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On-Study Form Bladder Cancer NCT00014534 CALGB-90104

- 8/21/15 - 1 formulario, 3 itemgroups, 61 items, 1 idioma

Itemgroups: Muscle Invasive Bladder Disease: Prior Treatment Affecting the Bladder, Prior Therapy Date, CCRR MODULE

On-Study Form Bladder Cancer NCT00014534 CALGB-90104 NCT00014534 NCI Cooperative Group On-Study Form-Revised (CALGB-90104) Combination Chemotherapy in Treating Patients With Bladder Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=BE1B6E9C-942E-7181-E034-0003BA12F5E7

On-Study - Superficial Bladder Cancer - On-Study Form - 2019333v2.31 - Superficial Bladder Cancer - On-Study Form

- 1/8/15 - 1 formulario, 5 itemgroups, 43 items, 1 idioma

Itemgroups: CRF Header, BLADDER: FORM ADMINISTRATION, BLADDER: DISEASE DESCRIPTION FOR SUPERFICIAL BLADDER CARCINOMA, SUPERFICIAL BLADDER DISEASE: PRIOR TREATMENT AFFECTING THE BLADDER, Comments

Superficial Bladder Cancer - On-Study Form Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=99CD59C5-A961-3FA4-E034-080020C9C0E0

On-Study - Palliative Treatment for Head and Neck Cancer - On-Study Form - 2267713v3.0 - Palliative Treatment for Head and Neck Cancer - On-Study Form

- 9/20/21 - 1 formulario, 9 itemgroups, 85 items, 1 idioma

Itemgroups: CRF Header, Head & Neck: Form Administration, Head & Neck: Patient Assessment, Head & Neck: Disease Description - Initial Diagnosis of Disease, Head & Neck: Disease Description - Current Diagnosis, Head & Neck: Prior Health History - Palliative, Head & Neck: Prior Treatment - Systemic Therapy, Head & Neck: Prior Treatment - Radiation Therapy, Head & Neck: Prior Treatment - Surgery

Palliative Treatment for Head and Neck Cancer - On-Study Form Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=20B9E4F5-9DD3-2343-E044-0003BA3F9857

On-Study - Metastatic Bladder/Urothelial Cancer - On-Study Form - 2019330v2.31 - Metastatic Bladder/Urothelial Cancer - On-Study Form

- 1/8/15 - 1 formulario, 6 itemgroups, 55 items, 1 idioma

Itemgroups: CRF Header, BLADDER/UROTHELIAL: FORM ADMINISTRATION, BLADDER/UROTHELIAL: DISEASE DESCRIPTION FOR METASTATIC BLADDER/UROTHELIAL CANCER, BLADDER/UROTHELIAL: SITE(S) OF DISEASE, BLADDER/UROTHELIAL: PRIOR TREATMENT AFFECTING THE BLADDER/UROTHELIUM , Comments

Metastatic Bladder/Urothelial Cancer - On-Study Form Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=99CD59C5-A95B-3FA4-E034-080020C9C0E0

On-Study - Muscle Invasive Bladder Cancer - On-Study Form - 2019331v2.31 - Muscle Invasive Bladder Cancer - On-Study Form

- 1/8/15 - 1 formulario, 5 itemgroups, 60 items, 1 idioma

Itemgroups: CRF Header, BLADDER: FORM ADMINISTRATION, BLADDER: DISEASE DESCRIPTION FOR MUSCLE INVASIVE BLADDER CANCER, MUSCLE INVASIVE BLADDER DISEASE: PRIOR TREATMENT AFFECTING THE BLADDER, Comments

Muscle Invasive Bladder Cancer - On-Study Form Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=99CD59C5-A95D-3FA4-E034-080020C9C0E0

On-Study Advanced Urinary Tract Cancer CALGB 90601 NCT00942331

- 7/30/15 - 1 formulario, 7 itemgroups, 65 items, 1 idioma

Itemgroups: Header Module, Initial Diagnosis, Bladder Malignant Neoplasm, Laboratory Values, Urinalysis, Prior Treatment - Systemic/Intravesical Regimens, Footer Module

CALGB 90601: On-Study Form NCT00942331 Gemcitabine Hydrochloride and Cisplatin With or Without Bevacizumab in Treating Patients With Advanced Urinary Tract Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=653FC86F-74B9-C88B-E040-BB89AD432982

Bladder Cancer NCT00445601 On-Study - S0337 Cystoscopy and Urine Markers Form - 2389143v1.0 - S0337 Cystoscopy and Urine Markers Form

- 9/20/21 - 1 formulario, 4 itemgroups, 25 items, 1 idioma

Itemgroups: Header, Urine Markers, Cytoscopy, Comments

S0337 Cystoscopy and Urine Markers Form Gemcitabine After Surgery in Treating Patients With Newly Diagnosed or Recurrent Bladder Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=FE26193B-C3C0-4C67-E034-0003BA3F9857

Breast Cancer NCT01242800 On-Study - E2108 Step 2 On-Study Form - 3130597v1.0 - E2108 Step 2 On-Study Form

- 9/20/21 - 1 formulario, 8 itemgroups, 40 items, 1 idioma

Itemgroups: Header Module, Header, Amended Data, Patient Characteristics, Disease Description, Treatment Plan, Circulating Tumor Cell (CTC) Enumeration, Comments

E2108 Step 2 On-Study Form Early Surgery or Standard Palliative Therapy in Treating Patients With Stage IV Breast Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=8E2EE15D-B7A5-69C7-E040-BB89AD431929

Breast Cancer NCT01242800 On-Study - E2108 Step 1 On-Study Form - ARM S - 3130381v1.0 - E2108 Step 1 On-Study Form - ARM S

- 9/20/21 - 1 formulario, 9 itemgroups, 59 items, 1 idioma

Itemgroups: Header Module, Header, Amended Data, Pre-Registration Evaluation, Disease Description, Metastatic Site(s) of Involvement (At Study Entry), STATUS OF LOCAL-REGIONAL DISEASE - Prior to initiation of Optimal Systemic Therapy, Breast Involvement, Comments

E2108 Step 1 On-Study Form - ARM S Early Surgery or Standard Palliative Therapy in Treating Patients With Stage IV Breast Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=8E2ED499-121B-8389-E040-BB89AD4330F7

On-Study - Metastatic Brain Cancer - On-Study Form - 2287553v3.0 - Metastatic Brain Cancer - On-Study Form

- 1/9/15 - 1 formulario, 10 itemgroups, 64 items, 1 idioma

Itemgroups: CRF Header, Brain: Form Administration, Non-CNS: Initial Disease Description, Brain: Current Disease Description, Brain: Concomitant Medications, Metastatic Brain: Prior Health History, Metastatic Brain: Prior Treatment, Brain: Prior Treatment - Systemic Regimens, Brain: Prior Treatment - CNS RT, Brain: Prior Treatment - CNS Surgery

Metastatic Brain Cancer - On-Study Form Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=EF3A8ACE-5457-4C56-E034-0003BA3F9857

Bladder Cancer NCT00014534 On-Study - NCI Cooperative Group On-Study Form (CALGB-90104) - 2056020v3.0 - NCI Cooperative Group On-Study Form (CALGB-90104)

- 1/8/15 - 1 formulario, 6 itemgroups, 51 items, 1 idioma

Itemgroups: MSKCC 00-138; CALGB-90104; ECOG, Form Administration, Disease Description for Muscle Invasive Bladder Cancer, Muscle Invasive Bladder Disease: Prior Treatment Affecting the Bladder, Comments, CCRR MODULE

NCI Cooperative Group On-Study Form (CALGB-90104) Combination Chemotherapy in Treating Patients With Bladder Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A9C0279B-A154-2673-E034-0003BA12F5E7

On-Study - Primary Brain Cancer - On-Study Form Recurrent Treatment - 2293986v3.0 - Primary Brain Cancer - On-Study Form Recurrent Treatment

- 1/9/15 - 1 formulario, 9 itemgroups, 62 items, 1 idioma

Itemgroups: CRF Header, Brain: Form Administration, Brain: Recurrent Disease Description, Brain: Neurologic Function, Brain: Concomitant Medications, Brain: Prior Health History, Brain: Prior Treatment, Brain: Prior Treatment - Systemic Regimens, Comments

Primary Brain Cancer - On-Study Form Recurrent Treatment Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=E51DA7FB-264B-3B94-E034-0003BA3F9857

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