Panobinostat or Placebo With Bortezomib and Dexamethasone in Patients With Relapsed Multiple Myeloma (PANORAMA-1)
A Multicenter, Randomized, Double Blind, Placebo Controlled Phase III Study of Panobinostat in Combination With Bortezomib and Dexamethasone in Patients With Relapsed Multiple Myeloma
Panobinostat (LBH589) is a highly potent pan-deacetylase inhibitor (pan-DACi), inclusive of HDAC6, which disrupts aggresome function, promotes accumulation of cytotoxic misfolded protein aggregates and triggers myeloma cell death. Combination of pan-DAC and protease inhibition by co-treatment with panobinostat (PAN) and bortezomib (BTZ) has demonstrated synergistic cytotoxicity in vitro and in vivo in pre-clinical experiments. Furthermore, clinical experience in advanced multiple myeloma (MM) patients treated by oral panobinostat and i.v bortezomib ± dexamethasone showed very encouraging results for efficacy and manageable toxicity profile.
Given the medical need for improved treatment strategies for patients with previously treated and relapsed MM, the purpose of this prospective, multinational, randomized, double-blind, placebo-controlled, parallel group Phase III study is to compare the results in progression-free survival of 2 combination therapies, panobinostat with bortezomib and dexamethasone or placebo with bortezomib and dexamethasone, in patients with previously treated MM whose disease has recurred or progressed.
調査の概要
研究の種類
入学 (実際)
段階
- フェーズ 3
連絡先と場所
研究場所
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Arizona
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Phoenix、Arizona、アメリカ
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California
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Anaheim、California、アメリカ、92801
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Concord、California、アメリカ、94520
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Los Angeles、California、アメリカ、90027
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San Diego、California、アメリカ、92120
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Stanford、California、アメリカ、94304
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Florida
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Boca Raton、Florida、アメリカ、33486
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Lake Worth、Florida、アメリカ、33467
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Miami Shores、Florida、アメリカ、33138
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Georgia
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Athens、Georgia、アメリカ、30607
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Atlanta、Georgia、アメリカ、30322
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Marietta、Georgia、アメリカ、30060
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Illinois
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Marywood、Illinois、アメリカ、60153
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Quincy、Illinois、アメリカ、62301
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Louisiana
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New Orleans、Louisiana、アメリカ、70115
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Maryland
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Baltimore、Maryland、アメリカ、21229
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Rockville、Maryland、アメリカ、20850
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Massachusetts
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Boston、Massachusetts、アメリカ、02215
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Michigan
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Southfield、Michigan、アメリカ
- Novartis Investigative Site
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Minnesota
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Edina、Minnesota、アメリカ、55435
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Minneapolis、Minnesota、アメリカ、55404
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Missouri
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Columbia、Missouri、アメリカ、65201
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New Jersey
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East Orange、New Jersey、アメリカ、07018-1095
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New York
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Mount Kisco、New York、アメリカ、10549
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North Carolina
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Durham、North Carolina、アメリカ、27710
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North Dakota
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Bismarck、North Dakota、アメリカ、58501
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Ohio
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Dayton、Ohio、アメリカ、45429
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Middletown、Ohio、アメリカ、45042
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Pennsylvania
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Pittsburgh、Pennsylvania、アメリカ、15224
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Rhode Island
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East Providence、Rhode Island、アメリカ、02915
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Tennessee
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Nashville、Tennessee、アメリカ、37203
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Nashville、Tennessee、アメリカ、37232
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Texas
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Amarillo、Texas、アメリカ、79106
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Houston、Texas、アメリカ、77030
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Washington
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Kennewick、Washington、アメリカ、99336
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Seattle、Washington、アメリカ、98104
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Walla Walla、Washington、アメリカ、33962
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West Virginia
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Morgantown、West Virginia、アメリカ、26506
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Buenos Aires、アルゼンチン、C1114AAN
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Cordoba、アルゼンチン、X5000JHQ
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Buenos Aires
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La Plata、Buenos Aires、アルゼンチン、B1900AWT
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London、イギリス、EC1A 7BE
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London、イギリス、W12 0HS
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London、イギリス、SE5 9RS
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London、イギリス、WC1E 6HX
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Manchester、イギリス、M20 4BX
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Wolverhampton、イギリス、WV10 0QP
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Scotland
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Aberdeen、Scotland、イギリス、AB25 2ZN
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Glasgow、Scotland、イギリス、G12 0YN
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Jerusalem、イスラエル、91120
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Kfar Saba、イスラエル、4428164
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Petach Tikva、イスラエル、49100
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Ramat Gan、イスラエル、5265601
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Napoli、イタリア、80131
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FG
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San Giovanni Rotondo、FG、イタリア、71013
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LE
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Lecce、LE、イタリア、73100
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MI
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Milano、MI、イタリア、20133
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PE
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Pescara、PE、イタリア、65124
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PI
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Pisa、PI、イタリア、56126
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PV
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Pavia、PV、イタリア、27100
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RC
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Reggio Calabria、RC、イタリア、89124
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RM
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Roma、RM、イタリア、00144
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Roma、RM、イタリア、00161
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SA
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Pagani、SA、イタリア、84016
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VR
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Verona、VR、イタリア、37134
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Alexandria、エジプト、21131
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Giza、エジプト、11451
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Rotterdam、オランダ、3015 CE
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Rotterdam、オランダ
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Utrecht、オランダ、3584 CX
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New South Wales
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St Leonards、New South Wales、オーストラリア、2065
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Queensland
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Herston、Queensland、オーストラリア、4029
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Woolloongabba、Queensland、オーストラリア、4102
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Victoria
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Franston、Victoria、オーストラリア、3199
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Western Australia
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Nedlands、Western Australia、オーストラリア、6009
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Perth、Western Australia、オーストラリア、6000
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Linz、オーストリア、A-4010
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Wien、オーストリア、A-1090
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Nova Scotia
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Halifax、Nova Scotia、カナダ、B3H 1V7
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Ontario
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Hamilton、Ontario、カナダ、L8V 5C2
- Novartis Investigative Site
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Toronto、Ontario、カナダ、M5G 2M9
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Quebec
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Greenfield Park、Quebec、カナダ、J4V 2H1
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Montreal、Quebec、カナダ、H1T 2M4
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Athens、ギリシャ、115 28
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GR
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Thessaloniki、GR、ギリシャ、570 10
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Singapore、シンガポール、169608
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Göteborg、スウェーデン、SE-413 45
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Linköping、スウェーデン、SE-581 85
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Luleå、スウェーデン、SE-971 80
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Stockholm、スウェーデン、SE-118 83
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Uppsala、スウェーデン、SE-751 85
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Barcelona、スペイン、08041
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Andalucia
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Cordoba、Andalucia、スペイン、14004
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Sevilla、Andalucia、スペイン、41013
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Castilla Y Leon
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Salamanca、Castilla Y Leon、スペイン、37007
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Catalunya
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Barcelona、Catalunya、スペイン、08036
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Comunidad Valenciana
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Valencia、Comunidad Valenciana、スペイン、46026
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Galicia
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Santiago de Compostela、Galicia、スペイン、15706
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Navarra
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Pamplona、Navarra、スペイン、31008
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Pais Vasco
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San Sebastian、Pais Vasco、スペイン、20080
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Santa Cruz De Tenerife
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La Laguna、Santa Cruz De Tenerife、スペイン、38320
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Bangkok、タイ、10330
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Bangkok、タイ、10700
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Bangkok、タイ、10400
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CZE
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Olomouc、CZE、チェコ、775 20
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Czech Republic
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Brno Bohunice、Czech Republic、チェコ、625 00
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Prague 2、Czech Republic、チェコ、128 08
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Copenhagen、デンマーク、DK-2100
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Odense、デンマーク、DK 5000
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Vejle、デンマーク、DK-7100
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Ålborg、デンマーク、DK-9100
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Århus、デンマーク、DK-8000
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Aachen、ドイツ、52074
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Bad Saarow、ドイツ、15526
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Bamberg、ドイツ、96049
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Berlin、ドイツ、13353
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Bremen、ドイツ、28177
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Dresden、ドイツ、01307
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Duisburg、ドイツ、47166
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Erlangen、ドイツ、91054
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Frankfurt、ドイツ、60590
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Hamburg、ドイツ、22763
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Jena、ドイツ、07740
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Kiel、ドイツ、24105
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Magdeburg、ドイツ、39120
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Muenchen、ドイツ、81737
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Rostock、ドイツ、18057
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Ulm、ドイツ、89081
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Wuerzburg、ドイツ、97080
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Bergen、ノルウェー、NO-5021
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Fredrikstad、ノルウェー、NO-1603
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Kristiansand、ノルウェー、NO-4605
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Oslo、ノルウェー、0407
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Skien、ノルウェー、NO-3710
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Trondheim、ノルウェー、7006
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HUS Helsinki、フィンランド、FIN-00029
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Turku、フィンランド、FIN-20521
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Blois Cedex、フランス、41016
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Dijon、フランス、21034
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Lille Cedex、フランス、59037
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Limoges cedex、フランス、87042
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Nantes、フランス、44035
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Paris、フランス、75231
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Pierre Benite、フランス、69310
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Strasbourg cedex、フランス、67085
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Vandoeuvre Les Nancy、フランス、54511
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DF
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Brasilia、DF、ブラジル、70710-904
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RJ
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Rio de Janeiro、RJ、ブラジル、20.211-030
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Rio de Janeiro、RJ、ブラジル、20551-030
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Rio de Janeiro、RJ、ブラジル、22640-102
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SP
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Barretos、SP、ブラジル、14784 400
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Campinas、SP、ブラジル、13083-970
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Sao Paulo、SP、ブラジル、05403 000
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São Paulo、SP、ブラジル、01224-000
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Bruxelles、ベルギー、1200
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Hasselt、ベルギー、3500
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Brussel
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Jette、Brussel、ベルギー、1090
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Warszawa、ポーランド、02 776
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Warszawa、ポーランド、02-097
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San Luis Potosí、メキシコ、78218
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Beirut、レバノン、6301
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Saratov、ロシア連邦、410028
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St Petersburg、ロシア連邦、191024
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Adana、七面鳥、01330
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Ankara、七面鳥、06100
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TUR
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Istanbul、TUR、七面鳥、34098
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Beijing、中国、100044
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Beijing、中国、100020
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Shanghai、中国、200003
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Shanghai、中国、200025
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Beijing
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Beijing、Beijing、中国、100730
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Guangxi
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Nanning、Guangxi、中国、530021
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Jiangsu
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Nanjing、Jiangsu、中国、210029
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Suzhou、Jiangsu、中国、215006
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Sichuan
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Chengdu、Sichuan、中国、610041
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Tianjin
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Tianjin、Tianjin、中国、300020
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Zhejiang
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Hangzhou、Zhejiang、中国、310003
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Parktown、南アフリカ、2193
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Pretoria、南アフリカ、0027
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Kaohsiung City、台湾、83301
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Taichung、台湾、40447
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Taipei、台湾、10048
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Taoyuan、台湾、333
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Busan、大韓民国、49201
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Busan、大韓民国、602739
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Incheon、大韓民国、405 760
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Jeollanam-do、大韓民国、519763
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Seoul、大韓民国、03080
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Seoul、大韓民国、06351
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Seoul、大韓民国、03722
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Taegu、大韓民国、41944
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Gyeonggi Do
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Suwon si、Gyeonggi Do、大韓民国、16499
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Seocho Gu
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Seoul、Seocho Gu、大韓民国、06591
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Hiroshima、日本、734-8551
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Niigata、日本、951-8566
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Osaka、日本、545-8586
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Aichi
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Nagoya、Aichi、日本、460-0001
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Nagoya-city、Aichi、日本、467-8602
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Ehime
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Matsuyama-city、Ehime、日本、790-8524
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Fukuoka
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Fukuoka city、Fukuoka、日本、812-8582
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Gifu
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Ogaki-city、Gifu、日本、503-8502
- Novartis Investigative Site
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Gunma
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Shibukawa、Gunma、日本、377-8511
- Novartis Investigative Site
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Hiroshima
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Kure-city、Hiroshima、日本、737-0023
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Ibaraki
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Higashiibaraki-gun、Ibaraki、日本、311-3193
- Novartis Investigative Site
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Okayama
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Okayama city、Okayama、日本、701-1192
- Novartis Investigative Site
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Osaka
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Suita city、Osaka、日本、565 0871
- Novartis Investigative Site
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Tokyo
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Shibuya、Tokyo、日本、150-8935
- Novartis Investigative Site
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Hong Kong、香港
- Novartis Investigative Site
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Hong Kong SAR、香港
- Novartis Investigative Site
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New Territories、香港
- Novartis Investigative Site
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- Patient has a previous diagnosis of multiple myeloma.
- Patient requires retreatment for multiple myeloma
- Patient has measurable M component in serum or urine at study screening
Exclusion Criteria:
- Patient who has progressed under all prior lines of anti MM therapy
- Patient who has been treated by bortezomib before, and did not reach at least a minor response under this therapy, or progressed under it or within 60 days of last dose
- Patient has shown intolerance to bortezomib or to dexamethasone or components of these drugs or has any contraindication to one or the other drug , following locally applicable prescribing information
- Patient received prior treatment with DAC inhibitors including panobinostat
- Patient has impaired cardiac function, or a prolonged QTc interval at screening ECG
- Patient taking medications with relative risk of prolonging the QT interval or inducing Torsade de pointes
- Female patient who is pregnant or breast feeding or with childbearing potential and not willing to use a double method of contraception up to 3 months after the end of study treatment. Male patient who is not willing to use a barrier method of contraception up to 3 months after the end of study treatment.
Other protocol-defined inclusion/exclusion criteria may apply.
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:ダブル
武器と介入
参加者グループ / アーム |
介入・治療 |
---|---|
実験的:Panobinostat + Bortezomib + Dexamethasone
|
Panobinostat was administered 3x week ( 2 weeks on 1 week off)
他の名前:
Bortezomib was administered 2 x week ( 2weeks on 1 week off)
他の名前:
Dexamethasone was adminstered on day of Bortezomib and the day after Bortezomib administration
|
プラセボコンパレーター:Placebo + Bortezomib + Dexamethasone
|
Bortezomib was administered 2 x week ( 2weeks on 1 week off)
他の名前:
Dexamethasone was adminstered on day of Bortezomib and the day after Bortezomib administration
Placebo was administered 3x week ( 2 weeks on 1 week off)
|
この研究は何を測定していますか?
主要な結果の測定
結果測定 |
時間枠 |
---|---|
Progression-free Survival Events in Patients Treated With Panobinostat in Combination With Bortezomib and Dexamethasone vs. Patients Treated by Placebo in Combination With Bortezomib and Dexamethasone.
時間枠:45 months
|
45 months
|
Progression Free Survival in Patients Treated With Panobinostat in Combination With Bortezomib and Dexamethasone vs. Patients Treated by Placebo in Combination With Bortezomib and Dexamethasone.
時間枠:45 months
|
45 months
|
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
---|---|---|
Overall Survival in Patients Treated With Panobinostat in Combination With Bortezomib and Dexamethasone vs. Patients Treated by Placebo in Combination With Bortezomib and Dexamethasone
時間枠:45 months
|
Number of OS events
|
45 months
|
Overall Survival in Patients Treated With Panobinostat in Combination With Bortezomib and Dexamethasone vs. Patients Treated by Placebo in Combination With Bortezomib and Dexamethasone
時間枠:45 months
|
survival time in months
|
45 months
|
Overall Response Rate in Patients Treated With Panobinostat in Combination With Bortezomib and Dexamethasone vs. Patients Treated by Placebo in Combination With Bortezomib and Dexamethasone.
時間枠:45 months
|
Best overall response based on mEBMT criteria per investigator assessment
|
45 months
|
Time to Response Per Investigator Assessment (mEBMT Criteria) of Response Patients Treated With Panobinostat in Combination With Bortezomib and Dexamethasone vs. Patients Treated by Placebo in Combination With Bortezomib and Dexamethasone.
時間枠:45 months
|
45 months
|
|
Duration of Response Per Investigator Assessment (mEBMT Criteria) Patients Treated With Panobinostat in Combination With Bortezomib and Dexamethasone vs. Patients Treated by Placebo in Combination With Bortezomib and Dexamethasone.
時間枠:45 months
|
45 months
|
|
Time to Progression/Relapse Per Investigator Assessment (mEBMT Criteria) Patients Treated With Panobinostat in Combination With Bortezomib and Dexamethasone vs. Patients Treated by Placebo in Combination With Bortezomib and Dexamethasone.
時間枠:45 months
|
45 months
|
|
European Organization for Research and Treatment of Cancer Multiple Myeloma Module (EORTC) QLQ-MY20-Change From Baseline by Treatment Group
時間枠:12, 24 and 48 weeks
|
Higher values in the disease symptoms and side effects of treatment scores indicate worsening.
Higher scores in the future perspective and body image scores indicate improvement.
LS Means and SEM are estimated from the repeated measures model.
Following factors and covariates are included in the repeated measurement model: time, treatment, treatment by time interaction, number of prior lines of anti-MM therapy (1/ 2 and 3), prior use of BTZ (Yes/ No), baseline score.Disease Symptom is the sum of 20 questions, total score ranges from 0 (best possible outcome) to 100 (worst possible outcome)", All subscales of EORTC QLQ-MY20 have the same score range of 0 -100.
Decrease in symptom scores from baseline indicate improvement in symptoms.
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12, 24 and 48 weeks
|
European Organization for Research and Treatment of Cancer Multiple Myeloma Module (EORTC ) QLQ-C30 - Summary Statistics by Treatment Group
時間枠:12, 24 and 48 weeks
|
The EORTC QLQ-C30 measures functional dimensions (physical, role, emotional, cognitive, and social), three multi-item symptom scales (fatigue, nausea/vomiting, and pain), six single-item symptom scales (dyspnea, sleep disturbance, appetite loss, constipation, diarrhea and financial impact) and a global health status/QoL scale.
Disease Symptom is the sum of 30 questions, total score ranges from 0 (best possible outcome) to 100 (worst possible outcome)", All subscales of EORTC QLQ-C30 have the same score range of 0 -100.
For global health status and other functional scales,an increase from baseline indicates improvement of QoL.
Whereas for symptoms scales, fatigue, dyspnea, insomnia, appetite loss, constipation and diarrhea, decrease in scores from baseline indicate improvement in symptoms.
|
12, 24 and 48 weeks
|
Functional Assessment of Chronic Illness Therapy (FACIT) Measurement System : FACT/GOG-NTX-Change From Baseline by Treatment Group
時間枠:12, 24 and 48 weeks
|
Chronic Illness Therapy (FACIT) Measurement System and focuses on four general quality of life domains for physical well being, functional well-being, social/family well-being, and emotional well-being, and includes additional items to characterize treatment-related neurotoxicity.
Higher subscales/total scores represent higher QOL.
In the case of the neurotoxicity subscale, lower scores correspond to higher neurotoxicity.
The recall period referenced in the questionnaire is the past 7 days.Ranges for FACT-G subscales are as follows:.PWB, scale 0 -28, , NtxS scale 0-44, FACT/GOG-Ntx trial outcome index scale is 0-100 and FACT-G scale is also scaled 0-100.
An increase from baseline in these scores indicate improvement.
|
12, 24 and 48 weeks
|
協力者と研究者
スポンサー
出版物と役立つリンク
一般刊行物
- San-Miguel JF, Einsele H, Moreau P. The Role of Panobinostat Plus Bortezomib and Dexamethasone in Treating Relapsed or Relapsed and Refractory Multiple Myeloma: A European Perspective. Adv Ther. 2016 Nov;33(11):1896-1920. doi: 10.1007/s12325-016-0413-7. Epub 2016 Sep 27.
- San-Miguel JF, Hungria VT, Yoon SS, Beksac M, Dimopoulos MA, Elghandour A, Jedrzejczak WW, Gunther A, Nakorn TN, Siritanaratkul N, Schlossman RL, Hou J, Moreau P, Lonial S, Lee JH, Einsele H, Sopala M, Bengoudifa BR, Binlich F, Richardson PG. Overall survival of patients with relapsed multiple myeloma treated with panobinostat or placebo plus bortezomib and dexamethasone (the PANORAMA 1 trial): a randomised, placebo-controlled, phase 3 trial. Lancet Haematol. 2016 Nov;3(11):e506-e515. doi: 10.1016/S2352-3026(16)30147-8. Epub 2016 Oct 14.
- Richardson PG, Hungria VT, Yoon SS, Beksac M, Dimopoulos MA, Elghandour A, Jedrzejczak WW, Guenther A, Nakorn TN, Siritanaratkul N, Schlossman RL, Hou J, Moreau P, Lonial S, Lee JH, Einsele H, Sopala M, Bengoudifa BR, Corrado C, Binlich F, San-Miguel JF. Panobinostat plus bortezomib and dexamethasone in previously treated multiple myeloma: outcomes by prior treatment. Blood. 2016 Feb 11;127(6):713-21. doi: 10.1182/blood-2015-09-665018. Epub 2015 Dec 2. Erratum In: Blood. 2016 Jun 30;127(26):3460.
- San-Miguel JF, Hungria VT, Yoon SS, Beksac M, Dimopoulos MA, Elghandour A, Jedrzejczak WW, Gunther A, Nakorn TN, Siritanaratkul N, Corradini P, Chuncharunee S, Lee JJ, Schlossman RL, Shelekhova T, Yong K, Tan D, Numbenjapon T, Cavenagh JD, Hou J, LeBlanc R, Nahi H, Qiu L, Salwender H, Pulini S, Moreau P, Warzocha K, White D, Blade J, Chen W, de la Rubia J, Gimsing P, Lonial S, Kaufman JL, Ocio EM, Veskovski L, Sohn SK, Wang MC, Lee JH, Einsele H, Sopala M, Corrado C, Bengoudifa BR, Binlich F, Richardson PG. Panobinostat plus bortezomib and dexamethasone versus placebo plus bortezomib and dexamethasone in patients with relapsed or relapsed and refractory multiple myeloma: a multicentre, randomised, double-blind phase 3 trial. Lancet Oncol. 2014 Oct;15(11):1195-206. doi: 10.1016/S1470-2045(14)70440-1. Epub 2014 Sep 18. Erratum In: Lancet Oncol. 2015 Jan;16(1):e6.
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研究開始 (実際)
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
追加の関連 MeSH 用語
その他の研究ID番号
- CLBH589D2308
- 2009-015507-52 (EudraCT番号)
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