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Trial registered on ANZCTR
Registration number
ACTRN12616001532493
Ethics application status
Approved
Date submitted
18/10/2016
Date registered
7/11/2016
Date last updated
20/01/2020
Date data sharing statement initially provided
20/01/2020
Date results provided
20/01/2020
Type of registration
Prospectively registered
Titles & IDs
Public title
Interaction between inulin supplementation and cyclophosphamide therapy in patients with breast cancer
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Scientific title
Expression of gluthatione S-Transferase isoforms, GSTT1, GSM1 and GSTP1 in women with breast cancer undergoing neoadjuvant chemotherapy and inulin supplementation.
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Secondary ID [1]
290285
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None
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Universal Trial Number (UTN)
U1111-1188-5265
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Trial acronym
GICBC
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Breast cancer
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Cachexy
300522
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Chemotherapy toxicity
300523
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Condition category
Condition code
Cancer
300382
300382
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0
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Breast
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Breast cancer female patients will be suplemented with inulin (15g/day) upon cyclofosfamide therapy. This supplementation will be performed daily for 21 days, it will start the day after the administration of cyclofosfamide (regardless the combination with other chemotherapeutic agents or the therapy round).
Inulin will be given as oral powder mixed in 250mL of water. In order to monitor adherence a food diary will be used as well as social networks (WhatsApp and Facebook). Moreover, hospital records of laboratory tests for albumin, transferrin and hemoglobin will be considered.
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Intervention code [1]
296089
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Treatment: Other
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Comparator / control treatment
There will be a control group (n=19) that will receive maltodextrin instead of inulin for the same period of supplementation (21 days).
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Control group
Placebo
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Outcomes
Primary outcome [1]
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The change in GSTP1 mRNA expression in lymphocytes will be analyzed by qPCR.
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Assessment method [1]
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Timepoint [1]
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Measures will be perfomed previuosly (day 0) and after inulin supplementation (21 days).
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Primary outcome [2]
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The change in GSTM1 mRNA expression in lymphocytes will be analyzed by qPCR.
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Assessment method [2]
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Timepoint [2]
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Measures will be perfomed previuosly (day 0) and after inulin supplementation (21 days).
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Primary outcome [3]
299992
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The change in GSTT1 mRNA expression in lymphocytes will be analyzed by qPCR.
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Assessment method [3]
299992
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Timepoint [3]
299992
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Measures will be perfomed previuosly (day 0) and after inulin supplementation (21 days).
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Secondary outcome [1]
328297
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Determination of body mass index will be performed using an InBody230 bioimpedance apparatus.
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Assessment method [1]
328297
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Timepoint [1]
328297
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The analysis will be performed 1 day before cyclophosphamide exposure, and on day 1 once supplementation is finished.
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Secondary outcome [2]
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Presence of gastrointestinal (nausea, vomit, diarrea) adverse events. This will be perfomed using "The service daily report of adverse events of the ISSEMYM Cancer Center".
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Assessment method [2]
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Timepoint [2]
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This evaluation will be performed upon cyclophosphamide and inulin exposure and after last day of inulin supplementation (day 22).
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Secondary outcome [3]
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Percentage of body fat mass will be determined using a Inbody230 bioimpedance apparatus.
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Assessment method [3]
328766
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Timepoint [3]
328766
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The analysis is performed 1 day before cyclophosphamide exposure, and on day 1 once supplementation is finished.
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Secondary outcome [4]
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Lean mass percentage will be determined using a InBody230 bioimpedance apparatus
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Assessment method [4]
328794
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Timepoint [4]
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The analysis is performed 1 day before cyclophosphamide exposure, and on day 1 once supplementation is finished.
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Secondary outcome [5]
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Lean mass distribution will evaluated using a Inbody230 bioimpedance apparatus.
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Assessment method [5]
328795
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Timepoint [5]
328795
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The analysis is performed 1 day before cyclophosphamide exposure, and on day 1 once supplementation is finished.
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Secondary outcome [6]
328796
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Body water content will be evaluated using a Inbody230 bioimpedance apparatus.
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Assessment method [6]
328796
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Timepoint [6]
328796
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The analysis will be performed 1 day before cyclophosphamide exposure, and on day 1 once supplementation is finished.
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Secondary outcome [7]
328797
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Body fat distribution will be evaluated using a InBody230 bioimpedance apparatus.
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Assessment method [7]
328797
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Timepoint [7]
328797
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The analysis is performed 1 day before cyclophosphamide exposure, and on day 1 once supplementation is finished.
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Eligibility
Key inclusion criteria
Patients with clinical diagnosis of breast cancer, with score "0" according to the scale "Eastern Cooperative Oncology Group" (ECOG) .
Patients who agree to participate and provide the required information.
Patients with chemotherapy scheme with cyclophosphamide alone or in combination with methotrexate, 5-fluorouracil and doxorubicin.
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Minimum age
34
Years
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Maximum age
70
Years
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Sex
Females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Patients with an ECOG score greater than or equal to 1.
Patients who do not sign informed consent.
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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)
Sealed opaque envelopes
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Coin tossing
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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
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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
Safety/efficacy
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Statistical methods / analysis
Sample size: non probabilistic, depending on number of patients registered at the hospital that are under cyclophosphamide therapy.
Analysis of GST mRNA expression: Mann Whitney U test
Adverse events: odds ratio, chi-squared
BMI: 2 way ANOVA
Fat and lean mass distribution as %: Friedman test
Content of water as %: Friedman test
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/12/2016
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Actual
9/01/2017
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Date of last participant enrolment
Anticipated
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Actual
9/05/2017
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Date of last data collection
Anticipated
29/12/2017
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Actual
30/06/2017
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Sample size
Target
60
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Accrual to date
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Final
40
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Recruitment outside Australia
Country [1]
8302
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Mexico
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State/province [1]
8302
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Estado de Mexico
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Funding & Sponsors
Funding source category [1]
294680
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University
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Name [1]
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Reseacrh Board of Universidad Autonoma del Estado de Mexico (UAEMEX), grant # 4319/2017CI
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Address [1]
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Instituto Literario 100-A Poniente, Centro, 50000 Toluca, MEX
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Country [1]
294680
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Mexico
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Funding source category [2]
294812
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University
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Name [2]
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Centro de Investigacion Medica (CICMED)
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Address [2]
294812
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Jesus Carranza #205, ZC 50130
Toluca, Estado de Mexico
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Country [2]
294812
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Mexico
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Primary sponsor type
University
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Name
Universidad Autonoma del Estado de Mexico- Facultad de Medicina
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Address
Paseo Tollocan esq. Jesus Carranza w/o number, ZC 50180
Toluca, Estado de Mexico
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Country
Mexico
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Secondary sponsor category [1]
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Hospital
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Name [1]
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Centro Oncologico ISSEMYM
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Address [1]
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Avenida Solidaridad Las Torres #101, Col. del Parque, ZC50180
Toluca, Estado de Mexico
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Country [1]
293528
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Mexico
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
296105
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Ethics Commitee of the "Centro Oncologico ISSEMYM"
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Ethics committee address [1]
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Avenida Solidaridad Las Torres #101, Col. del Parque, ZC 50180 Toluca, Estado de Mexico
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Ethics committee country [1]
296105
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Mexico
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Date submitted for ethics approval [1]
296105
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02/05/2016
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Approval date [1]
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26/05/2016
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Ethics approval number [1]
296105
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COE-UEI-/08/PT/2016
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Summary
Brief summary
Cyclophosphamide is one of the major drugs used in the treatment of breast cancer, however it has adverse effects that influence the quality of life, the response to cancer therapy and disease prognosis. The family of enzymes "Glutathione S-transferase" (GST) is essential for carrying out detoxification reactions from cyclophosphamide chemotherapy, allowing proper excretion of the drug. For this reason these enzymes are essential in the occurrence and degree of adverse effects resulting from drug chemotherapy. However, little is known about chemotherapy adjuvants to reduce the appearance of side effects such as leukopenia, nausea, vomiting, diarrhea and anorexia. In particular, inulin, an indigestible carbohydrate, generates short-chain fatty acids (SCFA) through colonic fermentation. SCFA may decrease the progression of leukemia in vitro, diarrheal episodes and anorexia. They also increase life expectancy by 70% in animal models treated with cyclophosphamide and synergistically supplemented with inulin. It also has important benefits such as stimulating the growth of probiotics in the colon like Bifidobacterium and Lactobacillus, and decreasing pathogenic microorganisms like Clostridium coccoides. Moreover, inulin fermentation enhances mucus production, ion absorption, bicarbonate formation in HIV patients and decreased serum triglycerides in patients with hypercholesterolemia. Consequently, these substances modulate immune function, possibly by improving health, quality and life expectancy. The hypothesis of this study is that inulin supplementation after cyclophosphamide therapy in patients with breast cancer modulates GSTT1, GSTM1 and GSTP1 mRNA and reduces gastrointestinal adverse reactions. The aims of this study are: 1. To determine whether mRNA of GSTT1, GSTM1 and GSTP1 in lymphocytes from patients under cyclophosphamide therapy is modified upon inulin supplementation; 2. To determine whether inulin supplementation reduces gastrointestinal adverse effect of cyclophosphamide therapy. In order to prove that, we designed a randomized triple blind study where a group of female breast cancer patients from the ISSEMyM State Cancer Center will be supplemented with inulin (15g/day) for 21 days after cyclophosphamide administration. Simultaneously, a second group of patients will receive maltodextrine for the same period of time as a control. The results of this study will provide insights about the utilization of inulin as a potential prebiotic adjuvant during chemotherapy and the mechanistic role of GST in the detoxification process upon cyclophosphamide exposure in humans.
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Trial website
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Trial related presentations / publications
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Public notes
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Attachments [1]
1182
1182
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/AnzctrAttachments/371615-Bioethic approval GST-inulin.pdf
(Ethics approval)
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Contacts
Principal investigator
Name
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Prof Alexandra Estela Soto-Pina
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Address
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Facultad de Medicina-Universidad Autonoma del Estado de Mexico
Paseo Tollocan esq. Jesus Carranza w/o number, ZC 50180 Toluca, Estado de Mexico
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Country
69518
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Mexico
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Phone
69518
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+52 722 2173552 ext 122
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Fax
69518
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Email
69518
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[email protected]
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Contact person for public queries
Name
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Yizel Becerril Alarcón
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Address
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Facultad de Medicina-Universidad Autonoma del Estado de Mexico
Paseo Tollocan esq. Jesus Carranza w/o number, ZC 50180 Toluca, Estado de Mexico
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Country
69519
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Mexico
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Phone
69519
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+52 722 5689666
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Fax
69519
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Email
69519
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[email protected]
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Contact person for scientific queries
Name
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Saúl Campos Gómez
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Address
69520
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Centro Oncológico Estatal ISSEMYM
Av. Solidaridad Las Torres No. 101, Esq. Prolongación Benito Juárez. Col. Del Parque.
50180 Toluca, Estado de Mexico
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Country
69520
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Mexico
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Phone
69520
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+52 55 2755 7562
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Fax
69520
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Email
69520
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
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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
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Inulin supplementation reduces systolic blood pressure in women with breast cancer undergoing neoadjuvant chemotherapy.
2019
https://dx.doi.org/10.1155/2019/5707150
N.B. These documents automatically identified may not have been verified by the study sponsor.
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