Description:

CALGB 90601: Adverse Event (AE) Form NCT00942331 Gemcitabine Hydrochloride and Cisplatin With or Without Bevacizumab in Treating Patients With Advanced Urinary Tract Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=65940F04-CE91-54E2-E040-BB89AD435A8C

Link:

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=65940F04-CE91-54E2-E040-BB89AD435A8C

Keywords:
Versions (4) ▾
  1. 8/26/12
  2. 1/9/15
  3. 1/9/15
  4. 7/8/15
Uploaded on:

July 8, 2015

DOI:
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License:
Creative Commons BY-NC 3.0 Legacy
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CALGB 90601: Adverse Event (AE) Form NCT00942331

If data are amended, circle amended items and check the "Yes" box. If submitting by mail, retain a copy for your records.

Header
Are data amended
Patient demographics
Adverse Event Expedited Reporting System filed?
Has an AdEERS been filed (with Central Office based on an event reported below)
Expected Adverse Events
CTC Adverse Event Term
CTC Select AE
CTC AE Attribution Code (^2)
CTC AE Attribution Code (^2)