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审核状态: Project audit state: |
通过审核 Successful |
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注册号: Registration number: |
ChiCTR2300073872 |
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最近更新日期: Date of Last Refreshed on: |
2023-09-16 23:06:04 |
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注册时间: Date of Registration: |
2023-07-24 00:00:00 |
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注册号状态: |
预注册 |
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Registration Status: |
Prospective registration |
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注册题目: |
评价FKC889在复发/难治性前体B细胞急性淋巴细胞白血病(r/r ALL)成人患者中的有效性和安全性的II期单臂、多中心、开放性研究 |
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Public title: |
A phase II single-arm, multicenter, open trial to evaluate the efficacy and safety of FKC889 in adult patients with relapsed/refractory precursor B-cell acute lymphoblastic leukemia (r/r ALL) |
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注册题目简写: |
FKC889在复发/难治性急性淋巴细胞白血病中有效性的研究 |
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English Acronym: |
Efficacy of FKC889 in relapsed/refractory acute lymphoblastic leukemia |
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研究课题的正式科学名称: |
评价FKC889在复发/难治性前体B细胞急性淋巴细胞白血病(r/r ALL)成人患者中的有效性和安全性的II期单臂、多中心、开放性研究 |
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Scientific title: |
A phase II single-arm, multicenter, open trial to evaluate the efficacy and safety of FKC889 in adult patients with relapsed/refractory precursor B-cell acute lymphoblastic leukemia (r/r ALL) |
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研究课题代号(代码): Study subject ID: |
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在二级注册机构或其它机构的注册号: The registration number of the Partner Registry or other register: |
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申请注册联系人: |
方海 |
研究负责人: |
黄晓军 |
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Applicant: |
Fang Hai |
Study leader: |
Xiaojun Huang |
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申请注册联系人电话: Applicant telephone: |
+86 156 1882 3506 |
研究负责人电话: Study leader's telephone: |
+86 137 0138 9625 |
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申请注册联系人传真 : Applicant Fax: |
研究负责人传真: Study leader's fax: |
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申请注册联系人电子邮件: Applicant E-mail: |
hai.fang@fosunkitebio.com |
研究负责人电子邮件: Study leader's E-mail: |
hai.fang@fosunkitebio.com |
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申请单位网址(自愿提供): Applicant website(voluntary supply): |
研究负责人网址(自愿提供): Study leader's website(voluntary supply): |
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申请注册联系人通讯地址: |
上海市浦东新区康南路222号 |
研究负责人通讯地址: |
北京市西城区西直门南大街11号 |
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Applicant address: |
222 Kangnan Road, Pudong New Area, Shanghai |
Study leader's address: |
11 Xizhimen South Street, Xicheng District, Beijing |
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申请注册联系人邮政编码: Applicant postcode: |
研究负责人邮政编码: Study leader's postcode: |
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申请人所在单位: |
复星凯特生物科技有限公司 |
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Applicant's institution: |
Fosun Kat Biotechnology Co., LTD |
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研究负责人所在单位: |
北京大学人民医院 |
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Affiliation of the Leader: |
Peking University People's Hospital |
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是否获伦理委员会批准: |
是/Yes |
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Approved by ethic committee: |
Yes |
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伦理委员会批件文号: Approved No. of ethic committee: |
2023PHC009-001 |
伦理委员会批件附件: Approved file of Ethical Committee: |
查看附件View |
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批准本研究的伦理委员会名称: |
北京大学人民医院伦理审查委员会 |
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Name of the ethic committee: |
Ethics Committee of Peking University People's Hospital |
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伦理委员会批准日期: Date of approved by ethic committee: |
2023-04-20 00:00:00 |
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伦理委员会联系人: |
丛翠翠 |
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Contact Name of the ethic committee: |
Cong Cuicui |
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伦理委员会联系地址: |
北京市西城区西直门南大街11号 |
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Contact Address of the ethic committee: |
11 Xizhimen South Street, Xicheng District, Beijing |
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伦理委员会联系人电话: Contact phone of the ethic committee: |
+86 10 8832 4516 |
伦理委员会联系人邮箱: Contact email of the ethic committee: |
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研究实施负责(组长)单位: |
北京大学人民医院 |
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Primary sponsor: |
Peking University People's Hospital |
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研究实施负责(组长)单位地址: |
北京市西城区西直门南大街11号 |
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Primary sponsor's address: |
11 Xizhimen South Street, Xicheng District, Beijing |
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试验主办单位(项目批准或申办者): Secondary sponsor: |
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经费或物资来源: |
自筹 |
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Source(s) of funding: |
by sponsor |
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Target disease: |
B-precursor Acute Lymphoblastic Leukemia |
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Target disease code: |
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研究类型: |
干预性研究 |
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Study type: |
Interventional study |
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研究所处阶段: |
II期临床试验 | ||||||||||||||||||||||
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Study phase: |
2 |
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研究设计: |
单臂 |
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Study design: |
Single arm |
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研究目的: |
主要目的: 评估FKC889治疗复发/难治性前体B细胞 ALL成人患者的有效性,检测 FKC889的总体完全缓解率(OCR定义为达到完全缓解(CR)和完全缓解伴血液学不完全恢复(CRi)的比例。 次要目的: 包括评估FKC889的安全性和耐受性以及其他疗效终点。 |
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Objectives of Study: |
The primary objective of Phase 2 is to evaluate the efficacy of FKC889, as measured by the overall complete remission rate defined as complete remission (CR) and complete remission with incomplete hematologic recovery (CRi) in adult subjects with r/r ALL. Secondary objectives will include assessing the safety and tolerability of FKC889 and additional efficacy endpoints. |
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药物成份或治疗方案详述: |
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Description for medicine or protocol of treatment in detail: |
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纳入标准: |
1. 复发或难治性前体B细胞急性淋巴细胞白血病,定义为以下之一: (1)原发难治性; (2)一线治疗后首次缓解持续时间≤12个月的首次复发; (3)二线或以上系统性治疗后难治或复发; (4)异基因造血干细胞移植后难治或复发(受试者移植日期需早于入组前100天,入组前已经停用免疫抑制剂不短于4周); 2. 骨髓形态学检查提示骨髓中原始或幼稚细胞 5%; 3. Ph阳性ALL患者酪氨酸激酶抑制剂TKI不耐受或在接受至少两种及以上的TKI治疗后出现难治或复发; 4. 年龄18岁或以上; 5. 东部肿瘤协作组(ECOG)体能状态评分为 0或 1分; 6. 中性粒细胞绝对值计数(ANC 0.5×109/L;或者中性粒细胞绝对计数< 0.5×109/L 但研究者认为受试者中性粒细胞减少是由白血病所致,且在抗白血病治疗后可能恢复 ; 7. 血小板计数 50×109/L;或者血小板计数 50×109/L 但研究者认为受试者血小板减少是由白血病所致,且在抗白血病治疗后可能恢复 ; 8. 淋巴细胞绝对值计数 0.1×109/L; 9. 充足的肾、肝、肺和心脏功能,定义为: (1)肌酐清除率 按 Cockcroft-Gault公式 估计 60 cc/min; (2)血清丙氨酸氨基转移酶 /天门冬氨酸氨基转移酶 ≤正常上限值 ULN 2.5倍; (3)总胆红素 ≤1.5 ULN Gilbert's综合征的受试者除外; (4)心脏射血分数超声心动图ECHO确定无心包积液无具有临床意义的心律失常 心功能不属于 NYHA标准的 III级或 IV级; (5)无具有临床意义的胸腔积液; (6)室内空气下基线经皮血氧饱和度 > 92%; 10. 有生育能力的女性的血清妊娠试验结果需为阴性 (经过手术绝育或绝经后至少 2年的女性认为不具有生育能力); 11. 如果受试者既往使用过 Blinatumomab,需要在末次治疗完成后抽取骨髓或者外周血检测证实原始细胞存在CD19表达如果能够定量检测原始细胞的CD19表达率需 90%。 |
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Inclusion criteria |
1. Relapsed or refractory B-precursor ALL defined as one of the following: (1) Primary refratory disease; (2) First relapse if first remission <= 12 months; (3) Relapsed or refractory disease after two or more lines of systemic therapy; (4) Relapsed or refractory disease after allogeneic transplant provided subject is at least 100 days from stem cell transplant at the time of enrollment and off of immunosuppressive medications for at least 4 weeks prior to enrollment; 2. Morphological disease in the bone marrow (> 5% blasts); 3. Subjects with Ph+ disease are eligible if they are intolerant to tyrosine kinase inhibitor (TKI) therapy, or if they have relapsed/refractory disease despite treatment with at least 2 different TKIs; 4. Age 18 or older; 5. Eastern cooperative oncology group (ECOG) performance status of 0 or 1; 6. ANC >= 500/μL unless in the opinion of the PI cytopenia is due to underlying leukemia and is potentially reversible with leukemia therapy; 7. Platelet count >= 50,000/μL unless in the opinion of the PI cytopenia is due to underlying leukemia and is potentially reversible with leukemia therapy; 8. Absolute lymphocyte count >= 100/μL; 9. Adequate renal, hepatic, pulmonary and cardiac function defined as: (1) Creatinine clearance (as estimated by Cockcroft Gault) >= 60 cc/min; (2) Serum ALT/AST <= 2.5 x ULN (upper limit normal); (3) Total bilirubin <= 1.5 mg/dl, except in subjects with Gilbert's syndrome; (4) Left ventricular ejection fraction (LVEF) >= 50%, no evidence of pericardial effusion as determined by an ECHO, no NYHA class III or class IV functional classification, and no clinically significant arrhythmias; (5) No clinically significant pleural effusion; (6) Baseline oxygen saturation > 92% on room air; 10. Females of childbearing potential must have a negative serum or urine pregnancy test; 11. In subjects previously treated with blinatumomab, CD19 tumor expression on blasts obtained from bone marrow or peripheral blood must be documented after completion of the most recent prior line of therapy. If CD19 expression is quantified, then blasts must be >= 90% CD19 positive. |
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排除标准: |
1. 根据 WHO分型诊断为伯基特白血病 /淋巴瘤 或慢性髓系白血病急淋变; 2. 曾患有其他恶性肿瘤,除非已无病生存且没有接受抗肿瘤治疗至少 3年;但非黑色素瘤的皮肤肿瘤、原位癌(例如子宫颈,膀胱,乳腺)除外; 3. 曾对氨基糖苷类或本研究中所用药物有严重的速发型超敏反应病史; 4. CNS异常: (1)CNS-3状态(定义为脑脊液中WBC≥5/mm3,可见原始淋巴细胞)伴或不伴神经系统异常表现; (2)CNS-2状态(定义为脑脊液中WBC<5/mm3,可见原始淋巴细胞)伴有神经系统异常表现; 注:CNS-1状态(定义为脑脊液中未见原始淋巴细胞)及CNS-2状态但不伴有神经系统异常表现者可以参加本研究; (3)现存或既往有CNS疾病,如癫痫发作、脑血管缺血/出血、痴呆、小脑疾病、脑水肿、可逆性后部脑病综合征、或任何CNS受累的自身免疫性疾病; 5. 与骨髓功能 衰竭 有关的遗传性 综合征类疾病如范可尼贫血Kostmann综合征, Shwachman-Diamond综合征; 6. 入组前 12个月内有心肌梗死、心脏血管成形术或支架植入术、不稳定型心绞痛或其他 具有临床意义的 心脏疾病病史; 7. 入组前 6个月内存在症状性深静脉血栓形成或肺栓塞病史; 8. 原发性免疫缺陷; 9. 存在人类免疫缺陷病毒( HIV)感染 ,梅毒螺旋体感染乙型或丙型肝炎感染史。有肝炎感染史的患者检测 HBV-DNA及 HCV-RNA低于可检出范围者可以入组; 10. 存在未控制的或需要静脉给药治疗的真菌、细菌、病毒或其他感染。如果对积极治疗有反应并且在与复星凯特 医学监 察 员协商之后,允许存在单纯的尿路感染( UTI)以及简单的细菌性咽炎; 11. 既往治疗: (1)系统性挽救治疗(包括化疗,Ph阳性ALL的TKI,及blinatumomab)的时间在入组前1周或5个半衰期之内(以较短者为准); (2)既往接受过除blinatumomab以外的CD19靶向治疗; (3)既往CD19靶向治疗曾出现4级神经系统事件(CTCAE分级)或4级CRS(Lee et al,2014分级); (4)入组前6月内有alemtuzumab使用史,或入组前3个月有氯法拉滨或克拉屈滨使用史,或入组前3周有培门冬酰胺酶使用史; (5)入组前28天内有供者淋巴细胞输注(DLI)史; (6)入组前4周内GVHD治疗药物使用史(包括钙调磷酸酶抑制剂,甲氨蝶呤,霉酚酸酯,雷帕霉素,沙利度胺)或者入组前4周内使用过免疫抑制性抗体(如抗CD20单抗,抗TNF单抗,抗IL-6单抗或抗IL-6R单抗); (7)入组前仍在系统性免疫检查点抑制/刺激药物治疗(如ipilimumab,nivolumab,pembrolizumab,atezolizumab,OX40激动剂,4-1BB激动剂等)的3个半衰期内; (8)入组前7天内使用过药理学剂量的糖皮质激素(泼尼松>5mg/天或等效剂量其他皮质类固醇激素)或其他免疫抑制剂; 12. 存 在任何留置导管 或引流管 (如:经皮肾造口置管、 留置胆道引流管 、 留置导尿管或胸膜腔 /腹膜腔 /心包导管 )。允许存在专用的中 心静脉通路导管,如 Port-a-Cath或 Hickman导管允许使用; 13. 存在 II-IV级的急性 GVHD Glucksberg标准)或 B-D度急性 GVHD IBMTR指数 );入组前 4周内有需要系统性治疗的急慢性 GVHD; 14. 入组前 4周内有活疫苗接种史; 15. 怀孕或哺乳期的女性受试者,因为预处理化疗对胎儿或婴儿具有潜在的风险; 16. 从签署知情同意开始到完成 FKC889输注后 6个月内,不愿意采取避孕措施的男性或女性受试者; 17. 根据 研究者判断 受试者难以完成研究方案要求的所有访视或操作(包括随访访视),或难以遵从参与研究的要求; 18. 最近 2年内,因自身免疫性疾病(如克罗恩病、类风湿性关节炎、系统性红斑狼疮)导致终末器官受损,或需要系统性应用免疫抑制或其他系统性控制疾病药物。 |
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Exclusion criteria: |
1. Diagnosis of Burkitt’s leukemia/lymphoma according to WHO classification or chronic myelogenous leukemia lymphoid blast crisis; 2. History of malignancy other than non-melanoma skin cancer or carcinoma in situ (eg, cervix, bladder, breast) unless disease free for at least 3 years; 3. History of severe hypersensitivity reaction to aminoglycosides or any of the agents used in this study; 4. CNS abnormalities; (1) Presence of CNS-3 disease defined as detectable cerebrospinal blast cells in a sample of CSF with >= 5 WBCs per mm3 with or without neurological changes; (2) Presence of CNS-2 disease defined as detectable cerebrospinal blast cells in a sample of CSF with < 5 WBCs per mm3 with neurological changes; Note: Subjects with CNS-1 (no detectable leukemia in the CSF) and those with CNS-2 without clinically evident neurological changes are eligible to participate in the study; (3) History or presence of any CNS disorder such as a seizure disorder, cerebrovascular ischemia/hemorrhage, dementia, cerebellar disease, any autoimmune disease with CNS involvement, posterior reversible encephalopathy syndrome (PRES), or cerebral edema; 5. History of concomitant genetic syndrome associated with bone marrow failure such as Fanconi anemia, Kostmann syndrome, Shwachman-Diamond syndrome; 6. History of myocardial infarction, cardiac angioplasty or stenting, unstable angina, or other clinically significant cardiac disease within 12 months of enrollment; 7. History of symptomatic deep vein thrombosis or pulmonary embolism within 6 months of enrollment; 8. Primary immunodeficiency; 9. Known infection with HIV, hepatitis B or hepatitis C virus. A history of hepatitis B or hepatitis C is permitted if the viral load is undetectable per quantitative PCR and/or nucleic acid testing; 10. Presence of fungal, bacterial, viral, or other infection that is uncontrolled or requiring antimicrobials for management. Simple UTI and uncomplicated bacterial pharyngitis are permitted if responding to active treatment and after consultation with the Kite Medical Monitor; 11. Prior medication: (1) Salvage systemic therapy (including chemotherapy, TKIs for Ph+ ALL, and blinatumomab) within 1 week or 5 half-lives (whichever is shorter) prior to enrollment; (2) Prior CD19 directed therapy other than blinatumomab; (3) History of CTCAE grade 4 neurologic event or grade 4 CRS (Lee et al, 2014) with prior CD19-directed therapy; (4) Treatment with alemtuzumab within 6 months prior to enrollment, clofarabine or cladribine within 3 months prior to enrollment, or PEG-asparaginase within 3 weeks prior to enrollment; (5) Donor lymphocyte infusion (DLI) within 28 days prior to enrollment; (6) Any drug used for GVHD within 4 weeks prior to enrollment (eg, calcineurin inhibitors, methotrexate, mycophenolyate, rapamycin, thalidomide), or immunosuppressive antibody used within 4 weeks prior to enrollment (eg, anti-CD20, anti-tumor necrosis factor, anti-interleukin 6 or anti-interleukin 6 receptor); (7) At least 3 half-lives must have elapsed from any prior systemic inhibitory/stimulatory immune checkpoint molecule therapy prior to enrollment (eg, ipilimumab, nivolumab, pembrolizumab, atezolizumab, OX40 agonists, 4-1BB agonists etc); (8) Corticosteroid therapy at a pharmacologic dose (> 5 mg/day of prednisone or equivalent doses of other corticosteroids) and other immunosuppressive drugs must be avoided for 7 days prior to enrollment; 12. Presence of any indwelling line or drain (eg, percutaneous nephrostomy tube, indwelling Foley catheter, biliary drain, or pleural/peritoneal/pericardial catheter). Ommaya reservoirs and dedicated central venous access catheters such as a Port-a-Cath or Hickman catheter are permitted; 13. Acute GVHD grade II-IV by Glucksberg criteria or severity B-D by IBMTR index; acute or chronic GVHD requiring systemic treatment within 4 weeks prior to enrollment; 14. Live vaccine <= 4 weeks prior to enrollment; 15. Women of child-bearing potential who are pregnant or breastfeeding because of the potentially dangerous effects of the preparative chemotherapy on the fetus or infant. Females who have undergone surgical sterilization or who have been postmenopausal for at least 2 years are not considered to be of childbearing potential; 16. Subjects of both genders of child-bearing potential who are not willing to practice birth control from the time of consent through 6 months after the completion of FKC889; 17. In the investigators judgment, the subject is unlikely to complete all protocol-required study visits or procedures, including follow-up visits, or comply with the study requirements for participation; 18. History of autoimmune disease (eg. Crohns, rheumatoid arthritis, systemic lupus) resulting in end organ injury or requiring systemic immunosuppression/systemic disease modifying agents within the last 2 years. |
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研究实施时间: Study execute time: |
从 From 2022-12-21 00:00:00至 To 2039-12-01 00:00:00 |
征募观察对象时间: Recruiting time: |
从From 2023-07-24 00:00:00 至 To 2024-03-31 00:00:00 |
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干预措施: Interventions: |
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研究实施地点: Countries of recruitment and research settings: |
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测量指标: Outcomes: |
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采集人体标本:
Collecting sample(s)
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征募研究对象情况: Recruiting status: |
尚未开始 Not yet recruiting |
年龄范围: Participant age: |
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性别: |
男女均可 |
Gender: |
Both |
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随机方法(请说明由何人用什么方法产生随机序列): |
开放标签 |
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Randomization Procedure (please state who generates the random number sequence and by what method): |
Open Label |
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是否公开试验完成后的统计结果: Calculated Results after the Study Completed public access: |
不公开/Private |
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盲法: |
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Blinding: |
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是否共享原始数据: IPD sharing |
No |
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共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址): |
不适用 |
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The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url): |
NA |
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数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC: |
EDC |
|
Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture: |
EDC |
|
数据与安全监察委员会: Data and Safety Monitoring Committee: |
无/No |