Non-muscle-invasive Bladder CancerPhase 2ReplaceCystoNCT05796375
Replacing Invasive Cystoscopy With Urine Testing for Non-muscle Invasive Bladder Cancer Surveillance
A Phase 2 study testing Cystoscopy, Bladder EpiCheck urine test and Xpert Bladder Cancer Monitor urine test in people with Non-muscle-invasive Bladder Cancer, run by White River Junction Veterans Affairs Medical Center at 10 sites in United States.
Trial summary
The purpose of this research is to determine whether bladder cancer monitoring can be improved by replacing some cystoscopy procedures with urine testing. Specifically, this study examines whether there are any differences in urinary symptoms, discomfort, number of invasive procedures, anxiety, complications, cancer… Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Non-muscle-invasive Bladder Cancer
- What is being tested?
- Cystoscopy, Bladder EpiCheck urine test and Xpert Bladder Cancer Monitor urine test
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 240 participants
- Where
- 10 sitesUnited States
- Study dates
- 17 Nov 2023to 30 Dec 2028
- Phase
- Phase 2
- Are there results?
- Not yet: the study is under way
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
- Aged 18 years or older
- History of low grade intermediate-risk non-muscle invasive bladder cancer, defined as most recent pathology report showing any of the following:
- multifocal low grade non-invasive urothelial carcinoma of any size
- solitary low grade non-invasive urothelial carcinoma greater than 3cm in size
- recurrent low grade non-invasive urothelial carcinoma
- Stated willingness to comply with all study procedures and availability for the duration of the study
- No evidence for recurrence at cystoscopy ≤6 months after most recent tumor resection
- Ability to consent in English or Spanish
Who cannot join
- History of total cystectomy of the bladder.
- History of urinary diversion (e.g., neo-bladder, colon pouch, or ileal conduit).
- History of muscle-invasive bladder tumor.
- Pregnancy or lactation.
- History of urothelial carcinoma of the ureter or renal pelvis status post endoscopic treatment or with evidence of recurrent upper tract disease (inclusion allowed if status post nephroureterectomy and recurrence free at time of inclusion)
- Anatomic constraints making cystoscopy impossible (e.g., history of urethrectomy, obliterated urethra secondary to stricture).
- Inability to provide a voided urine sample.
Trial locations and contacts
10 sites in 1 country. Contact the study team or a site near you to ask about taking part.
10 sites in 1 country
United States10 sites, 8 recruiting
- Recruiting
Bay Pines VA Healthcare System
Bay Pines, Florida, 33744
Anna Rosenblatt, 727-398-6661 ext. 17051, Anna.Rosenblatt2@va.gov
Andrew Leone, MD
- Active, not recruiting
Medical University of South Carolina
Charleston, South Carolina, 29425
- Recruiting
University Hospitals Cleveland Medical Center
Cleveland, Ohio, 44106
Paul Cinicola, 216-286-7376, paul.cinicola@uhhospitals.org
Juan Echeverria Serrano, 216 844 5878, Juan.Echeverria-Serrano@UHhospitals.org
- Recruiting
UT Southwestern Medical Center
Dallas, Texas, 75235
Sonobia Garrett, BSHS, Sonobia.Garrett@utsouthwestern.edu
Yair Lotan, MD
- Recruiting
Dartmouth Hitchcock Medical Center
Lebanon, New Hampshire, 03756
ZoeFaith Caraballo-Bobea,, BA, 603-653-3528, ZoeFaith.E.Caraballo.Bobea@hitchcock.org
Laura Tafe, MD
- Recruiting
VA St.Louis Healthcare System
St Louis, Missouri, 63016
Carley Browning, 314-652-4100 ext. 57697, Carley.Browning@va.gov
Lewis Thomas, MD
- Withdrawn
James A. Haley Veterans' Hospital
Tampa, Florida, 33612
- Recruiting
West Haven VA Medical Center
West Haven, Connecticut, 06516
Alicia Roy, 203-932-5711 ext. 3006, Alicia.Roy@va.gov
Preston Sprenkle, MD
- Recruiting
VA Boston Jamaica Plains Campus
West Roxbury, Massachusetts, 02132
Laura MacAdam, NP, 857-407-8074, Laura.MacAdam@va.gov
Lori Lerner, MD
- Recruiting
White River Junction Veterans Healthcare System
White River Junction, Vermont, 05009
Prabha L Loganathan, MS, 802-295-9363 ext. 6914, prabhavath.loganathan@va.gov
Laura Jensen, MPH, 802-295-9363 ext. 6953, Laura.Jensen@va.gov
About this study
The purpose of this research is to determine whether bladder cancer monitoring can be improved by replacing some cystoscopy procedures with urine testing. Specifically, this study examines whether there are any differences in urinary symptoms, discomfort, number of invasive procedures, anxiety, complications, cancer recurrence or cancer progression when some cystoscopy procedures are replaced with urine testing.
Read the detailed description
This is a multi-site randomized phase 2 trial including 240 patients with early-stage bladder cancer, in which patients will be randomized 1:1:1 to programmatic surveillance with the Xpert bladder cancer urine test, the Bladder EpiCheck urine test, or frequent cystoscopy. The primary outcome will be urinary quality of life measured 1 to 3 days after surveillance.
This study will have three groups, also called "arms": (1) Frequent Cystoscopy Arm, (2) Xpert Urine Test Arm, and (3) Epicheck Urine Test Arm. The aim of Frequent Cystoscopy is to detect any cancer that might have come back within the bladder by frequently inspecting the bladder. Those in the cystoscopy arm will have a cystoscopy procedure at specified time points for two years. The goal of the Xpert Urine Test arm is to detect any cancer that might have come back within the bladder, while decreasing the number of invasive cystoscopy procedures. Those in the Xpert arm will have a Xpert urine test and a check-up with a medical doctor at 6 months and 18 months, and have a cystoscopy procedure at 12 months and 24 months. The aim of the EpiCheck Urine Test arm is to detect any cancer that might have come back within the bladder, while decreasing the number of invasive cystoscopy procedures. Those in the EpiCheck Urine Test arm will have an Epicheck urine test and a check-up with a medical doctor at 6 months and 18 months and will have a cystoscopy procedure at 12 months and 24 months. The study performance period is 24 months.
- Conditions
- Non-muscle-invasive Bladder Cancer
- Being tested
- Cystoscopy, Bladder EpiCheck urine test, Xpert Bladder Cancer Monitor urine test
- Keywords
- Bladder, Cancer, Urology, Cystoscopy, Xpert, EpiCheck, Urine test
- Medical subject headings
- Non-Muscle Invasive Bladder Neoplasms, Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
CystoscopyProcedure or surgery
Cystoscopy entails direct inspection of the bladder via a cystoscope that is inserted into a patient's urethra.
Bladder EpiCheck urine testDiagnostic test
The Bladder EpiCheck is a laboratory-developed test for early-stage non-muscle invasive bladder cancer. The Bladder EpiCheck test is a DNA methylation test that is run on DNA extracted from cell pellet from centrifuged urine according to Standardized Operating Procedures. The test has internal controls and a dedicated software to ensure required quality assurance processes and prompt reporting of results.
Xpert Bladder Cancer Monitor urine testDiagnostic test
A 4.5 ml sample of voided urine is added to Xpert® Urine Transport Reagent, mixed, and then 4ml of treated urine are transferred to the Sample Chamber of the cartridge. In the cartridge, cells in the urine sample are captured on a filter and lysed by sonication. The released nucleic acid is eluted, mixed with dry RT-PCR reagents, and the solution is transferred to the reaction tube for RT-PCR and detection.
| Study group | Role | What they receive |
|---|---|---|
| Frequent Cystoscopy | Active comparator | Cystoscopy is conducted at 6, 12, 18, and 24 months for patients undergoing surveillance for low grade intermediate-risk non-muscle invasive bladder cancer Receives: Procedure: Cystoscopy |
| Xpert Urine Test | Experimental | Xpert arm includes urine testing using the Xpert Bladder Cancer Monitor urine test at 6 and 18 months. Cystoscopy is conducted at 12 and 24 months for patients undergoing surveillance for low grade intermediate-risk non-muscle invasive bladder cancer Receives: Procedure: Cystoscopy; Diagnostic Test: Xpert Bladder Cancer Monitor urine test |
| EpiCheck Urine Text | Experimental | EpiCheck arm includes urine testing using the Bladder EpiCheck urine test at 6 and 18 months. Cystoscopy is conducted at 12 and 24 months for patients undergoing surveillance for low grade intermediate-risk non-muscle invasive bladder cancer. Receives: Procedure: Cystoscopy; Diagnostic Test: Bladder EpiCheck urine test |
What is being measured
The primary outcome is the main question the study is designed to answer.
Quality of Life Questionnaire-Non-Muscle Invasive Bladder Cancer 24 (EORTC QLQ-NMIBC24)
Measuring change from baseline. Score range: 0-100. Lower score indicates higher quality of life.
Measured: Assessed at 3, 6, 12, 18, and 24 months.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted3 Apr 2023
- Study start17 Nov 2023
- Primary completion30 Nov 2028 (estimated)
- Study completion30 Dec 2028 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (3)Papers the sponsor has linked to this study.
- Other trials for Non-muscle-invasive Bladder 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
- Interventional
- Phase
- Phase 2
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Health care delivery parallel trial with 1:1:1 randomization
- Masking
- None (open label)
- Enrolment
- 240 participants (estimated)
Sponsor and investigators
- Lead sponsor
- White River Junction Veterans Affairs Medical Center
- Sponsor type
- US federal agency
- Collaborators
- National Cancer Institute (NCI), University of Texas Southwestern Medical Center, Medical University of South Carolina
- Responsible party
- Principal investigator, Florian Schroeck, White River Junction Veterans Affairs Medical Center
- Investigators
- Florian R Schroeck, MD, MS, Principal investigator, White River Junction VA Healthcare System
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05796375
- Sponsor's protocol ID
- 1732756
- Other IDs
- R37CA275916, 1R37CA275916-01
- Acronym
- ReplaceCysto
- Status last verified
- Sep 2026
- First submitted
- 21 Mar 2023
- Last updated
- 16 Sep 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- Yes
- Individual data sharing
- No
Publications
Koo K, Zubkoff L, Sirovich BE, Goodney PP, Robertson DJ, Seigne JD, Schroeck FR. The Burden of Cystoscopic Bladder Cancer Surveillance: Anxiety, Discomfort, and Patient Preferences for Decision Making. Urology. 2017 Oct;108:122-128. doi: 10.1016/j.urology.2017.07.016. Epub 2017 Jul 21.
PubMed 28739405Schroeck FR, Lynch KE, Li Z, MacKenzie TA, Han DS, Seigne JD, Robertson DJ, Sirovich B, Goodney PP. The impact of frequent cystoscopy on surgical care and cancer outcomes among patients with low-risk, non-muscle-invasive bladder cancer. Cancer. 2019 Sep 15;125(18):3147-3154. doi: 10.1002/cncr.32185. Epub 2019 May 23.
PubMed 31120559Schroeck FR, Grubb R, MacKenzie TA, Ould Ismail AA, Jensen L, Tsongalis GJ, Lotan Y. Clinical Trial Protocol for "Replace Cysto": Replacing Invasive Cystoscopy with Urine Testing for Non-muscle-invasive Bladder Cancer Surveillance-A Multicenter, Randomized, Phase 2 Healthcare Delivery Trial Comparing Quality of Life During Cancer Surveillance with Xpert Bladder Cancer Monitor or Bladder EpiCheck Urine Testing Versus Frequent Cystoscopy. Eur Urol Open Sci. 2024 Mar 21;63:19-30. doi: 10.1016/j.euros.2024.02.018. eCollection 2024 May.
PubMed 38558761
Study at a glance
From the registry record, last updated by the sponsor on 16 Sep 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Replacing Invasive Cystoscopy With Urine Testing for Non-muscle Invasive Bladder Cancer Surveillance
- ClinicalTrials.gov ID
- NCT05796375
- Acronym / sponsor ID
- ReplaceCysto / 1732756
- Conditions
- Non-muscle-invasive Bladder Cancer
- Keywords
- Bladder, Cancer, Urology, Cystoscopy, Xpert, EpiCheck, Urine test
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 240 participants (estimated)
- Lead sponsor
- White River Junction Veterans Affairs Medical CenterUS federal agency
- Collaborators
- National Cancer Institute (NCI), University of Texas Southwestern Medical Center, Medical University of South Carolina
- Study start
- 17 Nov 2023 (actual)
- Primary completion
- 30 Nov 2028 (estimated)
- Study completion
- 30 Dec 2028 (estimated)
- First posted
- 3 Apr 2023 (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 purpose of this research is to determine whether bladder cancer monitoring can be improved by replacing some cystoscopy procedures with urine testing. Specifically, this study examines whether there are any differences in urinary symptoms, discomfort, number of invasive procedures, anxiety, complications, cancer recurrence or cancer progression when some cystoscopy procedures are replaced with urine testing.
Detailed description
This is a multi-site randomized phase 2 trial including 240 patients with early-stage bladder cancer, in which patients will be randomized 1:1:1 to programmatic surveillance with the Xpert bladder cancer urine test, the Bladder EpiCheck urine test, or frequent cystoscopy. The primary outcome will be urinary quality of life measured 1 to 3 days after surveillance.
This study will have three groups, also called "arms": (1) Frequent Cystoscopy Arm, (2) Xpert Urine Test Arm, and (3) Epicheck Urine Test Arm. The aim of Frequent Cystoscopy is to detect any cancer that might have come back within the bladder by frequently inspecting the bladder. Those in the cystoscopy arm will have a cystoscopy procedure at specified time points for two years. The goal of the Xpert Urine Test arm is to detect any cancer that might have come back within the bladder, while decreasing the number of invasive cystoscopy procedures. Those in the Xpert arm will have a Xpert urine test and a check-up with a medical doctor at 6 months and 18 months, and have a cystoscopy procedure at 12 months and 24 months. The aim of the EpiCheck Urine Test arm is to detect any cancer that might have come back within the bladder, while decreasing the number of invasive cystoscopy procedures. Those in the EpiCheck Urine Test arm will have an Epicheck urine test and a check-up with a medical doctor at 6 months and 18 months and will have a cystoscopy procedure at 12 months and 24 months. The study performance period is 24 months.
Study design
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 3
- Model description
- Health care delivery parallel trial with 1:1:1 randomization
| Arm | Type | Receives |
|---|---|---|
| Frequent Cystoscopy | Active comparator | Procedure: CystoscopyCystoscopy is conducted at 6, 12, 18, and 24 months for patients undergoing surveillance for low grade intermediate-risk non-muscle invasive bladder cancer |
| Xpert Urine Test | Experimental | Procedure: Cystoscopy, Diagnostic Test: Xpert Bladder Cancer Monitor urine testXpert arm includes urine testing using the Xpert Bladder Cancer Monitor urine test at 6 and 18 months. Cystoscopy is conducted at 12 and 24 months for patients undergoing surveillance for low grade intermediate-risk non-muscle invasive bladder cancer |
| EpiCheck Urine Text | Experimental | Procedure: Cystoscopy, Diagnostic Test: Bladder EpiCheck urine testEpiCheck arm includes urine testing using the Bladder EpiCheck urine test at 6 and 18 months. Cystoscopy is conducted at 12 and 24 months for patients undergoing surveillance for low grade intermediate-risk non-muscle invasive bladder cancer. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (8 listed)
- Aged 18 years or older
- History of low grade intermediate-risk non-muscle invasive bladder cancer, defined as most recent pathology report showing any of the following:
- Stated willingness to comply with all study procedures and availability for the duration of the study
- No evidence for recurrence at cystoscopy ≤6 months after most recent tumor resection
- Ability to consent in English or Spanish
Key exclusion criteria (7 listed)
- History of total cystectomy of the bladder.
- History of urinary diversion (e.g., neo-bladder, colon pouch, or ileal conduit).
- History of muscle-invasive bladder tumor.
- Pregnancy or lactation.
- History of urothelial carcinoma of the ureter or renal pelvis status post endoscopic treatment or with evidence of recurrent upper tract disease (inclusion allowed if status post nephroureterectomy and recurrence free at time of inclusion)
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 |
|---|---|---|
| CystoscopyCystoscopy entails direct inspection of the bladder via a cystoscope that is inserted into a patient's urethra. | Procedure or surgery | EpiCheck Urine Text, Frequent Cystoscopy, Xpert Urine Test |
| Bladder EpiCheck urine testThe Bladder EpiCheck is a laboratory-developed test for early-stage non-muscle invasive bladder cancer. The Bladder EpiCheck test is a DNA methylation test that is run on DNA extracted from cell pellet from centrifuged urine according to Standardized Operating Procedures. The test has internal controls and a dedicated software to ensure required quality assurance processes and prompt reporting of results. | Diagnostic test | EpiCheck Urine Text |
| Xpert Bladder Cancer Monitor urine testA 4.5 ml sample of voided urine is added to Xpert® Urine Transport Reagent, mixed, and then 4ml of treated urine are transferred to the Sample Chamber of the cartridge. In the cartridge, cells in the urine sample are captured on a filter and lysed by sonication. The released nucleic acid is eluted, mixed with dry RT-PCR reagents, and the solution is transferred to the reaction tube for RT-PCR and detection. | Diagnostic test | Xpert Urine Test |
Primary outcome
Quality of Life Questionnaire-Non-Muscle Invasive Bladder Cancer 24 (EORTC QLQ-NMIBC24)
Time frame: Assessed at 3, 6, 12, 18, and 24 months.
Measuring change from baseline. Score range: 0-100. Lower score indicates higher quality of life.
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 16 Sep 2026.
- Background: PubMed 28739405Koo K, Zubkoff L, Sirovich BE, Goodney PP, Robertson DJ, Seigne JD, Schroeck FR. The Burden of Cystoscopic Bladder Cancer Surveillance: Anxiety, Discomfort, and Patient Preferences for Decision Making. Urology. 2017 Oct;108:122-128. doi: 10.1016/j.urology.2017.07.016. Epub 2017 Jul 21.
- Background: PubMed 31120559Schroeck FR, Lynch KE, Li Z, MacKenzie TA, Han DS, Seigne JD, Robertson DJ, Sirovich B, Goodney PP. The impact of frequent cystoscopy on surgical care and cancer outcomes among patients with low-risk, non-muscle-invasive bladder cancer. Cancer. 2019 Sep 15;125(18):3147-3154. doi: 10.1002/cncr.32185. Epub 2019 May 23.
- Background: PubMed 38558761Schroeck FR, Grubb R, MacKenzie TA, Ould Ismail AA, Jensen L, Tsongalis GJ, Lotan Y. Clinical Trial Protocol for "Replace Cysto": Replacing Invasive Cystoscopy with Urine Testing for Non-muscle-invasive Bladder Cancer Surveillance-A Multicenter, Randomized, Phase 2 Healthcare Delivery Trial Comparing Quality of Life During Cancer Surveillance with Xpert Bladder Cancer Monitor or Bladder EpiCheck Urine Testing Versus Frequent Cystoscopy. Eur Urol Open Sci. 2024 Mar 21;63:19-30. doi: 10.1016/j.euros.2024.02.018. eCollection 2024 May.
- Individual participant dataSharing planned: No
Related trials for Non-muscle-invasive Bladder Cancer
Active, not recruitingPhase 2
Treating Muscle-invasive Bladder Cancer With A Non-surgical Method Consisting of Anti-PD-1 Therapy and Chemoradiation
Muscle-Invasive Bladder Carcinoma, Programmed Cell Death Protein 1 Inhibitor
RecruitingPhase 3
Trial of Nadofaragene Firadenovec vs. Observation in Participants With Intermediate Risk Non-Muscle Invasive Bladder Cancer
Intermediate Risk Non-Muscle Invasive Bladder Cancer
Not yet recruiting
The Role of ERBT Plus Adjuvant Intravesical Induction and Maintenance Chemotherapy for Intermediate-Risk NMIBC
Bladder Cancer
RecruitingPhase 1
Inactivated UPEC-FimON for Non Muscle Invasive Bladder Cancer After BCG or Intravesical Chemotherapy Failure
Urinary Bladder Neoplasms
RecruitingPhase 3
A Trial to Evaluate Intravesical Nadofaragene Firadenovec Alone or in Combination With Chemotherapy or Immunotherapy in Participants With High-grade BCG Unresponsive Non-muscle Invasive Bladder Cancer
Non-muscle Invasive Bladder Cancer With Carcinoma in Situ
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.
Florian R Schroeck, MD, MS principal investigator
White River Junction VA Healthcare System
10 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing Cystoscopy, Bladder EpiCheck urine test and Xpert Bladder Cancer Monitor urine test in people with Non-muscle-invasive Bladder Cancer, run by White River Junction Veterans Affairs Medical Center at 10 sites in United States.
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 8 inclusion and 7 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: looking for participants now, as of the sponsor's last update on 16 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 10 sites in United States. 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?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Prabhavathi Loganathan, MS (802-295-9363 ext. 6914, Prabhavath.Loganathan@va.gov), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Quality of Life Questionnaire-Non-Muscle Invasive Bladder Cancer 24 (EORTC QLQ-NMIBC24) (time frame: Assessed at 3, 6, 12, 18, and 24 months.). 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 NCT05796375, which also lists 3 linked publications.
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 16 Sep 2026.