- ICH GCP
- Registro de ensaios clínicos dos EUA
- Ensaio Clínico NCT03568461
Eficácia e Segurança de Tisagenlecleucel em Pacientes Adultos com Linfoma Folicular Refratário ou Recidivante (ELARA)
Um estudo aberto de fase II, braço único, multicêntrico para determinar a eficácia e a segurança do Tisagenlecleucel (CTL019) em pacientes adultos com linfoma folicular refratário ou recidivante
Visão geral do estudo
Descrição detalhada
Tipo de estudo
Inscrição (Real)
Estágio
- Fase 2
Contactos e Locais
Locais de estudo
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Ulm, Alemanha, 89081
- Novartis Investigative Site
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Bavaria
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Munich, Bavaria, Alemanha, 81377
- Novartis Investigative Site
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North Rhine-Westphalia
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Cologne, North Rhine-Westphalia, Alemanha, 50937
- Novartis Investigative Site
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Herston, Austrália, QLD 4006
- Novartis Investigative Site
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New South Wales
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Camperdown, New South Wales, Austrália, 2050
- Novartis Investigative Site
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Victoria
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Melbourne, Victoria, Austrália, 3000
- Novartis Investigative Site
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Ghent, Bélgica, 9000
- Novartis Investigative Site
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Madrid, Espanha, 28041
- Novartis Investigative Site
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Seville, Espanha, 41013
- Novartis Investigative Site
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California
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Duarte, California, Estados Unidos, 91010 3000
- City of Hope National Medical Center
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San Francisco, California, Estados Unidos, 94143
- UCSF Medical Center
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Florida
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Tampa, Florida, Estados Unidos, 33612
- H Lee Moffitt Cancer Center and Research Institute
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Illinois
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Chicago, Illinois, Estados Unidos, 60637
- Uni of Chi Medi Ctr Hema and Onco
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Kansas
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Kansas City, Kansas, Estados Unidos, 66160
- Univ of Kansas Hosp and Med Ctr
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Michigan
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Ann Arbor, Michigan, Estados Unidos, 48109 5271
- Michigan Med University of Michigan
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Oregon
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Portland, Oregon, Estados Unidos, 97239
- Oregon Health Sciences University
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Pennsylvania
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Philadelphia, Pennsylvania, Estados Unidos, 19104
- University of Pennsylvania Clinical
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Texas
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Houston, Texas, Estados Unidos, 77030
- MD Anderson Cancer Center
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Paris, França, 75475
- Novartis Investigative Site
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Pierre-Bénite, França, 69495
- Novartis Investigative Site
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North Holland
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Amsterdam, North Holland, Holanda, 1081 HV
- Novartis Investigative Site
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BO
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Bologna, BO, Itália, 40138
- Novartis Investigative Site
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MI
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Milan, MI, Itália, 20132
- Novartis Investigative Site
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Fukuoka, Japão, 8128582
- Novartis Investigative Site
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Hokkaido
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Sapporo, Hokkaido, Japão, 060-8648
- Novartis Investigative Site
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Miyagi
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Sendai, Miyagi, Japão, 9808574
- Novartis Investigative Site
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Norway
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Oslo, Norway, Noruega, 0310
- Novartis Investigative Site
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London, Reino Unido, SE5 9RS
- Novartis Investigative Site
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West Midlands
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Birmingham, West Midlands, Reino Unido, B15 2TH
- Novartis Investigative Site
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Linz, Áustria, 4020
- Novartis Investigative Site
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Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
Aceita Voluntários Saudáveis
Descrição
Critério de inclusão:
- Linfoma folicular refratário ou recidivado (Grau 1, 2, 3A)
- Doença mensurável radiograficamente na triagem
Critério de exclusão:
- Evidência de transformação histológica
- Linfoma Folicular Grau 3B
- Terapia anti-CD19 prévia
- Terapia genética prévia
- Terapia adotiva anterior com células T
- Transplante alogênico prévio de células-tronco hematopoiéticas
- Envolvimento ativo do SNC por malignidade
Outros critérios de inclusão/exclusão definidos pelo protocolo podem ser aplicados.
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Tratamento
- Alocação: N / D
- Modelo Intervencional: Atribuição de grupo único
- Mascaramento: Nenhum (rótulo aberto)
Armas e Intervenções
Grupo de Participantes / Braço |
Intervenção / Tratamento |
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Experimental: CTL019
Todos os pacientes que receberam infusão de tisagenlecleucel.
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Tisagenlecleucel é uma infusão única.
Outros nomes:
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O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
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Taxa de resposta completa (CRR) por avaliação do Comitê de Revisão Independente (IRC)
Prazo: 1 ano
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A taxa de resposta completa foi definida como a porcentagem de participantes com uma melhor resposta geral (BOR) da resposta completa (CR) registrada desde a infusão de tisagenlecleucel até a progressão da doença ou início de uma nova terapia anticancerígena, o que ocorrer primeiro.
A CRR foi determinada por um comitê de revisão independente (IRC) e foi baseada nos critérios de resposta da classificação de Lugano 2014.
A resposta radiológica é obtida primeiro a partir de estudos de TC e PET de acordo com os critérios de Lugano 2014.
A resposta da TC é baseada em medições anatômicas de lesões indexadas/não indexadas/novas lesões e comprimento do baço.
Os possíveis resultados da resposta são resposta completa (CR), resposta parcial (PR), doença estável (SD) ou doença progressiva (PD).
Resposta PET com base em uma escala de 5 pontos (5PS) ou pontuação de Deauville.
Os resultados possíveis para a resposta PET são resposta metabólica completa (CMR), resposta metabólica parcial (PMR), nenhuma resposta metabólica (NMR) ou doença metabólica progressiva (PMD).
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1 ano
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Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
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Taxa de resposta geral (ORR) por avaliação de IRC
Prazo: 1 ano
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A taxa de resposta global é definida como a percentagem de participantes com uma melhor resposta global à doença de resposta completa (CR) ou resposta parcial (PR).
A resposta foi avaliada de acordo com os critérios de resposta da classificação de Lugano 2014.
A resposta radiológica é obtida primeiro a partir de estudos de TC e PET de acordo com os critérios de Lugano 2014.
A resposta da TC é baseada em medições anatômicas de lesões indexadas/não indexadas/novas lesões e comprimento do baço.
Os possíveis resultados da resposta são resposta completa (CR), resposta parcial (PR), doença estável (SD) ou doença progressiva (PD).
Resposta PET com base em uma escala de 5 pontos (5PS) ou pontuação de Deauville.
Os resultados possíveis para a resposta PET são resposta metabólica completa (CMR), resposta metabólica parcial (PMR), nenhuma resposta metabólica (NMR) ou doença metabólica progressiva (PMD).
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1 ano
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Duration of Response (DOR) Per IRC Assessment
Prazo: approx. 60 months
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Duration of response (DOR) applied only to participants whose best overall disease response was CR or PR.
It is defined as the time from the date of first documented disease response (CR or PR) to the date of first documented progression or death due to follicular lymphoma (FL).
DOR was estimated using the Kaplan-Meier method.
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approx. 60 months
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Duration of Response (DOR) for Complete Response (CR) Only Per IRC Assessment
Prazo: approx. 60 months
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Duration of response (DOR) applied only to participants whose best overall disease response was complete response (CR) only.
It is defined as the time from the date of first documented disease response (CR only) to the date of first documented progression or death due to follicular lymphoma (FL).
DOR was estimated using the Kaplan-Meier method.
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approx. 60 months
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Progression Free Survival (PFS) Per IRC Assessment
Prazo: up to 61.7 months
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Progression free survival is the time from tisagenlecleucel infusion to first documented disease progression or death due to any cause.
PFS was estimated using the Kaplan-Meier method.
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up to 61.7 months
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Overall Survival (OS)
Prazo: up to 65.8 months
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Overall Survival is the time from tisagenlecleucel infusion to death due to any cause.
OS was estimated using the Kaplan-Meier method.
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up to 65.8 months
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Tisagenlecleucel Transgene Concentration Levels as Measured by Quantitative Polymerase Chain Reaction (qPCR) Method, by Clinical Response Per IRC Assessment
Prazo: Month 60 (peripheral blood), Month 6 (bone marrow)
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This is the summary of cellular kinetic concentrations for tisagenlecleucel (CTL019) transgene levels in peripheral blood and bone marrow following infusion.
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Month 60 (peripheral blood), Month 6 (bone marrow)
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Cmax; Cellular Kinetic Parameter of Tisagenlecleucel Transgene Levels by qPCR, Based on Clinical Response IRC Assessment
Prazo: up to 60 months after infusion
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Cmax is the maximum (peak) observed in peripheral blood after single dose administration.
Actual sampling times were taken into consideration for the calculation of cellular kinetic parameters parameters.
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up to 60 months after infusion
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Tmax; Cellular Kinetic Parameter of Tisagenlecleucel Transgene Levels by qPCR, Based on Clinical Response by IRC Assessment
Prazo: up to 60 months after infusion
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Tmax is the time to reach maximum (peak) peripheral blood after single dose administration (days).
Actual sampling times were taken into consideration for the calculation of cellular kinetic parameters.
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up to 60 months after infusion
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AUC0-28d and AUC0-84d; Cellular Kinetic Parameter of Tisagenlecleucel Transgene Levels by qPCR, Based on Clinical Response by IRC Assessment
Prazo: 0 to 28 days after infusion, 0 to 84 days after infusion
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AUC0-28 is the area under curve (AUC) from time zero to day 28 in peripheral blood.
AUC0-84d is the AUC from time zero to day 84 in peripheral blood.
Actual sampling times were taken into consideration for the calculation of cellular kinetic parameters.
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0 to 28 days after infusion, 0 to 84 days after infusion
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AUC0-28d and AUC0-84d; Cellular Kinetic Parameter for Tisagenlecleucel by Flow Cytometry, Based on Clinical Response by IRC Assessment
Prazo: AUC0-28d: from time of infusion to 28 days post-dose; AUC0-84d: from time of infusion to 84 days post-infusion
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Exposure is summarized as area under the curve (AUC) from time 0 to 28 days (AUC0-28d) and from time to 84 days (AUC0-84d).
The cellular kinetic parameters were estimated from the percentages of CD3+/CTL019+ cells obtained from flow cytometry.
Flow cytometry measures the surface expression of chimeric antigen receptors (CARs) on T cells.
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AUC0-28d: from time of infusion to 28 days post-dose; AUC0-84d: from time of infusion to 84 days post-infusion
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Cmax; Cellular Kinetic Parameter for Tisagenlecleucel by Flow Cytometry, Based on Clinical Response by IRC Assessment
Prazo: From pre-dose until 60 months after infusion
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Cmax is the maximum (peak) observed in peripheral blood after single dose administration.
Actual sampling times were taken into consideration for the calculation of cellular kinetic parameters parameters.
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From pre-dose until 60 months after infusion
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Summary of Exposure of CD3+ Tisagenlecleucel Cells in Peripheral Blood for Tmax
Prazo: From pre-dose until 60 months after infusion
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In vivo cellular kinetics of CD3+/CTL019+ levels tisagenlecleucel cells detected by flow cytometry base on best overall response (BOR).
The cellular kinetic parameters were estimated from the percentages of CD3+/CTL019+ cells obtained from flow cytometry.
Flow cytometry measures the surface expression of chimeric antigen receptors (CARs) on T cells.
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From pre-dose until 60 months after infusion
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Humoral Immunogenicity: Number of Participants With Anti-mCAR19 Antibodies, Per IRC Assessment
Prazo: at any time post-baseline, up to 24 months post-infusion
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Antibody titers specific to the tisagenlecleucel molecule prior to and following infusion.
Percentage of participants who tested positive for anti-mCAR19 antibodies at any time post-baseline.
A participant was only defined as positive for tisagenlecleucel treatment-induced or -boosted anti-mCAR19 antibodies when the anti-mCAR19 antibody median fluorescence intensity (MFI) at any time post-infusion was at least 2.28-fold higher than pre-infusion levels for patients whose baseline status was positive (boosted) or if the baseline status was negative, but any post-baseline interpretation was positive (induced).
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at any time post-baseline, up to 24 months post-infusion
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Cellular Immunogenicity: Percentage of Interferon Gamma (IFNg+) Cells by Flow Cytometry Per IRC Assessment
Prazo: pre-infusion (pre-Lymph depletion evaluation), 24 months post-infusion
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Activation of T-cells in peripheral blood mononuclear cells collected from participants in response to mCAR19-derived peptides was used to assess the cellular immunogenicity against tisagenlecleucel. T-cell activation was measured by the percentage of interferon gamma (IFNg+) cells by flow cytometry. Cellular responses to mCART peptides were measured pre-infusion (enrollment) and post-tisagenlecleucel infusion. Pool 1 and Pool 2 are a pool of 60 peptides (peptides 1-60) and 59 peptides (peptides 61-119) , respectively, corresponding to the CTL019 transgene product. Together, they comprised 119 peptides spanning the CTL019 transgene product and were used to stimulate PBMCs to detect antigen-specific T cell responses via intracellular cytokine staining. |
pre-infusion (pre-Lymph depletion evaluation), 24 months post-infusion
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Summary Scores of Patient-reported Outcome (PRO) Measured by SF-36v2 Quality of Life Questionnaire by Visit
Prazo: Baseline (BL) Month (M) 3, M3, M6, M9, M12, M18, M24
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Effect of tisagenlecleucel therapy on patient reported outcomes were reported using the Short Form Health Survey (SF-36) v2 form.
The SF-36 v2 is a widely used and extensively studied instrument to measure health-related quality of life among healthy patients and patients with acute and chronic conditions.
It consists of eight subscales that can be scored individually: Physical Functioning, Role-Physical, Bodily Pain, General Health, Vitality, Social Functioning, Role-Emotional, and Mental Health.
Two overall summary scores, the Physical Component Summary (PCS) and the Mental Component Summary (MCS) were computed by summing the item responses on the questions for each domain in accordance with the respective scoring method provided by the developers.
Each item is scored on a 0 to 100 range so that the lowest and highest possible scores are 0 and 100, respectively.
A high score defines a more favorable health state.
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Baseline (BL) Month (M) 3, M3, M6, M9, M12, M18, M24
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Summary Scores of PRO Measured by SF-36v2 Quality of Life Questionnaire Reported by Change From Baseline
Prazo: Change from baseline (CFB) M3, CFB M6, CFB M9, CFB M12, CFB M18, CFB M24
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Effect of tisagenlecleucel therapy on patient reported outcomes were reported using the Short Form Health Survey (SF-36) v2 form.
The SF-36 v2 is a widely used and extensively studied instrument to measure health-related quality of life among healthy patients and patients with acute and chronic conditions.
It consists of eight subscales that can be scored individually: Physical Functioning, Role-Physical, Bodily Pain, General Health, Vitality, Social Functioning, Role-Emotional, and Mental Health.
Two overall summary scores, the Physical Component Summary (PCS) and the Mental Component Summary (MCS) were computed by summing the item responses on the questions for each domain in accordance with the respective scoring method provided by the developers.
Each item is scored on a 0 to 100 range so that the lowest and highest possible scores are 0 and 100, respectively.
A high score defines a more favorable health state.
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Change from baseline (CFB) M3, CFB M6, CFB M9, CFB M12, CFB M18, CFB M24
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Health Status Measured by EQ-5D-3L Questionnaire
Prazo: Baseline (BL), Month 3, Month 6, Month 9, Month 12, Month 18, Month 24, Month 36
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Effect of tisagenlecleucel therapy on patient-reported outcomes was assessed using the EuroQol 5-Dimension, 3-Level instrument (EQ-5D-3L).
The EQ-5D-3L is a widely used, self-administered questionnaire designed to evaluate health status in adults.
It consists of two sections.
The first includes one item for each of the five dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression).
Patients rate each dimension as "no problems" (level 1), "some problems" (level 2), or "extreme problems" (level 3).
This record summarizes, for each of the five dimensions, the number of patients falling into each response level.
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Baseline (BL), Month 3, Month 6, Month 9, Month 12, Month 18, Month 24, Month 36
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Summary Scores of PRO Measured by EQ-VAS Quality of Life Questionnaire by Visit
Prazo: Baseline (BL) Month (M) 3, M6, M9, M12, M18, M24, M36
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Effect of tisagenlecleucel therapy on patient reported outcomes were reported using the EQ-VAS (EuroQol Visual Analogue Scale).
The EQ-VAS is a 20 cm vertical, 0-100 numerical scale used alongside the EQ-5D questionnaire to measure a patient's self-rated health.
It anchors "best imaginable health" (100) at the top and "worst imaginable health" (0) at the bottom, providing a quick, subjective, quantitative, and global assessment of health status on the day of survey.
The second section of the questionnaire measures self-rated (global) health status utilizing a vertically oriented visual analogue scale where 100 represents the "best possible health state" and 0 represents the "worst possible health state."
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Baseline (BL) Month (M) 3, M6, M9, M12, M18, M24, M36
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Summary Scores of PRO Measured by EQ-VAS Quality of Life Questionnaire Reported by Change From Baseline
Prazo: Baseline (BL), M3 change from baseline (CFB), M6 CFB, M9 CFB, M12 CFB, M18 CFB, M24 CFB, M36 CFB
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Effect of tisagenlecleucel therapy on patient reported outcomes were reported using the EQ-VAS (EuroQol Visual Analogue Scale).
The EQ-VAS is a 20 cm vertical, 0-100 numerical scale used alongside the EQ-5D questionnaire to measure a patient's self-rated health.
It anchors "best imaginable health" (100) at the top and "worst imaginable health" (0) at the bottom, providing a quick, subjective, quantitative, and global assessment of health status on the day of survey
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Baseline (BL), M3 change from baseline (CFB), M6 CFB, M9 CFB, M12 CFB, M18 CFB, M24 CFB, M36 CFB
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Summary Scores of PRO Measured by FACT-Lym Quality of Life Questionnaire
Prazo: Baseline (BL) Month (M) 3, M6, M9, M12, M18, M24, M36
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The effect of tisagenlecleucel therapy on patient-reported outcomes was assessed using the Functional Assessment of Cancer Therapy-Lymphoma (FACT-Lym) questionnaire, which measures quality of life in participants with lymphoma.
FACT-Lym is composed of the FACT-G (27 items across Physical, Social/Family, Emotional, and Functional Well-Being, plus Additional Concerns) and a 15-item lymphoma-specific subscale.
All items use a five-point self-administered response scale (0-4), with higher scores indicating better quality of life.
The possible score ranges are as follows: - Physical Well-Being (PWB): 0-28 - Social/Family Well-Being (SWB): 0-28 - Emotional Well-Being (EWB): 0-24 - Functional Well-Being (FWB): 0-28 - Lym Subscale (15 items): 0-60 - Lymphoma Trial Outcome Index (TOI: PWB + FWB + Lym): 0-116 - FACT-G Total (PWB + SWB + EWB + FWB): 0-108 - FACT-Lym Total (FACT-G + Lym): 0-168 In all cases, higher scores indicate better outcomes within the corresponding domain.
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Baseline (BL) Month (M) 3, M6, M9, M12, M18, M24, M36
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Summary Scores of PRO Measured by FACT-Lym Quality of Life Questionnaire Reported by Change From Baseline
Prazo: Baseline (BL), M3 change from baseline (CFB), M6 CFB, M9 CFB, M12 CFB, M18 CFB, M24 CFB, M36 CFB
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The effect of tisagenlecleucel therapy on patient-reported outcomes was assessed using the Functional Assessment of Cancer Therapy-Lymphoma (FACT-Lym) questionnaire, which measures quality of life in participants with lymphoma.
FACT-Lym is composed of the FACT-G (27 items across Physical, Social/Family, Emotional, and Functional Well-Being, plus Additional Concerns) and a 15-item lymphoma-specific subscale.
All items use a five-point self-administered response scale (0-4), with higher scores indicating better quality of life.
The possible score ranges are as follows: - Physical Well-Being (PWB): 0-28 - Social/Family Well-Being (SWB): 0-28 - Emotional Well-Being (EWB): 0-24 - Functional Well-Being (FWB): 0-28 - Lym Subscale (15 items): 0-60 - Lymphoma Trial Outcome Index (TOI: PWB + FWB + Lym): 0-116 - FACT-G Total (PWB + SWB + EWB + FWB): 0-108 - FACT-Lym Total (FACT-G + Lym): 0-168 In all cases, higher scores indicate better outcomes within the corresponding domain.
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Baseline (BL), M3 change from baseline (CFB), M6 CFB, M9 CFB, M12 CFB, M18 CFB, M24 CFB, M36 CFB
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Colaboradores e Investigadores
Patrocinador
Investigadores
- Diretor de estudo: Novartis Pharmaceuticals, Novartis Pharmaceuticals
Publicações e links úteis
Publicações Gerais
- Salles G, Schuster SJ, Dreyling M, Fischer L, Kuruvilla J, Patten PEM, von Tresckow B, Smith SM, Jimenez-Ubieto A, Davis KL, Anjos C, Chu J, Zhang J, Lobetti Bodoni C, Thieblemont C, Fowler NH, Dickinson M, Martinez-Lopez J, Wang Y, Link BK. Efficacy comparison of tisagenlecleucel vs usual care in patients with relapsed or refractory follicular lymphoma. Blood Adv. 2022 Nov 22;6(22):5835-5843. doi: 10.1182/bloodadvances.2022008150.
- Fowler NH, Dickinson M, Dreyling M, Martinez-Lopez J, Kolstad A, Butler J, Ghosh M, Popplewell L, Chavez JC, Bachy E, Kato K, Harigae H, Kersten MJ, Andreadis C, Riedell PA, Ho PJ, Perez-Simon JA, Chen AI, Nastoupil LJ, von Tresckow B, Ferreri AJM, Teshima T, Patten PEM, McGuirk JP, Petzer AL, Offner F, Viardot A, Zinzani PL, Malladi R, Zia A, Awasthi R, Masood A, Anak O, Schuster SJ, Thieblemont C. Tisagenlecleucel in adult relapsed or refractory follicular lymphoma: the phase 2 ELARA trial. Nat Med. 2022 Feb;28(2):325-332. doi: 10.1038/s41591-021-01622-0. Epub 2021 Dec 17.
- Dreyling M, Fowler NH, Dickinson M, Martinez-Lopez J, Kolstad A, Butler J, Ghosh M, Popplewell L, Chavez JC, Bachy E, Kato K, Harigae H, Kersten MJ, Andreadis C, Riedell PA, Ho PJ, Perez-Simon JA, Chen AI, Nastoupil LJ, von Tresckow B, Maria Ferreri AJ, Teshima T, Patten PEM, McGuirk JP, Petzer AL, Offner F, Viardot A, Zinzani PL, Malladi R, Paule I, Zia A, Awasthi R, Han X, Germano D, O'Donovan D, Ramos R, Maier HJ, Masood A, Thieblemont C, Schuster SJ. Durable response after tisagenlecleucel in adults with relapsed/refractory follicular lymphoma: ELARA trial update. Blood. 2024 Apr 25;143(17):1713-1725. doi: 10.1182/blood.2023021567.
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo (Real)
Conclusão Primária (Real)
Conclusão do estudo (Real)
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Real)
Atualizações de registro de estudo
Última Atualização Postada (Real)
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Mais Informações
Termos relacionados a este estudo
Palavras-chave
Termos MeSH relevantes adicionais
- Processos Patológicos
- Neoplasias
- Atributos da doença
- Doenças do sistema imunológico
- Neoplasias por Tipo Histológico
- Doenças Linfáticas
- Distúrbios Linfoproliferativos
- Distúrbios imunoproliferativos
- Linfoma Não-Hodgkin
- Linfoma
- Condições Patológicas, Sinais e Sintomas
- Doenças hemic e linfáticas
- Recorrência
- Linfoma Folicular
- Agentes Antineoplásicos Imunológicos
- Agentes Antineoplásicos
- Tisagenlecleucel
Outros números de identificação do estudo
- CCTL019E2202
- 2017-004385-94 (Número EudraCT)
- 2023-508127-13-00 (Identificador de registro: EU CTIS)
Plano para dados de participantes individuais (IPD)
Planeja compartilhar dados de participantes individuais (IPD)?
Descrição do plano IPD
A Novartis está comprometida em compartilhar com pesquisadores externos qualificados, acesso a dados em nível de paciente e documentos clínicos de suporte de estudos elegíveis. Essas solicitações são analisadas e aprovadas por um painel de especialistas independentes com base no mérito científico. Todos os dados fornecidos são anonimizados para respeitar a privacidade dos pacientes que participaram do estudo, de acordo com as leis e regulamentos aplicáveis.
Os dados deste estudo estão atualmente disponíveis de acordo com o processo descrito em www.clinicalstudydatarequest.com.
Informações sobre medicamentos e dispositivos, documentos de estudo
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