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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT03924869
Registration number
NCT03924869
Ethics application status
Date submitted
22/04/2019
Date registered
23/04/2019
Titles & IDs
Public title
Efficacy and Safety Study of Stereotactic Body Radiotherapy (SBRT) With or Without Pembrolizumab (MK-3475) in Adults With Unresected Stage I or II Non-Small Cell Lung Cancer (NSCLC) (MK-3475-867/KEYNOTE-867)
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Scientific title
A Phase 3, Randomized, Placebo-Controlled Clinical Study to Evaluate the Safety and Efficacy of Stereotactic Body Radiotherapy (SBRT) With or Without Pembrolizumab (MK-3475) in Participants With Unresected Stages I or II Non Small Cell Lung Cancer (NSCLC) (KEYNOTE-867)
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Secondary ID [1]
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MK-3475-867
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Secondary ID [2]
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3475-867
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Non-Small Cell Lung Cancer
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Condition category
Condition code
Cancer
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Lung - Mesothelioma
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Cancer
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Lung - Non small cell
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Cancer
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Lung - Small cell
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Other - Stereotactic Body Radiotherapy (SBRT)
Treatment: Other - Pembrolizumab
Treatment: Drugs - Placebo
Experimental: SBRT+Pembolizumab - Participants receive SBRT once every 3 days for 3, 4, 5, or 8 fractions (dependent on tumor type/location; 45-70 Gray \[Gy\] total) over approximately 2 weeks PLUS pembrolizumab 200 mg via intravenous (IV) infusion once every 3 weeks for up to 17 cycles (up to approximately 1 year). Each cycle is 21 days.
Placebo comparator: SBRT+Placebo - Participants receive SBRT once every 3 days for 3, 4, 5, or 8 fractions (dependent on tumor type/location; 45-70 Gy total) over approximately 2 weeks PLUS placebo (normal saline solution) via IV infusion once every 3 weeks for up to 17 cycles (up to approximately 1 year). Each cycle is 21 days.
Treatment: Other: Stereotactic Body Radiotherapy (SBRT)
SBRT
Treatment: Other: Pembrolizumab
IV infusion
Treatment: Drugs: Placebo
IV infusion
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Intervention code [1]
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Treatment: Other
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Intervention code [2]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Event-free Survival (EFS)
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Assessment method [1]
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EFS is defined as the time from randomization to the first occurrence of any of the following events:
* Local, regional, or distant recurrence of disease as assessed by:
* Radiographic recurrence by blinded independent central review (BICR)
* Positive pathology by local assessment
* Physical examination by local assessment confirmed by positive pathology and/or radiographic recurrence by BICR OR
* Death due to any cause. EFS will be presented.
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Timepoint [1]
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Up to approximately 68 months
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Secondary outcome [1]
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Overall Survival (OS)
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Assessment method [1]
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OS is defined as the time from date of randomization to date of death from any cause. OS will be presented.
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Timepoint [1]
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Up to approximately 81 months
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Secondary outcome [2]
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Time to Death or Distant Metastases (TDDM)
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Assessment method [2]
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TTDM is defined as the time from randomization to the first documented distant metastases or death from any cause, whichever occurs first. The TDDM will be presented.
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Timepoint [2]
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Up to approximately 81 months
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Secondary outcome [3]
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Number of Participants Who Experience an Adverse Event (AE)
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Assessment method [3]
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An AE is any untoward medical occurrence in a participant, temporally associated with the use of study treatment, whether or not considered related to the study treatment. The number of participants who experience an AE will be presented.
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Timepoint [3]
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Up to approximately 16 months
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Secondary outcome [4]
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Number of Participants Who Discontinue Study Treatment Due to an Adverse Event (AE)
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Assessment method [4]
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An AE is any untoward medical occurrence in a participant, temporally associated with the use of study treatment, whether or not considered related to the study treatment. The number of participants who discontinue study treatment due to an AE will be presented.
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Timepoint [4]
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Up to approximately 1 year
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Secondary outcome [5]
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Change from Baseline in European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) Global Health Status/Quality of Life (Items 29 and 30) Score
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Assessment method [5]
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The EORTC QLQ-C30 is a questionnaire to assess the overall quality of life of cancer patients. Participant responses to the questions "How would you rate your overall health during the past week?" and "How would you rate your overall quality of life during the past week?" are scored on a 7-point scale (1=Very Poor to 7=Excellent). Using linear transformation, raw scores are standardized, so that scores range from 0 to 100. A higher score indicates a better overall outcome. The change from baseline in Global Health Status/Quality of Life (EORTC QLQ-C30 Items 29 and 30) combined score will be presented.
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Timepoint [5]
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Baseline and up to approximately 52 weeks
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Secondary outcome [6]
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Change from Baseline in European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Lung Cancer Module 13 (EORTC QLQ-LC13) Cough (Item 31) Score
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Assessment method [6]
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The EORTC QLQ-LC13 is a lung cancer-specific supplemental questionnaire used in combination with the EORTC QLQ-C30. Participant responses to the question "How much did you cough?" are scored on a 4-point scale (1=Not at All to 4=Very Much). Using linear transformation, raw scores are standardized, so that scores range from 0 to 100. A lower score indicates a better outcome. The change from baseline in cough (EORTC QLQ LC13 Item 31) score will be presented.
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Timepoint [6]
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Baseline and up to approximately 52 weeks
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Secondary outcome [7]
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Change from Baseline in European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Lung Cancer Module 13 (EORTC QLQ-LC13) Chest Pain (Item 10) Score
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Assessment method [7]
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The EORTC QLQ-LC13 is a lung cancer-specific supplemental questionnaire used in combination with the EORTC QLQ-C30. Participant responses to the question "Have you had pain in your chest?" are scored on a 4-point scale (1=Not at All to 4=Very Much). Using linear transformation, raw scores are standardized, so that scores range from 0 to 100. A lower score indicates a better outcome. The change from baseline in chest pain (EORTC QLQ-LC13 Item 40) score will be presented.
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Timepoint [7]
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Baseline and up to approximately 52 weeks
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Secondary outcome [8]
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Change from Baseline in European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) Dyspnea (Item 8) Score
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Assessment method [8]
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The EORTC QLQ-C30 is a questionnaire to assess the overall quality of life of cancer patients. Participant responses to the question "Were you short of breath?" are scored on a 4-point scale (1=Not at All to 4=Very Much). Using linear transformation, raw scores are standardized, so that scores range from 0 to 100. A lower score indicates a better outcome. The change from baseline in dyspnea (EORTC QLQ-C30 Item 8) score will be presented.
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Timepoint [8]
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Baseline and up to approximately 52 weeks
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Secondary outcome [9]
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Change from Baseline in European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC QLQ-C30) Physical Functioning (Items 1-5) Score
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Assessment method [9]
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The EORTC QLQ-C30 is a questionnaire to assess the overall quality of life of cancer patients. Participant responses to 5 questions about their physical functioning are scored on a 4-point scale (1=Not at All to 4=Very Much). Using linear transformation, raw scores are standardized, so that scores range from 0 to 100. A higher score indicates a better quality of life. The change from baseline in Physical Functioning (EORTC QLQ-C30 Items 1-5) combined score will be presented.
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Timepoint [9]
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Baseline and up to approximately 52 weeks
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Eligibility
Key inclusion criteria
* Has previously untreated non-small cell lung cancer (NSCLC) diagnosed by histology or cytology and confirmed as Stage I or II (T1 to limited T3, N0, M0) NSCLC (American Joint Committee on Cancer, AJCC) by chest computed tomography (CT) and positron emission tomography (PET) scan. Participants with pericardium invasion, >2 nodules or 2 nodules that cannot be treated in one field (>2 cm apart and/or total planned target volume [PTV] >163 cc) and diaphragm elevation suggestive of phrenic nerve invasion are excluded
* Cannot undergo thoracic surgery due to existing medical illness(es) as determined by the site's multi-disciplinary tumor board. Medically operable participants who decide to treat with stereotactic body radiotherapy (SBRT) as definitive therapy rather than surgery are also eligible, if patient's unwillingness to undergo surgical resection is clearly documented
* Has a Eastern Cooperative Oncology Group (ECOG) Performance Status of 0, 1, or 2
* Is able to receive SBRT and does not have an ultra-centrally located tumor
* Has adequate organ function within 7 days prior to the start of study treatment
* A female is eligible to participate if she is not pregnant, not breastfeeding, and at least one of the following conditions applies: a) not a women of childbearing potential (WOCBP) OR b) A WOCBP and uses contraceptive method that is highly effective (with a failure rate of <1% per year), or be abstinent from heterosexual intercourse as their preferred and usual lifestyle (abstinent on a long-term and persistent basis), during the intervention period and for at least 120 days after the last dose of pembrolizumab/placebo and 180 days after the last radiotherapy dose
* Male participants are eligible to participate if they agree to the following during the intervention period and for at least 90 days after the last dose of radiotherapy: refrain from donating sperm plus either be abstinent from heterosexual intercourse as their preferred and usual lifestyle (abstinent on a long-term and persistent basis) and agree to remain abstinent or must agree to use contraception per study protocol, unless confirmed to be azoospermic
* Has a radiation therapy plan approved by the central radiation therapy quality assurance vendor
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
* Has received prior therapy with an anti-programmed cell death-1 (anti-PD-1), anti-programmed cell death-ligand 1 (anti-PD-L1), or anti PD-L2 agent or with an agent directed to another stimulatory or co-inhibitory T-cell receptor (e.g. cytotoxic T-lymphocyte-associated antigen 4 [CTLA-4], tumor necrosis factor receptor superfamily member 4 [OX-40], tumor necrosis factor receptor superfamily member 9 [CD137])
* Has received prior radiotherapy to the thorax, including radiotherapy to the esophagus, mediastinum, or breast
* Has received a live vaccine within 30 days prior to the first dose of study intervention
* Has received an investigational agent or has used an investigational device within 4 weeks prior to the first dose of study intervention administration
* Has a diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy (in dosing exceeding 10 mg daily of prednisone equivalent) or any other form of immunosuppressive therapy within 7 days prior the first dose of study treatment
* Has a known additional malignancy that is progressing or has required active treatment within the past 3 years. A prior NSCLC that occurred and was treated curatively at least 2 years prior to the date of the current diagnosis would be considered a separate primary lung cancer, and therefore an additional malignancy. Note: Participants with basal cell carcinoma of the skin, squamous cell carcinoma of the skin, or carcinoma in situ (e.g. breast c carcinoma, cervical cancer in situ) that have undergone potentially curative therapy are not excluded.
* Has a known hypersensitivity (=Grade 3) to pembrolizumab and/or any of its excipients
* Has a history of (non-infectious) pneumonitis that required steroids or has current pneumonitis
* Has a known history of Hepatitis B or known active Hepatitis C virus infection
* Has an active autoimmune disease that has required systemic treatment in past 2 years, except replacement therapy
* Has an active infection requiring systemic therapy
* Has a known history of human immunodeficiency virus (HIV) infection
* Has a known history of active tuberculosis (TB; Bacillus tuberculosis)
* Is pregnant or breastfeeding or expecting to conceive or father children within the projected duration of the study, starting with the screening visit through 120 days after the last dose of pembrolizumab/placebo and 180 days after the last radiotherapy dose
* Have not adequately recovered from major surgery or have ongoing surgical complications
* Has had an allogenic tissue/solid organ transplant
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 3
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Active, not recruiting
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
25/06/2019
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
1/07/2026
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Actual
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Sample size
Target
436
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW,QLD,TAS,VIC
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Recruitment hospital [1]
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Port Macquarie Base Hospital ( Site 2500) - Port Macquarie
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GenesisCare North Shore ( Site 2508) - St Leonards
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Royal Brisbane and Women s Hospital ( Site 2502) - Herston
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Icon Cancer Centre Hobart ( Site 2507) - Hobart
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Austin Health ( Site 2501) - Melbourne
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Recruitment postcode(s) [1]
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2444 - Port Macquarie
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2065 - St Leonards
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4029 - Herston
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7000 - Hobart
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Recruitment postcode(s) [5]
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3084 - Melbourne
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Recruitment outside Australia
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Alabama
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Yamanashi
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Tokyo
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Utrecht
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Country [82]
0
0
New Zealand
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State/province [82]
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0
Auckland
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Country [83]
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0
Norway
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State/province [83]
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Sor-Trondelag
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Country [84]
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Norway
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State/province [84]
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0
Vestfold
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Country [85]
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Norway
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Oslo
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Country [86]
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Poland
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State/province [86]
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Kujawsko-pomorskie
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Country [87]
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Poland
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Lodzkie
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Country [88]
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Poland
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State/province [88]
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Malopolskie
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Country [89]
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Poland
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State/province [89]
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Mazowieckie
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Country [90]
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Poland
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State/province [90]
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Slaskie
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Country [91]
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Poland
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Warminsko-mazurskie
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Country [92]
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Romania
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State/province [92]
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Cluj
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Country [93]
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Russian Federation
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State/province [93]
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Chelyabinskaya Oblast
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Country [94]
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Russian Federation
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State/province [94]
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Lipetskaya Oblast
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Country [95]
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Russian Federation
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State/province [95]
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Moskva
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Country [96]
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Russian Federation
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State/province [96]
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Sankt-Peterburg
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Country [97]
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Russian Federation
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State/province [97]
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Sverdlovskaya Oblast
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Country [98]
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Russian Federation
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State/province [98]
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Tatarstan, Respublika
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Country [99]
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Spain
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State/province [99]
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Madrid
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Spain
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State/province [100]
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Valenciana, Comunitat
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Country [101]
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Spain
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State/province [101]
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Barcelona
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Switzerland
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Geneve
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Switzerland
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State/province [103]
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Zurich
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Taiwan
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State/province [104]
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Taipei
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Taiwan
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State/province [105]
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Kaohsiung
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Country [106]
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Turkey
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State/province [106]
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Adana
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Country [107]
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Turkey
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State/province [107]
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Ankara
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Country [108]
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Turkey
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State/province [108]
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Istanbul
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Country [109]
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Turkey
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State/province [109]
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Izmir
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Country [110]
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Turkey
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State/province [110]
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Kayseri
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Country [111]
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Turkey
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State/province [111]
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Sakarya
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Country [112]
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Ukraine
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State/province [112]
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Dnipropetrovska Oblast
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Country [113]
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Ukraine
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State/province [113]
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Kharkivska Oblast
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Country [114]
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Ukraine
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State/province [114]
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Kirovohradska Oblast
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Country [115]
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Ukraine
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State/province [115]
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Kyivska Oblast
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Country [116]
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Ukraine
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State/province [116]
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Kyiv
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Country [117]
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United Kingdom
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State/province [117]
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Bristol, City Of
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Country [118]
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United Kingdom
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State/province [118]
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Camden
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Country [119]
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United Kingdom
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State/province [119]
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Derbyshire
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Country [120]
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United Kingdom
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State/province [120]
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England
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Country [121]
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United Kingdom
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State/province [121]
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Lancashire
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Country [122]
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United Kingdom
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State/province [122]
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Leicestershire
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Country [123]
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United Kingdom
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State/province [123]
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London, City Of
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Country [124]
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United Kingdom
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State/province [124]
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Norfolk
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Country [125]
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United Kingdom
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State/province [125]
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Oxfordshire
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Country [126]
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United Kingdom
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State/province [126]
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Darlington
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Country [127]
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United Kingdom
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State/province [127]
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Northwood
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
Merck Sharp & Dohme LLC
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Address
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Country
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Ethics approval
Ethics application status
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Summary
Brief summary
The purpose of this study is to assess the efficacy and safety of stereotactic body radiotherapy (SBRT) plus pembrolizumab (MK-3475) in the treatment of adult participants with unresected stage I or II (Stage IIB N0, M0) non-small cell lung cancer (NSCLC). The primary study hypothesis is SBRT plus pembrolizumab prolongs Event-free Survival (EFS) compared to SBRT plus placebo (normal saline solution).
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Trial website
https://clinicaltrials.gov/study/NCT03924869
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
0
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Medical Director
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Address
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Merck Sharp & Dohme LLC
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0
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Fax
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Email
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Contact person for public queries
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
http://engagezone.msd.com/doc/ProcedureAccessClinicalTrialData.pdf
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When will data be available (start and end dates)?
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Available to whom?
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Available for what types of analyses?
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How or where can data be obtained?
IPD available at link: http://engagezone.msd.com/ds_documentation.php
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT03924869