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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: |
ChiCTR2600119671 |
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最近更新日期: Date of Last Refreshed on: |
2026-03-02 11:50:56 |
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注册时间: Date of Registration: |
2026-03-02 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: |
卡瑞利珠单抗联合阿帕替尼及局部治疗用于晚期肝细胞癌伴肺转移的有效性和安全性(CAPLocal):一项多中心、单臂前瞻性队列研究 |
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Public title: |
Efficacy and Safety of Camrelizumab plus Rivoceranib and Local Therapy for Hepatocellular Carcinoma with Lung Metastases (CAPLocal) : A Multicentre, Single-Arm,Prospective Cohort Study |
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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: |
卡瑞利珠单抗联合阿帕替尼及局部治疗用于晚期肝细胞癌伴肺转移的有效性和安全性(CAPLocal):一项多中心、单臂前瞻性队列研究 |
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Scientific title: |
Efficacy and Safety of Camrelizumab plus Rivoceranib and Local Therapy for Hepatocellular Carcinoma with Lung Metastases (CAPLocal) : A Multicentre, Single-Arm,Prospective Cohort Study |
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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: |
潘毅林 |
研究负责人: |
周乐杜 |
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Applicant: |
Yilin Pan |
Study leader: |
Ledu Zhou |
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申请注册联系人电话: Applicant telephone: |
+86 184 0820 1921 |
研究负责人电话: Study leader's telephone: |
+86 136 0748 0367 |
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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: |
pan_yilin810@163.com |
研究负责人电子邮件: Study leader's E-mail: |
zhould@csu.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: |
湖南省长沙市中南大学湘雅医院肝脏外科 |
研究负责人通讯地址: |
湖南省长沙市中南大学湘雅医院肝脏外科 |
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Applicant address: |
Department of Liver Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, China. |
Study leader's address: |
Department of Liver Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, China. |
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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: |
湖南省长沙市中南大学湘雅医院肝脏外科 |
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Applicant's institution: |
Department of Liver Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, China. |
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研究负责人所在单位: |
湖南省长沙市中南大学湘雅医院肝脏外科 |
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Affiliation of the Leader: |
Department of Liver Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, China. |
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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: |
伦审科第(202602023)号 |
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: |
中南大学湘雅医院临床医学伦理审查委员会 |
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Name of the ethic committee: |
Medical Ethics Review Committee of Xiangya Hospital Central South University |
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伦理委员会批准日期: Date of approved by ethic committee: |
2026-02-12 00:00:00 |
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伦理委员会联系人: |
张欣 |
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Contact Name of the ethic committee: |
Xin Zhang |
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伦理委员会联系地址: |
湖南省长沙市湘雅路87号 |
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Contact Address of the ethic committee: |
No.87 Xiangya Road Changsha(410008) Hunan |
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伦理委员会联系人电话: Contact phone of the ethic committee: |
+86 731 8432 7919 |
伦理委员会联系人邮箱: Contact email of the ethic committee: |
xyyyllwyh@126.com |
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研究实施负责(组长)单位: |
中南大学湘雅医院 |
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Primary sponsor: |
Xiangya Hospital Central South University |
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研究实施负责(组长)单位地址: |
湖南省长沙市中南大学湘雅医院肝脏外科 |
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Primary sponsor's address: |
Department of Liver Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, China. |
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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: |
资助方资助 |
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Source(s) of funding: |
Funding provided by the sponsor |
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Target disease: |
Hepatocellular Carcinoma |
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Target disease code: |
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研究类型: |
观察性研究 |
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Study type: |
Observational study |
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研究所处阶段: |
其它 | ||||||||||||||||||||||
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Study phase: |
N/A |
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研究设计: |
队列研究 |
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Study design: |
Cohort study |
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研究目的: |
1.1.主要目的 通过研究者依据RECIST v1.1确定的客观缓解率(ORR),评估系统治疗(卡瑞利珠单抗联合阿帕替尼)联合或不联合局部治疗(手术、放疗或消融治疗)对于晚期肝细胞癌伴肺转移患者的疗效。 1.2.次要目的 通过研究者依据RECIST v1.1、mRECIST确定的无进展生存期(PFS)、客观缓解率(ORR)等疗效指标,评估系统治疗(卡瑞利珠单抗联合阿帕替尼)联合或不联合局部治疗(手术、放疗或消融治疗)对于晚期肝细胞癌伴肺转移患者的疗效; 评估系统治疗(卡瑞利珠单抗联合阿帕替尼)联合或不联合局部治疗(手术、放疗或消融治疗)对于晚期肝细胞癌伴肺转移患者的安全性。 1.3.探索性目的 经过综合治疗后没有影像学可检测到的活性病灶(NED)的患者,评估累计持续时间(持续保持NED状态的时间之和)及局部治疗的安全性; 探索生物标记物与联合治疗方案疗效之间的相关性; 探索肝细胞癌肺转移数目、直径与治疗效果之间的关系。 |
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Objectives of Study: |
1.1. Main Objectives The objective response rate (ORR) determined by the researchers based on RECIST v1.1 was used to evaluate the efficacy of systemic therapy (carrycept combined with apatinib) in combination with or without local treatment (surgery, radiotherapy, or ablation therapy) for patients with advanced hepatocellular carcinoma with pulmonary metastases. 1.2. Secondary objectives Through efficacy indicators such as progression-free survival (PFS) and objective response rate (ORR) determined by researchers based on RECIST v1.1 and mRECIST, evaluate the efficacy of systemic therapy (carrietumab combined with apatinib) combined or not with local treatment (surgery, radiotherapy, or ablation therapy) for patients with advanced hepatocellular carcinoma with pulmonary metastases. Evaluate the safety of combining systemic therapy (caretuximab-rbsm in combination with apatinib) with or without local treatment (surgery, radiotherapy, or ablation therapy) for patients with advanced hepatocellular carcinoma with pulmonary metastases. 1.3. Exploratory Purpose Evaluate the cumulative duration (the sum of the time spent in a NED state) and the safety of local treatments for patients who have undergone comprehensive treatment and have no detectable active lesions on imaging studies (NED). Explore the correlation between biomarkers and the efficacy of combined treatment regimens. Explore the relationship between the number, diameter, and treatment outcomes of pulmonary metastases in hepatocellular carcinoma. |
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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: |
患者必须满足以下所有入选标准,才可纳入本研究: 1)患者自愿加入本研究,签署知情同意书; 2)年龄18~85岁,男女皆可; 3)经肿瘤组织的组织病理学检查或影像学评估,确诊的肝细胞癌(HCC)患者【参考《原发性肝癌诊疗指南(2024年版)》】; 4)伴有未经局部治疗的肝外肺转移病灶,且肝外肺转移病灶 ≤5个; 5)未接受过任何针对HCC的系统治疗; 6)至少有一个可测量病灶(根据 RECIST v1.1 要求,该可测量病灶螺旋CT扫描长径≥10 mm或肿大淋巴结短径≥15 mm;既往接受过局部治疗的病灶,根据RECIST v1.1标准明确进展后可作为靶病灶); 7)中性粒细胞淋巴细胞比值小于等于3(NLR≤3); 8)Child Pugh肝功能分级为A、或B级(≤7); 9)美国东部肿瘤协作组(Eastern Cooperative Oncology Group, ECOG)行为状态为0或1; 10)肺功能良好,预期可耐受手术或局部治疗; 11)其他主要器官功能基本正常(血液系统、肾等功能良好): 骨髓功能充足:白细胞计数≥4.0×10^9/L,绝对中性粒细胞计数(ANC)≥2.0×10^9/L,血小板计数≥100×10^9/L,血红蛋白浓度≥90 g/L(首次用药前2周内未输血、未使用造血因子和未使用药物纠正); 未接受抗凝治疗的患者,INR(凝血酶原时间国际标准化比率)与APTI(活化部分凝血活酶时间)≤1.5倍正常值上限。 肾功能充足:肌酐清除率≥60 mL/min; 12)患有活动性乙型肝炎病毒(HBV)感染的患者必须在研究治疗开始之前接受抗HBV治疗,且愿意在研究期间全程接受抗病毒治疗;丙型肝炎病毒(HCV)核糖核酸(RNA)阳性患者必须按当地标准治疗指南接受抗病毒治疗且肝功能在CTCAE 1级升高以内; 13)育龄女性应在研究入组前的7天内血清或尿妊娠试验阴性,且必须为非哺乳期患者,并同意在研究期间和研究结束后6个月内采用避孕措施;男性应同意在研究期间和研究期结束后6个月内必须采用避孕措施; 14)受试者自愿接受本临床研究相关治疗,配合随访。 |
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Inclusion criteria |
Patients must meet all of the following inclusion criteria in order to be eligible for participation in this study: 1. The patient voluntarily participates in this study and signs an informed consent form. 2. Age: 18 to 85 years, both male and female are eligible. 3. Patients with hepatocellular carcinoma (HCC) confirmed through histopathological examination of tumor tissue or imaging assessments [refer to the Guidelines for the Diagnosis and Treatment of Primary Hepatocellular Carcinoma (2024 Edition)]. 4. There are extrahepatic pulmonary metastases that have not been treated locally, and the number of these metastases is <= 5. 5. Has not received any form of systematic treatment for HCC. 6. There must be at least one measurable lesion (according to the RECIST v1.1 criteria, this measurable lesion must have a longitudinal diameter >= 10 mm on spiral CT scans or a short diameter >= 15 mm for enlarged lymph nodes; lesions that have previously received local treatment and have clearly progressed according to the RECIST v1.1 standards can be considered target lesions). 7. Neutrophil-to-lymphocyte ratio (NLR) <= 3. 8. The Child-Pugh liver function classification is Grade A or B (<= 7). 9. The Eastern Cooperative Oncology Group (ECOG) performance status is 0 or 1. 10. Good lung function, expected to be able to tolerate surgery or localized treatment. 11. Other major organ functions are generally normal: - Bone marrow function is adequate: white blood cell count >= 4.0 x 10^9/L, absolute neutrophil count (ANC) >= 2.0 x 10^9/L, platelet count >= 100 x 10^9/L, hemoglobin >= 90 g/L (no blood transfusions, no use of hematopoietic factors, and no medication correction within 2 weeks prior to the first administration). - For patients not receiving anticoagulant therapy, the INR and APTT values are <= 1.5 x ULN. - Adequate renal function: creatinine clearance >= 60 mL/min. 12. Patients with active hepatitis B virus (HBV) infection must receive anti-HBV treatment prior to the initiation of the study treatment and must be willing to undergo antiviral therapy throughout the study period. Patients with hepatitis C virus (HCV) RNA-positive status must receive antiviral treatment according to local standard treatment guidelines and have liver function levels within the range of CTCAE Grade 1 elevation. 13. Women of childbearing potential should have a negative serum or urine pregnancy test within 7 days prior to enrollment, and must be non-lactating and agree to use contraceptive measures during the study period and for 6 months after its completion. Male patients must agree to use contraceptive measures during the study period and for 6 months after its conclusion. 14. The participant voluntarily consents to receive treatment related to this clinical study and agrees to participate in follow-up assessments. |
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排除标准: |
患者若符合以下任何一种情况,将不得纳入本研究: 1)已知肝胆管细胞癌、肉瘤样HCC、混合细胞癌及纤维板层细胞癌;5年内或同时患有除HCC之外的其它活动性恶性肿瘤。已治愈的局限性肿瘤,如皮肤基底细胞癌、皮肤鳞癌、表浅膀胱癌、前列腺原位癌、宫颈原位癌、乳腺原位癌等可以入组; 2)既往接受过针对转移病灶的抗肿瘤治疗; 3)肝外转移部位非肺,或远处转移器官数量超过2个(包括2个); 4)患有任何无法控制的严重感染、严重的身心疾病或实验室检查异常,可能产生不可接受的风险,对试验依从性产生负面影响,或影响研究药物的给药、分布、代谢和排泄。例如,需要治疗的不稳定的心脏病、慢性肾病、控制不佳的糖尿病、情绪障碍、精神障碍、中枢神经系统异常、慢性腹泻、腹水和胸腔积液; 5)患有高血压,且经降压药物治疗无法获得良好控制(收缩压≥140 mmHg 或者舒张压≥90 mmHg),允许通过使用降压治疗实现上述参数;既往曾出现高血压危象或高血压性脑病; 6)人类免疫缺陷病毒(HIV)感染或者已知的获得性免疫缺陷综合征(AIDS)(或者活动性病毒性肝炎); 7)在本试验的治疗期间,同时接受其他临床研究的实验性治疗; 8)器官移植后长期使用免疫抑制剂; 9)经研究者判断,受试者有其他可能导致本研究被迫中途终止的因素,如不依从方案,有其他的严重疾病(含精神疾病)需要合并治疗,有严重的实验室检查异常,有精神药物滥用或吸毒史,伴有心理、社会、家庭或地理等因素,会影响到受试者的安全,或资料及样品的收集。 |
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Exclusion criteria: |
Patients who meet any of the following criteria will not be eligible to participate in this study: 1. Known cases of cholangiocarcinoma, sarcomatoid HCC, mixed cell carcinoma, and fibrolamellar cell carcinoma; having had an active malignant tumor other than HCC within 5 years or concurrently. Limited-stage tumors that have been cured, such as basal cell carcinoma of the skin, squamous cell carcinoma of the skin, superficial bladder cancer, prostate intraepithelial carcinoma, cervical intraepithelial carcinoma, and breast intraepithelial carcinoma, can be included. 2. Has previously received anti-cancer treatments targeting metastatic lesions. 3. The site of extrahepatic metastasis is not the lungs, or there are more than 2 distant metastasized organs (including 2). 4. Suffering from any severe infection, serious mental or physical illness, or laboratory test abnormalities that are uncontrollable, which may pose an unacceptable risk, negatively impact trial compliance, or affect the administration, distribution, metabolism, and excretion of the investigational drug. Examples include unstable heart disease, chronic kidney disease, poorly controlled diabetes, mood disorders, mental disorders, central nervous system abnormalities, chronic diarrhea, ascites, and pleural effusions requiring treatment. 5. Suffers from hypertension and cannot achieve adequate control with antihypertensive medication (systolic blood pressure >= 140 mmHg or diastolic blood pressure >= 90 mmHg). It is permissible to use antihypertensive treatment to achieve these parameters. Has previously experienced a hypertensive crisis or hypertensive encephalopathy. 6. Infection with human immunodeficiency virus (HIV) or known acquired immunodeficiency syndrome (AIDS) (or active viral hepatitis). 7. Received experimental treatments from other clinical studies concurrently during the course of this trial. 8. Long-term use of immunosuppressive agents following organ transplantation. 9. According to the investigators' assessment, the subject may have other factors that could lead to the forced discontinuation of this study. These include non-compliance with the protocol, the presence of other serious conditions (including mental illnesses) requiring concurrent treatment, significant laboratory abnormalities, a history of substance abuse or drug use, combined with psychological, social, familial, or geographic factors, which could impact the subject's safety or the collection of data and samples. |
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研究实施时间: Study execute time: |
从 From 2026-03-01 00:00:00至 To 2028-12-31 00:00:00 |
征募观察对象时间: Recruiting time: |
从From 2026-03-02 00:00:00 至 To 2027-03-01 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: |
病例记录表 |
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Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture: |
Case Record Form, CRF |
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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 |