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Toxicity - Brain Cancer - Adverse Event Form - 2263172v3.0 - Brain Cancer - Adverse Event Form

- 1/9/15 - 1 form, 4 itemgroups, 23 items, 1 language
Itemgroups: CRF Header, Brain: Form Administration, Brain: Adverse Events, Comments
Brain Cancer - Adverse Event Form Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=DE93FBC6-0592-249A-E034-0003BA12F5E7

RTOG-0525 AE: Adverse Event Evaluation Form NCT00304031

- 7/8/15 - 1 form, 2 itemgroups, 20 items, 1 language
Itemgroups: RTOG clinical trial administrative data, REPORT ALL CONTINUING OR NEW ADVERSE EVENTS
RTOG-0525 AE: Adverse Event Evaluation Form NCT00304031 Radiation Therapy and Temozolomide in Treating Patients With Newly Diagnosed Glioblastoma or Gliosarcoma Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=FD9B3E8E-5C94-635F-E034-0003BA3F9857

AMC-061 Adverse Events Form (ADV) NCT00890747

- 6/16/15 - 1 form, 2 itemgroups, 19 items, 1 language
Itemgroups: Adverse Event Information, Comments
AMC-061 Adverse Events Form (ADV) NCT00890747 Sunitinib Malate in Treating HIV-Positive Patients With Cancer Undergoing Highly Active Antiretroviral Therapy Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=71988CF7-F8CE-68F0-E040-BB89AD4358A1

Event Monitoring Form N0577

- 1/9/15 - 1 form, 7 itemgroups, 32 items, 1 language
Itemgroups: Header Module, VITAL STATUS, Disease Follow-up Status, Notice of First Relapse/Progression in the Event Monitoring Phase, Notice of First Subsequent Treatment, Notice of New Primary, Late Adverse Events
North Central Cancer Treatment Group N0577 Event Monitoring Form Radiation Therapy or Radiation Therapy and Temozolomide or Temozolomide Alone in Treating Patients With Newly Diagnosed Anaplastic Glioma Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=4C090D31-BB06-2FAA-E044-0003BA3F9857

Brain and Central Nervous System Tumors NCT00887146 Toxicity - North Central Cancer Treatment Group N0577 Baseline Adverse Events Form - 2745736v1.0 - North Central Cancer Treatment Group N0577 Baseline Adverse Events Form

- 1/8/15 - 1 form, 2 itemgroups, 10 items, 1 language
Itemgroups: Header Module, Required Baseline Adverse Events from Section 10.0 of Protocol
North Central Cancer Treatment Group N0577 Baseline Adverse Events Form Radiation Therapy or Radiation Therapy and Temozolomide or Temozolomide Alone in Treating Patients With Newly Diagnosed Anaplastic Glioma Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=4C096CEC-612D-47DB-E044-0003BA3F9857

Lapatinib + Topotecan or + Capecitabine in Recurrent Brain Metastases from Breast Cancer; NCT00437073 - Log

- 4/26/21 - 1 form, 9 itemgroups, 117 items, 1 language
Itemgroups: Date of visit, Assessment Date, Event Log, Status, Non-serious Adverse Event, Serious Adverse Event, Concomitant Agent, Concomitant Agent, Adrenal Cortex Hormones, Blood product; Supportive care, Collection of blood specimen for laboratory procedure, Pharmacogenetic Test, Informed Consent, Pharmacogenetic Test, Informed Consent, Withdraw (activity)
Study ID: 107671 Clinical Study ID: 107671 Study Title: EGF107671 – A Phase II Study of Lapatinib plus Topotecan or Lapatinib plus Capecitabine in the Treatment of Recurrent Brain Metastases from ErbB2-Positive Breast Cancer Following Cranial Radiotherapy Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: NCT00437073 Sponsor: GlaxoSmithKline Collaborators: N/A Phase: Phase 2 Study Recruitment Status: Completed Generic Name: N/A Trade Name: capecitabine, topotecan, lapatinib Study Indication: Neoplasms, Breast; Recurrent Brain Metastases

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