NCT05624996ClinicalTrials.gov
Testing the Addition of High Dose, Targeted Radiation to the Usual Treatment for Locally-Advanced Inoperable Non-Small Cell Lung Cancer
Phase III Prospective Randomized Trial of Primary Lung Tumor Stereotactic Body Radiation Therapy Followed by Concurrent Mediastinal Chemoradiation for Locally-Advanced Non-Small Cell Lung Cancer
בקצרה
This phase III trial compares the effect of adding stereotactic body radiation therapy (SBRT) to the usual treatment (conventional image guided radiation therapy \[IGRT\] and chemotherapy followed by immunotherapy with durvalumab or targeted therapy with osimertinib) versus the usual treatment…
שלב 3דרושים 474 משתתפים477 אתרים2 מדינות
קטגוריות
רשום במרשם אחד
- ClinicalTrials.govNCT05624996פתיחת רשומה זו ב־ClinicalTrials.govסונכרן החודש שעבר
מחקר יחיד יכול להיות רשום בכמה מרשמים. אנו מציגים אותו פעם אחת ומקשרים לכל רשומה שברשותנו.
מידע הניסוי מוצג כפי שפורסם על ידי המרשם, בשפת המקור שלו.
מתעניינים במחקר הזה?
התחברות או צרו חשבון כדי לרשום את התעניינותכם ולעקוב אחר המחקר הזה.
How this study is set up
The points below are drawn from the public registry record for this study. Each one cites the field or sentence it came from. A dash (—) means the record does not state something — not that it is missing or wrong. Many well-run studies, especially small ones, leave some of these blank.
- Present: Registered before enrolment beganFirst posted 2022-11-22; recorded start 2023-07-12
- Present: Has a defined primary outcomeA primary outcome measure is listed in the record
- Present: The primary outcome states a time frameThe primary outcome measure records a time frame
- Present: Participants are randomly assignedAllocation is recorded as randomised
- Present: Has a comparison groupThe record lists a placebo or comparator arm, or more than one study arm
- Not stated: Open label (no blinding)Masking is recorded as none (open label)
- Not stated: An ethics committee is not stated in the registry recordThis registry's ingested record has no ethics-committee field
- Not stated: Regulatory oversight (such as an IND or IDE) is not stated in the registry recordThis registry's ingested record has no regulatory-authorisation field
- Not stated: A data monitoring committee is not stated in the registry recordThis registry's ingested record has no data-monitoring-committee fieldA data monitoring committee is not required for many smaller studies, and its absence here is not unusual.
- Present: No cost to participants is mentioned in the recordChecked the summary, description and eligibility text; no cost-to-participant phrase found
- Present: Sponsor has 49 other studies in this databaseCounted from the lead sponsor named in the record (NRG Oncology)
- Present: Sponsor has posted results for at least one studyBased on the sponsor’s studies in this database
- The record lists 3 conditions.
- Lead sponsor type recorded as: other.
- Intervention regulatory context: investigational, within a phased regulatory pathway.
Trial stature
Three independent measures of this study, described from its registry record — not a recommendation about it. A rigorous study by investigators nobody has heard of is better evidence than a weak study led by a famous one. How these are scored.
A strong methodological design for a phase 3 study, judged from its ClinicalTrials.gov record.
How this score is built
- Randomised allocation20/20
Participants are randomly allocated between arms
- Blinding0/20
Open-label
- Control arm15/15
Active-comparator control arm
- Primary-outcome specificity10/10
Named primary outcome with a defined time frame
- Endpoint type10/10
Mortality / MACE endpoint (hard clinical outcome)
- Multi-centre8/8
Multi-centre: 477 sites
- Data monitoring committee0/7
No data monitoring committee stated
- Prospective registration5/5
Registered before the study start date
- Protocol / SAP posted0/5
No protocol or SAP posted to the registry
A medium-sized study, international in scope: 474 participants (target), run at 477 sites, across 2 countries.
How this score is built
- Enrolment26/40
474 participants (target)
- Site count25/25
477 sites
- Country count7/15
2 countries
- Planned duration10/10
Planned over about 101 months
- Sponsor scale6/10
NRG Oncology has led 49 trials in our corpus
We have no verifiable track record for the investigator named on this trial. That is common for early-career investigators and for records held outside ClinicalTrials.gov — it is not a negative signal.
How this score is built
- Investigator standing0/100
No investigator recorded in the registry for this trial
These describe the registry record only, and today we hold ClinicalTrials.gov data. Absent fields lower a score, and absence often reflects registration practice rather than study quality. A high-stature trial is not necessarily safer or a better choice for you — enrolling in a large definitive trial can mean a higher chance of receiving placebo, while a small early-phase study may be the only route to a new therapy.
תקציר
This phase III trial compares the effect of adding stereotactic body radiation therapy (SBRT) to the usual treatment (conventional image guided radiation therapy \[IGRT\] and chemotherapy followed by immunotherapy with durvalumab or targeted therapy with osimertinib) versus the usual treatment alone in treating patients with non-small cell lung cancer that has spread to nearby tissue or lymph nodes (locally advanced) and cannot be treated by surgery (inoperable). SBRT uses special equipment to position a patient and deliver radiation therapy to tumors with high precision. This method may kill tumor cells with fewer doses over a shorter period and cause less damage to normal tissue. IGRT is a type of radiation therapy that creates a picture of the tumor to help guide the radiation beam during therapy, making it more accurate and causing less damage to healthy tissue. Usual chemotherapy used in this trial consists of combinations of the following drugs: cisplatin, carboplatin, paclitaxel, nab-paclitaxel, pemetrexed, and etoposide. Cisplatin and carboplatin are in a class of medications known as platinum-containing compounds. Cisplatin works by killing, stopping, or slowing the growth of tumor cells. Carboplatin works in a way similar to the anticancer drug cisplatin but may be better tolerated than cisplatin. Carboplatin works by killing, stopping, or slowing the growth of tumor cells as well. Paclitaxel is in a class of medications called antimicrotubule agents. It works by stopping the growth and spread of tumor cells. Nab-paclitaxel is an albumin-stabilized nanoparticle formulation of paclitaxel which may have fewer side effects and work better than other forms of paclitaxel. Pemetrexed is in a class of medications called antifolate antineoplastic agents. It works by blocking the action of a certain substance in the body that may help tumor cells multiply. Etoposide is in a class of medications known as podophyllotoxin derivatives. It blocks a certain enzyme needed for cell division and deoxyribonucleic acid (DNA) repair and may kill tumor cells. Immunotherapy with durvalumab can induce changes in the body's immune system and can interfere with the ability of tumor cells to grow and spread. Osimertinib is in a class of medications called kinase inhibitors. It works by blocking the action of a protein called EGFR that signals cancer cells to multiply. This helps slow or stop the spread of tumor cells. Adding SBRT to the usual treatment of IGRT with chemotherapy and immunotherapy may be more effective at treating patients with locally-advanced non-small cell lung cancer than giving the usual treatment alone.
מצבים רפואיים
- Locally Advanced Lung Non-Small Cell Carcinoma
- Stage IIB Lung Cancer AJCC v8
- Stage III Lung Cancer AJCC v8
זכאות
| מין | הכול |
|---|---|
| גילאים | 18 Years – ללא מקסימום |
| מתנדבים בריאים | לא |
זכאות כפי שנכתבה במרשם
זכאות במשפטים פשוטים
הקריטריונים של רשומה זו טרם פורקו למשפטים נפרדים. טקסט המרשם שלמעלה שלם והוא הגרסה המחייבת.
תכנון המחקר
| סוג המחקר | התערבותי |
|---|---|
| שלב | שלב 3 |
| הקצאה | אקראי |
| מודל ההתערבות | PARALLEL |
| מטרה ראשית | TREATMENT |
| הסתרה | NONE (0) |
| גיוס | דרושים 474 משתתפים |
נותן חסות ושותפים
- NRG Oncology נותן חסות
זרועות והתערבויות
- Arm I (image guided RT, chemotherapy, immunotherapy)ACTIVE_COMPARATOR
Patients undergo conventional IGRT and receive usual care chemotherapy consisting of paclitaxel IV followed by carboplatin IV Q7D during radiotherapy or pemetrexed IV followed by carboplatin IV every 21 days during radiotherapy or etoposide IV on days 1 to 5 and days 29 to 33 followed by cisplatin IV on days 1, 8, 29, and 36 or pemetrexed IV followed by cisplatin IV every 21 days during radiotherapy. Patients then receive consolidation durvalumab IV every 2 or 4 weeks for up to one year or osimertinib PO QD in the absence of disease progression or unacceptable toxicity. Patients also undergo CT and/or PET/CT during follow-up.
- Arm II (SBRT, image guided RT, chemotherapy, immunotherapy)EXPERIMENTAL
Patients undergo SBRT and conventional IGRT and then receive standard-of-care chemotherapy consisting of paclitaxel IV followed by carboplatin IV Q7D during radiotherapy or pemetrexed IV followed by carboplatin IV every 21 days during radiotherapy or etoposide IV on days 1 to 5 and days 29 to 33 followed by cisplatin IV on days 1, 8, 29, and 36 or pemetrexed IV followed by cisplatin IV every 21 days during radiotherapy. Patients then receive consolidation durvalumab IV every 2 or 4 weeks for up to one year or osimertinib PO QD in the absence of disease progression or unacceptable toxicity. Patients also undergo CT and/or PET/CT during follow-up.
התערבויות
- תרופה Carboplatin
Given IV
- תרופה Cisplatin
Given IV
- פרוצדורה Computed Tomography
Undergo CT and/or PET/CT
- ביולוגי Durvalumab
Given IV
- תרופה Etoposide
Given IV
- קרינה Image Guided Radiation Therapy
Undergo IGRT
- תרופה Nab-paclitaxel
Given IV
- תרופה Osimertinib
Given PO
- תרופה Paclitaxel
Given IV
- תרופה Pemetrexed
Given IV
- פרוצדורה Positron Emission Tomography
Undergo PET/CT
- אחר Questionnaire Administration
Ancillary studies
- קרינה Stereotactic Body Radiation Therapy
Undergo SBRT
מדדי תוצאה
מדד תוצאה ראשוני
Overall survival (OS)
Non-inferiority (NI) between arm 2 and arm 1 (reference level) will be evaluated by comparing the upper bound of the 95% confidence interval for the hazard ratio to the pre-specified NI margin. NI of arm 2 will be concluded if the upper bound of the confidence interval is equal to, or falls below, the pre-specified margin at the final analysis. When evaluating the NI of arm 2 in OS, a Cox proportional hazards (PH) model stratified by stratification factors will be used to compute the hazard ratio and associated 95% confidence interval (CI). OS rates will be estimated using the Kaplan-Meier method. If the NI of arm 2 in OS is demonstrated, the superiority of arm 1 in OS will be tested at 1-sided significance level of 0.025 using a stratified log-rank test by adjusting for stratification factors.
מסגרת זמן Time between date of randomization and date of death due to any cause, assessed up to 8 years
מדד תוצאה ראשוני
Progression-free survival (PFS)
The PFS analysis will be conducted using the same methods and stratification factors as the OS analysis. The superiority of arm 2 in PFS will be tested at 1-sided significance level of 0.025 using a stratified log-rank test by adjusting for stratification factors. In the event that the NI of OS is not established, statistical inference of PFS will be considered exploratory in nature only. A Cox PH model stratified by stratification factors will be used to compute the hazard ratio and associated 95% CI.
מסגרת זמן Time between date of randomization and first date of documented progression or death due to any cause, assessed up to 8 years
מדד תוצאה משני
Objective response rate (ORR)
ORR (per Response Evaluation Criteria in Solid Tumors \[RECIST\] 1.1) is defined as the number (%) of patients with at least 1 visit response of complete response (CR) or partial response (PR) and will be based on all randomized patients who have measurable disease. Therefore, data obtained up until progression, or the last evaluable assessment in the absence of progression, will be included in the assessment of ORR. The ORR will be compared between arm 2 versus arm 1 using a Fisher's exact test. A binary response variable for ORR will be used for the analysis with the categories of CR and PR versus stable disease, progressive disease and inevaluable.
מסגרת זמן Up to 8 years
מדד תוצאה משני
Time to progression
Local control also known as time to progression will be defined as freedom from local progression, in which a failure is defined as intrathoracic tumor progression (failure in the lobe of the primary tumor or mediastinal lymph nodes) by RECIST 1.1 criteria. Local control will be analyzed as competing risks data based on cause-specific hazards approaches, where deaths without local failure will be considered as a competing event and analyzed as "censoring" of local failure. The rates at various timepoints (e.g., every 6 months after randomization) and medians of PFS for each arm will be estimated using the Kaplan-Meier method. The associated 95% CI will be calculated using Greenwood's formula and based on a log-log transformation applied on the survival function. Results from an unstratified analysis will also be provided.
מסגרת זמן Up to 8 years
מדד תוצאה משני
Time to primary, locoregional, or distant failure
Competing risks analysis will be used to analyze times to primary failure, locoregional failure and distant failure as the first failure. Competing events include primary failure, locoregional failure, distant failure and deaths without any failures. Rates at various timepoints (i.e., every 6 months after randomization) for each arm will be estimated using the cumulative incidence function. The associated 95% CI will be calculated using the Delta method and based on a log-log transformation applied on the estimated cumulative incidence functions. Statistical inferences of the development of each failure between arms will be based on cause-specific hazards using the log-rank test and Cox proportional hazard model. In addition, Gray's test and the Fine-Gray model will also be used to provide statistical inferences between arms based on cumulative incidence functions and subdistribution hazards.
מסגרת זמן Up to 8 years
מדד תוצאה משני
Changes in pulmonary function
Includes forced expiratory volume in 1 second (FEV1) and diffusion capacity of the lung for carbon monoxide (DLCO). Changes in pulmonary function (FEV1 and DLCO) will be summarized with descriptive statistics, and compared with Wilcoxon rank-sum test. The descriptive statistics of changes in FEV1 and diffusion capacity before and after treatment will be reported by treatment arm and by response categories (complete response; partial response; stable disease; progressive disease). Linear regression will be used to model changes with adjustment for treatment arms and possibly other baseline covariates, if applicable. The grade 3-5 NRG Oncology Pulmonary Toxicity Scale for changes will be reported with the frequency and grade by arm. Logistic regression will be used to model the distribution of the NRG Oncology Pulmonary Toxicity Scale by arms with and without adjustment for covariates.
מסגרת זמן From randomization to 6 months or 12 months
מדד תוצאה משני
Patient reported outcomes-Common Terminology Criteria for Adverse Events (PRO-CTCAE)
Adverse events will also be assessed using PRO-CTCAE items. The PRO-CTCAE is a patient-reported outcome measurement system developed to characterize the frequency, severity, and interference of symptomatic treatment toxicities. Items are scored on a Likert scale. For each symptom and each domain (i.e., frequency, severity, and interference), counts and frequencies will be summarized for the worst score experienced by the patient by the treatment arm. In addition, a composite grading algorithm (Basch 2021) will be used to derive a single numerical grade for each adverse event scored using PRO-CTCAE. PRO-CTCAE, the frequency of acute grade \>= 3 patient-reported toxicity will be compared to the corresponding rate of clinician-scored toxicity using a chi-square test or Fisher exact test, as appropriate. Distributions of clinician-reported and patient-reported adverse events will also be compared across study arms.
מסגרת זמן At 3, 12, and 24 months
מדד תוצאה משני
Functional Assessment of Cancer Therapy Lung (FACT-L) and Trial Outcome Index (TOI)
FACT-L and TOI is a measure that sums the functional well-being (FWB - 7 items), physical well-being (PWB - 7), and the lung cancer subscale (LCS - 9 items) of FACT-L. Questionnaire trial outcome index deterioration rates at 3 months and associated 95% confidence interval will be calculated for each treatment group, based on all randomized subjects. In addition, to explore if higher QOL scores will be maintained at 12 and 24 months from the end of radiotherapy as well, longitudinal data analysis will also be performed to characterize the trend of scores over time across the two treatment groups using hierarchical formulation of the linear mixed model. The Clopper-Pearson method will be used for calculating 95% CI. The deterioration rates of each arm will also be compared using Cochran-Mantel-Haenszel Test, stratified by PD-L1 expression and T-stage.
מסגרת זמן At 3, 12, and 24 months
מדד תוצאה משני
European Quality of Life Five Dimension (EQ-5D) scale
Subjects' overall health state on a visual analog scale (EQ-VAS) at each assessment time point will be summarized using descriptive statistics by treatment group, as randomized. Proportion of subjects reporting problems for the five EQ-5D dimensions at each assessment time point will be summarized by level of problem and by treatment group, as randomized. Percentages will be based on number subjects assessed at assessment time point.
מסגרת זמן At 3, 12, and 24 months
מדד תוצאה משני
Incidence of adverse events
For each patient, the maximum severity reported will be used in the summaries. Adverse events will be summarized regardless of relationship to protocol treatment as assessed by the investigator. Treatment-related adverse events using National Cancer Institute's Common Terminology Criteria for Adverse Events (CTCAE) will be presented in statistical analysis reports/publications in CTCAE version 5. Adverse event rates will be reported with the frequency and severity (e.g., type, grade, and attribution) by arm.
מסגרת זמן Up to 8 years
מדד תוצאה אחר
Clinical outcomes
Descriptive analyses will be reported, based on corresponding analysis plans within patients who actually receive proton and photon radiotherapy (e.g., per-protocol population), respectively.
מסגרת זמן Up to 8 years
מדד תוצאה אחר
Functional mean lung dose
Collection of 4-dimensional (4D) computed tomography (CT) planning CTs and calculation of radiation dose to regional lung ventilation will be performed among randomized patients with 4D CT planning CTs. To evaluate functional dose metrics, ventilation maps will be registered to the average 4DCT reference frame. Functional dose metrics and standard dose metrics will be calculated and evaluated. Functional mean lung dose will be defined as the mean dose delivered to functional lung. Dose to total lung and dose to functional lung will then be correlated with pulmonary toxicity including grade 2 or higher radiation pneumonitis or any grade 3 or higher cough, dyspnea, hypoxia or respiratory failure. Logistic regression models will be used to explore the correlation between pulmonary toxicity and functional mean lung dose.
מסגרת זמן Up to 8 years
מדד תוצאה אחר
Incidence of toxicities
Descriptive analyses will be reported, based on corresponding analysis plans within patients who actually receive proton and photon radiotherapy (e.g., per-protocol population), respectively.
מסגרת זמן Up to 8 years
מדד תוצאה אחר
Changes in pulmonary function
Descriptive analyses will be reported, based on corresponding analysis plans within patients who actually receive proton and photon radiotherapy (e.g., per-protocol population), respectively.
מסגרת זמן Up to 8 years
מדד תוצאה אחר
Changes in quality of life
Descriptive analyses will be reported, based on corresponding analysis plans within patients who actually receive proton and photon radiotherapy (e.g., per-protocol population), respectively.
מסגרת זמן Up to 8 years
מדד תוצאה אחר
Development and characterization of a machine learning/artificial intelligence (AI) algorithm for radiotherapy planning and/or quality assurance
Assessment will focus on four key areas: tumor volume contouring score, organs-at-risk contouring score, tumor volume dose-volume analysis score, and organs-at-risk dose-volume analysis score. Each area will be scored as per protocol: acceptable variation, unacceptable variation, or not evaluable. Cases deemed not evaluable will be considered as such, regardless of the reviewer. The scores generated by the AI algorithm will be compared with those from radiation oncologists, ensuring the AI algorithm adheres to the contours. The sensitivity of the AI algorithm, indicating its ability to detect deviations from the protocol, will be calculated. The AI algorithm will be refined until its sensitivity exceeds 95%. Inter-rater reliability between the AI algorithm and the radiation oncologists will be assessed using Cohen's κ. Concordance and discordance frequencies will also be recorded.
מסגרת זמן Up to 8 years
מדד תוצאה אחר
Treatment effect and confidence intervals by sex
מסגרת זמן Up to 8 years
מדד תוצאה אחר
Treatment effect and confidence intervals by race
מסגרת זמן Up to 8 years
מדד תוצאה אחר
Treatment effect and confidence intervals by ethnicity
מסגרת זמן Up to 8 years
תאריכים
| תאריך התחלה | 12 ביולי 2023 (בפועל) |
|---|---|
| סיום ראשוני | 15 באוקטובר 2031 (משוער) |
| סיום | 15 באוקטובר 2036 (משוער) |
| פורסם לראשונה | 22 בנובמבר 2022 (בפועל) |
| עודכן לאחרונה | 17 באוגוסט 2026 |
| התוצאות פורסמו | לא צוין ברשומת המרשם |
| המצב אומת לאחרונה | אוגוסט 2026 |
בפועל פירושו שהאירוע התרחש. משוער פירושו שנותן החסות צופה אותו. שתי המשמעויות שונות זו מזו.
מיקומים
446 אתרים מגייסים
Canada
| מתקן | עיר | מדינה או אזור | מצב |
|---|---|---|---|
| Ottawa Hospital and Cancer Center-General Campus | Ottawa | Ontario | מושהה |
United States
| מתקן | עיר | מדינה או אזור | מצב |
|---|---|---|---|
| Cleveland Clinic Akron General | Akron | Ohio | מגייס |
| Atrium Health Stanly/LCI-Albemarle | Albemarle | North Carolina | מגייס |
| Presbyterian Kaseman Hospital | Albuquerque | New Mexico | פעיל, ללא גיוס |
| University of New Mexico Cancer Center | Albuquerque | New Mexico | מגייס |
| Alton Memorial Hospital | Alton | Illinois | פעיל, ללא גיוס |
| Mary Greeley Medical Center | Ames | Iowa | מגייס |
| McFarland Clinic - Ames | Ames | Iowa | מגייס |
| UI Health Care Mission Cancer and Blood - Ankeny Clinic | Ankeny | Iowa | מגייס |
| Trinity Health Saint Joseph Mercy Hospital Ann Arbor | Ann Arbor | Michigan | מגייס |
| Luminis Health Anne Arundel Medical Center | Annapolis | Maryland | פעיל, ללא גיוס |
| Langlade Hospital and Cancer Center | Antigo | Wisconsin | מגייס |
| Northwest Wisconsin Cancer Center | Ashland | Wisconsin | מגייס |
| Duluth Clinic Ashland | Ashland | Wisconsin | מגייס |
| Emory Saint Joseph's Hospital | Atlanta | Georgia | מגייס |
| Grady Health System | Atlanta | Georgia | מגייס |
| Emory Proton Therapy Center | Atlanta | Georgia | מגייס |
| Emory University Hospital Midtown | Atlanta | Georgia | מגייס |
| Emory University Hospital/Winship Cancer Institute | Atlanta | Georgia | מגייס |
| Augusta University Medical Center | Augusta | Georgia | מגייס |
| UCHealth University of Colorado Hospital | Aurora | Colorado | מגייס |
| Rush-Copley Medical Center | Aurora | Illinois | מגייס |
| Advocate Outpatient Center - Aurora | Aurora | Illinois | מגייס |
| WellStar Cobb Hospital | Austell | Georgia | מגייס |
| UH Seidman Cancer Center at UH Avon Health Center | Avon | Ohio | מגייס |
| AIS Cancer Center at San Joaquin Community Hospital | Bakersfield | California | מגייס |
| Sinai Hospital of Baltimore | Baltimore | Maryland | מגייס |
| Greater Baltimore Medical Center | Baltimore | Maryland | מגייס |
| Advocate Good Shepherd Hospital | Barrington | Illinois | מגייס |
| Memorial Sloan Kettering Basking Ridge | Basking Ridge | New Jersey | מגייס |
| Wilmot Cancer Center at Batavia | Batavia | New York | מושהה |
| McLaren Cancer Institute-Bay City | Bay City | Michigan | מגייס |
| Bay Pines VA Healthcare System | Bay Pines | Florida | מגייס |
| Northwell Health Imbert Cancer Center | Bay Shore | New York | מגייס |
| UHHS-Chagrin Highlands Medical Center | Beachwood | Ohio | מגייס |
| Sanford Joe Lueken Cancer Center | Bemidji | Minnesota | מגייס |
| Central Vermont Medical Center/National Life Cancer Treatment | Berlin Corners | Vermont | מגייס |
| Billings Clinic Cancer Center | Billings | Montana | מגייס |
| The Kirklin Clinic at Acton Road | Birmingham | Alabama | מגייס |
| University of Alabama at Birmingham Cancer Center | Birmingham | Alabama | מגייס |
| Sanford Bismarck Medical Center | Bismarck | North Dakota | מגייס |
| OSF Saint Joseph Medical Center | Bloomington | Illinois | מגייס |
| Illinois CancerCare-Bloomington | Bloomington | Illinois | מגייס |
| Saint Joseph's/Candler - Bluffton Campus | Bluffton | South Carolina | מגייס |
| Bozeman Health Deaconess Hospital | Bozeman | Montana | מגייס |
| Essentia Health Saint Joseph's Medical Center | Brainerd | Minnesota | מגייס |
| Trinity Health IHA Medical Group Hematology Oncology - Brighton | Brighton | Michigan | מגייס |
| Trinity Health Medical Center - Brighton | Brighton | Michigan | מגייס |
| Henry Ford Cancer Institute-Downriver | Brownstown | Michigan | מגייס |
| Mills-Peninsula Medical Center | Burlingame | California | מגייס |
427 אתרים נוספים מצוינים ברשומת המרשם.
מסמכי המחקר
לא צורפו מסמכים ברשומת מרשם זו.
שינויים לאורך זמן
לא נרשמו שינויים מאז שקלטנו רשומה זו לראשונה.
שינוי נרשם בכל פעם שנותן החסות מעדכן את רשומת המרשם. מצב, תאריכים, גיוס ואתרים מופיעים כאן ככל שהם משתנים.