HL7 Europe Common Cancer Model
0.1.0 - ci-build 150

HL7 Europe Common Cancer Model, published by HL7 Europe. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-eu/cancer-common/ and changes regularly. See the Directory of published versions

Logical Model: SystemicTreatment - Detailed Descriptions

Draft as of 2026-05-13

Definitions for the SystemicTreatment logical model.

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).

ShortSystemicTreatment
Control0..*
Is Modifierfalse
Logical ModelInstances of this logical model are not marked to be the target of a Reference
Invariantsst-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.

ShortSubject
Control1..1
Typehttp://hl7.eu/fhir/cancer-common/StructureDefinition/CancerPatient
4. SystemicTreatment.cancerConditionAtDiagnosisReference
Definition

Reference to the cancer condition at diagnosis targeted by systemic treatment.

ShortCancerConditionAtDiagnosisReference
Control1..1
TypeReference(CancerConditionAtDiagnosis)
6. SystemicTreatment.clinicalCancerProgressionReference
Definition

Reference to the clinical progression event, if treatment is delivered in response to progression.

ShortClinicalCancerProgresionReference
Comments

It is not only required at the time of diagnosis; it must be provided in the event of ClinicalCancerProgression.

Control0..1
TypeReference(ClinicalCancerProgression)
8. SystemicTreatment.intent
Definition

Treatment intent (Definitive/curative vs Palliative).

ShortIntent
Comments

Choice: Definitive | Palliative

Control1..1
TypeCodeableConcept
10. SystemicTreatment.type
Definition

Category of systemic treatment (e.g. chemotherapy, immunotherapy, targeted therapy, hormonal therapy).

ShortType
Control1..1
TypeCodeableConcept
12. SystemicTreatment.startDate
Definition

Start date of the systemic treatment course.

ShortStartDate
Control1..1
TypedateTime
Primitive ValueThis 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).

ShortEndDate
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.

Control0..1
TypedateTime
Primitive ValueThis 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.

ShortOngoing
Comments

If the EndDate is not provided because it is ongoing, it must be indicates as True.

Control0..1
Typeboolean
Primitive ValueThis 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).

ShortSetting
Comments

Choice: Alone | Preoperative/Neoadjuvant | Postoperative/Adjuvant | Concomitant

Control0..1
TypeCodeableConcept

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).

ShortSystemicTreatment
Logical ModelInstances of this logical model are not marked to be the target of a Reference
Invariantsst-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.

ShortSubject
Control1..1
Typehttp://hl7.eu/fhir/cancer-common/StructureDefinition/CancerPatient
4. SystemicTreatment.cancerConditionAtDiagnosisReference
Definition

Reference to the cancer condition at diagnosis targeted by systemic treatment.

ShortCancerConditionAtDiagnosisReference
Control1..1
TypeReference(CancerConditionAtDiagnosis)
6. SystemicTreatment.clinicalCancerProgressionReference
Definition

Reference to the clinical progression event, if treatment is delivered in response to progression.

ShortClinicalCancerProgresionReference
Comments

It is not only required at the time of diagnosis; it must be provided in the event of ClinicalCancerProgression.

Control0..1
TypeReference(ClinicalCancerProgression)
8. SystemicTreatment.intent
Definition

Treatment intent (Definitive/curative vs Palliative).

ShortIntent
Comments

Choice: Definitive | Palliative

Control1..1
TypeCodeableConcept
10. SystemicTreatment.type
Definition

Category of systemic treatment (e.g. chemotherapy, immunotherapy, targeted therapy, hormonal therapy).

ShortType
Control1..1
TypeCodeableConcept
12. SystemicTreatment.startDate
Definition

Start date of the systemic treatment course.

ShortStartDate
Control1..1
TypedateTime
Primitive ValueThis 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).

ShortEndDate
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.

Control0..1
TypedateTime
Primitive ValueThis 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.

ShortOngoing
Comments

If the EndDate is not provided because it is ongoing, it must be indicates as True.

Control0..1
Typeboolean
Primitive ValueThis 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).

ShortSetting
Comments

Choice: Alone | Preoperative/Neoadjuvant | Postoperative/Adjuvant | Concomitant

Control0..1
TypeCodeableConcept

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).

ShortSystemicTreatment
Control0..*
Is Modifierfalse
Logical ModelInstances of this logical model are not marked to be the target of a Reference
Invariantsst-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.

ShortSubject
Control1..1
Typehttp://hl7.eu/fhir/cancer-common/StructureDefinition/CancerPatient
4. SystemicTreatment.cancerConditionAtDiagnosisReference
Definition

Reference to the cancer condition at diagnosis targeted by systemic treatment.

ShortCancerConditionAtDiagnosisReference
Control1..1
TypeReference(CancerConditionAtDiagnosis)
6. SystemicTreatment.clinicalCancerProgressionReference
Definition

Reference to the clinical progression event, if treatment is delivered in response to progression.

ShortClinicalCancerProgresionReference
Comments

It is not only required at the time of diagnosis; it must be provided in the event of ClinicalCancerProgression.

Control0..1
TypeReference(ClinicalCancerProgression)
8. SystemicTreatment.intent
Definition

Treatment intent (Definitive/curative vs Palliative).

ShortIntent
Comments

Choice: Definitive | Palliative

Control1..1
TypeCodeableConcept
10. SystemicTreatment.type
Definition

Category of systemic treatment (e.g. chemotherapy, immunotherapy, targeted therapy, hormonal therapy).

ShortType
Control1..1
TypeCodeableConcept
12. SystemicTreatment.startDate
Definition

Start date of the systemic treatment course.

ShortStartDate
Control1..1
TypedateTime
Primitive ValueThis 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).

ShortEndDate
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.

Control0..1
TypedateTime
Primitive ValueThis 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.

ShortOngoing
Comments

If the EndDate is not provided because it is ongoing, it must be indicates as True.

Control0..1
Typeboolean
Primitive ValueThis 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).

ShortSetting
Comments

Choice: Alone | Preoperative/Neoadjuvant | Postoperative/Adjuvant | Concomitant

Control0..1
TypeCodeableConcept