Description:

ECOG Off-Treatment Form NCT00520975 First-Line Chemotherapy and Trastuzumab With or Without Bevacizumab in Treating Patients With Metastatic Breast Cancer That Overexpresses HER-2/NEU Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=1723190D-DFB9-084E-E044-0003BA3F9857

Link:

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=1723190D-DFB9-084E-E044-0003BA3F9857

Keywords:
Versions (3) ▾
  1. 8/26/12
  2. 1/9/15
  3. 6/18/15
Uploaded on:

June 18, 2015

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License:
Creative Commons BY-NC 3.0 Legacy
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ECOG Off-Treatment Form NCT00520975

INSTRUCTIONS: After patient is off treatment, complete this form for each required follow-up report period (see forms submission schedule).

Header
Reporting Period
Patient demographics
Data amendment
Vital Status
Vital Status
Primary Cause of Death (if applicable)
Protocol therapy
Did patient receive protocol therapy?
Section I
Reason Treatment Ended
Section II
Reason treatment never started
Comments

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