Big Ten Cancer Research Consortium Sample Collection Kits and Supplies

Sample Collection Kits and Supplies

Complete the form below to order sample collection kits for Big Ten Cancer Research Consortium studies.

If you have any questions about ordering kits, please contact a member of our team:

Kraig Galbreath (kgalbreath@hoosiercancer.org or 317-634-5842, ext. 30)
Mayan Howard (mhoward@hoosiercancer.org or 317-634-5842, ext. 35)
Brian Kostoff (bkostoff@hoosiercancer.org or 317-634-5842, ext. 67)
Brittany Lowe (blowe@hoosiercancer.org or 317-634-5842, ext. 28)

Name*
First Last
Institution*
Shipping Address*
Street Address Address Line 2 City State ZIP Code
Email*
Enter Email Confirm Email
Phone*
Select the study and the number of supplies and kits you need for specific timepoints. You may order kits for multiple timepoints.
Expedited Shipping
- Check this box if you require expedited shipping. You will need to provide your FedEx account number.
Fed Ex Account Number
Study Number*
Thermosafe Shippers
FedEx Labels Addressed to Labs
FedEx Labels Addressed to Administrative Headquarters
FedEx Clinical Pak
Ambient Shipper
Screening
Screening (Phase 1)
Screening (Biopsy Tissue)
Screening (Archival Tissue)
Enrollment
Pre-Treatment
Surgical Resection
Randomization (Observation Arm)
Cycle 0, Day 1
Cycle 1, Day 1
Cycle 1, Day 1 (Pembrolizumab Arm)
Cycle 1, Day 1 (Pre-Dose)
Cycle 1, Day 1 (Pre-Treatment)
Cycle 1, Day 1 (Post-Treatment)
Cycle 1, Day 1 Whole Blood CTC (IUSCC Only)
Cycle 1, Day 3
Cycle 1, Day 4
Cycle 1, Day 8
Cycle 1, Day 14
Cycle 1, Day 15
After Cycle 1; Before Cycle 2
Cycle 1, Day 22
Cycle 1, Day 28
Cycle 1, Day 36
Cycle 2, Day 1
Cycle 2 Day 1 (Pembrolizumab Arm)
Cycle 2, Day 8
Cycle 2, Day 15
Cycle 2, Day 28
Cycle 3, Day 1
Cycle 3, Day 1 (Biopsy Tissue)
Cycle 3, Day 1 (Pembrolizumab Arm)
Cycle 3, Day 15
Cycle 3, Day 28
Cycle 4, Day 1
Cycle 4, Day 1 Whole Blood CTC (IUSCC Only)
Cycle 4, Day 15
Cycle 5, Day 1
Cycle 5, Day 8
Cycle 5, Day 1 (Pembrolizumab Arm)
Cycle 6, Day 1
Cycle 7, Day 1
Cycle 7, Day 8
Cycle 8, Day 1
Cycle 9, Day 1
Cycle 9, Day 8
Cycle 9, Day 1 (Pembrolizumab Arm)
Cycle 11, Day 1
Cycle 11, Day 8
Cycle 12, Day 1
Cycle 13, Day 1
Cycle 13, Day 1 (Pembrolizumab Arm)
Cycle 14, Day 1
Cycle 15, Day 1
Cycle 17, Day 1
Cycle 19, Day 1
Cycle 20, Day 2
Cycle 24, Day 1
Cycle 25, Day 1
Cycle 37, Day 1
Biopsy between Cycle 3 and Cycle 6
30 Days Post-Treatment
Day -14
Day 85
Day 30
Post durvaRT
Other Response Assessment
End of Treatment
End of Treatment/Progression
Progression
Progression/Safety Visit
Follow-up
Follow-Up/Safety Visit
Follow-up (IUSCC Only)
Serum Analyses Kit (Day 1 of every cycle & follow -up)

Please type in the cycle number that you need or specify if you will need a follow up time point visit
Safety Follow-up
Safety Follow-up (Pembrolizumab Arm)
Every 6 Months After Follow-up
12 Weeks (Observation Arm)
24 Weeks (Observation Arm)
36 Weeks (Observation Arm)
Week 60
Relapse
Covance Kit
Disease Recurrence (IUSCC Only)
Qualtek Kit
Comments
Untitled
- First Choice
- Second Choice
- Third Choice
Phone
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