ID

41541

Description

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

Keywords

Versions (2)
  1. 10/21/20 10/21/20 -
  2. 11/3/20 11/3/20 -
Copyright Holder

GlaxoSmithKline

Uploaded on

November 3, 2020

DOI

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License

Creative Commons BY 4.0
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Clinical activity of recMAGE-A3 + AS15 in patients with metastatic cutaneous melanoma NCT00942162

English

IMD Report - Other relevant information, Investigator signature (Report Final and Annex Report 2 Final)

1 forms  
Administrative
Description

Administrative

Alias
UMLS CUI-1
C1320722
Patient Number
Description

Patient Number

Data type

text

Alias
UMLS CUI [1]
C2348585
Other relevant information (including evolution)
Description

Other relevant information (including evolution)

Alias
UMLS CUI-1
C0517287
UMLS CUI-2
C0205394
UMLS CUI-3
C0332253
Is there any other relevant information to be recorded?
Description

Yes - Please describe below

Data type

boolean

Alias
UMLS CUI [1,1]
C0517287
UMLS CUI [1,2]
C0205394
Date
Description

Date

Data type

date

Alias
UMLS CUI [1]
C0011008
IMD additional/ follow-up information
Description

IMD additional/ follow-up information

Data type

text

Alias
UMLS CUI [1,1]
C0012634
UMLS CUI [1,2]
C4330477
UMLS CUI [2]
C1546922
UMLS CUI [3,1]
C1522577
UMLS CUI [3,2]
C1533716
Investigator Signature
Description

Investigator Signature

Alias
UMLS CUI-1
C2346576
Investigator's signature
Description

I confirm that I have reviewed the data in this Immune Mediated Disease report for this Patient. All information entered by myself or my colleagues is, to the best of my knowledge, complete and accurate, as of the date mentioned below.

Data type

text

Alias
UMLS CUI [1]
C2346576
Printed Investigator's name
Description

Printed Investigator's name

Data type

text

Alias
UMLS CUI [1]
C2826892
Investigator's Signature Date
Description

Investigator's Signature Date

Data type

date

Alias
UMLS CUI [1,1]
C2346576
UMLS CUI [1,2]
C0011008
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Similar models

IMD Report - Other relevant information, Investigator signature (Report Final and Annex Report 2 Final)

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Administrative
C1320722 (UMLS CUI-1)
Patient Number
Item
Patient Number
text
C2348585 (UMLS CUI [1])
Item Group
Other relevant information (including evolution)
C0517287 (UMLS CUI-1)
C0205394 (UMLS CUI-2)
C0332253 (UMLS CUI-3)
Is there any other relevant information to be recorded?
Item
Is there any other relevant information to be recorded?
boolean
C0517287 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
Date
Item
Date
date
C0011008 (UMLS CUI [1])
IMD additional/ follow-up information
Item
IMD additional/ follow-up information
text
C0012634 (UMLS CUI [1,1])
C4330477 (UMLS CUI [1,2])
C1546922 (UMLS CUI [2])
C1522577 (UMLS CUI [3,1])
C1533716 (UMLS CUI [3,2])
Item Group
Investigator Signature
C2346576 (UMLS CUI-1)
Investigator's signature
Item
Investigator's signature
text
C2346576 (UMLS CUI [1])
Printed Investigator's name
Item
Printed Investigator's name
text
C2826892 (UMLS CUI [1])
Investigator's Signature Date
Item
Investigator's Signature Date
date
C2346576 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
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