No Instruction available.

  1. StudyEvent: COG ADVL0912 OPEN Registration Worksheet
    1. No Instruction available.
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Stratification
Item
ADVL0912 Stratum
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C25320 (NCI Thesaurus ObjectClass)
C1507394 (UMLS 2011AA ObjectClass)
C16153 (NCI Thesaurus Property)
C1514984 (UMLS 2011AA Property)
Code List
ADVL0912 Stratum
CL Item
Patients With Relapsed/refractory Solid Tumors (including Cns Tumors), And Anaplastic Large Cell Lymphoma (alcl) Without Bone Marrow Involvement (Patients with relapsed/refractory solid tumors (including CNS tumors), and anaplastic large cell lymphoma (ALCL) WITHOUT bone marrow involvement)
CL Item
Patients With Relapsed/refractory Solid Tumors (including Cns Tumors), And Anaplastic Large Cell Lymphoma (alcl) With Or Without Bone Marrow Involvement (Patients with relapsed/refractory solid tumors (including CNS tumors), and anaplastic large cell lymphoma (ALCL) WITH OR WITHOUT bone marrow involvement)
CL Item
Patients With Relapsed Or Refractory Neuroblastoma, With Or Without Bone Marrow Involvement, Who Are Not Eligible For Part A1 Or A2 Or Cannot Enroll On Part A1 Because Of Stratum Suspension Or Lack Of Available Slots (Patients with relapsed or refractory neuroblastoma, with or without bone marrow involvement, who are not eligible for Part A1 or A2 or cannot enroll on Part A1 because of stratum suspension or lack of available slots)
TreatmentBeginDate
Item
Treatment Start Date
date
C15368 (NCI Thesaurus ObjectClass)
C25431 (NCI Thesaurus Property)
C0439659 (UMLS 2011AA Property)
C25275 (NCI Thesaurus Property-2)
C2745955 (UMLS 2011AA Property-2)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25431 (NCI Thesaurus ValueDomain-2)
C0439659 (UMLS 2011AA ValueDomain-2)
Item Group
Patient Criteria
PatientPriorRegistrationLaboratoryProcedureEligibilityDeterminationInd-2
Item
Were tests to determine eligibility performed during the indicated period (Indicated period refers to prior to enrollment. - - Note: All studies to determine eligibility must be performed within 7 days prior to enrollment unless otherwise indicated. Please see section 4.0 of the protocol for instructions on required repeated eligibility studies if more than 7 calendar days elapse between labs and start of therapy. - )
boolean
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25646 (NCI Thesaurus Property)
C1514821 (UMLS 2011AA Property)
C25629 (NCI Thesaurus Property-2)
C0332152 (UMLS 2011AA Property-2)
C25294 (NCI Thesaurus Property-3)
C0022885 (UMLS 2011AA Property-3)
C25171 (NCI Thesaurus Property-4)
C0013893 (UMLS 2011AA Property-4)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
PatientAgeEligibilityDeterminationInd-2
Item
Was the patient in the indicated age range at time of study enrollment (To be eligible, patient must be greater than 12 months and less than or equal to 21 years of age at the time of study enrollment.)
boolean
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25150 (NCI Thesaurus Property)
C0001779 (UMLS 2011AA Property)
C25171 (NCI Thesaurus Property-2)
C0013893 (UMLS 2011AA Property-2)
PersonGreaterBodySurfaceAreaClinicalTrialEligibilityCriteriaInd-2
Item
Does patient have a BSA (body surface area) greater than or equal to the indicated value (BSA Dose Level 0 and 1 only: To be eligible, patients must have a BSA >= 0.4 at the time of study enrollment. - )
boolean
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C61421 (NCI Thesaurus Property)
C1704243 (UMLS 2011AA Property)
C16112 (NCI Thesaurus Property-2)
C1516637 (UMLS 2011AA Property-2)
C25157 (NCI Thesaurus Property-3)
C0005902 (UMLS 2011AA Property-3)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
PersonBodySurfaceAreaValue
Item
BSA (In m2;)
float
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C25157 (NCI Thesaurus Property)
C0005902 (UMLS 2011AA Property)
DiseaseHistologicDiagnosisInd
Item
Does patient have histologic verification of the malignancy at the indicated time point (Indicated time point refers to original diagnosis or relapse. - - To be eligible, patient must have histologic verification of malignancy at original diagnosis or relapse. - - Patients with relapsed or refractory solid tumors, CNS tumors or anaplastic large cell lymphoma excluding patients with primary cutaneous ALCL. - - Please note: The requirement for histologic verification does not apply to patients with diffuse intrinsic brain stem tumors, optic pathway tumors, or patients with pineal region tumors with elevations of serum or CSF tumor markers e.g., alpha-fetoprotein or beta-HCG.)
boolean
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
C2991 (NCI Thesaurus ObjectClass)
C0012634 (UMLS 2011AA ObjectClass)
C15220 (NCI Thesaurus Property)
C0011900 (UMLS 2011AA Property)
NeuroblastomaDiagnosisInd-2
Item
Does patient have neuroblastoma
boolean
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C15220 (NCI Thesaurus Property)
C0011900 (UMLS 2011AA Property)
C3270 (NCI Thesaurus ObjectClass)
C0027819 (UMLS 2011AA ObjectClass)
AnaplasticLargeCellLymphomaDiagnosisInd-2
Item
Does patient have ALCL (anaplastic large cell lymphoma)
boolean
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C3720 (NCI Thesaurus ObjectClass)
C0206180 (UMLS 2011AA ObjectClass)
C15220 (NCI Thesaurus Property)
C0011900 (UMLS 2011AA Property)
PersonALKGeneAbnormalityClinicalTrialEligibilityCriteriaInd-2
Item
Does patient have histologic verification of the malignancy at the indicated time point (For patients with ALK fusion proteins, ALK mutations or ALK amplification defined as greater than 4-fold increase in the ALK signal number as compared to reference signal number on chromosome 2q arm. - - Indicated time point refers to original diagnosis or relapse. - - Patients must have had histologic verification of malignancy at original diagnosis or relapse. - - To be eligible, patients must have confirmed ALK protein, mutations and/or amplification defined as greater than 4-fold increase in the ALK signal number as compared to reference signal number on chromosome 2q arm. Testing for eligibility purposes must be performed as a CLIA certified assay.)
boolean
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C9440 (NCI Thesaurus Property)
C1704258 (UMLS 2011AA Property)
C16112 (NCI Thesaurus Property-2)
C1516637 (UMLS 2011AA Property-2)
C38184 (NCI Thesaurus Property-3)
C1332080 (UMLS 2011AA Property-3)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
PersonALKGeneAbnormalityVerificationClinicalTrialEligibilityCriteriaInd-2
Item
Did patient have ALK molecular abnormality verified by a Clinical Laboratory Improvement Amendments (CLIA) certified laboratory (For patients with ALK fusion proteins, ALK mutations, or ALK amplification defined as greater than 4-fold increase in the ALK signal number as compared to reference signal number on chromosome 2q arm. - - To be eligible, patients must have confirmed ALK protein, mutation and/or amplification. Testing for eligibility purposes must be performed as a CLIA certified assay. )
boolean
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C9440 (NCI Thesaurus Property)
C1704258 (UMLS 2011AA Property)
C16112 (NCI Thesaurus Property-2)
C1516637 (UMLS 2011AA Property-2)
C45513 (NCI Thesaurus Property-3)
C1711411 (UMLS 2011AA Property-3)
C38184 (NCI Thesaurus Property-4)
C1332080 (UMLS 2011AA Property-4)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
PersonRelapseRefractoryNeuroblastomaClinicalTrialEligibilityCriteriaInd-2
Item
Does patient have histologic verification of the malignancy at the indicated time point (For Part A3 patients - - Indicated time point refers to original diagnosis or relapse. - - To be eligible, patient must have histologic verification of malignancy at original diagnosis or relapse. - - To be eligible, patients must have relapsed or refractory neuroblastoma, with or without bone marrow involvement, who are not eligible for Part A1 or A2 or cannot enroll on Part A1 because of Part suspension or lack of available slots. These patients will be enrolled at one dose level below the dose level at which patients on Part A1 are actively enrolling.)
boolean
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C38014 (NCI Thesaurus Property)
C0205269 (UMLS 2011AA Property)
C3270 (NCI Thesaurus Property-2)
C0027819 (UMLS 2011AA Property-2)
C16112 (NCI Thesaurus Property-3)
C1516637 (UMLS 2011AA Property-3)
C0699753 (NCI Metathesaurus Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
Measurable disease
Item
Does patient meet the disease status requirement
boolean
C25190 (NCI Thesaurus ObjectClass)
C25626 (NCI Thesaurus Property)
C9305 (NCI Thesaurus Property-2)
C8507 (NCI Thesaurus Property-3)
C16112 (NCI Thesaurus Property-4)
C25180 (NCI Thesaurus ValueDomain)
C1513041 (UMLS CUI [1])
PersonNoStandardTreatmentRegimenOptionsClinicalTrialEligibilityCriteriaInd-2
Item
Is patient's current disease state one for which there is no known curative therapy available or therapy proven to prolong survival with an acceptable quality of life (To be eligible, patient's current disease state must be one for which there is no known curative therapy or therapy proven to prolong survival with an acceptable quality of life.)
boolean
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C49487 (NCI Thesaurus Property)
C1298908 (UMLS 2011AA Property)
C15697 (NCI Thesaurus Property-2)
C0040808 (UMLS 2011AA Property-2)
C44275 (NCI Thesaurus Property-3)
C1442989 (UMLS 2011AA Property-3)
C16112 (NCI Thesaurus Property-4)
C1516637 (UMLS 2011AA Property-4)
C25374 (NCI Thesaurus Property-5)
C1518601 (UMLS 2011AA Property-5)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
Item
Karnofsky Performance Status Score (To be eligible, patients greater than 16 years of age must have a Karnofsky performance score greater than or equal to 50. - - Note: Neurologic deficits in patients with CNS tumors must have been relatively stable for a minimum of 1 week prior to study enrollment. Patients who are unable to walk because of paralysis, but who are up in a wheelchair, will be considered ambulatory for the purpose of assessing the performance score. See Appendix I)
text
C25367 (NCI Thesaurus Property)
C20641 (NCI Thesaurus ObjectClass)
C1518965 (UMLS 2011AA ObjectClass)
C25338 (NCI Thesaurus ValueDomain)
C0449820 (UMLS 2011AA ValueDomain)
Code List
Karnofsky Performance Status Score (To be eligible, patients greater than 16 years of age must have a Karnofsky performance score greater than or equal to 50. - - Note: Neurologic deficits in patients with CNS tumors must have been relatively stable for a minimum of 1 week prior to study enrollment. Patients who are unable to walk because of paralysis, but who are up in a wheelchair, will be considered ambulatory for the purpose of assessing the performance score. See Appendix I)
CL Item
Normal, No Complaints, No Evidence Of Disease (100)
CL Item
Able To Carry On Normal Activity; Minor Signs Or Symptoms Of Disease (90)
CL Item
Normal Activity With Effort; Some Signs Or Symptoms Of Disease (80)
CL Item
Cares For Self, Unable To Carry On Normal Activity Or To Do Active Work (70)
CL Item
Requires Occasional Assistance, But Is Able To Care For Most Of His/her Needs (60)
CL Item
Requires Considerable Assistance And Frequent Medical Care (50)
CL Item
Disabled, Requires Special Care And Assistance (40)
CL Item
Severely Disabled, Hospitalization Indicated. Death Not Imminent (30)
CL Item
Very Sick, Hospitalization Indicated. Death Not Imminent (20)
CL Item
Moribund, Fatal Processes Progressing Rapidly (10)
CL Item
Dead (0)
Item
Lansky Performance Status Score (To be eligible, patients less than or equal to 16 years of age must have a Lansky play score greater than or equal to 50. - - Note: Neurologic deficits in patients with CNS tumors must have been relatively stable for a minimum of 1 week prior to study enrollment. Patients who are unable to walk because of paralysis, but who are up in a wheelchair, will be considered ambulatory for the purpose of assessing the performance score. See Appendix I - )
text
C25367 (NCI Thesaurus Property)
C20641 (NCI Thesaurus ObjectClass)
C1518965 (UMLS 2011AA ObjectClass)
C25338 (NCI Thesaurus ValueDomain)
C0449820 (UMLS 2011AA ValueDomain)
Code List
Lansky Performance Status Score (To be eligible, patients less than or equal to 16 years of age must have a Lansky play score greater than or equal to 50. - - Note: Neurologic deficits in patients with CNS tumors must have been relatively stable for a minimum of 1 week prior to study enrollment. Patients who are unable to walk because of paralysis, but who are up in a wheelchair, will be considered ambulatory for the purpose of assessing the performance score. See Appendix I - )
CL Item
Fully Active, Normal (100)
CL Item
Minor Restrictions In Physically Strenuous Activity (90)
CL Item
Active, But Tires More Quickly (80)
CL Item
Both Greater Restriction Of And Less Time Spent In Play Activity (70)
CL Item
Up And Around, But Minimal Active Play; Keeps Busy With Quieter Activities. (60)
CL Item
Gets Dressed, But Lies Around Much Of The Day; No Active Play, Able To Participate In All Quiet Play And Activities. (50)
CL Item
Mostly In Bed; Participates In Quiet Activities. (40)
CL Item
In Bed; Needs Assistance Even For Quiet Play. (30)
CL Item
Often Sleeping; Play Entirely Limited To Very Passive Activities. (20)
CL Item
No Play; Does Not Get Out Of Bed. (10)
CL Item
Unresponsive (0)
PersonRecoveredorResolvedPriorTreatmentRegimenClinicalTrialEligibilityCriteriaInd-2
Item
Has patient fully recovered from the acute toxic effects of all prior chemotherapy, immunotherapy, or radiotherapy prior to entering this study (- Myelosuppressive chemotherapy: Solid Tumors: Patients with solid tumors must not have received within 3 weeks of enrollment onto this study 6 weeks if prior nitrosourea. - Lymphoma: Patients with lymphoma who relapse during standard maintenance therapy are eligible at time of relapse. For patients with ALCL who relapse while they are receiving cytotoxic therapy, at least 14 days must have elapsed since the completion of cytotoxic therapy. Note: Cytoreduction with hydroxyurea can be initiated and continued for up to 24 hours prior to the start of PF-02341066. - - - Hematopoietic growth factors: At least 7 days since the completion of therapy with a growth factor. - - - Biologic anti-neoplastic agent: At least 7 days since the completion of therapy with a biologic agent. For agents that have known adverse events occurring beyond 7 days after administration, this period must be extended beyond the time during which adverse events are known to occur. The duration of this interval must be discussed with the Study Chair. - - - Monoclonal antibodies: At least 7 days or 3 half-lives, whichever is longer, must have elapsed since prior treatment with a monoclonal antibody. - - - XRT: >= 2 wks for local palliative XRT small port; >= 6 weeks must have elapsed since treatment with therapeutic doses of MIBG; >= 6 months must have elapsed if prior TBI, craniospinal XRT or >= 50% radiation of pelvis; >= 6 wks must have elapsed if other substantial BM radiation. - - - Bone Marrow/Stem Cell Transplant or Rescue without TBI: - - Part A1 or Part C: No evidence of active graft vs. host disease and >= 3 months must have elapsed since stem cell transplant or infusion. - - Part A2, Part A3, or Part B: No evidence of active graft vs. host disease and >= 6 weeks must have elapsed since stem cell transplant or infusion. - - )
boolean
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C25629 (NCI Thesaurus Property)
C0332152 (UMLS 2011AA Property)
C49498 (NCI Thesaurus Property-2)
C1709863 (UMLS 2011AA Property-2)
C15697 (NCI Thesaurus Property-3)
C0040808 (UMLS 2011AA Property-3)
C16112 (NCI Thesaurus Property-4)
C1516637 (UMLS 2011AA Property-4)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
Item
Prior therapy type
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C25629 (NCI Thesaurus ObjectClass)
C0332152 (UMLS 2011AA ObjectClass)
C15368 (NCI Thesaurus ObjectClass-2)
C25365 (NCI Thesaurus Property)
C0678257 (UMLS 2011AA Property)
Code List
Prior therapy type
CL Item
Chemotherapy Myelosuppressive Therapy (Myelosuppressive Chemotherapy)
C15632 (NCI Thesaurus)
C0392920 (UMLS 2011AA)
C15690 (NCI Thesaurus-3)
C1513793 (UMLS 2011AA-4)
CL Item
Hematopoietic Growth Factor (Hematopoietic Growth Factor)
C20427 (NCI Thesaurus)
C0021757 (UMLS 2011AA)
CL Item
Targeted Ionizing Radiation Therapy Utilizing Radioactive Implants Or Seeds (Radiation therapy)
CL Item
Autologous Stem Cell Rescue Stem Cell Transplantation (Stem Cell Transplant or Rescue without TBI)
C15431 (NCI Thesaurus)
C0472699 (UMLS 2011AA)
C82054 (NCI Thesaurus-3)
C2825926 (UMLS 2011AA-4)
CL Item
Prior Therapy (nos) (Prior therapy NOS)
CL Item
No Previous Exposure To Drug (nos) (No prior therapy)
PersonPriorTreatmentRegimenNitrosoureaCompoundClinicalTrialEligibilityCriteriaInd-2
Item
Did patient receive nitrosourea (If prior therapy was myelosuppressive chemotherapy - - To be eligible, patients with solid tumors must not have received within 6 weeks of enrollment onto this study if prior nitrosourea.)
boolean
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C25629 (NCI Thesaurus Property)
C0332152 (UMLS 2011AA Property)
C15697 (NCI Thesaurus Property-2)
C0040808 (UMLS 2011AA Property-2)
C699 (NCI Thesaurus Property-3)
C0028210 (UMLS 2011AA Property-3)
C16112 (NCI Thesaurus Property-4)
C1516637 (UMLS 2011AA Property-4)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
LastTreatmentDate
Item
Last Treatment Date (prior to enrolling on this study)
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C15368 (NCI Thesaurus ObjectClass)
C25551 (NCI Thesaurus ObjectClass-2)
C1517741 (UMLS 2011AA ObjectClass)
C25275 (NCI Thesaurus Property)
C2745955 (UMLS 2011AA Property)
PersonPriorClinicalStudyAgentClinicalTrialEligibilityCriteriaInd-2
Item
Has patient previously received any of the indicated agents (To be eligible, patients must not have received prior therapy with PF-02341066.)
boolean
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C25629 (NCI Thesaurus Property)
C0332152 (UMLS 2011AA Property)
C1708 (NCI Thesaurus Property-2)
C0450442 (UMLS 2011AA Property-2)
C15206 (NCI Thesaurus Property-3)
C0008972 (UMLS 2011AA Property-3)
C16112 (NCI Thesaurus Property-4)
C1516637 (UMLS 2011AA Property-4)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
Item Group
Organ Function - Hematological
BoneMarrowInvolvementInd-3
Item
Does patient have bone marrow involvement
boolean
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C12431 (NCI Thesaurus ObjectClass)
C0005953 (UMLS 2011AA ObjectClass)
C25548 (NCI Thesaurus Property)
C1314939 (UMLS 2011AA Property)
PatientBoneMarrowFunctionRequiredInd-2
Item
Does patient have adequate bone marrow function?
boolean
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25518 (NCI Thesaurus Property)
C0542341 (UMLS 2011AA Property)
HematologySpecimenCollectedDate
Item
Lab, Hematology, Sample Collection Date
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C16673 (NCI Thesaurus ObjectClass)
C0018943 (UMLS 2011AA ObjectClass)
C19157 (NCI Thesaurus ObjectClass-2)
C0370003 (UMLS 2011AA ObjectClass-2)
C25452 (NCI Thesaurus Property)
LaboratoryProcedureLeukocyteResultUnspecifiedValue
Item
WBC
float
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C12529 (NCI Thesaurus Property)
C0023516 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property-2)
C1274040 (UMLS 2011AA Property-2)
C38046 (NCI Thesaurus ValueDomain)
C0205370 (UMLS 2011AA ValueDomain)
C25712 (NCI Thesaurus ValueDomain-2)
C1522609 (UMLS 2011AA ValueDomain-2)
LaboratoryProcedureAbsoluteNeutrophilCountResultUnspecifiedValue
Item
Absolute neutrophil count (ANC)
float
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C63321 (NCI Thesaurus Property-2)
C0948762 (UMLS 2011AA Property-2)
C38046 (NCI Thesaurus ValueDomain)
C0205370 (UMLS 2011AA ValueDomain)
C25712 (NCI Thesaurus ValueDomain-2)
C1522609 (UMLS 2011AA ValueDomain-2)
LaboratoryProcedureSegmentedNeutrophilOutcomePercentageValue
Item
Segs
float
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C36719 (NCI Thesaurus Property-2)
C0229640 (UMLS 2011AA Property-2)
C25613 (NCI Thesaurus ValueDomain)
C0439165 (UMLS 2011AA ValueDomain)
C25712 (NCI Thesaurus ValueDomain-2)
C1522609 (UMLS 2011AA ValueDomain-2)
LaboratoryProcedureNeutrophilBandFormCountResultPercentageValue
Item
Bands
float
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C64830 (NCI Thesaurus Property-2)
C1882076 (UMLS 2011AA Property-2)
C49100 (NCI Thesaurus ValueDomain)
C1704610 (UMLS 2011AA ValueDomain)
LaboratoryProcedurePlateletResultUnspecifiedValue
Item
Peripheral Platelet Count
float
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C12520 (NCI Thesaurus Property-2)
C0005821 (UMLS 2011AA Property-2)
C38046 (NCI Thesaurus ValueDomain)
C0205370 (UMLS 2011AA ValueDomain)
C25712 (NCI Thesaurus ValueDomain-2)
C1522609 (UMLS 2011AA ValueDomain-2)
LaboratoryProcedureHemoglobinResultUnspecifiedValue
Item
Hemoglobin
float
C16676 (NCI Thesaurus Property)
C0019046 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property-2)
C1274040 (UMLS 2011AA Property-2)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
Item
Were transfusions given
text
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
C25639 (NCI Thesaurus Property)
C1514756 (UMLS 2011AA Property)
C15408 (NCI Thesaurus ObjectClass)
Code List
Were transfusions given
CL Item
No Transfusion (No)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
CL Item
Transfusion With Platelets And Red Blood Cells (Yes, both)
CL Item
Transfusion With Platelets (Yes, platelets)
CL Item
Transfusion With Red Blood Cells (Yes, red blood cells)
Item Group
Organ Function - Non Hematological
PatientRenalFunctionRequiredInd-2
Item
Does patient have adequate renal function?
boolean
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25518 (NCI Thesaurus Property)
C0542341 (UMLS 2011AA Property)
Creatinine Clearance Date
Item
Date of Creatinine Clearance
date
C25164 (NCI Thesaurus ValueDomain)
C20200 (NCI Thesaurus Property)
C25747 (NCI Thesaurus Property-2)
C25294 (NCI Thesaurus ObjectClass)
C0011008 (UMLS CUI [1,1])
C0373595 (UMLS CUI [1,2])
Creatinine, Serum
Item
Creatinine
float
C25294 (NCI Thesaurus ObjectClass)
C20200 (NCI Thesaurus Property)
C399 (NCI Thesaurus Property-2)
C38046 (NCI Thesaurus ValueDomain)
C25712 (NCI Thesaurus ValueDomain-2)
C0201976 (UMLS CUI [1])
LaboratoryProcedureGlomerularFiltrationRateOutcomeSpecifiedValue
Item
What is the GFR for the indicated period (ml/min/1.73m2)
float
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C90505 (NCI Thesaurus Property-2)
PatientLiverFunctionRequiredInd-2
Item
Does patient have adequate liver function?
boolean
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25518 (NCI Thesaurus Property)
C0542341 (UMLS 2011AA Property)
LaboratoryProcedureBilirubinOutcomeDate
Item
Date
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C305 (NCI Thesaurus Property-2)
C0005437 (UMLS 2011AA Property-2)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
Bilirubin, total
Item
Total Bilirubin
float
C25294 (NCI Thesaurus ObjectClass)
C20200 (NCI Thesaurus Property)
C38037 (NCI Thesaurus Property-2)
C25712 (NCI Thesaurus ValueDomain)
C38024 (NCI Thesaurus ValueDomain-2)
C0201913 (UMLS CUI [1])
LaboratoryProcedureTotalBilirubinResultSpecifiedUpperLimitofNormalValue
Item
Total bilirubin ULN
float
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C38037 (NCI Thesaurus Property-2)
C0201913 (UMLS 2011AA Property-2)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C38024 (NCI Thesaurus ValueDomain-2)
C0205369 (UMLS 2011AA ValueDomain-2)
C25706 (NCI Thesaurus ValueDomain-3)
C1519815 (UMLS 2011AA ValueDomain-3)
LaboratoryProcedureSerumGlutamicPyruvicTransaminaseResultUnspecifiedValue
Item
SGPT
float
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C25293 (NCI Thesaurus Property-2)
C0376147 (UMLS 2011AA Property-2)
C38046 (NCI Thesaurus ValueDomain)
C0205370 (UMLS 2011AA ValueDomain)
C25712 (NCI Thesaurus ValueDomain-2)
C1522609 (UMLS 2011AA ValueDomain-2)
LaboratoryProcedureAlbuminResultSpecifiedValue
Item
Albumin (Serum)
float
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C214 (NCI Thesaurus Property-2)
C0001924 (UMLS 2011AA Property-2)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
PatientSwallowingAssessmentInd-2
Item
Is patient able to swallow capsules or a liquid suspension
boolean
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C38028 (NCI Thesaurus Property-2)
C0011167 (UMLS 2011AA Property-2)
Item Group
Exclusion Criteria
PregnancyTestPerformedInd-2
Item
Pregnancy test done
boolean
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
C25742 (NCI Thesaurus ObjectClass)
C0032961 (UMLS 2011AA ObjectClass)
C25294 (NCI Thesaurus ObjectClass-2)
C0022885 (UMLS 2011AA ObjectClass-2)
PatientPregnancyInd-2
Item
Is patient pregnant
boolean
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25742 (NCI Thesaurus Property)
C0032961 (UMLS 2011AA Property)
NursingMotherInd-3
Item
Is patient nursing
boolean
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C25189 (NCI Thesaurus Property)
C0026591 (UMLS 2011AA Property)
C16926 (NCI Thesaurus ObjectClass)
C0028677 (UMLS 2011AA ObjectClass)
Item
Has patient agreed to use an effective contraceptive method
text
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
C37932 (NCI Thesaurus ObjectClass)
C0700589 (UMLS 2011AA ObjectClass)
C25369 (NCI Thesaurus Property)
C0680240 (UMLS 2011AA Property)
Code List
Has patient agreed to use an effective contraceptive method
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
N/a, Patient Is Not Of Reproductive Potential (N/A, patient is not of reproductive potential)
CorticosteroidAdministrationInd-3
Item
Is the patient receiving corticosteroids?
boolean
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C25629 (NCI Thesaurus Property)
C0332152 (UMLS 2011AA Property)
C2322 (NCI Thesaurus ObjectClass)
C0001617 (UMLS 2011AA ObjectClass)
C25382 (NCI Thesaurus Property-2)
C1521801 (UMLS 2011AA Property-2)
CorticosteroidStableLowerDoseAdministeredIndicator
Item
Has patient been on a stable or decreasing dose of corticosteroids for the indicated period
boolean
C2322 (NCI Thesaurus ObjectClass)
C0001617 (UMLS 2011AA ObjectClass)
C30103 (NCI Thesaurus Property)
C0205360 (UMLS 2011AA Property)
C25488 (NCI Thesaurus Property-2)
C0178602 (UMLS 2011AA Property-2)
C86568 (NCI Thesaurus Property-3)
C2003888 (UMLS 2011AA Property-3)
C25382 (NCI Thesaurus Property-4)
C1521801 (UMLS 2011AA Property-4)
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
CancerTreatmentConcurrentAdministeredInd-2
Item
Is patient currently receiving any other anticancer or experimental drug therapy
boolean
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C25456 (NCI Thesaurus Property)
C0205420 (UMLS 2011AA Property)
C16212 (NCI Thesaurus ObjectClass)
C0920425 (UMLS 2011AA ObjectClass)
C25382 (NCI Thesaurus Property-2)
C1521801 (UMLS 2011AA Property-2)
PatientInfectionInd-2
Item
Does patient have an uncontrolled infection?
boolean
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C26726 (NCI Thesaurus Property)
C0009450 (UMLS 2011AA Property)
PatientClinicalTrialSafetyComplianceInd-2
Item
Is patient, in the opinion of the investigator, able to comply with the safety monitoring requirements of the study
boolean
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C71104 (NCI Thesaurus Property)
C0008976 (UMLS 2011AA Property)
C25194 (NCI Thesaurus Property-2)
C60828 (NCI Thesaurus Property-3)
C0036043 (UMLS 2011AA Property-2)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
PersonCytochromeP4503A4SubstrateDomainEligibilityDeterminationInd-2
Item
Is patient receiving CYP3A4 substrates with narrow therapeutic indices
boolean
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C25171 (NCI Thesaurus Property)
C0013893 (UMLS 2011AA Property)
C17573 (NCI Thesaurus Property-2)
C1142644 (UMLS 2011AA Property-2)
C14073 (NCI Thesaurus Property-3)
C1515032 (UMLS 2011AA Property-3)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
PersonCytochromeP4503A4InhibitionAgentEligibilityDeterminationInd-2
Item
Did patient receive CYP3A4 inhibitor during the indicated period
boolean
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C1708 (NCI Thesaurus Property)
C0450442 (UMLS 2011AA Property)
C25171 (NCI Thesaurus Property-2)
C0013893 (UMLS 2011AA Property-2)
C17573 (NCI Thesaurus Property-3)
C1142644 (UMLS 2011AA Property-3)
C42791 (NCI Thesaurus Property-4)
C0021469 (UMLS 2011AA Property-4)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
PersonCytochromeP4503A4InductionAgentEligibilityDeterminationInd-2
Item
Did patient receive CYP3A4 inducer during the indicated period
boolean
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C61367 (NCI Thesaurus Property)
C0205263 (UMLS 2011AA Property)
C1708 (NCI Thesaurus Property-2)
C0450442 (UMLS 2011AA Property-2)
C25171 (NCI Thesaurus Property-3)
C0013893 (UMLS 2011AA Property-3)
C17573 (NCI Thesaurus Property-4)
C1142644 (UMLS 2011AA Property-4)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
Item Group
Consent For Research Studies
InformedConsentFormSignedDate
Item
Date Informed Consent Signed
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25367 (NCI Thesaurus ValueDomain-2)
C16468 (NCI Thesaurus ObjectClass)
C0009797 (UMLS 2011AA ObjectClass)
C25679 (NCI Thesaurus Property)
PatientPharmacokineticStudyConsentInd-2
Item
Was consent signed for Pharmacokinetics
boolean
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25460 (NCI Thesaurus Property)
C1511481 (UMLS 2011AA Property)
C49663 (NCI Thesaurus Property-2)
C0201734 (UMLS 2011AA Property-2)
SpecimenRelatedGeneticResearchConsentInd-2
Item
Does the participant agree to participate in the pharmacogenetics study associated with this protocol
boolean
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
C15319 (NCI Thesaurus Property)
C25648 (NCI Thesaurus Property-2)
C0439849 (UMLS 2011AA Property)
C17938 (NCI Thesaurus Property-3)
C0314603 (UMLS 2011AA Property-2)
C25460 (NCI Thesaurus Property-4)
C1511481 (UMLS 2011AA Property-3)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
PatientCorrelativeStudyTissueSpecimenConsentInd-2
Item
Patient consents to tissue submission
boolean
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C12801 (NCI Thesaurus Property)
C0040300 (UMLS 2011AA Property)
C19157 (NCI Thesaurus Property-2)
C0370003 (UMLS 2011AA Property-2)
C25460 (NCI Thesaurus Property-3)
C1511481 (UMLS 2011AA Property-3)
C16100 (NCI Thesaurus Property-4)
C1511524 (UMLS 2011AA Property-4)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
PatientCorrelativeStudyBloodSpecimenConsentInd-2
Item
Patient consents to blood submission
boolean
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C12434 (NCI Thesaurus Property)
C0229664 (UMLS 2011AA Property)
C19157 (NCI Thesaurus Property-2)
C0370003 (UMLS 2011AA Property-2)
C25460 (NCI Thesaurus Property-3)
C1511481 (UMLS 2011AA Property-3)
C16100 (NCI Thesaurus Property-4)
C1511524 (UMLS 2011AA Property-4)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
ResearchCommentsText
Item
Comments
text
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
C0282411 (UMLS 2011AA Property)
ResponsiblePersonSignatureText
Item
Signature
text
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C25657 (NCI Thesaurus ObjectClass-2)
C1273518 (UMLS 2011AA ObjectClass-2)
C25678 (NCI Thesaurus Property)
C1519316 (UMLS 2011AA Property)

Please use this form for feedback, questions and suggestions for improvements.

Fields marked with * are required.

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