Bladder Cancer Clinical Trial
Testing the Addition of the Anti-cancer Drug, Cabozantinib, to the Usual Immunotherapy Treatment, Avelumab, in Patients With Metastatic Urothelial Cancer, MAIN-CAV Study
Summary
This phase III trial compares the effect of adding cabozantinib to avelumab versus avelumab alone in treating patients with urothelial cancer that has spread to other places in the body (metastatic). Cabozantinib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Immunotherapy with monoclonal antibodies, such as avelumab, may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. Giving cabozantinib and avelumab together may further shrink the cancer or prevent it from returning/progressing.
Full Description
PRIMARY OBJECTIVE:
I. To evaluate the effect of cabozantinib S-malate (cabozantinib) in combination with avelumab on overall survival (OS) compared to avelumab alone in patients with metastatic urothelial cancer (mUC) who did not progress during first-line platinum-based chemotherapy therapy, i.e. patients who had complete response (CR), partial response (PR) or stable disease (SD) after completion of first line platinum-based chemotherapy.
SECONDARY OBJECTIVES:
I. To evaluate the effect of cabozantinib in combination with avelumab on progression-free survival (PFS) compared to avelumab alone for maintenance treatment following initial first-line treatment in patients who had a CR, PR or SD upon completion of first-line platinum-based chemotherapy.
II. To evaluate the safety and tolerability of cabozantinib in combination with avelumab in mUC compared to avelumab alone for maintenance treatment following initial first-line treatment in patients who had a CR, PR or SD upon completion of first-line platinum-based chemotherapy.
III. To evaluate activity of cabozantinib in combination with avelumab based on Response Evaluation Criteria in Solid Tumors (RECIST) compared to avelumab alone for maintenance treatment following initial first-line treatment in patients who had a CR, PR or SD upon completion of first-line platinum-based chemotherapy.
IV. Results of the primary analysis will be examined for consistency, while accounting for the stratification factors and/or covariates of baseline quality of life (QOL) and fatigue.
V. To evaluate the activity of cabozantinib in combination with avelumab compared to avelumab alone based on PD-L1 status of patients' tumors.
QUALITY OF LIFE (QOL) OBJECTIVES:
I. To compare quality-adjusted survival between patients randomized to receive cabozantinib and avelumab versus (vs.) avelumab alone using the European Quality of Life Five Dimension Five Level Scale Questionnaire (EQ-5D-5L).
II. To compare patient-reported fatigue as assessed by the Patient Reported Outcomes Measurement Information System (PROMIS)-Fatigue 4a from baseline through 12 months between patients randomized to receive cabozantinib and avelumab vs. avelumab alone.
III. To compare patient-reported global health status/quality of life as assessed by the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ)-Core (C)30 from baseline through 12 months between patients randomized to receive cabozantinib and avelumab vs. avelumab alone.
IV. To compare scale scores of the EORTC QLQ-Bladder Cancer Muscle-Invasive (BLM)30 (urinary symptoms, urostomy problems, catheter problems, future perspectives, abdominal bloating and flatulence, body image, sexual function) at 3, 6, 12, 18, and 24 months between patients randomized to receive cabozantinib and avelumab vs. avelumab alone.
V. To compare scale scores of the EORTC QLQ-C30 (global health status/quality of life; physical, role, emotional, cognitive, and social function; symptoms) at 3, 6, 12, 18, and 24 months between patients randomized to receive cabozantinib and avelumab vs. avelumab alone.
OUTLINE: Patients are randomized to 1 of 2 arms.
ARM A: Patients receive avelumab intravenously (IV) over 60 minutes on days 1 and 15 of each cycle. Cycles repeat every 28 days for 24 months in the absence of disease progression or unacceptable toxicity. Patients also undergo bone scan at screening and undergo computed tomography (CT) or magnetic resonance imaging (MRI) and biospecimen collection throughout the trial.
ARM B: Patients receive avelumab IV over 60 minutes on days 1 and 15 of each cycle and cabozantinib orally (PO) daily on days 1-28 of each cycle. Cycles repeat every 28 days for 24 months in the absence of disease progression or unacceptable toxicity. Patients also undergo bone scan at screening and undergo CT or MRI and biospecimen collection throughout the trial.
After completion of study treatment, patients are followed every 30 days through 90 days, then every 3 months for 5 years.
Eligibility Criteria
Inclusion Criteria:
Histologically or cytologically-confirmed diagnosis of advanced or metastatic urothelial cancer of the renal pelvis, ureter, bladder, or urethra (transitional cell and mixed transitional/non-transitional cell histologies except for small-cell histology), including N3 only disease prior to start of first-line platinum-based chemotherapy
Prior first-line treatment must have consisted of 4-6 cycles of 1st-line therapy (platinum-based chemotherapy; gemcitabine-cisplatin, gemcitabine-carboplatin, methotrexate, vinblastine, doxorubicin and cisplatin [MVAC] or dose-dense [dd]MVAC)
No more than 1 line of prior chemotherapy for metastatic or locally advanced disease (neoadjuvant or adjuvant chemotherapy will be allowed if given 12 or more months prior to registration)
Tumor objective response of CR, PR, or SD upon completion of first line platinum-based chemotherapy by treating physician's assessment
The last dose of first-line chemotherapy must have been received no less than 3 weeks, and no more than 10 weeks, prior to randomization in the present study
No prior immunotherapy with IL-2, IFN-alpha, or an anti-PD-1, anti-PD-L1, anti-PD-L2, anti-CD137, or CTLA-4 antibody (including ipilimumab), or any other antibody or drug specifically targeting T-cell co-stimulation or immune checkpoint pathways
Age >= 18 years
Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
Not pregnant and not nursing, because this study involves an agent that has known genotoxic, mutagenic and teratogenic effects
Women of childbearing potential must have a negative pregnancy test =< 14 days prior to registration.
Women of childbearing potential include women who have experienced menarche and who have not undergone successful surgical sterilization (hysterectomy, bilateral tubal ligation, or bilateral oophorectomy) or are not postmenopausal. Post menopause is defined as amenorrhea >= 12 consecutive months. Note: women who have been amenorrheic for 12 or more months are still considered to be of childbearing potential if the amenorrhea is possibly due to prior chemotherapy, antiestrogens, ovarian suppression or any other reversible reason
No use of immunosuppressive medication within 7 days prior to randomization except:
Intranasal, inhaled, topical steroids, or local steroid injections (e.g., intra-articular injection);
Systemic corticosteroids at physiologic doses =< 10 mg/day of prednisone or equivalent;
Steroids as premedication for hypersensitivity reactions (e.g., computed tomography [CT] scan premedication)
Human immunodeficiency virus (HIV)-infected patients on effective anti-retroviral therapy with undetectable viral load within 6 months are eligible for this trial
Patients with diabetes type I, vitiligo, psoriasis, or hypo or hyperthyroid disease not requiring immunosuppressive treatment are eligible
None of the following:
Active autoimmune disease that might deteriorate when receiving the anti PD-L1 agent, avelumab.
No known symptomatic central nervous system (CNS) metastases. Patients with previously diagnosed CNS metastases are eligible if they have completed their treatment and have recovered from the acute effects of radiation therapy or surgery prior to randomization, have discontinued corticosteroid treatment for at least 2 weeks, and are neurologically stable. Baseline brain imaging with contrast-enhanced CT or MRI scans for subjects with known brain metastases is required to confirm eligibility.
No major surgery within 4 weeks prior to randomization. Subjects must have complete wound healing from surgery before randomization. Subjects with clinically relevant ongoing complications from prior surgery are not eligible.
No palliative radiotherapy within 48 hours prior to patient randomization.
No hemoptysis of ≥ 0.5 teaspoon (2.5 mL) of red blood, clinically significant hematuria, hematemesis, coagulopathy, or other history of significant bleeding (eg. Pulmonary hemorrhage) within 3 months before randomization.
No known cavitating pulmonary lesion(s) or known endobronchial disease manifestation.
No administration of a live, attenuated vaccine within 30 days prior to randomization. The use of inactivated (killed) vaccines for the prevention of infectious disease is permitted. The use of COVID-19 vaccines is permitted.
No uncontrolled, significant intercurrent or recent illness including, but not limited to, the following conditions:
Cardiovascular disorders including:
Congestive heart failure (CHF): New York Heart Association (NYHA) class III (moderate) or class IV (severe) at the time of screening.
Concurrent uncontrolled hypertension defined as sustained blood pressure (BP) > 150 mm Hg systolic, or > 90 mm Hg diastolic despite optimal antihypertensive treatment.
The patient has a known history of corrected QT interval calculated by the Fridericia formula (QTcF) > 500 ms and confirmed by electrocardiogram (ECG) within 28 days before randomization. Note: if initial QTcF is found to be > 500 ms, two additional electrocardiograms (EKGs) separated by at least 3 minutes should be performed. If the average of these three consecutive results for QTcF is ≤ 500 ms, the subject meets eligibility in this regard.
Any history of congenital long QT syndrome.
Stroke, transient ischemic attack (TIA), myocardial infarction, or other symptomatic ischemic event or thromboembolic event (eg, deep venous thrombosis, pulmonary embolism [DVT/PE]) within 6 months before randomization. Subjects with a diagnosis of incidental, subsegmental PE or DVT within 6 months are allowed if asymptomatic and stable at screening and treated with low molecular weight heparin (LMWH) or the direct factor Xa inhibitors rivaroxaban, edoxaban, or apixaban for at least 1 week before randomization. Non-symptomatic white matter disease in the brain is acceptable.
No significant gastrointestinal disorders, particularly those associated with a high risk of perforation or fistula formation including unresolved active peptic ulcer disease, cholecystitis, diverticultis, symptomatic cholangitis or appendicitis, or malabsorption syndrome within 28 days of randomization.
No other clinically significant disorders such as:
Any active infection requiring systemic treatment within 14 days before randomization. Subjects receiving oral (including prophylactic) antibiotics with no symptoms of infection at randomization are eligible.
Serious non-healing wound/ulcer/bone fracture within 28 days before randomization
History of organ or allogeneic stem cell transplant
No persisting toxicity related to prior therapy grade > 2 constituting a safety risk based on the investigator's judgment.
No diagnosis of any other malignancy within 3 years prior to randomization, except for locally curable cancers that have been adequately treated such as basal cell or squamous cell skin cancer, or carcinoma in situ of the breast or of the cervix, Gleason < 7 prostate cancer on surveillance without any plans for treatment intervention (eg, surgery, radiation, or castration), or prostate cancer that has been adequately treated with prostatectomy or radiotherapy and currently with no evidence of disease or symptoms and no indication for treatment.
No concomitant anticoagulation with coumarin agents (e.g., warfarin), direct thrombin inhibitors (e.g., dabigatran), direct factor Xa inhibitor betrixaban, or platelet inhibitors (e.g., clopidogrel).
Allowed anticoagulants are the following:
Prophylactic use of low-dose aspirin for cardio-protection (per local applicable guidelines) and low-dose low molecular weight heparins (LMWH).Therapeutic doses of LMWH or anticoagulation with direct factor Xa inhibitors rivaroxaban, edoxaban, or apixaban in subjects without known brain metastases who are on a stable dose of the anticoagulant for at least 1 week before first dose of study treatment without clinically significant hemorrhagic complications from the anticoagulation regimen or the tumor
Absolute neutrophil count (ANC) >= 1,000/mm^3
Platelet count >= 100,000/mm^3
Hemoglobin >= 8 g/dL
Calculated (Calc.) creatinine clearance >= 30 mL/min using the Cockcroft-Gault equation
Total serum bilirubin =< 1.5 x upper limit of normal (ULN)
Aspartate aminotransferase (AST)/alanine aminotransferase (ALT) =< 2.5 x ULN (or =< 5 x ULN for patients with liver metastases or Gilbert's disease)
Urine protein creatinine (UPC) ratio =< 1 or 24-hour protein < 1 g
Physicians should consider whether any of the following may render the patient inappropriate for this protocol:
Psychiatric illness which would prevent the patient from giving informed consent.
Uncontrolled medical conditions which, in the opinion of the treating physician, would make this protocol unreasonably hazardous for the patient.
Patients who cannot swallow oral formulations of the agent(s).
In addition:
Women and men of reproductive potential should agree to use an appropriate method of birth control throughout their participation in this study due to the teratogenic potential of the therapy utilized in this trial. Include as applicable: Appropriate methods of birth control include abstinence, oral contraceptives, implantable hormonal contraceptives or double barrier method (diaphragm plus condom).
Patients with rheumatoid arthritis and other rheumatologic arthropathies, Sjogren's syndrome and psoriasis controlled with topical medication and or steroids equivalent to < 10 mg prednisone daily, not on immunosuppressive medications and patients with positive serology are eligible. Patients with vitiligo, endocrine deficiencies including hypo or hyper thyroid disease managed with replacement, diabetes type 1 are eligible.
Sexually active subjects (men and women) must agree to use medically accepted barrier methods of contraception (e.g., male or female condom) during the study and continue for 4 months after the last dose of study drugs, even if oral contraceptives are also used.
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There are 239 Locations for this study
Phoenix Arizona, 85054, United States More Info
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Auburn California, 95602, United States More Info
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Berkeley California, 94704, United States More Info
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Fremont California, 94538, United States More Info
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Modesto California, 95355, United States More Info
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Mountain View California, 94040, United States More Info
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Palo Alto California, 94301, United States More Info
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Roseville California, 95661, United States More Info
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Sacramento California, 95816, United States More Info
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Sacramento California, 95817, United States More Info
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San Francisco California, 94115, United States More Info
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Santa Cruz California, 95065, United States More Info
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Sunnyvale California, 94086, United States More Info
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Vallejo California, 94589, United States More Info
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Frankford Delaware, 19945, United States More Info
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Newark Delaware, 19713, United States More Info
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Newark Delaware, 19713, United States More Info
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Rehoboth Beach Delaware, 19971, United States More Info
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Washington District of Columbia, 20010, United States More Info
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Gainesville Florida, 32610, United States More Info
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Jacksonville Florida, 32224, United States More Info
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Weston Florida, 33331, United States More Info
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Aurora Illinois, 60504, United States More Info
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Barrington Illinois, 60010, United States More Info
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Bloomington Illinois, 61704, United States More Info
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Canton Illinois, 61520, United States More Info
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Carthage Illinois, 62321, United States More Info
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Centralia Illinois, 62801, United States More Info
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Chicago Illinois, 60611, United States More Info
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Chicago Illinois, 60612, United States More Info
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Chicago Illinois, 60612, United States More Info
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Chicago Illinois, 60657, United States More Info
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Crystal Lake Illinois, 60014, United States More Info
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Danville Illinois, 61832, United States More Info
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Decatur Illinois, 62526, United States More Info
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DeKalb Illinois, 60115, United States More Info
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Dixon Illinois, 61021, United States More Info
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Downers Grove Illinois, 60515, United States More Info
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Effingham Illinois, 62401, United States More Info
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Effingham Illinois, 62401, United States More Info
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Elgin Illinois, 60123, United States More Info
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Eureka Illinois, 61530, United States More Info
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Galesburg Illinois, 61401, United States More Info
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Geneva Illinois, 60134, United States More Info
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Hazel Crest Illinois, 60429, United States More Info
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Kewanee Illinois, 61443, United States More Info
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Lake Forest Illinois, 60045, United States More Info
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Libertyville Illinois, 60048, United States More Info
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Libertyville Illinois, 60048, United States More Info
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Macomb Illinois, 61455, United States More Info
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Mattoon Illinois, 61938, United States More Info
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O'Fallon Illinois, 62269, United States More Info
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Oak Lawn Illinois, 60453, United States More Info
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Ottawa Illinois, 61350, United States More Info
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Park Ridge Illinois, 60068, United States More Info
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Pekin Illinois, 61554, United States More Info
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Peoria Illinois, 61615, United States More Info
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Peru Illinois, 61354, United States More Info
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Princeton Illinois, 61356, United States More Info
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Springfield Illinois, 62702, United States More Info
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Springfield Illinois, 62702, United States More Info
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Springfield Illinois, 62781, United States More Info
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Urbana Illinois, 61801, United States More Info
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Warrenville Illinois, 60555, United States More Info
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Washington Illinois, 61571, United States More Info
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Yorkville Illinois, 60560, United States More Info
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Crown Point Indiana, 46307, United States More Info
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Dyer Indiana, 46311, United States More Info
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Hobart Indiana, 46342, United States More Info
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Hobart Indiana, 46342, United States More Info
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Indianapolis Indiana, 46312, United States More Info
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Munster Indiana, 46321, United States More Info
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Munster Indiana, 46321, United States More Info
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Valparaiso Indiana, 46383, United States More Info
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Ames Iowa, 50010, United States More Info
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Ames Iowa, 50010, United States More Info
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Boone Iowa, 50036, United States More Info
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Fort Dodge Iowa, 50501, United States More Info
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Jefferson Iowa, 50129, United States More Info
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Marshalltown Iowa, 50158, United States More Info
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Louisville Kentucky, 40207, United States More Info
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Augusta Maine, 04330, United States More Info
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Bethesda Maryland, 20892, United States More Info
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Worcester Massachusetts, 01655, United States More Info
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Ann Arbor Michigan, 48106, United States More Info
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Battle Creek Michigan, 49017, United States More Info
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Brighton Michigan, 48114, United States More Info
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Brighton Michigan, 48114, United States More Info
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Canton Michigan, 48188, United States More Info
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Canton Michigan, 48188, United States More Info
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Chelsea Michigan, 48118, United States More Info
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Chelsea Michigan, 48118, United States More Info
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Clarkston Michigan, 48346, United States More Info
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Clarkston Michigan, 48346, United States More Info
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Flint Michigan, 48503, United States More Info
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Flint Michigan, 48503, United States More Info
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Flint Michigan, 48503, United States More Info
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Flint Michigan, 48503, United States More Info
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Grand Rapids Michigan, 49503, United States More Info
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Grand Rapids Michigan, 49503, United States More Info
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Kalamazoo Michigan, 49007, United States More Info
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Kalamazoo Michigan, 49007, United States More Info
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Kalamazoo Michigan, 49009, United States More Info
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Lansing Michigan, 48912, United States More Info
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Livonia Michigan, 48154, United States More Info
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Macomb Michigan, 48044, United States More Info
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Muskegon Michigan, 49444, United States More Info
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Norton Shores Michigan, 49444, United States More Info
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Pontiac Michigan, 48341, United States More Info
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Pontiac Michigan, 48341, United States More Info
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Pontiac Michigan, 48341, United States More Info
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Pontiac Michigan, 48341, United States More Info
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Reed City Michigan, 49677, United States More Info
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Saint Joseph Michigan, 49085, United States More Info
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Traverse City Michigan, 49684, United States More Info
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Wyoming Michigan, 49519, United States More Info
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Ypsilanti Michigan, 48106, United States More Info
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Ypsilanti Michigan, 48197, United States More Info
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Bemidji Minnesota, 56601, United States More Info
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Minneapolis Minnesota, 55407, United States More Info
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Rochester Minnesota, 55905, United States More Info
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Saint Cloud Minnesota, 56303, United States More Info
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Saint Louis Park Minnesota, 55416, United States More Info
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Saint Paul Minnesota, 55101, United States More Info
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Willmar Minnesota, 56201, United States More Info
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Cape Girardeau Missouri, 63703, United States More Info
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Columbia Missouri, 65212, United States More Info
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Creve Coeur Missouri, 63141, United States More Info
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Kansas City Missouri, 64111, United States More Info
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Lee's Summit Missouri, 64086, United States More Info
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Saint Louis Missouri, 63110, United States More Info
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Saint Louis Missouri, 63129, United States More Info
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Saint Louis Missouri, 63136, United States More Info
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Saint Peters Missouri, 63376, United States More Info
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Henderson Nevada, 89052, United States More Info
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Las Vegas Nevada, 89102, United States More Info
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Las Vegas Nevada, 89148, United States More Info
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Concord New Hampshire, 03301, United States More Info
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Manchester New Hampshire, 03103, United States More Info
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Basking Ridge New Jersey, 07920, United States More Info
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Hackensack New Jersey, 07601, United States More Info
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Middletown New Jersey, 07748, United States More Info
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Montvale New Jersey, 07645, United States More Info
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Morristown New Jersey, 07960, United States More Info
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Paterson New Jersey, 07503, United States More Info
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Summit New Jersey, 07902, United States More Info
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Albuquerque New Mexico, 87102, United States More Info
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Las Cruces New Mexico, 88011, United States More Info
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Commack New York, 11725, United States More Info
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Elmira New York, 14905, United States More Info
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Glens Falls New York, 12801, United States
Harrison New York, 10604, United States More Info
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New York New York, 10065, United States More Info
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Oswego New York, 13126, United States More Info
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Stony Brook New York, 11794, United States More Info
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Syracuse New York, 13210, United States More Info
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Syracuse New York, 13215, United States More Info
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Uniondale New York, 11553, United States More Info
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Verona New York, 13478, United States More Info
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Charlotte North Carolina, 28203, United States More Info
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Charlotte North Carolina, 28262, United States More Info
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Charlotte North Carolina, 28277, United States More Info
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Clinton North Carolina, 28328, United States More Info
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Concord North Carolina, 28025, United States More Info
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Goldsboro North Carolina, 27534, United States More Info
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Jacksonville North Carolina, 28546, United States More Info
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Lincolnton North Carolina, 28092, United States More Info
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Shelby North Carolina, 28150, United States More Info
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Winston-Salem North Carolina, 27157, United States More Info
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Bismarck North Dakota, 58501, United States More Info
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Fargo North Dakota, 58122, United States More Info
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Fargo North Dakota, 58122, United States More Info
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Akron Ohio, 44307, United States More Info
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Centerville Ohio, 45459, United States More Info
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Cleveland Ohio, 44111, United States More Info
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Cleveland Ohio, 44195, United States More Info
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Dayton Ohio, 45409, United States More Info
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Dayton Ohio, 45415, United States More Info
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Dayton Ohio, 45415, United States More Info
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Franklin Ohio, 45005, United States More Info
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Greenville Ohio, 45331, United States More Info
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Kettering Ohio, 45429, United States More Info
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Mansfield Ohio, 44906, United States More Info
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Mayfield Heights Ohio, 44124, United States More Info
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Sandusky Ohio, 44870, United States More Info
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Strongsville Ohio, 44136, United States More Info
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Toledo Ohio, 43623, United States More Info
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Troy Ohio, 45373, United States More Info
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Warrensville Heights Ohio, 44122, United States More Info
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Wooster Ohio, 44691, United States More Info
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Oklahoma City Oklahoma, 73104, United States More Info
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Tulsa Oklahoma, 74146, United States More Info
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Gresham Oregon, 97030, United States More Info
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Portland Oregon, 97210, United States More Info
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Tualatin Oregon, 97062, United States More Info
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Allentown Pennsylvania, 18103, United States More Info
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Bethlehem Pennsylvania, 18017, United States More Info
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Harrisburg Pennsylvania, 17111, United States More Info
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Hershey Pennsylvania, 17033, United States More Info
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Philadelphia Pennsylvania, 19107, United States More Info
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Philadelphia Pennsylvania, 19148, United States More Info
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Boiling Springs South Carolina, 29316, United States More Info
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Charleston South Carolina, 29425, United States More Info
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Easley South Carolina, 29640, United States More Info
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Greenville South Carolina, 29605, United States More Info
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Greenville South Carolina, 29605, United States More Info
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Greenville South Carolina, 29605, United States More Info
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Greenville South Carolina, 29615, United States More Info
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Greer South Carolina, 29650, United States More Info
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Rock Hill South Carolina, 29732, United States More Info
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Seneca South Carolina, 29672, United States More Info
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Aberdeen South Dakota, 57401, United States More Info
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Sioux Falls South Dakota, 57104, United States More Info
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Sioux Falls South Dakota, 57105, United States More Info
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Sioux Falls South Dakota, 57117, United States More Info
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Yankton South Dakota, 57078, United States More Info
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Alcoa Tennessee, 37701, United States More Info
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Knoxville Tennessee, 37920, United States More Info
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Dallas Texas, 75237, United States More Info
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Dallas Texas, 75390, United States More Info
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Fort Worth Texas, 76104, United States More Info
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Richardson Texas, 75080, United States More Info
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Mechanicsville Virginia, 23116, United States More Info
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Midlothian Virginia, 23114, United States More Info
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Richmond Virginia, 23226, United States More Info
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Richmond Virginia, 23229, United States More Info
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Richmond Virginia, 23235, United States More Info
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Richmond Virginia, 23298, United States More Info
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South Hill Virginia, 23970, United States More Info
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Winchester Virginia, 22601, United States More Info
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Renton Washington, 98055, United States More Info
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Vancouver Washington, 98684, United States More Info
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Vancouver Washington, 98686, United States More Info
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Charleston West Virginia, 25304, United States More Info
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Burlington Wisconsin, 53105, United States More Info
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Eau Claire Wisconsin, 54701, United States More Info
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Germantown Wisconsin, 53022, United States More Info
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Grafton Wisconsin, 53024, United States More Info
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Green Bay Wisconsin, 54311, United States More Info
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Kenosha Wisconsin, 53142, United States More Info
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Marinette Wisconsin, 54143, United States More Info
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Marshfield Wisconsin, 54449, United States More Info
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Menomonee Falls Wisconsin, 53051, United States More Info
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Milwaukee Wisconsin, 53209, United States More Info
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Milwaukee Wisconsin, 53215, United States More Info
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Milwaukee Wisconsin, 53226, United States
Milwaukee Wisconsin, 53233, United States More Info
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Minocqua Wisconsin, 54548, United States More Info
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Mukwonago Wisconsin, 53149, United States More Info
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New Richmond Wisconsin, 54017, United States More Info
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Oak Creek Wisconsin, 53154, United States More Info
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Oconomowoc Wisconsin, 53066, United States More Info
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Oshkosh Wisconsin, 54904, United States More Info
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Racine Wisconsin, 53406, United States More Info
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Rice Lake Wisconsin, 54868, United States More Info
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Sheboygan Wisconsin, 53081, United States More Info
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Stevens Point Wisconsin, 54482, United States More Info
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Summit Wisconsin, 53066, United States More Info
Principal Investigator
Two Rivers Wisconsin, 54241, United States More Info
Principal Investigator
Waukesha Wisconsin, 53188, United States More Info
Principal Investigator
Waukesha Wisconsin, 53188, United States More Info
Principal Investigator
Wauwatosa Wisconsin, 53226, United States More Info
Principal Investigator
West Allis Wisconsin, 53227, United States More Info
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West Bend Wisconsin, 53095, United States More Info
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Weston Wisconsin, 54476, United States More Info
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Edmonton Alberta, T6G 1, Canada More Info
Principal Investigator
Toronto Ontario, M5G 2, Canada More Info
Principal Investigator
Saskatoon Saskatchewan, S7N 4, Canada More Info
Principal Investigator
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