Combination Trial of Tipifarnib and Alpelisib in Adult Recurrent/ Metastatic Head and Neck Squamous Cell Carcinoma (R/M HNSCC)
A Phase 1/2 Open-label, Biomarker-defined Cohort Trial to Evaluate the Safety, Determine the Recommended Combination Dosing, and Assess Early Antitumor Activity of Tipifarnib and Alpelisib for the Treatment of Adult Participants Who Have HRAS-overexpressing and/or PIK3CA-mutated and/or - Amplified Recurrent/Metastatic Head and Neck Squamous Cell Carcinoma
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 2
- Phase 1
Expanded Access
Expanded Access
Available
- Available: Expanded access is currently available for this investigational treatment, and patients who are not participants in the clinical study may be able to gain access to the drug, biologic, or medical device being studied.
- No longer available: Expanded access was available for this intervention previously but is not currently available and will not be available in the future.
- Temporarily not available: Expanded access is not currently available for this intervention but is expected to be available in the future.
- Approved for marketing: The intervention has been approved by the U.S. Food and Drug Administration for use by the public.
Contacts and Locations
Study Contact
Study Contact
- Name: Clinical Operations
- Phone Number: 617-588-3755
- Email: KO-TIP-013@kuraoncology.com
Study Locations
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California
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Duarte, California, United States, 91010
- City of Hope Comprehensive Cancer Center
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Florida
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Orlando, Florida, United States, 32827
- Lake Nona DDU (Florida Cancer Specialists)
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Maryland
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Baltimore, Maryland, United States, 21201
- University of Maryland School of Medicine (Marlene and Stewart Greenebaum Comprehensive Cancer Center)
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Baltimore, Maryland, United States, 21231
- Johns Hopkins University School of Medicine (Sidney Kimmel Comprehensive Cancer Center)
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Massachusetts
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Boston, Massachusetts, United States, 02215
- Dana-Farber Cancer Institute (Head and Neck Cancer Treatment Center)
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Missouri
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St Louis, Missouri, United States, 63110
- Washington University, School of Medicine
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New York
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New York, New York, United States, 10065
- Memorial Sloan Kettering Cancer Center
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Pennsylvania
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Pittsburgh, Pennsylvania, United States, 15232
- UPMC Hillman Cancer Center
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Texas
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Dallas, Texas, United States, 75390
- UT Southwestern Medical Center (Harold C. Simmons Comprehensive Cancer Center)
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Houston, Texas, United States, 77030
- University of Texas MD Anderson Cancer Center
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Wisconsin
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Madison, Wisconsin, United States, 53792
- University of Wisconsin Carbone Cancer Center
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- At least 18 years of age.
- Histologically confirmed head and neck cancer of squamous histology not amenable to local therapy with curative intent (surgery or radiation therapy with or without chemotherapy).
- Documented treatment failure from at least 1 prior systemic therapy in the R/M setting, unless determined not appropriate.
- Measurable disease by Response Evaluation Criteria in Solid Tumors (RECIST) v1.1.
- Has a tumor that is dependent upon HRAS and/or PIK3CA.
- Eastern Cooperative Oncology Group (ECOG) performance status of 0-1.
- Acceptable liver, renal, endocrine, and hematologic function.
- Must be able to swallow alpelisib whole tablet or oral suspension containing crushed tablets. Feeding tube may not be used for alpelisib administration.
- Other protocol defined inclusion criteria may apply.
Exclusion Criteria:
- Histologically confirmed salivary gland, thyroid, (primary) cutaneous squamous or nonsquamous histologies (eg, mucosal melanoma).
- Ongoing treatment with certain anticancer agents.
- Prior treatment (at least 1 full treatment cycle) with an FTI or PI3K, mTOR, or AKT inhibitor.
- Received treatment for unstable angina, myocardial infarction, and/or cerebro-vascular attack within the prior 6 months.
- Non-tolerable Grade 2, or ≥ Grade 3 neuropathy or evidence of unstable neurological symptoms within 4 weeks of Cycle 1 Day 1.
- Major surgery, other than diagnostic surgery, within 2 weeks prior to Cycle 1 Day 1, without complete recovery.
- Active, uncontrolled bacterial, viral, or fungal infections requiring systemic therapy.
- Participant with an established diagnosis of diabetes mellitus Type 1 or not controlled Type 2.
- Participant has impairment of gastrointestinal (GI) function or GI disease that may significantly alter the absorption of the trial drugs based on Investigator discretion.
- Participant has currently documented pneumonitis/interstitial lung disease.
- Participant has a history of severe cutaneous reaction, such as Stevens-Johnson Syndrome (SJS), Erythema Multiforme (EM), Toxic Epidermal Necrolysis (TEN), or Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS).
- Other protocol defined exclusion criteria may apply.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: PIK3CA-dependent (Cohort 1)
Adult participants with R/M HNSCC whose tumors harbor PI3KCA (activating) mutations and/or amplifications
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Oral administration
Oral administration
Other Names:
|
|
Experimental: HRAS-dependent (Cohort 2)
Adult participants with R/M HNSCC whose tumors have increased HRAS dependency, defined as HRAS overexpression
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Oral administration
Oral administration
Other Names:
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Dose-limiting toxicity (DLT)
Time Frame: First 28 days (1 cycle) of combination therapy
|
Rate of DLTs evaluated according to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) version 5.0.
A Treatment-Emergent Adverse Event (TEAE) is an AE occurring on or after Cycle 1 Day 1 and within 30 days of the last dose of tipifarnib or alpelisib, whichever is later.
Patients with multiple events are counted only once at the highest CTCAE grade.
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First 28 days (1 cycle) of combination therapy
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Descriptive statistics of Adverse Events (AEs)
Time Frame: From Cycle 1 Day 1 until 30 days after last trial intervention dose or 30 days after trial completion, whichever comes first, assessed up to 2 years
|
Descriptive statistics of Treatment-Emergent Adverse Events (TEAEs) and Serious TEAEs; AE severity will be assessed per the NCI CTCAE v 5.0.
AEs are coded using the MedDRA dictionary version 28.0.
A TEAE is an AE occurring on or after Cycle 1 Day 1 and within 30 days of the last dose of tipifarnib or alpelisib, whichever is later.
At each level of summation (system organ class, preferred term), a patient reporting more than one adverse event is counted only once.
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From Cycle 1 Day 1 until 30 days after last trial intervention dose or 30 days after trial completion, whichever comes first, assessed up to 2 years
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Disease control rate (DCR)
Time Frame: From Cycle 1 Day 1 until first documentation of disease progression, the start of new anti-cancer therapy, or death, whichever occurs first, assessed up to 2 years
|
Disease control rate (CR + PR + SD)
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From Cycle 1 Day 1 until first documentation of disease progression, the start of new anti-cancer therapy, or death, whichever occurs first, assessed up to 2 years
|
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Median duration of Disease Control
Time Frame: From first documentation of response until first documentation of disease progression, the start of new anti-cancer therapy, or death, whichever occurs first, assessed up to 2 years
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Defined for participants with confirmed objective response as the time in months from the first documentation of response to the first documentation of disease progression by RECIST v1.1 or to death due to any cause before new anti-cancer treatment, whichever occurs first, in patients with confirmed CR/PR
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From first documentation of response until first documentation of disease progression, the start of new anti-cancer therapy, or death, whichever occurs first, assessed up to 2 years
|
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Rate of Stable Disease
Time Frame: From Cycle 1 Day 1 until first documentation of disease progression, the start of new anti-cancer therapy, or death, whichever occurs first, assessed up to 2 years
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From Cycle 1 Day 1 until first documentation of disease progression, the start of new anti-cancer therapy, or death, whichever occurs first, assessed up to 2 years
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|
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Median duration of Stable Disease (SD)
Time Frame: From first documentation of response until first documentation of disease progression, the start of new anti-cancer therapy, or death, whichever occurs first, assessed up to 2 years
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Defined as durable SD (>= 12 weeks) by RECIST v1.1
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From first documentation of response until first documentation of disease progression, the start of new anti-cancer therapy, or death, whichever occurs first, assessed up to 2 years
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Objective Response Rate (ORR)
Time Frame: From Cycle 1 Day 1 until first documentation of disease progression, the start of new anti-cancer therapy, or death, whichever occurs first, assessed up to 2 years
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Defined as the proportion of participants with best overall response as a confirmed complete response (CR) or confirmed partial response (PR) by RECIST v1.1.
Clopper-Pearson 95% confidence intervals are calculated based on binomial distribution.
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From Cycle 1 Day 1 until first documentation of disease progression, the start of new anti-cancer therapy, or death, whichever occurs first, assessed up to 2 years
|
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Median duration of response
Time Frame: From first documentation of response to first documentation of disease progression, the start of new anti-cancer therapy, or death, whichever occurs first, assessed up to 2 years
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Defined for participants with confirmed objective response as the time from the first documentation of response to the first documentation of disease progression by RECIST v1.1 or to death due to any cause before new anti-cancer treatment, whichever occurs first.
Median is calculated using Kaplan-Meier method.
Confidence interval for median is calculated using the Brookmeyer-Crowley method.
Minimum and maximum are actual values rather than estimates.
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From first documentation of response to first documentation of disease progression, the start of new anti-cancer therapy, or death, whichever occurs first, assessed up to 2 years
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Cmax of tipifarnib and alpelisib when administered in combination
Time Frame: Blood samples will be collected on day 1 and day 2 of Cycle 1 and Cycle 2, and on day 1 of Cycle 3 through Cycle 6. Each cycle is 28 days.
|
Maximum observed concentration following single dose and multiple dose administration
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Blood samples will be collected on day 1 and day 2 of Cycle 1 and Cycle 2, and on day 1 of Cycle 3 through Cycle 6. Each cycle is 28 days.
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Tmax of tipifarnib and alpelisib when administered in combination
Time Frame: Blood samples will be collected on day 1 and day 2 of Cycle 1 and Cycle 2, and on day 1 of Cycle 3 through Cycle 6. Each cycle is 28 days.
|
Time to reach maximum observed concentration following single dose and multiple dose administration
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Blood samples will be collected on day 1 and day 2 of Cycle 1 and Cycle 2, and on day 1 of Cycle 3 through Cycle 6. Each cycle is 28 days.
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AUC(0-last) of tipifarnib and alpelisib when administered in combination
Time Frame: Blood samples will be collected on day 1 and day 2 of Cycle 1 and Cycle 2, and on day 1 of Cycle 3 through Cycle 6. Each cycle is 28 days.
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Area under the concentration-time curve from time zero to time of last quantifiable concentration following single dose and multiple dose administration
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Blood samples will be collected on day 1 and day 2 of Cycle 1 and Cycle 2, and on day 1 of Cycle 3 through Cycle 6. Each cycle is 28 days.
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AUC(tau) of tipifarnib and alpelisib when administered in combination
Time Frame: Blood samples will be collected on day 1 and day 2 of Cycle 1 and Cycle 2, and on day 1 of Cycle 3 through Cycle 6. Each cycle is 28 days.
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Area under the concentration-time curve during a dosage interval following single dose and multiple dose administration
|
Blood samples will be collected on day 1 and day 2 of Cycle 1 and Cycle 2, and on day 1 of Cycle 3 through Cycle 6. Each cycle is 28 days.
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AUC(0-infinity) of tipifarnib and alpelisib when administered in combination
Time Frame: Blood samples will be collected on day 1 and day 2 of Cycle 1 and Cycle 2, and on day 1 of Cycle 3 through Cycle 6. Each cycle is 28 days.
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Area under the concentration-time curve from time zero to infinity following single dose administration
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Blood samples will be collected on day 1 and day 2 of Cycle 1 and Cycle 2, and on day 1 of Cycle 3 through Cycle 6. Each cycle is 28 days.
|
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CL/F of tipifarnib and alpelisib when administered in combination
Time Frame: Blood samples will be collected on day 1 and day 2 of Cycle 1 and Cycle 2, and on day 1 of Cycle 3 through Cycle 6. Each cycle is 28 days.
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Apparent total clearance of the drug following single dose and multiple dose administration
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Blood samples will be collected on day 1 and day 2 of Cycle 1 and Cycle 2, and on day 1 of Cycle 3 through Cycle 6. Each cycle is 28 days.
|
|
Vd/F of tipifarnib and alpelisib when administered in combination
Time Frame: Blood samples will be collected on day 1 and day 2 of Cycle 1 and Cycle 2, and on day 1 of Cycle 3 through Cycle 6. Each cycle is 28 days.
|
Apparent volume of distribution following single dose and multiple dose administration
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Blood samples will be collected on day 1 and day 2 of Cycle 1 and Cycle 2, and on day 1 of Cycle 3 through Cycle 6. Each cycle is 28 days.
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Half-life of tipifarnib and alpelisib when administered in combination
Time Frame: Blood samples will be collected on day 1 and day 2 of Cycle 1 and Cycle 2, and on day 1 of Cycle 3 through Cycle 6. Each cycle is 28 days.
|
Time required for the amount of drug in the body to decrease by half following single dose and multiple dose administration
|
Blood samples will be collected on day 1 and day 2 of Cycle 1 and Cycle 2, and on day 1 of Cycle 3 through Cycle 6. Each cycle is 28 days.
|
|
Accumulation ratio of tipifarnib and alpelisib when administered in combination
Time Frame: Blood samples will be collected on day 1 and day 2 of Cycle 1 and Cycle 2, and on day 1 of Cycle 3 through Cycle 6. Each cycle is 28 days.
|
Defined as the ratio of drug exposure at steady state to exposure following a single dose.
For tipifarnib, the accumulation ratio was calculated as the ratio of area under the plasma concentration-time curve over the dosing interval (AUCτ) on Cycle 2 Day 1 (C2D1) to AUC from time zero to 12 hours (AUC₀-12) on Cycle 1 Day 1 (C1D1).
For alpelisib, the accumulation ratio was calculated as the ratio of AUCτ on C2D1 to AUC from time zero to 24 hours (AUC₀-24) on C1D1.
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Blood samples will be collected on day 1 and day 2 of Cycle 1 and Cycle 2, and on day 1 of Cycle 3 through Cycle 6. Each cycle is 28 days.
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Progression-free survival (PFS)
Time Frame: From Cycle 1 Day 1 until first documentation of disease progression, the start of new anti-cancer therapy, or death, whichever occurs first, assessed up to 3 years
|
Defined as the time in months from C1D1 to the first documentation of disease progression or death due to any cause before new anti-cancer treatment.
Median is calculated using Kaplan-Meier method.
Confidence interval for median is calculated using the Brookmeyer-Crowley method.
Minimum and maximum are actual values rather than estimates.
|
From Cycle 1 Day 1 until first documentation of disease progression, the start of new anti-cancer therapy, or death, whichever occurs first, assessed up to 3 years
|
|
Proportion of participants with PFS at 6 months
Time Frame: From Cycle 1 Day 1 until first documentation of disease progression, the start of new anti-cancer therapy, or death, whichever occurs first, assessed up to 6 months
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Proportion of participants alive and without disease progression at 6 months and before new anti-cancer treatment.
Survival probability and confidence interval are calculated based on Kaplan-Meier product-limit method and Greenwood's formula.
|
From Cycle 1 Day 1 until first documentation of disease progression, the start of new anti-cancer therapy, or death, whichever occurs first, assessed up to 6 months
|
|
Overall Survival (OS)
Time Frame: From Cycle 1 Day 1 until 3 years of treatment or death from any cause, whichever comes first
|
OS is the time in months from C1D1 to the date of death due to any cause.
For patients with no events, OS will be censored at the last known to be alive date.
Median is calculated using Kaplan-Meier method.
Confidence interval for median is calculated using the Brookmeyer-Crowley method.
Minimum and maximum are actual values rather than estimates.
|
From Cycle 1 Day 1 until 3 years of treatment or death from any cause, whichever comes first
|
|
Proportion of patients with OS at 12 months
Time Frame: From Cycle 1 Day 1 until 12 months of treatment or death from any cause, whichever comes first
|
Proportion of participants alive at 12 months.
For patients with no events, OS will be censored at the last known to be alive date.
Survival probability and confidence interval are calculated based on Kaplan-Meier product-limit method and Greenwood's formula.
|
From Cycle 1 Day 1 until 12 months of treatment or death from any cause, whichever comes first
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Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Nervous System Diseases
- Pathologic Processes
- Neoplasms by Site
- Neoplasms
- Neuromuscular Diseases
- Disease Attributes
- Genetic Diseases, Inborn
- Peripheral Nervous System Diseases
- Neoplasms by Histologic Type
- Neurodegenerative Diseases
- Neoplasms, Glandular and Epithelial
- Carcinoma
- Congenital Abnormalities
- Heredodegenerative Disorders, Nervous System
- Nervous System Malformations
- Carcinoma, Squamous Cell
- Polyneuropathies
- Congenital, Hereditary, and Neonatal Diseases and Abnormalities
- Pathological Conditions, Signs and Symptoms
- Squamous Cell Carcinoma of Head and Neck
- Recurrence
- Head and Neck Neoplasms
- Hereditary Sensory and Autonomic Neuropathies
- Antineoplastic Agents
- Alpelisib
- tipifarnib
Other Study ID Numbers
Other Study ID Numbers
- KO-TIP-013
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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