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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/ct2/show/NCT02927262
Registration number
NCT02927262
Ethics application status
Date submitted
5/10/2016
Date registered
7/10/2016
Date last updated
27/10/2023
Titles & IDs
Public title
A Study of ASP2215 (Gilteritinib), Administered as Maintenance Therapy Following Induction/Consolidation Therapy for Subjects With FMS-like Tyrosine Kinase 3 (FLT3/ITD) Acute Myeloid Leukemia (AML) in First Complete Remission
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Scientific title
A Phase 2 Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial of the FLT3 Inhibitor Gilteritinib (ASP2215) Administered as Maintenance Therapy Following Induction/Consolidation Therapy for Subjects With FLT3/ITD AML in First Complete Remission
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Secondary ID [1]
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2016-001643-39
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Secondary ID [2]
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2215-CL-0302
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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:
Condition category
Condition code
Cancer
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Leukaemia - Acute leukaemia
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Cancer
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Leukaemia - Chronic leukaemia
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Cancer
0
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Children's - Leukaemia & Lymphoma
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Intervention/exposure
Study type
Interventional(has expanded access)
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Description of intervention(s) / exposure
Treatment: Drugs - Gilteritinib
Treatment: Drugs - Placebo
Experimental: Gilteritinib - Participants received gilteritinib 120 mg (three tablets of 40 mg) orally, once daily (QD) for up to 2 years or until a protocol-specified discontinuation criterion was met.
Placebo Comparator: Placebo - Participants received gilteritinib matching placebo orally, QD for up to 2 years or until a protocol-specified discontinuation criterion was met.
Treatment: Drugs: Gilteritinib
Oral tablet
Treatment: Drugs: Placebo
Oral tablet
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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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Relapse-free Survival (RFS) Per Independent Review Committee (IRC) Adjudication
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Assessment method [1]
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RFS was defined as the time from the date of randomization until the date of documented relapse or death from any cause, whichever occurred first. Relapse after complete remission (CR) [including complete remission with incomplete platelet recovery (CRp) and Complete remission with incomplete hematologic recovery (CRi)], was defined as bone marrow blasts 5% or higher (not attributable to regenerating bone marrow), any circulating blasts, any extra-medullary blast foci as per Revised International Working Group (IWG) criteria.
Participants were classified as:
CRi, if they fulfilled all the criteria for CR except for incomplete hematological recovery with residual neutropenia < 1 × 10^9/L with or without complete platelet recovery. RBC and platelet transfusion independence was not required.
CRp, if they achieved CR except for incomplete platelet recovery (< 100 × 10^9/L).
RFS was estimated using Kaplan-Meier estimates. hazard ratio (HR), cox proportional hazards model (CHM)
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Timepoint [1]
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From the date of randomization until the date of documented relapse, or death; (Median time on study drug was 427 days for gilteritinib group and 212 days for placebo group)
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Secondary outcome [1]
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Overall Survival (OS)
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Assessment method [1]
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OS was defined as the time from the date of randomization until the date of death from any cause. OS was estimated using Kaplan-Meiers method.
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Timepoint [1]
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From the date of randomization until the date of death from any cause; (Median time on study drug was 427 days for gilteritinib group and 212 days for placebo group)
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Secondary outcome [2]
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Event-Free Survival (EFS)
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Assessment method [2]
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EFS was defined as the time from the date of randomization until the date of documented relapse or discontinuation of the treatment, or initiation of other anti-leukemic treatment or death from any cause, whichever occurred first. Relapse after CR (including CRp and CRi), was defined as bone marrow blasts 5% or higher (not attributable to regenerating bone marrow), any circulating blasts, any extra-medullary blast foci as per Revised IWG criteria.
Participants were classified as:
CRi, if they fulfilled all the criteria for CR except for incomplete hematological recovery with residual neutropenia < 1 × 10^9/L with or without complete platelet recovery. RBC and platelet transfusion independence was not required.
CRp, if they achieved CR except for incomplete platelet recovery (< 100 × 10^9/L).
EFS was estimated using Kaplan-Meier's method.
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Timepoint [2]
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From date of randomization until the date of documented relapse or discontinuation of the treatment, or initiation of other anti-leukemic treatment or death from any cause; (Median time on study drug was 427 days for gilteritinib and 212 days for Placebo)
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Secondary outcome [3]
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Change From Baseline in Quantitative Minimal Residual Disease Measured as Log10-transformed Overall FLT3/ITD Mutation Ratio at Months 3, 6, 12, 24/End of Treatment (EoT)
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Assessment method [3]
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MRD was measured from bone marrow samples. FLT3/ITD mutation ratio was measured in relation to total FLT3. For a participant with multiple ITD mutations, the overall FLT3/ITD mutation ratio was calculated from the sum of all ITD mutations. Absence of Minimal Residual Disease (MRD) is defined as log10-transformed overall FLT3/ITD mutation ratio = -4.
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Timepoint [3]
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Baseline and months 3, 6, 12, 24/EoT
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Secondary outcome [4]
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Number of Participants With Adverse Events (AE)
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Assessment method [4]
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AE:any untoward medical occurrence in participants administered study treatment (ST)/had undergone study procedures & did not necessarily have a causal relationship with treatment. Abnormalities was defined as AE only if met 1 of the criteria:Induced clinical signs/symptoms, required active intervention, required interruption or discontinuation of ST, abnormality or investigational value was clinically significant. Serious AE:resulted in death, was life threatening, persistent or significant disability/incapacity or substantial disruption of ability to conduct normal life functions, congenital anomaly/birth defect, required hospitalization or prolongation of hospitalization, other medically important events. Treatment-emergent AE:recorded on treatment = 30 days from last ST. Relapse: defined in Outcome Measure #1. Grades(Gr) based on National Cancer Institute Common Terminology Criteria (NCI-CTCAE) (Gr 1=mild, Gr 2=moderate, Gr 3 =severe, Gr 4 =life threatening, Gr 5 =death).
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Timepoint [4]
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From first dose date up to 30 days after last dose or data cut-off date 25-May 2021 (Maximum treatment duration was 744 days)
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Secondary outcome [5]
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Number of Participants With Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) Score
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Assessment method [5]
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ECOG performance status was measured on an 6 point scale. 0-Fully active, able to carry on all pre-disease performance without restriction.
Restricted in physically strenuous activity but ambulatory and able to carry out work of a light or sedentary nature, e.g., light house work, office work.
Ambulatory and capable of all self-care but unable to carry out any work activities. Up and about more than 50% of waking hours.
Capable of only limited self-care, confined to bed or chair more than 50% of waking hours.
Completely disabled. Cannot carry on any self-care. Totally confined to bed or chair.
Dead.
Number of participants with ECOG PS was reported. ECOG PS grades with zero participants were not reported.
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Timepoint [5]
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Months 1, 2, 3, 4, 5, 6, 8, 10. 12, 14, 16, 18, 20, 22 and 24/EoT
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Eligibility
Key inclusion criteria
- Subject is considered an adult according to local regulation at the time of obtaining
consent form (ICF).
- Subject consents to allow access to subject's diagnostic bone marrow aspirate or
peripheral blood sample and/or the DNA derived from that sample, if available, that
may be used to validate a companion diagnostic test for gilteritinib.
- Subject has confirmed morphologically documented AML, excluding acute promyelocytic
leukemia (APL), in CR1 (including CRp and CRi). For the purposes of enrollment, CR
will be defined as < 5% blasts in the bone marrow with no morphologic characteristics
of acute leukemia (e.g., Auer rods) in the bone marrow with no evidence of
extramedullary disease such as central nervous system involvement or granulocytic
sarcoma.
- Subject will not proceed with transplantation as either a decision not to proceed with
transplantation has been made either on the recommendation of the treating physician
or by the patient or a suitable donor could not be identified.
- Subject is < 2 months from the start of the last cycle of consolidation and should
have completed the recommended number of consolidations per local practice.
- Subject has had no use of investigational agents, with the exception of FLT3
inhibiting agents during induction and/or consolidation therapy, within the prior 4
weeks.
- Subject has had presence of the FLT3/ITD activating mutation in the bone marrow or
peripheral blood as determined by the local institution at diagnosis.
- Subject has an ECOG performance status 0 to 2.
- Subject must meet the following criteria as indicated on the clinical laboratory
tests:
- Serum creatinine = 1.5 x institutional upper limit of normal (ULN), or if serum
creatinine outside normal range, then glomerular filtration rate (GFR) > 40
mL/min/1.73m^2 as calculated with the 4-parameter Modification of Diet in Renal
Disease (MDRD) equation.
- Serum total bilirubin = 2.5 mg/dL (43 µmol/L), except for subjects with Gilbert's
syndrome.
- Serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) < 3 x
ULN.
- Serum potassium and serum magnesium = institutional lower limit of normal (LLN).
- Absolute neutrophil count (ANC) = 500/µl and platelets = 20000/µl (unsupported by
transfusions).
- Subject is suitable for oral administration of study drug.
- Female subject must either:
- Be of nonchildbearing potential:
- Postmenopausal (defined as at least 1 year without any menses) prior to
screening, or
- Documented surgically sterile or status posthysterectomy (at least 1 month prior
to screening)
- Or, if of childbearing potential,
- Agree not to try to become pregnant during the study and for 6 months after the
final study drug administration
- And have a negative urine or serum pregnancy test at screening
- And, if heterosexually active, agree to consistently use highly effective
contraception per locally accepted standards (in addition to a barrier method)
starting at screening and throughout the study period and for 6 months after the
final study drug administration.
- Female subject must agree not to breastfeed starting at screening and throughout the
study period, and for 2 months and 1 week after the final study drug administration.
- Female subject must not donate ova starting at screening and throughout the study
period, and for 6 months after the final study drug administration.
- Male subject and subject's female partners who are of childbearing potential must be
using highly effective contraception per locally accepted standards (in addition to a
barrier method) starting at screening and continue throughout the study period and for
4 months and 1 week after the final study drug administration.
- Male subject must not donate sperm starting at screening and throughout the study
period and for 4 months and 1 week after the final study drug administration.
- Subject agrees not to participate in another interventional study while on treatment.
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Minimum age
18
Years
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Maximum age
No limit
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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
- Subject has had prior allogeneic transplant.
- Subject has QTcF interval > 450 msec (average of triplicate determinations based on
central reading).
- Subject with Long QT Syndrome.
- Subject with hypokalemia and hypomagnesemia at screening (defined as values below
LLN).
- Subject has clinically active central nervous system leukemia.
- Subject is known to have human immunodeficiency virus infection.
- Subject has active hepatitis B or C.
- Subject has an uncontrolled infection. If a bacterial or viral infection is present,
the subject must be receiving definitive therapy and have no signs of progressing
infection for 72 hours prior to randomization. If a fungal infection is present, the
subject must be receiving definitive systemic anti-fungal therapy and have no signs of
progressing infection for 1 week prior to randomization.
- Subject has progressing infection defined as hemodynamic instability attributable to
sepsis or new symptoms, worsening physical signs or radiographic findings attributable
to infection. Persisting fever without other signs or symptoms will not be interpreted
as progressing infection.
- Subject has uncontrolled angina, severe uncontrolled ventricular arrhythmias,
electrocardiographic evidence of acute ischemia, congestive heart failure New York
Heart Association (NYHA) class 3 or 4 or subject has a history of congestive heart
failure NYHA class 3 or 4 in the past, unless a screening echocardiogram or multigated
acquisition (MUGA) scan performed within 1 month prior to study entry results in a
left ventricular ejection fraction that is = 45%.
- Subject requires treatment with concomitant drugs that are strong inducers of
cytochrome P450 (CYP) 3A.
- Subject requires treatment with concomitant drugs that are strong inhibitors or
inducers of P-glycoprotein (P-gp) with the exception of drugs that are considered
absolutely essential for the care of the subject.
- Subject requires treatment with concomitant drugs that target serotonin
5-hydroxytryptamine receptor 1 (5HT1R) or 5-hydroxytryptamine receptor 2B (5HT2BR) or
sigma nonspecific receptor with the exception of drugs that are considered absolutely
essential for the care of the subject.
- Subject has a serious medical or psychiatric illness likely to interfere with
participation in this clinical study.
- Subject has prior malignancies, except resected basal cell carcinoma or treated
cervical carcinoma in situ. Cancer treated with curative intent = 5 years previously
will be allowed. Cancer treated with curative intent < 5 years previously will not be
allowed.
- Subject has any condition which makes the subject unsuitable for study participation.
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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
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people analysing the results/data
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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
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Statistical methods / analysis
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Recruitment
Recruitment status
Active, not 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
10/01/2017
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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
29/02/2024
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Actual
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Sample size
Target
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Accrual to date
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Final
98
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Recruitment in Australia
Recruitment state(s)
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Recruitment outside Australia
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Florida
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Illinois
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Nottingham
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Funding & Sponsors
Primary sponsor type
Commercial sector/Industry
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Name
Astellas Pharma Global Development, Inc.
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Address
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Ethics approval
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Summary
Brief summary
The purpose of this study was to compare relapse-free survival (RFS) between participants with FMS-like tyrosine kinase 3 (FLT3) / internal tandem duplication (ITD) acute myeloid leukemia (AML) in first complete remission (CR1) and who were randomized to receive gilteritinib or placebo beginning after completion of induction/consolidation chemotherapy for a two-year period.
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Trial website
https://clinicaltrials.gov/ct2/show/NCT02927262
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Trial related presentations / publications
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Public notes
This record is viewable in the ANZCTR as it had previously listed Australia and/or New Zealand as a recruitment site, however these sites have since been removed
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Contacts
Principal investigator
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Executive Medical Director
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Astellas Pharma Global Development, Inc.
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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
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/ct2/show/NCT02927262
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