NSABP Protocol B-40 - On-Study Form A Randomized Phase III Trial of Neoadjuvant Therapy in Patients With Palpable and Operable Breast Cancer Evaluating the Effect on Pathologic Complete Response (pCR) of Adding Capecitabine or Gemcitabine to Docetaxel When Administered Before AC With or Without Bevacizumab and Correlative Science Studies Attempting to Identify Predictors of High Likelihood for pCR With Each of the Regimens NCT00408408 Source Form: NCI FormBuilder:

  1. 12/18/14 12/18/14 - Martin Dugas
  2. 1/9/15 1/9/15 - Martin Dugas
  3. 4/1/15 4/1/15 - Martin Dugas
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April 1, 2015

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Creative Commons BY-NC 3.0 Legacy
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Breast Cancer On-Study NCT00408408 NSABP B-40

Submit every 6 months from date of randomization for the first 5 years; yearly thereafter, and when a protocol event occurs. Fax Form F to 412-622-2111

Are data amended
Patient characteristics
Tumor Laterality
Histologic Type (from diagnostic core needle biopsy - Mark predominant tumor type if more than one applies.)
Receptor Status, ER (from diagnostic core needle biopsy)
Receptor Status, PgR
Histologic Grade (from diagnostic core needle biopsy Use combined histologic grade SBR/Elston classification.)
HER-2/neu status (if yes from core needle biopsy - )
Does the patient have any first degree relatives who died from heart disease before the age of 55 ("First degree relatives" include parents, children, brothers and sisters.)
Did the patient take medications for any of the following medical conditions in the 12 months prior to study entry
Medical Condition

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