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审核状态: Project audit state: |
通过审核 Successful |
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注册号: Registration number: |
ChiCTR2500107283 |
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最近更新日期: Date of Last Refreshed on: |
2025-08-07 16:14:45 |
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注册时间: Date of Registration: |
2025-08-07 00:00:00 |
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注册号状态: |
预注册 |
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Registration Status: |
Prospective registration |
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注册题目: |
评价QL1706联合贝伐珠单抗在晚期肝细胞肝癌患者一线PD-1/PD-L1单抗联合TKI治疗失败后二线治疗的有效性和安全性的II期临床研究 |
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Public title: |
A Phase II Clinical Study Evaluating the Efficacy and Safety of QL1706 Combined with Bevacizumab as Second-Line Therapy in Patients with Advanced Hepatocellular Carcinoma After Failure of First-Line PD-1/PD-L1 Inhibitor Plus TKI Therapy. |
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注册题目简写: |
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English Acronym: |
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研究课题的正式科学名称: |
评价QL1706联合贝伐珠单抗在晚期肝细胞肝癌患者一线PD-1/PD-L1单抗联合TKI治疗失败后二线治疗的有效性和安全性的II期临床研究 |
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Scientific title: |
A Phase II Clinical Study Evaluating the Efficacy and Safety of QL1706 Combined with Bevacizumab as Second-Line Therapy in Patients with Advanced Hepatocellular Carcinoma After Failure of First-Line PD-1/PD-L1 Inhibitor Plus TKI Therapy. |
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研究课题代号(代码): Study subject ID: |
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在二级注册机构或其它机构的注册号: The registration number of the Partner Registry or other register: |
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申请注册联系人: |
熊志勇 |
研究负责人: |
熊志勇 |
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Applicant: |
Zhiyong Xiong |
Study leader: |
Zhiyong Xiong |
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申请注册联系人电话: Applicant telephone: |
+86 188 9853 4185 |
研究负责人电话: Study leader's telephone: |
+86 188 9853 4185 |
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申请注册联系人传真 : Applicant Fax: |
研究负责人传真: Study leader's fax: |
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申请注册联系人电子邮件: Applicant E-mail: |
xiongzhy@mail2.sysu.edu.cn |
研究负责人电子邮件: Study leader's E-mail: |
xiongzhy@mail2.sysu.edu.cn |
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申请单位网址(自愿提供): Applicant website(voluntary supply): |
研究负责人网址(自愿提供): Study leader's website(voluntary supply): |
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申请注册联系人通讯地址: |
广东省广州市黄埔区开创大道2693号 |
研究负责人通讯地址: |
广东省广州市黄埔区开创大道2693号 |
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Applicant address: |
No. 2693, Kaichuang Avenue, Huangpu District, Guangzhou, Guangdong |
Study leader's address: |
No. 2693, Kaichuang Avenue, Huangpu District, Guangzhou, Guangdong |
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申请注册联系人邮政编码: Applicant postcode: |
研究负责人邮政编码: Study leader's postcode: |
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申请人所在单位: |
中山大学附属第三医院 |
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Applicant's institution: |
The Third Affiliated Hospital of Sun Yat-sen University |
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研究负责人所在单位: |
中山大学附属第三医院 |
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Affiliation of the Leader: |
The Third Affiliated Hospital of Sun Yat-sen University |
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是否获伦理委员会批准: |
是/Yes |
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Approved by ethic committee: |
Yes |
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伦理委员会批件文号: Approved No. of ethic committee: |
中大附三医伦 II2025-214-02 |
伦理委员会批件附件: Approved file of Ethical Committee: |
查看附件View |
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批准本研究的伦理委员会名称: |
中山大学附属第三医院医学伦理委员会 |
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Name of the ethic committee: |
Medical Ethics Committee The Third Affiliated Hospital of Sun Yat-sen University |
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伦理委员会批准日期: Date of approved by ethic committee: |
2025-07-30 00:00:00 |
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伦理委员会联系人: |
黄凯琪 |
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Contact Name of the ethic committee: |
Kaiqi Huang |
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伦理委员会联系地址: |
广东省广州市天河区天河路600号 |
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Contact Address of the ethic committee: |
No. 600, Tianhe Road, Tianhe District, Guangzhou, Guangdong |
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伦理委员会联系人电话: Contact phone of the ethic committee: |
+86 85253302 |
伦理委员会联系人邮箱: Contact email of the ethic committee: |
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研究实施负责(组长)单位: |
中山大学附属第三医院 |
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Primary sponsor: |
The Third Affiliated Hospital of Sun Yat-sen University |
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研究实施负责(组长)单位地址: |
广东省广州市黄埔区开创大道2693号 |
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Primary sponsor's address: |
No. 2693, Kaichuang Avenue, Huangpu District, Guangzhou, Guangdong |
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试验主办单位(项目批准或申办者): Secondary sponsor: |
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经费或物资来源: |
齐鲁制药有限公司 |
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Source(s) of funding: |
Qilu Pharmaceutical Co., Ltd. |
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Target disease: |
Hepatocellular Carcinoma |
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Target disease code: |
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研究类型: |
干预性研究 |
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Study type: |
Interventional study |
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研究所处阶段: |
II期临床试验 | ||||||||||||||||||||||
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Study phase: |
2 |
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研究设计: |
单臂 |
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Study design: |
Single arm |
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研究目的: |
探索QL1706联合贝伐珠单抗二线治疗PD-1/PD-L1单抗联合TKI耐药的晚期HCC患者的有效性和安全性 |
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Objectives of Study: |
A Phase II Study Investigating the Efficacy and Safety of QL1706 Plus Bevacizumab as Second-Line Therapy in Advanced HCC Patients Refractory to PD-1/PD-L1 Inhibitor Combined with TKI Treatment |
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药物成份或治疗方案详述: |
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Description for medicine or protocol of treatment in detail: |
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纳入标准: |
1. 自愿签署知情同意书,并遵循方案要求; 2. 性别不限; 3. 年龄:≥18岁且≤75岁; 4. 预期生存时间≥3个月; 5. 经病理组织学和/或细胞学确诊的晚期肝细胞肝癌; 6. 患者既往接受过一线标准治疗后治疗失败,治疗失败的定义为治疗过程中或末次治疗后的3个月内出现疾病进展或毒副作用不可耐受; 注:一线标准治疗药物需包括经NMPA批准拥有晚期肝细胞肝癌一线适应症的PD-1/L1单抗(包括但不限于替雷利珠单抗、阿替利珠单抗、信迪利单抗、卡瑞丽珠单抗等)和小分子TKI(包括但不限于多纳非尼、仑伐替尼等) 7. 必须具有至少一处符合RECIST v1.1定义的可测量病灶; 8. 体力状况评分ECOG 0-2分; 9. 肝功能Child-Pugh A级; 10. 既往抗肿瘤治疗的毒性已恢复至NCI-CTCAE v5.0定义的≤1级(研究者考虑无症状性实验室检查异常除外,如ALP升高、高尿酸血症、血糖升高等;研究者判断无安全风险的毒性除外,如脱发、2级外周神经毒性等;或血红蛋白降低但≥90 g/L除外); 11. 无严重心脏功能异常,左心室射血分数≥50%; 12. 筛选期检查前 14 天内不允许输血、不允许使用任何细胞生长因子和/或升血小板药前提下,器官功能水平必须符合以下标准:a) 骨髓功能:中性粒细胞计数绝对值(ANC)≥1.5×10^9/L,血小板计数≥90×10^9/L,血红蛋白≥90 g/L;b) 肝脏功能:总胆红素(TBIL≤1.5 ULN),无肝转移者AST和ALT均≤2.5 ULN,有肝转移时AST和ALT均≤5.0 ULN;c)肾脏功能:肌酐(Cr)≤1.5 ULN,或肌酐清除率(Ccr)≥50 mL/min(根据Cockcroft and Gault公式)。 13. 凝血功能:国际标准化比值(INR)≤1.5,且活化部分凝血活酶时间(APTT)≤1.5 ULN; 14. 尿蛋白≤2+或≤1000mg/24h; 15. 合并腹水患者无明显症状且无需临床干预; 16. 对于绝经前有生育可能的妇女必须在开始治疗之前的7天内做妊娠试验,血清或尿妊娠必须为阴性,必须为非哺乳期;所有入组患者(不管男性或女性)均应在整个治疗周期及治疗结束后6个月采取充分的屏障避孕措施。 |
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Inclusion criteria |
1. Voluntarily sign the informed consent and follow the requirements of the protocol; 2. No gender limit; 3. Age: >=18 years old and <=75 years old; 4. Expected survival time >=3 months; 5. Advanced hepatocellular carcinoma confirmed by histopathology and/or cytology; 6. Patients who had received previous first-line standard therapy had treatment failure, which was defined as disease progression or intolerable side effects during treatment or within 3 months after the last treatment; Note: First-line standard therapy should include PD-1/L1 monoclonal antibodies (including but not limited to tislelizumab, atezolizumab, sintilizumab, carrelizumab, etc.) and small molecule Tkis (including but not limited to donapinb, lenvatinib, etc.) approved by the NMPA for first-line indications in advanced hepatocellular carcinoma. 7. Must have at least one measurable lesion according to RECIST v1.1 definition; 8. ECOG score 0-2; 9. Liver function, Child-Pugh grade A; 10. Toxicity of previous antineoplastic therapy has returned to grade 1 or less as defined by NCI-CTCAE v5.0 (except for asymptomatic laboratory abnormalities considered by investigators, such as elevated alkaline phosphatase, hyperuricemia, and elevated blood glucose; Toxicities that were judged by the investigators to be no safety risk, such as alopecia and grade 2 peripheral neurotoxicity, were excluded. Or decreased hemoglobin (>=90 g/L); 11. No severe cardiac dysfunction, left ventricular ejection fraction>=50%; 12. With no blood transfusion and no use of any cell growth factors and/or platelet-raising agents for 14 days prior to screening, organ function levels must meet the following criteria: a) Bone marrow function: Absolute neutrophil count (ANC) >=1.5×10^9/L, platelet count >=90×10^9/L, hemoglobin>=90 g/L; b) Liver function: total bilirubin (TBIL<=1.5 ULN), AST and ALT <=2.5 ULN in patients without liver metastasis, AST and ALT <=5.0 ULN in patients with liver metastasis; c) Renal function: creatinine (Cr) <=1.5 ULN, or creatinine clearance (Ccr) >=50 mL/min (according to Cockcroft and Gault formula). 13. Coagulation function: international normalized ratio (INR) <=1.5, and activated partial thromboplastin time (APTT) <=1.5 ULN; 14. Urine protein <=2+ or <=1000mg/24h; 15. Patients with ascites have no obvious symptoms and no need for clinical intervention; 16. For premenopausal women with childbearing potential, a pregnancy test must be performed within 7 days before the start of treatment, serum or urine must be negative for pregnancy, and must be non-lactating; All enrolled patients (male or female) were advised to use adequate barrier contraception throughout the treatment cycle and for 6 months after the end of treatment. |
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排除标准: |
1. 本研究首次给药前2周内使用过化疗、生物治疗、免疫治疗、根治性放疗、大手术、靶向治疗(包括小分子酪氨酸激酶抑制剂)等抗肿瘤治疗或参与过其它临床研究; 2. 既往接受过贝伐珠单抗治疗; 3. 既往使用过抗CTLA-4单抗治疗; 4. 本研究首次给药前2周内使用过免疫调节药物,包括但不限于胸腺肽、白介素-2、干扰素等,须排除; 5. 本研究首次给药前2周内需要接受系统性皮质激素治疗(>10mg/天强的松,或等量的其他皮质激素);吸入或局部应用激素,或因肾上腺功能不全而接受生理替代剂量的激素治疗除外; 6. 曾接受免疫治疗并出现根据CSCO指南定义的≥3级irAE或≥2级免疫相关性心肌炎,须排除; 7. 严重心脏病病史,例如:症状性充血性心力衰竭(CHF)≥2级(CTCAE 5.0)病史、纽约心脏学会(NYHA)≥2级的心力衰竭、透壁性心肌梗死病史、不稳定型心绞痛等; 8. QT间期延长(男性QTc>450 msec或女性QTc>470 msec)、完全性左束支传导阻滞,III度房室传导阻滞; 9. 活动性自身免疫性疾病和炎性疾病,例如:系统性红斑狼疮、需全身治疗的银屑病、类风湿性关节炎、炎性肠道疾病和桥本氏甲状腺炎等;I型糖尿病、仅替代治疗可以控制的甲状腺功能减退、无需全身治疗的皮肤病(如白癜风、银屑病)除外; 10. 本研究首次给药前5年内诊断为其他恶性肿瘤,以下情况例外:经过根治的皮肤基底细胞癌、皮肤鳞状细胞癌、浅表性膀胱癌、经过根治切除的原位癌,如乳腺原位癌等; 11. 开始研究治疗前,存在:a)控制不佳的糖尿病(空腹血糖 ≥ 13.3 mmol/L),b)控制不佳的高血压(收缩压 ≥ 160 mmHg 和/或舒张压 ≥ 90 mmHg),c) 高血压危象或高血压脑病病史 12. 筛选前6个月内需要治疗干预的不稳定的深静脉血栓、动脉血栓和肺动脉栓塞等血栓事件;输液器相关的血栓形成除外; 13. 有临床症状或影像学证据提示脑转移的患者; 14. 人类免疫缺陷病毒抗体(HIVAb)阳性、活动性结核、活动性乙型肝炎病毒感染(HBV-DNA拷贝数>103 IU/ml)或丙型肝炎病毒感染(HCV抗体阳性且HCV-RNA>检测下限); 15. 需全身性治疗的活动性感染,如重度肺炎、菌血症、败血症等; 16. 无法配合临床试验要求的精神类疾病或药物滥用史患者; 17. 研究者认为不适合采用参加本临床试验的其它情况。 |
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Exclusion criteria: |
1. Anti-tumor therapy such as chemotherapy, biological therapy, immunotherapy, radical radiotherapy, major surgery, targeted therapy (including small molecule tyrosine kinase inhibitors) or participating in other clinical studies within 2 weeks before the first dose of this study; 2. Prior treatment with bevacizumab; 3. Previous treatment with anti-CTLA-4 monoclonal antibody; 4. The use of immunomodulatory drugs within 2 weeks before the first dose of this study, including but not limited to thymosin, interleukin-2, interferon, etc., must be excluded; 5. Systemic corticosteroid therapy (> 10mg/ day prednisone, or other corticosteroid equivalent) within 2 weeks before the first dose of the study; Exceptions were inhaled or topical corticosteroids or physiological replacement doses of corticosteroids for adrenal insufficiency. 6. Patients with prior immunotherapy and grade >=3 irAE or grade >=2 immune-related myocarditis defined according to the CSCO guidelines must be excluded; 7. History of severe heart disease, such as symptomatic congestive heart failure (CHF) ≥ grade 2 (CTCAE 5.0), New York Heart Association (NYHA) >= grade 2 heart failure, transmural myocardial infarction, unstable angina, etc. 8. Prolonged QT interval (QTc > 450 msec in men or QTc > 470 msec in women), complete left bundle branch block, and III degree atrioventricular block; 9. Active autoimmune and inflammatory diseases, such as systemic lupus erythematosus, psoriasis requiring systemic treatment, rheumatoid arthritis, inflammatory bowel disease, and Hashimoto's thyroiditis; Type I diabetes mellitus, hypothyroidism that can be controlled only by replacement therapy, and skin diseases (such as vitiligo and psoriasis) that do not require systemic treatment were excluded. 10. Other malignant tumors diagnosed within 5 years before the first drug administration in this study, except for radical skin basal cell carcinoma, skin squamous cell carcinoma, superficial bladder cancer, radical resection of carcinoma in situ, such as breast carcinoma in situ, etc. 11. History of a) poorly controlled diabetes (fasting blood glucose >= 13.3 mmol/L), b) poorly controlled hypertension (systolic blood pressure >=160 mmHg and/or diastolic blood pressure >= 90 mmHg), and c) hypertensive crisis or hypertensive encephalopathy before starting study treatment 12. Unstable deep vein thrombosis, arterial thrombosis, and pulmonary embolism requiring medical intervention within 6 months before screening; Infusion-related thrombosis was excluded. 13. Patients with clinical symptoms or imaging evidence of brain metastases; 14. Human immunodeficiency virus antibody (HIVAb) positive, active tuberculosis, active hepatitis B virus infection (HBV-DNA copy number > 103 IU/ml) or hepatitis C virus infection (HCV antibody positive and HCV-RNA > detection limit); 15. Active infections requiring systemic therapy, such as severe pneumonia, bacteremia, sepsis, etc. 16. Patients with a history of mental illness or drug abuse who are unable to comply with clinical trial requirements; 17. Other conditions for participation in the trial were not considered appropriate by the investigator. |
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研究实施时间: Study execute time: |
从 From 2025-08-17 00:00:00至 To 2026-12-31 00:00:00 |
征募观察对象时间: Recruiting time: |
从From 2025-08-17 00:00:00 至 To 2026-12-31 00:00:00 |
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干预措施: Interventions: |
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研究实施地点: Countries of recruitment and research settings: |
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测量指标: Outcomes: |
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采集人体标本:
Collecting sample(s)
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征募研究对象情况: Recruiting status: |
尚未开始 Not yet recruiting |
年龄范围: Participant age: |
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性别: |
男女均可 |
Gender: |
Both |
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随机方法(请说明由何人用什么方法产生随机序列): |
无 |
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Randomization Procedure (please state who generates the random number sequence and by what method): |
None |
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是否公开试验完成后的统计结果: Calculated Results after the Study Completed public access: |
公开/Public |
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盲法: |
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Blinding: |
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试验完成后的统计结果(上传文件): |
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Calculated Results after
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是否共享原始数据: IPD sharing |
No |
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共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址): |
无 |
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The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url): |
None |
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数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC: |
通过纸质CRF收集,后续通过中山大学附属第三医院伦理系统和立项系统进行电子化管理 |
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Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture: |
Data will be collected via paper CRFs initially, followed by electronic management through the ethics review system and project approval system of The Third Affiliated Hospital of Sun Yat-sen University. |
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数据与安全监察委员会: Data and Safety Monitoring Committee: |
暂未确定/Not yet |