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Studie fáze III Porovnání AAA817+ARPI versus standard péče u dospělých účastníků s PSMA-pozitivním MCRPC (AcTFirst)

14. října 2026 aktualizováno: Novartis Pharmaceuticals

Fáze III, otevřená značka, více centra, randomizovaná studie porovnávající AAA817+ARPI versus standard péče u dospělých účastníků s PSMA-pozitivním metastatickou kastrací odolný proti rakovině prostaty

The purpose of this study is to determine whether [225Ac]Ac-PSMA-617 (AAA817), given for up to 6 cycles at a dose of 10 Megabecquerel (MBq) +/- 10%, plus androgen receptor pathway inhibitor (ARPI), improves the radiographic progression free survival (rPFS) compared to investigator's choice of standard of care (SOC) (ARPI change or taxane-based chemotherapy or [177Lu]Lu-PSMA-617 (AAA617)) in adult participants with PSMA-positive metastatic castration resistant prostate cancer (mCRPC) treated with another ARPI as last treatment and who have not been exposed to a taxane-containing chemotherapy in the mCRPC setting nor have received any prior PSMA-targeting radioligand therapy.

Přehled studie

Postavení

Nábor

Podmínky

Intervence / Léčba

Detailní popis

This is a phase III, open label, multicenter randomized study. The study aims at evaluating the superiority of 225Ac-PSMA-617 combined with androgen receptor pathway inhibitor (ARPI) over a change of ARPI or chemotherapy or [177Lu]Lu-PSMA-617 (AAA617) in prolonging progression free survival (rPFS).

Screening period: At screening, the participants will be assessed for eligibility and will undergo a positron emission tomography (PET)/computed tomography (CT) scan to evaluate PSMA positivity. Only participants with PSMA positive cancer and confirmed eligibility criteria will be randomized.

Participants randomized to the investigational arms will receive up to 6 doses of AAA817 10 Mbq +/- 10% given intravenously with or without an ARPI (oral enzalutamide or oral abiraterone) per investigator's choice. Treatment with ARPI should continue as per protocol end of treatment criteria.

Participants randomized to SoC will be treated with an ARPI change (oral enzalutamide or oral abiraterone) or taxane-based chemotherapy (docetaxel or cabazitaxel) or [177Lu]Lu-PSMA-617 (AAA617)' per investigator's choice. Treatment with ARPI should continue as per protocol end of treatment criteria. Treatment duration with taxane-based chemotherapy or AAA617will depend on the chosen regimen per the investigator's discretion following local guidelines as per standard of care and product labels and adhere to the protocol end of treatment criteria.

Supportive care will be allowed in both arms at the discretion of the investigator and includes available care for the eligible participant according to best institutional practice for mCRPC treatment, including androgen deprivation therapy (ADT).

Safety will be assessed routinely during the study. Crossover is not allowed among study arms.

The study will be conducted in the USA among other countries globally.

Typ studie

Intervenční

Zápis (Odhadovaný)

940

Fáze

  • Fáze 3

Kontakty a umístění

Tato část poskytuje kontaktní údaje pro ty, kteří studii provádějí, a informace o tom, kde se tato studie provádí.

Studijní kontakt

Studijní záloha kontaktů

  • Jméno: Novartis Pharmaceuticals
  • Telefonní číslo: +41613241111

Studijní místa

      • Adelaide, Austrálie, 5000
        • Nábor
        • Novartis Investigative Site
    • New South Wales
      • Darlinghurst, New South Wales, Austrálie, 2010
        • Nábor
        • Novartis Investigative Site
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      • Orange, California, Spojené státy, 92868
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      • Denver, Colorado, Spojené státy, 80218
        • Nábor
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        • Vrchní vyšetřovatel:
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      • Chicago, Illinois, Spojené státy, 60611
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        • Vrchní vyšetřovatel:
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      • Chicago, Illinois, Spojené státy, 60612
        • Nábor
        • University of Illinois Cancer Center at Chicago
        • Vrchní vyšetřovatel:
          • Natalie Reizine
        • Kontakt:
          • Ethan Gu
          • Telefonní číslo: 312-413-2746
          • E-mail: egu3@uic.edu
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      • Iowa City, Iowa, Spojené státy, 52242
        • Nábor
        • Univ Of Iowa Hospitals And Clinics
        • Kontakt:
        • Vrchní vyšetřovatel:
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      • Kansas City, Kansas, Spojené státy, 66160
        • Nábor
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      • Scarborough, Maine, Spojené státy, 04074
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        • Vrchní vyšetřovatel:
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      • Baltimore, Maryland, Spojené státy, 21287
        • Nábor
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        • Vrchní vyšetřovatel:
          • Ana Kiess
        • Kontakt:
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      • Boston, Massachusetts, Spojené státy, 02215
      • Boston, Massachusetts, Spojené státy, 02215
        • Nábor
        • Beth Israel Deaconess Med Center
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          • Glenn Bubley
        • Kontakt:
    • Michigan
      • Detroit, Michigan, Spojené státy, 48201
        • Nábor
        • Karmanos Cancer Institute
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        • Vrchní vyšetřovatel:
          • Nitin Vaishampayan
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      • St Louis, Missouri, Spojené státy, 63110
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          • Jeff Michalski
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      • Omaha, Nebraska, Spojené státy, 68154
    • New Jersey
      • East Brunswick, New Jersey, Spojené státy, 08816
      • Voorhees Township, New Jersey, Spojené státy, 08043
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        • Vrchní vyšetřovatel:
          • Gordon Brown
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      • Albuquerque, New Mexico, Spojené státy, 87109
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      • Cooperstown, New York, Spojené státy, 13326
        • Nábor
        • Bassett Medical Center
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        • Vrchní vyšetřovatel:
          • Timothy Korytko
      • New York, New York, Spojené státy, 10021
        • Nábor
        • Weill Cornell Medicine NY-Presb
        • Vrchní vyšetřovatel:
          • Scott Tagawa
        • Kontakt:
      • Rochester, New York, Spojené státy, 14642
      • Syracuse, New York, Spojené státy, 13210
        • Nábor
        • Associated Med Professionals of NY
        • Vrchní vyšetřovatel:
          • Steven Finkelstein
        • Kontakt:
      • The Bronx, New York, Spojené státy, 10461
        • Nábor
        • Montefiore Medical Center
        • Vrchní vyšetřovatel:
          • Benjamin A Gartrell
        • Kontakt:
    • Ohio
      • Cincinnati, Ohio, Spojené státy, 45212
        • Nábor
        • Urology Group - Solaris Network
        • Kontakt:
        • Vrchní vyšetřovatel:
          • Marc Pliskin
      • Gahanna, Ohio, Spojené státy, 43230
    • South Carolina
      • Charleston, South Carolina, Spojené státy, 29425
        • Nábor
        • MUSC Hollings Cancer Center
        • Vrchní vyšetřovatel:
          • Kevin Becker
        • Kontakt:
      • Myrtle Beach, South Carolina, Spojené státy, 29572
        • Nábor
        • Carolina Urologic Research Center
        • Vrchní vyšetřovatel:
          • Neal D Shore
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    • Tennessee
      • Chattanooga, Tennessee, Spojené státy, 37404
        • Nábor
        • Tennessee Oncology PLLC
        • Vrchní vyšetřovatel:
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    • Texas
      • Lakeway, Texas, Spojené státy, 78738
      • San Antonio, Texas, Spojené státy, 78229
      • The Woodlands, Texas, Spojené státy, 77384
        • Nábor
        • Woodlands Cancer Institute American Oncology Partners
        • Kontakt:
        • Vrchní vyšetřovatel:
          • Jason Berilgen
    • Washington
      • Seattle, Washington, Spojené státy, 98122-4379
        • Nábor
        • Swedish Medical Center
        • Vrchní vyšetřovatel:
          • Song Zhao
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      • Tacoma, Washington, Spojené státy, 98405
        • Nábor
        • Northwest Medical Specialties
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          • Li Zhang
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    • West Virginia
      • Morgantown, West Virginia, Spojené státy, 26506
        • Nábor
        • West Virginia University Hospital
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        • Vrchní vyšetřovatel:
          • Raheel Siddiqui
    • Wisconsin
      • Milwaukee, Wisconsin, Spojené státy, 53226
        • Nábor
        • Medical College of Wisconsin
        • Vrchní vyšetřovatel:
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        • Kontakt:
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Kritéria účasti

Výzkumníci hledají lidi, kteří odpovídají určitému popisu, kterému se říká kritéria způsobilosti. Některé příklady těchto kritérií jsou celkový zdravotní stav osoby nebo předchozí léčba.

Kritéria způsobilosti

Věk způsobilý ke studiu

18 let až 100 let (Dospělý, Starší dospělý)

Přijímá zdravé dobrovolníky

Ne

Pohlaví způsobilá ke studiu

Mužský

Popis

Key Inclusion Criteria:

  • Signed informed consent must be obtained prior to participation in the study.

  • Participants must be adults ≥ 18 years of age.

  • Participants must have an ECOG performance status of 0 to 2.

  • Participants must have histological, and/or cytological confirmation of adenocarcinoma of the prostate. Participants with mixed histology (neuroendocrine) are not eligible.

  • Participants who have received taxane-based chemotherapy in mHSPC setting are eligible if they are deemed appropriate for chemotherapy, ARPI change or AAA617 as the next line of therapy in the opinion of the Investigator. Note: Participants who have received taxane-based chemotherapy for mCRPC are excluded.

  • Participants must not have received taxane-based chemotherapy in mCRPC setting (allowed in mHSPC setting).

  • Participants must have PSMA-PET positive disease using a PSMA imaging agent that is approved as per protocol.

  • Participant must have been diagnosed with mCRPC with documented progressive disease while on treatment with ARPI in mHSPC or earlier setting as their last treatment (and did not progress on more than one ARPI).

    • Participants with deleterious or suspected deleterious germline or somatic homologous recombination repair (HRR) gene-mutated metastatic castration-resistant prostate cancer, as per local testing, may be enrolled if they had prior exposure to PARPi.

Key Exclusion Criteria:

  • Previous anti-cancer treatment with any approved or investigational radiopharmaceuticals (for example, [177Lu]Lu-PSMA, [177Lu]-DOTA, or Radium- 223.)

  • Previous treatment with any external beam radiotherapy including hemi-body radiation within 6 weeks of randomization (within 2 weeks for radiotherapy of localized metastases).

    • Any prior PARP inhibitor or other systemic anticancer therapy administered for metastatic castration-resistant prostate cancer (mCRPC). Any other approved or investigational systemic therapy (including chemotherapy, immunotherapy, biologics, or monoclonal antibodies) is prohibited within 28 days or 5 half-lives (whichever is shorter) before randomization.

Note: Prior ARPI administered in the mHSPC setting or earlier may continue until C1D1.

Other protocol-defined inclusion/exclusion criteria may apply.

Studijní plán

Tato část poskytuje podrobnosti o studijním plánu, včetně toho, jak je studie navržena a co studie měří.

Jak je studie koncipována?

Detaily designu

  • Primární účel: Diagnostický
  • Přidělení: Randomizované
  • Intervenční model: Paralelní přiřazení
  • Maskování: Žádné (otevřený štítek)

Zbraně a zásahy

Skupina účastníků / Arm
Intervence / Léčba
Experimentální: Investigational Arm: AAA817+ARPI (enzalutamide or abiraterone)

Participants will receive AAA817 infusion directly into a vein with ARPIs.

AAA817 is being studied for treating PSMA positive mCRPC. Inside the body, it attaches itself to PSMA on the cell surface of the prostate cancer cells and emits radiation to kill them. This treatment is also called a radioligand therapy.

Ostatní jména:
  • [225Ac]Ac-PSMA-617

Androgen receptor pathway inhibitor (ARPI): An ARPI is approved for the treatment of prostate cancer. It works by blocking signals from male hormones, such as testosterone, that helps cancer cells grow. By blocking these signals, an ARPI slows down or stops the growth of prostate cancer cells. In this trial, participants will be given either enzalutamide or abiraterone.

Ostatní jména:
  • Enzalutamid nebo Abiraterone
Experimentální: Investigational Arm: AAA817

Participants will receive AAA817 infusion directly into a vein.

AAA817 is being studied for treating PSMA positive mCRPC. Inside the body, it attaches itself to PSMA on the cell surface of the prostate cancer cells and emits radiation to kill them. This treatment is also called a radioligand therapy.

Ostatní jména:
  • [225Ac]Ac-PSMA-617
Aktivní komparátor: Control arm: Investigator's choice of SoC (ARPI or chemotherapy or AAA617)

Participants will receive standard treatment as decided by the trial doctor either as a taxane-based chemotherapy infusion directly into a vein or ARPI change either as capsules or tablets or AAA617 monotherapy infusion directly into a vein.

Androgen receptor pathway inhibitor (ARPI): An ARPI is approved for the treatment of prostate cancer. It works by blocking signals from male hormones, such as testosterone, that helps cancer cells grow. By blocking these signals, an ARPI slows down or stops the growth of prostate cancer cells. In this trial, participants will be given either enzalutamide or abiraterone.

Ostatní jména:
  • Enzalutamid nebo Abiraterone

Standard treatment includes approved treatment for mCRPC. In this trial, the trial doctor will decide which available treatment participants will receive. The trial doctor will select either an ARPI of enzalutamide or abiraterone, or a taxane based chemotherapy of docetaxel or cabazitaxel or [177Lu]Lu-PSMA-617 (AAA617).

Ostatní jména:
  • Arpi enzalutamid
  • Arpi Abiraterone
  • Chemoterapie docetaxelu na bázi taxanu
  • Chemoterapie Cabazitaxelu na bázi taxanu
  • [177Lu]Lu-PSMA-617 (AAA617)

Co je měření studie?

Primární výstupní opatření

Měření výsledku
Popis opatření
Časové okno
Radiographic Progression Free Survival (rPFS)
Časové okno: From the date of randomization to the date of the first documented radiographic disease progression using conventional imaging, or death due to any cause, whichever occurs first, assessed up to approximately 40.0 months.

Time to radiographic disease progression or death due to any cause.

From the date of randomization to the date of the first documented radiographic disease progression using conventional imaging, or death due to any cause, whichever occurs first, assessed up to approximately 40.0 months.

Sekundární výstupní opatření

Měření výsledku
Popis opatření
Časové okno
Overall Survival (OS) (Key Secondary Endpoint)
Časové okno: From the date of randomization to the date of death due to any cause, assessed up to approximately 40 months.

Time to death due to any cause.

From the date of randomization to the date of death due to any cause, assessed up to approximately 40 months.
Radiographic Progression Free Survival by by Prostate Cancer Working Group 3 (PCWG3)-modified RECIST v1.1 (Key Secondary)
Časové okno: From date of randomization to the date of the first documented radiographic disease progression or death due to any cause, whichever occurs first, assessed up to approximately 40.0 months.

Time to radiographic disease progression, using by blinded independent central review (BICR) using conventional imaging and Prostate Cancer Working Group 3 (PCWG3)-modified RECIST v1.1 criteria or death due to any cause.

From date of randomization to the date of the first documented radiographic disease progression or death due to any cause, whichever occurs first, assessed up to approximately 40.0 months.
Overall Survival in participants with PSMA-positive mCRPC treated with another ARPI. (Key Secondary)
Časové okno: From the date of randomization to the date of death due to any cause.

Time to death due to any cause.

From the date of randomization to the date of death due to any cause.
rPFS in participants treated with AAA817
Časové okno: From the date of randomization to the date of the first documented radiographic disease progression, or death due to any cause, whichever occurs first, assessed up to approximately 40.0 months.

rPFS time to the date of first documented radiographic disease progression or death due to any cause, whichever occurs first.

From the date of randomization to the date of the first documented radiographic disease progression, or death due to any cause, whichever occurs first, assessed up to approximately 40.0 months.
Progression Free Survival (PFS)
Časové okno: From date of randomization to the first documented progression by investigator's assessment or death due to any cause, whichever occurs first, assessed up to approximately 40.0 months.

Time to first documented progression or death due to any cause.

From date of randomization to the first documented progression by investigator's assessment or death due to any cause, whichever occurs first, assessed up to approximately 40.0 months.
Progression Free Survival (PFS2)
Časové okno: From date of randomization until date of second progression or date of death from any cause, whichever comes first, assessed up to approximately 40.0 months.

Time to first documented progression on next line of antineoplastic therapy or death from any cause.

From date of randomization until date of second progression or date of death from any cause, whichever comes first, assessed up to approximately 40.0 months.
Overall Response Rate (ORR)
Časové okno: From the date of randomization to the date of the first documented radiographic disease progression, or death due to any cause, whichever occurs first, assessed up to approximately 40.0 months.

The proportion of participants with best overall response (BOR) of confirmed complete response (CR) or partial response (PR) in soft tissue.

From the date of randomization to the date of the first documented radiographic disease progression, or death due to any cause, whichever occurs first, assessed up to approximately 40.0 months.
Disease Control Rate (DCR)
Časové okno: From the date of randomization to the date of the first documented radiographic disease progression or death due to any cause, whichever occurs first, assessed up to approximately 40.0 months.

The proportion of participants with BOR of confirmed CR, PR, stable disease (SD) or non-CR/non-progressive disease (PD) in soft tissue.

From the date of randomization to the date of the first documented radiographic disease progression or death due to any cause, whichever occurs first, assessed up to approximately 40.0 months.
Duration of Response (DoR)
Časové okno: From the date of first documented response (CR or PR) for confirmed responders and the date of first documented radiographic progression in soft tissue or death due to any cause, whichever occurs first, assessed up to approximately 40.0 months.

Time between the date of first documented response and the date of first documented radiographic progression or death due to any cause.

From the date of first documented response (CR or PR) for confirmed responders and the date of first documented radiographic progression in soft tissue or death due to any cause, whichever occurs first, assessed up to approximately 40.0 months.
Time to first radiographic soft tissue progression (TTSTP)
Časové okno: From the date of randomization to the date of radiographic soft tissue progression or death due to any cause, whichever occurs first, assessed up to approximately 40.0 months.

Time to radiographic soft tissue progression.

From the date of randomization to the date of radiographic soft tissue progression or death due to any cause, whichever occurs first, assessed up to approximately 40.0 months.
Time to first symptomatic skeletal event (TTSSE)
Časové okno: From the date of randomization to the date of the first documented radiographic disease progression, or death due to any cause, whichever occurs first, assessed up to approximately 40.0 months.

Time to date of first new symptomatic skeletal event of death due to any cause.

From the date of randomization to the date of the first documented radiographic disease progression, or death due to any cause, whichever occurs first, assessed up to approximately 40.0 months.
Prostate specific antigen response (PSA50 and PSA90)
Časové okno: From the date of randomization to the date of safety follow up, assessed up to approximately 40.0 months.

The percentage of participants who achieved ≥ 50% and ≥ 90% decrease from baseline, respectively.

From the date of randomization to the date of safety follow up, assessed up to approximately 40.0 months.
Time-concentration profiles and PK parameters of AAA817
Časové okno: From Cycle 1 Day 1 up to approximately cycle 5 days 11 (each cycle is 8 weeks).

Time-concentration profiles and PK parameters of AAA817 (e.g. AUC, Cmax).

From Cycle 1 Day 1 up to approximately cycle 5 days 11 (each cycle is 8 weeks).
Change from baseline on FACT-P Prostate Cancer Subscale (PCS)
Časové okno: From randomization to the first occurrence of worsening on the score or death due to any cause, whichever occurs first, assessed up to approximately 40.0 months.

Change from baseline on FACT-P Prostate Cancer Subscale (PCS). FACT-P assesses symptoms/problems related to prostate carcinoma and its treatment.

From randomization to the first occurrence of worsening on the score or death due to any cause, whichever occurs first, assessed up to approximately 40.0 months.
Time to worsening on the Worst Pain
Časové okno: From randomization to the first occurrence of worsening from baseline, or death due to any cause, whichever occurs first, assessed up to approximately 40.0 months.

Time to worsening on the Worst Pain is defined as the time from randomization to the first occurrence of worsening on the Worst Pain item (BPI-SF) or death due to any cause, whichever occurs first.

From randomization to the first occurrence of worsening from baseline, or death due to any cause, whichever occurs first, assessed up to approximately 40.0 months.

Spolupracovníci a vyšetřovatelé

Zde najdete lidi a organizace zapojené do této studie.

Sponzor

Vyšetřovatelé

  • Ředitel studie: Novartis Pharmaceuticals, Novartis Pharmaceuticals

Termíny studijních záznamů

Tato data sledují průběh záznamů studie a předkládání souhrnných výsledků na ClinicalTrials.gov. Záznamy ze studií a hlášené výsledky jsou před zveřejněním na veřejné webové stránce přezkoumány Národní lékařskou knihovnou (NLM), aby se ujistily, že splňují specifické standardy kontroly kvality.

Hlavní termíny studia

Začátek studia (Aktuální)

1. července 2025

Primární dokončení (Odhadovaný)

29. září 2028

Dokončení studie (Odhadovaný)

4. listopadu 2032

Termíny zápisu do studia

První předloženo

18. února 2025

První předloženo, které splnilo kritéria kontroly kvality

26. února 2025

První zveřejněno (Aktuální)

3. března 2025

Aktualizace studijních záznamů

Poslední zveřejněná aktualizace (Aktuální)

15. října 2026

Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality

14. října 2026

Naposledy ověřeno

1. října 2026

Více informací

Termíny související s touto studií

Další identifikační čísla studie

  • CAAA817B12301
  • 2024-512340-32 (Identifikátor registru: EU CTIS)

Plán pro data jednotlivých účastníků (IPD)

Plánujete sdílet data jednotlivých účastníků (IPD)?

ANO

Popis plánu IPD

Novartis is committed to sharing with qualified external researchers, access to patient-level data and supporting clinical documents from eligible studies. These requests are reviewed and approved by an independent review panel on the basis of scientific merit. All data provided is anonymized to respect the privacy of patients who have participated in the trial in line with applicable laws and regulations.

This trial data availability is according to the criteria and process described on www.clinicalstudydatarequest.com

Informace o lécích a zařízeních, studijní dokumenty

Studuje lékový produkt regulovaný americkým FDA

Ano

Studuje produkt zařízení regulovaný americkým úřadem FDA

Ne

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