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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT01189266
Registration number
NCT01189266
Ethics application status
Date submitted
25/08/2010
Date registered
26/08/2010
Date last updated
28/10/2021
Titles & IDs
Public title
Vorinostat and Radiation Therapy Followed by Maintenance Therapy With Vorinostat in Treating Younger Patients With Newly Diagnosed Diffuse Intrinsic Pontine Glioma
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Scientific title
A Phase 1/2 Study of Suberoylanilide Hydroxamic Acid (SAHA, Vorinostat) and Local Irradiation, Followed by Maintenance SAHA in Children With Newly Diagnosed Diffuse Intrinsic Pontine Gliomas (DIPG)
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Secondary ID [1]
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NCI-2011-02600
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Secondary ID [2]
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NCI-2011-02600
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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:
Anaplastic Astrocytoma
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Anaplastic Oligoastrocytoma
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Diffuse Intrinsic Pontine Glioma
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Gliosarcoma
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Condition category
Condition code
Cancer
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Brain
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Cancer
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Children's - Brain
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Other - 3-Dimensional Conformal Radiation Therapy
Treatment: Other - Intensity-Modulated Radiation Therapy
Other interventions - Laboratory Biomarker Analysis
Treatment: Drugs - Vorinostat
Experimental: Arm 1 Phase I Vorinostat 180 mg/m^2 - Patients in phase I received vorinostat at 180 mg/m\^2/day PO on Monday through Friday weekly for the duration of radiation therapy (6-7 weeks). Patients underwent 3D conformal or intensity-modulated radiation therapy 5 days per week for 6 weeks. After completing concurrent vorinostat and radiation therapy, patients then received maintenance therapy comprising of vorinostat at 230 mg/m\^2/day PO on days 1-28. Treatment repeats every 28 days for up to 12 courses in the absence of disease progression or unacceptable toxicity.
Experimental: Arm 2 Phase 1 Vorinostat 230 mg/m^2 - Patients received a higher dose of vorinostat at 230 mg/m\^2/day PO on Monday through Friday weekly for the duration of radiation therapy (6-7 weeks). Patients underwent 3D conformal or intensity-modulated radiation therapy 5 days per week for 6 weeks. After completing concurrent vorinostat and radiation therapy, patients then received maintenance therapy comprising of vorinostat at 230 mg/m\^2/day PO on days 1-28. Treatment repeats every 28 days for up to 12 courses in the absence of disease progression or unacceptable toxicity.
Experimental: Arm 3 Phase II Evaluation Vorinostat 230 mg/m^2 - Patients received a higher dose of vorinostat at 230 mg/m\^2/day PO on Monday through Friday weekly for the duration of radiation therapy (6-7 weeks). Patients underwent 3D conformal or intensity-modulated radiation therapy 5 days per week for 6 weeks. After completing concurrent vorinostat and radiation therapy, patients then received maintenance therapy comprising of vorinostat at 230 mg/m\^2/ day PO on days 1-28. Treatment repeats every 28 days for up to 12 courses in the absence of disease progression or unacceptable toxicity.
Treatment: Other: 3-Dimensional Conformal Radiation Therapy
Undergo 3D conformal radiation therapy
Treatment: Other: Intensity-Modulated Radiation Therapy
Undergo intensity-modulated radiation therapy
Other interventions: Laboratory Biomarker Analysis
Correlative studies
Treatment: Drugs: Vorinostat
Given PO
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Intervention code [1]
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Treatment: Other
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Intervention code [2]
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Other interventions
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Intervention code [3]
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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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Maximum Tolerated Dose (MTD) of Vorinostat
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Assessment method [1]
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The dose of vorinostat in mg/sqm/day to be administered with combination chemotherapy and radiation therapy
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Timepoint [1]
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Planned 7 weeks during chemoradiotherapy
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Primary outcome [2]
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Event-Free Survival
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Assessment method [2]
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Time from enrollment to disease progression, diagnosis of a second malignant neoplasm, death or last follow-up, whichever occurs first.
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Timepoint [2]
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2 years after study enrollment
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Primary outcome [3]
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Incidence of Toxicity During Chemoradiation Therapy
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Assessment method [3]
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Proportion of patients who experience any grade 3 or higher CTC AE Version 4 adverse experience
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Timepoint [3]
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Planned 7 weeks during chemoradiotherapy
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Primary outcome [4]
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Incidence of Toxicity During Maintenance Therapy
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Assessment method [4]
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Proportion of patients who experience any grade 3 or higher CTC AE Version 4 adverse experience
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Timepoint [4]
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Planned 12 months of maintenance with Vorinostat
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Secondary outcome [1]
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Overall Survival
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Assessment method [1]
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Time from enrollment to death or last follow-up, whichever occurs first.
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Timepoint [1]
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2 years after study enrollment
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Secondary outcome [2]
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Change in H3 and H4 Acetylation Levels in PBMCs
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Assessment method [2]
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Degree of acetylation in peripheral blood monocytes will be divided into quartiles and coded as none, mild, moderation or marked.
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Timepoint [2]
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Baseline to up to 7 weeks
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Secondary outcome [3]
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Change in NHEJ Activity in PBMCs
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Assessment method [3]
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Descriptive statistics will be used to summarize the biological/laboratory measures and the changes in these measures across time-points.
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Timepoint [3]
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Baseline to up to 7 weeks
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Secondary outcome [4]
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Levels of DNA Repair Proteins in Paraffin-embedded Blocks, Measured Via Immunohistochemistry or Western Analysis
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Assessment method [4]
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For immunohistochemistry from tumor blocks, the intensity will be graded from 1 to 3; for Western analysis, a percentage of the intensity relative to the tumor with the highest level will be measured.
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Timepoint [4]
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Baseline
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Eligibility
Key inclusion criteria
* Patients with newly diagnosed diffuse intrinsic pontine gliomas (DIPGs), defined as tumors with a pontine epicenter and diffuse involvement of at least 2/3 of the pons, are eligible without histologic confirmation; patients with brainstem tumors that do not meet these criteria or not considered to be typical intrinsic pontine gliomas will only be eligible if the tumors are biopsied and proven to be an anaplastic astrocytoma, glioblastoma multiforme, gliosarcoma, or anaplastic mixed glioma; patients with juvenile pilocytic astrocytoma, fibrillary astrocytoma, gangliogliomas, or other mixed gliomas without anaplasia are not eligible; patients with disseminated disease are not eligible, and magnetic resonance imaging (MRI) of spine must be performed if disseminated disease is suspected by the treating physician
* Karnofsky >= 50% for patients > 16 years of age and Lansky >= 50 for patients =< 16 years of age; patients who are unable to walk because of paralysis, but who are up in a wheelchair, will be considered ambulatory for the purpose of assessing the performance score
* Patients must not have received any prior treatment except dexamethasone and/or surgery
* Peripheral absolute neutrophil count (ANC) >= 1000/uL
* Platelet count >= 100,000/uL (transfusion independent, defined as not receiving platelet transfusions within a 7 day period prior to enrollment)
* Hemoglobin >= 8.0 g/dL (may receive red blood cell [RBC] transfusions)
* Creatinine clearance or radioisotope glomerular filtration rate (GFR) >= 70ml/min/1.73 m^2 or a serum creatinine based on age/gender as follows:
* 0.8 mg/dL (3 to < 6 years of age)
* 1 mg/dL (6 to < 10 years of age)
* 1.2 mg/dL (10 to < 13 years of age)
* 1.5 mg/dL (male) or 1.4 mg/dL (female) (13 to < 16 years of age)
* 1.7 mg/dL (male) or 1.4 mg/dL (female) (>= 16 years of age)
* Bilirubin (sum of conjugated + unconjugated) =< 1.5 x upper limit of normal (ULN) for age
* Serum glutamate pyruvate transaminase (SGPT) (alanine aminotransferase [ALT]) =< 110 U/L; for the purpose of this study, the ULN for SGPT (ALT) is 45 U/L
* Serum albumin >= 2 g/dL
* Patients with seizure disorder may be enrolled if on non-enzyme inducing anticonvulsants (with the exception of valproic acid) and seizures are well controlled
* Patients must be able to swallow capsules or liquids; patients dependent on nasogastric (NG) tube feeding are not permitted to receive protocol therapy
* Enrollment must be no later than 28 days after the date of radiographic diagnosis or surgery, whichever is the later date
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Minimum age
37
Months
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Maximum age
21
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
* Pregnant or breast-feeding women will not be entered on this study; pregnancy tests must be obtained in girls who are post-menarchal; males or females of reproductive potential may not participate unless they have agreed to use an effective contraceptive method
* Growth factors that support platelet or white cell number or function must not have been administered within the 7 days prior to enrollment
* Patients who are currently receiving another investigational drug are not eligible
* Patients who are currently receiving other anti-cancer agents are not eligible
* Patients must not currently be receiving enzyme inducing anticonvulsants
* Patients on valproic acid must discontinue valproic acid for at least 2 weeks before starting protocol therapy
* Patients receiving coumadin, heparin, low-molecular weight heparin, or any other anti-coagulants are not eligible for study entry
* Patients receiving acetylsalicylic acid (ASA) (> 81 mg/day), non-steroidal anti-inflammatory drugs, clopidogrel (Plavix), dipyridamole (Persantine), or any other drug that inhibits platelet function are not eligible for study entry
* Patients who have an uncontrolled infection are not eligible
* Patients who in the opinion of the investigator may not be able to comply with the safety monitoring requirements of the study are not eligible
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Study design
Purpose of the study
Treatment
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Allocation to intervention
NA
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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
Single group
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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
Completed
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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
9/08/2010
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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
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Actual
30/09/2021
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Sample size
Target
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Accrual to date
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Final
79
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Recruitment in Australia
Recruitment state(s)
QLD,WA
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Recruitment hospital [1]
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Royal Children's Hospital-Brisbane - Herston
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Recruitment hospital [2]
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Queensland Children's Hospital - South Brisbane
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Recruitment hospital [3]
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Princess Margaret Hospital for Children - Perth
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Recruitment postcode(s) [1]
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4029 - Herston
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Recruitment postcode(s) [2]
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4101 - South Brisbane
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Recruitment postcode(s) [3]
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6008 - Perth
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Recruitment outside Australia
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United States of America
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Alabama
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United States of America
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Arkansas
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California
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Colorado
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Connecticut
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Delaware
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District of Columbia
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Florida
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Funding & Sponsors
Primary sponsor type
Government body
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Name
National Cancer Institute (NCI)
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Address
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Ethics approval
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Summary
Brief summary
This phase I/II trial studies the side effects and best dose of vorinostat and to see how well it works when given together with radiation therapy followed by maintenance therapy with vorinostat in treating younger patients with newly diagnosed diffuse intrinsic pontine glioma (a brainstem tumor). Vorinostat may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Radiation therapy uses high-energy x-rays to kill tumor cells. Giving vorinostat together with radiation therapy may kill more tumor cells.
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Trial website
https://clinicaltrials.gov/study/NCT01189266
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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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Jack M Su
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Address
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Children's Oncology Group
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Contact person for scientific queries
No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Type
Other Details
Attachment
Study protocol
Study Protocol and Statistical Analysis Plan
https://cdn.clinicaltrials.gov/large-docs/66/NCT01189266/Prot_SAP_000.pdf
Statistical analysis plan
Study Protocol and Statistical Analysis Plan
https://cdn.clinicaltrials.gov/large-docs/66/NCT01189266/Prot_SAP_000.pdf
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results are available at
https://clinicaltrials.gov/study/NCT01189266
Download to PDF