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XELODA and Lapatinib Advanced or Metastatic Breast Cancer Demography NCT00078572

- 20/09/21 - 1 modulo, 2 itemgroups, 8 elementi, 1 linguaggio
Itemgroups: Demography, Demography for Females
XELODA and Lapatinib Advanced or Metastatic Breast Cancer Study ID: 100151 Clinical Study ID: EGF100151 Study Title: A Phase III, Randomized, Open-label, Multicenter Study Comparing GW572016 and Capecitabine (XELODA) versus Capecitabine in Women with Refractory Advanced or Metastatic Breast Cancer Clinicaltrials.gov Identifier: NCT00078572 https://clinicaltrials.gov/ct2/show/NCT00078572 Procedure: Demography Sponsor: GlaxoSmithKline Collaborators: N/A Phase: phase 3 Study Recruitment Status: Completed Generic Name: lapatinib Trade Name: Tyverb,Tykerb,Tycerb Study Indication: Breast Cancer; Neoplasms, Breast

Case Report Form GSK - Case report form RRL 100013

- 20/09/21 - 1 modulo, 1 ItemGroup, 6 elementi, 2 lingue
ItemGroup: Patient demographics
Protocol Identifier RRL 100013 A 12 Week, Double-Blind, Placebo Controlled, Twice Daily Dosing Study to Assess the Efficacy and Safety of Ropinirole in Patients Suffering from Restless Legs Syndrome (RLS) Requiring Extended Treatment Coverage

Screening demography Ropinirole Case Report Form GSK RRL100013

- 20/09/21 - 1 modulo, 2 itemgroups, 5 elementi, 1 linguaggio
Itemgroups: Administrative Data, demography
Demography Ropinirole Case Report FormStudy ID: 100013 Clinical Study ID: RRL100013 A 12-Week, Double-Blind, Placebo-Controlled, Twice-Daily Dosing Study to Assess the Efficacy and Safety of Ropinirole in Patients Suffering from Restless Legs Syndrome (RLS) Requiring Extended Treatment Coverage

Screening: Demography Multiple Sclerosis ALAIN01 NCT02419378

- 20/09/21 - 1 modulo, 1 ItemGroup, 5 elementi, 1 linguaggio
ItemGroup: Demography
Alemtuzumab in Autoimmune Inflammatory Neurodegeneration: Mechanisms of Action and Neuroprotective Potential (ALAIN01) https://clinicaltrials.gov/ct2/show/NCT02419378 Principal Investigator Prof. Dr. Dr. Sven Meuth, University Hospital Muenster, Germany Part: Screening

Demography GSK study Dyskinesia in Parkinson's disease NCT00363727

- 20/09/21 - 1 modulo, 2 itemgroups, 7 elementi, 1 linguaggio
Itemgroups: General information, Demography
Study ID: 101468/228 Clinical Study ID: 101468/228 Study Title:A two year Phase IIIb randomised, multicenter, double-blind, SINEMET controlled, parallel group, flexible dose study, to assess the effectiveness of controlled release ropinirole add-on therapy to L-dopa at increasing the time to onset of dyskinesia in Parkinson's disease subjects. Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: NCT00363727 Sponsor: GlaxoSmithKline Collaborators: N/A Phase: phase 3 Study Recruitment Status: Completed Generic Name: ropinirole Trade Name: Zygara,ZIPEREVE,ZEPREVE,Requip Depot,REQUIP,REPREVE,Modutab,ADARTREL Study Indication : Dyskinesias; Parkinson Disease; Parkinson's Disease Study part: Demography.

Lymphoma NCT00392834 Demographic - AMC-048 Demographic Form (DEM) - 2655243v1.0 - AMC-048 Demographic Form (DEM)

- 20/09/21 - 1 modulo, 1 ItemGroup, 7 elementi, 1 linguaggio
ItemGroup: Header
AMC-048 Demographic Form (DEM) Rituximab and Combination Chemotherapy in Treating Patients With Newly Diagnosed, HIV-Associated Burkitt's Lymphoma Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=32E18FA2-33B5-4AF2-E044-0003BA3F9857

Demographic A0 HQ Confirmation Prostate Cancer NCT00288080

- 20/09/21 - 1 modulo, 1 ItemGroup, 29 elementi, 1 linguaggio
ItemGroup: Patient Information
A0 HQ Confirmation - Radiation Therapy Oncology Group PROSTATE:CONFORMAL RT PLUS ANDROGEN ABLATION Hormone Therapy and Radiation Therapy or Hormone Therapy and Radiation Therapy Followed by Docetaxel and Prednisone in Treating Patients With Localized Prostate Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=53DF7CA6-6269-4FBB-E044-0003BA3F9857

Demographic - MetLife - Dental Survey 01 - 2448788v1.0 - MetLife - Dental Survey 01

- 20/09/21 - 1 modulo, 11 itemgroups, 69 elementi, 1 linguaggio
Itemgroups: 1. Contact Information, A. Post Operative Hypersensitivity with Composite Resin Restorations , B. Dental Care For Pregnant Women, C. Porcelain Repair, D. Deep Carious Dentin, E. Smoking Cessation, F. Visual Classification Of Caries, G. Cracked Tooth, H. Leaking Sealant Detection, II. Professional Information, III. Description Of Your Practice
MetLife - Dental Survey 01 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=0C367FF0-9A1C-3FCD-E044-0003BA3F9857

Nonneoplastic Condition NCT01057121 Demographic - AMC-070 Demographic Form (DEM) - 3146420v1.0 - AMC-070 Demographic Form (DEM)

- 20/09/21 - 1 modulo, 1 ItemGroup, 7 elementi, 1 linguaggio
ItemGroup: Demographics
AMC-070 Demographic Form (DEM) Lenalidomide in Treating Patients With AIDS-Related Kaposi Sarcoma Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=91E333A1-42F8-701C-E040-BB89AD433C30

Brain and Central Nervous System Tumors NCT00890747 Demographic - AMC-061 Demographic Form (DEM) - 2978032v1.0 - AMC-061 Demographic Form (DEM)

- 17/09/21 - 1 modulo, 1 ItemGroup, 7 elementi, 1 linguaggio
ItemGroup: Demographics
AMC-061 Demographic Form (DEM) 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=7C6E3CDA-FFD3-B993-E040-BB89AD432712

Breast Cancer NCT00881361 Demographic - Demographic Worksheet - 2932449v1.0 - Demographic Worksheet

- 17/09/21 - 1 modulo, 1 ItemGroup, 10 elementi, 1 linguaggio
ItemGroup: Patient Demographics
Demographic Worksheet Surgery to Remove the Sentinel Lymph Node and Axillary Lymph Nodes After Chemotherapy in Treating Women With Stage II, Stage IIIA, or Stage IIIB Breast Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=70F88030-783B-64C6-E040-BB89AD432159

Breast Cancer NCT00684983 Demographic - NCCTG N0733 Demography Form - 2842806v1.0 - Demography Form NCCTG N0733

- 17/09/21 - 1 modulo, 5 itemgroups, 18 elementi, 1 linguaggio
Itemgroups: Patient Identifier, Demographics, Race, Payment, Optional Questions
NCCTG N0733 Demography Form Capecitabine and Lapatinib With or Without Cixutumumab in Treating Patients With Previously Treated HER2-Positive Stage IIIB, Stage IIIC, or Stage IV Breast Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=643B1D4E-2802-CA4C-E040-BB89AD432C8F

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