Gefitinib With or Without Carboplatin and Paclitaxel in Treating Older Patients With Unresectable or Metastatic Non-Small Cell Lung Cancer
Parallel Phase II Trials of ZD1839 (Iressa) Alone or Weekly Carboplatin and Paclitaxel Followed by ZD1839 (Iressa) (Oncologists Must Choose) for Metastatic Non-Small Cell Lung Cancer in Patients > or = 65 Years of Age
RATIONALE: Biological therapies such as gefitinib may interfere with the growth of cancer cells and slow the growth of the tumor. Drugs used in chemotherapy such as carboplatin and paclitaxel use different ways to stop tumor cells from dividing so they stop growing or die. Combining gefitinib with carboplatin and paclitaxel may kill more tumor cells.
PURPOSE: This phase II trial is studying how well giving gefitinib alone or together with carboplatin and paclitaxel works in treating older patients with unresectable or metastatic non-small cell lung cancer.
Přehled studie
Postavení
Postavení
Podmínky
Podmínky
Intervence / Léčba
Intervence / Léčba
Detailní popis
OBJECTIVES:
Primary
- Determine the 6-month progression status of older patients with unresectable or metastatic non-small cell lung cancer treated with gefitinib alone or with carboplatin and paclitaxel.
Secondary
- Determine the response rate in patients treated with these regimens.
- Determine the quality of life of patients treated with these regimens.
- Determine whether serum-secreted or soluble epidermal growth factor receptor (EGFR) concentrations predict response in patients treated with these regimens.
- Correlate the presence of social support for these patients with toxicity and efficacy of these regimens.
- Determine whether social support for these patients differs according to gender.
- Determine the reasons an oncologist would choose a chemotherapy vs a nonchemotherapy regimen for these patients.
Tertiary
- Correlate EGFR signaling pathway markers, RNA expression profile, gene polymorphisms of prespecified germline and tumor genes, and plasma and urine proteomic patterns with response rate and time to progression of patients receiving treatment in group I.
OUTLINE: This is a nonrandomized, multicenter study. Patients are assigned to 1 of 2 treatment groups as determined by their treating physician.
- Group I: Patients receive oral gefitinib on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.
- Group II: Patients receive paclitaxel IV over 1 hour and carboplatin IV over 30 minutes on days 1, 8, and 15. Treatment repeats every 28 days for up to 4 courses in the absence of disease progression or unacceptable toxicity. After completion of chemotherapy and in the absence of disease progression, patients receive oral gefitinib as in group I.
Quality of life is assessed at baseline and after the completion of course 2.
Patients are followed every 3 months for 5 years.
PROJECTED ACCRUAL: A total of 107 patients (51 for group I and 56 for group II) will be accrued for this study within 1.7 years.
Typ studie
Typ studie
Zápis (Aktuální)
Zápis
Fáze
Fáze
- Fáze 2
Kontakty a umístění
Studijní místa
-
-
Saskatchewan
-
Regina, Saskatchewan, Kanada, S4T 7T1
- Allan Blair Cancer Centre at Pasqua Hospital
-
-
-
-
Arizona
-
Scottsdale, Arizona, Spojené státy, 85259
- Mayo Clinic Scottsdale
-
-
Colorado
-
Fort Collins, Colorado, Spojené státy, 80524
- Front Range Cancer Specialists
-
-
Florida
-
Jacksonville, Florida, Spojené státy, 32224
- Mayo Clinic - Jacksonville
-
-
Illinois
-
Aurora, Illinois, Spojené státy, 60507
- Rush-Copley Cancer Care Center
-
Bloomington, Illinois, Spojené státy, 61701
- St. Joseph Medical Center
-
Canton, Illinois, Spojené státy, 61520
- Graham Hospital
-
Carthage, Illinois, Spojené státy, 62321
- Memorial Hospital
-
Effingham, Illinois, Spojené státy, 62401
- St. Anthony's Memorial Hospital
-
Eureka, Illinois, Spojené státy, 61530
- Eureka Community Hospital
-
Galesburg, Illinois, Spojené státy, 61401
- Galesburg Cottage Hospital
-
Galesburg, Illinois, Spojené státy, 61401
- Galesburg Clinic
-
Havana, Illinois, Spojené státy, 62644
- Mason District Hospital
-
Hopedale, Illinois, Spojené státy, 61747
- Hopedale Medical Complex
-
Joliet, Illinois, Spojené státy, 60435
- Joliet Oncology Hematology Associates, Limited - West
-
Kewanee, Illinois, Spojené státy, 61443
- Kewanee Hospital
-
Macomb, Illinois, Spojené státy, 61455
- Mcdonough District Hospital
-
Normal, Illinois, Spojené státy, 61761
- Bromenn Regional Medical Center
-
Normal, Illinois, Spojené státy, 61761
- Community Cancer Center
-
Ottawa, Illinois, Spojené státy, 61350
- Community Hospital of Ottawa
-
Ottawa, Illinois, Spojené státy, 61350
- Oncology Hematology Associates of Central Illinois - Ottawa
-
Pekin, Illinois, Spojené státy, 61554
- Cancer Treatment Center at Pekin Hospital
-
Peoria, Illinois, Spojené státy, 61636
- Methodist Medical Center of Illinois
-
Peoria, Illinois, Spojené státy, 61614
- Proctor Hospital
-
Peoria, Illinois, Spojené státy, 61637
- OSF St. Francis Medical Center
-
Peoria, Illinois, Spojené státy, 61615
- CCOP - Illinois Oncology Research Association
-
Peoria, Illinois, Spojené státy, 61615
- Oncology/Hematology Associates of Central Illinois, P.C.
-
Peru, Illinois, Spojené státy, 61354
- Illinois Valley Community Hospital
-
Princeton, Illinois, Spojené státy, 61356
- Perry Memorial Hospital
-
Spring Valley, Illinois, Spojené státy, 61362
- St. Margaret's Hospital
-
Urbana, Illinois, Spojené státy, 61801
- Carle Cancer Center at Carle Foundation Hospital
-
Urbana, Illinois, Spojené státy, 61801
- CCOP - Carle Cancer Center
-
-
Indiana
-
Beech Grove, Indiana, Spojené státy, 46107
- St. Francis Hospital and Health Centers - Beech Grove Campus
-
Michigan City, Indiana, Spojené státy, 46360
- Saint Anthony Memorial Health Centers
-
-
Iowa
-
Cedar Rapids, Iowa, Spojené státy, 52402
- St. Luke's Hospital
-
Cedar Rapids, Iowa, Spojené státy, 52403
- Cedar Rapids Oncology Associates
-
Cedar Rapids, Iowa, Spojené státy, 52403
- Mercy Regional Cancer Center at Mercy Medical Center
-
Des Moines, Iowa, Spojené státy, 50309
- CCOP - Iowa Oncology Research Association
-
Des Moines, Iowa, Spojené státy, 50309
- John Stoddard Cancer Center at Iowa Methodist Medical Center
-
Des Moines, Iowa, Spojené státy, 50309
- Medical Oncology and Hematology Associates at John Stoddard Cancer Center
-
Des Moines, Iowa, Spojené státy, 50314
- Medical Oncology and Hematology Associates at Mercy Cancer Center
-
Des Moines, Iowa, Spojené státy, 50314
- Mercy Cancer Center at Mercy Medical Center - Des Moines
-
Des Moines, Iowa, Spojené státy, 50307
- Mercy Capitol Hospital
-
Des Moines, Iowa, Spojené státy, 50316-2301
- John Stoddard Cancer Center at Iowa Lutheran Hospital
-
Sioux City, Iowa, Spojené státy, 51101
- Siouxland Regional Cancer Center
-
Sioux City, Iowa, Spojené státy, 51104
- St. Luke's Regional Medical Center
-
Sioux City, Iowa, Spojené státy, 51104
- Mercy Medical Center - Sioux City
-
Sioux City, Iowa, Spojené státy, 51101
- Siouxland Hematology-Oncology Associates at June E. Nylen Cancer Center
-
West Des Moines, Iowa, Spojené státy, 50266
- Medical Oncology and Hematology Associates - West Des Moines
-
-
Kansas
-
Chanute, Kansas, Spojené státy, 66720
- Cancer Center of Kansas, P.A. - Chanute
-
Dodge City, Kansas, Spojené státy, 67801
- Cancer Center of Kansas, P.A. - Dodge City
-
El Dorado, Kansas, Spojené státy, 67042
- Cancer Center of Kansas, P.A. - El Dorado
-
Kingman, Kansas, Spojené státy, 67068
- Cancer Center of Kansas, P.A. - Kingman
-
Liberal, Kansas, Spojené státy, 67901
- Southwest Medical Center
-
Newton, Kansas, Spojené státy, 67114
- Cancer Center of Kansas, P.A. - Newton
-
Parsons, Kansas, Spojené státy, 67357
- Cancer Center of Kansas, P.A. - Parsons
-
Pratt, Kansas, Spojené státy, 67124
- Cancer Center of Kansas, P.A. - Pratt
-
Salina, Kansas, Spojené státy, 67042
- Cancer Center of Kansas, P.A. - Salina
-
Wellington, Kansas, Spojené státy, 67152
- Cancer Center of Kansas, P.A. - Wellington
-
Wichita, Kansas, Spojené státy, 67214
- CCOP - Wichita
-
Wichita, Kansas, Spojené státy, 67214
- Via Christi Cancer Center at Via Christi Regional Medical Center
-
Wichita, Kansas, Spojené státy, 67214
- Cancer Center of Kansas, P.A. - Wichita
-
Wichita, Kansas, Spojené státy, 67203
- Associates in Womens Health, P.A. - North Review
-
Wichita, Kansas, Spojené státy, 67208
- Cancer Center of Kansas, P.A. - Medical Arts Tower
-
Winfield, Kansas, Spojené státy, 67156
- Cancer Center of Kansas, P.A. - Winfield
-
-
Michigan
-
Adrian, Michigan, Spojené státy, 49221
- Hickman Cancer Center at Bixby Medical Center
-
Lambertville, Michigan, Spojené státy, 48144
- Haematology-Oncology Associates of Ohio and Michigan, P.C.
-
Monroe, Michigan, Spojené státy, 48162
- Community Cancer Center of Monroe
-
Monroe, Michigan, Spojené státy, 48162
- Mercy Memorial Hospital System
-
-
Minnesota
-
Alexandria, Minnesota, Spojené státy, 56308
-
Bemidji, Minnesota, Spojené státy, 56601
- MeritCare Clinic - Bemidji
-
Brainerd, Minnesota, Spojené státy, 56401
- Brainerd Medical Center
-
Brainerd, Minnesota, Spojené státy, 56401
- St. Joseph's Medical Center
-
Burnsville, Minnesota, Spojené státy, 55337
- Fairview Ridges Hospital
-
Coon Rapids, Minnesota, Spojené státy, 55433
- Mercy and Unity Cancer Center at Mercy Hospital
-
Edina, Minnesota, Spojené státy, 55435
- Fairview Southdale Hospital
-
Fergus Falls, Minnesota, Spojené státy, 56537
-
Fridley, Minnesota, Spojené státy, 55432
- Mercy and Unity Cancer Center at Unity Hospital
-
Hutchinson, Minnesota, Spojené státy, 55350
- Hutchinson Area Health Care
-
Lichfield, Minnesota, Spojené státy, 55355
- Meeker County Memorial Hospital
-
Maplewood, Minnesota, Spojené státy, 55109
- St. John's Hospital
-
Minneapolis, Minnesota, Spojené státy, 55415
- Hennepin County Medical Center - Minneapolis
-
Minneapolis, Minnesota, Spojené státy, 55407
- Virginia Piper Cancer Institute at Abbott-Northwestern Hospital
-
Montevideo, Minnesota, Spojené státy, 56265
- Chippewa County - Montevideo Hospital
-
Robbinsdale, Minnesota, Spojené státy, 55422-2900
- Hubert H. Humphrey Cancer Center at North Memorial Medical Center
-
Rochester, Minnesota, Spojené státy, 55905
- Mayo Clinic Cancer Center
-
Saint Cloud, Minnesota, Spojené státy, 56303
- Coborn Cancer Center
-
Saint Louis Park, Minnesota, Spojené státy, 55416
- CCOP - Metro-Minnesota
-
Shakopee, Minnesota, Spojené státy, 55379
- Saint Francis Cancer Center
-
St Paul, Minnesota, Spojené státy, 55102
- St. Joseph's Hospital
-
St. Cloud, Minnesota, Spojené státy, 56303
- CentraCare Clinic - River Campus
-
St. Louis Park, Minnesota, Spojené státy, 55416
- Park Nicollet Health Services
-
St. Paul, Minnesota, Spojené státy, 55102
- United Hospital
-
St. Paul, Minnesota, Spojené státy, 55101
- Regions Hospital Cancer Care Center
-
Waconia, Minnesota, Spojené státy, 55387
- Ridgeview Medical Center
-
Woodbury, Minnesota, Spojené státy, 55125
- Woodwinds Health Campus
-
-
North Dakota
-
Bismarck, North Dakota, Spojené státy, 58501
- Bismarck Cancer Center
-
Bismarck, North Dakota, Spojené státy, 58501
- Cancer Care Center at Medcenter One Hospital
-
Bismarck, North Dakota, Spojené státy, 58501
- Mid Dakota Clinic, P. C.
-
Bismarck, North Dakota, Spojené státy, 58502
- St. Alexius Medical Center
-
Fargo, North Dakota, Spojené státy, 58122
- CCOP - MeritCare Hospital
-
Fargo, North Dakota, Spojené státy, 58122
- MeritCare Medical Group
-
Grand Forks, North Dakota, Spojené státy, 58201
- Altru Cancer Center at Altru Hospital
-
-
Ohio
-
Bowling Green, Ohio, Spojené státy, 43402
- Wood County Oncology Center
-
Dayton, Ohio, Spojené státy, 45428
- Veterans Affairs Medical Center - Dayton
-
Dayton, Ohio, Spojené státy, 45405
- Grandview Hospital
-
Dayton, Ohio, Spojené státy, 45406
- Good Samaritan Hospital
-
Dayton, Ohio, Spojené státy, 45409
- David L. Rike Cancer Center at Miami Valley Hospital
-
Dayton, Ohio, Spojené státy, 45415
- Samaritan North Cancer Care Center
-
Dayton, Ohio, Spojené státy, 45429
- CCOP - Dayton
-
Findlay, Ohio, Spojené státy, 45840
- Blanchard Valley Medical Associates
-
Fremont, Ohio, Spojené státy, 43420
- Fremont Memorial Hospital
-
Kenton, Ohio, Spojené státy, 43326
- Kenton Oncology, Incorporated
-
Kettering, Ohio, Spojené státy, 45429
- Charles F. Kettering Memorial Hospital
-
Lima, Ohio, Spojené státy, 45804
- Lima Memorial Hospital
-
Maumee, Ohio, Spojené státy, 43537
- Northwest Ohio Oncology Center
-
Maumee, Ohio, Spojené státy, 43537
- St. Luke's Hospital
-
Middletown, Ohio, Spojené státy, 45044
- Middletown Regional Hospital
-
Oregon, Ohio, Spojené státy, 43616
- St. Charles Mercy Hospital
-
Oregon, Ohio, Spojené státy, 43616
- Toledo Clinic - Oregon
-
Sandusky, Ohio, Spojené státy, 44870
- Firelands Regional Medical Center
-
Sandusky, Ohio, Spojené státy, 44870
- North Coast Cancer Care, Incorporated
-
Sylvania, Ohio, Spojené státy, 43560
- Promedica Cancer Center at Flower Hospital
-
Tiffin, Ohio, Spojené státy, 44883
- Mercy Hospital of Tiffin
-
Toledo, Ohio, Spojené státy, 43608
- St. Vincent Mercy Medical Center
-
Toledo, Ohio, Spojené státy, 43606
- Toledo Hospital
-
Toledo, Ohio, Spojené státy, 43623
- Toledo Clinic, Incorporated - Main Clinic
-
Toledo, Ohio, Spojené státy, 43623
- CCOP - Toledo Community Hospital
-
Toledo, Ohio, Spojené státy, 43614
- Medical College of Ohio Cancer Institute
-
Toledo, Ohio, Spojené státy, 43623
- Toledo Surgical Specialists
-
Troy, Ohio, Spojené státy, 45373-1300
- UVMC Cancer Care Center at Upper Valley Medical Center
-
Wauseon, Ohio, Spojené státy, 43567
- Fulton County Health Center
-
Xenia, Ohio, Spojené státy, 45385
- Ruth G. McMillan Cancer Center at Greene Memorial Hospital
-
-
Pennsylvania
-
Allentown, Pennsylvania, Spojené státy, 18105
- Morgan Cancer Center at Lehigh Valley Hospital - Cedar Crest
-
Danville, Pennsylvania, Spojené státy, 17822-0001
- Geisinger Medical Center
-
State College, Pennsylvania, Spojené státy, 16801
- Geisinger Medical Group
-
Wilkes-Barre, Pennsylvania, Spojené státy, 18711
- Frank M. and Dorothea Henry Cancer Center at Geisinger Wyoming Valley Medical Center
-
-
South Dakota
-
Sioux Falls, South Dakota, Spojené státy, 57117-5039
- Sioux Valley Hospital and University of South Dakota Medical Center
-
Sioux Falls, South Dakota, Spojené státy, 57105-1080
- Avera McKennan Hospital and University Health Center
-
Sioux Falls, South Dakota, Spojené státy, 57105
- Medical X-Ray Center, P. C.
-
-
Wisconsin
-
La Crosse, Wisconsin, Spojené státy, 54601
- Franciscan Skemp Healthcare
-
-
Kritéria účasti
Kritéria způsobilosti
Kritéria způsobilosti
Věk způsobilý ke studiu
Přijímá zdravé dobrovolníky
Pohlaví způsobilá ke studiu
Popis
DISEASE CHARACTERISTICS:
Histologically or cytologically confirmed non-small cell lung cancer (NSCLC)
- Metastatic or unresectable disease
Measurable disease
- At least 1 lesion at least 2.0 cm
- Disease must be completely outside prior radiotherapy port OR documented disease progression since the completion of radiotherapy
- No meningeal carcinomatosis
No untreated brain metastases
- Current metastatic CNS disease must have been treated and clinically stable for at least 2 weeks prior to study chemotherapy
- No potentially curative treatment options available (e.g., chemotherapy with surgery or radiotherapy)
PATIENT CHARACTERISTICS:
Age
- 65 and over
Performance status
- ECOG 0-2
Life expectancy
- At least 12 weeks
Hematopoietic
- Absolute neutrophil count at least 1,500/mm^3
- Platelet count at least 100,000/mm^3
- Hemoglobin at least 10.0 g/dL
Hepatic
- Bilirubin no greater than 2.0 mg/dL
- No uncontrolled hepatic disease
Renal
- Creatinine no greater than 2 times upper limit of normal
- No uncontrolled renal disease
Cardiovascular
- No uncontrolled cardiac disease
Pulmonary
No clinically active interstitial lung disease
- Asymptomatic, chronic stable radiographic changes allowed
- No uncontrolled respiratory disease
Other
- Fertile patients must use effective contraception
- Able and willing to complete questionnaires alone or with assistance
- No known hypersensitivity to gefitinib or any of its excipients
- No active infection within the past 2 weeks
- No other prior malignancy within the past 5 years except basal cell skin cancer
- No grade 2 or greater peripheral neuropathy (CTC v2.0)
- No uncontrolled diabetes mellitus (for patients receiving study chemotherapy)
- No dysphagia or inability to swallow intact capsules
- No significant medical condition that would preclude study treatment or follow-up
- No severe or uncontrolled systemic disease
PRIOR CONCURRENT THERAPY:
Biologic therapy
- Not specified
Chemotherapy
- See Disease Characteristics
- No prior chemotherapy for metastatic NSCLC
Endocrine therapy
- Concurrent steroids allowed provided the dose is not changed
Radiotherapy
- See Disease Characteristics
- At least 3 weeks since prior radiotherapy and recovered
- No prior radiotherapy to more than 25% of marrow-containing skeleton
- No concurrent radiotherapy (including palliative)
Surgery
- See Disease Characteristics
- At least 3 weeks since prior major surgery
- No surgery within 7 days after study participation
Other
- More than 30 days since prior non-FDA approved investigational drugs
- No concurrent oral retinoids
No concurrent CYP3A4-inducing agents, including the following:
- Carbamazepine
- Oxcarbazepine
- Modafinil
- Ethosuximide
- Griseofulvin
- Nafcillin
- Phenobarbital
- Phenylbutazone
- Phenytoin
- Primidone
- Rifampin
- Hypericum perforatum (St. John's wort)
- Barbiturates
- Sulfinpyrazone
- No concurrent drugs that cause sustained elevation of gastric pH (≥ 5)
- No concurrent antacids within 4 hours before, during, and within 4 hours after gefitinib administration
- No concurrent itraconazole, fluconazole, ketoconazole, or erythromycin
Studijní plán
Jak je studie koncipována?
Detaily designu
- Primární účel: Léčba
- Přidělení: Nerandomizované
- Intervenční model: Paralelní přiřazení
- Maskování: Žádné (otevřený štítek)
Počet zbraní
Zbraně a zásahy
Skupina účastníků / ArmSkupina účastníků / Arm |
Intervence / LéčbaIntervence / Léčba |
|---|---|
|
Experimentální: gefitinib
Patients receive oral gefitinib on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. Quality of life is assessed at baseline and after the completion of course 2. Patients are followed every 3 months for 5 years. |
|
|
Experimentální: paclitaxel + carboplatin + gefitinib
Patients receive paclitaxel IV over 1 hour and carboplatin IV over 30 minutes on days 1, 8, and 15. Treatment repeats every 28 days for up to 4 courses in the absence of disease progression or unacceptable toxicity. After completion of chemotherapy and in the absence of disease progression, patients receive oral gefitinib as in group I. Quality of life is assessed at baseline and after the completion of course 2. Patients are followed every 3 months for 5 years. |
Co je měření studie?
Primární výstupní opatření
Primární výstupní opatření
Měření výsledku |
Časové okno |
|---|---|
|
Progression status at 6 months
Časové okno: at 6 months
|
at 6 months
|
Sekundární výstupní opatření
Sekundární výstupní opatření
Měření výsledku |
Časové okno |
|---|---|
|
Přežití bez progrese
Časové okno: Až 5 let
|
Až 5 let
|
|
Celkové přežití
Časové okno: Až 5 let
|
Až 5 let
|
|
Confirmed response rate (complete or partial response)
Časové okno: Up to 5 years
|
Up to 5 years
|
|
Quality of life as assessed by the Lung Cancer Symptom scale
Časové okno: Up to 5 years
|
Up to 5 years
|
|
Social support measure as assessed by the Lubben Social Network scale
Časové okno: Up to 5 years
|
Up to 5 years
|
Spolupracovníci a vyšetřovatelé
Sponzor
Sponzor
Spolupracovníci
Spolupracovníci
Publikace a užitečné odkazy
Termíny studijních záznamů
Hlavní termíny studia
Začátek studia
Začátek studia
Primární dokončení (Aktuální)
Primární dokončení
Dokončení studie (Aktuální)
Dokončení studie
Termíny zápisu do studia
První předloženo
První předloženo
První předloženo, které splnilo kritéria kontroly kvality
První předloženo, které splnilo kritéria kontroly kvality
První zveřejněno (Odhad)
První zveřejněno
Aktualizace studijních záznamů
Poslední zveřejněná aktualizace (Odhad)
Poslední zveřejněná aktualizace
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Naposledy ověřeno
Naposledy ověřeno
Více informací
Termíny související s touto studií
Další relevantní podmínky MeSH
- Nemoci dýchacích cest
- Novotvary
- Plicní onemocnění
- Novotvary podle místa
- Novotvary dýchacího traktu
- Novotvary hrudníku
- Karcinom, Bronchogenní
- Bronchiální novotvary
- Novotvary plic
- Karcinom, nemalobuněčné plíce
- Molekulární mechanismy farmakologického působení
- Inhibitory enzymů
- Antineoplastická činidla
- Tubulinové modulátory
- Antimitotické látky
- Modulátory mitózy
- Antineoplastické látky, fytogenní
- Inhibitory proteinkinázy
- Karboplatina
- Paklitaxel
- Gefitinib
Další identifikační čísla studie
Další identifikační čísla studie
- NCCTG-N0222
- NCI-2012-02535 (Identifikátor registru: CTRP (Clinical Trials Reporting System))
- CDR0000304453 (Identifikátor registru: PDQ (Physician Data Query))
Tyto informace byly beze změn načteny přímo z webu clinicaltrials.gov. Máte-li jakékoli požadavky na změnu, odstranění nebo aktualizaci podrobností studie, kontaktujte prosím register@clinicaltrials.gov. Jakmile bude změna implementována na clinicaltrials.gov, bude automaticky aktualizována i na našem webu .