T DESCRIBE
When analysis requires computation (statistics, data processing, scoring, enrichment), write and run Python code via Bash. Don't describe what you would do — execute it and report actual results. Use ToolUniverse tools to retrieve data, then Python (pandas, scipy, statsmodels, matplotlib) to analyze it.

## When to Use

Apply when user asks:
- "What clinical trials are available for my NSCLC with EGFR L858R?"
- "Patient has BRAF V600E melanoma, failed ipilimumab - what trials?"
- "Find basket trials for NTRK fusion"
- "Breast cancer with HER2 amplification, post-CDK4/6 inhibitor trials"
- "KRAS G12C colorectal cancer clinical trials"
- "Immunotherapy trials for TMB-high solid tumors"
- "Clinical trials near Boston for lung cancer"
- "What are my options after failing osimertinib for EGFR+ NSCLC?"

**NOT for** (use other skills instead):
- Single variant interpretation without trial focus -> Use `tooluniverse-cancer-variant-interpretation`
- Drug safety profiling -> Use `tooluniverse-adverse-event-detection`
- Target validation -> Use `tooluniverse-drug-target-validation`
- General disease research -> Use `tooluniverse-disease-research`

---

## Input Parsing

### Required Input
- **Disease/cancer type**: Free-text disease name (e.g., "non-small cell lung cancer", "melanoma")

### Strongly Recommended
- **Molecular alterations**: One or more biomarkers (e.g., "EGFR L858R", "KRAS G12C", "PD-L1 50%", "TMB-high")
- **Stage/grade**: Disease stage (e.g., "Stage IV", "metastatic", "locally advanced")
- **Prior treatments**: Previous therapies and outcomes (e.g., "failed platinum chemotherapy", "progressed on osimertinib")

### Optional
- **Performance status**: ECOG or Karnofsky score
- **Geographic location**: City/state for proximity filtering
- **Trial phase preference**: I, II, III, IV, or "any"
- **Intervention type**: drug, biological, device, etc.
- **Recruiting status preference**: recruiting, not yet recruiting, active

For biomarker parsing rules and gene symbol normalization, see [MATCHING_ALGORITHMS.md](./MATCHING_ALGORITHMS.md).

---

## Workflow Overview

```
Input: Patient profile (disease + biomarkers + stage + prior treatments)

Phase 1: Patient Profile Standardization
  - Resolve disease to EFO/ontology IDs (OpenTargets, OLS)
  - Parse molecular alterations to gene + variant
  - Resolve gene symbols to Ensembl/Entrez IDs (MyGene)
  - Classify biomarker actionability (FDA-approved vs investigational)

Phase 2: Broad Trial Discovery
  - Disease-based trial search (ClinicalTrials.gov)
  - Biomarker-specific trial search
  - Intervention-based search (for known drugs targeting patient's biomarkers)
  - Deduplicate and collect NCT IDs

Phase 3: Trial Characterization (batch, groups of 10)
  - Eligibility criteria, conditions/interventions, locations, status, descriptions

Phase 4: Molecular Eligibility Matching
  - Parse eligibility text for biomarker requirements
  - Match patient's molecular profile to trial requirements
  - Score molecular eligibility (0-40 points)

Phase 5: Drug-Biomarker Alignment
  - Identify trial intervention drugs and mechanisms (OpenTargets, ChEMBL)
  - FDA approval status for biomarker-drug combinations
  - Classify drugs (targeted therapy, immunotherapy, chemotherapy)

Phase 6: Evidence Assessment
  - FDA-approved biomarker-drug combinations
  - Clinical trial results (PubMed), CIViC evidence, PharmGKB
  - Evidence tier classification (T1-T4)

Phase 7: Geographic & Feasibility Analysis
  - Trial site locations, enrollment status, proximity scoring

Phase 8: Alternative Options
  - Basket trials, expanded access, related studies

Phase 9: Scoring & Ranking (0-100 composite score)
  - Ti

Excerpt, first 6,000 characters of SKILL.md, verbatim from the audited commit. It is text from someone else’s repository, quoted so you can judge it before your agent reads it.

git clone https://github.com/mims-harvard/tooluniverse
git -C tooluniverse checkout 43be0fac747b

Works in

1. 2026-10-31
   ✓SAFE B 89 / 100

   first audit · source 43be0fac747b

Questions about tooluniverse-clinical-trial-matching

• github.com/mims-harvard/tooluniverse/tree/main/skills/tooluniver — the audited source at commit 43be0fac747b and every finding aboveObserved · 31 Oct 2026

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