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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT05005299
Registration number
NCT05005299
Ethics application status
Date submitted
8/08/2021
Date registered
13/08/2021
Titles & IDs
Public title
Venetoclax in Combination With Non-myeloablative Conditioning Allogeneic Haematopoietic Stem Cell Transplantation
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Scientific title
The VICTORY Study: A Phase I Study of Venetoclax in Combination With Non-myeloablative Conditioning Allogeneic Haematopoietic Stem Cell Transplantation
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Secondary ID [1]
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2021.238
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Universal Trial Number (UTN)
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Trial acronym
VICTORY
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Leukemia, Myeloid, Acute
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Leukemia, Lymphoblastic, Acute, L1
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Leukemia, Lymphoblastic, Acute, L2
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0
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Myelodysplastic Syndromes
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0
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Non-hodgkin Lymphoma
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0
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Plasma Cell Myeloma
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0
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Condition category
Condition code
Cancer
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0
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Leukaemia - Acute leukaemia
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Cancer
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0
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0
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Leukaemia - Chronic leukaemia
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Cancer
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0
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0
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Children's - Leukaemia & Lymphoma
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Cancer
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0
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0
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Lymphoma (non Hodgkin's lymphoma) - High grade lymphoma
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Cancer
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0
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Lymphoma (non Hodgkin's lymphoma) - Low grade lymphoma
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Blood
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0
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Haematological diseases
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Cancer
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Other cancer types
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Blood
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Other blood disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Venetoclax
Treatment: Drugs - Fludarabine
Treatment: Drugs - Cyclophosphamide
Experimental: Dose Level A - Subjects will receive receive short-course venetoclax on day -11 to -6 \[venetoclax 100mg daily administered on day -11 to -6 (total venetoclax dose: 600mg)\], followed by intravenous fludarabine 30mg/m2 daily (day -5 to -3) and intravenous cyclophosphamide 750mg/m2 daily (day -5 to -3). Allogeneic stem cell infusion will occur on day 0.
Experimental: Dose Level B - Subjects will receive receive short-course venetoclax on day -11 to -6 \[venetoclax 100mg daily administered on day -11, followed by 200mg daily administered on day -10 to -6 (total venetoclax dose: 1100mg)\], followed by intravenous fludarabine 30mg/m2 daily (day -5 to -3) and intravenous cyclophosphamide 750mg/m2 daily (day -5 to -3). Allogeneic stem cell infusion will occur on day 0.
Experimental: Dose Level C - Subjects will receive receive short-course venetoclax on day -11 to -6 \[venetoclax 100mg daily administered on day -11, followed by 200mg daily administered on day -10, 400mg daily administered on day -9 and 600mg daily administered on day -8 to -6 (total venetoclax dose: 2500mg)\], followed by intravenous fludarabine 30mg/m2 daily (day -5 to -3) and intravenous cyclophosphamide 750mg/m2 daily (day -5 to -3). Allogeneic stem cell infusion will occur on day 0.
Experimental: Dose Level B' - Subjects will receive receive short-course venetoclax on day -11 to -6 \[venetoclax 100mg daily administered on day -11, followed by 200mg daily administered on day -10 and 400mg daily administered on day -9 to -6 (total venetoclax dose: 1900mg)\], followed by intravenous fludarabine 30mg/m2 daily (day -5 to -3) and intravenous cyclophosphamide 750mg/m2 daily (day -5 to -3). Allogeneic stem cell infusion will occur on day 0.
Treatment: Drugs: Venetoclax
Venetoclax is administered as an oral tablet once daily.
Treatment: Drugs: Fludarabine
Fludarabine is administered as an intravenous infusion at a dose of 30mg/m2 daily, to be administered over 30 minutes.
Treatment: Drugs: Cyclophosphamide
Cyclophosphamide is administered as an intravenous infusion at a dose of 750mg/m2 daily, to be administered over 30 minutes and to commence 1 hour after fludarabine 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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The development of any dose-limiting toxicities
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Assessment method [1]
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Dose-limiting toxicities (DLT), defined as any of the following which cannot be clearly attributed to a concurrent illness, concomitant medication or those expected as part of standard allogeneic stem cell transplant (alloSCT) complications:
* Any grade 3-4 non-haematological adverse events between day -11 to day -1
* Primary failure of neutrophil engraftment by day 30 post-alloSCT. The date of neutrophil engraftment is defined as the first of 3 consecutive days of neutrophil count = 0.5 x 10\^9/L.
* Primary failure of platelet engraftment by day 30 post-alloSCT. The date of platelet engraftment is defined as the first day of platelet count = 20 x 10\^9/L, with no transfusions for at least 7 days prior.
* Grade 3-4 acute graft-versus-host disease (GVHD) prior to day 30 post-alloSCT
* Development of Clinical Tumour Lysis Syndrome
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Timepoint [1]
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Time point between time of first dose of venetoclax to day 30 post-alloSCT
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Secondary outcome [1]
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Acute GVHD incidence and severity
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Assessment method [1]
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Acute GVHD (grade 1-4 and grade 3-4) is classified according to the Przepiorka criteria
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Timepoint [1]
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180 days post allo-SCT
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Secondary outcome [2]
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Chronic GVHD incidence and severity
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Assessment method [2]
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Chronic GVHD (mild, moderate or severe) is classified according to the Filipovich criteria
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Timepoint [2]
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1-year post-alloSCT
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Secondary outcome [3]
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GVHD, relapse-free survival (GRFS) incidence
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Assessment method [3]
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GRFS is defined as freedom from grade 3-4 acute GVHD, systemic therapy-requiring chronic GVHD, relapse or death in the first year following alloSCT
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Timepoint [3]
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1-year post-alloSCT
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Secondary outcome [4]
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Relapse and non-relapse mortality incidence
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Assessment method [4]
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Relapse is defined as recurrence of disease, determined by radiological or histological grounds.
Non-relapse mortality is defined as all-cause mortality without recurrence or progressive disease following alloSCT.
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Timepoint [4]
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1-year post-alloSCT
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Secondary outcome [5]
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Donor/recipient chimerism
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Assessment method [5]
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Myeloid and T-cell chimerism by fragment analysis and capillary electrophoresis of shor tandem repeat markers.
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Timepoint [5]
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Measured at days 30, 60, 100, 1 year and 2 years following alloSCT
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Eligibility
Key inclusion criteria
Patients are eligible for inclusion if all of the following criteria are met:
* Age = 18 years
* Planned to undergo alloSCT for one of the following haematological malignancies: acute leukaemia (including myeloid and/or lymphoid lineage or biphenotypic), myelodysplastic syndrome, chronic lymphocytic leukaemia (CLL), B-cell non-Hodgkin lymphoma (NHL) and plasma cell myeloma
* Physician preference for a non-myeloablative conditioning regimen
* Available 10/10 HLA-matched related or unrelated haematopoietic stem cell donor
* Transplantation to be performed from a peripheral blood stem cell source
* Adequate renal and hepatic function at screening as follows:
1. Calculated creatinine clearance >50ml/min as measured by Cockroft Gault formula
2. AST and ALT = 3.0 x ULN
3. Bilirubin = 1.5 x ULN (except patients with Gilbert's Syndrome)
* Able to tolerate oral medications
* Disease status at the time of transplantation as follows:
1. Acute leukaemia in complete morphologic remission
2. Myelodysplastic syndrome with less than 10% bone marrow blasts
3. CLL in complete remission (CR), partial response (PR) or PR with lymphocytosis
4. NHL in CR or PR
5. Myeloma in CR, very good partial response (VGPR) or PR within 3 months of prior autologous stem cell transplantation as part of a tandem auto-allo transplant approach
* ECOG performance status 0-1
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Minimum age
18
Years
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Maximum age
75
Years
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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
Patients will be excluded from this study if any of the following criteria are met:
* Moderate or high risk of tumour lysis syndrome prior to conditioning for allogeneic transplantation, defined as:
1. For CLL: Diameter of any lymph node or tumour mass >5cm OR absolute lymphocyte count=25x10^9/L
2. For NHL: Diameter of any lymph node or tumour mass >5cm
* Prior intolerance of venetoclax or another BCL-2 inhibitor with the exception of cytopenias. Patients with prior clinical tumour lysis syndrome following venetoclax or other BCL-2 inhibitor will be excluded from the study if at the time of prior TLS their disease burden was as follows:
1. For CLL: Diameter of any lymph node or tumour mass <5cm OR absolute lymphocyte count=25x10^9/L
2. For NHL: Diameter of any lymph node or tumour mass <5cm
* Reticulin fibrosis of the marrow of grade MF 2-3
* Prior allogeneic stem cell transplantation
* Haemopoietic cell transplantation - comorbidity index (HCT-CI) score > 5
* Any currently active malignancy other than the primary indication for alloSCT (except localized basal cell carcinoma or squamous cell carcinoma of the skin)
* Uncontrolled systemic infection
* Known malabsorption syndrome
* Has received within 7 days prior to the first dose of venetoclax CYP3A4 inducers such as rifampicin, carbamazepine, phenytoin and St John's wort
* Has received within 7 days prior to the first dose of venetoclax CYP3A4 inhibitors
* Known positivity to HIV
* Significant physical or psychiatric comorbid illness that in the investigator's opinion would impair the patient's ability to participate in the study.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised 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
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Other
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Other design features
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Phase
Phase 1
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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
8/06/2022
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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
31/03/2026
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Actual
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Sample size
Target
18
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
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Melbourne Health - Melbourne
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Recruitment postcode(s) [1]
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3050 - Melbourne
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Funding & Sponsors
Primary sponsor type
Other
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Name
Melbourne Health
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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
This is a Phase 1, open-label, single center study of short-course oral venetoclax therapy prior to non-myeloablative conditioning with fludarabine and cyclophosphamide in subjects with haematological malignancies who are planned for allogeneic stem cell transplantation (alloSCT). The primary study objective is to determine the safety and maximum tolerated dose of venetoclax when used in combination with fludarabine and cyclophosphamide conditioning. Secondary objectives were to evaluate the transplant outcomes and donor/recipient engraftment of this regimen.
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Trial website
https://clinicaltrials.gov/study/NCT05005299
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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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David Ritchie
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Address
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Melbourne Health
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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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David Ritchie
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Address
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Country
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Phone
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+61393427000
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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/NCT05005299