{
  "meta": {
    "data_length": 2,
    "message": "Statements retrieved successfully",
    "request_url": "http://api.moalmanac.org/statements?proposition_id=589&agent_id=fda&agent_id=ema&agent_id=hse&agent_id=hpra",
    "status": "success",
    "status_code": 200,
    "timestamp_elapsed": 0.036464,
    "timestamp_received": "2026-08-10T07:40:35.883839+00:00Z",
    "timestamp_returned": "2026-08-10T07:40:35.920303+00:00Z",
    "trace_id": "d58face9-c631-4abc-9734-8e5414096526"
  },
  "service": {
    "github": "https://github.com/vanallenlab/moalmanac-db",
    "name": "Molecular Oncology Almanac",
    "license": "GPL-2.0",
    "release": "draft",
    "url": "https://dev.moalmanac.org",
    "last_updated": "2026-05-07"
  },
  "data": [
    {
      "id": 753,
      "type": "Statement",
      "description": "The European Medicines Agency (EMA) has authorized pembrolizumab as a monotherapy for the first-line treatment of metastatic non-small cell lung carcinoma in adult patients whose tumors express PD-L1 with a >= 50% tumor proportion score (TPS) with no EGFR or ALK positive tumor mutations.",
      "contributions": [
        {
          "id": 13,
          "type": "Contribution",
          "agent": {
            "id": "vanallenlab",
            "type": "Agent",
            "agentType": "contributor",
            "name": "Van Allen lab",
            "description": "Van Allen lab, Dana-Farber Cancer Institute",
            "last_updated": null,
            "url": null
          },
          "description": "Adding EMA approvals for use to database",
          "date": "2024-10-20"
        }
      ],
      "reportedIn": [
        {
          "id": "doc:ema.keytruda",
          "type": "Document",
          "documentType": "Regulatory approval",
          "name": "Keytruda (pembrolizumab) [product information]. EMA.",
          "title": null,
          "aliases": [],
          "description": "Merck Sharp & Dohme B.V. Keytruda (pembrolizumab) [product information]. European Medicines Agency website. https://www.ema.europa.eu/en/documents/product-information/keytruda-epar-product-information_en.pdf. Revised January 2024. Accessed March 10, 2024.",
          "urls": [
            "https://www.ema.europa.eu/en/medicines/human/EPAR/keytruda",
            "https://www.ema.europa.eu/en/documents/product-information/keytruda-epar-product-information_en.pdf"
          ],
          "doi": null,
          "pmid": null,
          "extensions": [
            {
              "name": "agent",
              "value": {
                "id": "ema",
                "type": "Agent",
                "agentType": "organization",
                "name": "European Medicines Agency",
                "description": "Regulatory agency that approves medicines for use in the European Union.",
                "extensions": [
                  {
                    "name": "last_updated",
                    "value": "2026-05-05",
                    "description": ""
                  },
                  {
                    "name": "url",
                    "value": "https://www.ema.europa.eu/en/medicines",
                    "description": ""
                  }
                ]
              },
              "description": "The organization that published this document."
            },
            {
              "name": "company",
              "value": "Merck Sharp & Dohme B.V.",
              "description": "The company that manufactures the cancer drug. Only applicable to market authorization documents."
            },
            {
              "name": "drug_name_brand",
              "value": "Keytruda",
              "description": "The brand name of the cancer drug, per this document. Only applicable to market authorization documents."
            },
            {
              "name": "drug_name_generic",
              "value": "pembrolizumab",
              "description": "The generic name of the cancer drug, per this document. Only applicable to market authorization documents."
            },
            {
              "name": "first_publication_date",
              "value": "2015-07-30",
              "description": "The publication date for the initial version of this document."
            },
            {
              "name": "identification_number",
              "value": null,
              "description": "Identification number used by the publishing organization."
            },
            {
              "name": "publication_date",
              "value": "2024-01-11",
              "description": "The publication date for the document."
            },
            {
              "name": "status",
              "value": "Active",
              "description": "Whether this document is Active or Deprecated within moalmanac-db."
            }
          ]
        }
      ],
      "direction": "supports",
      "indication": {
        "id": "ind:ema.keytruda:0",
        "indication": "KEYTRUDA as monotherapy is indicated for the first-line treatment of metastatic non-small cell lung carcinoma in adults whose tumours express PD-L1 with a >= 50% tumour proportion score (TPS) with no EGFR or ALK positive tumour mutations.",
        "initial_approval_date": "2017-01-27",
        "initial_approval_url": "https://www.ema.europa.eu/en/documents/variation-report/keytruda-h-c-3820-ii-0011-epar-assessment-report-variation_en.pdf",
        "description": "The European Medicines Agency (EMA) has authorized pembrolizumab as a monotherapy for the first-line treatment of metastatic non-small cell lung carcinoma in adult patients whose tumors express PD-L1 with a >= 50% tumor proportion score (TPS) with no EGFR or ALK positive tumor mutations.",
        "raw_biomarkers": null,
        "raw_cancer_type": "non-small cell lung carcinoma",
        "raw_therapeutics": "Keytruda (pembrolizumab)",
        "icd10": null,
        "regimen_code": null,
        "reimbursement_category": null,
        "reimbursement_date": null,
        "reimbursement_details": null,
        "date_regular_approval": null,
        "date_accelerated_approval": null,
        "document": {
          "id": "doc:ema.keytruda",
          "type": "Document",
          "documentType": "Regulatory approval",
          "name": "Keytruda (pembrolizumab) [product information]. EMA.",
          "title": null,
          "aliases": [],
          "description": "Merck Sharp & Dohme B.V. Keytruda (pembrolizumab) [product information]. European Medicines Agency website. https://www.ema.europa.eu/en/documents/product-information/keytruda-epar-product-information_en.pdf. Revised January 2024. Accessed March 10, 2024.",
          "urls": [
            "https://www.ema.europa.eu/en/medicines/human/EPAR/keytruda",
            "https://www.ema.europa.eu/en/documents/product-information/keytruda-epar-product-information_en.pdf"
          ],
          "doi": null,
          "pmid": null,
          "extensions": [
            {
              "name": "agent",
              "value": {
                "id": "ema",
                "type": "Agent",
                "agentType": "organization",
                "name": "European Medicines Agency",
                "description": "Regulatory agency that approves medicines for use in the European Union.",
                "extensions": [
                  {
                    "name": "last_updated",
                    "value": "2026-05-05",
                    "description": ""
                  },
                  {
                    "name": "url",
                    "value": "https://www.ema.europa.eu/en/medicines",
                    "description": ""
                  }
                ]
              },
              "description": "The organization that published this document."
            },
            {
              "name": "company",
              "value": "Merck Sharp & Dohme B.V.",
              "description": "The company that manufactures the cancer drug. Only applicable to market authorization documents."
            },
            {
              "name": "drug_name_brand",
              "value": "Keytruda",
              "description": "The brand name of the cancer drug, per this document. Only applicable to market authorization documents."
            },
            {
              "name": "drug_name_generic",
              "value": "pembrolizumab",
              "description": "The generic name of the cancer drug, per this document. Only applicable to market authorization documents."
            },
            {
              "name": "first_publication_date",
              "value": "2015-07-30",
              "description": "The publication date for the initial version of this document."
            },
            {
              "name": "identification_number",
              "value": null,
              "description": "Identification number used by the publishing organization."
            },
            {
              "name": "publication_date",
              "value": "2024-01-11",
              "description": "The publication date for the document."
            },
            {
              "name": "status",
              "value": "Active",
              "description": "Whether this document is Active or Deprecated within moalmanac-db."
            }
          ]
        }
      },
      "proposition": {
        "id": 589,
        "type": "VariantTherapeuticResponseProposition",
        "predicate": "predictSensitivityTo",
        "biomarkers": [
          {
            "id": 35,
            "name": "Wild type EGFR",
            "genes": [
              {
                "id": 17,
                "name": "EGFR",
                "primaryCoding": {
                  "id": "hgnc:3236",
                  "code": "HGNC:3236",
                  "name": null,
                  "system": "https://genenames.org",
                  "systemVersion": null,
                  "iris": [
                    "https://www.genenames.org/data/gene-symbol-report/#!/hgnc_id/HGNC:3236"
                  ]
                },
                "mappings": [
                  {
                    "relation": "relatedMatch",
                    "coding": {
                      "id": "refseq:NM_005228.5",
                      "code": "NM_005228.5",
                      "name": null,
                      "system": "https://www.ncbi.nlm.nih.gov/nuccore",
                      "systemVersion": null,
                      "iris": [
                        "https://www.ncbi.nlm.nih.gov/nuccore/NM_005228.5"
                      ]
                    }
                  },
                  {
                    "relation": "exactMatch",
                    "coding": {
                      "id": "ensembl:ensg00000146648",
                      "code": "ENSG00000146648",
                      "name": null,
                      "system": "https://www.ensembl.org",
                      "systemVersion": null,
                      "iris": [
                        "https://www.ensembl.org/id/ENSG00000146648"
                      ]
                    }
                  },
                  {
                    "relation": "exactMatch",
                    "coding": {
                      "id": "ncbi:1956",
                      "code": "1956",
                      "name": null,
                      "system": "https://www.ncbi.nlm.nih.gov/gene",
                      "systemVersion": null,
                      "iris": [
                        "https://www.ncbi.nlm.nih.gov/gene/1956"
                      ]
                    }
                  }
                ],
                "extensions": [
                  {
                    "name": "location",
                    "value": "7p11.2"
                  },
                  {
                    "name": "location_sortable",
                    "value": "07p11.2"
                  }
                ]
              }
            ],
            "type": "CategoricalVariant",
            "extensions": [
              {
                "name": "biomarker_type",
                "value": "Wild type"
              },
              {
                "name": "present",
                "value": true
              }
            ]
          },
          {
            "id": 34,
            "name": "Wild type ALK",
            "genes": [
              {
                "id": 2,
                "name": "ALK",
                "primaryCoding": {
                  "id": "hgnc:427",
                  "code": "HGNC:427",
                  "name": null,
                  "system": "https://genenames.org",
                  "systemVersion": null,
                  "iris": [
                    "https://www.genenames.org/data/gene-symbol-report/#!/hgnc_id/HGNC:427"
                  ]
                },
                "mappings": [
                  {
                    "relation": "exactMatch",
                    "coding": {
                      "id": "ensembl:ensg00000171094",
                      "code": "ENSG00000171094",
                      "name": null,
                      "system": "https://www.ensembl.org",
                      "systemVersion": null,
                      "iris": [
                        "https://www.ensembl.org/id/ENSG00000171094"
                      ]
                    }
                  },
                  {
                    "relation": "exactMatch",
                    "coding": {
                      "id": "ncbi:238",
                      "code": "238",
                      "name": null,
                      "system": "https://www.ncbi.nlm.nih.gov/gene",
                      "systemVersion": null,
                      "iris": [
                        "https://www.ncbi.nlm.nih.gov/gene/238"
                      ]
                    }
                  },
                  {
                    "relation": "relatedMatch",
                    "coding": {
                      "id": "refseq:NM_004304.5",
                      "code": "NM_004304.5",
                      "name": null,
                      "system": "https://www.ncbi.nlm.nih.gov/nuccore",
                      "systemVersion": null,
                      "iris": [
                        "https://www.ncbi.nlm.nih.gov/nuccore/NM_004304.5"
                      ]
                    }
                  }
                ],
                "extensions": [
                  {
                    "name": "location",
                    "value": "2p23.2-p23.1"
                  },
                  {
                    "name": "location_sortable",
                    "value": "02p23.2-p23.1"
                  }
                ]
              }
            ],
            "type": "CategoricalVariant",
            "extensions": [
              {
                "name": "biomarker_type",
                "value": "Wild type"
              },
              {
                "name": "present",
                "value": true
              }
            ]
          },
          {
            "id": 40,
            "name": "CD274 amplification",
            "genes": [
              {
                "id": 13,
                "name": "CD274",
                "primaryCoding": {
                  "id": "hgnc:17635",
                  "code": "HGNC:17635",
                  "name": null,
                  "system": "https://genenames.org",
                  "systemVersion": null,
                  "iris": [
                    "https://www.genenames.org/data/gene-symbol-report/#!/hgnc_id/HGNC:17635"
                  ]
                },
                "mappings": [
                  {
                    "relation": "relatedMatch",
                    "coding": {
                      "id": "refseq:NM_014143.4",
                      "code": "NM_014143.4",
                      "name": null,
                      "system": "https://www.ncbi.nlm.nih.gov/nuccore",
                      "systemVersion": null,
                      "iris": [
                        "https://www.ncbi.nlm.nih.gov/nuccore/NM_014143.4"
                      ]
                    }
                  },
                  {
                    "relation": "exactMatch",
                    "coding": {
                      "id": "ensembl:ensg00000120217",
                      "code": "ENSG00000120217",
                      "name": null,
                      "system": "https://www.ensembl.org",
                      "systemVersion": null,
                      "iris": [
                        "https://www.ensembl.org/id/ENSG00000120217"
                      ]
                    }
                  },
                  {
                    "relation": "exactMatch",
                    "coding": {
                      "id": "ncbi:29126",
                      "code": "29126",
                      "name": null,
                      "system": "https://www.ncbi.nlm.nih.gov/gene",
                      "systemVersion": null,
                      "iris": [
                        "https://www.ncbi.nlm.nih.gov/gene/29126"
                      ]
                    }
                  }
                ],
                "extensions": [
                  {
                    "name": "location",
                    "value": "9p24.1"
                  },
                  {
                    "name": "location_sortable",
                    "value": "09p24.1"
                  }
                ]
              }
            ],
            "type": "CategoricalVariant",
            "extensions": [
              {
                "name": "biomarker_type",
                "value": "Copy Number"
              },
              {
                "name": "present",
                "value": true
              },
              {
                "name": "direction",
                "value": "Amplification"
              }
            ]
          }
        ],
        "subjectVariant": {},
        "conditionQualifier": {
          "id": 47,
          "conceptType": "Disease",
          "name": "Non-Small Cell Lung Cancer",
          "primaryCoding": {
            "id": "oncotree:NSCLC",
            "code": "NSCLC",
            "name": "Non-Small Cell Lung Cancer",
            "system": "https://oncotree.mskcc.org",
            "systemVersion": "oncotree_2021_11_02",
            "iris": [
              "https://oncotree.mskcc.org/?version=oncotree_2021_11_02&field=CODE&search=NSCLC"
            ]
          },
          "mappings": []
        },
        "objectTherapeutic": {
          "id": 48,
          "conceptType": "Drug",
          "name": "Pembrolizumab",
          "primaryCoding": {
            "id": "ncit:C106432",
            "code": "C106432",
            "name": "Pembrolizumab",
            "system": "https://evsexplore.semantics.cancer.gov",
            "systemVersion": "25.01d",
            "iris": [
              "https://evsexplore.semantics.cancer.gov/evsexplore/concept/ncit/C106432"
            ]
          },
          "mappings": [
            {
              "relation": "relatedMatch",
              "coding": {
                "id": "rxcui:1547545",
                "code": "1547545",
                "name": "pembrolizumab",
                "system": "RxNorm",
                "systemVersion": "02-Mar-2026",
                "iris": [
                  "https://mor.nlm.nih.gov/RxNav/search?searchBy=RXCUI&searchTerm=1547545"
                ]
              }
            },
            {
              "relation": "relatedMatch",
              "coding": {
                "id": "omop:45775965",
                "code": "45775965",
                "name": "pembrolizumab",
                "system": "OMOP",
                "systemVersion": "v20260227",
                "iris": [
                  "https://athena.ohdsi.org/search-terms/terms/45775965"
                ]
              }
            },
            {
              "relation": "relatedMatch",
              "coding": {
                "id": "sctid:716125002",
                "code": "716125002",
                "name": "Pembrolizumab",
                "system": "SNOMED",
                "systemVersion": "2025-03-01",
                "iris": [
                  "https://browser.ihtsdotools.org/?perspective=full&conceptId1=716125002&edition=MAIN/2025-03-01&release=&languages=en"
                ]
              }
            },
            {
              "relation": "relatedMatch",
              "coding": {
                "id": "omop:37396350",
                "code": "37396350",
                "name": "Pembrolizumab",
                "system": "OMOP",
                "systemVersion": "v20260227",
                "iris": [
                  "https://athena.ohdsi.org/search-terms/terms/37396350"
                ]
              }
            }
          ],
          "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"
            }
          ]
        }
      }
    },
    {
      "id": 1261,
      "type": "Statement",
      "description": "The Republic of Ireland's Health Service Executive (HSE) has approved pembrolizumab (200mg and 400mg) for reimbursement as a first-line treatment option for the treatment of adult patients with metastatic non-small cell lung carcinoma (NSCLC) whose tumors express PD-L1 with a >= 50% tumor proportion score (TPS) with no EGFR mutations or ALK translocations.",
      "contributions": [
        {
          "id": 41,
          "type": "Contribution",
          "agent": {
            "id": "vanallenlab",
            "type": "Agent",
            "agentType": "contributor",
            "name": "Van Allen lab",
            "description": "Van Allen lab, Dana-Farber Cancer Institute",
            "last_updated": null,
            "url": null
          },
          "description": "Adding HSE approvals for reimbursement to database",
          "date": "2024-01-16"
        }
      ],
      "reportedIn": [
        {
          "id": "doc:hse.00455",
          "type": "Document",
          "documentType": "Regulatory approval",
          "name": "Pembrolizumab 200mg Monotherapy. NCCP National SACT Regimen. HSE.",
          "title": null,
          "aliases": [],
          "description": "Pembrolizumab 200mg Monotherapy, 2020, version number 7, NCCP National SACT Regimen, NCCP, viewed 26/03/2026, https://healthservice.hse.ie/documents/6903/455_V15b__Pembrolizumab_200mg_Monotherapy.pdf",
          "urls": [
            "https://healthservice.hse.ie/documents/6903/455_V15b__Pembrolizumab_200mg_Monotherapy.pdf"
          ],
          "doi": null,
          "pmid": null,
          "extensions": [
            {
              "name": "agent",
              "value": {
                "id": "hse",
                "type": "Agent",
                "agentType": "organization",
                "name": "Health Service Executive",
                "description": "Regulatory agency that approves medicines for reimbursement by the public health system in the Republic of Ireland.",
                "extensions": [
                  {
                    "name": "last_updated",
                    "value": "2025-10-01",
                    "description": ""
                  },
                  {
                    "name": "url",
                    "value": "https://healthservice.hse.ie/staff/information-healthcare-workers/nccp/national-sact-regimens/",
                    "description": ""
                  }
                ]
              },
              "description": "The organization that published this document."
            },
            {
              "name": "company",
              "value": "",
              "description": "The company that manufactures the cancer drug. Only applicable to market authorization documents."
            },
            {
              "name": "drug_name_brand",
              "value": null,
              "description": "The brand name of the cancer drug, per this document. Only applicable to market authorization documents."
            },
            {
              "name": "drug_name_generic",
              "value": null,
              "description": "The generic name of the cancer drug, per this document. Only applicable to market authorization documents."
            },
            {
              "name": "first_publication_date",
              "value": null,
              "description": "The publication date for the initial version of this document."
            },
            {
              "name": "identification_number",
              "value": null,
              "description": "Identification number used by the publishing organization."
            },
            {
              "name": "publication_date",
              "value": "2023-04-01",
              "description": "The publication date for the document."
            },
            {
              "name": "status",
              "value": "Active",
              "description": "Whether this document is Active or Deprecated within moalmanac-db."
            }
          ]
        }
      ],
      "direction": "supports",
      "indication": {
        "id": "ind:hse.00455:a",
        "indication": "First-line treatment of metastatic non-small cell lung carcinoma (NSCLC) in adults whose tumours express PD-L1 with a >= 50% tumour proportion score (TPS) with no EGFR mutations or ALK translocations.",
        "initial_approval_date": "2018-04-01",
        "initial_approval_url": null,
        "description": "The Republic of Ireland's Health Service Executive (HSE) has approved pembrolizumab (200mg and 400mg) for reimbursement as a first-line treatment option for the treatment of adult patients with metastatic non-small cell lung carcinoma (NSCLC) whose tumors express PD-L1 with a >= 50% tumor proportion score (TPS) with no EGFR mutations or ALK translocations.",
        "raw_biomarkers": null,
        "raw_cancer_type": "non-small cell lung carcinoma",
        "raw_therapeutics": "Pembrolizumab 200mg monotherapy",
        "icd10": null,
        "regimen_code": null,
        "reimbursement_category": null,
        "reimbursement_date": null,
        "reimbursement_details": null,
        "date_regular_approval": null,
        "date_accelerated_approval": null,
        "document": {
          "id": "doc:hse.00455",
          "type": "Document",
          "documentType": "Regulatory approval",
          "name": "Pembrolizumab 200mg Monotherapy. NCCP National SACT Regimen. HSE.",
          "title": null,
          "aliases": [],
          "description": "Pembrolizumab 200mg Monotherapy, 2020, version number 7, NCCP National SACT Regimen, NCCP, viewed 26/03/2026, https://healthservice.hse.ie/documents/6903/455_V15b__Pembrolizumab_200mg_Monotherapy.pdf",
          "urls": [
            "https://healthservice.hse.ie/documents/6903/455_V15b__Pembrolizumab_200mg_Monotherapy.pdf"
          ],
          "doi": null,
          "pmid": null,
          "extensions": [
            {
              "name": "agent",
              "value": {
                "id": "hse",
                "type": "Agent",
                "agentType": "organization",
                "name": "Health Service Executive",
                "description": "Regulatory agency that approves medicines for reimbursement by the public health system in the Republic of Ireland.",
                "extensions": [
                  {
                    "name": "last_updated",
                    "value": "2025-10-01",
                    "description": ""
                  },
                  {
                    "name": "url",
                    "value": "https://healthservice.hse.ie/staff/information-healthcare-workers/nccp/national-sact-regimens/",
                    "description": ""
                  }
                ]
              },
              "description": "The organization that published this document."
            },
            {
              "name": "company",
              "value": "",
              "description": "The company that manufactures the cancer drug. Only applicable to market authorization documents."
            },
            {
              "name": "drug_name_brand",
              "value": null,
              "description": "The brand name of the cancer drug, per this document. Only applicable to market authorization documents."
            },
            {
              "name": "drug_name_generic",
              "value": null,
              "description": "The generic name of the cancer drug, per this document. Only applicable to market authorization documents."
            },
            {
              "name": "first_publication_date",
              "value": null,
              "description": "The publication date for the initial version of this document."
            },
            {
              "name": "identification_number",
              "value": null,
              "description": "Identification number used by the publishing organization."
            },
            {
              "name": "publication_date",
              "value": "2023-04-01",
              "description": "The publication date for the document."
            },
            {
              "name": "status",
              "value": "Active",
              "description": "Whether this document is Active or Deprecated within moalmanac-db."
            }
          ]
        }
      },
      "proposition": {
        "id": 589,
        "type": "VariantTherapeuticResponseProposition",
        "predicate": "predictSensitivityTo",
        "biomarkers": [
          {
            "id": 35,
            "name": "Wild type EGFR",
            "genes": [
              {
                "id": 17,
                "name": "EGFR",
                "primaryCoding": {
                  "id": "hgnc:3236",
                  "code": "HGNC:3236",
                  "name": null,
                  "system": "https://genenames.org",
                  "systemVersion": null,
                  "iris": [
                    "https://www.genenames.org/data/gene-symbol-report/#!/hgnc_id/HGNC:3236"
                  ]
                },
                "mappings": [
                  {
                    "relation": "relatedMatch",
                    "coding": {
                      "id": "refseq:NM_005228.5",
                      "code": "NM_005228.5",
                      "name": null,
                      "system": "https://www.ncbi.nlm.nih.gov/nuccore",
                      "systemVersion": null,
                      "iris": [
                        "https://www.ncbi.nlm.nih.gov/nuccore/NM_005228.5"
                      ]
                    }
                  },
                  {
                    "relation": "exactMatch",
                    "coding": {
                      "id": "ensembl:ensg00000146648",
                      "code": "ENSG00000146648",
                      "name": null,
                      "system": "https://www.ensembl.org",
                      "systemVersion": null,
                      "iris": [
                        "https://www.ensembl.org/id/ENSG00000146648"
                      ]
                    }
                  },
                  {
                    "relation": "exactMatch",
                    "coding": {
                      "id": "ncbi:1956",
                      "code": "1956",
                      "name": null,
                      "system": "https://www.ncbi.nlm.nih.gov/gene",
                      "systemVersion": null,
                      "iris": [
                        "https://www.ncbi.nlm.nih.gov/gene/1956"
                      ]
                    }
                  }
                ],
                "extensions": [
                  {
                    "name": "location",
                    "value": "7p11.2"
                  },
                  {
                    "name": "location_sortable",
                    "value": "07p11.2"
                  }
                ]
              }
            ],
            "type": "CategoricalVariant",
            "extensions": [
              {
                "name": "biomarker_type",
                "value": "Wild type"
              },
              {
                "name": "present",
                "value": true
              }
            ]
          },
          {
            "id": 34,
            "name": "Wild type ALK",
            "genes": [
              {
                "id": 2,
                "name": "ALK",
                "primaryCoding": {
                  "id": "hgnc:427",
                  "code": "HGNC:427",
                  "name": null,
                  "system": "https://genenames.org",
                  "systemVersion": null,
                  "iris": [
                    "https://www.genenames.org/data/gene-symbol-report/#!/hgnc_id/HGNC:427"
                  ]
                },
                "mappings": [
                  {
                    "relation": "exactMatch",
                    "coding": {
                      "id": "ensembl:ensg00000171094",
                      "code": "ENSG00000171094",
                      "name": null,
                      "system": "https://www.ensembl.org",
                      "systemVersion": null,
                      "iris": [
                        "https://www.ensembl.org/id/ENSG00000171094"
                      ]
                    }
                  },
                  {
                    "relation": "exactMatch",
                    "coding": {
                      "id": "ncbi:238",
                      "code": "238",
                      "name": null,
                      "system": "https://www.ncbi.nlm.nih.gov/gene",
                      "systemVersion": null,
                      "iris": [
                        "https://www.ncbi.nlm.nih.gov/gene/238"
                      ]
                    }
                  },
                  {
                    "relation": "relatedMatch",
                    "coding": {
                      "id": "refseq:NM_004304.5",
                      "code": "NM_004304.5",
                      "name": null,
                      "system": "https://www.ncbi.nlm.nih.gov/nuccore",
                      "systemVersion": null,
                      "iris": [
                        "https://www.ncbi.nlm.nih.gov/nuccore/NM_004304.5"
                      ]
                    }
                  }
                ],
                "extensions": [
                  {
                    "name": "location",
                    "value": "2p23.2-p23.1"
                  },
                  {
                    "name": "location_sortable",
                    "value": "02p23.2-p23.1"
                  }
                ]
              }
            ],
            "type": "CategoricalVariant",
            "extensions": [
              {
                "name": "biomarker_type",
                "value": "Wild type"
              },
              {
                "name": "present",
                "value": true
              }
            ]
          },
          {
            "id": 40,
            "name": "CD274 amplification",
            "genes": [
              {
                "id": 13,
                "name": "CD274",
                "primaryCoding": {
                  "id": "hgnc:17635",
                  "code": "HGNC:17635",
                  "name": null,
                  "system": "https://genenames.org",
                  "systemVersion": null,
                  "iris": [
                    "https://www.genenames.org/data/gene-symbol-report/#!/hgnc_id/HGNC:17635"
                  ]
                },
                "mappings": [
                  {
                    "relation": "relatedMatch",
                    "coding": {
                      "id": "refseq:NM_014143.4",
                      "code": "NM_014143.4",
                      "name": null,
                      "system": "https://www.ncbi.nlm.nih.gov/nuccore",
                      "systemVersion": null,
                      "iris": [
                        "https://www.ncbi.nlm.nih.gov/nuccore/NM_014143.4"
                      ]
                    }
                  },
                  {
                    "relation": "exactMatch",
                    "coding": {
                      "id": "ensembl:ensg00000120217",
                      "code": "ENSG00000120217",
                      "name": null,
                      "system": "https://www.ensembl.org",
                      "systemVersion": null,
                      "iris": [
                        "https://www.ensembl.org/id/ENSG00000120217"
                      ]
                    }
                  },
                  {
                    "relation": "exactMatch",
                    "coding": {
                      "id": "ncbi:29126",
                      "code": "29126",
                      "name": null,
                      "system": "https://www.ncbi.nlm.nih.gov/gene",
                      "systemVersion": null,
                      "iris": [
                        "https://www.ncbi.nlm.nih.gov/gene/29126"
                      ]
                    }
                  }
                ],
                "extensions": [
                  {
                    "name": "location",
                    "value": "9p24.1"
                  },
                  {
                    "name": "location_sortable",
                    "value": "09p24.1"
                  }
                ]
              }
            ],
            "type": "CategoricalVariant",
            "extensions": [
              {
                "name": "biomarker_type",
                "value": "Copy Number"
              },
              {
                "name": "present",
                "value": true
              },
              {
                "name": "direction",
                "value": "Amplification"
              }
            ]
          }
        ],
        "subjectVariant": {},
        "conditionQualifier": {
          "id": 47,
          "conceptType": "Disease",
          "name": "Non-Small Cell Lung Cancer",
          "primaryCoding": {
            "id": "oncotree:NSCLC",
            "code": "NSCLC",
            "name": "Non-Small Cell Lung Cancer",
            "system": "https://oncotree.mskcc.org",
            "systemVersion": "oncotree_2021_11_02",
            "iris": [
              "https://oncotree.mskcc.org/?version=oncotree_2021_11_02&field=CODE&search=NSCLC"
            ]
          },
          "mappings": []
        },
        "objectTherapeutic": {
          "id": 48,
          "conceptType": "Drug",
          "name": "Pembrolizumab",
          "primaryCoding": {
            "id": "ncit:C106432",
            "code": "C106432",
            "name": "Pembrolizumab",
            "system": "https://evsexplore.semantics.cancer.gov",
            "systemVersion": "25.01d",
            "iris": [
              "https://evsexplore.semantics.cancer.gov/evsexplore/concept/ncit/C106432"
            ]
          },
          "mappings": [
            {
              "relation": "relatedMatch",
              "coding": {
                "id": "rxcui:1547545",
                "code": "1547545",
                "name": "pembrolizumab",
                "system": "RxNorm",
                "systemVersion": "02-Mar-2026",
                "iris": [
                  "https://mor.nlm.nih.gov/RxNav/search?searchBy=RXCUI&searchTerm=1547545"
                ]
              }
            },
            {
              "relation": "relatedMatch",
              "coding": {
                "id": "omop:45775965",
                "code": "45775965",
                "name": "pembrolizumab",
                "system": "OMOP",
                "systemVersion": "v20260227",
                "iris": [
                  "https://athena.ohdsi.org/search-terms/terms/45775965"
                ]
              }
            },
            {
              "relation": "relatedMatch",
              "coding": {
                "id": "sctid:716125002",
                "code": "716125002",
                "name": "Pembrolizumab",
                "system": "SNOMED",
                "systemVersion": "2025-03-01",
                "iris": [
                  "https://browser.ihtsdotools.org/?perspective=full&conceptId1=716125002&edition=MAIN/2025-03-01&release=&languages=en"
                ]
              }
            },
            {
              "relation": "relatedMatch",
              "coding": {
                "id": "omop:37396350",
                "code": "37396350",
                "name": "Pembrolizumab",
                "system": "OMOP",
                "systemVersion": "v20260227",
                "iris": [
                  "https://athena.ohdsi.org/search-terms/terms/37396350"
                ]
              }
            }
          ],
          "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"
            }
          ]
        }
      }
    }
  ]
}