Submit a project

Name

First

Last

Affiliation

Contact Information (email, phone number):

Characteristics of the Population of Interest

Population Size:

Cancer Type:

Stage(s):

If Stage IV, are you looking for specific metastatic location(s) in your population? If yes, please specify metastasis location(s) of interest:

If necessary, please provide a range for initial diagnosis date?

Treatment (If necessary, please specify the line of treatment):

If necessary, please specify if the patients need to have received a prior treatment or surgery or radiation:

Biomarkers (please specify the name of the gene and the list of specific mutation(s)/copy number variation (CNV)/fusion/status of interest):

If necessary, specify the testing method(s) for the biomarker(s) identification:

What is the minimum follow-up time in months since the diagnosis of interest?

Other details:

Study Information

What type of observational study are you interested in:

Retrospective

Prospective

What is the expected start and end date for the study?

Start (MM/YYYY):

End (MM/YYYY):

For clinicians and researchers, is the study funded by a private third party? If yes, please specify.

Exactis can provide various services for a project: protocol development, eCRF design, EDC building, study startup, project management, on-site monitoring, central monitoring, data entry, data analysis and scientific report/publication.

Which services are you interested in for your project?

Please provide a list of the objective(s) and study endpoint(s) (it doesn’t have to include all of them but will help us make a more accurate overview of the project to provide timelines and estimated cost):

Please provide a list of variables to be collected for the study (it doesn’t have to include all of them but it will help us to make a more accurate estimate of the project to provide timelines and cost):

Are you interested in collecting other types of data not present in the patient’s medical records?

If progression free survival is one of the end point, do you want to use RECIST1.0 or RECIST1.1?

Does the study need the collection and sharing of patient’s imaging data or patient samples?

Please add all the information you think is important for the evaluation of your project. The additional information can be provided as independent documents if necessary (for example a draft or final study protocol, if available).

Characteristics of the Population of Interest

Study Information

Want to hear the
latest from Exactis?

SUBMIT A PROJECT

Characteristics of the Population of Interest

Study Information

Want to hear the latest from Exactis?

Want to hear the
latest from Exactis?