PROTOCOL 6677 Data Forms

Forms Revisions
Case Report Forms Set
Forms Index
DATA FORMS                                                                     
Pre Study Baseline MRI:
M0  Pre-Study Standard MRI - Baseline Form
V0   Pre- Study Advanced MRI - Baseline Form
Week 2
VX   Week 2 Advanced MRI
Week 8 (Post 2nd cycle of treatment):
M1  Week 8 Standard MRI
V1  Week 8 Advanced MRI
Week 16 (Post 4th cycle of treatment):
M2   Week 16 Standard MRI
V2   Week 16 Advanced MRI
Week 24 (Post 6th cycle of treatment):
M3  Week 24 Standard MRI
V3  Week 24 Advanced MRI
Week 32 (Post 8th cycle of treatment):
M4    Week 32 Standard MRI
V4    Week 32 Advanced MRI
Week 40 (Post 10th cycle of treatment):
M5   Week 40 Standard MRI
V5    Week 40 Advanced MRI
Week 48 (Post 12th cycle of treatment):
M6    Week 48 Standard MRI
V6    Week 48 Advanced MRI
Week 56 (Post 14th cycle of treatment):
M7    Week 56 Standard MRI
V7    Week 56 Advanced MRI
Week 64 (Post 16th cycle of treatment):
M8    Week 64 Standard MRI
V8    Week 64 Advanced MRI
Week 72 (Post 18th cycle of treatment):
M9    Week 72 Standard MRI
V9    Week 72 Advanced MRI
Week 80 (Post 20th cycle of treatment):
MA    Week 80 Standard MRI
VA    Week 80 Advanced MRI
Week 88 (Post 22th cycle of treatment):
MB    Week 88 Standard MRI
VB     Week 88 Advanced MRI
Week 96 (Post 24th cycle of treatment):
MC    Week 96 Standard MRI
VC     Week 96 Advanced MRI
Final (Off-Study Assessment):
MD    Final Standard MRI
VD     Final Advanced MRI
Interval Scan Advanced MRI:
G1    Advanced MRI Interval Scan
Interval Scan Standard MRI:
B1    Standard MRI Interval Scan
End of Study:
DS    End of Study
Additional Forms:
AE     Adverse Events        
PR    Protocol Deviation

For additional information regarding Adverse Events,
please visit ACRIN’s Protocol Development and Regulatory Resources page: