CALGB: 80802 Treatment Form Sorafenib Tosylate With or Without Doxorubicin Hydrochloride in Treating Patients With Locally Advanced or Metastatic Liver Cancer NCT01015833 Source Form: NCI FormBuilder:

  1. 9/19/12 9/19/12 -
  2. 1/3/15 1/3/15 - Martin Dugas
Uploaded on:

January 3, 2015

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Creative Commons BY-NC 3.0 Legacy
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Treatment Form Liver Cancer CALGB 80802

INSTRUCTIONS: Complete and submit this form as required by the protocol. Information in the upper right box must be completed for this form to be accepted. For optimal accuracy use black ink. Mark an X in the appropriate box for fields with a choice

Header Module
Are data amended
Treatment Data
Dose level received on reporting period start date
Method of administration
Was the doxorubicin dose reduced this cycle
Was the sorafenib dose reduced during this cycle
Were any doses of sorafenib missed this cycle
Did patient receive G-CSF or GM-CSF per protocol
Did the patient receive any additional supportive care during this reporting period
Off Treatment Reason (only applicable if protocol therapy has been discontinued permanently Mark one with an X.)

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