ID

41380

Descrição

Study ID: 111476 Clinical Study ID: 111476 Study Title: An open, single-arm trial to assess the clinical activity of recMAGE-A3 + AS15 in patients with unresectable MAGE-A3-positive metastatic cutaneous melanoma Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: NCT00942162 Sponsor: GlaxoSmithKline Phase: Phase 2 Study Recruitment Status: Completed Generic Name: Antigen-Specific Cancer Immunotherapeutic Study Indication: Melanoma

Palavras-chave

  1. 18/09/2020 18/09/2020 -
  2. 30/10/2020 30/10/2020 -
Titular dos direitos

GlaxoSmithKline

Transferido a

18 de setembro de 2020

DOI

Para um pedido faça login.

Licença

Creative Commons BY 4.0

Comentários do modelo :

Aqui pode comentar o modelo. Pode comentá-lo especificamente através dos balões de texto nos grupos de itens e itens.

Comentários do grupo de itens para :

Comentários do item para :

Para descarregar formulários, precisa de ter uma sessão iniciada. Por favor faça login ou registe-se gratuitamente.

Clinical activity of recMAGE-A3 + AS15 in patients with metastatic cutaneous melanoma NCT00942162

Yearly Follow-up contact; Anti Cancer Therapy

Adminstrative
Descrição

Adminstrative

Alias
UMLS CUI-1
C1320722
Patient Number
Descrição

Patient Number

Tipo de dados

text

Alias
UMLS CUI [1]
C2348585
Yearly Follow-up - Check for Follow-up contact
Descrição

Yearly Follow-up - Check for Follow-up contact

Alias
UMLS CUI-1
C1522577
UMLS CUI-2
C0332158
Is the patient still alive?
Descrição

Yes → Date of contact No → Please complete the Death Form. Please complete the Study Conclusion Unknown → Please specify the reason

Tipo de dados

text

Alias
UMLS CUI [1]
C2584946
If patient ist alive, enter date of contact
Descrição

If patient ist alive, enter date of contact

Tipo de dados

date

Alias
UMLS CUI [1,1]
C2584946
UMLS CUI [1,2]
C0011008
UMLS CUI [1,3]
C1705415
If unknown if patient is still alive, please specify reason
Descrição

If unknown if patient is still alive, please specify reason

Tipo de dados

text

Alias
UMLS CUI [1]
C2584946
UMLS CUI [2]
C0439673
UMLS CUI [3,1]
C0392360
UMLS CUI [3,2]
C2348235
If other reason, please specify
Descrição

If other reason, please specify

Tipo de dados

text

Alias
UMLS CUI [1,1]
C3840932
UMLS CUI [1,2]
C2348235
End of yearly Follow-up contact
Descrição

End of yearly Follow-up contact

Alias
UMLS CUI-1
C1522577
UMLS CUI-2
C0332158
UMLS CUI-3
C0444930
Is it the last Yearly Follow-up contact for this patient?
Descrição

Yes → Please complete the Study Conclusion. No → Please schedule the next Yearly Follow-up contact.

Tipo de dados

boolean

Alias
UMLS CUI [1,1]
C1522577
UMLS CUI [1,2]
C1517741
UMLS CUI [1,3]
C0332158
Anti-cancer therapy(ies) following last study treatment administration
Descrição

Anti-cancer therapy(ies) following last study treatment administration

Alias
UMLS CUI-1
C0920425
UMLS CUI-2
C3469597
UMLS CUI-3
C0304229
UMLS CUI-4
C1517741
Has the patient received any anti-cancer therapy(ies) following last study treatment administration?
Descrição

Yes → Please record any subsequent treatment the patient received

Tipo de dados

boolean

Alias
UMLS CUI [1]
C0920425
UMLS CUI [2,1]
C3469597
UMLS CUI [2,2]
C0304229
UMLS CUI [3]
C1517741
Subsequent treatment
Descrição

Subsequent treatment

Alias
UMLS CUI-1
C0087111
UMLS CUI-2
C0332282
Type of therapy
Descrição

Type of therapy

Tipo de dados

text

Alias
UMLS CUI [1,1]
C0332307
UMLS CUI [1,2]
C0087111
Specify
Descrição

Specify

Tipo de dados

text

Alias
UMLS CUI [1]
C2348235
Date of First Treatment administration/ surgery
Descrição

Date of First Treatment administration/ surgery

Tipo de dados

date

Alias
UMLS CUI [1,1]
C3469597
UMLS CUI [1,2]
C0304229
UMLS CUI [1,3]
C0205435
UMLS CUI [1,4]
C0011008
UMLS CUI [2,1]
C0543467
UMLS CUI [2,2]
C0205435
UMLS CUI [2,3]
C0011008
Date of last Treatment administration (Not applicable for surgery)
Descrição

Date of last Treatment administration (Not applicable for surgery)

Tipo de dados

date

Alias
UMLS CUI [1,1]
C3469597
UMLS CUI [1,2]
C0304229
UMLS CUI [1,3]
C1517741
UMLS CUI [1,4]
C0011008

Similar models

Yearly Follow-up contact; Anti Cancer Therapy

Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de dados
Alias
Item Group
Adminstrative
C1320722 (UMLS CUI-1)
Patient Number
Item
Patient Number
text
C2348585 (UMLS CUI [1])
Item Group
Yearly Follow-up - Check for Follow-up contact
C1522577 (UMLS CUI-1)
C0332158 (UMLS CUI-2)
Item
Is the patient still alive?
text
C2584946 (UMLS CUI [1])
Code List
Is the patient still alive?
CL Item
Yes (Y)
CL Item
No (N)
CL Item
Unknown (U)
If patient ist alive, enter date of contact
Item
If patient ist alive, enter date of contact
date
C2584946 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
C1705415 (UMLS CUI [1,3])
Item
If unknown if patient is still alive, please specify reason
text
C2584946 (UMLS CUI [1])
C0439673 (UMLS CUI [2])
C0392360 (UMLS CUI [3,1])
C2348235 (UMLS CUI [3,2])
Code List
If unknown if patient is still alive, please specify reason
CL Item
Lost to follow-up  (LFU)
CL Item
Consent withdrawal  (CWS)
CL Item
Other, please specify (OTH)
If other reason, please specify
Item
If other reason, please specify
text
C3840932 (UMLS CUI [1,1])
C2348235 (UMLS CUI [1,2])
Item Group
End of yearly Follow-up contact
C1522577 (UMLS CUI-1)
C0332158 (UMLS CUI-2)
C0444930 (UMLS CUI-3)
Is it the last Yearly Follow-up contact for this patient?
Item
Is it the last Yearly Follow-up contact for this patient?
boolean
C1522577 (UMLS CUI [1,1])
C1517741 (UMLS CUI [1,2])
C0332158 (UMLS CUI [1,3])
Item Group
Anti-cancer therapy(ies) following last study treatment administration
C0920425 (UMLS CUI-1)
C3469597 (UMLS CUI-2)
C0304229 (UMLS CUI-3)
C1517741 (UMLS CUI-4)
Has the patient received any anti-cancer therapy(ies) following last study treatment administration?
Item
Has the patient received any anti-cancer therapy(ies) following last study treatment administration?
boolean
C0920425 (UMLS CUI [1])
C3469597 (UMLS CUI [2,1])
C0304229 (UMLS CUI [2,2])
C1517741 (UMLS CUI [3])
Item Group
Subsequent treatment
C0087111 (UMLS CUI-1)
C0332282 (UMLS CUI-2)
Item
Type of therapy
text
C0332307 (UMLS CUI [1,1])
C0087111 (UMLS CUI [1,2])
Code List
Type of therapy
CL Item
Surgery  (S)
CL Item
Biological response modifier (B)
CL Item
Chemotherapy  (C)
CL Item
Hormonal therapy  (H)
CL Item
Radiation  (R)
CL Item
Other  (O)
CL Item
Immunotherapy (I)
Specify
Item
Specify
text
C2348235 (UMLS CUI [1])
Date of First Treatment administration/ surgery
Item
Date of First Treatment administration/ surgery
date
C3469597 (UMLS CUI [1,1])
C0304229 (UMLS CUI [1,2])
C0205435 (UMLS CUI [1,3])
C0011008 (UMLS CUI [1,4])
C0543467 (UMLS CUI [2,1])
C0205435 (UMLS CUI [2,2])
C0011008 (UMLS CUI [2,3])
Date of last Treatment administration (Not applicable for surgery)
Item
Date of last Treatment administration (Not applicable for surgery)
date
C3469597 (UMLS CUI [1,1])
C0304229 (UMLS CUI [1,2])
C1517741 (UMLS CUI [1,3])
C0011008 (UMLS CUI [1,4])

Use este formulário para feedback, perguntas e sugestões de aperfeiçoamento.

Campos marcados com * são obrigatórios.

Do you need help on how to use the search function? Please watch the corresponding tutorial video for more details and learn how to use the search function most efficiently.

Watch Tutorial