SarcomaPhase 2NCT00112489
Paclitaxel and Carboplatin in Treating Patients With Persistent or Recurrent Stage III or Stage IV Uterine Cancer
A Phase 2 study testing carboplatin and paclitaxel in people with Sarcoma, run by Gynecologic Oncology Group at 110 sites in 2 countries.
Trial summary
RATIONALE: Drugs used in chemotherapy, such as paclitaxel and carboplatin, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving more than one drug (combination chemotherapy) may kill more tumor cells. Read more about this study
- Who is it for?
- Ages 18 to 120 years, women only
- Conditions the study is for
- Sarcoma
- What is being tested?
- carboplatin and paclitaxel
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 55 participants
- Where
- 110 sitesin 2 countries
- Study dates
- May 2005to Jul 2010
- Phase
- Phase 2
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 120 years
- Women only
- No healthy volunteers
- Adult, Older adult
DISEASE CHARACTERISTICS:
- Histologically confirmed uterine carcinosarcoma (mixed mesodermal tumor)
- Stage III or IV disease
- Persistent or recurrent disease
- Documented disease progression
- Measurable disease, defined as ≥ 1 unidimensionally measurable lesion ≥ 20 mm by conventional techniques OR ≥ 10 mm by spiral CT scan
- At least 1 target lesion
- Tumors within a previously irradiated field are not considered target lesions unless there is documented disease progression
- Ineligible for any higher priority Gynecology Oncology Group (GOG) protocol (i.e., any active GOG phase III protocol for the same patient population)
PATIENT CHARACTERISTICS:
Age
- 18 and over
Performance status
- GOG 0-2
Life expectancy
- Not specified
Hematopoietic
- Platelet count ≥ 100,000/mm^3
- Absolute neutrophil count ≥ 1,500/mm^3
Hepatic
- Bilirubin ≤ 1.5 times upper limit of normal (ULN)
- SGOT ≤ 2.5 times ULN
- Alkaline phosphatase ≤ 2.5 times ULN
Renal
- Creatinine ≤ 1.5 times ULN
Other
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception
- No active infection requiring antibiotics
- No other invasive malignancy within the past 5 years except nonmelanoma skin cancer
- No sensory or motor neuropathy > grade 1
PRIOR CONCURRENT THERAPY:
Biologic therapy
- Not specified
Chemotherapy
- No prior cytotoxic chemotherapy for uterine sarcoma
Endocrine therapy
- At least 1 week since prior hormonal therapy for uterine sarcoma
- Concurrent hormone replacement therapy allowed
Radiotherapy
- See Disease Characteristics
Surgery
- Not specified
Other
- Recovered from all prior therapy
- No prior anticancer therapy that would preclude study therapy
Trial locations and contacts
110 sites in 2 countries.
110 sites in 2 countries
United States99 sites
Rosenfeld Cancer Center at Abington Memorial Hospital
Abington, Pennsylvania, 19001
Morgan Cancer Center at Lehigh Valley Hospital - Cedar Crest
Allentown, Pennsylvania, 18105
Harrington Cancer Center
Amarillo, Texas, 79106
Saint Joseph Mercy Cancer Center
Ann Arbor, Michigan, 48106-0995
CCOP - Michigan Cancer Research Consortium
Ann Arbor, Michigan, 48106
Hope A Women's Cancer Center
Asheville, North Carolina, 28801
MBCCOP - Medical College of Georgia Cancer Center
Augusta, Georgia, 30912
Rush-Copley Cancer Care Center
Aurora, Illinois, 60504
Woman's Hospital
Baton Rouge, Louisiana, 70815
Battle Creek Health System Cancer Care Center
Battle Creek, Michigan, 49017
Mecosta County Medical Center
Big Rapids, Michigan, 49307
Lurleen Wallace Comprehensive Cancer at University of Alabama - Birmingham
Birmingham, Alabama, 35294
SUNY Downstate Medical Center
Brooklyn, New York, 11203
Fletcher Allen Health Care - University Health Center Campus
Burlington, Vermont, 05401
Lineberger Comprehensive Cancer Center at University of North Carolina - Chapel Hill
Chapel Hill, North Carolina, 27599-7295
Blumenthal Cancer Center at Carolinas Medical Center
Charlotte, North Carolina, 28232-2861
Presbyterian Cancer Center at Presbyterian Hospital
Charlotte, North Carolina, 28233-3549
University of Illinois Cancer Center
Chicago, Illinois, 60612-7243
University of Chicago Cancer Research Center
Chicago, Illinois, 60637-1470
Charles M. Barrett Cancer Center at University Hospital
Cincinnati, Ohio, 45267
Case Comprehensive Cancer Center
Cleveland, Ohio, 44106-5065
MetroHealth Cancer Care Center at MetroHealth Medical Center
Cleveland, Ohio, 44109
Cleveland Clinic Cancer Center at Fairview Hospital
Cleveland, Ohio, 44111
Cleveland Clinic Taussig Cancer Center
Cleveland, Ohio, 44195
Arthur G. James Cancer Hospital and Solove Research Institute at Ohio State University Medical Center
Columbus, Ohio, 43210-1240
Riverside Methodist Hospital Cancer Care
Columbus, Ohio, 43214-3998
Mount Carmel Health - West Hospital
Columbus, Ohio, 43222
Parkland Memorial Hospital
Dallas, Texas, 75235
Simmons Comprehensive Cancer Center at University of Texas Southwestern Medical Center - Dallas
Dallas, Texas, 75390
David L. Rike Cancer Center at Miami Valley Hospital
Dayton, Ohio, 45409
Oakwood Cancer Center at Oakwood Hospital and Medical Center
Dearborn, Michigan, 48123-2500
Barbara Ann Karmanos Cancer Institute
Detroit, Michigan, 48201-1379
Duke Comprehensive Cancer Center
Durham, North Carolina, 27710
Union Hospital Cancer Program at Union Hospital
Elkton, Maryland, 21921
Genesys Hurley Cancer Institute
Flint, Michigan, 48503
Hurley Medical Center
Flint, Michigan, 48503
University of Texas Medical Branch
Galveston, Texas, 77555-0361
Butterworth Hospital at Spectrum Health
Grand Rapids, Michigan, 49503
CCOP - Grand Rapids
Grand Rapids, Michigan, 49503
Lacks Cancer Center at Saint Mary's Health Care
Grand Rapids, Michigan, 49503
Metro Health Hospital
Grand Rapids, Michigan, 49506
Van Elslander Cancer Center at St. John Hospital and Medical Center
Grosse Pointe Woods, Michigan, 48236
Hinsdale Hematology Oncology Associates
Hinsdale, Illinois, 60521
Holland Community Hospital
Holland, Michigan, 49423
St. Vincent Indianapolis Hospital
Indianapolis, Indiana, 46260
Holden Comprehensive Cancer Center at University of Iowa
Iowa City, Iowa, 52242-1002
Foote Memorial Hospital
Jackson, Michigan, 49201
University of Mississippi Cancer Clinic
Jackson, Mississippi, 39216
St. Vincent's Medical Center
Jacksonville, Florida, 32204
Joliet Oncology-Hematology Associates, Limited - West
Joliet, Illinois, 60435
Borgess Medical Center
Kalamazoo, Michigan, 49001
West Michigan Cancer Center
Kalamazoo, Michigan, 49007-3731
Bronson Methodist Hospital
Kalamazoo, Michigan, 49007
Hall and Martin, M.Ds., PC
Knoxville, Tennessee, 37920
Sparrow Regional Cancer Center
Lansing, Michigan, 48912-1811
Tunnell Cancer Center at Beebe Medical Center
Lewes, Delaware, 19958
Lucille P. Markey Cancer Center at University of Kentucky
Lexington, Kentucky, 40536-0093
St. Mary Mercy Hospital
Livonia, Michigan, 48154
Jonsson Comprehensive Cancer Center at UCLA
Los Angeles, California, 90095-1781
James Graham Brown Cancer Center at University of Louisville
Louisville, Kentucky, 40202
University of Wisconsin Paul P. Carbone Comprehensive Cancer Center
Madison, Wisconsin, 53792-6164
Hillcrest Cancer Center at Hillcrest Hospital
Mayfield Heights, Ohio, 44124
Lake/University Ireland Cancer Center
Mentor, Ohio, 44060
Saint Anthony Memorial Health Centers
Michigan City, Indiana, 46360
Froedtert Hospital and Medical College of Wisconsin
Milwaukee, Wisconsin, 53226
Medical College of Wisconsin Cancer Center
Milwaukee, Wisconsin, 53226
Hackley Hospital
Muskegon, Michigan, 49442
Jersey Shore Cancer Center at Jersey Shore University Medical Center
Neptune City, New Jersey, 07754-0397
George Bray Cancer Center at the Hospital of Central Connecticut - New Britain Campus
New Britain, Connecticut, 06050
Mount Sinai Medical Center
New York, New York, 10029
CCOP - Christiana Care Health Services
Newark, Delaware, 19713
Oklahoma University Cancer Institute
Oklahoma City, Oklahoma, 73104
Methodist Estabrook Cancer Center
Omaha, Nebraska, 68114
Fox Chase Cancer Center - Philadelphia
Philadelphia, Pennsylvania, 19111-2497
Fox Chase Cancer Center CCOP Research Base
Philadelphia, Pennsylvania, 19140
St. Joseph Mercy Oakland
Pontiac, Michigan, 48341-2985
Mercy Regional Cancer Center at Mercy Hospital
Port Huron, Michigan, 48060
Women and Infants Hospital of Rhode Island
Providence, Rhode Island, 02905
Black Hills Obstetrics & Gynecology LLP
Rapid City, South Dakota, 57701
Virginia Commonwealth University Massey Cancer Center
Richmond, Virginia, 23298-0037
Carilion Gynecologic Oncology Associates
Roanoke, Virginia, 24014
Seton Cancer Institute at Saint Mary's - Saginaw
Saginaw, Michigan, 48601
Curtis and Elizabeth Anderson Cancer Institute at Memorial Health University Medical Center
Savannah, Georgia, 31403-3089
Fred Hutchinson Cancer Research Center
Seattle, Washington, 98104
University Cancer Center at University of Washington Medical Center
Seattle, Washington, 98195-6043
Avera Cancer Institute
Sioux Falls, South Dakota, 57105
CCOP - Cancer Research for the Ozarks
Springfield, Missouri, 65802
St. John's Regional Health Center
Springfield, Missouri, 65804
Hulston Cancer Center at Cox Medical Center South
Springfield, Missouri, 65807
Siteman Cancer Center at Barnes-Jewish St. Peters Hospital - Saint Louis
St Louis, Missouri, 63110
Saint Mary's Health Center
St Louis, Missouri, 63117
Munson Medical Center
Traverse City, Michigan, 49684
Cancer Care Associates - Midtown Tulsa
Tulsa, Oklahoma, 74104
Carle Cancer Center at Carle Foundation Hospital
Urbana, Illinois, 61801
CCOP - Carle Cancer Center
Urbana, Illinois, 61801
Cancer Institute of New Jersey at Cooper - Voorhees
Voorhees Township, New Jersey, 08043
St. John Macomb Hospital
Warren, Michigan, 48093
Piedmont Hematology-Oncology Associates
Winston-Salem, North Carolina, 27103
Wake Forest University Comprehensive Cancer Center
Winston-Salem, North Carolina, 27157-1096
Japan11 sites
Kagoshima City Hospital
Kagoshima City, Kagoshima, 892-8580
Kobe Medical Center
Kobe, 654-0155
National Hospital Organization - Medical Center of Kure
Kure, 737
Shikoku Cancer Center
Matsuyama, 791-0288
National Kyushu Cancer Center
Minamiku, 811 1395
Iwate Medical University Hospital
Morioka, Iwate, 020-8505
Kinki University School of Medicine
Osaka, Osaka, 589 8511
Hokkaido University Hospital
Sapporo, 060-8648
Tohoku University Graduate School of Medicine
Sendai
Keio University School of Medicine
Shinjuku-ku, 160-8582
Tottori University Hospital
Tottori, 680-8550
About this study
Official title: A Phase II Evaluation of Paclitaxel (Taxol, NSC # 673089) and Carboplatin (Paraplatin, NSC #241240) in the Treatment of Advanced, Persistent, or Recurrent Uterine Carcinosarcoma
RATIONALE: Drugs used in chemotherapy, such as paclitaxel and carboplatin, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving more than one drug (combination chemotherapy) may kill more tumor cells.
PURPOSE: This phase II trial is studying how well giving paclitaxel together with carboplatin works in treating patients with persistent or recurrent stage III or stage IV uterine cancer.
Read the detailed description
OBJECTIVES:
- Determine the antitumor activity of paclitaxel and carboplatin in patients with persistent or recurrent stage III or IV uterine carcinosarcoma.
- Determine the nature and degree of toxicity of this regimen in these patients.
OUTLINE: This is a non-randomized, multicenter study.
Patients receive paclitaxel IV over 3 hours followed by carboplatin IV over 30 minutes on day 1. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.
After completion of study treatment, patients are followed every 3 months for 2 years and then every 6 months for 3 years.
PROJECTED ACCRUAL: Approximately 14-47 patients will be accrued for this study within 20 months.
- Conditions
- Sarcoma
- Being tested
- carboplatin, paclitaxel
- Keywords
- recurrent uterine sarcoma, stage III uterine sarcoma, stage IV uterine sarcoma, uterine carcinosarcoma
- Medical subject headings
- Sarcoma
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
carboplatinDrug
paclitaxelDrug
| Study group | Role | What they receive |
|---|---|---|
| Taxol-Carbo | Experimental | Paclitaxel 175 mg/m2 IV over 3 hours followed by carboplatin AUC = 6 IV over 30 minutes every 21 days until disease progression or adverse effects prohibit further therapy Receives: Drug: carboplatin; Drug: paclitaxel |
What is being measured
The primary outcome is the main question the study is designed to answer.
Nature and Degree of Toxicity
Number of patients who experienced grade 1 or higher serious adverse event (term or group) regardless of attribution using CTCAE v3.0
Measured: During study treatment and up to 30 days after stopping study treatment
Response Evaluation Criteria in Solid Tumors Criteria (RECIST) 1.0 Best Response
Primary outcome measured according to RECIST v1.0 Best Response:
Complete Response (CR) is disappearance of all target and non-target lesions and no evidence of new lesions documented by two disease assessments at least 4 weeks apart Disease Progression is at least a 20% increase in the sum of LD of target lesions taking as references the smallest sum LD or the appearance of new lesions within 8 weeks of study entry.
Partial Response (PR) is at least a 30% decrease in the sum of longest dimensions (LD) of all target measurable lesions taking as reference the baseline sum of LD. There can be no unequivocal progression of nontarget lesions and no new lesions. Documentation by two disease assessments at least 4 weeks apart is required Stable Disease is any condition not meeting the above criteria. Indeterminate is defined as having no repeat tumor assessments following initiation of study therapy for reasons unrelated to symptoms or signs of disease.
Measured: Response was measured every other cycle (q 6 weeks) until disease progression is documented.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted3 Jun 2005 (estimated)
- Study startMay 2005
- Primary completionJul 2010
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for SarcomaStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 2
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 55 participants (actual)
Sponsor and investigators
- Lead sponsor
- Gynecologic Oncology Group
- Sponsor type
- Research network
- Collaborators
- National Cancer Institute (NCI)
- Responsible party
- Sponsor
- Investigators
- Matthew A. Powell, MD, Study chair, Washington University Siteman Cancer Center
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00112489
- Sponsor's protocol ID
- CDR0000432956
- Other IDs
- GOG-0232B
- Status last verified
- Apr 2014
- First submitted
- 2 Jun 2005
- Last updated
- 25 Sep 2018
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
Publications
Powell MA, Filiaci VL, Rose PG, Mannel RS, Hanjani P, Degeest K, Miller BE, Susumu N, Ueland FR. Phase II evaluation of paclitaxel and carboplatin in the treatment of carcinosarcoma of the uterus: a Gynecologic Oncology Group study. J Clin Oncol. 2010 Jun 1;28(16):2727-31. doi: 10.1200/JCO.2009.26.8326. Epub 2010 Apr 26.
PubMed 20421537
Study at a glance
From the registry record, last updated by the sponsor on 25 Sep 2018. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase II Evaluation of Paclitaxel (Taxol, NSC # 673089) and Carboplatin (Paraplatin, NSC #241240) in the Treatment of Advanced, Persistent, or Recurrent Uterine Carcinosarcoma
- ClinicalTrials.gov ID
- NCT00112489
- Acronym / sponsor ID
- CDR0000432956
- Conditions
- Sarcoma
- Keywords
- recurrent uterine sarcoma, stage III uterine sarcoma, stage IV uterine sarcoma, uterine carcinosarcoma
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 55 participants (actual)
- Lead sponsor
- Gynecologic Oncology GroupResearch network
- Collaborators
- National Cancer Institute (NCI)
- Study start
- May 2005
- Primary completion
- Jul 2010 (actual)
- First posted
- 3 Jun 2005 (estimated)
- Results
- Posted 12 May 2014
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
RATIONALE: Drugs used in chemotherapy, such as paclitaxel and carboplatin, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving more than one drug (combination chemotherapy) may kill more tumor cells.
PURPOSE: This phase II trial is studying how well giving paclitaxel together with carboplatin works in treating patients with persistent or recurrent stage III or stage IV uterine cancer.
Detailed description
OBJECTIVES:
- Determine the antitumor activity of paclitaxel and carboplatin in patients with persistent or recurrent stage III or IV uterine carcinosarcoma.
- Determine the nature and degree of toxicity of this regimen in these patients.
OUTLINE: This is a non-randomized, multicenter study.
Patients receive paclitaxel IV over 3 hours followed by carboplatin IV over 30 minutes on day 1. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.
After completion of study treatment, patients are followed every 3 months for 2 years and then every 6 months for 3 years.
PROJECTED ACCRUAL: Approximately 14-47 patients will be accrued for this study within 20 months.
Study design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Taxol-Carbo | Experimental | Drug: carboplatin, Drug: paclitaxelPaclitaxel 175 mg/m2 IV over 3 hours followed by carboplatin AUC = 6 IV over 30 minutes every 21 days until disease progression or adverse effects prohibit further therapy |
Who may qualify
- Ages
- 18 to 120 years
- Sex
- Female only
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| carboplatin | Drug | Taxol-Carbo |
| paclitaxel | Drug | Taxol-Carbo |
Primary outcome
Nature and Degree of Toxicity
Time frame: During study treatment and up to 30 days after stopping study treatment
Number of patients who experienced grade 1 or higher serious adverse event (term or group) regardless of attribution using CTCAE v3.0
Response Evaluation Criteria in Solid Tumors Criteria (RECIST) 1.0 Best Response
Time frame: Response was measured every other cycle (q 6 weeks) until disease progression is documented.
Primary outcome measured according to RECIST v1.0 Best Response: Complete Response (CR) is disappearance of all target and non-target lesions and no evidence of new lesions documented by two disease assessments at least 4 weeks apart Disease Progression is at least a 20% increase in the sum of LD of target lesions taking as references the smallest sum LD or the appearance of new lesions within 8 weeks of study entry. Partial Response (PR) is at least a 30% decrease in the sum of longest dimensions (LD) of all target measurable lesions taking as reference the baseline sum of LD. There can be no unequivocal progression of nontarget lesions and no new lesions. Documentation by two disease assessments at least 4 weeks apart is required Stable Disease is any condition not meeting the above criteria. Indeterminate is defined as having no repeat tumor assessments following initiation of study therapy for reasons unrelated to symptoms or signs of disease.
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 25 Sep 2018.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Results publication: PubMed 20421537Powell MA, Filiaci VL, Rose PG, Mannel RS, Hanjani P, Degeest K, Miller BE, Susumu N, Ueland FR. Phase II evaluation of paclitaxel and carboplatin in the treatment of carcinosarcoma of the uterus: a Gynecologic Oncology Group study. J Clin Oncol. 2010 Jun 1;28(16):2727-31. doi: 10.1200/JCO.2009.26.8326. Epub 2010 Apr 26.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Matthew A. Powell, MD study chair
Washington University Siteman Cancer Center
110 sites in 2 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing carboplatin and paclitaxel in people with Sarcoma, run by Gynecologic Oncology Group at 110 sites in 2 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 25 Sep 2018. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 110 sites in United States, Japan. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 12 May 2014). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Nature and Degree of Toxicity (time frame: During study treatment and up to 30 days after stopping study treatment). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT00112489, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 25 Sep 2018.