- ICH GCP
- Registro degli studi clinici negli Stati Uniti
- Sperimentazione clinica NCT03743766
Nivolumab, BMS-936558 in associazione con Relatlimab, BMS-986016 in pazienti con melanoma metastatico naïve a precedente immunoterapia nel setting metastatico
Uno studio di fase II sull'anticorpo monoclonale anti-PD1 (Nivolumab, BMS-936558) somministrato in combinazione con l'anticorpo monoclonale anti-LAG3 (Relatlimab, BMS-986016) in pazienti con melanoma metastatico naïve a precedente immunoterapia nel setting metastatico
Panoramica dello studio
Stato
Condizioni
Intervento / Trattamento
Descrizione dettagliata
Tipo di studio
Iscrizione (Effettivo)
Fase
- Fase 2
Contatti e Sedi
Luoghi di studio
-
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Pennsylvania
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Pittsburgh, Pennsylvania, Stati Uniti, 15232
- UPMC Hillman Cancer Center
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Criteri di partecipazione
Criteri di ammissibilità
Età idonea allo studio
Accetta volontari sani
Descrizione
Criterio di inclusione:
• Uomini o donne di età pari o superiore a 18 anni che soddisfano i criteri AJCC 8a edizione per melanoma non resecabile in stadio IIIB, stadio IIIC, stadio IIID o stadio IV che non hanno ricevuto trattamento con immunoterapia nel contesto metastatico
Criteri di esclusione:
Metastasi del SNC note o sospette, con le seguenti eccezioni:
- I soggetti con metastasi cerebrali controllate potranno iscriversi. Le metastasi cerebrali controllate sono definite come nessuna progressione radiografica per almeno 4 settimane dopo la radioterapia e/o il trattamento chirurgico al momento del consenso. I soggetti devono essere senza steroidi per almeno 2 settimane prima della randomizzazione.
- I soggetti con segni o sintomi di metastasi cerebrali non sono ammissibili a meno che le metastasi cerebrali non siano escluse dalla tomografia computerizzata o dalla risonanza magnetica.
- Malattia autoimmune attiva che richiede trattamento, ad eccezione di diabete mellito di tipo 1, vitiligine, asma/atopia infantile risolta, iper/ipotiroidismo controllato, iposurrenalismo o ipopituitarismo.
- - Precedente trattamento sistemico nel contesto metastatico, inclusi anticorpi anti-PD1, anti-PDL1, anti-PDL2, anti-CTLA-4 o qualsiasi altro anticorpo o farmaco mirato specificamente alla costimolazione delle cellule T o ai percorsi del checkpoint immunitario; o chemioterapia.
- Precedente trattamento adiuvante con anticorpo anti-PD1, anti-PDL1 e/o anti-LAG3. Si noti che un precedente trattamento adiuvante con terapia mirata (ad es. sarebbe consentita l'inibizione di BRAF/MEK), l'anti-CTLA4 o il trattamento non altrimenti specificato sopra.
- Melanoma oculare
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Trattamento
- Assegnazione: Randomizzato
- Modello interventistico: Assegnazione parallela
- Mascheramento: Nessuno (etichetta aperta)
Armi e interventi
Gruppo di partecipanti / Arm |
Intervento / Trattamento |
|---|---|
|
Sperimentale: Relatlimab
Ciclo 1: Relatlimab (BMS-986016) viene fornito come formulazione sterile da 10 mg/mL da somministrare come infusione endovenosa (IV) a 160 mg IV per le prime 4 settimane (ciclo 1). Ciclo 2+: la terapia di combinazione verrà somministrata mediante infusione sequenziale. Nivolumab somministrato a 480 mg EV seguito da infusione di relatlimab a 160 mg EV una volta ogni 4 settimane. |
Relatlimab (BMS-986016) - Formulazione da 10 mg/mL da somministrare come infusione endovenosa (IV) a 160 mg IV.
Altri nomi:
|
|
Sperimentale: Nivolumab
Ciclo 1: Nivolumab (BMS-936558) viene fornito come formulazione sterile da 10 mg/mL da somministrare come infusione endovenosa a 480 mg EV per le prime 4 settimane. Ciclo 2+: la terapia di combinazione verrà somministrata mediante infusione sequenziale. Nivolumab somministrato a 480 mg EV seguito da infusione di relatlimab a 160 mg EV una volta ogni 4 settimane. |
Nivolumab (BMS-936558) - Formulazione da 10 mg/mL da somministrare come infusione endovenosa a 480 mg EV.
Altri nomi:
|
|
Sperimentale: Relatlimab + Nivolumab
Ciclo 1+: la terapia di combinazione verrà somministrata mediante infusione sequenziale.
Nivolumab somministrato a 480 mg EV seguito da infusione di relatlimab a 160 mg EV per le prime 4 settimane (Ciclo 1), quindi una volta ogni 4 settimane successivamente.
|
La terapia di combinazione (Relatlimab + Nivolumab) verrà somministrata mediante infusione sequenziale.
Nivolumab somministrato a 480 mg EV seguito da infusione di relatlimab a 160 mg EV.
Altri nomi:
|
Cosa sta misurando lo studio?
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
LAG3 Gene Expression From scRNAseq
Lasso di tempo: At Baseline
|
Percent Lymphocyte-activation gene 3 (LAG3) level (cell surface molecule expressed on activated T cells) expression from scRNAseq
|
At Baseline
|
|
LAG3 Gene Expression From scRNAseq
Lasso di tempo: At Week 4
|
Percent Lymphocyte-activation gene 3 (LAG3) level (cell surface molecule expressed on activated T cells) expression from scRNAseq
|
At Week 4
|
|
PD1 Expression
Lasso di tempo: At baseline (Week 0)
|
Percent PD1 (programmed cell death protein 1) expression after completion of lead-in phase.
|
At baseline (Week 0)
|
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PD1 Expression
Lasso di tempo: At Week 4
|
Percent PD1 (programmed cell death protein 1) expression after completion of lead-in phase.
|
At Week 4
|
|
Change in Tumor Size
Lasso di tempo: At baseline and at 4 weeks
|
Percentage change in tumor size assessed per Response Evaluation Criteria in Solid Tumors. Per RECIST 1.1, Tumor lesions: Must be accurately measured in at least one dimension (longest diameter in the plane of measurement is to be recorded) with a minimum size of:
|
At baseline and at 4 weeks
|
|
Overall Response Rate (ORR)
Lasso di tempo: Beginning at 12 weeks post initial treatment, up to 4 years
|
Percent of participants experiencing Complete Response (CR) + Number of participants experiencing Partial Response (PR)/total patients assessed.
Per RECIST v1.1, CR: Disappearance of all target lesions.
Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to <10 mm.
PR: At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters.
PD: At least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study).
In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm.
(Note: the appearance of one or more new lesions is also considered progression).
SD: Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum diameters while on study.
|
Beginning at 12 weeks post initial treatment, up to 4 years
|
|
Overall Response Rate (ORR) - ITT (Intent-to-treat) Population
Lasso di tempo: Beginning at 12 weeks post initial treatment, up to 4 years
|
Percent of participants experiencing Complete Response (CR) + Number of participants experiencing Partial Response (PR)/total patients assessed.
Per RECIST v1.1, CR: Disappearance of all target lesions.
Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to <10 mm.
PR: At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters.
PD: At least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study).
In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm.
(Note: the appearance of one or more new lesions is also considered progression).
SD: Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum diameters while on study.
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Beginning at 12 weeks post initial treatment, up to 4 years
|
Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Durata della risposta
Lasso di tempo: 12 settimane dopo il trattamento iniziale, fino a 4 anni
|
Tempo dalla prima risposta completa (CR) o risposta parziale (PR) documentata fino alla prima data in cui la malattia progressiva è oggettivamente documentata.
Secondo RECIST v1.1, CR: scomparsa di tutte le lesioni bersaglio.
Eventuali linfonodi patologici (bersaglio o non bersaglio) devono presentare una riduzione in asse corto a
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12 settimane dopo il trattamento iniziale, fino a 4 anni
|
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Sopravvivenza libera da progressione (PFS)
Lasso di tempo: Fino a 4 anni
|
La sopravvivenza libera da progressione è definita come il tempo che intercorre tra la data di randomizzazione e la prima data di progressione documentata o decesso dovuto a qualsiasi causa, a seconda di quale evento si verifichi per primo.
Secondo RECIST v1.1, Malattia progressiva (PD): almeno un aumento del 20% nella somma dei diametri delle lesioni bersaglio, prendendo come riferimento la somma più piccola nello studio (questa include la somma di riferimento se questa è la più piccola nello studio).
Oltre all'incremento relativo del 20%, la somma deve dimostrare anche un incremento assoluto di almeno 5 mm.
|
Fino a 4 anni
|
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Sopravvivenza globale (SO)
Lasso di tempo: Fino a 4 anni
|
La sopravvivenza globale è definita come il tempo che intercorre tra la data di randomizzazione e la data di morte per qualsiasi causa.
|
Fino a 4 anni
|
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Secondary Outcome: Clinical Benefit Rate
Lasso di tempo: 12 weeks post initial treatment, up to 4 years
|
Percent of patients with Complete Response (CR) + Partial Response (PR) + Stable Disease (SD) / total patients assessed per RECIST v1.1.
CR: Disappearance of all target lesions.
Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to <10 mm.
PR: At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters; SD: Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum diameters while on study.
|
12 weeks post initial treatment, up to 4 years
|
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Clinical Benefit Rate - ITT (Intent-to-treat) Population
Lasso di tempo: 12 weeks post initial treatment, up to 4 years
|
Percent of patients with Complete Response (CR) + Partial Response (PR) + Stable Disease (SD) / total patients assessed per RECIST v1.1.
CR: Disappearance of all target lesions.
Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to <10 mm.
PR: At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters; SD: Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum diameters while on study.
|
12 weeks post initial treatment, up to 4 years
|
|
Progression-free Survival (PFS) by Lead-in Arm
Lasso di tempo: Up to 4 years
|
Progression-free survival is defined as the time between the date of randomization and the first date of documented progression or death due to any cause, whichever occurs first.
Per RECIST v1.1, Progressive Disease (PD): At least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study).
In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm.
|
Up to 4 years
|
|
CD8+ Tumor Infiltrating Lymphocytes
Lasso di tempo: At Baseline
|
Number of CD8+ tumor infiltrating lymphocytes present.
|
At Baseline
|
|
CD8+ Tumor Infiltrating Lymphocytes
Lasso di tempo: At Week 4
|
Number of CD8+ tumor infiltrating lymphocytes present.
|
At Week 4
|
|
CD4+ Tumor Infiltrating Lymphocytes
Lasso di tempo: At Week 4
|
Number of CD4+ tumor infiltrating lymphocytes present.
|
At Week 4
|
|
CD4+ Tumor Infiltrating Lymphocytes
Lasso di tempo: At Baseline
|
Number of CD4+ tumor infiltrating lymphocytes present.
|
At Baseline
|
|
LAG3 Levels - PBMC
Lasso di tempo: At Baseline
|
To determine the amount of LAG3 expressed on activated T cells in the blood through single-cell RNA sequencing.
The LAG3 expression is reported as the natural log (ln) of the number of LAG3 transcripts divided by the number of total mapped reads plus 1.
|
At Baseline
|
|
LAG3 Levels - PBMC
Lasso di tempo: At Week 4
|
To determine the amount of LAG3 expressed on activated T cells in the blood through single-cell RNA sequencing.
The LAG3 expression is reported as the natural log (ln) of the number of LAG3 transcripts divided by the number of total mapped reads plus 1.
|
At Week 4
|
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LAG3 Levels - TIL
Lasso di tempo: At Baseline
|
To determine the amount of LAG3 expressed on activated tumor infiltrating lymphocytes (TIL) through single-cell RNA sequencing.
The LAG3 expression is reported as the natural log (ln) of the number of LAG3 transcripts divided by the number of total mapped reads plus 1.
|
At Baseline
|
|
LAG3 Levels - PBMC
Lasso di tempo: At Week 16
|
To determine the amount of LAG3 expressed on activated T cells in the blood through single-cell RNA sequencing.
The LAG3 expression is reported as the natural log (ln) of the number of LAG3 transcripts divided by the number of total mapped reads plus 1.
|
At Week 16
|
|
LAG3 Levels - TIL
Lasso di tempo: At Week 4
|
To determine the amount of LAG3 expressed on activated tumor infiltrating lymphocytes (TIL) through single-cell RNA sequencing.
The LAG3 expression is reported as the natural log (ln) of the number of LAG3 transcripts divided by the number of total mapped reads plus 1.
|
At Week 4
|
|
PD-1 Expression in PBMC
Lasso di tempo: At Baseline
|
To determine the amount of PD-1 (programmed cell death protein 1) expressed on PBMCs through single-cell RNA sequencing in treated patients.
The PD-1 expression is reported as the natural log (ln) of the number of PD-1 transcripts divided by the number of total mapped reads plus 1.
|
At Baseline
|
|
PD-1 Expression in PBMC
Lasso di tempo: At Week 4
|
To determine the amount of PD-1 (programmed cell death protein 1) expressed on PBMCs through single-cell RNA sequencing in treated patients.
The PD-1 expression is reported as the natural log (ln) of the number of PD-1 transcripts divided by the number of total mapped reads plus 1.
|
At Week 4
|
|
PD-1 Expression in PBMC
Lasso di tempo: At Week 16
|
To determine the amount of PD-1 (programmed cell death protein 1) expressed on PBMCs through single-cell RNA sequencing in treated patients.
The PD-1 expression is reported as the natural log (ln) of the number of PD-1 transcripts divided by the number of total mapped reads plus 1.
|
At Week 16
|
|
PD-1 Expression in TIL
Lasso di tempo: At Baseline
|
To determine the amount of PD-1 (programmed cell death protein 1) expressed on TILs through single-cell RNA sequencing in treated patients.
The PD-1 expression is reported as the natural log (ln) of the number of PD-1 transcripts divided by the number of total mapped reads plus 1.
|
At Baseline
|
|
PD-1 Expression in TIL
Lasso di tempo: At Week 4
|
To determine the amount of PD-1 (programmed cell death protein 1) expressed on TILs through single-cell RNA sequencing in treated patients.
The PD-1 expression is reported as the natural log (ln) of the number of PD-1 transcripts divided by the number of total mapped reads plus 1.
|
At Week 4
|
|
Cell Effector/Memory Status - TIL
Lasso di tempo: At Baseline
|
Measure of cells that have previously encountered and responded to their cognate antigen in TIL.
|
At Baseline
|
|
Cell Effector/Memory Status - TIL
Lasso di tempo: At Week 4
|
Measure of cells that have previously encountered and responded to their cognate antigen in TIL.
|
At Week 4
|
|
Cell Effector/Memory Status - PBMCs
Lasso di tempo: At Baseline
|
Measure of cells that have previously encountered and responded to their cognate antigen in PBMCs.
|
At Baseline
|
|
Cell Effector/Memory Status - PBMC
Lasso di tempo: At Week 4
|
Measure of cells that have previously encountered and responded to their cognate antigen in PBMCs.
|
At Week 4
|
|
Cell Effector/Memory Status - PBMC
Lasso di tempo: At Week 16
|
Measure of cells that have previously encountered and responded to their cognate antigen in PBMCs.
|
At Week 16
|
|
Regulatory T Cell (Treg) Marker Levels - PMBCs
Lasso di tempo: At Baseline
|
Amount of Regulatory T cell (Treg) markers present in PBMCs in treated patients.
|
At Baseline
|
|
Regulatory T Cell (Treg) Marker Levels - PMBCs
Lasso di tempo: At Week 4
|
Amount of Regulatory T cell (Treg) markers present in PBMCs in treated patients.
|
At Week 4
|
|
Regulatory T Cell (Treg) Marker Levels - PMBCs
Lasso di tempo: At Week 16
|
Amount of Regulatory T cell (Treg) markers present in PBMCs in treated patients.
|
At Week 16
|
|
Regulatory T Cell (Treg) Marker Levels - TIL
Lasso di tempo: At Baseline
|
Amount of Regulatory T cell (Treg) markers present in TILs in treated patients.
|
At Baseline
|
|
Regulatory T Cell (Treg) Marker Levels - TIL
Lasso di tempo: At Week 4
|
Amount of Regulatory T cell (Treg) markers present in TILs in treated patients.
|
At Week 4
|
|
Activation and Maturation of Dendritic Cells - PBMC
Lasso di tempo: At Baseline
|
Measure of expression of activation and maturation of dendritic cells in PBMCs.
|
At Baseline
|
|
Activation and Maturation of Dendritic Cells - PBMC
Lasso di tempo: At Week 4
|
Measure of expression of activation and maturation of dendritic cells in PBMCs.
|
At Week 4
|
|
Activation and Maturation of Dendritic Cells - PBMC
Lasso di tempo: At Week 16
|
Measure of expression of activation and maturation of dendritic cells in PBMCs.
|
At Week 16
|
|
Activation and Maturation of Dendritic Cells - TIL
Lasso di tempo: At Baseline
|
Measure of expression of activation and maturation of dendritic cells in tumor (TIL).
|
At Baseline
|
|
Activation and Maturation of Dendritic Cells - TIL
Lasso di tempo: At Week 4
|
Measure of expression of activation and maturation of dendritic cells in tumor (TIL).
|
At Week 4
|
|
Soluble LAG3 Levels - PBMC
Lasso di tempo: At the time of disease progression - up to 4 years
|
Amount of LAG3 (cell surface molecule expressed on activated T cells) protein present in blood in patients that had previously demonstrated complete response (CR), partial response (PR), or stable disease (SD) per RECIST 1.1.
CR: Disappearance of all target lesions.
Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to <10 mm.
PR: At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters; SD: Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum diameters while on study.
|
At the time of disease progression - up to 4 years
|
|
Soluble LAG3 Levels - TIL
Lasso di tempo: At the time of disease progression - up to 4 years
|
Amount of LAG3 (cell surface molecule expressed on activated T cells) protein present in tumor tissue in patients that had previously demonstrated complete response (CR), partial response (PR), or stable disease (SD) per RECIST 1.1.
CR: Disappearance of all target lesions.
Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to <10 mm.
PR: At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters; SD: Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum diameters while on study.
|
At the time of disease progression - up to 4 years
|
|
Granzyme B Serum Levels
Lasso di tempo: At 2 weeks prior first study treatment, at 4 weeks, at 12 weeks
|
Level of granzyme B (a serine protease secreted cells to mediate apoptosis in target cells) in serum.
|
At 2 weeks prior first study treatment, at 4 weeks, at 12 weeks
|
|
T Cell Count
Lasso di tempo: At 4 weeks
|
Number of T cells present in TIL or PBMC.
|
At 4 weeks
|
|
T Cell Count
Lasso di tempo: At 12 weeks
|
Number of T cells present in TIL or PBMC.
|
At 12 weeks
|
|
T Cell Count
Lasso di tempo: At the time of disease progression - up to 4 years
|
Number of T cells present in TIL or PBMC.
|
At the time of disease progression - up to 4 years
|
Altre misure di risultato
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
Single Cell RNA Sequencing
Lasso di tempo: 2 weeks
|
The presence and quantity of RNA in in blood and tumor tissue.
|
2 weeks
|
|
Single Cell RNA Sequencing
Lasso di tempo: At 4 weeks post Cycle 1
|
The presence and quantity of RNA in in blood and tumor tissue.
|
At 4 weeks post Cycle 1
|
|
Single Cell RNA Sequencing
Lasso di tempo: At week 16 (12 weeks post combination treatment (3 cycles)
|
The presence and quantity of RNA in in blood and tumor tissue.
|
At week 16 (12 weeks post combination treatment (3 cycles)
|
|
Single Cell RNA Sequencing
Lasso di tempo: At the time of disease progression - up to 4 years
|
The presence and quantity of RNA in in blood and tumor tissue in patients that had previously demonstrated complete response (CR), partial response (PR), or stable disease (SD) per RECIST 1.1.
CR: Disappearance of all target lesions.
Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to <10 mm.
PR: At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters; SD: Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum diameters while on study.
|
At the time of disease progression - up to 4 years
|
Collaboratori e investigatori
Sponsor
Collaboratori
Investigatori
- Investigatore principale: John Kirkwood, MD, University of Pittsburgh
Studiare le date dei record
Studia le date principali
Inizio studio (Effettivo)
Completamento primario (Effettivo)
Completamento dello studio (Effettivo)
Date di iscrizione allo studio
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Effettivo)
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Effettivo)
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
Parole chiave
Termini MeSH pertinenti aggiuntivi
- Neoplasie per sede
- Neoplasie
- Neoplasie per tipo istologico
- Malattie della pelle
- Tumori neuroectodermici
- Neoplasie, cellule germinali ed embrionali
- Neoplasie, tessuto nervoso
- Tumori neuroendocrini
- Nevi e melanomi
- Neoplasie cutanee
- Malattie della pelle e del tessuto connettivo
- Melanoma
- Aminoacidi, peptidi e proteine
- Proteine
- Anticorpi, monoclonali, umanizzati
- Anticorpi, monoclonali
- Anticorpi
- Immunoglobuline
- Immunoproteine
- Proteine del sangue
- Globuline sieriche
- Globuline
- Nivolumab
- Relatlimab
Altri numeri di identificazione dello studio
- 18-071
Piano per i dati dei singoli partecipanti (IPD)
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Informazioni su farmaci e dispositivi, documenti di studio
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Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .