<?xml version="1.0" encoding="UTF-8"?>

<PlanDefinition xmlns="http://hl7.org/fhir">
  <id value="RegimenDdACT"/>
  <meta>
    <profile value="http://hl7.org/fhir/us/codex-mopa/StructureDefinition/anticancer-regimen-plandefinition"/>
  </meta>
  <language value="en"/>
  <text>
    <status value="extensions"/><div xmlns="http://www.w3.org/1999/xhtml">
  <table class="narrative-table">
    <tbody>
<tr>


<th colspan="2" scope="row" class="row-header">Metadata</th>


</tr>

<tr>


<th scope="row" class="row-header">Title</th>



<td class="content-container">ddAC→T: Dose-Dense Doxorubicin/Cyclophosphamide then Paclitaxel — Breast Cancer</td>


</tr>



<tr>


<th scope="row" class="row-header">Version</th>



<td class="content-container">0.1.1-snapshot-080926</td>


</tr>













<tr>


<th scope="row" class="row-header">Experimental</th>



<td class="content-container">true</td>


</tr>



<tr>


<th scope="row" class="row-header">Subject Type</th>



<td class="content-container">
    Malignant neoplasm of breast


</td>


</tr>



<tr>


<th scope="row" class="row-header">Jurisdiction</th>



<td class="content-container">
    United States of America


</td>


</tr>








<tr>


<th scope="row" class="row-header">Steward (Publisher)</th>



<td class="content-container">HL7 International / Clinical Interoperability Council</td>


</tr>



<tr>


<th scope="row" class="row-header">Steward Contact</th>



<td class="content-container">HL7 International / Clinical Interoperability Council</td>


</tr>







<tr>


<th scope="row" class="row-header">Description</th>



<td class="content-container"><div><p>Dose-dense AC x4 cycles (q14d) with pegfilgrastim support, followed by paclitaxel x4 cycles (q14d) for breast cancer.</p>
</div></td>


</tr>






<tr>


<th scope="row" class="row-header">Type</th>



<td class="content-container">
    Order Set


</td>


</tr>




<tr>


<th colspan="2" scope="row" class="row-header">PlanDefinition Action</th>


</tr>

<tr>


<th scope="row" class="row-header">Id</th>



<td class="content-container">ac-phase</td>


</tr>




<tr>


<th scope="row" class="row-header">Title</th>



<td class="content-container">AC Phase — Doxorubicin + Cyclophosphamide (q14d × 4 cycles)</td>


</tr>













<tr>


<th scope="row" class="row-header">Timing</th>



<td class="content-container">Count 4  times, Once per 14 days</td>


</tr>












  
    
      
      
<tr>


<th colspan="2" scope="row" class="row-header">PlanDefinition Sub-Action (Parent Action ID: ac-phase)</th>


</tr>

<tr>


<th scope="row" class="row-header">Id</th>



<td class="content-container">doxorubicin-ac</td>


</tr>




<tr>


<th scope="row" class="row-header">Title</th>



<td class="content-container">Doxorubicin 60 mg/m² IV — Day 1 of each 14-day cycle</td>


</tr>













<tr>


<th scope="row" class="row-header">Timing</th>



<td class="content-container">Once per 14 days</td>


</tr>












    
    
      
<tr>


<th colspan="2" scope="row" class="row-header">PlanDefinition Sub-Action</th>


</tr>

<tr>


<th scope="row" class="row-header">Id</th>



<td class="content-container">doxorubicin-ac</td>


</tr>




<tr>


<th scope="row" class="row-header">Title</th>



<td class="content-container">Doxorubicin 60 mg/m² IV — Day 1 of each 14-day cycle</td>


</tr>













<tr>


<th scope="row" class="row-header">Timing</th>



<td class="content-container">Once per 14 days</td>


</tr>












    
  
    
      
      
<tr>


<th colspan="2" scope="row" class="row-header">PlanDefinition Sub-Action (Parent Action ID: ac-phase)</th>


</tr>

<tr>


<th scope="row" class="row-header">Id</th>



<td class="content-container">pegfilgrastim-ac</td>


</tr>




<tr>


<th scope="row" class="row-header">Title</th>



<td class="content-container">Pegfilgrastim 6 mg subcutaneous — Day 2 of each 14-day cycle</td>


</tr>


<tr>


<th scope="row" class="row-header">Description</th>



<td class="content-container">Pegfilgrastim supportive care on day 2 of each ddAC cycle</td>


</tr>












<tr>


<th scope="row" class="row-header">Timing</th>



<td class="content-container">Once per 14 days</td>


</tr>












    
    
      
<tr>


<th colspan="2" scope="row" class="row-header">PlanDefinition Sub-Action</th>


</tr>

<tr>


<th scope="row" class="row-header">Id</th>



<td class="content-container">pegfilgrastim-ac</td>


</tr>




<tr>


<th scope="row" class="row-header">Title</th>



<td class="content-container">Pegfilgrastim 6 mg subcutaneous — Day 2 of each 14-day cycle</td>


</tr>


<tr>


<th scope="row" class="row-header">Description</th>



<td class="content-container">Pegfilgrastim supportive care on day 2 of each ddAC cycle</td>


</tr>












<tr>


<th scope="row" class="row-header">Timing</th>



<td class="content-container">Once per 14 days</td>


</tr>












    
  
    
      
      
<tr>


<th colspan="2" scope="row" class="row-header">PlanDefinition Sub-Action (Parent Action ID: ac-phase)</th>


</tr>

<tr>


<th scope="row" class="row-header">Id</th>



<td class="content-container">cyclophosphamide-ac</td>


</tr>




<tr>


<th scope="row" class="row-header">Title</th>



<td class="content-container">Cyclophosphamide 600 mg/m² IV — Day 1 of each 14-day cycle</td>


</tr>













<tr>


<th scope="row" class="row-header">Timing</th>



<td class="content-container">Once per 14 days</td>


</tr>












    
    
      
<tr>


<th colspan="2" scope="row" class="row-header">PlanDefinition Sub-Action</th>


</tr>

<tr>


<th scope="row" class="row-header">Id</th>



<td class="content-container">cyclophosphamide-ac</td>


</tr>




<tr>


<th scope="row" class="row-header">Title</th>



<td class="content-container">Cyclophosphamide 600 mg/m² IV — Day 1 of each 14-day cycle</td>


</tr>













<tr>


<th scope="row" class="row-header">Timing</th>



<td class="content-container">Once per 14 days</td>


</tr>












    
  



<tr>


<th colspan="2" scope="row" class="row-header">PlanDefinition Action</th>


</tr>

<tr>


<th scope="row" class="row-header">Id</th>



<td class="content-container">t-phase</td>


</tr>




<tr>


<th scope="row" class="row-header">Title</th>



<td class="content-container">T Phase — Paclitaxel (q14d × 4 cycles)</td>


</tr>













<tr>


<th scope="row" class="row-header">Timing</th>



<td class="content-container">Count 4  times, Once per 14 days</td>


</tr>












  
    
      
      
<tr>


<th colspan="2" scope="row" class="row-header">PlanDefinition Sub-Action (Parent Action ID: t-phase)</th>


</tr>

<tr>


<th scope="row" class="row-header">Id</th>



<td class="content-container">paclitaxel-t</td>


</tr>




<tr>


<th scope="row" class="row-header">Title</th>



<td class="content-container">Paclitaxel 175 mg/m² IV — Day 1 of each 14-day cycle</td>


</tr>













<tr>


<th scope="row" class="row-header">Timing</th>



<td class="content-container">Once per 14 days</td>


</tr>












    
    
      
<tr>


<th colspan="2" scope="row" class="row-header">PlanDefinition Sub-Action</th>


</tr>

<tr>


<th scope="row" class="row-header">Id</th>



<td class="content-container">paclitaxel-t</td>


</tr>




<tr>


<th scope="row" class="row-header">Title</th>



<td class="content-container">Paclitaxel 175 mg/m² IV — Day 1 of each 14-day cycle</td>


</tr>













<tr>


<th scope="row" class="row-header">Timing</th>



<td class="content-container">Once per 14 days</td>


</tr>












    
  





<tr>
  <th colspan="2" scope="row" class="row-header">Generated using version 0.5.4 of the sample-content-ig Liquid templates</th>
</tr>

    </tbody>
  </table>
</div>
  </text>
  <url value="http://hl7.org/fhir/us/codex-mopa/PlanDefinition/RegimenDdACT"/>
  <version value="0.1.1-snapshot-080926"/>
  <name value="RegimenDdACT"/>
  <title value="ddAC→T: Dose-Dense Doxorubicin/Cyclophosphamide then Paclitaxel — Breast Cancer"/>
  <type>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/plan-definition-type"/>
      <code value="order-set"/>
      <display value="Order Set"/>
    </coding>
  </type>
  <status value="active"/>
  <experimental value="true"/>
  <subjectCodeableConcept>
    <coding>
      <system value="http://snomed.info/sct"/>
      <code value="254837009"/>
      <display value="Malignant neoplasm of breast"/>
    </coding>
  </subjectCodeableConcept>
  <date value="2026-09-08T18:17:28-04:00"/>
  <publisher value="HL7 International / Clinical Interoperability Council"/>
  <contact>
    <name value="HL7 International / Clinical Interoperability Council"/>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/Special/committees/cic"/>
    </telecom>
    <telecom>
      <system value="email"/>
      <value value="ciclist@lists.HL7.org"/>
    </telecom>
  </contact>
  <description value="Dose-dense AC x4 cycles (q14d) with pegfilgrastim support, followed by paclitaxel x4 cycles (q14d) for breast cancer."/>
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166"/>
      <code value="US"/>
      <display value="United States of America"/>
    </coding>
  </jurisdiction>
  <action id="ac-phase">
    <title value="AC Phase — Doxorubicin + Cyclophosphamide (q14d × 4 cycles)"/>
    <timingTiming>
      <repeat>
        <count value="4"/>
        <period value="14"/>
        <periodUnit value="d"/>
      </repeat>
    </timingTiming>
    <action id="doxorubicin-ac">
      <title value="Doxorubicin 60 mg/m² IV — Day 1 of each 14-day cycle"/>
      <timingTiming>
        <repeat>
          <period value="14"/>
          <periodUnit value="d"/>
        </repeat>
      </timingTiming>
    </action>
    <action id="pegfilgrastim-ac">
      <title value="Pegfilgrastim 6 mg subcutaneous — Day 2 of each 14-day cycle"/>
      <description value="Pegfilgrastim supportive care on day 2 of each ddAC cycle"/>
      <timingTiming>
        <extension url="http://hl7.org/fhir/us/codex-mopa/StructureDefinition/regimen-days-of-cycle">
          <extension url="day">
            <valueInteger value="2"/>
          </extension>
        </extension>
        <repeat>
          <period value="14"/>
          <periodUnit value="d"/>
        </repeat>
      </timingTiming>
    </action>
    <action id="cyclophosphamide-ac">
      <title value="Cyclophosphamide 600 mg/m² IV — Day 1 of each 14-day cycle"/>
      <timingTiming>
        <repeat>
          <period value="14"/>
          <periodUnit value="d"/>
        </repeat>
      </timingTiming>
    </action>
  </action>
  <action id="t-phase">
    <title value="T Phase — Paclitaxel (q14d × 4 cycles)"/>
    <relatedAction>
      <actionId value="ac-phase"/>
      <relationship value="after-end"/>
    </relatedAction>
    <timingTiming>
      <repeat>
        <count value="4"/>
        <period value="14"/>
        <periodUnit value="d"/>
      </repeat>
    </timingTiming>
    <action id="paclitaxel-t">
      <title value="Paclitaxel 175 mg/m² IV — Day 1 of each 14-day cycle"/>
      <timingTiming>
        <repeat>
          <period value="14"/>
          <periodUnit value="d"/>
        </repeat>
      </timingTiming>
    </action>
  </action>
</PlanDefinition>