{
  "schema": "fcai-oneview",
  "schemaVersion": "0.1",
  "builtOn": "HL7 mCODE (structure)",
  "meta": {"version": "1.0", "asOfDate": "2026-10-08", "nextReview": "after C5 CT", "mode": "public"},
  "disease": {
    "cancerType": "Colorectal adenocarcinoma, moderately differentiated",
    "primarySite": "Rectosigmoid colon",
    "diagnosisYear": 2021,
    "tnm": {"t": "ypT4a", "n": "ypN1b", "m": "M1a", "type": "pathological (post-neoadjuvant)", "notes": "3/24 nodes; V+"},
    "stageGroup": "IV",
    "sitesOfDisease": [
      {"site": "Lungs (left perihilar, right lower lobe, nodules)", "dateFound": "2023-02"},
      {"site": "Mediastinal lymph nodes", "dateFound": "2024-11"},
      {"site": "Liver segment VII", "dateFound": "2026-07-23"}
    ],
    "provenance": "Clinician letter 2026-05-18; Imaging report 2026-07-23"
  },
  "genomics": {
    "source": "Exacta, 2025-09-01",
    "variants": [
      {"gene": "APC", "hgvs": "c.4245del p.S1415Rfs*4", "vafTissue": 8.5, "vafBlood": 0.62, "class": "pathogenic"},
      {"gene": "TP53", "hgvs": "c.1024C>T p.R342*", "vafTissue": 9.21, "class": "pathogenic"}
    ],
    "standardMarkers": [
      {"marker": "KRAS", "result": "wild-type"},
      {"marker": "NRAS", "result": "wild-type"},
      {"marker": "BRAF", "result": "wild-type"},
      {"marker": "MMR/MSI", "result": "pMMR / MSS"},
      {"marker": "HER2", "result": "not amplified"},
      {"marker": "TMB", "result": "3 Mut/Mb (low)"},
      {"marker": "PD-L1", "result": "<1%"},
      {"marker": "PTEN", "result": "no variant detected"}
    ],
    "vus": ["RUNX1T1", "FANCM", "CIC", "BCR", "CYP2D6"],
    "exploratory": {"source": "Astron, 2025-09-10", "icc": ["mTOR positive", "VEGFR1/2 positive", "HMGB1 overexpressed"]}
  },
  "tumourMarkers": [
    {"name": "CEA", "unit": "ug/L", "referenceRange": "0-4.9", "date": "2026-04-20", "value": 16.8},
    {"name": "CEA", "unit": "ug/L", "referenceRange": "0-5.2", "date": "2026-07-23", "value": 49.4},
    {"name": "CEA", "unit": "ug/L", "referenceRange": "0-5.2", "date": "2026-08-07", "value": 87.6},
    {"name": "CEA", "unit": "ug/L", "referenceRange": "0-5.2", "date": "2026-09-01", "value": 146.0},
    {"name": "CEA", "unit": "ug/L", "referenceRange": "0-5.2", "date": "2026-09-14", "value": 50.9},
    {"name": "CEA", "unit": "ug/L", "referenceRange": "0-5.2", "date": "2026-09-29", "value": 44.6}
  ],
  "healthAssessment": {
    "performanceStatus": {"scale": "WHO", "value": 0, "date": "2026-08-24"},
    "otherConditions": ["Smouldering myeloma (surveillance)", "Gilbert's syndrome", "Persistent cough (2026-08)"],
    "allergies": ["No known drug allergies"]
  },
  "treatmentLines": [
    {"label": "Neoadjuvant", "regimen": "XELOX", "cycles": 4, "start": "2021-12", "stop": "2022-02", "bestResponse": "good partial response"},
    {"label": "Surgery", "regimen": "High anterior resection", "start": "2022-03-28"},
    {"label": "Surgery", "regimen": "Liver 4b/5 resection R0 + cholecystectomy", "start": "2022-06-30"},
    {"label": "Peri-operative", "regimen": "XELOX", "cycles": 4, "start": "2022-05", "stop": "2022-10", "notes": "1 stopped for liver progression; 3 adjuvant"},
    {"label": "Radiotherapy", "regimen": "SABR 55 Gy/5 to lung", "start": "2023-04"},
    {"label": "Ablation", "regimen": "Percutaneous lung ablation, 6 lesions", "start": "2024-06", "stop": "2024-08"},
    {"label": "Line 1", "regimen": "FOLFIRI + cetuximab", "cycles": 6, "start": "2025-04", "stop": "2025-07", "bestResponse": "good partial response"},
    {"label": "Line 1 rechallenge", "regimen": "FOLFIRI + cetuximab", "cycles": 6, "start": "2026-02", "stop": "2026-05", "bestResponse": "good response (CT 2026-05-12)"},
    {"label": "Line 1 rechallenge, block 3", "regimen": "FOLFIRI + cetuximab", "start": "2026-08-19", "stop": null, "cyclesGiven": 4, "nextCycle": "2026-10-14"}
  ],
  "latestImaging": {"date": "2026-07-23", "summary": "Progression in chest; new liver segment VII lesion. Next CT after C5."},
  "latestBloods": {"date": "2026-09-29", "flags": ["Hb 126 g/L LOW", "RBC 4.09 LOW", "ALP 169 U/L HIGH", "Bilirubin 21 umol/L HIGH (Gilbert's)"], "platelets": "pending"},
  "openQuestions": [
    "Is now the time to treat the liver lesion: surgery or ablation?",
    "If responding, continue or step down (e.g. drop irinotecan)?",
    "What comes next after this line?"
  ],
  "_notes": {
    "whatThisIs": "FC:AI One View — the short, structured summary. The full feed, with every blood panel, the chemo log and the sequencing manifest, is at /data/profile.json.",
    "notMedicalAdvice": "Patient-maintained. Verify against source records before acting on anything here.",
    "privacy": "Deliberately carries no date of birth, address, phone, NHS number, hospital or lab reference numbers, or care team names."
  }
}