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Trial registered on ANZCTR
Registration number
ACTRN12616000394448
Ethics application status
Approved
Date submitted
29/01/2016
Date registered
24/03/2016
Date last updated
27/10/2016
Type of registration
Retrospectively registered
Titles & IDs
Public title
Efficacy of a maintenance therapy with supplements containing indole-3-carbinol (I3C) and epigallocatechin-3-gallate (EGCG) in ovarian cancer patients
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Scientific title
An open randomized controlled clinical trial to evaluate the efficacy of a maintenance therapy with supplements containing I3C and EGCG in ovarian cancer patients
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Secondary ID [1]
288343
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None
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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:
Ovarian cancer
297331
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Condition category
Condition code
Cancer
297528
297528
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0
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Ovarian and primary peritoneal
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Arm 1
Patients of Arm 1 received neoadjuvant chemotherapy consisted of 2–4 cycles of TP regimen (1st day: paclitaxel 175 mg/m^2 by intravenous 3-h infusion with pre-medication; 2nd day: cisplatin 75-100 mg/m^2 by intravenous >= 1-h infusion with hyper-hydration) or TC regimen (1st day: paclitaxel 175 mg/m^2 by intravenous 3-h infusion with pre-medication; 2nd day: carboplatin AUC 5 by intravenous >= 1-h infusion), every 21 days. Surgical treatment (panhysterectomy with subtotal resection of the greater omentum and the maximum removal of disseminated tumor foci) was carried out 24 days after the last cycle of neoadjuvant chemotherapy. 14 days after surgery patients were treated with postoperative adjuvant chemotherapy consisted of 5-6 cycles of TP regimen or TC regimen every 21 days. Maintenance therapy with oral administration of Indinol Forto (Registered Trademark) (200 mg of I3C 2 times a day continuously) was started 14 days before the primary neoadjuvant therapy and continued after completion of postoperative adjuvant chemotherapy for 5 years of the study.
The number of cycles of chemotherapy depends on time of achieved CA-125 level =<35 U/mL and general declining profile of CA-125; the number of cycles of chemotherapy also varied depending on set of clinical and laboratory data, including physical condition.
Arm 2
Patients of Arm 2 received neoadjuvant chemotherapy consisted of 2–4 cycles of TP regimen (1st day: paclitaxel 175 mg/m^2 by intravenous 3-h infusion with pre-medication; 2nd day: cisplatin 75-100 mg/m^2 by intravenous >= 1-h infusion with hyper-hydration) or TC regimen (1st day: paclitaxel 175 mg/m^2 by intravenous 3-h infusion with pre-medication; 2nd day: carboplatin AUC 5 by intravenous >= 1-h infusion), every 21 days. Surgical treatment (panhysterectomy with subtotal resection of the greater omentum and the maximum removal of disseminated tumor foci) was carried out 24 days after the last cycle of neoadjuvant chemotherapy. 14 days after surgery patients were treated with postoperative adjuvant chemotherapy consisted of 5-6 cycles of TP regimen or TC regimen every 21 days. Maintenance therapy with oral administration of Promisan (Registered Trademark) (200 mg of I3C + 100 mg of EGCG 2 times a day continuously) was started 14 days before the primary neoadjuvant therapy and continued after completion of postoperative adjuvant chemotherapy for 5 years of the study.
The number of cycles of chemotherapy depends on time of achieved CA-125 level =<35 U/mL and general declining profile of CA-125; the number of cycles of chemotherapy also varied depending on set of clinical and laboratory data, including physical condition.
Arm 3
Patients of Arm 3 received neoadjuvant chemotherapy consisted of 2–4 cycles of TP regimen (1st day: paclitaxel 175 mg/m^2 by intravenous 3-h infusion with pre-medication; 2nd day: cisplatin 75-100 mg/m^2 by intravenous >= 1-h infusion with hyper-hydration) or TC regimen (1st day: paclitaxel 175 mg/m^2 by intravenous 3-h infusion with pre-medication; 2nd day: carboplatin AUC 5 by intravenous >= 1-h infusion), every 21 days. Surgical treatment (panhysterectomy with subtotal resection of the greater omentum and the maximum removal of disseminated tumor foci) was carried out 24 days after the last cycle of neoadjuvant chemotherapy. 14 days after surgery patients were treated with postoperative adjuvant chemotherapy consisted of 5-6 cycles of TP regimen or TC regimen every 21 days. Patients also received long-term chemotherapy TP regimen or TC regimen after the last cycle of postoperative adjuvant chemotherapy every 2-3 months for 5 years of the study. Maintenance therapy with oral administration of Promisan (Registered Trademark) (200 mg of I3C + 100 mg of EGCG 2 times a day continuously) was started 14 days before the primary neoadjuvant therapy and continued after completion of postoperative adjuvant chemotherapy for 5 years of the study.
The number of cycles of chemotherapy depends on time of achieved CA-125 level =<35 U/mL and general declining profile of CA-125; the number of cycles of chemotherapy also varied depending on set of clinical and laboratory data, including physical condition.
TP or TC regimen was chosen randomly. Adherence to the intervention was measured by counting returned tablets and checking diaries of self-control.
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Intervention code [1]
293650
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Treatment: Other
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Intervention code [2]
293983
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Treatment: Drugs
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Comparator / control treatment
Control Arm 4
In control Arm 4 patients received surgical treatment (panhysterectomy with subtotal resection of the greater omentum and the maximum removal of disseminated tumor foci) followed by postoperative adjuvant chemotherapy consisted of 5-6 cycles of TP regimen (1st day: paclitaxel 175 mg/m^2 by intravenous 3-h infusion with pre-medication; 2nd day: cisplatin 75-100 mg/m^2 by intravenous >= 1-h infusion with hyper-hydration) or TC regimen (1st day: paclitaxel 175 mg/m^2 by intravenous 3-h infusion with pre-medication; 2nd day: carboplatin AUC 5 by intravenous >= 1-h infusion) every 21 days.
The number of cycles of chemotherapy depends on time of achieved CA-125 level =<35 U/mL and general declining profile of CA-125; the number of cycles of chemotherapy also varied depending on set of clinical and laboratory data, including physical condition.
Control Arm 5
In control Arm 5 patients received neoadjuvant chemotherapy consisted of 2–4 cycles of TP regimen (1st day: paclitaxel 175 mg/m^2 by intravenous 3-h infusion with pre-medication; 2nd day: cisplatin 75-100 mg/m^2 by intravenous >= 1-h infusion with hyper-hydration) or TC regimen (1st day: paclitaxel 175 mg/m^2 by intravenous 3-h infusion with pre-medication; 2nd day: carboplatin AUC 5 by intravenous >= 1-h infusion) every 21 days. Surgical treatment (panhysterectomy with subtotal resection of the greater omentum and the maximum removal of disseminated tumor foci) was carried out 24 days after the last cycle of neoadjuvant chemotherapy. 14 days after surgery patients were treated with postoperative adjuvant chemotherapy consisted of 5-6 cycles of TP regimen or TC regimen every 21 days.
The number of cycles of chemotherapy depends on time of achieved CA-125 level =<35 U/mL and general declining profile of CA-125; the number of cycles of chemotherapy also varied depending on set of clinical and laboratory data, including physical condition.
TP or TC regimen was chosen randomly. Adherence to the intervention was measured by counting returned tablets and checking diaries of self-control.
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Control group
Active
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Outcomes
Primary outcome [1]
297084
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Overall survival defined as the interval between date of diagnosis to the date of death
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Assessment method [1]
297084
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Timepoint [1]
297084
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5 years post standard treatment commencement
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Secondary outcome [1]
320002
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Progression-free survival defined as the earliest disease progression per clinical progression, RECIST, CA-125 progression, or death. CA-125 determination and ultrasonography (US) were conducted every month. Tomographic studies were conducted every 3-4 months.
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Assessment method [1]
320002
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Timepoint [1]
320002
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5 years post standard treatment commencement
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Secondary outcome [2]
320003
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Rate of patients with recurrent ovarian cancer with ascite formation. Detection of ascite formation has been defined by US, tomographic studies, and intraoperative findings.
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Assessment method [2]
320003
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Timepoint [2]
320003
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5 years post standard treatment commencement
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Eligibility
Key inclusion criteria
1) diagnosis of histologically confirmed International Federation Gynecology Obstetrics (FIGO) stage III serous ovarian cancer
2) patients with a general condition corresponding to WHO 0-2
3) absolute granulocyte count >= 1.5 x 10^3/mm^3; platelets >= 100 x 10^3/mm^3
4) adequate liver and renal function (bilirubin, creatinine within normal limits; aspartate aminotransferase (AST) and alanine aminotransferase (ALT) < 2.0 times upper normal limit;
AST and ALT must be < 5.0 times upper normal limit if liver metastases present)
5) absence of significant coexisting diseases (documented history of gastric/duodenal ulcer within last 12 months, polyneuropathy, decompensated diabetes, heart attack within 1 year ago)
6) written informed consent
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Minimum age
39
Years
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Maximum age
No limit
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Sex
Females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1) point mutations in the BRCA genes
2) malignant tumors of other localizations
3) positive RW or HIV tests, alcohol or drug abuse
4) pregnancy or lactation
5) organizational problems which could impair the ability to commit treatment and monitoring (remote accommodation etc.)
6) psychiatric illness or uncontrolled psychiatric condition which may hamper compliance with the trial protocol
7) severe coexisting disease which may, in the opinion of the investigator influence 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
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
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
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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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Date of first participant enrolment
Anticipated
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Actual
12/01/2004
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Date of last participant enrolment
Anticipated
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Actual
30/12/2009
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Date of last data collection
Anticipated
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Actual
16/01/2015
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Sample size
Target
284
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Accrual to date
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Final
284
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Recruitment outside Australia
Country [1]
7535
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Russian Federation
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State/province [1]
7535
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Moscow
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Funding & Sponsors
Funding source category [1]
292706
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Other
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Name [1]
292706
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Russian Scientific Center of Roentgenoradiology
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Address [1]
292706
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86 Profsoyuznaya St., Moscow, 117997, Russia
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Country [1]
292706
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Russian Federation
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Primary sponsor type
Other
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Name
Russian Scientific Center of Roentgenoradiology
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Address
117997 Moscow, Profsoyuznaya str., 86
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Country
Russian Federation
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Secondary sponsor category [1]
291438
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None
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Name [1]
291438
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Address [1]
291438
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Country [1]
291438
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
294192
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The Medical Ethics Committee of the Russian Research Centre of Roentgenology and Radiology
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Ethics committee address [1]
294192
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86 Profsoyuznaya St., Moscow, 117997, Russia.
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Ethics committee country [1]
294192
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Russian Federation
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Date submitted for ethics approval [1]
294192
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Approval date [1]
294192
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03/02/2003
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Ethics approval number [1]
294192
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Summary
Brief summary
An open randomized controlled clinical trial in five arms. The purpose of the trial was to evaluate the efficacy of a maintenance therapy with supplements containing indole-3-carbinol (I3C) and epigallocatechine-3-gallate (EGCG) in ovarian cancer patients. 284 patients >= 39 years with histologically confirmed International Federation Gynecology Obstetrics (FIGO) stage III serous ovarian cancer who met the study criteria were randomized into five arms. Active therapy was conducted for 5 years of the study with control visits at the beginning of the study and then every month. The primary endpoint was overall survival (OS), defined as the interval between date of diagnosis to the date of death. Timepoint: 5 years post standard treatment commencement. Secondary endpoints were progression-free survival (PFS) and rate of patients with recurrent ovarian cancer with ascite formation. PFS was defined as the interval between date of the start of treatment to first documentation of disease progression or death resulting from any cause, including toxic complications. A PFS event defined as the earliest disease progression per clinical progression, RECIST, CA-125 progression, or death. CA-125 determination and ultrasonography (US) were conducted every month. Tomographic studies were conducted every 3-4 months. Detection of ascite formation has been defined by US, tomographic studies, and intraoperative findings. Timepoints of secondary endpoints: 5 years post standard treatment commencement. 5-year survival rate has been increased in the active groups of patients who took the combination of standard chemotherapy, surgery and maintenance therapy with I3C and EGCG (or only I3C). Ovarian cancer patients should be advised the long-term maintenance therapy with indole-3-carbinol and epigallocatechin-3-gallate to reduce the relapse rate and improve tumor susceptibility to standard chemotherapy.
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Trial website
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Trial related presentations / publications
L.A. Ashrafyan, I.B. Antonova, O.I. Aleshikova, E.V. Gerfanova. ESGO-0560. Indole-3-carbinol and epigallocatechin-3-gallate in combination therapy of ovarian cancer. ´International Journal of Gynecological Cancer´ (IJGC): Vol 25, Supplement 2, October 2015.
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Public notes
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Contacts
Principal investigator
Name
62822
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Prof Levon Ashrafyan
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Address
62822
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Russian Scientific Center of Roentgenoradiology
86 Profsoyuznaya St., Moscow, 117997, Russia.
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Country
62822
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Russian Federation
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Phone
62822
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+7 (495) 333-91-20
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Fax
62822
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Email
62822
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[email protected]
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Contact person for public queries
Name
62823
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Evgeniya Gerfanova
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Address
62823
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Russian Scientific Center of Roentgenoradiology
86 Profsoyuznaya St., Moscow, 117997, Russia.
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Country
62823
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Russian Federation
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Phone
62823
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+7 (495) 333-91-20
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Fax
62823
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Email
62823
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[email protected]
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Contact person for scientific queries
Name
62824
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Evgeniya Gerfanova
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Address
62824
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Russian Scientific Center of Roentgenoradiology
86 Profsoyuznaya St., Moscow, 117997, Russia.
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Country
62824
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Russian Federation
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Phone
62824
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+7 (495) 333-91-20
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Fax
62824
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Email
62824
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
A new promising way of maintenance therapy in advanced ovarian cancer: A comparative clinical study.
2018
https://dx.doi.org/10.1186/s12885-018-4792-9
N.B. These documents automatically identified may not have been verified by the study sponsor.
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