HL7 Europe Common Cancer Model
1.0.0-ballot - ballot 150

HL7 Europe Common Cancer Model - Local Development build (v1.0.0-ballot) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

## Logical Model: SystemicTreatment - Detailed Descriptions

Active as of 2026-06-14

Definitions for the SystemicTreatment logical model.

- Key Elements Table
- Differential Elements Table
- Snapshot Elements Table

Guidance on how to interpret the contents of this table can be foundhere

0. SystemicTreatment
Definition | Logical model representing a systemic anti-cancer treatment episode delivered to the patient, either at diagnosis or following disease progression. Derived from Cancer_Common_Logical_Model_20260521.xlsx (sheet SystemicTreatment).
Short | SystemicTreatment
Control | 0..*
Is Modifier | false
Logical Model | Instances of this logical model are not marked to be the target of a Reference
Invariants | st-1: If ongoing is true, endDate must not be present; if endDate is not present, ongoing must be true. (`((ongoing = true) implies endDate.empty()) and (endDate.exists() implies (ongoing.exists().not() or ongoing = false))`) st-2: If endDate is present, it should be greater than or equal to startDate. (`endDate.empty() or endDate > startDate`)
2. SystemicTreatment.subject
Definition | Reference to the patient (subject) receiving systemic treatment.
Short | Subject
Control | 1..1
Type | Reference(Cancer Patient)
4. SystemicTreatment.cancerConditionAtDiagnosisReference
Definition | Reference to the cancer condition at diagnosis targeted by systemic treatment.
Short | CancerConditionAtDiagnosisReference
Control | 1..1
Type | Reference(CancerConditionAtDiagnosis)
6. SystemicTreatment.clinicalCancerProgressionReference
Definition | Reference to the clinical progression event, if treatment is delivered in response to progression.
Short | ClinicalCancerProgresionReference
Comments | It is not only required at the time of diagnosis; it must be provided in the event of ClinicalCancerProgression.
Control | 0..1
Type | Reference(ClinicalCancerProgression)
8. SystemicTreatment.intent
Definition | Treatment intent (Definitive/curative vs Palliative).
Short | Intent
Comments | Choice: Definitive | Palliative
Control | 1..1
Type | CodeableConcept
10. SystemicTreatment.type
Definition | Category of systemic treatment (e.g. chemotherapy, immunotherapy, targeted therapy, hormonal therapy).
Short | Type
Control | 1..1
Type | CodeableConcept
12. SystemicTreatment.startDate
Definition | Start date of the systemic treatment course.
Short | StartDate
Control | 1..1
Type | dateTime
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
14. SystemicTreatment.endDate
Definition | End date of the systemic treatment course (may be missing while ongoing).
Short | EndDate
Comments | It might not be available while the treatment is still ongoing; however, an end date must eventually be recorded, which in the most extreme case will coincide with the patient's date of death.
Control | 0..1
Type | dateTime
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
16. SystemicTreatment.ongoing
Definition | Indicates that the treatment is ongoing when EndDate is not available.
Short | Ongoing
Comments | If the EndDate is not provided because it is ongoing, it must be indicates as True.
Control | 0..1
Type | boolean
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
18. SystemicTreatment.setting
Definition | Strategic timing/setting of systemic treatment (e.g. neoadjuvant, adjuvant, concomitant, alone).
Short | Setting
Comments | Choice: Alone | Preoperative/Neoadjuvant | Postoperative/Adjuvant | Concomitant
Control | 0..1
Type | CodeableConcept

Guidance on how to interpret the contents of this table can be foundhere

0. SystemicTreatment
Definition | Logical model representing a systemic anti-cancer treatment episode delivered to the patient, either at diagnosis or following disease progression. Derived from Cancer_Common_Logical_Model_20260521.xlsx (sheet SystemicTreatment).
Short | SystemicTreatment
Logical Model | Instances of this logical model are not marked to be the target of a Reference
Invariants | st-1: If ongoing is true, endDate must not be present; if endDate is not present, ongoing must be true. (`((ongoing = true) implies endDate.empty()) and (endDate.exists() implies (ongoing.exists().not() or ongoing = false))`) st-2: If endDate is present, it should be greater than or equal to startDate. (`endDate.empty() or endDate > startDate`)
2. SystemicTreatment.subject
Definition | Reference to the patient (subject) receiving systemic treatment.
Short | Subject
Control | 1..1
Type | Reference(Cancer Patient)
4. SystemicTreatment.cancerConditionAtDiagnosisReference
Definition | Reference to the cancer condition at diagnosis targeted by systemic treatment.
Short | CancerConditionAtDiagnosisReference
Control | 1..1
Type | Reference(CancerConditionAtDiagnosis)
6. SystemicTreatment.clinicalCancerProgressionReference
Definition | Reference to the clinical progression event, if treatment is delivered in response to progression.
Short | ClinicalCancerProgresionReference
Comments | It is not only required at the time of diagnosis; it must be provided in the event of ClinicalCancerProgression.
Control | 0..1
Type | Reference(ClinicalCancerProgression)
8. SystemicTreatment.intent
Definition | Treatment intent (Definitive/curative vs Palliative).
Short | Intent
Comments | Choice: Definitive | Palliative
Control | 1..1
Type | CodeableConcept
10. SystemicTreatment.type
Definition | Category of systemic treatment (e.g. chemotherapy, immunotherapy, targeted therapy, hormonal therapy).
Short | Type
Control | 1..1
Type | CodeableConcept
12. SystemicTreatment.startDate
Definition | Start date of the systemic treatment course.
Short | StartDate
Control | 1..1
Type | dateTime
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
14. SystemicTreatment.endDate
Definition | End date of the systemic treatment course (may be missing while ongoing).
Short | EndDate
Comments | It might not be available while the treatment is still ongoing; however, an end date must eventually be recorded, which in the most extreme case will coincide with the patient's date of death.
Control | 0..1
Type | dateTime
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
16. SystemicTreatment.ongoing
Definition | Indicates that the treatment is ongoing when EndDate is not available.
Short | Ongoing
Comments | If the EndDate is not provided because it is ongoing, it must be indicates as True.
Control | 0..1
Type | boolean
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
18. SystemicTreatment.setting
Definition | Strategic timing/setting of systemic treatment (e.g. neoadjuvant, adjuvant, concomitant, alone).
Short | Setting
Comments | Choice: Alone | Preoperative/Neoadjuvant | Postoperative/Adjuvant | Concomitant
Control | 0..1
Type | CodeableConcept

Guidance on how to interpret the contents of this table can be foundhere

0. SystemicTreatment
Definition | Logical model representing a systemic anti-cancer treatment episode delivered to the patient, either at diagnosis or following disease progression. Derived from Cancer_Common_Logical_Model_20260521.xlsx (sheet SystemicTreatment).
Short | SystemicTreatment
Control | 0..*
Is Modifier | false
Logical Model | Instances of this logical model are not marked to be the target of a Reference
Invariants | st-1: If ongoing is true, endDate must not be present; if endDate is not present, ongoing must be true. (`((ongoing = true) implies endDate.empty()) and (endDate.exists() implies (ongoing.exists().not() or ongoing = false))`) st-2: If endDate is present, it should be greater than or equal to startDate. (`endDate.empty() or endDate > startDate`)
2. SystemicTreatment.subject
Definition | Reference to the patient (subject) receiving systemic treatment.
Short | Subject
Control | 1..1
Type | Reference(Cancer Patient)
4. SystemicTreatment.cancerConditionAtDiagnosisReference
Definition | Reference to the cancer condition at diagnosis targeted by systemic treatment.
Short | CancerConditionAtDiagnosisReference
Control | 1..1
Type | Reference(CancerConditionAtDiagnosis)
6. SystemicTreatment.clinicalCancerProgressionReference
Definition | Reference to the clinical progression event, if treatment is delivered in response to progression.
Short | ClinicalCancerProgresionReference
Comments | It is not only required at the time of diagnosis; it must be provided in the event of ClinicalCancerProgression.
Control | 0..1
Type | Reference(ClinicalCancerProgression)
8. SystemicTreatment.intent
Definition | Treatment intent (Definitive/curative vs Palliative).
Short | Intent
Comments | Choice: Definitive | Palliative
Control | 1..1
Type | CodeableConcept
10. SystemicTreatment.type
Definition | Category of systemic treatment (e.g. chemotherapy, immunotherapy, targeted therapy, hormonal therapy).
Short | Type
Control | 1..1
Type | CodeableConcept
12. SystemicTreatment.startDate
Definition | Start date of the systemic treatment course.
Short | StartDate
Control | 1..1
Type | dateTime
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
14. SystemicTreatment.endDate
Definition | End date of the systemic treatment course (may be missing while ongoing).
Short | EndDate
Comments | It might not be available while the treatment is still ongoing; however, an end date must eventually be recorded, which in the most extreme case will coincide with the patient's date of death.
Control | 0..1
Type | dateTime
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
16. SystemicTreatment.ongoing
Definition | Indicates that the treatment is ongoing when EndDate is not available.
Short | Ongoing
Comments | If the EndDate is not provided because it is ongoing, it must be indicates as True.
Control | 0..1
Type | boolean
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
18. SystemicTreatment.setting
Definition | Strategic timing/setting of systemic treatment (e.g. neoadjuvant, adjuvant, concomitant, alone).
Short | Setting
Comments | Choice: Alone | Preoperative/Neoadjuvant | Postoperative/Adjuvant | Concomitant
Control | 0..1
Type | CodeableConcept