ChiCTR2000040006 版本V1.0 版本创建时间2020/11/18 00:13:16 中国临床试验注册中心

审核状态:

Project audit state:

通过审核

Successful

注册号:

Registration number:

ChiCTR2000040006 

最近更新日期:

Date of Last Refreshed on:

2020-11-18 00:13:06 

注册时间:

Date of Registration:

2020-11-18 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

卡瑞利珠单抗联合培美曲塞和铂类一线治疗胸膜间皮瘤的单臂、前瞻性、Ⅱ期、探索性临床研究

Public title:

A Single-arm, Prospective, Phase II, Exploratory Clinical Study of Camrelizumab in Combination with Pemetrexed and Platinum in the First-line Treatment of Pleural Mesothelioma

注册题目简写:

English Acronym:

研究课题的正式科学名称:

卡瑞利珠单抗联合培美曲塞和铂类一线治疗胸膜间皮瘤的单臂、前瞻性、Ⅱ期、探索性临床研究

Scientific title:

A Single-arm, Prospective, Phase II, Exploratory Clinical Study of Carrelizumab in Combination with Pemetrexed and Platinum in the First-line Treatment of Pleural Mesothelioma

研究课题代号(代码):

Study subject ID:

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:

申请注册联系人:

朱豪华 

研究负责人:

胡兴胜 

Applicant:

Haohua Zhu 

Study leader:

Xingsheng Hu 

申请注册联系人电话:

Applicant telephone:

18810681383

研究负责人电话:

Study leader's telephone:

13641361385

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

申请注册联系人电子邮件:

Applicant E-mail:

834707250@qq.com

研究负责人电子邮件:

Study leader's E-mail:

huxingsheng66@163.com

申请单位网址(自愿提供):

Applicant website(voluntary supply):

http://www.cicams.ac.cn/

研究负责人网址(自愿提供):

Study leader's website(voluntary supply):

http://www.cicams.ac.cn/

申请注册联系人通讯地址:

北京市朝阳区潘家园南里17号中国医学科学院肿瘤医院

研究负责人通讯地址:

北京市朝阳区潘家园南里17号中国医学科学院肿瘤医院

Applicant address:

17 Pan-Jia-Yuan Street South, Chaoyang District, Beijing, China

Study leader's address:

17 Pan-Jia-Yuan Street South, Chaoyang District, Beijing, China

申请注册联系人邮政编码:

Applicant postcode:

100021

研究负责人邮政编码:

Study leader's postcode:

100021

申请人所在单位:

国家癌症中心/中国医学科学院北京协和医学院肿瘤医院

Applicant's institution:

National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College

研究负责人所在单位:

国家癌症中心/中国医学科学院北京协和医学院肿瘤医院

Affiliation of the Leader:

National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College

是否获伦理委员会批准:

是/Yes

Approved by ethic committee:

Yes

伦理委员会批件文号:

Approved No. of ethic committee:

20/314-2510

伦理委员会批件附件:

Approved file of Ethical Committee:

查看附件View

批准本研究的伦理委员会名称:

国家癌症中心/中国医学科学院北京协和医学院肿瘤医院国家抗肿瘤GCP中心,伦理委员会

Name of the ethic committee:

National Cancer Center /Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National GCP Center for Anticancer Drugs,The Independent Ethics Committee

伦理委员会批准日期:

Date of approved by ethic committee:

2020-10-26 00:00:00

伦理委员会联系人:

吴大维

Contact Name of the ethic committee:

Dawei Wu

伦理委员会联系地址:

北京市朝阳区潘家园南里17号院

Contact Address of the ethic committee:

17 Panjiayuan Steet South, Chaoyang District, Beijing, China

伦理委员会联系人电话:

Contact phone of the ethic committee:

伦理委员会联系人邮箱:

Contact email of the ethic committee:

研究实施负责(组长)单位:

国家癌症中心/中国医学科学院北京协和医学院肿瘤医院

Primary sponsor:

National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College

研究实施负责(组长)单位地址:

北京市朝阳区潘家园南里17号

Primary sponsor's address:

17 Pan-Jia-Yuan Street South, Chaoyang District, Beijing, China

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

北京

市(区县):

北京

Country:

China

Province:

Beijing

City:

Beijing

单位(医院):

中国医学科学院肿瘤医院

具体地址:

北京市朝阳区潘家园南里17号

Institution
hospital:

Cancer Hospital Chinese Academy of Medical Sciences

Address:

17 Pan-Jia-Yuan Street South, Chaoyang District, Beijing, China

经费或物资来源:

Source(s) of funding:

N/A

Target disease:

Pleural Mesothelioma

Target disease code:

2C26.0

研究类型:

干预性研究

Study type:

Interventional study

研究所处阶段:

II期临床试验 

Study phase:

2

研究设计:

单臂 

Study design:

Single arm 

研究目的:

探索卡瑞利珠单抗联合培美曲塞和铂类一线治疗胸膜间皮瘤的有效性、安全性,不同亚型胸膜间皮瘤的疗效差别,以及肿瘤组织和血液中与预测疗效和安全性有关的生物标志物。  

Objectives of Study:

To explore the efficacy and safety of camrelizumab combined with pemetrexed and platinum in the first-line treatment of pleural mesothelioma, the difference in efficacy between different subtypes of pleural mesothelioma, and biomarkers in tumor tissue and blood related to predict efficacy and safety.

药物成份或治疗方案详述:

诱导治疗期:(4-6周期) 卡瑞利珠单抗:静脉滴注给药,固定剂量 200 mg,以 30-60分钟时间静脉滴注,第1天, 每 3周为一个周期。 培美曲塞:静脉注射给药,剂量500 mg/m2,第1天给药,每 3周为一个周期; 卡铂/顺铂:卡铂:静脉注射给药,剂量AUC=4~5,第1天给药,每 3周为一个周期/顺铂:静脉注射给药,剂量75 mg/m2,第1天给药,每 3周为一个周期; 每3周(21天)为一个治疗周期,4-6周期治疗后,进入卡瑞利珠单抗联合培美曲塞的维持治疗期阶段。 维持治疗期: 卡瑞利珠单抗:静脉滴注给药,固定剂量 200 mg,以 30-60分钟时间静脉滴注,第1天, 每3周为一个周期。 培美曲塞:静脉注射给药,剂量500 mg/m2,第1天给药,每 3周为一个周期; 每3周为一个治疗周期,维持用药直到出现下列情况为止:疾病进展、毒性不能耐受、受试者主动要求退出和研究者判断受试者需要退出研究。卡瑞利珠单抗治疗最长不超过35周期(2年)。 

Description for medicine or protocol of treatment in detail:

Induction therapy phase: (4 – 6 cycles) Camrelizumab: 200 mg intravenous over 30–60 minutes on day 1 every 3 weeks as a cycle; Pemetrexed: 500 mg/m2 intravenous on day 1 every 3 weeks; carboplatin/cisplatin: carboplatin, AUC = 4 to 5 intravenous on day 1 every 3 weeks a cycle: cisplatin, 75 mg/m2 intravenous on day 1 every 3 weeks; every 3 weeks (21 days) as a treatment cycle, after 4 – 6 cycles of treatment, enter the maintenance treatment phase of camrelizumab combined with pemetrexed. Maintenance treatment phase: Camrelizumab: 200 mg intravenous over 30-60 minutes on day 1, every 3 weeks as a cycle. Pemetrexed: 500 mg/m2 intravenously on Day 1 of each 3-week cycle; maintenance dosing every 3 weeks until disease progression, intolerable toxicity, withdrawal by the subject, or withdrawal by the investigator. No more than 35 cycles (2 years) of treatment with camrelizumab. 

纳入标准:

受试者必须符合以下所有入组标准,才具有进入本试验的资格:
1.年龄为18-75岁,男女不限;
2.在组织学上已确认诊断为晚期不可切除的胸膜间皮瘤;
3.既往未接受过针对晚期/转移性疾病的任何系统性抗肿瘤治疗;(对于既往曾接受过含铂辅助化疗、新辅助化疗,如果疾病进展发生在最后一次治疗结束之后> 6个月,且符合由于先前(新)辅助治疗引起的不良反应恢复到 ≤1级或基线,神经毒性≤2级,则可纳入);
4.预期寿命至少为3个月;
5.ECOG评分:0-1分;
6.研究者根据 RECIST 1.1 标准证实具有至少一个可测量病灶;
7.主要器官功能正常,筛选时的试验结果必须符合以下要求:
(1)血常规检查标准需符合(14天内未输血及血制品,未使用G-CSF及其他造血刺激因子纠正):
a. 血红蛋白(Hb) ≥ 90 g/L;
b. 中性粒细胞数(ANC) ≥ 1.5 × 109/L;
c. 血小板计数(PLT) ≥ 100×109/L;
(2)生化检查需符合以下标准:
a. 总胆红素(TBIL) < 1.5 倍正常值上限(ULN);
b. 谷丙转氨酶(ALT)和谷草转氨酶(AST) < 2.5ULN,而对于肝转移患者则< 5ULN;
c.血清肌酐(Cr) ≤ 1.5 ULN或者内生肌酐清除率> 60ml/min(Cockcroft-Gault公式);
d.尿常规检测结果显示尿蛋白(UPRO) < 2+ 或24小时尿蛋白定量<1g;
8.育龄妇女必须已经采取可靠的避孕措施或在入组前7天内进行妊娠试验(血清或尿液),且结果为阴性,并且愿意在试验期间和末次给予试验药物后60天采用适当的方法避孕。对于男性,须同意在试验期间和末次给予试验药物后120天采用适当的方法避孕或已手术绝育;
9.签署书面知情同意书,预计对研究方案依从性良好。

Inclusion criteria

Subjects must meet all of the following criteria to be eligible for this trial:
1. Male or female aged 18-75 years;
2. Histologically confirmed diagnosis of advanced unresectable pleural mesothelioma;
3. No previous systemic anti-tumor treatment for advanced/metastatic disease; (it can be included if the disease progression occurred > 6 months after the last treatment, and adverse events caused by previous (neoadjuvant) adjuvant therapy recovered to ≤ grade 1 or baseline, neurotoxicity ≤ grade 2, for previous platinum-based adjuvant chemotherapy, neoadjuvant chemotherapy);
4. Life expectancy of 3 months at least;
5. ECOG score: 0-1;
6. At least one measurable lesion confirmed by investigator according to RECIST 1.1 criteria;
7. The main organ function is normal, and the test results at screening must meet the following requirements: (1) blood routine examination results must meet (no blood transfusion and no use of blood products, G-CSF and other hematopoietic stimulating factors): a. hemoglobin (Hb) ≥ 90 g/L; b. neutrophil count (ANC) ≥ 1.5 × 109/L; c. platelet count (PLT) ≥ 100 × 109/L; (2) biochemical examination must meet the following criteria: a. total bilirubin (TBIL) < 1.5 times the upper limit of normal (ULN); b. alanine aminotransferase (ALT) and aspartate aminotransferase (AST) < 2.5ULN, however, for patients with liver metastases < 5 ULN; c. serum creatinine (Cr) ≤ 1.5 ULN or endogenous creatinine clearance > 60 ml/min (Cockcroft-Gault formula); d. urine routine test results showed urine protein (UPRO) < 2 + or 24-hour urine protein quantification < 1 g;
8. Fertile women must have used reliable contraception or had a pregnancy test (serum or urine) within 7 days prior to enrollment and had a negative result, and be willing to use an appropriate method of contraception during the trial and for 60 days after administration of the trial drug. Men should agree to use appropriate methods of contraception during the trial period and 120 days after the last administration of the trial drug or have undergone surgical sterilization;
9. Sign the informed consent form, have good compliance to the study protocol.

排除标准:

具有以下任何一项的患者不能入组本研究:
1.活动性脑转移患者(对于脑转移病灶经治疗后症状稳定得患者,只要符合下列所有标准,可参与本项研究:中枢神经系统之外有可测量得病灶;无中脑、脑桥、小脑、脑膜、延髓或脊髓转移;保持稳定状态至少2周);
2.肺纤维化或间质性肺炎患者;
3.既往接受过下列疗法:抗 PD-1、抗PD-L1或抗PD-L2药物或者针对另一种刺激或协同抑制T 细胞受体(例如,CTLA-4、OX-40、CD137)的药物;
4.首次使用卡瑞利珠单抗前14天之内使用过免疫抑制药物,不包括喷鼻和吸入性皮质类固醇或生理剂量的系统性类固醇激素(即不超过10 mg/天强的松龙或同等药物生理学剂量的其他皮质类固醇);
5.首次使用卡瑞利珠单抗前14天之内接受过具有抗肿瘤适应症的中草药或免疫调节作用的药物(包括胸腺肽、干扰素、白介素,除外为控制胸水局部使用)的系统性全身治疗;
6.首次给药前 7 天内接受过姑息性放射治疗。对于首次给药前 7 天前接受过姑息性放射治疗的患者,必须满足下述所有条件方可入组:目前不存在任何放疗相关的毒性反应,不需要服用糖皮质激素,排除放射性肺炎;
7.患有严重的心血管疾病:Ⅱ级以上心肌缺血或心肌梗塞、控制不良的心律失常(包括QTc间期男性 ≥ 450 ms、女性 ≥ 470 ms);Ⅲ~Ⅳ级心功能不全(根据纽约心脏学会NYHA分级),或心脏彩超检查提示左室射血分数(LVEF)< 50%者;
8.当前正在参与干预性临床研究治疗,或在首次给药前4周内接受过其他研究药物或研究器械治疗;在首次给药前,尚未从任何干预措施引起的毒性和/或并发症中充分恢复(即,≦1级或达到基线,不包括乏力或脱发);
9.伴有未控制的需要反复引流的胸腔积液、心包积液,或腹水(一个月引流一次或更频繁);
10.入组前14天内做过胸膜固定术;
11.入组前14天内进行局部或表面麻醉的手术;
12.受试者已经或计划在研究期间接受实体脏器或血液系统移植(角膜移植除外);
13.存在活动性自身免疫病或免疫缺陷,或具有以下病史,包括但不局限于:自身免疫性肝炎、肺炎、葡萄膜炎、类风湿性关节炎、炎症性肠病、垂体炎、血管炎、肾炎等。以下情况例外:自身免疫性甲状腺机能减退病史但接受甲状腺激素替代疗法的患者可入选研究,通过胰岛素给药方案治疗后,血糖得以控制的 1 型糖尿病患者可参与本项研究。
14.受试者进行支气管扩张剂等系统治疗,哮喘控制不满意(在童年期哮喘已完全缓解,成人后无需任何干预的可纳入)。
15.首次用药前4周内并发重度感染(如:需要静脉滴注抗生素、抗真菌或抗病毒药物),或在筛选期间/首次给药前出现不明原因的发热>38.5°C;或首次用药前3周内接受重大的手术治疗;
16.首次用药30天内或预期在研究期间接种减毒活疫苗;
17.人类免疫缺陷病毒(HIV)感染或已知有获得性免疫缺陷综合征(艾滋病),未经治疗的活动性乙型肝炎,丙型肝炎(丙肝抗体阳性,且 HCV-RNA 高于分析方法的检测下限)或合并乙肝和丙肝共同感染;
注:符合下列标准的乙肝受试者也符合入选条件:首次给药前 HBV 病毒载量必须<1000 拷贝/ml(200 IU/ml),受试者应在整个研究期间接受抗HBV 治疗避免病毒再激活。对于抗 HBc(+)、HBsAg(-)、抗HBs(-)和HBV 病毒载量(-)的受试者,不需要接受预防性抗HBV 治疗,但是需要密切监测病毒再激活;
18.有明确过敏史的病人,已知对卡瑞利珠单抗、培美曲塞、卡铂或顺铂活性成分和或任何辅料有过敏反应;
19.具有精神类药物滥用史且无法戒除者或有精神障碍的;
20.增加参加研究或研究药物相关的风险,并且根据研究者的判断,可导致患者不适合入选研究的其他情况。

Exclusion criteria:

Subjects who meet any of the following criteria will be excluded from this trial:
1. Patients with active brain metastases (patients with stable symptoms of brain metastases after treatment can participate in this study as long as they meet all the following criteria: measurable lesions outside the central nervous system; no midbrain, pons, cerebellum, meninges, medulla oblongata or spinal cord metastases; remain stable for at least 2 weeks); 2. Patients with pulmonary fibrosis or interstitial pneumonia;
3. Previously received the following therapies: anti-PD-1, anti-PD-L1, or anti-PD-L2 drugs or drugs that stimulate or synergistically inhibit another T cell receptor (e.g., CTLA-4, OX-40, CD137);
4. Use of immunosuppressive drugs within 14 days before the first use of camrelizumab, excluding nasal spray and inhaled corticosteroids or physiological doses of systemic steroids (i.e., no more than 10 mg/day prednisolone or other corticosteroids at the same physiological doses);
5. Systemic treatment with Chinese herbal medicine or immunomodulatory drugs with anti-tumor indications (including thymosin, interferon, interleukin, except for local use to control pleural effusion) within 14 days before the first use of camrelizumab;
6. Palliative radiation therapy within 7 days prior to first dose. Patients who have received palliative radiotherapy 7 days before the first dose must meet all the following conditions: there is no radiation-related toxicity, glucocorticoid is not required, and radiation pneumonitis is excluded;
7. Patients with severe cardiovascular disease: myocardial ischemia or myocardial infarction above grade II, poorly controlled arrhythmia (including QTc interval ≥ 450ms in males and ≥ 470ms in females); cardiac insufficiency grade III-IV (according to New York Heart Association NYHA classification), or cardiac ultrasound examination showed that LVEF < 50%;
8. Current participation in an interventional clinical trial, or treatment with another investigational drug or investigational device 4 weeks prior to the first dose; insufficient recovery (i.e., ≦ 1 grade or at baseline, excluding fatigue or alopecia) from toxicities and/or complications caused by any intervention before the first dose;
9. With uncontrolled pleural effusion, pericardial effusion, or ascites requiring repeated drainage (drainage once a month or more frequently);
10.Pleurodesis within 14 days before enrollment;
11.Surgery with local or topical anesthesia within 14 days prior to enrollment;
12.The subject has received or plans to receive organ or hematologic transplantation (except for corneal transplantation) during the study period;
13.Presence of active autoimmune diseases, immunodeficiency, or history as following, including but not limited to: autoimmune hepatitis, pneumonia, uveitis, rheumatoid arthritis, inflammatory bowel disease, hypophysitis, vasculitis, nephritis, etc. Exceptions include patients with a history of autoimmune hypothyroidism who are receiving thyroid hormone replacement therapy and patients with type 1 diabetes who are controlled with their insulin regimen are allowed to participate;
14. Not satisfactorily controlled asthma even the subject has received systemic treatment including bronchodilator (subjects can be enrolled if the asthma has been completely relieved in childhood, without any intervention after adulthood);
15.Ssevere infection (such as requiring intravenous antibiotics, antifungal or antiviral drugs) occurred within 4 weeks before the first dose, or unexplained fever > 38.5°C during screening/before the first dose; or received major surgical treatment within 3 weeks before first dose;
16. receive live attenuated vaccine within 30 days before first dose or expected to receive during the study;
17.Human immunodeficiency virus (HIV) infection or acquired immunodeficiency syndrome (AIDS), untreated active hepatitis B, hepatitis C (hepatitis C antibody positive and HCV-RNA above the lower limit of detection of the analytical method) or combined hepatitis B and C infection; Note: hepatitis B subjects who meet the following criteria are also eligible: HBV viral load must be < 1000 copies/ml (200 IU/ml) before the first dose, and subjects should receive anti-HBV treatment throughout the study to avoid viral reactivation. For subjects with anti-HBc (+), HBsAg (-), anti-HBs (-), and HBV viral load (-), prophylactic anti-HBV therapy is not required, but viral reactivation needs to be closely monitored;
18.Patients with a clear history of allergy who are known to have allergic reactions to the active ingredients and or any excipients of camrelizumab, pemetrexed, carboplatin, or cisplatin;
19.History of psychotropic substance abuse and inability to abstain or mental disorders; increase the risk associated with study participation or study drug, and other conditions that, in the judgment of the investigator, would make the patient inappropriate for entry into the study.

研究实施时间:

Study execute time:

From 2020-12-01 00:00:00 To 2024-12-31 00:00:00  

征募观察对象时间:

Recruiting time:

From 2020-12-01 00:00:00 To 2022-12-31 00:00:00  

干预措施:

Interventions:

组别:

试验组(单臂)

样本量:

20

Group:

Case series

Sample size:

干预措施:

卡瑞利珠单抗联合培美曲塞和铂类

干预措施代码:

Intervention:

camrelizumab combined with pemetrexed and platinum

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

北京 

市(区县):

北京 

Country:

China 

Province:

Beijing 

City:

Beijing 

单位(医院):

中国医学科学院肿瘤医院 

单位级别:

三级甲等 

Institution
hospital:

Cancer Hospital Chinese Academy of Medical Sciences

Level of the institution:

Tertiary A Hospital

测量指标:

Outcomes:

指标中文名:

无进展生存期(PFS)

指标类型:

主要指标

Outcome:

Progression free survival (PFS)

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

总体生存期(OS)

指标类型:

次要指标

Outcome:

Overall survival (OS)

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

客观缓解率(ORR)

指标类型:

次要指标

Outcome:

Objective response rate (ORR)

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

疾病控制率(DCR)

指标类型:

次要指标

Outcome:

Disease control rate (DCR)

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

缓解持续时间(DOR)

指标类型:

次要指标

Outcome:

Duration of remission (DOR)

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

生物标志物

指标类型:

附加指标

Outcome:

Biomarker

Type:

Additional indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

肿瘤组织

组织:

胸膜

Sample Name:

Tumor tissue

Tissue:

pleura

人体标本去向

使用后销毁  

说明

Fate of sample:

Destruction after use  

Note:

标本中文名:

血液

组织:

Sample Name:

Blood

Tissue:

人体标本去向

使用后销毁  

说明

Fate of sample:

Destruction after use  

Note:

征募研究对象情况:

Recruiting status:

尚未开始

Not yet recruiting

年龄范围:

Participant age:

最小 Min age 18 years
最大 Max age 75 years

性别:

男女均可

Gender:

Both

随机方法(请说明由何人用什么方法产生随机序列):

非随机

Randomization Procedure (please state who generates the random number sequence and by what method):

non-random

是否公开试验完成后的统计结果:

Calculated Results after the Study Completed public access:

公开/Public

盲法:

Blinding:

试验完成后的统计结果(上传文件):

Calculated Results after
the Study Completed(upload file):

是否共享原始数据:

IPD sharing

Yes

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):

临床试验公共管理平台ResMan(www.medresman.org)或邮件

The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url):

ResMan(www.medresman.org)/Email

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:

纸质病历记录表、电子数据采集和管理系统

Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture:

Case Record Form,Electronic Data(EDC)

数据与安全监察委员会:

Data and Safety Monitoring Committee:

无/No

注册人:

Name of Registration:

 2020-11-18 00:13:06