ID

37649

Beschreibung

Study ID: 104864/612 Clinical Study ID: 104864/612 Study Title: A Prospective, Open Label Phase II Study to Evaluate the Efficacy and Safety of Topotecan (HycamtinTM) in Combination with Carboplatin as First-line Chemotherapy in Patients with Ovarian Cancer Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: N/A Sponsor: GlaxoSmithKline Collaborators: N/A Phase: Phase 2 Study Recruitment Status: Completed Generic Name: Topotecan Trade Name: HycamtinTM Study Indication: Ovarian Cancer

Stichworte

Versionen (1)
  1. 13.08.19 13.08.19 -
Rechteinhaber

GlaxoSmithKline

Hochgeladen am

13. August 2019

DOI

Für eine Beantragung loggen Sie sich ein.

Lizenz

Creative Commons BY-NC 3.0
Modell Kommentare :

Hier können Sie das Modell kommentieren. Über die Sprechblasen an den Itemgruppen und Items können Sie diese spezifisch kommentieren.

Zurück zu Modell Kommentaren
Itemgroup Kommentare für :

Item Kommentare für :

Um Formulare herunterzuladen müssen Sie angemeldet sein. Bitte loggen Sie sich ein oder registrieren Sie sich kostenlos.

Topotecan (HycamtinTM) with Carboplatin as First-Line Chemotherapy in Patients with Ovarian Cancer; 104864/612

Englisch

Study End

1 Formulare  
  1. StudyEvent: ODM
    1. Study End
Administrative Data
Beschreibung

Administrative Data

Alias
UMLS CUI-1
C1320722
Patient Number
Beschreibung

Patient number

Datentyp

integer

Alias
UMLS CUI [1]
C1830427
Study End
Beschreibung

Study End

Alias
UMLS CUI-1
C0008972
UMLS CUI-2
C0444930
Did the patient prematurely terminate the study or was she prematurely withdrawn?
Beschreibung

Clinical Trials, Withdraw

Datentyp

boolean

Alias
UMLS CUI [1,1]
C0008976
UMLS CUI [1,2]
C2349954
If "yes", please document the date
Beschreibung

Clinical Trials, Withdraw, Date in time

Datentyp

date

Alias
UMLS CUI [1,1]
C0008976
UMLS CUI [1,2]
C2349954
UMLS CUI [1,3]
C0011008
If "yes", please provide the primary reason for withdrawal
Beschreibung

Clinical Trials, Withdraw, Reason and justification

Datentyp

text

Alias
UMLS CUI [1,1]
C0008976
UMLS CUI [1,2]
C2349954
UMLS CUI [1,3]
C0566251
Please specify
Beschreibung

Clinical Trials, Withdraw, Reason and justification

Datentyp

text

Alias
UMLS CUI [1,1]
C0008976
UMLS CUI [1,2]
C2349954
UMLS CUI [1,3]
C0566251
Confirmation of the investigator
Beschreibung

Confirmation of the investigator

Alias
UMLS CUI-1
C2346576
UMLS CUI-2
C0750484
Signature of the responsible investigator I hereby declare that the data documented in his case report form are an exact and correct repetition of the patient's findings, that the trial was conducted according to protocol, and that the patient's consent for the study participation has been obtained.
Beschreibung

Investigator Signature

Datentyp

text

Alias
UMLS CUI [1]
C2346576
Date
Beschreibung

Investigator Signature, Date in time

Datentyp

date

Alias
UMLS CUI [1,1]
C2346576
UMLS CUI [1,2]
C0011008
Name in printed letters or practice stamp
Beschreibung

Investigator Name

Datentyp

text

Alias
UMLS CUI [1]
C2826892
Zum Seitenanfang zurückkehren

Ähnliche Modelle

Study End

1 Formulare
  1. StudyEvent: ODM
    1. Study End
Name
Typ
Description | Question | Decode (Coded Value)
Datentyp
Alias
Item Group
Administrative Data
C1320722 (UMLS CUI-1)
Patient number
Item
Patient Number
integer
C1830427 (UMLS CUI [1])
Item Group
Study End
C0008972 (UMLS CUI-1)
C0444930 (UMLS CUI-2)
Clinical Trials, Withdraw
Item
Did the patient prematurely terminate the study or was she prematurely withdrawn?
boolean
C0008976 (UMLS CUI [1,1])
C2349954 (UMLS CUI [1,2])
Clinical Trials, Withdraw, Date in time
Item
If "yes", please document the date
date
C0008976 (UMLS CUI [1,1])
C2349954 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,3])
Item
If "yes", please provide the primary reason for withdrawal
text
C0008976 (UMLS CUI [1,1])
C2349954 (UMLS CUI [1,2])
C0566251 (UMLS CUI [1,3])
Clinical Trials, Withdraw, Reason and justification
Code List
If "yes", please provide the primary reason for withdrawal
CL Item
Adverse event (1)
CL Item
Insufficient therapeutic effect (2)
CL Item
Protocol violation (incl. non-compliance) (3)
CL Item
Patient is lost to follow-up (4)
CL Item
Other, please specify (5)
Clinical Trials, Withdraw, Reason and justification
Item
Please specify
text
C0008976 (UMLS CUI [1,1])
C2349954 (UMLS CUI [1,2])
C0566251 (UMLS CUI [1,3])
Item Group
Confirmation of the investigator
C2346576 (UMLS CUI-1)
C0750484 (UMLS CUI-2)
Investigator Signature
Item
Signature of the responsible investigator I hereby declare that the data documented in his case report form are an exact and correct repetition of the patient's findings, that the trial was conducted according to protocol, and that the patient's consent for the study participation has been obtained.
text
C2346576 (UMLS CUI [1])
Investigator Signature, Date in time
Item
Date
date
C2346576 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Investigator Name
Item
Name in printed letters or practice stamp
text
C2826892 (UMLS CUI [1])
Zum Seitenanfang zurückkehren 

Kontakt

Benutzen Sie dieses Formular für Rückmeldungen, Fragen und Verbesserungsvorschläge.

Mit * gekennzeichnete Felder sind notwendig.

Hilfe

Benötigen Sie Hilfe bei der Suche? Um mehr Details zu erfahren und die Suche effektiver nutzen zu können schauen Sie sich doch das entsprechende Video auf unserer Tutorial Seite an.

Zum Video