Please note that the copy function is not enabled for this field.
If you wish to
modify
existing outcomes, please copy and paste the current outcome text into the Update field.
LOGIN
CREATE ACCOUNT
LOGIN
CREATE ACCOUNT
MY TRIALS
REGISTER TRIAL
FAQs
HINTS AND TIPS
DEFINITIONS
Trial Review
The ANZCTR website will be unavailable from 1pm until 3pm (AEDT) on Wednesday the 30th of October for website maintenance. Please be sure to log out of the system in order to avoid any loss of data.
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been endorsed by the ANZCTR. Before participating in a study, talk to your health care provider and refer to this
information for consumers
Download to PDF
Trial registered on ANZCTR
Registration number
ACTRN12622001339741
Ethics application status
Approved
Date submitted
16/09/2022
Date registered
18/10/2022
Date last updated
20/02/2024
Date data sharing statement initially provided
18/10/2022
Type of registration
Prospectively registered
Titles & IDs
Public title
A First-in-Human Study to Evaluate the Safety and Tolerability of HH3806 in Patients With Advanced Tumors
Query!
Scientific title
A Phase I, Open-label, Multicenter, First in Human Study to Evaluate the Safety and Tolerability of HH3806 in Patients with Advanced Malignancies
Query!
Secondary ID [1]
307823
0
HH3806-A101
Query!
Universal Trial Number (UTN)
Query!
Trial acronym
Query!
Linked study record
Query!
Health condition
Health condition(s) or problem(s) studied:
Solid Tumors
327617
0
Query!
relapsed/refractory Non-Hodgkin’s lymphomas (NHL)
327618
0
Query!
Condition category
Condition code
Cancer
324706
324706
0
0
Query!
Any cancer
Query!
Intervention/exposure
Study type
Interventional
Query!
Description of intervention(s) / exposure
HH3806 is a novel highly potent and selective inhibitor against the BD2 of bromo- and extra-terminal domain (BET ) proteins family (BET-BD2). BET family proteins is known to play important roles in human cancers, associated with tumour cell growth. HH3806 has exhibited strong anti-tumor effects in pre-clinical and animal studies.
In this First-In Human study, HH3806 is being studied for the treatment of advanced non-Hodgkin’s lymphomas (NHL), solid tumours and will evaluate the safety and tolerability of HH3806.
Approximately 36 participants with either relapsed/ refractory NHL or solid tumours will be enrolled in this study.
HH3806 capsule will be administered as an oral capsule once daily for the duration of each 28-day treatment cycle without any study treatment interruption between each cycle. The starting dose level of HH3806 is 10 mg once daily and the decision to dose escalate to the next dose level will be made based on the emerging safety data. Dosing schedule and cycle may be adjusted during the study on the basis of this data. The provisional dose in the dose escalation planned for this study is 10mg, 20mg, 30mg, 40mg, 50mg, 60mg, 75mg, 90mg, 110mg, 135mg and 165mg once daily.
The dose level for individual participants will vary depending on the dose level enrolling participants at the time of study entry.
HH3806 will be administered at the clinic on days 1, 8, 15 and 22 of cycle 1 & days 1 and 15 of cycle 2. It is to be taken at home on the others days. HH3806 will also be administered at clinic on approx. 3 days before cycle 1 if you are first participant in first 3 dose levels. The participants will complete a dosing diary to record time when HH3806 capsules are taken each day.
Intra-patient dose escalation is not permitted at any time within the first four cycles of treatment. After the first four cycles are completed and the participant must have not experienced CTCAE v5.0 grade greater than or equal to 2 HH3806 related toxicity over at least four cycles of therapy at the lower dose, the participant may be considered for treatment at a higher dose of HH3806, which can be only the last cleared dose level of the study drug.
The participant who develops any non-DLT during DLT observation period, treatment may be interrupted depending on the grade of AE, but dose modification is not allowed in first cycle. In principle, each participant is only allowed 2 dose reductions. If participant need to modify dose for the third time, the investigator must contact the sponsor to evaluate patient’s benefit and interest, then make the decision together.
HH3806 dispensing and administration will also be documented as per study guidelines which will be monitored, and accountability assessed by Sponsor representatives.
Study treatment could be continued until disease progression, unacceptable toxicity, death or withdrawal of consent until the date of the last data collection (1 year post-treatment commencement), whichever occurs first.
After the completion of the study, if a patient still requires administration of HH3806 which has been assessed as beneficial per the study doctor, the sponsor and the study doctor will discuss the post-study provisions for the patient’s access to HH3806.
Query!
Intervention code [1]
324417
0
Treatment: Drugs
Query!
Comparator / control treatment
No control group
Query!
Control group
Uncontrolled
Query!
Outcomes
Primary outcome [1]
332524
0
To determine the Maximum Tolerated Dose (MTD) and/or to establish the Recommended Phase 2 Dose (RP2D, dose for the following study of HH3806) by evaluating the incidence rate of Dose-limiting toxicity (DLT). A DLT could be neutropenia (low count of neutrophils, a type of white blood cells), anaemia (low red blood cells), thrombocytopenia (low platelet level), increase in level of enzymes in the liver, nausea, vomiting, diarrhoea, fatigue, cardiac disorders (myocarditis (inflammation in the heart wall)).
1.Blood tests are used to assess full blood count and liver function, including neutropenia, anaemia, thrombocytopenia and increase in level of enzymes in the liver.
2.The National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) (Version 5) is used to assess the incidence, severity and relationship of treatment-emergent adverse events including nausea, vomiting, diarrhoea, fatigue.
3.Echocardiography is used to assess for cardiac disorders.
Query!
Assessment method [1]
332524
0
Query!
Timepoint [1]
332524
0
Assessment will be performed throughout Day 1 to Day 28 (cycle 1: the first treatment cycle) of each dose level. All patients will be closely monitored and will be seen at the clinic, specifically:
1.Blood tests will be performed on Day 1, Day 8, Day 15 and Day 22 of Cycle 1.
2.Daily from the screening, the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) (Version 5) is used to assess the incidence, severity and relationship of treatment-emergent adverse events including nausea, vomiting, diarrhoea, fatigue upon the AE occurs.
3.Echocardiography will be performed on Day 1, Day 8, Day 15 and Day 22 of Cycle 1 and as needed.
Query!
Primary outcome [2]
332525
0
To evaluate the Safety and tolerability of HH3806, which will be measured by a composite of:
1. Incidence and severity (as graded by National Cancer Institute Common Terminology Criteria for Adverse Events version 5.0 [NCI CTCAE v5.0]) of treatment-emergent AEs (TEAEs), serious adverse events (SAEs), and adverse events (AEs) leading to discontinuation from study treatment
2. Clinical laboratory analyses including Aspartate aminotransferase, Alanine aminotransferase, creatinine, Platelets, total bilirubin, hemoglobin, activated partial prothrombin time (APTT) and international normalized ratio (INR) and Cardiac enzymes (troponin T/I), all assessed by blood test.
3. Left ventricular ejection fraction (LVEF) assessed by echocardiogram
4. Vital signs-heart rate by pulse oximeter, blood pressure by sphygmomanometer and temperature by thermometer.
5. Eastern Cooperative Oncology Group (ECOG) performance status,
6. Physical examination finding - weight assessed using digital standing scales.
Query!
Assessment method [2]
332525
0
Query!
Timepoint [2]
332525
0
1. AE- Daily from first treatment dose until 28 days after the last treatment dose
2. Clinical laboratory - at screening, Day 1, Day 8, Day 15 and Day 22 of Cycle 1, Day 1 and Day 15 of Cycle 2, Day 1 of Cycle 3 and Subsequent cycles, End of treatment visit (within 7 days after the last treatment dose), safety follow up visit (28 days after the last dose)
3. LVEF is examined with echocardiography every 12 weeks for the duration of treatment and if clinically indicated.
4. Vital signs- At screening, Day 1, Day 8, Day 15 and Day 22 of Cycle 1, Day 1 and Day 15 of Cycle 2, Day 1 of Cycle 3 and Subsequent cycles, End of treatment visit (within 7 days after the last treatment dose), safety follow up visit (28 days after the last dose)
5. ECOG-at Screening, Day 1 of Cycle 1, Cycle 2, Cycle 3 and Subsequent cycles, end of treatment visit (within 7 days after the last treatment dose) and safety follow up visit (28 days after the last dose)
6. Physical examination (weight) - at Screening, Day 1 of Cycle 1, Cycle 2, Cycle 3 and Subsequent cycles, end of treatment visit (within 7 days after the last treatment dose) and safety follow up visit (28 days after the last dose)
Query!
Secondary outcome [1]
413817
0
To characterize the pharmacokinetic (PK) of HH3806 by evaluating the HH3806 and metabolites plasma concentration-time profiles and PK parameters, including Cmax, Tmax, AUC0-24h, AUCinf. Other PK parameters such as CL/F, Vz/F and the terminal half-life (T1/2), Accumulation Ratio (Rac_AUC /Rac_Cmax). These parameters will be calculated from serum concentration of HH3806 using blood samples collected at various time points.
Query!
Assessment method [1]
413817
0
Query!
Timepoint [1]
413817
0
Blood samples for the PK analysis will be collected at the following timepoints:
Cycle 1 Day 1 pre-dose, Cycle 1 Day 15 at pre-dose and 0.5, 1, 2, 3, 4, 6, 8, 12 and 24 hours post dose, pre-dose on Cycle 1 Day 8, Cycle 1 Day 22 and pre-dose on Day 1 of cycles 2, 3, 4, 5 and the day of End of Treatment visit (within 7 days of the last dose of study drug or within 7 days of the decision to discontinue study treatment).
Query!
Secondary outcome [2]
413818
0
To assess the preliminary efficacy of HH3806 in patients with advanced malignancies by calculating the Objective response rate (ORR) defined as the proportion of patients with a second confirmed completed response (CR) or partial response (PR) as evaluated according to RECIST v1.1 by CT scans for solid tumor and according to the Lugano Classification for NHL by CT/MRI and PET-CT scans.
Query!
Assessment method [2]
413818
0
Query!
Timepoint [2]
413818
0
The tumor assessment will be performed every 6 weeks (±7 days) after the first dose of HH3806 from Cycle 1 Day 1 (C1D1) until 1 year post-treatment commencement, followed by every 12 weeks (±7 days) until disease progression, intolerability or withdrawal of consent.
Query!
Secondary outcome [3]
414282
0
To assess the preliminary efficacy of HH3806 in patients with advanced malignancies by calculating the Disease control rate (DCR) defined as the proportion of patients with confirmed CR, PR and Stable disease (SD) as evaluated according to RECIST v1.1 by CT scans for solid tumor and according to the Lugano Classification for NHL by CT/MRI and PET-CT scans lasting for greater than or equal to 4 weeks.
Query!
Assessment method [3]
414282
0
Query!
Timepoint [3]
414282
0
The tumor assessment will be performed every 6 weeks (±7 days) after the first dose of HH3806 from Cycle 1 Day 1 (C1D1) until 1 year post-treatment commencement, followed by every 12 weeks (±7 days) until disease progression, intolerability or withdrawal of consent.
Query!
Secondary outcome [4]
414283
0
To assess the preliminary efficacy of HH3806 in patients with advanced malignancies by calculating the Duration of Response (DOR) defined as the time from first confirmed CR or PR as evaluated according to RECIST v1.1 by CT scans for solid tumor and according to the Lugano Classification for NHL by CT/MRI and PET-CT scans to tumor progression or death due to any reason, whichever comes first. If no tumor progression or death is observed, censoring will be made at the date of the last tumor imaging.
Query!
Assessment method [4]
414283
0
Query!
Timepoint [4]
414283
0
The tumor assessment will be performed every 6 weeks (±7 days) after the first dose of HH3806 from Cycle 1 Day 1 (C1D1) until 1 year post-treatment commencement, followed by every 12 weeks (±7 days) until disease progression, intolerability or withdrawal of consent.
Query!
Secondary outcome [5]
414284
0
To assess the preliminary efficacy of HH3806 in patients with advanced malignancies by calculating the Time to Response (TTR) defined as the time from the first dose of study treatment to confirmed CR or PR as evaluated according to RECIST v1.1 by CT scans for solid tumor and according to the Lugano Classification for NHL by CT/MRI and PET-CT scans
Query!
Assessment method [5]
414284
0
Query!
Timepoint [5]
414284
0
The tumor assessment will be performed every 6 weeks (±7 days) after the first dose of HH3806 from Cycle 1 Day 1 (C1D1) until 1 year post-treatment commencement, followed by every 12 weeks (±7 days) until disease progression, intolerability or withdrawal of consent.
Query!
Eligibility
Key inclusion criteria
1. Male and female patients 18years of age or older .
2. Provide informed consent voluntarily prior to initiation of any study-related procedures.
3. Tumor type criteria: Histologically or cytologically confirmed diagnosis of one of the following advanced malignancy:
a) Solid tumors that meet the following criteria:
- Measurable disease by RECIST v1.1 in at least 1 site with the exception of Castration-Resistant Prostate Cancer (CRPC), who may be enrolled with objective evidence of disease as per certain criteria; disease progression with the last line of therapy and at least one prior standard of care regimens, or for which there is no approved therapy, or for which standard therapy is unsuitable or refused. Patients must have disease not amenable to surgery, radiation, or combined modality therapy with curative intent. Patients without treatment options available known to provide clinical benefit are also eligible
b) Relapsed/refractory NHL must have received at least 2 prior systemic therapies and there is no standard salvage regimen available.
4. Life expectancy greater than or equal to 3 months.
5. ECOG performance status less than or equal to 1.
6. Patient must have adequate organ function measured within 28 days of screening.
Query!
Minimum age
18
Years
Query!
Query!
Maximum age
No limit
Query!
Query!
Sex
Both males and females
Query!
Can healthy volunteers participate?
No
Query!
Key exclusion criteria
Patients are ineligible for this study if they meet any of the following criteria:
1. Anticancer therapy (including chemotherapy, targeted therapy, biotherapy, hormone therapy, traditional Chinese medication with cancer indication or other investigational agents) within 4 weeks or 5 times of half-lives (whichever is shorter) prior to the first dose of the study drug.
2. Patients who had prior treatment with any BET inhibitor.
3. Radical radiation therapy within 4 weeks prior to the first dose of the investigational product or received local palliative radiation therapy for bone metastases within 2 weeks.
4. Any toxicities from prior treatment that have not recovered to baseline or less than or equal to NCI-CTCAE v5.0 Grade 1 before the start of study treatment, except for Adverse Events not considered a likely safety risk.
5. Patients who have been treated with any hematopoietic colony-stimulating growth factors 2 weeks prior to starting study drug.
6. Patients who have symptomatic CNS metastasis which is neurologically unstable or those who have CNS disease requiring increase in the dose of steroid. (Note: Patients with controlled CNS metastasis can participate in the trial. Before entering the study, patients should have finished radiotherapy, or have received operation for CNS tumor metastasis at least two weeks before. Patients’ neurological function must be in a stable state; no new neurological deficit is found during clinical examination and no new abnormality is found during CNS imaging examinations. If patients need to use steroids to treat CNS metastasis, the therapeutic dose of steroid should be stable for 3 months at least two weeks prior to entering the study with treatment dose no more than dexamethasone 4 mg daily or an equivalent dose of steroids).
7. Major surgery or had significant traumatic injury within 28 days prior to the first dose of the investigational product or has not recovered from major side effects.
8. Patients with prior immunodeficiency, or organ transplantation or patients after allogeneic stem cell transplantation if they are less than 100 days has elapsed from the day of transplantation, they are on any treatment for graft-versus-host disease, or they have not been off calcineurin inhibitors for at least 4 weeks are excluded.
9. Patients diagnosed with cataract who have not undergone surgery and do not meet either of the following conditions: best corrected visual acuity greater than or equal to 0.6, Postmydriatic LOCS III lens opacity classification criteria: posterior subcapsular (P) = 0, cortex (C) less than or equal to 2, nuclear (N) less than or equal to 2.
10. Known HIV.
11. Active hepatitis B and hepatitis C.
12. Patients with clinically significant cardiovascular disease.
13. Any active malignancy 2 years before the first dose of study drugs, except for the specific cancer under investigation and any locally recurring cancer that has been treated with curative intent.
14. Any condition that required systemic treatment with either corticosteroids or other immunosuppressive medication 14 days before the first dose of study drugs.
15. Unable or unwilling to swallow study medication or gastrointestinal condition which could impair absorption of study medication.
16. Patient has any other concurrent severe and/or uncontrolled medical condition such as active infection, unresolved bowel obstruction, or psychiatric disorders that would, in the investigator’s judgment, contraindicate patient participation in the clinical study.
17. Patients with a history of interstitial lung disease (ILD), drug-induced ILD, radiation pneumonitis which required steroid treatment, noninfectious pneumonitis, or uncontrolled lung diseases, including but not limited to pulmonary fibrosis, acute lung disease, etc.
18. Severe chronic or active infections requiring systemic antibacterial, antifungal or antiviral therapy, including tuberculosis infection, etc.
19. Activity gastrointestinal ulcers within 2 months.
20. Was administered a live vaccine 4 weeks before first dose of study drug.
21. Any diseases or medical conditions, at the investigator's discretion, that may be unstable or influence their safety or study compliance, including organ transplantation, abuse of psychotropic medication, alcohol abuse or history of drug abuse.
22. Concurrent participation in another therapeutic clinical study.
23. Known immediate or delayed hypersensitivity reaction or idiosyncrasy to drugs chemically related to the study drug or their excipients.
24. Pregnant or breast-feeding patients. Women of childbearing potential will be enrolled only after a confirmed menstrual period. Breast-feeding women can become eligible for this study if she stops breast-feeding, however, cannot restart the breast-feeding on/after the completion of the study treatment.
25. Male and Female of childbearing potential not using effective contraception during the trial and within 6 months after the end of treatment.
Query!
Study design
Purpose of the study
Treatment
Query!
Allocation to intervention
Non-randomised trial
Query!
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Query!
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Query!
Masking / blinding
Open (masking not used)
Query!
Who is / are masked / blinded?
Query!
Query!
Query!
Query!
Intervention assignment
Single group
Query!
Other design features
Query!
Phase
Phase 1
Query!
Type of endpoint/s
Safety/efficacy
Query!
Statistical methods / analysis
Query!
Recruitment
Recruitment status
Recruiting
Query!
Date of first participant enrolment
Anticipated
31/01/2023
Query!
Actual
13/03/2023
Query!
Date of last participant enrolment
Anticipated
28/02/2025
Query!
Actual
Query!
Date of last data collection
Anticipated
1/03/2026
Query!
Actual
Query!
Sample size
Target
36
Query!
Accrual to date
13
Query!
Final
Query!
Recruitment in Australia
Recruitment state(s)
QLD,VIC
Query!
Recruitment hospital [1]
23151
0
Peninsula Oncology Centre - Frankston
Query!
Recruitment hospital [2]
23786
0
Icon Cancer Care South Brisbane - South Brisbane
Query!
Recruitment hospital [3]
24550
0
Monash Medical Centre - Clayton campus - Clayton
Query!
Recruitment postcode(s) [1]
38509
0
3199 - Frankston
Query!
Recruitment postcode(s) [2]
39236
0
4101 - South Brisbane
Query!
Recruitment postcode(s) [3]
40144
0
3168 - Clayton
Query!
Funding & Sponsors
Funding source category [1]
312094
0
Commercial sector/Industry
Query!
Name [1]
312094
0
Taizhou Haihe Pharmaceutical Co.,Ltd.
Query!
Address [1]
312094
0
Westside of Xiushui Road, Northside of China Medical City, Taizhou, Jiangsu, 225300,China
Query!
Country [1]
312094
0
China
Query!
Primary sponsor type
Commercial sector/Industry
Query!
Name
Tigermed Australia Pty Ltd
Query!
Address
Level 35, International Tower One, 100 Barangaroo Avenu . Sydney 2000 , Australia
Query!
Country
Australia
Query!
Secondary sponsor category [1]
313762
0
None
Query!
Name [1]
313762
0
Query!
Address [1]
313762
0
Query!
Country [1]
313762
0
Query!
Ethics approval
Ethics application status
Approved
Query!
Ethics committee name [1]
311500
0
Bellberry Human Research Ethics Committee
Query!
Ethics committee address [1]
311500
0
123 Glen Osmond Rd,Eastwood SA 5063 Australia
Query!
Ethics committee country [1]
311500
0
Australia
Query!
Date submitted for ethics approval [1]
311500
0
23/08/2022
Query!
Approval date [1]
311500
0
04/11/2022
Query!
Ethics approval number [1]
311500
0
Query!
Ethics committee name [2]
312215
0
Bellberry Human Research Ethics Committee
Query!
Ethics committee address [2]
312215
0
Bellberry Human Research Ethics Committee
Query!
Ethics committee country [2]
312215
0
Australia
Query!
Date submitted for ethics approval [2]
312215
0
21/11/2022
Query!
Approval date [2]
312215
0
15/12/2022
Query!
Ethics approval number [2]
312215
0
Query!
Ethics committee name [3]
312834
0
Monash Health Human Research Ethics Committee
Query!
Ethics committee address [3]
312834
0
Level 2, i Block, Monash Medical Centre, 246 Clayton Road Clayton VIC 3168, Australia
Query!
Ethics committee country [3]
312834
0
Australia
Query!
Date submitted for ethics approval [3]
312834
0
23/11/2022
Query!
Approval date [3]
312834
0
15/03/2023
Query!
Ethics approval number [3]
312834
0
Query!
Summary
Brief summary
This is a first in human study of a new potential treatment drug HH3806 for patients with relapsed/refractory NHL or advanced solid tumors. This study aims to determine the maximum safest dose of HH3806 that may be administered to cancer patients as a single therapy. The purpose of this study is to evaluate the safety, tolerability, pharmacokinetics (PK), and to determine maximum safest dose of HH3806 that will be administered orally as a single therapy in adult patients with advanced malignancies. Who is it for? You may be eligible for this study if you are an adult aged 18 or older and you have been diagnosed with relapsed/refractory NHL or advanced solid tumors. Study details This study will be conducted for eleven dose levels. Participant will receive HH3806 once daily till disease progression. HH3806 capsule will be administered as an oral capsule once daily for the duration of each 28-day treatment cycle without any study treatment interruption between each cycle. All participants will undergo additional tests (including blood tests, echocardiograms and imaging) to assess the effect of the treatment on their cancer, and to monitor for side effects. Study participation for each participant could be continued until disease progression, unacceptable toxicity, death or withdrawal of consent until the date of the last data collection (1 year post-treatment commencement), whichever occurs first. A Safety Review Committee (SRC) consisting of the Investigators and the Sponsor’s designated representatives will monitor safety throughout the study and make dose escalation decisions (including any decisions to explore intermediate, higher, or lower doses and/or alternative dosing schedules). It is hoped that this research will demonstrate the safety of HH3806 and find the ideal dose for larger-scale studies.
Query!
Trial website
Query!
Trial related presentations / publications
Query!
Public notes
Query!
Contacts
Principal investigator
Name
121318
0
A/Prof Vinod Ganju
Query!
Address
121318
0
Peninsula & South Eastern Haematology and Oncology Group, Level 3, Suite 7, North Building, Frankston Private, 5 Susono Way, Frankston, VIC 3199,Australia
Query!
Country
121318
0
Australia
Query!
Phone
121318
0
+610397815244
Query!
Fax
121318
0
Query!
Email
121318
0
[email protected]
Query!
Contact person for public queries
Name
121319
0
Yu Zhou
Query!
Address
121319
0
Haihe Biopharma Co., Ltd.,No.865 Zuchongzhi Road, Zhangjiang Hi-Tech, Pudong, Shanghai 201203,Chna
Query!
Country
121319
0
China
Query!
Phone
121319
0
+8602120568888
Query!
Fax
121319
0
Query!
Email
121319
0
[email protected]
Query!
Contact person for scientific queries
Name
121320
0
Ni Song
Query!
Address
121320
0
Haihe Biopharma Co., Ltd.,No.865 Zuchongzhi Road, Zhangjiang Hi-Tech, Pudong, Shanghai 201203,China
Query!
Country
121320
0
China
Query!
Phone
121320
0
+8615989184257
Query!
Fax
121320
0
Query!
Email
121320
0
[email protected]
Query!
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
Query!
No/undecided IPD sharing reason/comment
Privacy and intellectual property considerations
Query!
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
No additional documents have been identified.
Download to PDF