- ICH GCP
- Register voor klinische proeven in de VS.
- Klinische proef NCT03833154
Durvalumab versus Placebo met stereotactische lichaamsstralingstherapie bij patiënten met niet-gereseceerde niet-kleincellige longkanker (NSCLC) in een vroeg stadium / Osimertinib na SBRT bij patiënten met niet-gereseceerd NSCLC in een vroeg stadium met een EGFR-mutatie (PACIFIC-4)
Een gerandomiseerde, placebogecontroleerde, dubbelblinde, multicenter, internationale fase III-studie van Durvalumab met stereotactische lichaamsstralingstherapie (SBRT) voor de behandeling van patiënten met niet-gereseceerd stadium I/II, lymfekliernegatieve niet-kleincellige Longkanker (PACIFIC-4/RTOG-3515) Osimertinib na SBRT, een eenarmig cohort voor patiënten met niet-gereseceerd stadium I/II, lymfeklier-negatieve NSCLC met een sensibiliserende EGFR-mutatie
This is a Phase III, randomized, placebo-controlled, double-blind, multi-center study assessing the efficacy and safety of durvalumab with SoC SBRT versus placebo with SoC SBRT in patients with unresected clinical Stage I/II lymph node-negative (T1 to T3N0M0) NSCLC.
An additional cohort will assess Osimertinib following SBRT in patients with early stage unresected T1 to T3N0M0 NSCLC harbouring an EGFR mutation.
Studie Overzicht
Toestand
Conditie
Interventie / Behandeling
Gedetailleerde beschrijving
Patients with Stage I/II lymph node negative NSCLC and confirmed to meet all eligibility criteria will be randomized 1:1 to receive either Durvalumab + SoC SBRT or placebo + SoC SBRT.
The primary objective of main cohort is to assess the efficacy of Durvalumab with SoC SBRT compared to placebo with SoC SBRT in terms of PFS. Key secondary is to assess the efficacy of Durvalumab with SoC SBRT compared to placebo with SoC SBRT in terms of Overall Survival (OS).
In addition, a study cohort with a sufficient number of patients harboring an EGFR-TKI sensitizing mutation, will receive Osimertinib treatment after completion of SoC SBRT as definitive treatment of Stage I/II lymph node-negative NSCLC. The primary objective of Osimertinib cohort is to assess efficacy of Osimertinib following SoC SBRT in terms of 4-year PFS. Key secondary objectives include safety, OS and efficacy of Osimertininb treatment with SBRT.
Studietype
Inschrijving (Werkelijk)
Fase
- Fase 3
Contacten en locaties
Studie Locaties
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Clayton, Australië, 3168
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Aalst, België, 9300
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Charleroi, België, 6060
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Edegem, België, 2650
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Ghent, België, 9000
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Leuven, België, 3000
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Barretos, Brazilië, 14784-400
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Porto Alegre, Brazilië, 90110-270
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Recife, Brazilië, 52010-075
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Rio de Janeiro, Brazilië, 22271-110
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São Paulo, Brazilië, 01327-001
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Volta Redonda, Brazilië, 27258-000
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Alberta
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Edmonton, Alberta, Canada, T6G 1Z2
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Ontario
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London, Ontario, Canada, N6A 5W9
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Toronto, Ontario, Canada, M5G 2M9
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Toronto, Ontario, Canada, M4N 3M5
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Quebec
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Montreal, Quebec, Canada, H2X 3E4
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Beijing, China, 100142
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Beijing, China, 100021
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Changchun, China, 130021
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Changsha, China, 410013
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Chengdu, China, 610042
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Fuzhou, China, 350005
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Hangzhou, China, 310022
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Hangzhou, China, 310002
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Hefei, China, 230031
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Jinan, China, 250117
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Nanjing, China, 210009
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Shanghai, China, 200032
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Shanghai, China, 200433
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Shanghai, China, 200030
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Shanghai, China, 200002
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Shenyang, China, 100003
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Suzhou, China, 215006
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Wenzhou, China, 325000
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Wuhan, China, 430022
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Wuhan, China, 430030
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Zhengzhou, China, 450008
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Dresden, Duitsland, 01307
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Göttingen, Duitsland, 37075
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Halle, Duitsland, 06120
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Hanover, Duitsland, 30459
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Heidelberg, Duitsland, 69126
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Homburg, Duitsland, 66424
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Regensburg, Duitsland, 93053
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Trier, Duitsland, 54292
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Bron, Frankrijk, 69677
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Dijon, Frankrijk, 21079
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Lyon, Frankrijk, 69317
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Nantes, Frankrijk, 44202
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Pierre-Bénite, Frankrijk, 69310
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Toulouse, Frankrijk, 31000
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Villejuif, Frankrijk, 94805
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Athens, Griekenland, 11527
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Athens, Griekenland, 11526
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Thessaloniki, Griekenland, 55236
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Haifa, Israël, 31096
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Jerusalem, Israël, 91120
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Kfar Saba, Israël, 95847
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Petah Tikva, Israël, 49100
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Ramat Gan, Israël, 52621
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Tel Aviv, Israël, 64239
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Florence, Italië, 50134
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Genova, Italië, 16132
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Milan, Italië, 20132
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Orbassano, Italië, 10043
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Padova, Italië, 35128
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Pavia, Italië, 27100
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Roma, Italië, 00128
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Rozzano, Italië, 20089
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Akashi-shi, Japan, 673-8558
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Bunkyō City, Japan, 113-8677
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Chūōku, Japan, 104-0045
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Fukuoka, Japan, 812-8582
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Hirosaki-shi, Japan, 036-8563
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Hiroshima, Japan, 734-8551
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Kobe, Japan, 650-0047
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Niigata, Japan, 951-8566
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Osaka, Japan, 541-8567
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Sakaishi, Japan, 591-8555
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Sapporo, Japan, 060-8648
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Sunto-gun, Japan, 411-8777
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Toyoake-shi, Japan, 470-1192
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Yokohama, Japan, 241-8515
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Amsterdam, Nederland, 1081 HV
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Groningen, Nederland, 9713 GZ
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Utrecht, Nederland, 3584 CX
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Bydgoszcz, Polen, 85-796
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Elblag, Polen, 02-300
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Gdansk, Polen, 80-952
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Katowice, Polen, 40-514
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Lodz, Polen, 93-513
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Warsaw, Polen, 02-781
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Hato Rey, Puerto Rico, 00917
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Kazan, Tatarstan, Rusland, 420029
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Moscow, Rusland, 115478
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Moscow, Rusland, 105229
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Moscow, Rusland, 119421
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Saint Petersburg, Rusland, 197758
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Ufa, Rusland, 450054
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Yekaterinburg, Rusland, 620905
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Badajoz, Spanje, 6006
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Barcelona, Spanje, 08041
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L'Hospitalet de Llobregat, Spanje, 08907
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Madrid, Spanje, 28034
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Madrid, Spanje, 28046
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Madrid, Spanje, 28041
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Madrid, Spanje, 28040
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Málaga, Spanje, 29010
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San Sebastián, Spanje, 20014
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Santiago de Compostela, Spanje, 15706
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Seville, Spanje, 41013
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Valencia, Spanje, 46010
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Zaragoza, Spanje, 50009
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Ankara, Turkije (Türkiye), 06520
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Ankara, Turkije (Türkiye), 06010
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Istanbul, Turkije (Türkiye), 34214
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Izmir, Turkije (Türkiye), 35340
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Kocaeli, Turkije (Türkiye), 41400
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Birmingham, Verenigd Koninkrijk, B9 5SS
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Leeds, Verenigd Koninkrijk, LS9 7TF
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London, Verenigd Koninkrijk, EC1A 7BE
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Manchester, Verenigd Koninkrijk, M20 4BX
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Alabama
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Tuscaloosa, Alabama, Verenigde Staten, 35401
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Arizona
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Chandler, Arizona, Verenigde Staten, 85224
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Phoenix, Arizona, Verenigde Staten, 85004
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Tucson, Arizona, Verenigde Staten, 85719
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California
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Duarte, California, Verenigde Staten, 91010
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Long Beach, California, Verenigde Staten, 90806
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Los Angeles, California, Verenigde Staten, 90095
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San Diego, California, Verenigde Staten, 92123
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Delaware
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Newark, Delaware, Verenigde Staten, 10709
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District of Columbia
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Washington D.C., District of Columbia, Verenigde Staten, 20010
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Florida
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Bay Pines, Florida, Verenigde Staten, 33744
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Jacksonville, Florida, Verenigde Staten, 32256
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Miami Beach, Florida, Verenigde Staten, 33140
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Orlando, Florida, Verenigde Staten, 32804
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Georgia
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Atlanta, Georgia, Verenigde Staten, 30322
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Atlanta, Georgia, Verenigde Staten, 30342
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Illinois
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Chicago, Illinois, Verenigde Staten, 60612
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Chicago, Illinois, Verenigde Staten, 60637
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Chicago, Illinois, Verenigde Staten, 60611
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Decatur, Illinois, Verenigde Staten, 62526
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Elmhurst, Illinois, Verenigde Staten, 60126
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Naperville, Illinois, Verenigde Staten, 60540
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Indiana
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Fort Wayne, Indiana, Verenigde Staten, 46845
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Iowa
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Cedar Rapids, Iowa, Verenigde Staten, 52403
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Iowa City, Iowa, Verenigde Staten, 52242
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Kentucky
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Elizabethtown, Kentucky, Verenigde Staten, 42701
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Lexington, Kentucky, Verenigde Staten, 40503
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Louisville, Kentucky, Verenigde Staten, 40202
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Louisiana
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Metairie, Louisiana, Verenigde Staten, 70006
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New Orleans, Louisiana, Verenigde Staten, 70121
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Maine
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South Portland, Maine, Verenigde Staten, 04106
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Maryland
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Annapolis, Maryland, Verenigde Staten, 21401
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Baltimore, Maryland, Verenigde Staten, 21201
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Rosedale, Maryland, Verenigde Staten, 21237
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Silver Spring, Maryland, Verenigde Staten, 20910
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Towson, Maryland, Verenigde Staten, 21204
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Massachusetts
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Boston, Massachusetts, Verenigde Staten, 02215
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Michigan
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Ann Arbor, Michigan, Verenigde Staten, 48197
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Detroit, Michigan, Verenigde Staten, 48201
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Royal Oak, Michigan, Verenigde Staten, 48073
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Minnesota
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Duluth, Minnesota, Verenigde Staten, 55805
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Rochester, Minnesota, Verenigde Staten, 55905
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Missouri
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St Louis, Missouri, Verenigde Staten, 63110
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Nebraska
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Omaha, Nebraska, Verenigde Staten, 68105
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Nevada
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Las Vegas, Nevada, Verenigde Staten, 89169
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New Hampshire
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Lebanon, New Hampshire, Verenigde Staten, 03756
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New Jersey
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Camden, New Jersey, Verenigde Staten, 08103
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Paramus, New Jersey, Verenigde Staten, 07652
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New York
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Albany, New York, Verenigde Staten, 12206
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East Syracuse, New York, Verenigde Staten, 13057
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New Hyde Park, New York, Verenigde Staten, 11042
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New York, New York, Verenigde Staten, 10016
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Rochester, New York, Verenigde Staten, 14642
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Stony Brook, New York, Verenigde Staten, 11794
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Syracuse, New York, Verenigde Staten, 13210
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The Bronx, New York, Verenigde Staten, 10461
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The Bronx, New York, Verenigde Staten, 10467
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North Carolina
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Winston-Salem, North Carolina, Verenigde Staten, 27157
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North Dakota
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Grand Forks, North Dakota, Verenigde Staten, 58201
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Ohio
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Akron, Ohio, Verenigde Staten, 44304
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Blue Ash, Ohio, Verenigde Staten, 45242
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Cincinnati, Ohio, Verenigde Staten, 45219
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Cleveland, Ohio, Verenigde Staten, 44106
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Oregon
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Portland, Oregon, Verenigde Staten, 97213
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Portland, Oregon, Verenigde Staten, 97210
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Pennsylvania
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Philadelphia, Pennsylvania, Verenigde Staten, 19107
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Pittsburgh, Pennsylvania, Verenigde Staten, 15212
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South Carolina
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Charleston, South Carolina, Verenigde Staten, 29425
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South Dakota
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Sioux Falls, South Dakota, Verenigde Staten, 57105
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Watertown, South Dakota, Verenigde Staten, 57201
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Texas
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Austin, Texas, Verenigde Staten, 78745
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Dallas, Texas, Verenigde Staten, 75235
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Houston, Texas, Verenigde Staten, 77030
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Sherman, Texas, Verenigde Staten, 75090
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Vermont
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Burlington, Vermont, Verenigde Staten, 05401
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Virginia
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Richmond, Virginia, Verenigde Staten, 23249
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Washington
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Bellingham, Washington, Verenigde Staten, 98225
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Seattle, Washington, Verenigde Staten, 98195
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Spokane Valley, Washington, Verenigde Staten, 99216
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Wisconsin
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Milwaukee, Wisconsin, Verenigde Staten, 53226
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Cheongju-si, Zuid -Korea, 28644
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Goyang-si, Zuid -Korea, 10408
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Gyeonggi-do, Zuid -Korea, 13620
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Seoul, Zuid -Korea, 03722
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Seoul, Zuid -Korea, 05505
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Seoul, Zuid -Korea, 06351
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Geslachten die in aanmerking komen voor studie
Beschrijving
Main Cohort Key Inclusion Criteria:
- Age ≥18 years
- Planned SoC SBRT as definitive treatment
- World Health Organization (WHO)/ECOG PS of 0, 1 or 2
- Life expectancy of at least 12 weeks
- Body weight >30 kg
- Submission of tumor tissue sample if available
- Adequate organ and marrow function required
- Patients with central or peripheral lesions are eligible
- Staging studies must be done during screening (PET-CT within 10 weeks)
- Patients with a history of metachronous NSCLC and synchronous lesions are eligible with some exceptions
Main Cohort Key Exclusion Criteria:
- Mixed small cell and non-small cell cancer
- History of allogeneic organ transplantation
- History of another primary malignancy with exceptions
- History of active primary immunodeficiency
- Epidermal growth factor receptor local testing is strongly recommended prior to enrollment. Patients with a tumor harboring an EGFRm per local testing will be excluded from the main cohort
- Prior exposure to immune-mediated therapy with exceptions
Osimertinib Cohort Key Inclusion Criteria
- Age ≥18 years
- Planned SoC SBRT as definitive treatment
- WHO/ECOG PS of 0, 1, or 2
- Patients with central or peripheral lesions are eligible
- Patients with a history of metachronous NSCLC and synchronous lesions are eligible with some exceptions
- Staging studies must be done during screening (PET-CT within 10 weeks)
- Submission of tumor tissue sample if available
- Confirmation by local laboratory that the tumor harbors one of the 2 common EGFR mutations known to be associated with EGFR-TKI sensitivity (Ex19del, L858R)
- Adequate bone marrow reserve or organ function required
- Female patients should be using highly effective contraceptive measures
- Male patients should be asked to use barrier contraceptives (ie, condoms) during sex with all partners during the trial and avoid procreation
Osimertinib Cohort Key Exclusion Criteria
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Mixed small cell and non-small cell cancer
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Patients with known or increased risk factor for QTc prolongation
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Treatment with any of the following:
- Preoperative or adjuvant platinum-based or other chemotherapy for the disease under investigation
- Prior treatment with neoadjuvant or adjuvant EGFR TKI
- Patients currently receiving (or unable to stop use prior to receiving the first dose of study treatment) medications or herbal supplements known to be potent inducers of CYP3A4
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Refractory nausea and vomiting, chronic gastrointestinal diseases, inability to swallow the formulated product, or previous significant bowel resection that would preclude adequate absorption of osimertinib
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Any of the following cardiac criteria
- Mean resting corrected QT interval >470 msec, obtained from 3 ECGs
- Any clinically important abnormalities in rhythm, conduction, or morphology of resting ECG.
- Any factors that increase the risk of QTc prolongation or risk of arrhythmic events, or unexplained -sudden death under 40 years of age in first-degree relatives or any concomitant medication known to prolong the QT interval
- Past medical history of ILD, drug-induced ILD, radiation pneumonitis which required steroid treatment, or any evidence of clinically active ILD
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Verviervoudigen
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
|---|---|
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Experimenteel: SoC SBRT + Durvalumab Therapy (Main Cohort)
SBRT Durvalumab (PD-L1 monoclonal antibody) 1500 mg every 4 weeks [q4w] intravenously [iv] for up to 26 cycles or until progression or other discontinuation criteria are met. |
Durvalumab 1500 mg every 4 weeks [q4w] intravenously [iv] for up to 26 cycles or until progression or other discontinuation criteria are met.
Andere namen:
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Placebo-vergelijker: SoC SBRT + Placebo Therapy (Main Cohort)
SBRT Placebo (matching placebo for infusion) every 4 weeks iv for up to 26 cycles or until progression or other discontinuation criteria are met. |
Matching placebo for infusion every 4 weeks iv for up to 26 cycles or until progression or other discontinuation criteria are met. |
|
Experimenteel: SoC SBRT + Osimertinib Therapy (Osimertinib cohort, single-arm, open-label separate cohort)
SBRT Osimertinib 80mg every day [qd] for oral administration up to 36 months or until progression. Osimertinib treatment should start within 7 to 14 days after completion of SBRT |
Osimertinib 80 mg every day [qd] orally for up to 36 months or until progression or other discontinuation criteria are met. Osimertinib treatment should start from 7 to 14 days after completion of SBRT |
Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Progression-Free Survival (PFS) assessed by Blinded Independent Central Review (BICR) according to RECIST 1.1 in subpopulation of patients with Stage I/II NSCLC
Tijdsspanne: from randomization up to 6 years
|
Main Cohort |
from randomization up to 6 years
|
|
4-year Progression-Free Survival (4y-PFS) by ICR according to RECIST 1.1 criteria
Tijdsspanne: from treatment start up to 5 years
|
Osimertinib Cohort |
from treatment start up to 5 years
|
Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Progression-Free Survival (PFS) assessed by BICR per RECIST 1.1 in all randomised patients with Stage I/II NSCLC
Tijdsspanne: from randomization up to 6 years
|
Main Cohort |
from randomization up to 6 years
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Overall Survival (OS)
Tijdsspanne: from randomization up to 7 years
|
Main Cohort |
from randomization up to 7 years
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Concentration of durvalumab in serum such as peak concentration and trough
Tijdsspanne: 12 weeks after last dose
|
Main Cohort |
12 weeks after last dose
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Detection of ADA neutralising antibodies titers
Tijdsspanne: up to 6 months after last dose
|
Main Cohort |
up to 6 months after last dose
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Health-related quality of life in patients treated with durvalumab with SoC SBRT compared to placebo with SoC SBRT using the EORTC QLQ-C30
Tijdsspanne: from randomization up to 7 years
|
Main Cohort |
from randomization up to 7 years
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|
Proportion of patients alive and progression free at 24 months from randomisation (PFS24) assessed by BICR according to RECIST 1.1
Tijdsspanne: at 24 months following randomization
|
Main Cohort |
at 24 months following randomization
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Time to progression (TTP) assessed by BICR according to RECIST 1.1
Tijdsspanne: from randomization up to 6 years
|
Main Cohort |
from randomization up to 6 years
|
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Time to death or distant metastasis (TTDM) assessed by BICR according to RECIST 1.1
Tijdsspanne: from randomization up to 6 years
|
Main Cohort |
from randomization up to 6 years
|
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Time from randomisation to second progression (PFS2) as defined by local standard clinical practice
Tijdsspanne: from randomization up to 7 years
|
Main Cohort |
from randomization up to 7 years
|
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Assessment of AEs by CTCAE v 5.0 as measures of the safety and tolerability of Durvalumab with SoC SBRT compared to placebo with SoC SBRT
Tijdsspanne: up to 3 months after last dose
|
Main Cohort |
up to 3 months after last dose
|
|
Assessment of AEs by CTCAE v 5.0 as measures of the safety, tolerability and compliance of osimertinib with SoC SBRT therapy
Tijdsspanne: Up to 35 days after last dose
|
Osimertinib Cohort |
Up to 35 days after last dose
|
|
WHO performance status
Tijdsspanne: from treatment start up to 5 years
|
Osimertinib Cohort |
from treatment start up to 5 years
|
|
ECG QT interval
Tijdsspanne: Up to 156 weeks of treatment or treatment discontinuation
|
Osimertinib Cohort |
Up to 156 weeks of treatment or treatment discontinuation
|
|
Overall Survival
Tijdsspanne: from treatment start up to 5 years
|
Osimertinib Cohort |
from treatment start up to 5 years
|
|
Time To Progression (TTP)
Tijdsspanne: from treatment start up to 5 years
|
Osimertinib Cohort |
from treatment start up to 5 years
|
|
Time to CNS progression
Tijdsspanne: from treatment start up to 5 years
|
Osimertinib Cohort |
from treatment start up to 5 years
|
|
PFS2
Tijdsspanne: from treatment start up to 5 years
|
Osimertinib Cohort |
from treatment start up to 5 years
|
|
Site(s) of disease progression
Tijdsspanne: from treatment start up to 5 years
|
Osimertinib Cohort |
from treatment start up to 5 years
|
|
PFS by ICR using RECIST 1.1
Tijdsspanne: from treatment start up to 5 years
|
Osimertinib Cohort |
from treatment start up to 5 years
|
Andere uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Lung cancer mortality
Tijdsspanne: from treatment start up to 5 years
|
Osimertinib Cohort |
from treatment start up to 5 years
|
|
Lung Cancer Mortality
Tijdsspanne: from randomization Up to 5 years
|
Main Cohort |
from randomization Up to 5 years
|
Medewerkers en onderzoekers
Sponsor
Publicaties en nuttige links
Nuttige links
Studie record data
Bestudeer belangrijke data
Studie start (Werkelijk)
Primaire voltooiing (Geschat)
Studie voltooiing (Geschat)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Werkelijk)
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
- D9103C00001
- 2018 (Subsidie/contract van de Amerikaanse NIH)
- 2018-002572-41 (EudraCT-nummer)
Plan Individuele Deelnemersgegevens (IPD)
Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?
Beschrijving IPD-plan
Qualified researchers can request access to anonymized individual patient-level data from AstraZeneca group of companies sponsored clinical trials via the request portal. All request will be evaluated as per the AZ disclosure commitment: https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure.
IPD-tijdsbestek voor delen
AstraZeneca will meet or exceed data availability as per the commitments made to the EFPIA Pharma Data Sharing Principles. For details of our timelines, please rerefer to our disclosure commitment at https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure.
IPD-toegangscriteria voor delen
When a request has been approved AstraZeneca will provide access to the de-identified individual patient-level data in an approved sponsored tool . Signed Data Sharing Agreement (non-negotiable contract for data accessors) must be in place before accessing requested information. Additionally, all users will need to accept the terms and conditions of the SAS MSE to gain access. For additional details, please review the Disclosure Statements at https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure.
IPD delen Ondersteunend informatietype
- LEERPROTOCOOL
- SAP
Informatie over medicijnen en apparaten, studiedocumenten
Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel
Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct
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