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Protocol and Consent Forms
Last Updated: February 3, 2012


8/25/11: See
attached letter from KCCOP's IRB Coordinator regarding our new contact phone number on all consent forms.
NOTE: Limited funding may be available to offset costs on certain protocols. Contact KCCOP for more information.
Brain/CNS
Also, see Cancer Control section for symptom
management/prevention trials.
Glioma
RTOG 0837 :
Protocol Summary |
Consent Form
GLIOMA, Glioblastoma or Gliosarcoma (WHO grade IV), newly
dx; Central Path Review, Conventional chemoradiation + Adjuv
Temozolimide + Cediranib/placebo (see RT credentialing requirements in
protocol) ALERT: Possible delays with RTOG's pathology processing and
MGMT testing. Please identify potential patients with as much lead time as
possible.
Meningioma
RTOG 0539: Protocol Summary |
Consent Form
MENINGIOMA,
WHO Grade I, II, or III, new dx or recur, any resection extent; IMRT for
high-risk group (See RT credentialing
requirements in protocol.)
Mets
RTOG 0933: Protocol Summary |
Consent Form
METS, >5mm from either hippocampus, non-hematopoietic malig (except SC lung or
germ cell); Eval of WBRT w/Hippocampal Avoidance using IMRT (See RT & Neurocognitive
Function Testing requirements in protocol.)
CTSU N0574: Protocol Summary |
Consent Form
METS, 1-3 from
any extra-cerebral site, able to be treated w/gamma knife or linear accel-base radiosurgery;
Radiosurgery +/- Whole Brain RT
(See RT & Neurocognitive Function Testing
requirements in protocol.)
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Breast
Also, see
Cancer Control section for symptom
management/prevention trials.
Stage 0
NSABP B-39: Protocol Summary |
Consent Form
Adj., Stg. 0, I, II; Conventional Whole Breast RT vs Partial Breast RT (Multi-Catheter, Mammosite
[or other intracavitary device], or 3D-CRT)
(Sites need approval - check RT requirements in protocol.)
RTOG 1005: Protocol Summary |
Consent Form
(Neo-)Adj., Selected Stgs 0-II, resected by lumpectomy & whole breast RT,
no regional nodal RT planned; Accelerated Whole Breast RT + Hypofractionation
+ Concurrent Boost vs Standard Whole Breast RT + Sequential Boost (Sites
need approval - check RT requirements in protocol.)
Stage I
CTSU NCIC MA.32: Protocol Summary |
Consent Form
(Neo-)Adj., T1-3, N0-3, M0, invasive, >4 wks
since surgery &/or chemo + SN bx &/or full axillary LN dissect; Metformin
vs placebo
RTOG 1005: Protocol Summary |
Consent Form
(Neo-)Adj., Selected Stgs 0-II, resected by lumpectomy & whole breast RT,
no regional nodal RT planned; Accelerated Whole Breast RT + Hypofractionation
+ Concurrent Boost vs Standard Whole Breast RT + Sequential Boost (Sites
need approval - check RT requirements in protocol.)
NSABP B-47: Protocol Summary |
Consent Form
Adj., T1-3, Node+ or Hi-Risk Node(-), prim
tumor HER2-Low, post-mastectomy/lumpectomy + eval of nodal status; Chemo Alone
(Docetaxel + Cyclophosphamide or Doxorubicin + Cyclophosphamide →
Weekly Paclitaxel) vs Chemo (same regimens) + Trastuzumab
NSABP B-39: Protocol Summary |
Consent Form
Adj., Stg. 0, I, II; Conventional Whole Breast RT vs Partial Breast RT (Multi-Catheter, Mammosite
[or other intracavitary device], or 3D-CRT)
(Sites need approval - check RT requirements in protocol.)
Stage II
CTSU NCIC MA.32: Protocol Summary |
Consent Form
(Neo-)Adj., T1-3, N0-3, M0, invasive, >4 wks
since surgery &/or chemo + SN bx &/or full axillary LN dissect; Metformin
vs placebo
RTOG 1005: Protocol Summary |
Consent Form
(Neo-)Adj., Selected Stgs 0-II, resected by lumpectomy & whole breast RT,
no regional nodal RT planned; Accelerated Whole Breast RT + Hypofractionation
+ Concurrent Boost vs Standard Whole Breast RT + Sequential Boost (Sites
need approval - check RT requirements in protocol.)
NSABP B-47: Protocol Summary |
Consent Form
Adj., T1-3, Node+ or Hi-Risk Node(-), prim
tumor HER2-Low, post-mastectomy/lumpectomy + eval of nodal status; Chemo Alone
(Docetaxel + Cyclophosphamide or Doxorubicin + Cyclophosphamide →
Weekly Paclitaxel) vs Chemo (same regimens) + Trastuzumab
NSABP B-39: Protocol Summary |
Consent Form
Adj., Stg. 0, I, II; Conventional Whole Breast RT vs Partial Breast RT (Multi-Catheter, Mammosite
[or other intracavitary device], or 3D-CRT)
(Sites need approval - check RT requirements in protocol.)
Stage III
CTSU NCIC MA.32: Protocol Summary |
Consent Form
(Neo-)Adj., T1-3, N0-3, M0, invasive, >4 wks
since surgery &/or chemo + SN bx &/or full axillary LN dissect; Metformin
vs placebo
NSABP B-47: Protocol Summary |
Consent Form
Adj., T1-3, Node+ or Hi-Risk Node(-), prim
tumor HER2-Low, post-mastectomy/lumpectomy + eval of nodal status; Chemo Alone
(Docetaxel + Cyclophosphamide or Doxorubicin + Cyclophosphamide →
Weekly Paclitaxel) vs Chemo (same regimens) + Trastuzumab
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Cancer Control
Cancer Control: Any Site
SWOG S0702:
Protocol Summary |
Consent Form
Bone Mets
from any site, plan to receive Zoledronic acid; Observational study of ONJ
MDA 2007-0914A: Protocol Summary |
Consent Form
Any cancer dx, starting new anthracycline-based chemo
course (not limited to 1st-line therapy); Eval of Biomarkers for
Cardiotoxicity (Equipment & training is provided; each site must become
certified to use Biosite – see protocol.)
URCC 08106: Protocol Summary |
Consent Form
Any cancer dx (no leukemia), M0, chemo naive, planning to start chemo lasting >6
wks (tx cycles can be 2, 3, or 4 wks); Effects of exercise on cancer-related
fatigue (Staff administering exercise intervention must be trained &
approved by URCC.)
Cancer Control: Breast
NSABP B-43-CC:
Protocol Summary |
Pre-Entry HER2 Test Consent Form |
Consent Form
Adj., Stg 0 (DCIS
or mixed DCIS/LCIS), post-lumpectomy, HER2+; RT +/- concurrent Trastuzumab
CALGB 70604: Protocol Summary |
Consent Form
BONE METS (from Breast, Prostate, Mult Myeloma), no prior
IV bisphosphonates or radiopharmaceuticals; Standard vs Longer Dosing Interval
of Zoledronic Acid
URCC 10055: Protocol Summary |
Consent Form
BREAST (invasive, Stg I-IIIC) or LYMPHOMA (interm- or
high-grade), no prior chemo & scheduled to begin chemo; Asmt of Cognitive
Function (Requires control subject. Training in cognitive testing & blood
handling procedures is required.)
CTSU CCCWF 97609: Protocol Summary |
Consent Form
Stgs 0-IIIA, new dx, post-lumpectomy, -quadrantectomy, or
–mastectomy, planned adjuv RT to whole breast +/- regional LNs; Eval of
genomics & exposures on Radiosensitivity
Cancer Control: GI
NSABP P-5: Protocol Summary |
Consent Form
COLON, resected adenocarcinoma, Stg I or II, post-adjuv
therapy; Rosuvastatin vs placebo polyp prevention trial
MDA 2008-0005: Protocol Summary |
Consent Form
COLORECTAL, Mets, scheduled to receive
Irinotecan alone or w/5-FU, Cetuximab, or other biologics; CASAD vs placebo
for diarrhea tx/prevention (PARTICIPATION CURRENTLY LIMITED TO SLCI &
RMC)
CTSU N08CB: Protocol Summary |
Consent Form
COLON or RECTUM, adenocarcinoma, post-curative
resection, Stg II-III or IV (completely resected & no residual tumor),
scheduled for Oxaliplatin-based adjuv chemo; IV Ca/Mg in 2 versions (vs
placebo) to prevent sensory neurotoxicity
Cancer Control:
GU
CALGB 70604: Protocol Summary |
Consent Form
BONE METS (from Breast, Prostate, Mult Myeloma), no prior
IV bisphosphonates or radiopharmaceuticals; Standard vs Longer Dosing Interval
of Zoledronic Acid
Cancer Control: Gyn
GOG-0237: Protocol Summary |
Consent Form
CERVICAL, Atypical glandular cells; Analysis
of CA-IX, p16, proliferative markers, & HPV in diagnosing cervical lesions
GOG-0259: Protocol Summary |
Consent Form
OVARIAN, FALLOPIAN TUBE, or PRIM PERITONEAL,
Recur or Persis, active disease or tx not required; Nurse-Delivered WRITE
Symptoms vs Self-Directed WRITE Symptoms vs Care as Usual
Cancer Control: Lymphoma
URCC 10055: Protocol Summary |
Consent Form
BREAST (invasive, Stg I-IIIC) or LYMPHOMA (interm- or
high-grade), no prior chemo & scheduled to begin chemo; Asmt of Cognitive
Function
(Requires control subject. Training in cognitive testing & blood
handling procedures is required.)
Cancer Control: Myeloma
CALGB 70604: Protocol Summary |
Consent Form
BONE METS (from Breast, Prostate, Mult Myeloma), no prior
IV bisphosphonates or radiopharmaceuticals; Standard vs Longer Dosing Interval
of Zoledronic Acid
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GI
Also, see
Cancer Control section for symptom
management/prevention trials.
Colon
CALGB 80702:
Protocol Summary |
Consent Form
COLON, Stg III, resected; 6 vs 12 txs of adjuv FOLFOX +
Celecoxib/placebo
Colorectal
CALGB 80405:
Protocol Summary |
Consent Form
COLORECTAL, Adenocarcinoma (Adv or Mets), Untreated, Wild type
K-ras (determined pre-regist); Either FOLFOX or FOLFIRI with either Bevacizumab or Cetuximab
Esophagus
RTOG 1010:
Protocol Summary |
Consent Form
ESOPHAGUS, adenocarcinoma (involving mid, distal, EG
junction, or stomach), Stg T1N1-2 or T2-3N0-2; MANDATORY tissue submission for
HER2 (if HER2+) → RT + Paclitaxel
+ Carbo +/- Trastuzumab → Surgery +/-
Maintenance Trastuzumab
(See RT
credentialing requirements in protocol.)
RTOG 0436:
Protocol Summary |
Consent Form
ESOPHAGUS or GE JUNCTION, squamous or adenocarcinoma,
T1N1M0, T2-4 Any N M0, or Any T, Any N, M1a; RT + Paclitaxel + Cisplatin +/-
Cetuximab (See RT credentialing requirements in protocol.)
Liver
CALGB 80802:
Protocol Summary |
Consent Form
HEPATOCELLULAR, locally adv or mets, no prior allografts;
Doxorubicin +/- Sorafenib
CTSU E1208:
Protocol Summary |
Consent Form
HEPATOCELLULAR (limited to liver), unresectable;
Chemoemobilization +/- Sorafenib
Other
RTOG 0436:
Protocol Summary |
Consent Form
ESOPHAGUS or GE JUNCTION, squamous or adenocarcinoma,
T1N1M0, T2-4 Any N M0, or Any T, Any N, M1a; RT + Paclitaxel + Cisplatin +/-
Cetuximab (See RT credentialing requirements in protocol.)
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GU
Also, see
Cancer Control section for symptom
management/prevention trials.
Prostate: Stage II
RTOG 0534: Protocol Summary |
Consent Form
PROSTATE, Adenocarcinoma, T3N0/Nx or T2N0/Nx +/- positive
surg margin, rising PSA post-radical prostatectomy; Prostate Bed RT (PBRT) vs PBRT + Neoadjuv & Concurrent short-term androgen depriv (NC-STAD) vs PBRT +
NC-STAD + Pelvic Lymph Node RT (See RT & neurocognitive function
credentialing requirements in protocol.)
RTOG 0232: Protocol Summary |
Consent Form
PROSTATE, T1c-2b, Nx/N0, M0; Ext Beam RT+Transperineal
Interstitial Permanent Brachytherapy vs Brachytherapy alone (Sites need approval - check RT requirements in protocol.)
RTOG 0815: Protocol Summary |
Consent Form
PROSTATE, Adenocarcinoma, Interm risk (Gleason 7, PSA>10
& <20, &/or Clin Stg T2b-T2c); Dose-Escal RT +/- Short-Term Androgen
Deprivation (See RT credentialing requirements in protocol.)
Prostate: Stage III
RTOG 0534: Protocol Summary |
Consent Form
PROSTATE, Adenocarcinoma, T3N0/Nx or T2N0/Nx +/- positive
surg margin, rising PSA post-radical prostatectomy; Prostate Bed RT (PBRT) vs
PBRT + Neoadjuv & Concurrent short-term androgen depriv (NC-STAD) vs PBRT +
NC-STAD + Pelvic Lymph Node RT (See RT & neurocognitive function
credentialing requirements in protocol.)
Renal
CALGB 90802:
Protocol Summary |
Consent Form
RENAL (w/some clear cell histol), mets or unresec,
progression or intolerance after >1 prior VEGFR tyrosine kinase
inhibitor; Everolimus + Bevacizumab/placebo
SWOG S0931:
Protocol Summary |
Consent Form
RENAL, Interm High Risk or Very High Risk, no distant
mets, post radical nephrectomy or partial nephrectomy; Everolimus/placebo x 54
wks
Urinary Tract
CALGB 90601: Protocol Summary |
Consent Form
URINARY TRACT (Renal Pelvis, Ureter, Bladder, Prostate, or
Urethra), Transitional cell, Mets or Locally Adv; Gemcitabine + Cisplatin +
Bevacizumab/placebo
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GYN
Also, see
Cancer Control section for symptom
management/prevention trials.
Endometrial
GOG-0249:
Protocol Summary |
Consent Form
ENDOMETRIAL, Post-Hyst/BSO
& peritoneal cytol, Stg I-IIA (high-interm risk), IIB (occult, any histol, +/-
risk factors), I-IIB (occult, serous or clear, +/- risk factors); Pelvic RT vs
Vaginal Cuff Brachy + Paclitaxel & Carboplatin (See RT
credentialing requirements in protocol.)
GOG-0258: Protocol Summary |
Consent Form
ENDOMETRIAL, Stgs I or II (selected) & all Stg III or
IVA, post-hysterectomy & BSO; Cisplatin + volume-directed RT → Carboplatin +
Paclitaxel vs Carboplatin + Paclitaxel alone (See RT credentialing
requirements in protocol – for investigator & facility.)
GOG-0261: Protocol Summary |
Consent Form
UTERINE or OVARIAN, Carcinosarcoma (mixed mesodermal),
persistent or recur, Stgs I-IV, newly dxd & chemo naive; Paclitaxel +
Carboplatin vs Ifosfamide + Paclitaxel
Ovarian
GOG-0262: Protocol Summary |
Consent Form
OVARIAN (Epithelial), PERITONEAL (Prim), or FALLOPIAN,
suboptimally debulked Stg III or Stg IV; Paclitaxel (q3wks vs dose-dense
weekly) + Carboplatin + optional concurrent & consolidation Bevacizumab
GOG-0213: Protocol Summary |
Consent Form
OVARIAN (Epithelial), PERITONEAL (Prim), or FALLOPIAN,
recurrent, platinum-sensitive; Secondary Cytoreduction vs no surg
! Carbo + Paclitaxel +/- Bevacizumab
! Maintenance
Bevacizumab
GOG-0212: Protocol Summary |
Consent Form
OVARIAN or FALLOPIAN TUBE (Adv, Epith) or PERITONEAL (Prim), CR after Prim Platinum/Taxane chemo; Maint Chemo (12 monthly cycles of Paclitaxel
or CT-2103) vs No Tx until relapse (PARTICIPATION LIMITED)
GOG-0261: Protocol Summary |
Consent Form
UTERINE or OVARIAN, Carcinosarcoma (mixed mesodermal),
persistent or recur, Stgs I-IV, newly dxd & chemo naive; Paclitaxel +
Carboplatin vs Ifosfamide + Paclitaxel
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Head & Neck
CTSU E1305:
Protocol Summary |
Consent Form
Squamous,
any prim site (including unknown), recur or mets; Cisplatin-doublet +/-
Bevacizumab
RTOG 0920:
Protocol Summary |
Consent Form
ORAL CAVITY, OROPHARYNX, or LARYNX, squamous & its
variants, T1 N1-2 or T2-3 N0-2 M0 w/no distant mets, post-total resection
w/curative intent; EGFR (& HPV - oropharynx pts only) analyses
! IMRT (or optional IGRT) +/- Cetuximab (See RT credentialing
requirements in protocol.)
RTOG 1016:
Protocol Summary |
Consent Form
OROPHARYNX, p16 positive,
T1-2 N2a-N3 or T3-4, any N;
p16 analysis
! Accelerated IMRT + high dose DDP vs Accelerated IMRT +
Cetuximab (See IMRT & IGRT credentialing requirements in protocol.
Register w/CASI system & set up CRA account b/f 1st regist.)
Leukemia
Also, see Cancer Control section for symptom
management/prevention trials.
Acute
SWOG S0703:
Protocol Summary |
Consent Form
AML (non-M3), no prior tx, age >60; Azacitidine +
Gemtuzumab Ozogamicin as Induction & Post-Remission therapy
SWOG S0535:
Protocol Summary |
Consent Form
APL, High-Risk, prev untreated, pre-tx
cytogenetics mandatory; (Induction) ATRA+Gemtuzumab
Ozogamicin+Arsenic Trioxide
! (Consolidation) Arsenic Trioxide (Cy 1 &
2)
! ATRA+Daunomycin (Cy 3 & 4)
! Gemtuzumab Ozogamicin (Cy 5 &
6)
Chronic
CTSU E2905:
Protocol Summary |
Consent Form
MDS or non-proliferative CMML, Low- or Intermediate-1-risk, symptomatic
anemia; Frequency of Major Erythroid Response to Lenalidomide +/- Epoetin Alfa
(Each site must have 2 trained counselors available for counseling
Lenalidomide pts.)
CALGB 10404:
Protocol Summary |
Consent Form
CLL (B-cell), symptomatic & active intermediate or
high-risk Rai staging, no prior tx; Randomized study of 4 Fludarabine/Antibody
Combinations
(Each site must have 2 trained counselors available for counseling
Lenalidomide pts.)
Ancillary
SWOG S9910: Protocol Summary |
Consent Form
Ancillary; specimen submission to Centralized Reference Lab & Tissue Repository
CALGB 8461: Protocol Summary |
Consent Form
Cytogenetics study for prev untreated AML, ALL, MDS
CALGB 9665: Protocol Summary |
Consent Form
Tissue Bank for prev untreated leukemia pts (acute or chronic) & MDS
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LungAlso, see
Cancer Control section for symptom
management/prevention trials.
NSC: Stage I
CALGB 140503:
Protocol Summary |
Consent Form
NSC,
peripheral nodule <2cm, N0, M0; Lobectomy vs Sublobar Resection (If
pt is randomized to Lobectomy arm & surgeon plans to use VATS procedure,
surgeon must be credentialed per protocol.)
CTSU E1505:
Protocol Summary |
Consent Form
NSC, Stgs IB (>4cm) - IIIA, completely resected; 1 of 4 chemo
regimens +/- Bevacizumab
RTOG 0813:
Protocol Summary |
Consent Form
NSC, Stg I, centrally located, medically inoperable; Eval
of Stereotactic Lung RT (See RT credentialing requirements in protocol.)
NSC: Stage II
CTSU E1505:
Protocol Summary |
Consent Form
NSC, Stgs IB (>4cm) - IIIA, completely resected; 1 of 4 chemo
regimens +/- Bevacizumab
NSC: Stage IIIA
CTSU E1505:
Protocol Summary |
Consent Form
NSC, Stgs IB (>4cm) - IIIA, completely resected; 1 of 4 chemo
regimens +/- Bevacizumab
NSC: Stage IIIB
CALGB
30607:
Protocol Summary |
Consent Form
NSC, Stg IIIB-IV, must have rcvd 4 cycles of
platinum-based chemo +/- Bevacizumab & had no progression; Sunitinib vs
placebo
CTSU E5508:
Protocol Summary |
Consent Form
NSC, Stg IV & selected Stg IIIB, non-squamous; Carbo +
Paclitaxel + Bevacizumab à
maintenance Bevacizumab vs Pemetrexed vs Bevacizumab/Pemetrexed
NSC: Stage IV
CALGB
30607:
Protocol Summary |
Consent Form
NSC, Stg IIIB-IV, must have rcvd 4 cycles of
platinum-based chemo +/- Bevacizumab & had no progression; Sunitinib vs
placebo
SWOG S0819:
Protocol Summary |
Consent Form
NSC, Stg IV, new dx or recur; Carboplatin/Paclitaxel vs
Carboplatin/Paclitaxel/Bevacizumab +/- Concurrent Cetuximab
CTSU E5508:
Protocol Summary |
Consent Form
NSC, Stg IV & selected Stg IIIB, non-squamous; Carbo +
Paclitaxel + Bevacizumab à
maintenance Bevacizumab vs Pemetrexed vs Bevacizumab/Pemetrexed
Small Cell
CALGB 30610:
Protocol Summary |
Consent Form
SC (max 1 hemithorax w/regional LN mets), no
prior RT, chemo, or complete resection; Comparison of 3 thoracic RT regimens +
Cisplatin & Etoposide
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Lymphoma
Hodgkin's
SWOG S0816:
Protocol Summary |
Consent Form
Hodgkin’s, Stgs III-IV, prev untreated; ABVD
!
Full Body FDG-PET
! 4 ABVD cycles or 6 BEACOPP cycles (based on
FDG-PET outcome), Central Review of all FDG-PET scans required
Non Hodgkin's
SWOG S0806:
Protocol Summary |
Consent Form
NH, Diffuse Large B-Cell, Stg II (bulky) or Stgs III-IV,
new dx; Vorinostat + Rituximab-CHOP
CALGB 50904:
Protocol Summary |
Consent Form
NH, follicular, WHO Grade 1, 2, 3a, no prior tx;
Ofatumumab + Bendamustine +/- Bortezomib (Sites must be credentialed for FDG-PET/CT imaging –
see protocol.)
Melanoma
CTSU E1609:
Protocol Summary |
Consent Form
Stgs IIIB, IIIC, or IV, cutaneous or unknown prim (w/cutaneous,
subcutaneous, nodal, or lung mets), completely surgically resected;
Ipilimumab Anti-CTLA4 vs High-Dose Interferon α-2b (Investigator
Ipilimumab training/exam required b/f registering 1st pt - see
protocol.)
SWOG S0933:
Protocol Summary |
Consent Form
Stg IV, cutaneous or unknown origin (no ocular primary or
mucosal primary); Eval of RO4929097
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