ID

25157

Description

CALGB 50901 Prior Therapy Form Ofatumumab in Treating Patients With Previously Untreated Stage II, Stage III, or Stage IV Follicular Non-Hodgkin Lymphoma Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=9F3F8197-1E45-C1E1-E040-BB89AD4335C2

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=9F3F8197-1E45-C1E1-E040-BB89AD4335C2

Keywords

Versions (2)
  1. 9/19/12 9/19/12 -
  2. 8/28/17 8/28/17 -
Uploaded on

August 28, 2017

DOI

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License

Creative Commons BY-NC 3.0 Legacy
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Lymphoma NCT01190449 Treatment - CALGB 50901 Prior Therapy Form - 3210308v1.0

English

Please indicate all prior cancer treatment the patient has received. More than one therapy may be included. Multi-modality treatment should be listed separately (e.g. mastectomy followed by tamoxifen - code as surgery and hormonal therapy).

1 forms  
Prior Therapy
Description

Prior Therapy

Alias
UMLS CUI-1
C1514463
UMLS CUI-2
C0024301
Prior therapy type
Description

Prior therapy type

Data type

integer

Alias
NCI Thesaurus ValueDomain
C25284
NCI Thesaurus ObjectClass
C25629
NCI Thesaurus ObjectClass-2
C15368
NCI Thesaurus Property
C25365
UMLS CUI [1,1]
C1514463
UMLS CUI [1,2]
C0332307
Number of prior chemotherapy regimens
Description

PriorChemotherapyRegimenNumber

Data type

integer

Alias
NCI Thesaurus ValueDomain
C25337
NCI Thesaurus ObjectClass
C15632
NCI Thesaurus ObjectClass-2
C25629
NCI Thesaurus Property
C15697
UMLS CUI [1,1]
C0392920
UMLS CUI [1,2]
C0449788
MedDRA Disease Code
Description

MedDRA Disease Code

Data type

integer

Alias
NCI Thesaurus ObjectClass
C41331
NCI Thesaurus ObjectClass-2
C71886
NCI Thesaurus Property
C25162
NCI Thesaurus Property-2
C43820
NCI Thesaurus ValueDomain
C25162
NCI Thesaurus ValueDomain-2
C41331
NCI Thesaurus ValueDomain-3
C45255
NCI Thesaurus ValueDomain-4
C43820
NCI Thesaurus ValueDomain-5
C25714
UMLS CUI [1,1]
C0012634
UMLS CUI [1,2]
C1552878
Assigned Treatment Arm
Description

Assigned Treatment Arm

Data type

integer

Alias
NCI Thesaurus ObjectClass
C15368
NCI Thesaurus ObjectClass-2
C42651
NCI Thesaurus Property
C32141
NCI Thesaurus Property-2
C25426
NCI Thesaurus ValueDomain
C25284
UMLS CUI [1,1]
C1522541
UMLS CUI [1,2]
C1832027
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Similar models

Please indicate all prior cancer treatment the patient has received. More than one therapy may be included. Multi-modality treatment should be listed separately (e.g. mastectomy followed by tamoxifen - code as surgery and hormonal therapy).

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Prior Therapy
C1514463 (UMLS CUI-1)
C0024301 (UMLS CUI-2)
Item
Prior therapy type
integer
C25284 (NCI Thesaurus ValueDomain)
C25629 (NCI Thesaurus ObjectClass)
C15368 (NCI Thesaurus ObjectClass-2)
C25365 (NCI Thesaurus Property)
C1514463 (UMLS CUI [1,1])
C0332307 (UMLS CUI [1,2])
CL.1
Code List
Prior therapy type
CL Item
No Previous Exposure To Drug (nos) (1)
(Comment:en)
CL Item
Systemic Chemotherapy With A Single Agent Regimen (2)
(Comment:en)
CL Item
Systemic Chemotherapy With A Regimen Containing Multiple Agents (3)
(Comment:en)
CL Item
Non-systemic Chemotherapy Treatment Or Chemotherapy Not Described By Chemotherapy Single Agent Systemic Or Multi-agent Systemic (4)
(Comment:en)
CL Item
Prior Therapy With Agents That Are Not Known To Cause Damage To Cycling Cells (5)
(Comment:en)
CL Item
Drug And/or Immunotherapy (6)
(Comment:en)
CL Item
Cancer Therapy Which Incorporates Hormonal Manipulation (7)
(Comment:en)
CL Item
Surgical Procedure, Or Operation, With Therapeutic Intent (8)
(Comment:en)
CL Item
Targeted Ionizing Radiation Therapy Utilizing Radioactive Implants Or Seeds (9)
(Comment:en)
CL Item
High Dose Chemotherapy Combined With Transplantation Of Bone Marrow Cells (10)
(Comment:en)
CL Item
Prior Therapy (nos) (11)
(Comment:en)
CL Item
Treatment Of Human Disease By Gene Transfer (12)
(Comment:en)
CL Item
Agents Administered To Control The Replication And/or Spread Of Viruses (13)
(Comment:en)
CL Item
Treatment With An Agent That Prevents Or Impairs The Translation Of The Genetic Message For Production Of A Specific Protein (14)
(Comment:en)
CL Item
Anticancer Treatment With A Live, Replication-competent Virus (15)
(Comment:en)
CL Item
Substance Or Group Of Substances Administered To Induce The Immune System To Recognize And Destroy Tumors Or Microorganisms (16)
(Comment:en)
CL Item
Therapy Nos (17)
(Comment:en)
CL Item
Hematopoietic Stem Cell Transplantation (18)
(Comment:en)
CL Item
Image Directed Local Therapy (19)
(Comment:en)
Number of prior chemotherapy regimens
Item
Number of prior chemotherapy regimens
integer
C25337 (NCI Thesaurus ValueDomain)
C15632 (NCI Thesaurus ObjectClass)
C25629 (NCI Thesaurus ObjectClass-2)
C15697 (NCI Thesaurus Property)
C0392920 (UMLS CUI [1,1])
C0449788 (UMLS CUI [1,2])
MedDRA Disease Code
Item
MedDRA Disease Code
integer
C41331 (NCI Thesaurus ObjectClass)
C71886 (NCI Thesaurus ObjectClass-2)
C25162 (NCI Thesaurus Property)
C43820 (NCI Thesaurus Property-2)
C25162 (NCI Thesaurus ValueDomain)
C41331 (NCI Thesaurus ValueDomain-2)
C45255 (NCI Thesaurus ValueDomain-3)
C43820 (NCI Thesaurus ValueDomain-4)
C25714 (NCI Thesaurus ValueDomain-5)
C0012634 (UMLS CUI [1,1])
C1552878 (UMLS CUI [1,2])
Item
Assigned Treatment Arm
integer
C15368 (NCI Thesaurus ObjectClass)
C42651 (NCI Thesaurus ObjectClass-2)
C32141 (NCI Thesaurus Property)
C25426 (NCI Thesaurus Property-2)
C25284 (NCI Thesaurus ValueDomain)
C1522541 (UMLS CUI [1,1])
C1832027 (UMLS CUI [1,2])
CL.2
Code List
Assigned Treatment Arm
CL Item
Ofatumumab 500 Mg (1)
CL Item
Ofatumumab 1000 Mg (2)
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