Melanoma (Skin)Phase 2/3DETECTIONNCT04901988
Circulating Tumour DNA guidEd Therapy for Stage IIB/C mElanoma After surgiCal resecTION
A Phase 2/3 study testing Nivolumab 10 MG/ML in people with Melanoma (Skin) and Melanoma, Stage II, run by The Christie NHS Foundation Trust at 1 site in United Kingdom.
Trial summary
The trial is looking for new and better ways to treat melanoma, an aggressive type of skin cancer. Having surgery to remove the melanoma will cure the majority of patients with early stage disease. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Melanoma (Skin), Melanoma, Stage II
- What is being tested?
- Nivolumab 10 MG/ML
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 8 participants
- Where
- 1 siteUnited Kingdom
- Study dates
- 8 Nov 2021to 30 Jan 2023
- Phase
- Phase 2/3
- 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 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Signed written informed consent.
- Patients must be willing and able to comply with scheduled visits, treatment schedule, laboratory tests and other requirements of the study.
- Histological confirmation of cutaneous melanoma
- ≥ 18 years.
- Stage IIB or IIC melanoma (sentinel lymph node (SNLB) staged) according to AJCC version 8 (4).
- Complete resection (including SNLB) must have been performed within 12 weeks prior to registration.
Show all 12Show fewer
- Disease-free status documented both clinically and radiologically within 4 weeks prior to registration.
- Mutation confirmed in at least one of the following BRAF (p.V600E/p.V600K/p.V600R) /NRAS (p.Q61R/p.Q61K, p.Q61L/p.G12D), which can be tracked in ctDNA with exact point mutation known.
- ECOG performance status 0/1.
- Adequate organ function and screening laboratory values must meet the following criteria: WBC ≥ 2.0x109/L, Absolute neutrophil count (ANC) ≥1.5x109/L, Platelets ≥100 x109/L, Haemoglobin ≥90 g/L, Creatinine ≤1.5x ULN or creatinine clearance >30mL/minute using Cockcroft-Gault, AST ≤ 1.5 x ULN, ALT ≤ 1.5 x ULN, Bilirubin ≤1.5 x ULN unless the patient has familial hyperbilirubinaemia.
- LDH ≤1.5x ULN as per local institution parameters.
- Patients who are pregnant or breastfeeding will be eligible to join the trial. However, if they are allocated to Arm B, women of childbearing potential (WOCBP) must agree to have a serum or urine pregnancy test (minimum sensitivity 25 IU/L or equivalent units of HCG) and must be withdrawn if pregnant or breastfeeding. WOCBP and males who are sexually active with WOCBP must also agree to follow instructions for method(s) of contraception for the duration of treatment plus 5 months for WOCBP or plus 7 months for males who are sexually active with WOCBP (if randomised to Arm B or while receiving any systemic treatment and to follow local guidance if given on Arm A). See Appendix A for further information.
Who cannot join
- If previously received prior immunotherapy, chemotherapy, cancer directed vaccine therapy or BRAF/MEK targeted therapy for cancer.
- Patients with active, known or suspected autoimmune disease. Patients with type 1 diabetes mellitus, rheumatoid arthritis not requiring disease modifying drugs, hypothyroidism only requiring hormone replacement, skin disorders (such as vitiligo, psoriasis or alopecia) not requiring systemic treatment, or conditions not expected to recur in the absence of an external trigger will be permitted to enrol.
- Current other malignancy or history of another malignancy within the last 3 years. Patients who have been disease-free for 3 years, (i.e. patients with second malignancies that have been definitively treated at least 3 years ago) or patients with a history of completely resected non-melanoma skin cancer are eligible.
- Any serious or unstable pre-existing medical conditions (aside from malignancy exceptions specified above), psychiatric disorders, or other conditions that could interfere with the patient's safety, obtaining informed consent, or compliance with study procedures.
- Patients with a condition requiring ongoing/long-term (>3 months) systemic treatment with either corticosteroids (>10 mg daily prednisone equivalent) or other immunosuppressive medications. Inhaled or topical steroids and adrenal replacement steroid doses ≤10 mg daily prednisolone equivalent are permitted in the absence of active autoimmune disease.
- Patients with interstitial lung disease that is symptomatic or may interfere with the detection or management of suspected drug-related pulmonary toxicity.
Show all 9Show fewer
- History of allergies or adverse drug reaction to any of the study drug components or to any monoclonal antibody.
- Known Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV), or Hepatitis C Virus (HCV) infection.
- Prisoners or patients who are involuntarily incarcerated.
Trial locations and contacts
1 site in 1 country.
United Kingdom1 site
The Christie NHS Foundation Trust
Manchester, Greater Manchester, M204BJ
About this study
Official title: Circulating Tumour DNA guidEd Therapy for Stage IIB/C mElanoma After surgiCal resecTION (DETECTION)
The trial is looking for new and better ways to treat melanoma, an aggressive type of skin cancer. Having surgery to remove the melanoma will cure the majority of patients with early stage disease. However, a small percentage of these patients will go on to develop further disease, which may spread to other places in their body.
Currently, patients who have been cured of melanoma will have appointments in clinic to check that further disease has not developed or returned and some may also receive regular scans.
Read more
The trial team has developed a blood test that tells us whether cancer cells are still present or is becoming active after a patient has been 'cured' of melanoma, even if a scan looks normal. The test looks for pieces of DNA in the blood that are known to have come from the cancer, which we call 'circulating tumour DNA', or ctDNA. Patients who have ctDNA in their blood have an extremely high chance of the cancer returning.
By using the blood test that we have developed we think that we can identify patients earlier than normal. We think that some of the treatments that are used when melanoma cancer has spread may benefit patients at this earlier stage.
We want to see if these patients with ctDNA in their blood, who have a higher risk of their cancer returning or spreading, and receive treatment early have a better response to their cancer compared to those patients who receive treatment when their cancer has returned and it can be seen on a scan. This could mean we would be able to offer patients earlier treatment in the future using just a blood test rather than a scan, while also providing reassurance to those patients that do not have ctDNA in their blood that they do not need treatment and their cancer is not returning.
- Conditions
- Melanoma (Skin), Melanoma, Stage II
- Being tested
- Nivolumab 10 MG/ML
- Medical subject headings
- Melanoma
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Nivolumab 10 MG/MLDrug
Eligible patients randomised to Arm B will receive 480 mg nivolumab monotherapy 4 weekly via IV infusion for up to 2 years.
| Study group | Role | What they receive |
|---|---|---|
| Arm A | No intervention | In Arm A, patients and clinicians will remain blinded to the ctDNA result and will be managed as per standard of care with regular clinical review and imaging, and treated if they develop evidence of disease recurrence. |
| Arm B | Experimental | Patients randomised to Arm B will not be blinded to the positive ctDNA result and will be treated with the intervention. Receives: Drug: Nivolumab 10 MG/ML |
What is being measured
The primary outcome is the main question the study is designed to answer.
Overall Survival (OS)
Measured: From randomisation until death by any cause, assessed up to 84 months.
Secondary outcomes (13)
Relapse Free Survival
Measured: From randomisation to radiological (recist v1.1)/clinical (confirmed histologically) progression, assessed up to 84 months.
Distant metastasis free survival(DMFS)
Measured: From randomisation to distant metastatic relapse or death, assessed up to 84 months.
Progression-free survival (PFS) on first line therapy (commenced in Arm A at relapse, and Arm B from randomisation).
Measured: From start of treatment (day of first dose) until disease progression defined as clinical (confirmed pathologically) or radiological (recist v1.1) progression or death, assessed up to 84 months.
Time from randomisation to disease progression on first line systemic therapy (Arm A first systemic therapy given at relapse, and Arm B nivolumab from randomisation).
Measured: Time from randomisation to disease progression on first line systemic therapy (Arm A first systemic therapy given at relapse, and Arm B nivolumab from randomisation), assessed up to 84 months.
Radiological response in Arm A (CR, PR, SD and PD) and PD vs. no PD in Arm B to first line systemic therapy.
Measured: Radiological response in Arm A (CR, PR, SD and PD) and PD vs. no PD in Arm B to first line systemic therapy, assessed up to 84 months.
Time from registration to ctDNA detection.
Measured: Time from registration to ctDNA detection, assessed at registration and then every 3 months (year 1 to 3) and every 6 months (year 4 and 5).
Number of patients with undetectable ctDNA (not detectable according to the DETECTION assay), but clinical/radiological progression and site of progression (local or distant in addition to organ site).
Measured: From registration to clinical/radiological progression with undetectable ctDNA, assessed up to 84 months.
RFS of patients with undetectable ctDNA (not randomised) vs. patients with detectable ctDNA in Arm A.
Measured: From registration to radiological (recist v1.1)/clinical (confirmed histologically) progression in not randomised and in Arm A participants, assessed up to 84 months.
DMFS of patients with undetectable ctDNA (not randomised) vs. patients with detectable ctDNA in Arm A.
Measured: From registration to distant metastatic relapse or death in not randomised and in Arm A participants, assessed up to 84 months.
OS defined as time from registration until death of patients with undetectable ctDNA (not randomised) vs. patients in Arm A.
Measured: From registration until death of patients with undetectable ctDNA (not randomised) vs. patients in Arm A, assessed up to 84 months.
To assess treatment-free survival.
Defined as the area between Kaplan-Meier curves between time to first line therapy cessation defined as time from initiation of first line therapy until its cessation and time to subsequent therapy initiation or death defined as time from initiation of first line therapy until initiation of subsequent systemic anticancer therapy or death in Arm A vs. Arm B.
Measured: Time to first line therapy cessation, assessed up to 84 months.
Toxicity measured according to Common Terminology Criteria for Adverse Events (CTCAE) v5.0.
Measured: From consent until the end of the trial or until disease progression and at least 100 days post the last treatment dose of nivolumab, assessed up to 84 months.
Health economics assessment as assessed by EQ-5D-5L and resource use questionnaires.
Measured: At registration and every 6 months for both monitoring and post randomisation, with an additional questionnaire at baseline prior to therapy on Arm B and at relapse and every 6 Mo until relapse on first line therapy on Arm A, assessed up to 84 months.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted26 May 2021
- Study start8 Nov 2021
- Primary completion30 Jan 2023
- Study completion30 Jan 2023
Why it stopped: Closed earlier than expected due to the need for a redesign to reflect the recent change in standard of care guidelines. New design will include these treatments.
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Melanoma (Skin)Studies 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 2/3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 8 participants (actual)
Sponsor and investigators
- Lead sponsor
- The Christie NHS Foundation Trust
- Sponsor type
- University, hospital or other
- Collaborators
- University of Manchester, Manchester Academic Health Science Centre, University of Liverpool
- Responsible party
- Sponsor
- Investigators
- Paul Lorigan, Professor, Principal investigator, The Christie NHS Foundation Trust
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04901988
- Sponsor's protocol ID
- CFTSp135
- Acronym
- DETECTION
- Status last verified
- Apr 2023
- First submitted
- 16 Apr 2021
- Last updated
- 27 Feb 2025
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- Yes: At the end of the trial, after the primary results have been published, the de-identified individual participant data (IPD) and associated documentation (e.g. protocol, statistical analysis plan, annotated blank CRF) will be prepared in order to be shared with external researchers. All requests for access to the IPD will be reviewed by an internal committee at the Clinical Trials Unit (CTU) and discussed with the Chief Investigator in accordance with the CTU policy on data sharing. All data sharing must be authorised by the Sponsor.
Study at a glance
From the registry record, last updated by the sponsor on 27 Feb 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Circulating Tumour DNA guidEd Therapy for Stage IIB/C mElanoma After surgiCal resecTION (DETECTION)
- ClinicalTrials.gov ID
- NCT04901988
- Acronym / sponsor ID
- DETECTION / CFTSp135
- Conditions
- Melanoma (Skin), Melanoma, Stage II
- Phase
- Phase 2/3
- Study type
- Interventional
- Recruitment status
- TerminatedReason stopped: Closed earlier than expected due to the need for a redesign to reflect the recent change in standard of care guidelines. New design will include these treatments.
- Enrolment
- 8 participants (actual)
- Lead sponsor
- The Christie NHS Foundation TrustUniversity, hospital or other
- Collaborators
- University of Manchester, Manchester Academic Health Science Centre, University of Liverpool
- Study start
- 8 Nov 2021 (actual)
- Primary completion
- 30 Jan 2023 (actual)
- Study completion
- 30 Jan 2023 (actual)
- First posted
- 26 May 2021 (actual)
- 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.
The trial is looking for new and better ways to treat melanoma, an aggressive type of skin cancer. Having surgery to remove the melanoma will cure the majority of patients with early stage disease. However, a small percentage of these patients will go on to develop further disease, which may spread to other places in their body.
Currently, patients who have been cured of melanoma will have appointments in clinic to check that further disease has not developed or returned and some may also receive regular scans.
The trial team has developed a blood test that tells us whether cancer cells are still present or is becoming active after a patient has been 'cured' of melanoma, even if a scan looks normal. The test looks for pieces of DNA in the blood that are known to have come from the cancer, which we call 'circulating tumour DNA', or ctDNA. Patients who have ctDNA in their blood have an extremely high chance of the cancer returning.
By using the blood test that we have developed we think that we can identify patients earlier than normal. We think that some of the treatments that are used when melanoma cancer has spread may benefit patients at this earlier stage.
We want to see if these patients with ctDNA in their blood, who have a higher risk of their cancer returning or spreading, and receive treatment early have a better response to their cancer compared to those patients who receive treatment when their cancer has returned and it can be seen on a scan. This could mean we would be able to offer patients earlier treatment in the future using just a blood test rather than a scan, while also providing reassurance to those patients that do not have ctDNA in their blood that they do not need treatment and their cancer is not returning.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Arm A | No intervention | –In Arm A, patients and clinicians will remain blinded to the ctDNA result and will be managed as per standard of care with regular clinical review and imaging, and treated if they develop evidence of disease recurrence. |
| Arm B | Experimental | Drug: Nivolumab 10 MG/MLPatients randomised to Arm B will not be blinded to the positive ctDNA result and will be treated with the intervention. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (12 listed)
- Signed written informed consent.
- Patients must be willing and able to comply with scheduled visits, treatment schedule, laboratory tests and other requirements of the study.
- Histological confirmation of cutaneous melanoma
- ≥ 18 years.
- Stage IIB or IIC melanoma (sentinel lymph node (SNLB) staged) according to AJCC version 8 (4).
Key exclusion criteria (9 listed)
- If previously received prior immunotherapy, chemotherapy, cancer directed vaccine therapy or BRAF/MEK targeted therapy for cancer.
- Patients with active, known or suspected autoimmune disease. Patients with type 1 diabetes mellitus, rheumatoid arthritis not requiring disease modifying drugs, hypothyroidism only requiring hormone replacement, skin disorders (such as vitiligo, psoriasis or alopecia) not requiring systemic treatment, or conditions not expected to recur in the absence of an external trigger will be permitted to enrol.
- Current other malignancy or history of another malignancy within the last 3 years. Patients who have been disease-free for 3 years, (i.e. patients with second malignancies that have been definitively treated at least 3 years ago) or patients with a history of completely resected non-melanoma skin cancer are eligible.
- Any serious or unstable pre-existing medical conditions (aside from malignancy exceptions specified above), psychiatric disorders, or other conditions that could interfere with the patient's safety, obtaining informed consent, or compliance with study procedures.
- Patients with a condition requiring ongoing/long-term (>3 months) systemic treatment with either corticosteroids (>10 mg daily prednisone equivalent) or other immunosuppressive medications. Inhaled or topical steroids and adrenal replacement steroid doses ≤10 mg daily prednisolone equivalent are permitted in the absence of active autoimmune disease.
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 |
|---|---|---|
| Nivolumab 10 MG/MLEligible patients randomised to Arm B will receive 480 mg nivolumab monotherapy 4 weekly via IV infusion for up to 2 years. | Drug | Arm B |
Primary outcome
Overall Survival (OS)
Time frame: From randomisation until death by any cause, assessed up to 84 months.
13 secondary outcomes
Relapse Free Survival
Time frame: From randomisation to radiological (recist v1.1)/clinical (confirmed histologically) progression, assessed up to 84 months.
Distant metastasis free survival(DMFS)
Time frame: From randomisation to distant metastatic relapse or death, assessed up to 84 months.
Progression-free survival (PFS) on first line therapy (commenced in Arm A at relapse, and Arm B from randomisation).
Time frame: From start of treatment (day of first dose) until disease progression defined as clinical (confirmed pathologically) or radiological (recist v1.1) progression or death, assessed up to 84 months.
Time from randomisation to disease progression on first line systemic therapy (Arm A first systemic therapy given at relapse, and Arm B nivolumab from randomisation).
Time frame: Time from randomisation to disease progression on first line systemic therapy (Arm A first systemic therapy given at relapse, and Arm B nivolumab from randomisation), assessed up to 84 months.
Radiological response in Arm A (CR, PR, SD and PD) and PD vs. no PD in Arm B to first line systemic therapy.
Time frame: Radiological response in Arm A (CR, PR, SD and PD) and PD vs. no PD in Arm B to first line systemic therapy, assessed up to 84 months.
Time from registration to ctDNA detection.
Time frame: Time from registration to ctDNA detection, assessed at registration and then every 3 months (year 1 to 3) and every 6 months (year 4 and 5).
Number of patients with undetectable ctDNA (not detectable according to the DETECTION assay), but clinical/radiological progression and site of progression (local or distant in addition to organ site).
Time frame: From registration to clinical/radiological progression with undetectable ctDNA, assessed up to 84 months.
RFS of patients with undetectable ctDNA (not randomised) vs. patients with detectable ctDNA in Arm A.
Time frame: From registration to radiological (recist v1.1)/clinical (confirmed histologically) progression in not randomised and in Arm A participants, assessed up to 84 months.
DMFS of patients with undetectable ctDNA (not randomised) vs. patients with detectable ctDNA in Arm A.
Time frame: From registration to distant metastatic relapse or death in not randomised and in Arm A participants, assessed up to 84 months.
OS defined as time from registration until death of patients with undetectable ctDNA (not randomised) vs. patients in Arm A.
Time frame: From registration until death of patients with undetectable ctDNA (not randomised) vs. patients in Arm A, assessed up to 84 months.
To assess treatment-free survival.
Time frame: Time to first line therapy cessation, assessed up to 84 months.
Toxicity measured according to Common Terminology Criteria for Adverse Events (CTCAE) v5.0.
Time frame: From consent until the end of the trial or until disease progression and at least 100 days post the last treatment dose of nivolumab, assessed up to 84 months.
Health economics assessment as assessed by EQ-5D-5L and resource use questionnaires.
Time frame: At registration and every 6 months for both monitoring and post randomisation, with an additional questionnaire at baseline prior to therapy on Arm B and at relapse and every 6 Mo until relapse on first line therapy on Arm A, assessed up to 84 months.
Results and safety
The study was stopped early (reason given: Closed earlier than expected due to the need for a redesign to reflect the recent change in standard of care guidelines. New design will include these treatments.). Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 27 Feb 2025.
- HRA summary of results- there are no study results due to early termination. See HRA summary link for more details.Link provided by the sponsor.
- Individual participant dataSharing planned: Yes. At the end of the trial, after the primary results have been published, the de-identified individual participant data (IPD) and associated documentation (e.g. protocol, statistical analysis plan, annotated blank CRF) will be prepared in order to be shared with external researchers. All requests for access to the IPD will be reviewed by an internal committee at the Clinical Trials Unit (CTU) and discussed with the Chief Investigator in accordance with the CTU policy on data sharing. All data sharing must be authorised by the Sponsor.
Related trials for Melanoma (Skin)
RecruitingPhase 1/2
Study of INBRX-106 and INBRX-106 in Combination With Pembrolizumab (Keytruda®) in Subjects With Locally Advanced or Metastatic Solid Tumors (Hexavalent OX40 Agonist)
Solid Tumor, Non-Small Cell Lung Cancer
RecruitingPhase 1
IL-17 Blockade to Decrease irAEs (REPLAY)
Metastatic Melanoma
Enrolling by invitationObservational study
Natural History Study of Early Life Exposures in Agriculture (ELEA)
Prostate Cancer, Leukemia
RecruitingPhase 1
A Feasibility Study Utilizing Immune Recall to Increase Response to Checkpoint Therapy
Melanoma
Active, not recruitingPhase 1/2
A Study of Dapansutrile Plus Pembrolizumab in Patients With PD-1 Refractory Advanced Melanoma
Melanoma
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.
Paul Lorigan, Professor principal investigator
The Christie NHS Foundation Trust
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2/3 study testing Nivolumab 10 MG/ML in people with Melanoma (Skin) and Melanoma, Stage II, run by The Christie NHS Foundation Trust at 1 site in United Kingdom.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 12 inclusion and 9 exclusion criteria. 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: stopped early, as of the sponsor's last update on 27 Feb 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United Kingdom. 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 combined 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.
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
The study was stopped early (reason given: Closed earlier than expected due to the need for a redesign to reflect the recent change in standard of care guidelines. New design will include these treatments.). Results are not available in the source record.
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?
Overall Survival (OS) (time frame: From randomisation until death by any cause, assessed up to 84 months.). 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 27 Feb 2025.