Search results - Portal of Medical Data Models (MDM-Portal)

Breast Cancer NCT00041119 - ON-STUDY FORM Breast Cancer CALGB 40101 NCT00041119

- 3/23/15 - 1 form, 2 itemgroups, 45 items, 1 language

Itemgroups: Header, Patient data

CALGB: 40101 ON-STUDY FORM Four Versus Six Cycles of Cyclophosphamide/Doxorubicin or Paclitaxel in Adjuvant Breast Cancer NCT00041119 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A4E097B4-CDDD-18B4-E034-080020C9C0E0

On Study Breast Cancer CALGB_40301

- 8/21/15 - 1 form, 8 itemgroups, 53 items, 1 language

Itemgroups: Header, Patient demographics, PATIENT CHARACTERISTICS, DISEASE DESCRIPTION, SITE OF PROGRESSION OR RECURRENCE, PRIOR SYSTEMIC THERAPY, PRIOR SYSTEMIC REGIMENS, LABORATORY VALUES

Randomized Placebo-Controlled Phase III Trial of Letrozole Alone or Letrozole and Tipifarnib (Zarnestra, R115777) for Postmenopausal women with ER/PR+ Tamoxifen resistant MBC CALGB_40301_ON_STUDY_FORM Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=E53B0CD1-788E-25B9-E034-0003BA3F9857

Breast Cancer On-Study NCT00408408 NSABP B-40 - On-Study Form Breast Cancer NCT00408408

- 4/1/15 - 1 form, 2 itemgroups, 18 items, 1 language

Itemgroups: Header, Patient characteristics

NSABP Protocol B-40 - On-Study Form A Randomized Phase III Trial of Neoadjuvant Therapy in Patients With Palpable and Operable Breast Cancer Evaluating the Effect on Pathologic Complete Response (pCR) of Adding Capecitabine or Gemcitabine to Docetaxel When Administered Before AC With or Without Bevacizumab and Correlative Science Studies Attempting to Identify Predictors of High Likelihood for pCR With Each of the Regimens NCT00408408 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=1B3E2A3A-F3C8-3045-E044-0003BA3F9857

On-Study - Breast Cancer - Adjuvant On-Study Form - 2263232v3.0 - Breast Cancer - Adjuvant On-Study Form

- 1/9/15 - 1 form, 5 itemgroups, 26 items, 1 language

Itemgroups: CRF Header, Breast: Form Administration, Breast: Patient Characteristics, Breast: Surgical Procedures, Breast: Disease Description

Breast Cancer - Adjuvant On-Study Form Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=DA189DBB-8EE5-059F-E034-0003BA12F5E7

Neoplasms, Breast DRKS00003651 NCT00490139 On-Study - BIG 2-06 / NCCTG N063D / EGF106708 - Second Primary Malignancy and Contralateral Breast Cancer - 2640082v1.0 - BIG 2-06 / NCCTG N063D / EGF106708 - Second Primary Malignancy and Contralateral Breast Cancer

- 1/9/15 - 1 form, 2 itemgroups, 8 items, 1 language

Itemgroups: Header Module, Second primary malignancy and contralateral breast cancer

BIG 2-06 / NCCTG N063D / EGF106708 - Second Primary Malignancy and Contralateral Breast Cancer ALTTO (Adjuvant Lapatinib And/Or Trastuzumab Treatment Optimisation) Study; BIG 2-06/N063D Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=30FE4342-8C69-1B74-E044-0003BA3F9857

On-Study - Breast Cancer - Advanced Disease On-Study Form - 2262184v3.0 - Breast Cancer - Advanced Disease On-Study Form

- 1/9/15 - 1 form, 7 itemgroups, 36 items, 1 language

Itemgroups: CRF Header, Breast: Form Administration, Breast: Patient Characteristics, Breast: Advanced Disease Description, Breast: Site(s) of Progression, Breast: Advanced Treatment - Prior Systemic Therapy, Breast: Advanced Prior Treatment - Systemic Regimens

Breast Cancer - Advanced Disease On-Study Form Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=DE332B4F-910E-38FA-E034-0003BA12F5E7

RTOG-1005 I1: Radiation Therapy Oncology Group Phase III Whole Breast Irradiation for Early Stage Breast Cancer - Initial Evaluation Form NCT01349322

- 9/20/21 - 1 form, 10 itemgroups, 93 items, 1 language

Itemgroups: RTOG clinical trial administrative data, Patient status, Tumor Involvement, pStage I, II breast cancer AND at least one of the following (see below and code all), Tumor Information, Study Cancer, Baseline Labs, Examinations/Consultations, General Conditions, Footer Module

RTOG-1005 I1: Radiation Therapy Oncology Group Phase III Whole Breast Irradiation for Early Stage Breast Cancer - Initial Evaluation Form NCT01349322 Higher-Dose Radiation Therapy or Standard Radiation Therapy in Treating Patients With Early-Stage Breast Cancer That Was Removed by Surgery Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=9C06B696-F1B0-F7B4-E040-BB89AD434CCB

On-Study - Phase II Breast Cancer - Adjuvant On-Study Form - 2556117v1.0 - Phase II Breast Cancer - Adjuvant On-Study Form

- 9/20/21 - 1 form, 6 itemgroups, 47 items, 1 language

Itemgroups: CRF Header, Breast: Form Administration, Breast: Patient Characteristics, Breast: Surgical Procedures, Breast: Disease Description, Header

Phase II Breast Cancer - Adjuvant On-Study Form Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=24E7C2C2-27C7-70B6-E044-0003BA3F9857

Breast Cancer NCT00601900 On-Study - CALGB 40503 ON-STUDY FORM - 2551476v1.0 - CALGB 40503 ON-STUDY FORM

- 1/9/15 - 1 form, 10 itemgroups, 47 items, 1 language

Itemgroups: Header Module, Header, PATIENT CHARACTERISTICS, ADVANCED DISEASE DESCRIPTION, SITES(S) OF INVOLVMENT, LABORATORY VALUES, URINALYSIS, IMMUNOHISTOCHEMISTRY, PRIOR TREATMENT - SYSTEMIC REGIMENS, Footer module

CALGB 40503 ON-STUDY FORM Tamoxifen or Letrozole With or Without Bevacizumab in Treating Women With Stage III or Stage IV Breast Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=24087EF3-EA58-6B28-E044-0003BA3F9857

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

- 9/20/21 - 1 form, 8 itemgroups, 40 items, 1 language

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 NCT00659373 On-Study - Clinical Form (Form 24-B) - 2074000v3.0 - Clinical Form (Form 24-B)

- 1/9/15 - 1 form, 5 itemgroups, 75 items, 1 language

Itemgroups: CCRR MODULE, INITIAL DATA, Primary Disease, Required Clinical Investigations, FAMILY HISTORY

Clinical Form (Form 24-B) Brain Function in Premenopausal Women Receiving Tamoxifen With or Without Ovarian Function Suppression for Early-Stage Breast Cancer on Clinical Trial IBCSG-2402 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=B121C37B-513A-4BC8-E034-0003BA12F5E7

On-Study - Phase II Breast Cancer - Advanced Disease On-Study Form - 2583382v1.0 - Phase II Breast Cancer - Advanced Disease On-Study Form

- 1/9/15 - 1 form, 10 itemgroups, 71 items, 1 language

Itemgroups: CRF Header, Breast: Form Administration, Breast: Patient Characteristics, Breast: Advanced Disease Description, Breast: Site(s) of Progression, Breast: Advanced Treatment - Prior Systemic Therapy, Breast: Advanced Prior Treatment, Breast: Prior Radiation Therapy, Breast: Prior Surgery, Breast: Prior Surgery

Phase II Breast Cancer - Advanced Disease On-Study Form Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=258957C7-A3E4-6659-E044-0003BA3F9857

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