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Neoadjuvant Chemotherapy With or Without Second-Look Surgery Followed by Radiation Therapy With or Without Peripheral Stem Cell Transplantation in Treating Patients With Intracranial Germ Cell Tumors

17 januari 2018 bijgewerkt door: Children's Oncology Group

A Phase II Study To Assess The Ability Of Neoadjuvant Chemotherapy Plus/Minus Second Look Surgery To Eliminate All Measurable Disease Prior To Radiotherapy For NGGCT

RATIONALE: Drugs used in chemotherapy work in different ways to stop tumor cells from dividing so they stop growing or die. Giving a chemotherapy drug before surgery may shrink the tumor so that it is no longer present by conventional imaging and tumor markers from serum and cerebrospinal fluid. Radiation therapy uses high-energy x-rays to damage tumor cells. Peripheral stem cell transplantation may allow the doctor to give higher doses of chemotherapy drugs and kill more tumor cells. Combining different types of therapy may kill more tumor cells.

PURPOSE: This Phase II trial is studying how well neoadjuvant chemotherapy with or without surgery and with or without high dose chemotherapy and peripheral stem cell transplantation, can increase response rates prior to radiation therapy and increase progression free and overall surviving patients with newly diagnosed intracranial germ cell tumors.

Studie Overzicht

Gedetailleerde beschrijving

OBJECTIVES:

  • Determine the response rate of patients with non-germinomatous germ cell tumors treated with neoadjuvant chemotherapy.
  • Determine the progression-free survival and overall survival of patients treated with neoadjuvant chemotherapy with or without second-look surgery followed by radiotherapy with or without autologous peripheral blood stem cell transplantation (PBSCT).
  • Determine whether additional complete responses can be achieved after high-dose thiotepa and etoposide with PBSCT in patients with persistently positive markers, histological evidence of residual malignant elements, or unresectable residual tumors after initial neoadjuvant chemotherapy.
  • Determine patterns of recurrence in patients treated with this regimen.
  • Correlate tumor marker response with radiographic and clinical measures of response, as well as findings at second-look surgery in patients with radiological evidence of residual disease.

OUTLINE:

  • Induction chemotherapy:

    • Courses 1, 3, and 5: Patients receive carboplatin IV over 1 hour on day 1 and etoposide IV over 1 hour on days 1-3. Beginning on day 4, patients receive filgrastim (G-CSF) IV or subcutaneously (SC) for 10 days or until blood counts recover. Courses are 3 weeks in duration.
    • Courses 2, 4, and 6: Patients receive etoposide IV over 1 hour followed by ifosfamide IV over 1 hour on days 1-5. Beginning on day 6, patients receive G-CSF IV or SC for 10 days or until blood counts recover. Courses are 3 weeks in duration.

Patients undergo re-evaluation. Patients with a complete response (CR) go directly to radiotherapy. Approximately 3 weeks after completion of induction chemotherapy, all patients with less than a CR are encouraged to undergo second-look surgery.

After second-look surgery, patients with a CR or a partial response (PR) go directly to radiotherapy. Patients with less than a PR undergo consolidation chemotherapy with peripheral blood stem cell rescue (PBSC) followed by radiotherapy.

  • Consolidation chemotherapy: Patients undergo PBSC collection. Patients receive G-CSF SC until PBSC collection is complete. Patients then receive thiotepa IV over 3 hours followed by etoposide IV over 3 hours on days -5 to -3. PBSCs are reinfused on day 0. Beginning on day 1 and continuing until blood counts recover, patients receive G-CSF SC daily.
  • Radiotherapy: All patients receive radiotherapy once daily 5 days a week for 5-6 weeks beginning after recovery from induction chemotherapy or second-look surgery or within 9 weeks after PBSC reinfusion.

Patients are followed every 3 months for 1 year, every 4 months for 1 year, every 6 months for 1 year, and then annually thereafter.

PROJECTED ACCRUAL: A total of 80-100 patients will be accrued for this study within 36-42 months.

Studietype

Ingrijpend

Inschrijving (Werkelijk)

104

Fase

  • Fase 2

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studie Locaties

    • Queensland
      • Brisbane, Queensland, Australië, 4029
        • Royal Children's Hospital
    • Victoria
      • Parkville, Victoria, Australië, 3052
        • Royal Children's Hospital
    • Western Australia
      • Perth, Western Australia, Australië, 6001
        • Princess Margaret Hospital for Children
      • Quebec, Canada, G1V 4G2
        • Centre Hospitalier Universitaire de Quebec
    • British Columbia
      • Vancouver, British Columbia, Canada, V6H 3V4
        • Children's & Women's Hospital of British Columbia
    • Newfoundland and Labrador
      • St. John's, Newfoundland and Labrador, Canada, A1B 3V6
        • Janeway Children's Health and Rehabilitation Centre
    • Nova Scotia
      • Halifax, Nova Scotia, Canada, B3K 6R8
        • IWK Health Centre
    • Ontario
      • Hamilton, Ontario, Canada, L8N 3Z5
        • McMaster Children's Hospital at Hamilton Health Sciences
      • Toronto, Ontario, Canada, M5G 1X8
        • Hospital for Sick Children
    • Quebec
      • Montreal, Quebec, Canada, H3H 1P3
        • Montreal Children's Hospital at McGill University Health Center
      • Montreal, Quebec, Canada, H3T 1C5
        • Hôpital Sainte Justine
    • Saskatchewan
      • Saskatoon, Saskatchewan, Canada, S7N 4H4
        • Saskatoon Cancer Centre at the University of Saskatchewan
      • Auckland, Nieuw-Zeeland, 1
        • Starship Children's Health
      • Christchurch, Nieuw-Zeeland
        • Christchurch Hospital
    • Alabama
      • Birmingham, Alabama, Verenigde Staten, 35294
        • Lurleen Wallace Comprehensive Cancer at University of Alabama - Birmingham
    • Arizona
      • Phoenix, Arizona, Verenigde Staten, 85016-7710
        • Phoenix Children's Hospital
    • Arkansas
      • Little Rock, Arkansas, Verenigde Staten, 72205
        • Arkansas Cancer Research Center at University of Arkansas for Medical Sciences
    • California
      • Downey, California, Verenigde Staten, 90242-2814
        • Southern California Permanente Medical Group
      • Loma Linda, California, Verenigde Staten, 92354
        • Loma Linda University Cancer Institute at Loma Linda University Medical Center
      • Long Beach, California, Verenigde Staten, 90801
        • Jonathan Jaques Children's Cancer Center at Miller Children's Hospital
      • Los Angeles, California, Verenigde Staten, 90027
        • Childrens Hospital Los Angeles
      • Madera, California, Verenigde Staten, 93638-8762
        • Children's Hospital Central California
      • Oakland, California, Verenigde Staten, 94609
        • Children's Hospital and Research Center Oakland
      • Orange, California, Verenigde Staten, 92868
        • Children's Hospital of Orange County
      • Sacramento, California, Verenigde Staten, 95816
        • Sutter Cancer Center
      • San Diego, California, Verenigde Staten, 92123-4282
        • Rady Children's Hospital - San Diego
      • San Francisco, California, Verenigde Staten, 94115
        • UCSF Helen Diller Family Comprehensive Cancer Center
      • Stanford, California, Verenigde Staten, 94305-5824
        • Stanford Cancer Center
    • Connecticut
      • Farmington, Connecticut, Verenigde Staten, 06360-2875
        • Carole and Ray Neag Comprehensive Cancer Center at the University of Connecticut Health Center
    • Delaware
      • Wilmington, Delaware, Verenigde Staten, 19803
        • Alfred I. DuPont Hospital for Children
    • District of Columbia
      • Washington, District of Columbia, Verenigde Staten, 20010-2970
        • Children's National Medical Center
    • Florida
      • Fort Myers, Florida, Verenigde Staten, 33901
        • Lee Cancer Care of Lee Memorial Health System
      • Gainesville, Florida, Verenigde Staten, 32610-0232
        • University of Florida Shands Cancer Center
      • Jacksonville, Florida, Verenigde Staten, 32207
        • Nemours Children's Clinic
      • Miami, Florida, Verenigde Staten, 33136
        • University of Miami Sylvester Comprehensive Cancer Center - Miami
      • Miami, Florida, Verenigde Staten, 33155
        • Miami Children's Hospital
      • Orlando, Florida, Verenigde Staten, 32803-1273
        • Florida Hospital Cancer Institute at Florida Hospital Orlando
      • Pensacola, Florida, Verenigde Staten, 32504
        • Sacred Heart Cancer Center at Sacred Heart Hospital
      • Saint Petersburg, Florida, Verenigde Staten, 33701
        • All Children's Hospital
      • Tampa, Florida, Verenigde Staten, 33607
        • St. Joseph's Cancer Institute at St. Joseph's Hospital
      • West Palm Beach, Florida, Verenigde Staten, 33407
        • Kaplan Cancer Center at St. Mary's Medical Center
    • Georgia
      • Atlanta, Georgia, Verenigde Staten, 30322
        • Winship Cancer Institute of Emory University
      • Augusta, Georgia, Verenigde Staten, 30912-3730
        • MBCCOP - Medical College of Georgia Cancer Center
    • Illinois
      • Chicago, Illinois, Verenigde Staten, 60611
        • Ann & Robert H. Lurie Children's Hospital of Chicago
      • Chicago, Illinois, Verenigde Staten, 60637-1470
        • University of Chicago Cancer Research Center
      • Park Ridge, Illinois, Verenigde Staten, 60068-1174
        • Advocate Lutheran General Cancer Care Center
      • Springfield, Illinois, Verenigde Staten, 62794-9677
        • Simmons Cooper Cancer Institute
    • Indiana
      • Indianapolis, Indiana, Verenigde Staten, 46202-5289
        • Indiana University Melvin and Bren Simon Cancer Center
      • Indianapolis, Indiana, Verenigde Staten, 46260
        • St. Vincent Indianapolis Hospital
    • Kansas
      • Kansas City, Kansas, Verenigde Staten, 66160-7357
        • Kansas Masonic Cancer Research Institute at the University of Kansas Medical Center
    • Maryland
      • Baltimore, Maryland, Verenigde Staten, 21231-2410
        • Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
    • Massachusetts
      • Boston, Massachusetts, Verenigde Staten, 02115
        • Dana-Farber/Harvard Cancer Center at Dana Farber Cancer Institute
      • Boston, Massachusetts, Verenigde Staten, 02111
        • Floating Hospital for Children at Tufts - New England Medical Center
    • Michigan
      • Detroit, Michigan, Verenigde Staten, 48201-1379
        • Barbara Ann Karmanos Cancer Institute
      • Grand Rapids, Michigan, Verenigde Staten, 49503-2560
        • Butterworth Hospital at Spectrum Health
      • Grosse Pointe Woods, Michigan, Verenigde Staten, 48236
        • Van Elslander Cancer Center at St. John Hospital and Medical Center
      • Lansing, Michigan, Verenigde Staten, 48910
        • Breslin Cancer Center at Ingham Regional Medical Center
    • Minnesota
      • Minneapolis, Minnesota, Verenigde Staten, 55404
        • Children's Hospitals and Clinics of Minnesota - Minneapolis
      • Minneapolis, Minnesota, Verenigde Staten, 55455
        • Masonic Cancer Center at University of Minnesota
      • Rochester, Minnesota, Verenigde Staten, 55905
        • Mayo Clinic Cancer Center
    • Mississippi
      • Jackson, Mississippi, Verenigde Staten, 39216-4505
        • University of Mississippi Cancer Clinic
    • Missouri
      • Kansas City, Missouri, Verenigde Staten, 64108
        • Children's Mercy Hospital
      • Saint Louis, Missouri, Verenigde Staten, 63110
        • Siteman Cancer Center at Barnes-Jewish Hospital - Saint Louis
    • New Jersey
      • Hackensack, New Jersey, Verenigde Staten, 07601
        • Hackensack University Medical Center Cancer Center
      • New Brunswick, New Jersey, Verenigde Staten, 08903
        • Cancer Institute of New Jersey at UMDNJ - Robert Wood Johnson Medical School
      • Newark, New Jersey, Verenigde Staten, 07112
        • Newark Beth Israel Medical Center
      • Paterson, New Jersey, Verenigde Staten, 07503
        • St. Joseph's Hospital and Medical Center
    • New Mexico
      • Albuquerque, New Mexico, Verenigde Staten, 87131-5636
        • University of New Mexico Cancer Center
    • New York
      • Bronx, New York, Verenigde Staten, 10461
        • Albert Einstein Cancer Center at Albert Einstein College of Medicine
      • New York, New York, Verenigde Staten, 10016
        • NYU Cancer Institute at New York University Medical Center
      • New York, New York, Verenigde Staten, 10032
        • Herbert Irving Comprehensive Cancer Center at Columbia University Medical Center
      • Syracuse, New York, Verenigde Staten, 13210
        • SUNY Upstate Medical University Hospital
      • Valhalla, New York, Verenigde Staten, 10595
        • New York Medical College
    • North Carolina
      • Charlotte, North Carolina, Verenigde Staten, 28232-2861
        • Blumenthal Cancer Center at Carolinas Medical Center
      • Durham, North Carolina, Verenigde Staten, 27710
        • Duke Comprehensive Cancer Center
    • Ohio
      • Akron, Ohio, Verenigde Staten, 44308-1062
        • Akron Children's Hospital
      • Cincinnati, Ohio, Verenigde Staten, 45229-3039
        • Cincinnati Children's Hospital Medical Center
      • Cleveland, Ohio, Verenigde Staten, 44195
        • Cleveland Clinic Taussig Cancer Center
      • Columbus, Ohio, Verenigde Staten, 43205-2696
        • Nationwide Children's Hospital
      • Dayton, Ohio, Verenigde Staten, 45404-1815
        • Children's Medical Center - Dayton
    • Oklahoma
      • Oklahoma City, Oklahoma, Verenigde Staten, 73104
        • Oklahoma University Cancer Institute
    • Oregon
      • Portland, Oregon, Verenigde Staten, 97239-3098
        • Oregon Health and Science University Cancer Institute
    • Pennsylvania
      • Hershey, Pennsylvania, Verenigde Staten, 17033-0850
        • Penn State Cancer Institute at Milton S. Hershey Medical Center
      • Philadelphia, Pennsylvania, Verenigde Staten, 19134-1095
        • St. Christopher's Hospital for Children
      • Philadelphia, Pennsylvania, Verenigde Staten, 19104-9786
        • Children's Hospital of Philadelphia
      • Pittsburgh, Pennsylvania, Verenigde Staten, 15213
        • Children's Hospital of Pittsburgh
    • Rhode Island
      • Providence, Rhode Island, Verenigde Staten, 02903
        • Rhode Island Hospital Comprehensive Cancer Center
    • South Carolina
      • Charleston, South Carolina, Verenigde Staten, 29425
        • Hollings Cancer Center at Medical University of South Carolina
    • South Dakota
      • Sioux Falls, South Dakota, Verenigde Staten, 57117-5039
        • Sanford Cancer Center at Sanford USD Medical Center
    • Tennessee
      • Memphis, Tennessee, Verenigde Staten, 38105
        • St. Jude Children's Research Hospital
      • Nashville, Tennessee, Verenigde Staten, 37232-6838
        • Vanderbilt-Ingram Cancer Center
    • Texas
      • Austin, Texas, Verenigde Staten, 78723
        • Dell Children's Medical Center of Central Texas
      • Corpus Christi, Texas, Verenigde Staten, 78411
        • Driscoll Children's Hospital
      • Dallas, Texas, Verenigde Staten, 75390
        • Simmons Comprehensive Cancer Center at University of Texas Southwestern Medical Center - Dallas
      • Fort Worth, Texas, Verenigde Staten, 76104
        • Cook Children's Medical Center - Fort Worth
      • Lubbock, Texas, Verenigde Staten, 79410
        • Covenant Children's Hospital
      • San Antonio, Texas, Verenigde Staten, 78229-3993
        • Methodist Children's Hospital of South Texas
      • San Antonio, Texas, Verenigde Staten, 78207
        • University of Texas Health Science Center at San Antonio
    • Utah
      • Salt Lake City, Utah, Verenigde Staten, 84113-1100
        • Primary Children's Medical Center
    • Virginia
      • Norfolk, Virginia, Verenigde Staten, 23507-1971
        • Children's Hospital of The King's Daughters
    • West Virginia
      • Charleston, West Virginia, Verenigde Staten, 25302
        • West Virginia University Health Sciences Center - Charleston
    • Wisconsin
      • Green Bay, Wisconsin, Verenigde Staten, 54307-3508
        • St. Vincent Hospital Regional Cancer Center
      • Marshfield, Wisconsin, Verenigde Staten, 54449
        • Marshfield Clinic - Marshfield Center
      • Milwaukee, Wisconsin, Verenigde Staten, 53226
        • Midwest Children's Cancer Center
      • Bern, Zwitserland, 3010
        • Swiss Pediatric Oncology Group Bern
      • Geneva, Zwitserland, 1205
        • Swiss Pediatric Oncology Group Geneva

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

3 jaar tot 24 jaar (Kind, Volwassen)

Accepteert gezonde vrijwilligers

Nee

Geslachten die in aanmerking komen voor studie

Allemaal

Beschrijving

DISEASE CHARACTERISTICS:

  • One of the following diagnoses:

    • Histologically confirmed intracranial non-germinomatous germ cell tumor (NGGCT) of 1 of the following types:

      • Endodermal sinus tumor (yolk sac tumor)
      • Embryonal carcinoma
      • Choriocarcinoma
      • Immature teratoma and teratoma with malignant transformation
      • Mixed germ cell tumor
    • Histologically confirmed germinoma with elevation of serum/CSF beta human chorionic gonadotropin (HCG) levels greater than 50 mIU/mL or any serum/CSF alpha-fetoprotein (AFP) levels greater than 10 ng/ml or above institutional norm
    • Histologically unconfirmed pineal and/or suprasellar tumors with serum/CSF beta HCG levels greater than 50 mIU/mL or AFP levels greater than 10 ng/ml or above institutional norm
  • Patients with normal AFP and beta HCG < 50 mIU/mL without histologic diagnosis of a NGGCT or patients with pure germinoma without elevation of tumor marker are ineligible
  • Initial diagnosis within the past 31 days

PATIENT CHARACTERISTICS:

Age

  • 3 to 24 at diagnosis

Performance status

  • No minimum performance level

Life expectancy

  • At least 8 weeks

Hematopoietic

  • Absolute neutrophil count at least 1,000/mm^3
  • Platelet count at least 100,000/mm^3 (transfusion independent)
  • Hemoglobin at least 10.0 g/dL (transfusion allowed)

Hepatic

  • Bilirubin no greater than 1.5 times upper limit of normal (ULN)
  • ALT no greater than 2.5 times ULN

Renal

  • Creatinine no greater than 1.5 times ULN OR
  • Creatinine clearance or radioisotope glomerular filtration rate at least 70 mL/min

Pulmonary

  • No assisted ventilation

Other

  • Seizure disorders allowed
  • No patients in status or coma
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patient must use effective contraception

PRIOR CONCURRENT THERAPY:

Biologic therapy

  • Not specified

Chemotherapy

  • Not specified

Endocrine therapy

  • Prior corticosteroids allowed
  • Concurrent corticosteroids allowed
  • Concurrent endocrine replacement therapy allowed (e.g., L-thyroxine, testosterone, estrogen, desmopressin acetate)
  • No concurrent growth hormone therapy

Radiotherapy

  • Not specified

Surgery

  • More than 1 prior surgery allowed

Other

  • No other prior therapy for malignancy

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Behandeling
  • Toewijzing: NVT
  • Interventioneel model: Opdracht voor een enkele groep
  • Masker: Geen (open label)

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Experimenteel: Radiation Therapy (CR from Induction)
Patients will receive 6 cycles of Induction chemotherapy consisting of carboplatin and etoposide (Cycles 1, 3, and 5) alternating with ifosfamide and etoposide (Cycles 2, 4, and 6). The entire length of Induction is 18 weeks unless delay occurs due to myelosuppression or unanticipated toxicity. Each cycle of Induction will begin when ANC > 750/L and platelets > 75,000/L and when off filgrastim (G-CSF) for at least 48 hours. Following the Induction phase (weeks 0-18) those patient in CR will undergo radiation therapy.
IV gegeven
Andere namen:
  • VP-16
  • Etopofos
  • VePesid
  • NSC # 141540
IV gegeven
Andere namen:
  • Paraplatine
  • NSC # 241240
IV gegeven
Andere namen:
  • Thiofosfamide
  • Tespa
  • Triethyleenthiofosforamide Tspa
  • WR-45312
  • NSC #6396
IV gegeven
Andere namen:
  • Ifex
  • Ifosfamide
  • Isofosfamide
  • Z4942
  • NSC # 109724
craniospinal irradiation
Andere namen:
  • Craniospinal irradiation (CSI) followed by boost radiation to the sites of gross disease at diagnosis.

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Response to Induction Chemotherapy
Tijdsspanne: 18 weeks
A patient who achieves a complete or partial response, defined a reduction of at least 65% in tumor size after induction chemotherapy will be considered to have experienced response.
18 weeks

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
The Probability of Event-free Survival (EFS)
Tijdsspanne: At 3 years from study entry
Event-free Survival was defined as time from study entry to death from any cause, disease progression or recurrence, or second malignant neoplasm. Event-free survival was estimated by KM estimate.
At 3 years from study entry
Progression-free Survival (PFS)
Tijdsspanne: At 3 years from study entry
Progression-free Survival was defined as time from study entry to disease progression or recurrence. Deaths that are clearly unrelated to disease progression, and second neoplasms are censored in this analysis. Progression -free survival was estimated by KM estimate.
At 3 years from study entry
Overall Survival (OS)
Tijdsspanne: At 3 years from study entry
Overall Survival was defined as time from study entry to death from any cause. Overall survival was estimated by KM estimate.
At 3 years from study entry
Number of Patients Experiencing Toxic Death
Tijdsspanne: During chemotherapy (up to 18 weeks)
Toxic death, defined as death predominantly attributable to treatment-related causes.
During chemotherapy (up to 18 weeks)
Occurrence of Non-hematological Grade 4 Toxicity Occurrence of Nonhematological Grade 4 Toxicity
Tijdsspanne: During chemotherapy(up to 18 weeks)
The number of patients who experienced non-hematological grade 4 toxicities anytime during chemotherapy.
During chemotherapy(up to 18 weeks)

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Onderzoekers

  • Studie stoel: Stewart Goldman, MD, Ann & Robert H Lurie Children's hospital of Chicago

Publicaties en nuttige links

De persoon die verantwoordelijk is voor het invoeren van informatie over het onderzoek stelt deze publicaties vrijwillig ter beschikking. Dit kan gaan over alles wat met het onderzoek te maken heeft.

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start

1 januari 2004

Primaire voltooiing (Werkelijk)

1 februari 2009

Studie voltooiing (Werkelijk)

1 februari 2009

Studieregistratiedata

Eerst ingediend

3 oktober 2002

Eerst ingediend dat voldeed aan de QC-criteria

26 januari 2003

Eerst geplaatst (Schatting)

27 januari 2003

Updates van studierecords

Laatste update geplaatst (Werkelijk)

14 februari 2018

Laatste update ingediend die voldeed aan QC-criteria

17 januari 2018

Laatst geverifieerd

1 januari 2018

Meer informatie

Deze informatie is zonder wijzigingen rechtstreeks van de website clinicaltrials.gov gehaald. Als u verzoeken heeft om uw onderzoeksgegevens te wijzigen, te verwijderen of bij te werken, neem dan contact op met register@clinicaltrials.gov. Zodra er een wijziging wordt doorgevoerd op clinicaltrials.gov, wordt deze ook automatisch bijgewerkt op onze website .

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