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            "code": "COADREAD",
            "name": "Colorectal Adenocarcinoma",
            "system": "https://oncotree.mskcc.org",
            "systemVersion": "oncotree_2021_11_02",
            "iris": [
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                    "name": "Ipilimumab",
                    "system": "SNOMED",
                    "systemVersion": "2025-03-01",
                    "iris": [
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                    ]
                  }
                },
                {
                  "relation": "relatedMatch",
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                    "name": "Ipilimumab",
                    "system": "OMOP",
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                    "iris": [
                      "https://athena.ohdsi.org/search-terms/terms/44783810"
                    ]
                  }
                }
              ],
              "extensions": [
                {
                  "name": "therapy_strategy",
                  "value": [
                    "CTLA-4 inhibition"
                  ],
                  "description": "Associated therapeutic strategy or mechanism of action of the therapy."
                },
                {
                  "name": "therapy_type",
                  "value": "Immunotherapy",
                  "description": "Type of cancer treatment from cancer.gov: https://www.cancer.gov/about-cancer/treatment/types"
                }
              ],
              "primaryCoding": {
                "id": "coding:ncit:C2654",
                "code": "C2654",
                "name": "Ipilimumab",
                "system": "https://evsexplore.semantics.cancer.gov",
                "systemVersion": "25.01d",
                "iris": [
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            },
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              "id": "tx:ncit:C68814",
              "conceptType": "Therapy",
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              "mappings": [
                {
                  "relation": "relatedMatch",
                  "coding": {
                    "id": "coding:rxcui:1597876",
                    "code": "1597876",
                    "name": "nivolumab",
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                    "systemVersion": "02-Mar-2026",
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                      "https://mor.nlm.nih.gov/RxNav/search?searchBy=RXCUI&searchTerm=1597876"
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                },
                {
                  "relation": "relatedMatch",
                  "coding": {
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                    "name": "nivolumab",
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                },
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                  }
                }
              ],
              "extensions": [
                {
                  "name": "therapy_strategy",
                  "value": [
                    "PD-1/PD-L1 inhibition"
                  ],
                  "description": "Associated therapeutic strategy or mechanism of action of the therapy."
                },
                {
                  "name": "therapy_type",
                  "value": "Immunotherapy",
                  "description": "Type of cancer treatment from cancer.gov: https://www.cancer.gov/about-cancer/treatment/types"
                }
              ],
              "primaryCoding": {
                "id": "coding:ncit:C68814",
                "code": "C68814",
                "name": "Nivolumab",
                "system": "https://evsexplore.semantics.cancer.gov",
                "systemVersion": "25.01d",
                "iris": [
                  "https://evsexplore.semantics.cancer.gov/evsexplore/concept/ncit/C68814"
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          ]
        },
        "extensions": [
          {
            "name": "biomarkers",
            "value": [
              {
                "id": "bmkr.criterion:36",
                "present": true,
                "subject": {
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                  "type": "CategoricalVariant",
                  "name": "dMMR",
                  "constraints": [],
                  "extensions": [
                    {
                      "name": "biomarker_type",
                      "value": "Mismatch repair"
                    },
                    {
                      "name": "status",
                      "value": "Deficient"
                    }
                  ]
                }
              }
            ],
            "description": "The biomarkers associated with this Proposition, each with a `present` flag indicating if the biomarker is present (true) or absent (false). Multiple biomarkers are combined with implied AND logic."
          }
        ]
      },
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        "conceptType": "Evidence",
        "name": "Approval",
        "mappings": [],
        "primaryCoding": {
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          "code": "C25425",
          "name": "Approval",
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          "systemVersion": "25.01d",
          "iris": [
            "https://evsexplore.semantics.cancer.gov/evsexplore/concept/ncit/C25425"
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        }
      },
      "extensions": [
        {
          "name": "status",
          "value": "Active",
          "description": "Whether this Statement is Active, Superseded, or Deprecated within moalmanac-db."
        },
        {
          "name": "indication",
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            "type": "Indication",
            "description": "OPDIVO is a programmed death receptor-1 (PD-1)-blocking antibody indicated for the treatment of adult and pediatric (12 years and older) patients with unresectable or metastatic microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR) colorectal cancer (CRC) in combination with ipilimumab.",
            "contributions": [
              {
                "id": "ctrb:vanallenlab:2025-04-30:0",
                "type": "Contribution",
                "description": "The FDA provided regular approval to nivolumab in combination with ipilimumab the treatment of adults and pediatric patients 12 years and older with microsatellite instability-high (MSI-H) or DNA mismatch repair deficient (dMMR), metastatic colorectal cancer that has progressed following treatment with a fluoropyrimidine, oxaliplatin, and irinotecan. However, they split the approval in two indications: as a single agent and still as a combination for patients who have progressed on the previously listed therapies. We added a new indication to cover the combination treatment and updated all statements and propositions accordingly.",
                "date": "2025-04-30",
                "contributor": {
                  "id": "agent:user:vanallenlab",
                  "type": "Agent",
                  "agentType": "contributor",
                  "name": "Van Allen lab",
                  "description": "Van Allen lab, Dana-Farber Cancer Institute"
                }
              },
              {
                "id": "ctrb:fda:2025-04-08:0",
                "type": "Contribution",
                "description": "Indication received traditional approval.",
                "date": "2025-04-08",
                "contributor": {
                  "id": "agent:org:fda",
                  "type": "Agent",
                  "agentType": "organization",
                  "name": "Food and Drug Administration",
                  "description": "Regulatory agency that approves drugs for use in the United States."
                }
              },
              {
                "id": "ctrb:vanallenlab:2024-10-30:0",
                "type": "Contribution",
                "description": "Initial access of FDA approvals",
                "date": "2024-10-30",
                "contributor": {
                  "id": "agent:user:vanallenlab",
                  "type": "Agent",
                  "agentType": "contributor",
                  "name": "Van Allen lab",
                  "description": "Van Allen lab, Dana-Farber Cancer Institute"
                }
              },
              {
                "id": "ctrb:fda:2018-07-10:0",
                "type": "Contribution",
                "description": "Indication received accelerated approval.",
                "date": "2018-07-10",
                "contributor": {
                  "id": "agent:org:fda",
                  "type": "Agent",
                  "agentType": "organization",
                  "name": "Food and Drug Administration",
                  "description": "Regulatory agency that approves drugs for use in the United States."
                }
              }
            ],
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                "type": "Document",
                "documentType": "Regulatory approval",
                "name": "Opdivo (nivolumab) [package insert]. FDA.",
                "title": null,
                "aliases": [],
                "description": "Bristol-Myers Squibb Company. Opdivo (nivolumab) [package insert]. U.S. Food and Drug Administration website. https://www.accessdata.fda.gov/drugsatfda_docs/label/2025/125554s129lbl.pdf. Revised April 2025. Accessed April 30, 2025.",
                "urls": [
                  "https://www.accessdata.fda.gov/drugsatfda_docs/label/2025/125554s129lbl.pdf",
                  "https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=125554"
                ],
                "doi": null,
                "pmid": null,
                "extensions": [
                  {
                    "name": "agent",
                    "value": {
                      "id": "agent:org:fda",
                      "type": "Agent",
                      "agentType": "organization",
                      "name": "Food and Drug Administration",
                      "description": "Regulatory agency that approves drugs for use in the United States."
                    },
                    "description": "The organization that published this document."
                  },
                  {
                    "name": "company",
                    "value": "Bristol-Myers Squibb Company.",
                    "description": "The company that manufactures the cancer drug. Only applicable to market authorization documents."
                  },
                  {
                    "name": "drug_name_brand",
                    "value": "Opdivo",
                    "description": "The brand name of the cancer drug, per this document. Only applicable to market authorization documents."
                  },
                  {
                    "name": "drug_name_generic",
                    "value": "nivolumab",
                    "description": "The generic name of the cancer drug, per this document. Only applicable to market authorization documents."
                  },
                  {
                    "name": "first_publication_date",
                    "value": "2014-12-22",
                    "description": "The publication date for the initial version of this document."
                  },
                  {
                    "name": "identification_number",
                    "value": 125554,
                    "description": "Identification number used by the publishing organization."
                  },
                  {
                    "name": "publication_date",
                    "value": "2025-04-11",
                    "description": "The publication date for the document."
                  },
                  {
                    "name": "status",
                    "value": "Active",
                    "description": "Whether this document is Active or Deprecated within moalmanac-db."
                  }
                ]
              }
            ],
            "extensions": [
              {
                "name": "status",
                "value": "Approved",
                "description": "Current approval status."
              }
            ]
          },
          "description": "The underlying Indication supporting this Statement."
        }
      ]
    }
  ]
}