Colorectal CancerNCT00898846
Identifying Prognostic Factors in Patients Receiving Tegafur-Uracil for Stage II Colon Cancer That Was Completely Removed By Surgery
An observational study of Colorectal Cancer, run by Translational Research Center for Medical Innovation, Kobe, Hyogo, Japan at 152 sites in Japan.
Trial summary
RATIONALE: Studying samples of tumor tissue in the laboratory from patients with cancer may help doctors learn more about changes that occur in DNA and identify biomarkers related to cancer. It may also help doctors predict which patients will respond to treatment. Read more about this study
- Who is it for?
- Ages 20 to 80 years
- Conditions the study is for
- Colorectal Cancer
- What is being tested?
- UFT adjuvant chemotherapy
- How many people
- 1,111 participants
- Where
- 152 sitesJapan
- Study dates
- Oct 2006to Sep 2016
- Phase
- Observational
- Are there results?
- None posted in the registry
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 20 to 80 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Study population: Patients with curatively resected stage II colon cancer in Japan.
DISEASE CHARACTERISTICS:
- Histologically confirmed adenocarcinoma of the colon or rectosigmoid
- Stage II disease
- Must be registered on clinical trial TMDU-BRI-CC-05-01
- Must have resected tumor tissue available
- No hereditary colorectal cancer
PATIENT CHARACTERISTICS:
- ECOG performance status 0-1
PRIOR CONCURRENT THERAPY:
- Not specified
Trial locations and contacts
152 sites in 1 country.
152 sites in 1 country
Japan152 sites
Hyogo Cancer Center
Akashi, Hyōgo, 673-8558
Ako City Hospital
Akou, Hyōgo, 678-0232
Hyogo Prefectural Amagasaki Hospital
Amagasaki, Hyōgo, 660-0828
Kansai Rosai Hospital
Amagasaki, Hyōgo, 660-8511
Anan Kyoei Hospital
Anan, Tokushima, 770-8503
Asahikawa Medical College
Asahikawa, Hokkaido, 078-8510
Otaru Ekisaikai Hospital
Asahikawa, Hokkaido, 078-8510
Kanagawa Prefectural Ashigawa-kami Hospital
Ashigarakami-gun, Kanagawa, 258-0003
Chiba Cancer Center
Chiba, Chiba, 260-8717
Chigasaki Municipal Hospital
Chigasaki, 253-0083, Kanagawa, 253-0083
University of Yamanashi Faculty of Medicine
Chu-o-shi, Yamanashi, 409-3898
St. Luke's International Hospital
Chuo-ku, Tokyo, 104-8560
Tokyo Metropolitan Fuchu Hospital
Fuchū, Tokyo, 183-8524
Fujieda Municipal General Hospital
Fujieda, Shizuoka, 426-8677
Fukaya Red Cross Hospital
Fukaya, Saitama, 366-0052
Fukuiken Saiseikai Hospital
Fukui-shi, Fukui, 918-8503
National Hospital Organization Kyushu Medical Center
Fukuoka, Fukuoka, 810-0065
Kyushu University Hospital
Fukuoka, Fukuoka, 812-8582
Fukushima Medical University Hospital
Fukushima, Fukushima, 960-1295
National Hospital Organization Fukuyama Medical Center
Fukuyama, Hiroshima, 720-0825
Chugoku Central Hospital of the Mutual Aid Association of Public School Teachers
Fukuyama, Hiroshima, 721-8581
Gifu Municipal Hospital
Gifu, Gifu, 500-8323
Matsunami General Hospital
Gifu, Gifu, 501-6062
Hakodate Goryoukaku Hospital
Hakodate, Hokkaido, 040-8611
Hamamatsu University School of Medicine
Hamamatsu, Shizuoka, 431-3192
Hashima City Hospital
Hashima, Gifu, 501-6206
Hasuda Hospital
Hasuda, Saitama, 349-0123
Himeji St. Mary's Hospital
Himeji, Hyōgo, 670-0801
Himeji Central Hospital
Himeji, Hyōgo, 672-8501
Kagawa University Hospital
Hiragi, Kagawa-ken, 761-0793
Hoshigaoka Koseinenkin Hospital
Hirakata, Osaka, 573-8511
Hiroshima University Hospital
Hiroshima, Hiroshima, 734-8551
National Hospital Organization Mito Medical Center
Ibaraki, Ibaraki, 311-3193
Teikyo University Chiba Medical Center
Ichihara, Chiba, 299-0111
Iida Municipal Hospital
Iida, Nagano, 395-8502
Asahi General Hospital
Inba-gunn, Chiba, 270-1694
Rinku General Medical Center
Izumisano, Osaka, 598-8577
Shimane Prefectural Central Hospital
Izumo-shi, Shimane, 693-0068
Nanpuh Hospital
Kagoshima, Kagoshima-ken, 892-8512
Kakogawa Municipal Hospital
Kakogawa, Hyōgo, 675-8611
Kitasato University School of Medicine
Kanagawa, Kanagawa, 228-8555
Kyoto Second Red Cross Hospital
Kanigyou-ku, Kyoto, 602-8026
Saitama Medical School Hospital
Kawagoe-shi, Saitama, 350-8550
Kanto Rosai Hospital
Kawasaki, Kanagawa, 211-8510
Kitakyushu Municipal Medical Center
Kitakyushu, Fukuoka, 802-0077
Kobe University Hospital
Kobe, Hyōgo, 650-0017
Kobe City General Hospital
Kobe, Hyōgo, 650-0046
Nishi-Kobe Medical Center
Kobe, Hyōgo, 651-2273
Kobe West City Hospital
Kobe, Hyōgo, 653-0013
Kobe Medical Center
Kobe, Hyōgo, 654-0155
Sano Hospital
Kobe, Hyōgo, 655-0031
Shouwa General Hospital
Kodaira, Tokyo, 187-0004
Daisan Hospital
Komae, Tokyo, 201
Showa-Inan General Hospital
Komagane, Nagano, 399-4191
Kumamoto University Faculty of Medical and Pharmaceutical Sciences
Kumamoto, Kumamoto, 860-8556
Japanese Red Cross Kumamoto Hospital
Kumamoto, Kumamoto, 861-8520
Kurashiki Central Hospital
Kurashiki, Okayama-ken, 710-8602
National Hospital Organization Kure Medical Center
Kure, Hiroshima, 737-0023
Kurume University School of Medicine
Kurume, Fukuoka, 830-0011
Saint Mary's Hospital
Kurume, Fukuoka, 830-8543
Kyoto Prefectural University of Medicine
Kyoto, Kyoto, 602-0841
Nishijin Hospital
Kyoto, Kyoto, 602
Gunma University Graduate School of Medicine
Maebashi, Gunma, 371-8511
Aizawa Hospital
Matsumoto, Nagano, 390-8510
Minoh City Hospital
Mino, Osaka, 562-0014
Kyorin University School of Medicine - Mitaka Campus
Mitaka, Tokyo, 181-8611
Miyoshi Central Hospital
Miyoshi, Hiroshima, 728-8502
Nagahama City Hospital
Nagahama, Shiga, 526-8580
Nagano Red Cross Hospital
Nagano, Nagano, 380-0
Nagano Municipal Hospital
Nagano, Nagano, 381-8551
Nagasaki University Hospital
Nagasaki, Nagasaki, 852-8501
Nagoya Ekisaikai Hospital
Nagoya, Aichi-ken, 454-8502
Ban Buntane Houtokukai Hospital
Nagoya, Aichi-ken, 454-8509
Nagoya University Hospital
Nagoya, Aichi-ken, 466-8550
Nagoya University School of Medicine
Nagoya, Aichi-ken, 466
Nagoya Midori Municipal Hospital
Nagoya, Aichi-ken
Hokushin Hospital
Nakano, Nagano, 383-0021
Kochi Medical School
Nankoku, Kochi, 783-8505
Saiseikai Nara Hospital
Nara, Nara, 6308145
Miyagi Cancer Center
Natori-shi, Miyagi, 981-1293
Saiseikai Niigata Daini Hospital
Niigata, Niigata, 950-1104
Niigata University Medical and Dental Hospital
Niigata, Niigata, 951-8122
Niigata Cancer Center Hospital
Niigata, Niigata, 951-8566
Hyogo College of Medicine
Nishinomiya, Hyōgo, 663-8501
Yamamoto Kumiai General Hospital
Noshiro, Akita, 016-0014
Ogaki Municipal Hospital
Ogaki-shi, Gifu, 503-8502
Okayama University Medical School
Okayama, Okayama-ken, 700-8558
Aichi Prefectural Hospital
Okazaki, Aichi-ken
Kitano Hospital
Osaka, Osaka, 530-8480
Osaka City Juso Hospital
Osaka, Osaka, 532-0
Osaka City General Hospital
Osaka, Osaka, 534-0021
Otemae Hospital
Osaka, Osaka, 540-0008
Osaka Police Hospital
Osaka, Osaka, 543-8502
Higashi Sumiyoshi Morimoto Hospital
Osaka, Osaka, 546-0012
Nissay Hospital
Osaka, Osaka, 550-0012
Osaka Kosei Nenkin Hospital
Osaka, Osaka, 553-0003
Osaka General Medical Center
Osaka, Osaka, 558-8558
Osaka Saiseikai Noe Hospital
Osaka, Osaka, Joto-ku
Minamiosaka Hospital
Osaka, Osaka
Osaka Red Cross Hospital
Osaka, 543-8555
Hirosaki University, School of Medicine
Otaru-shi, Hokkaido, 047-0031
Gunma Cancer Center
Otashi, Gunma, 373-8550
Otsu Municipal Hospital
Ōtsu, Shiga, 520-0804
Saitama Social Insurance Hospital
Saitama, Saitama, 330-0074
Osaka Rosai Hospital
Sakai-shi, Osaka, 591-8025
Sapporo Medical University
Sapporo, Hokkaido, 060-8556
Sapporo City General Hospital
Sapporo, Hokkaido, 060-8604
Hokkaido University Graduate School of Medicine
Sapporo, Hokkaido, 060-8638
Tohoku Rosai Hospital
Sendai, Miyagi, 981-0911
National Hospital Organization - Kanmon Medical Center
Shimonoseki, Yamaguchi, 240-8555
Shimonoseki Kosei Hospital
Shimonoseki, Yamaguchi, 750-0061
Jichi Medical School
Shimotsuke-shi, Tochigi, 329-0498
Social Insurance Chuo General Hospital
Shinjuku-ku, Tokyo, 169-0073
Tokyo Women's Medical University
Shinjyuku-ku, Tokyo, 162-8666
Shizuoka City Hospital
Shizuoka, Shizuoka, 420 -8630
Shizuoka Municipal Shimizu Hospital
Shizuoka, Shizuoka, 424-0911
Suita Municipal Hospital
Suita-shi, Osaka, 564-0082
Hyogo Prefectural Awaji Hospital
Sumoto, Hyōgo, 656-0013
Social Insurance Tagawa Hospital
Tagawa, Fukuoka, 826-8585
Kagawa Prefectural Central Hospital
Takamatsu, Kagawa-ken, 760-8557
Koseiren Takaoka Hospital
Takaoka-shi, Toyama, 933-8555
Takarazuka Municipal Hospital
Takarazuka, Hyōgo, 665-0827
Higashi Takarazuka Satoh Hospital
Takarazukai, Hyōgo, 665-0873
Osaka Medical College
Takatsuki, Osaka, 569-8686
Social Insurance Kinan Hospital
Tanabe, Wakayama, 646-8588
Mie University Graduate School of Medicine
Thu-shi, Mie-ken, 514-8507
National Defense Medical College
Tokorozawa, Saitama, 359-8513
Mita Hospital at the International University of Health and Welfare
Tokyo, Tokyo, 108-8329
Tokyo Medical and Dental University
Tokyo, Tokyo, 113-8510
Nippon Medical School
Tokyo, Tokyo, 113-8603
Toho University School of Medicine
Tokyo, Tokyo, 143-8541
Japanese Red Cross Medical Center
Tokyo, Tokyo, 150-8935
International Medical Center of Japan
Tokyo, Tokyo, 162-8655
Teikyo University School of Medicine
Tokyo, Tokyo, 173-8605
Itabashi Chuo Medical Center
Tokyo, Tokyo, 174-8691
Takasago Kyoritsu Hospital
Tokyo, Tokyo
Saiseikai Tondabayashi Hospital
Tondabayashi, Osaka, 584-0082
Yamaguchi University Graduate School of Medicine
Ube, Yamaguchi, 755-8505
National Hospital Organization - Kumamotominami Hospital
Uki, Kumamoto, 869-0
Tochigi Cancer Center
Utsunomiya, Tochigi, 320-0834
Yaizu Municipal Hospital
Yaizu, Shizuoka, 425-8505
Yamagata Prefectural Central Hospital
Yamagata, Yamagata, 990-2292
Yamagata University Hospital
Yamagata, Yamagata, 990-9585
Kenseikai Nara Coloproctology Center
Yamatotakada, Nara, 635-0022
Yatsushiro Health Insurance General Hospital
Yatsushiro, Kumamoto, 866-8660
Yokohama City Hospital
Yokohama, Kanagawa, 240
Kanagawa Cancer Center
Yokohama, Kanagawa, 241-0815
International Goodwill Hospital
Yokohama, Kanagawa, 245-0006
Hiraka General Hospital
Yokote, Akita, 013-8610
Tottori University - Faculty of Medicine
Yonago, Tottori, 683-8503
University of Fukui Hospital
Yoshida-gun, Fukui, 910-1193
Oita University Hospital
Yufu-shi, Oita Prefecture, 879-5593
About this study
Official title: Identification of the Prognostic Factors of Stage II Colon Cancer Patients Receiving Adjuvant Chemotherapy With UFT
RATIONALE: Studying samples of tumor tissue in the laboratory from patients with cancer may help doctors learn more about changes that occur in DNA and identify biomarkers related to cancer. It may also help doctors predict which patients will respond to treatment.
PURPOSE: This laboratory study is looking at prognostic factors in patients receiving tegafur-uracil for stage II colon cancer that was completely removed by surgery.
Read the detailed description
OBJECTIVES:
- Identify the prognostic factors in patients with curatively resected stage II colon cancer receiving adjuvant chemotherapy with tegafur-uracil.
- Identify predictive factors of chemosensitivity to this regimen in these patients.
OUTLINE: Available tumor tissue samples are analyzed by real-time reverse transcriptase-PCR for TS, DPD, TP, OPRT, VEGF, cyclooxygenase-2, and FPGS; by PCR for microsatellite instability and genomic deletions on chromosome arm 18q; and pathologically for tumor budding, Crohn's-like lymphoid reaction, category of extent of poor differentiation, and fibrotic cancer stroma. The candidate prognostic and predictive markers are analyzed for correlation with disease-free survival, relapse-free survival, and overall survival of patients.
- Conditions
- Colorectal Cancer
- Being tested
- UFT adjuvant chemotherapy
- Keywords
- stage II colon cancer, stage II rectal cancer, adenocarcinoma of the colon, adenocarcinoma of the rectum
- Medical subject headings
- Colorectal Neoplasms, Colonic Neoplasms, Rectal Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
UFT adjuvant chemotherapyDrug
Also called Adjuvant chemotherapy with tegafur-uracil
UFT is given at a dose of 500-600 mg/day as tegafur in 2 divided doses after meals for 5 days, followed by a 2-day rest. This one-week cycle is repeated for one year.
| Study group | Role | What they receive |
|---|---|---|
| UFT adjuvant therapy group | UFT is given at a dose of 500-600 mg/day as tegafur in 2 divided doses after meals for 5 days, followed by a 2-day rest. This one-week cycle is repeated for one year. During protocol treatment, clinical findings and laboratory values are evaluated every month. After the completion of protocol treatment, patients are followed-up, according to the schedule defined in the study protocol, for 5 years until recurrence, other malignancy or death is confirmed. Receives: Drug: UFT adjuvant chemotherapy | |
| Observation group | Patients are followed-up without adjuvant treatment, according to the schedule defined in the study protocol, for 5 years until recurrence, other malignancy or death is confirmed. |
What is being measured
The primary outcome is the main question the study is designed to answer.
mRNA levels
mRNA levels of patients are analyzed by the Danenberg tumor profile (DTP) method in the following indicators: thymidylate synthase (TS), dihydropyrimidine dehydrogenase (DPD), thymidine phosphorylase (TP), orotate phosphoribosyltransferase (OPRT), folylpolyglutamate synthetase (FPGS) vascular endothelial growth factor (VEGF), and cyclooxygenase-2 (Cox-2) mRNA levels.
Measured: 9years
Secondary outcomes (2)
Analysis of microsatellite instability (MSI) and chromosomal instability (CIN)
MSI and CIN (i.e., 18q LOH) are analyzed using paraffin embedded samples.
Measured: At enrollment
Histopathological examination
Tumor budding, category of extent of poor differentiation, Crohn's-like lymphoid reaction, and fibrotic cancer stroma are analyzed using hematoxylin and eosin (H\&E) staining of paraffin embedded samples.
Measured: At enrollment
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted12 May 2009 (estimated)
- Study startOct 2006
- Primary completionOct 2015
- Study completionSep 2016
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Colorectal CancerStudies 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
- Observational
- Observational model
- Cohort
- Time perspective
- Prospective
- Enrolment
- 1,111 participants (actual)
Sponsor and investigators
- Lead sponsor
- Translational Research Center for Medical Innovation, Kobe, Hyogo, Japan
- Sponsor type
- University, hospital or other
- Collaborators
- Tokyo Medical and Dental University
- Responsible party
- Sponsor
- Investigators
- Kenichi Sugihara, MD, PhD, Study chair, Tokyo Medical and Dental University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00898846
- Sponsor's protocol ID
- CDR0000551714
- Other IDs
- TMDU-BRI-CC-05-02
- Status last verified
- Sep 2016
- First submitted
- 9 May 2009
- Last updated
- 28 Sep 2016
- Results posted
- No
- Data monitoring committee
- Yes
Study at a glance
From the registry record, last updated by the sponsor on 28 Sep 2016. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Identification of the Prognostic Factors of Stage II Colon Cancer Patients Receiving Adjuvant Chemotherapy With UFT
- ClinicalTrials.gov ID
- NCT00898846
- Acronym / sponsor ID
- CDR0000551714
- Conditions
- Colorectal Cancer
- Keywords
- stage II colon cancer, stage II rectal cancer, adenocarcinoma of the colon, adenocarcinoma of the rectum
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 1,111 participants (actual)
- Lead sponsor
- Translational Research Center for Medical Innovation, Kobe, Hyogo, JapanUniversity, hospital or other
- Collaborators
- Tokyo Medical and Dental University
- Study start
- Oct 2006
- Primary completion
- Oct 2015 (actual)
- Study completion
- Sep 2016 (actual)
- First posted
- 12 May 2009 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
RATIONALE: Studying samples of tumor tissue in the laboratory from patients with cancer may help doctors learn more about changes that occur in DNA and identify biomarkers related to cancer. It may also help doctors predict which patients will respond to treatment.
PURPOSE: This laboratory study is looking at prognostic factors in patients receiving tegafur-uracil for stage II colon cancer that was completely removed by surgery.
Detailed description
OBJECTIVES:
- Identify the prognostic factors in patients with curatively resected stage II colon cancer receiving adjuvant chemotherapy with tegafur-uracil.
- Identify predictive factors of chemosensitivity to this regimen in these patients.
OUTLINE: Available tumor tissue samples are analyzed by real-time reverse transcriptase-PCR for TS, DPD, TP, OPRT, VEGF, cyclooxygenase-2, and FPGS; by PCR for microsatellite instability and genomic deletions on chromosome arm 18q; and pathologically for tumor budding, Crohn's-like lymphoid reaction, category of extent of poor differentiation, and fibrotic cancer stroma. The candidate prognostic and predictive markers are analyzed for correlation with disease-free survival, relapse-free survival, and overall survival of patients.
Study design
- Observational model
- Cohort
- Time perspective
- Prospective
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| UFT adjuvant therapy group | – | Drug: UFT adjuvant chemotherapyUFT is given at a dose of 500-600 mg/day as tegafur in 2 divided doses after meals for 5 days, followed by a 2-day rest. This one-week cycle is repeated for one year. During protocol treatment, clinical findings and laboratory values are evaluated every month. After the completion of protocol treatment, patients are followed-up, according to the schedule defined in the study protocol, for 5 years until recurrence, other malignancy or death is confirmed. |
| Observation group | – | –Patients are followed-up without adjuvant treatment, according to the schedule defined in the study protocol, for 5 years until recurrence, other malignancy or death is confirmed. |
Who may qualify
- Ages
- 20 to 80 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- Patients with curatively resected stage II colon cancer in Japan.
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 |
|---|---|---|
| UFT adjuvant chemotherapyAlso: Adjuvant chemotherapy with tegafur-uracilUFT is given at a dose of 500-600 mg/day as tegafur in 2 divided doses after meals for 5 days, followed by a 2-day rest. This one-week cycle is repeated for one year. | Drug | UFT adjuvant therapy group |
Primary outcome
mRNA levels
Time frame: 9years
mRNA levels of patients are analyzed by the Danenberg tumor profile (DTP) method in the following indicators: thymidylate synthase (TS), dihydropyrimidine dehydrogenase (DPD), thymidine phosphorylase (TP), orotate phosphoribosyltransferase (OPRT), folylpolyglutamate synthetase (FPGS) vascular endothelial growth factor (VEGF), and cyclooxygenase-2 (Cox-2) mRNA levels.
2 secondary outcomes
Analysis of microsatellite instability (MSI) and chromosomal instability (CIN)
Time frame: At enrollment
Histopathological examination
Time frame: At enrollment
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 28 Sep 2016.
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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.
Kenichi Sugihara, MD, PhD study chair
Tokyo Medical and Dental University
152 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Colorectal Cancer, run by Translational Research Center for Medical Innovation, Kobe, Hyogo, Japan at 152 sites in Japan.
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 28 Sep 2016. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 152 sites in 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.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
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?
mRNA levels (time frame: 9years). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 28 Sep 2016.