Description:

E1208 Registration Worksheet/Step 1 Chemoembolization With or Without Sorafenib Tosylate in Treating Patients With Liver Cancer That Cannot Be Removed By Surgery Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=7454791C-AC85-65C0-E040-BB89AD431786

Link:
https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=7454791C-AC85-65C0-E040-BB89AD431786
Keywords:
  1. 9/19/12 9/19/12 -
  2. 1/9/15 1/9/15 - Martin Dugas
  3. 9/17/21 9/17/21 -
Uploaded on:

September 17, 2021

DOI:
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License :
Creative Commons BY-NC 3.0 Legacy
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Liver Cancer NCT01004978 Eligibility - E1208 Registration Worksheet/Step 1 - 2944998v1.0

No Instruction available.

  1. StudyEvent: E1208 Registration Worksheet/Step 1
    1. No Instruction available.
Eligibility
Has the eligibility checklist been completed?
In the opinion of the investigator, is the patient eligible?
Has written informed consent been obtained?
Has HIPAA authorization been obtained?
Macrovascular intrahepatic portal vein invasion
Child Pugh Score
What method does institution plan to use to administer TACE?
Do you wish to use an express carrier to ship the drugs (at your expense)?
I agree to participate in the drug level studies that are being done as part of this clinical trial.
I agree to participate in the protein and DNA studies that are being done as part of this clinical trial.
My specimens may be kept for use in research to learn about, prevent, treat, or cure cancer.
My specimens may be kept for use in research about other health problems (for example: causes of diabetes, Alzheimer's disease, or heart disease) (for example: causes of diabetes, Alzheimer's disease, and heart disease)
Someone from this institution may contact me in the future to ask me to take part in more research.
Patient Demographics / Pre-treatment Characteristics
Patient's Sex
Patient's Race
Patient Ethnicity
Method of payment (check one)
Country of residence
I Have Reviewed The Above Data And Agree The Date Are Accurate And Correct

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