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

- 2021-09-20 - 1 Formulär, 9 Item-grupper, 85 Dataelement, 1 Språk
Item-grupper: 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

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

- 2021-09-20 - 1 Formulär, 8 Item-grupper, 40 Dataelement, 1 Språk
Item-grupper: 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

- 2021-09-20 - 1 Formulär, 9 Item-grupper, 59 Dataelement, 1 Språk
Item-grupper: 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

Breast Cancer NCT01242800 Follow-Up - E2108 Step 2 Follow-up Form - 3130846v1.0 - E2108 Step 2 Follow-up Form

- 2021-09-20 - 1 Formulär, 12 Item-grupper, 67 Dataelement, 1 Språk
Item-grupper: Header Module, Header, Amended Data, Report Period, Section I - Vital Status, Section II - Reporting Period, Status of Local-Regional Disease, CHEST WALL, Breast Involvement, Section IV - Status of Distant Disease, Circulating Tumor Cell (CTC) Enumeration, Comments
E2108 Step 2 Follow-up 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=8E30083E-7422-9EAD-E040-BB89AD430E1D

Breast Cancer NCT01242800 Follow-Up - E2108 Surgical Resection Form - 3145725v1.0 - E2108 Surgical Resection Form

- 2015-01-09 - 1 Formulär, 3 Item-grupper, 27 Dataelement, 1 Språk
Item-grupper: General information, Surgery, Footer Module
E2108 Surgical Resection 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=91CE8B54-1649-B633-E040-BB89AD433125

E2108 Vital Status Form NCT01242800

- 2015-06-08 - 1 Formulär, 6 Item-grupper, 22 Dataelement, 1 Språk
Item-grupper: ECOG clinical trial administrative data, Data amendment, Report Period, Section II - Reporting Period, Section 1 - Vital Status, Footer Module
E2108 Vital Status Form NCT01242800 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=918F7A63-0F65-C218-E040-BB89AD43477E

Breast Cancer NCT01242800 Off Treatment - E2108 End-of-Study Form - 3128917v1.0 - E2108 End-of-Study Form

- 2015-01-09 - 1 Formulär, 6 Item-grupper, 21 Dataelement, 1 Språk
Item-grupper: Header Module, Header, Amended Data, Vital Status, Section I, Comments
E2108 End-of-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=8DF34112-9349-8BCA-E040-BB89AD4347FD

E2108 Optimal Systemic Therapy Summary Form NCT01242800

- 2015-06-16 - 1 Formulär, 9 Item-grupper, 31 Dataelement, 1 Språk
Item-grupper: ECOG clinical trial administrative data, Report Period, Data amendment, Section II - Reporting Period, Section 1 - Vital Status, Therapy Administered - Chemotherapy, Therapy Administered - Hormone therapy, Therapy Administered - New Progression, Footer Module
E2108 Optimal Systemic Therapy Summary Form NCT01242800 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=91E1D8B2-2FF5-DD0A-E040-BB89AD434391

E2108 Optimal Systemic Therapy Summary Form NCT01242800

- 2015-06-08 - 1 Formulär, 5 Item-grupper, 18 Dataelement, 1 Språk
Item-grupper: ECOG clinical trial administrative data, Data amendment, Section II - Reporting Period, Section 1 - Vital Status, Footer Module
E2108 Optimal Systemic Therapy Summary Form NCT01242800 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=9192F0DC-00AE-56AC-E040-BB89AD431CAF

E2108 Step 2 Disease Evaluation Form (RECIST 1.1) NCT01242800

- 2015-06-08 - 1 Formulär, 11 Item-grupper, 38 Dataelement, 1 Språk
Item-grupper: ECOG clinical trial administrative data, Data amendment, ON TREATMENT, Disease Assessment, TARGET LESIONS - NON-NODAL, TARGET LESIONS - NODAL, NONTARGET LESIONS, New Lesions, Overall Response per RECIST Criteria - Target, Nontarget and New Lesions, Symptomatic Deterioration, Footer Module
E2108 Step 2 Disease Evaluation Form (RECIST 1.1) NCT01242800 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=8E091CE3-4B63-4A3C-E040-BB89AD4304A1

Breast Cancer NCT01242800 On-Study - E2108 Baseline Disease Evaluation Form (RECIST 1.1) - 3129560v1.0 - E2108 Baseline Disease Evaluation Form (RECIST 1.1)

- 2015-01-09 - 1 Formulär, 8 Item-grupper, 38 Dataelement, 1 Språk
Item-grupper: Header Module, Header, Amended Data, TARGET LESIONS, TARGET LESIONS - NON NODAL, TARGET LESIONS - NODAL, NONTARGET LESIONS, Footer Module
E2108 Baseline Disease Evaluation Form (RECIST 1.1) 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=8E091CE3-49A1-4A3C-E040-BB89AD4304A1

LEOSS: Lean European Open Survey on SARS-CoV-2 Infected Patients - Ethics and palliative care details

- 2021-06-29 - 1 Formulär, 8 Item-grupper, 41 Dataelement, 1 Språk
Item-grupper: Reasons for change of therapeutic goals from life-prolonging to palliative, Ethics consultation, Patient declined life-prolonging measures in case of life threatening diseases, Specialist palliative care setting, Specialist palliative care type, Specialist palliative care professionals involved, Drugs prescribed for symptom control (e.g. breathlessness, pain, death rattle), Is data entry for this section finished?
Study Title: LEOSS: Lean European Open Survey on SARS-CoV-2 Infected Patients https://leoss.net Study Indication: COVID-19 Date: 21.03.2021 Published with permission by Prof. Dr. med. J.-J. Vehreschild. LEOSS, a multi-center cohort study, has been created to get more in-depth knowledge about the epidemiology and clinical course of patients infected with SARS-CoV-2. Initiated by the ESCMID Emerging Infections Task Force (EITaF) and the German Infectious Disease Society, and supported by all German Centers for Health Research (DZG), LEOSS has developed into an international network of contributors. Via an integrative research approach with anonymous recruitment and collection of routine data in an open science context, LEOSS is building a uniform clinical dataset and providing real-time analyses. For more information feel free to explore https://leoss.net/. This document is for ethics and palliative care details. If a text field can't be filled out, note 'ND'.

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