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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT04291885
Registration number
NCT04291885
Ethics application status
Date submitted
6/02/2020
Date registered
2/03/2020
Titles & IDs
Public title
Immunotherapy Adjuvant Trial in Patients With Stage I-III Merkel Cell Carcinoma
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Scientific title
A Randomised, Placebo-controlled, Phase II Trial of Adjuvant Avelumab in Patients With Stage I-III Merkel Cell Carcinoma
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Secondary ID [1]
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03.18
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Universal Trial Number (UTN)
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Trial acronym
I-MAT
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Merkel Cell Carcinoma
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Merkel Cell Carcinoma, Stage I
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Merkel Cell Carcinoma, Stage II
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Merkel Cell Carcinoma, Stage III
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Neuroendocrine Tumors
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Carcinoma Neuroendocrine Skin
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Condition category
Condition code
Cancer
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Malignant melanoma
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Cancer
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Non melanoma skin cancer
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Cancer
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Kidney
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Cancer
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Neuroendocrine tumour (NET)
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Avelumab
Treatment: Drugs - Placebo
Experimental: Avelumab - 6 months of Avelumab at a dose of 800mg as a 60-minute intravenous (IV) infusion once every 2 weeks (13 doses)
Placebo comparator: Placebo - 6 months of Placebo as a 60-minute intravenous (IV) infusion once every 2 weeks (13 doses)
Treatment: Drugs: Avelumab
Avelumab IV infusion
Treatment: Drugs: Placebo
Placebo IV infusion
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Intervention code [1]
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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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Recurrence-free survival (RFS)
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Assessment method [1]
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Recurrence-free survival (RFS) as the primary endpoint, is anticipated to be analysed over an average planned follow-up of 3.5 years. An analysis of RFS at the 24 month time point of follow-up will also be conducted as it is anticipated that the minimum follow-up for participants will be 24 months and the sample size rationale utilises RFS rates at 24 months in historical controls. RFS is defined as the time from treatment initiation until the first date of any signs or symptoms of recurrence of tumour.
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Timepoint [1]
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24 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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Overall survival rates at 12 and 24 months. Overall survival is defined as the time from treatment initiation to the date of death due to any cause.
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Timepoint [1]
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24 Months
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Secondary outcome [2]
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Disease-specific survival (DSS)
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Assessment method [2]
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Disease-specific survival at 24 months from treatment initiation. Disease-specific survival is the percentage of participants who have not died from Merkel Cell Carcinoma
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Timepoint [2]
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24 Months
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Secondary outcome [3]
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Rate of loco-regional failure free survival (LRFFS)
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Assessment method [3]
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Rate of loco-regional failure free survival (LRFFS) is defined as the time from treatment initiation to the first recurrence of the loco-regional tumour.
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Timepoint [3]
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24 Months
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Secondary outcome [4]
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Distant metastasis-free survival (DMFS)
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Assessment method [4]
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DMFS is defined as the time from treatment initiation to the first evidence of distant metastatic disease.
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Timepoint [4]
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24 Months
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Secondary outcome [5]
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Treatment toxicity and tolerability as assessed by NCI CTCAE v5.0
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Assessment method [5]
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Rate of treatment-related adverse events (AEs). Safety will be measured by serious adverse events (SAEs) and AEs assessed as per NCI CTCAE v5.0, including immune-related adverse events.
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Timepoint [5]
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24 Months
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Secondary outcome [6]
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Patient-reported quality of life (QoL) as assessed by FACT-M questionnaire
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Assessment method [6]
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FACT-M form (version 4) will be utilised. This will include patient-reported questions relating to physical wellbeing, social/family wellbeing, emotional wellbeing, functional wellbeing and additional patient concerns which are measured from 0-4 (Not at all - Very Much).
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Timepoint [6]
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24 Months
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Eligibility
Key inclusion criteria
1. Histologically confirmed Merkel cell carcinoma (MCC) which is either:
* clinical stage I;
* pathological stage I with positive LVSI only;
* clinical or pathological stage II (including IIA and IIB);
* clinical or pathological stage III (including IIIA and IIIB).
2. Absence of distant metastatic disease on baseline 18-Fludeoxyglucose (18FDG) - Positron Emission Tomography (PET) / Computed Tomography (CT) scan.
3. 18 years of age or older.
4. Eastern Cooperative Oncology Group (ECOG) of 0 - 2.
5. Willing and able to provide written informed consent and comply with all study requirements.
6. Adequate haematological, liver and renal function as determined by the screening laboratory values outlined in the protocol obtained within 14 days prior to randomisation.
7. Agreeable to collection of archival tumour material. Where possible, the most recently acquired tumour specimen should be provided.
8. Women of child bearing potential (WOCBP) must have a negative serum or urine pregnancy test within 72 hours prior to the start of treatment.
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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
1. Ongoing or recent (within 5 years) evidence of significant autoimmune disease that required treatment with systemic immunosuppressive treatments, which may suggest significant risk for immune-related adverse events.
2. Prior treatment with an agent that blocks the PD-1/PD-L1 pathway.
3. Previous cancer immunotherapy, specifically interferon, anti-CD137, or anti-CTLA-4 antibody or any other antibody or drug specifically targeting T cell co-stimulation or checkpoint pathways are not permitted.
4. Prior treatment with other immune-modulating agents that was within fewer than 28 days prior to the first dose of Avelumab.
5. Active infection requiring antibiotics within 7 days of study entry.
6. Active tuberculosis.
7. Known history of testing positive for human immunodeficiency virus (HIV) or known acquired immunodeficiency syndrome (AIDS).
8. Uncontrolled infection with hepatitis B or hepatitis C virus (HBV or HCV) infection; Patients with previously successfully treated HCV, with positive anti-HCV antibody but undetectable (HCV) ribonucleic acid (RNA) levels are allowed on trial.
9. Current use of immunosuppressive medication, except for the following: a. intranasal, inhaled, topical steroids, or local steroid injection ; b. systemic corticosteroids at physiologic doses = 10 mg/day of prednisone or equivalent; c. steroids as premedication for hypersensitivity reactions
10. Any systemic anti-cancer treatment (chemotherapy, targeted systemic therapy) investigational or standard of care, within 28 days of the first dose of Avelumab or planned to occur during the study period. Patients receiving bisphosphonates or denosumab will not be excluded.
11. Pregnant or breastfeeding.
12. History of idiopathic pulmonary fibrosis (including pneumonitis), drug-induced pneumonitis, organising pneumonia (i.e., bronchiolitis obliterans, cryptogenic organising pneumonia), or evidence of active pneumonitis on screening chest CT scan).
13. Uncontrolled cardiac disease including not limited to symptomatic congestive heart failure, unstable angina pectoris, life-threatening cardiac arrhythmia
14. Known prior severe hypersensitivity to investigational product or any component in its formulations, including known severe hypersensitivity reactions to monoclonal antibodies (NCI CTCAE v5 Grade 3).
15. Use of live attenuated vaccines within 28 days of first dose of Avelumab.
16. Any acute or chronic psychiatric problems that, in the opinion of the Investigator, make the patient ineligible for participation due to compliance concerns.
17. Patients with prior allogeneic stem cell or solid organ transplantation.
18. Patients who are involuntarily incarcerated.
19. No evidence of other malignancy in the past 3 years, with exception of tumours with negligible risk of metastasis or death.
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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 administering the treatment/s
The people assessing the outcomes
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 2
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
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
26/10/2020
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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
1/04/2028
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Actual
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Sample size
Target
132
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW,QLD,SA,TAS,VIC
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Recruitment hospital [1]
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Port Macquarie Base Hospital - Port Macquarie
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Recruitment hospital [2]
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Chris O'Brien Lifehouse - Sydney
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Recruitment hospital [3]
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Melanoma Institute Australia - Sydney
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Recruitment hospital [4]
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Royal North Shore Hospital - Sydney
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Recruitment hospital [5]
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Westmead Hospital - Sydney
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Recruitment hospital [6]
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Calvary Mater Hospital - Sydney
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Recruitment hospital [7]
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Southern Medical Day Care Centre - Wollongong
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Recruitment hospital [8]
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Royal Brisbane and Woman's Hospital - Brisbane
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Recruitment hospital [9]
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Cancer Care Service, Bundaberg Base Hospital - Bundaberg
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Recruitment hospital [10]
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Cairns Hospital - Cairns
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Recruitment hospital [11]
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Cancer Care Service, Hervey Bay Hospital - Hervey Bay
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Recruitment hospital [12]
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Mackay Hospital and Health Service - Mackay
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Recruitment hospital [13]
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Townsville Hospital - Townsville
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Recruitment hospital [14]
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Princess Alexandra Hospital - Woolloongabba
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Recruitment hospital [15]
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Royal Adelaide Hospital - Adelaide
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Recruitment hospital [16]
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Icon Cancer Centre Hobart - Hobart
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Recruitment hospital [17]
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Alfred Hospital - Melbourne
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Recruitment hospital [18]
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Peter MacCallum Cancer Centre - Melbourne
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Recruitment postcode(s) [1]
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2444 - Port Macquarie
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Recruitment postcode(s) [2]
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2050 - Sydney
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Recruitment postcode(s) [3]
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2065 - Sydney
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Recruitment postcode(s) [4]
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2145 - Sydney
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Recruitment postcode(s) [5]
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2298 - Sydney
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Recruitment postcode(s) [6]
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2500 - Wollongong
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Recruitment postcode(s) [7]
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4029 - Brisbane
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Recruitment postcode(s) [8]
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4670 - Bundaberg
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Recruitment postcode(s) [9]
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4870 - Cairns
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Recruitment postcode(s) [10]
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4655 - Hervey Bay
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Recruitment postcode(s) [11]
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4740 - Mackay
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Recruitment postcode(s) [12]
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- Townsville
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Recruitment postcode(s) [13]
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4102 - Woolloongabba
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Recruitment postcode(s) [14]
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5000 - Adelaide
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Recruitment postcode(s) [15]
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7000 - Hobart
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Recruitment postcode(s) [16]
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3000 - Melbourne
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Recruitment outside Australia
Country [1]
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New Zealand
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State/province [1]
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Auckland
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Funding & Sponsors
Primary sponsor type
Other
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Name
Melanoma and Skin Cancer Trials Limited
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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 I-MAT trial is a randomised, placebo-controlled, phase II trial of adjuvant Avelumab in patients with stage I-III Merkel cell carcinoma aiming to explore the efficacy of avelumab as adjuvant immunotherapy.
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Trial website
https://clinicaltrials.gov/study/NCT04291885
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Wen Xu, MBBS, FRACP
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Address
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Princess Alexandra Hospital
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Melanoma and Skin Cancer Trials Ltd Project officer
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Address
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Country
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Phone
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+61 3 9903 9022
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Fax
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Email
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[email protected]
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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)?
No
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No/undecided IPD sharing reason/comment
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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/NCT04291885