STUDY TITLE

STUDY REFERENCE STUDY REFERENCEDrMrMrsMissOther

PLANNED TERM FOR STUDY

START DATE

END DATE

Title TitleDrMrMrsMissOther

First Name

Last Name

Degree(s)

Affiliation

Email Address

Phone

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Hypothesis - Up to 300 words

Specific aims - Up to 300 words

Patient eligibility population

Current stage of tumour Current stage of tumour 1 2 3 4 OM/Uveal (localised) OM/Uveal (metastatic)

PRO data of interest PRO data of interest EQ-5D-5L EORTC QLQ-C30 PRO-CTCAE

Other data domains Other data domains Demographics Diagnosis and staging Medical team Pharmacological treatments Non-pharmacological treatments Lifestyle

Insert any additional text here - Up to 300 words

Study design/Statistical analysis plan - Up to 300 words

Proposed timelines (start date, critical deadlines, FDA dates) - Up to 300 words