{"id":"6bae94f6-a6e3-5716-9848-bd5ebb2e2ec1","stable_key":"fd37d270-3395-56d6-9f1c-ddda56e606f6:arg-tumor-survival","predicate":"improves_trial_outcome","statement":"Adding pegargiminase to chemotherapy increased median survival from 7.7 to 9.3 months; death hazard ratio 0.71.","claim_class":"observational","status":"source_derived_draft","evidence_grade":"ungraded","direction":"positive","is_public":true,"mechanism_event_id":"8c38c259-6a0b-53aa-8844-dbaaf669e05a","mechanism_event_label":"Arginine depletion can have a therapeutic role in a specific tumor context.","subject":{"id":"5c735378-f146-59bb-851a-01a54d53b84b","slug":"pegargiminase","display_name":"Pegargiminase / ADI-PEG20","entity_type_key":"protein"},"object":{"id":"409a171d-e14c-5304-9125-be29a2f50ca4","slug":"mesothelioma-overall-survival","display_name":"Overall survival in nonepithelioid pleural mesothelioma","entity_type_key":"cellular_process"},"evidence_count":1,"mechanism_event":{"id":"8c38c259-6a0b-53aa-8844-dbaaf669e05a","stable_key":"fd37d270-3395-56d6-9f1c-ddda56e606f6:arg-tumor-survival-event","event_type":"observed_relationship","label":"Arginine depletion can have a therapeutic role in a specific tumor context.","description":"Adding pegargiminase to chemotherapy increased median survival from 7.7 to 9.3 months; 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weekly 36.8 mg/m² plus pemetrexed/platinum.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"limitations","value_text":"Drug combination trial, not dietary restriction or a general cancer treatment.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"nutrient_topic","value_text":"L-Arginine collection; tissue, species, dose and formulation distinctions retained.","comparator":null,"unit":null,"notes":"","entity":{"slug":"arginine","display_name":"L-Arginine","entity_type_key":"small_molecule"}},{"dimension":"plain_language","value_text":"Arginine depletion can have a therapeutic role in a specific tumor context.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"primary_references","value_text":"Pegargiminase Plus First-Line Chemotherapy in Patients With Nonepithelioid Pleural Mesothelioma: The ATOMIC-Meso Randomized Clinical Trial. · 2024 · https://pubmed.ncbi.nlm.nih.gov/38358753/ · DOI 10.1001/jamaoncol.2023.6789","comparator":null,"unit":null,"notes":"","entity":null}],"evidence":[{"id":"05908248-b42e-54ae-83c3-2c101a4f72d7","evidence_kind":"source_excerpt","locator":"Lines 406-412","start_line":406,"end_line":412,"excerpt":"## arg-tumor-survival\nArginine depletion can have a therapeutic role in a specific tumor context.\nAdding pegargiminase to chemotherapy increased median survival from 7.7 to 9.3 months; death hazard ratio 0.71.\nModel: ATOMIC-Meso: 249 patients, nonepithelioid pleural mesothelioma; weekly 36.8 mg/m² plus pemetrexed/platinum.\nLimitations: Drug combination trial, not dietary restriction or a general cancer treatment.\nEvidence access: Primary abstract\nPegargiminase Plus First-Line Chemotherapy in Patients With Nonepithelioid Pleural Mesothelioma: The ATOMIC-Meso Randomized Clinical Trial. · 2024 · https://pubmed.ncbi.nlm.nih.gov/38358753/ · DOI 10.1001/jamaoncol.2023.6789","model_system":"ATOMIC-Meso: 249 patients, nonepithelioid pleural mesothelioma; weekly 36.8 mg/m² plus pemetrexed/platinum.","directness":"reported_statement","verification_status":"source_derived_draft","notes":"Original curation paraphrase; primary evidence access stated per claim.","relationship":"supports","weight":1.0,"link_notes":"","source":{"id":"bb9a67ea-904f-5b8a-93a4-459081212bdd","stable_key":"import-fd37d270-3395-56d6-9f1c-ddda56e606f6","title":"L-Arginine: transport, metabolic branches, nutrient interactions, availability and discovery questions (2026-09-18)","document_type":"imported_text","citation_label":"AI-assisted research curation; primary-abstract references and experimental limitations individually identified. 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