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CompletedNCT02129075Updated Nov 16, 2021Results posted

A Vaccine (CDX-1401) With or Without a Biologic Drug (CDX-301) for the Treatment of Patients With Stage IIB-IV Melanoma

A Phase 2 interventional study of DEC-205/NY-ESO-1 Fusion Protein CDX-1401 and Poly ICLC in Cutaneous Melanoma, Melanoma and Melanoma of Unknown Primary, sponsored by National Cancer Institute (NCI). Completed at 7 sites in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2021-11-16.

Sponsored by National Cancer Institute (NCI) · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
60
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

This phase II trial studies the effect of a vaccine called CDX-1401 given with or without a biologic drug called CDX-301 in treating patients with stage IIB-IV melanoma. The cancer vaccine CDX-1401 attaches to a protein that is made in tumor cells. The vaccine helps the body recognize the tumor to fight the cancer. The biologic drug CDX-301 may help the body make more of the tumor fighting cells, known as dendritic cells. Another biologic drug, poly-ICLC, may stimulate the immune system and help these dendritic cells mature so that they can recognize the tumor. Giving CDX-301 may make the immune response to a combination of CDX-1401 and poly-ICLC better.

Read the detailed description

PRIMARY OBJECTIVE:

I. To determine whether the immune response to NY-ESO-1 elicited by vaccination with DEC-205/NY-ESO-1 fusion protein CDX-1401 (CDX-1401) plus polyinosinic-polycytidylic acid stabilized with poly-L-lysine and carboxymethylcellulose (poly-ICLC) is substantially increased by prior expansion in the number of circulating dendritic cells (DC) by therapy with recombinant Flt3 ligand (CDX-301) (fms-related tyrosine kinase 3 ligand [Flt3L]).

SECONDARY OBJECTIVES:

I. To assess the effect of the vaccine regimen on immune responses to other ongoing and nascent antitumor response antigens associated with melanoma (e.g., PRAME, MAGE-A3, p53, and gp100) as well as memory viral responses (influenza A) and chronic viral responses (cytomegalovirus [CMV], Epstein-Barr virus [EBV]).

II. To assess the effect of the vaccine regimen on the frequency and phenotypic character of peripheral blood mononuclear cell (PBMC) subsets including DCs, monocyte populations, T cells, and natural killer (NK) cells.

III. To assess the safety, tolerability, and clinical efficacy of the vaccine regimens.

OUTLINE: Patients are randomized to 1 of 2 treatment arms.

ARM I: Patients receive recombinant Flt3 ligand (CDX-301) subcutaneously (SC) on days -7 to -1, 1-3, and 22-28 of cycle 1 and only on days 1-3 of cycle 2. Patients also receive CDX-1401 SC or intradermally (ID) on day 1 of each cycle and poly-ICLC SC on days 1-2 of each cycle. Treatment repeats every 28 days for 4 cycles in the absence of disease progression or unacceptable toxicity.

ARM II: Patients receive CDX-1401 and poly-ICLC as in Arm I. Treatment repeats every 28 days for 4 cycles in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed up at 4 and 12 weeks and then annually thereafter.

02

Conditions studied

  • Cutaneous Melanoma
  • Melanoma
  • Melanoma of Unknown Primary
  • Mucosal Melanoma
  • Ocular Melanoma
  • Stage IIB Cutaneous Melanoma AJCC v6 and v7
  • Stage IIC Cutaneous Melanoma AJCC v6 and v7
  • Stage III Cutaneous Melanoma AJCC v7
  • Stage IIIA Cutaneous Melanoma AJCC v7
  • Stage IIIB Cutaneous Melanoma AJCC v7
  • Stage IIIC Cutaneous Melanoma AJCC v7
  • Stage IV Cutaneous Melanoma AJCC v6 and v7
03

In context

Melanoma

3,006 studies on the registry are indexed under Melanoma; 520 are open to participants now.

This study's enrollment of 60 is above the median of 38 across 2,351 interventional studies indexed under Melanoma.

Browse Melanoma studies →

Lead sponsor

National Cancer Institute (NCI) is the lead sponsor of 3,506 studies on the registry; 334 are open to participants now.

Of its 402 completed or terminated interventional studies of FDA-regulated products, 365 (91%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Patients with fully resected stage IIb through IV melanoma, with melanoma validated by histology or cytology, who have NOT received prior therapy.

    • Patients may have had primary cutaneous, mucosal, or ocular melanoma or metastasis from an unknown primary site.
    • Tissue should be submitted for evaluation of NY-ESO-1 expression and T-cell infiltrates. However, availability of tissue and/or positivity for NY-ESO-1 is not mandatory.
  • Prior radiation, chemotherapy or biologics NOT allowed
  • Not currently receiving any anticancer therapy
  • Age >= 18 years

    • Because no dosing or adverse event (AE) data are currently available on the use of CDX-1401 or CDX-301 in patients \< 18 years of age, children are excluded from this study, but will be eligible for future pediatric trials.
  • Eastern Cooperative Oncology Group (ECOG) performance score of 0-1
  • Life expectancy of at least 6 months
  • Leukocytes >= 3,000/mcL
  • Absolute neutrophil count >= 1,000/mcL
  • Platelets >= 75,000/mcL
  • Hemoglobin > 9 g/dL
  • Total bilirubin \< 1.5 x institutional upper limit of normal (bilirubin \< 3 x institutional upper limit of normal for Gilbert's syndrome)
  • Aspartate aminotransferase (AST)(serum glutamic-oxaloacetic transaminase [SGOT])/alanine aminotransferase (ALT)(serum glutamate pyruvate transaminase [SGPT]) =\< 2.5 x institutional upper limit of normal
  • Creatinine \< 1.5 x institutional upper limit of normal OR creatinine clearance >= 60 mL/min/1.73 m\^2 for patients with creatinine levels above institutional normal
  • The first six patients enrolled in the Flt3L arm of the study cannot be human immunodeficiency virus (HIV)-positive. After the evaluation of safety in the first 6 patients, HIV-positive patients with adequate immune function as evidenced by stable CD4 counts >= 350/mm\^3 are allowed to participate if the following criteria are met:

    • maintained on stable antiretroviral therapy with no significant drug interactions, and
    • no recent history of acquired immunodeficiency syndrome (AIDS) indicator conditions (> 2 years from enrolling in trial), and
    • physician providing patient's care for HIV must also approve of patient entering the study
  • Females of childbearing potential must have a negative pregnancy test within 7 days before the initiation of protocol therapy.

    • The effects of CDX-1401 or CDX-301 on the developing human fetus are unknown. For this reason, women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control or abstinence) before study entry and for the duration of study participation. Should a woman become pregnant or suspect she is pregnant while she or her partner is participating in this study, she should inform her treating physician immediately. Men treated or enrolled on this protocol must also agree to use adequate contraception before the study, for the duration of study participation, and 4 months after completion of CDX-1401 or CDX-301 administration.
    • NOTE: Subjects are considered not of child-bearing potential if they are surgically sterile, they have undergone a hysterectomy, bilateral tubal ligation, or bilateral oophorectomy, or they are postmenopausal. Menopause is the age associated with complete cessation of menstrual cycles, menses, and implies the loss of reproductive potential. By a practical definition, it assumes menopause after 1 year without menses with an appropriate clinical profile at the appropriate age.
  • Ability to understand and the willingness to sign a written informed consent document

Exclusion criteria

Exclusion Criteria:

  • Patients who have had cytotoxic chemotherapy, radiotherapy, interferon (IFN), or ipilimumab before entering the study
  • Immunosuppressive therapy within 30 days prior to initiation of protocol therapy
  • Steroid therapy, or steroid therapy with more than 7 consecutive days of steroids within the prior 4 weeks

    • The use of prednisone or equivalent \< 0.125 mg/kg/day (absolute maximum of 10 mg/day) as replacement therapy is permitted
    • Inhaled or topical corticosteroids are permitted
  • Patients who are receiving any other investigational agents
  • Current or history of systemic autoimmune disease requiring systemic therapy.

    • NOTE: The following will not be exclusionary:

      • The presence of laboratory evidence of autoimmune disease (e.g., positive antinuclear antibody [ANA] titer) without associated symptoms
      • Clinical evidence of vitiligo
      • Other forms of depigmenting illness
  • Cardiovascular disease that meets one of the following: congestive heart failure (New York Heart Association Class III or IV), active angina pectoris, or recent myocardial infarction (within the last 6 months)
  • Cirrhosis or chronic hepatitis C virus positivity or chronic hepatitis B infection

    • NOTE: A positive hepatitis B serology indicative of previous immunization (i.e., hepatitis B virus surface antibody [HBsAb]-positive and hepatitis B virus core antibody [HBcAb]-negative), or a fully resolved acute hepatitis B virus infection is not an exclusion criterion
  • Known history of immunodeficiency disorder other than HIV-positive status
  • Extensive active brain disease including symptomatic brain metastases or presence of leptomeningeal disease

    • NOTE: Patients with brain metastasis, after definitive therapy with surgery or stereotactic radiation and stable off steroids for >= 4 weeks, are eligible
  • Other invasive cancers that are clinically active
  • Pregnancy or nursing or unwilling to take adequate birth control during therapy

    • NOTE: Pregnant women are excluded from this study because CDX-1401 or CDX-301 and poly-ICLC have an unknown potential for teratogenic or abortifacient effects. Because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with CDX-1401 or CDX-301, breastfeeding should be discontinued if the mother is treated with CDX-1401 or CDX-301 and poly-ICLC
  • History of allergic reactions attributed to compounds of similar chemical or biologic composition to CDX-1401 or CDX-301 or poly-ICLC
  • Prior organ allograft or allogeneic transplantation, if the transplanted tissue is still in place
  • Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements
  • Medical or psychiatric illness that would, in the opinion of the investigator, preclude participation in the study or the ability of patients to provide informed consent for themselves
  • History of pulmonary disease such as emphysema or chronic obstructive pulmonary disease (COPD) (forced expiratory volume in 1 second [FEV1] \< 60% of predicted for height and age). Pulmonary function tests (PFTs) are required in patients with prolonged smoking history or symptoms of respiratory dysfunction
  • Vaccinations other than those given as part of this research study (with the exception of influenza vaccine) are prohibited throughout the duration of study participation.

    • NOTE: Influenza vaccination (inactivated) is permitted during the flu season. The preferred time is 7 to 14 days after CDX-1401 administration
05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
60 participants (actual)

Study arms

  • Experimental
    Arm I (CDX-301, CDX-1401, poly-ICLC)

    Patients receive recombinant Flt3 ligand (CDX-301) SC on days -7 to -1, 1-3, and 22-28 of cycle 1 and only on days 1-3 of cycle 2. Patients also receive CDX-1401 SC or ID on day 1 of each cycle and poly-ICLC SC on days 1-2 of each cycle. Treatment repeats every 28 days for 4 cycles in the absence of disease progression or unacceptable toxicity.

    Biological: DEC-205/NY-ESO-1 Fusion Protein CDX-1401 · Drug: Poly ICLC · Biological: Recombinant Flt3 Ligand

  • Active comparator
    Arm II (CDX-1401, poly-ICLC)

    Patients receive CDX-1401 and poly-ICLC as in Arm I. Treatment repeats every 28 days for 4 cycles in the absence of disease progression or unacceptable toxicity.

    Biological: DEC-205/NY-ESO-1 Fusion Protein CDX-1401 · Drug: Poly ICLC

Interventions

  • BiologicalDEC-205/NY-ESO-1 Fusion Protein CDX-1401

    Given SC or ID

    Also known as: CDX-1401

  • DrugPoly ICLC

    Given SC

    Also known as: Hiltonol, Poly I:Poly C with Poly-L-Lysine Stabilizer, poly-ICLC, PolyI:PolyC with Poly-L-Lysine Stabilizer, Polyinosinic-Polycytidylic Acid Stabilized with Polylysine and Carboxymethylcellulose, Polyriboinosinic-Polyribocytidylic Acid-Polylysine Carboxymethylcellulose, Stabilized Polyriboinosinic/Polyribocytidylic Acid

  • BiologicalRecombinant Flt3 Ligand

    Given SC

    Also known as: CDX-301, FLT 3 Ligand, FLT3 Ligand, Flt3-Ligand, Flt3L, Mobist, Mobista, rhuFlt3L

06

What researchers measure

Primary outcomes

  1. Immune T-cell Response to NY-ESO-1

    Response rates will be analyzed by tabulating the frequency of positive response for each assay by antigen and treatment arm at each time point for which an assessment is performed. Response rates will be presented with their corresponding 95% confidence interval estimates calculated using the score test method. Fisher's exact tests will be used to compare cohort 1 and cohort 2 at the peak time point, with a significant difference declared if the 1-sided P value is =\< 0.10.

    Time frame: At 12 weeks after final vaccination

Secondary outcomes

  1. T Cell Responses to Other Ongoing and Nascent Antitumor Response Antigens Associated With Melanoma (e.g. PRAME, MAGE-A3, p53, and gp1000) as Well as Memory and Chronic Viral Responses (CMV, EBV)

    Response rates will be analyzed by tabulating the frequency of positive response for each assay by antigen and treatment arm at each time point for which an assessment is performed. Response rates will be presented with their corresponding 95% confidence interval estimates calculated using the score test method. Fisher's exact tests will be used to compare cohort 1 and cohort 2 at the peak time point, with a significant difference declared if the 1-sided P value is =\< 0.10.

    Time frame: Up to 12 weeks after final vaccination

  2. Frequency and Phenotypic Character of PBMC Subsets Including DCs, Monocyte Populations, T Cells, and NK Cells - Highest Peak Fold Change Over Baseline (Log 2 Fold)

    Graphical and tabular summaries of the assay data will be made. Linear mixed effects model and possibly weighted generalized estimating equation methods will be considered for a supportive analysis of the longitudinal data over time.

    Time frame: Up to 12 weeks after final vaccination

  3. Tumor Recurrence

    Time to first recurrence from first vaccine among subjects who have experienced recurrence. (days)

    Time frame: Up to 600 days from first vaccine

  4. Overall Survival

    Overall survival not assessed

    Time frame: Up to 1 year after patient's 12 week visit

07

Results

Posted Nov 16, 2021

Participant flow

Participant flow — Overall Study
MilestoneArm I (CDX-301, CDX-1401, and Poly-ICLC)Arm II (CDX-1401 and Poly-ICLC)
Started3030
Completed3030
Not completed00

Outcome measures

PrimaryImmune T-cell Response to NY-ESO-1

Response rates will be analyzed by tabulating the frequency of positive response for each assay by antigen and treatment arm at each time point for which an assessment is performed. Response rates will be presented with their corresponding 95% confidence interval estimates calculated using the score test method. Fisher's exact tests will be used to compare cohort 1 and cohort 2 at the peak time point, with a significant difference declared if the 1-sided P value is =\< 0.10.

Time frame:
At 12 weeks after final vaccination
Reported as:
Count of participants · Participants
Immune T-cell Response to NY-ESO-1
ParticipantsArm I (CDX-301, CDX-1401, and Poly-ICLC)Arm II (CDX-1401 and Poly-ICLC)
Immune T-cell Response to NY-ESO-11510
SecondaryT Cell Responses to Other Ongoing and Nascent Antitumor Response Antigens Associated With Melanoma (e.g. PRAME, MAGE-A3, p53, and gp1000) as Well as Memory and Chronic Viral Responses (CMV, EBV)

Response rates will be analyzed by tabulating the frequency of positive response for each assay by antigen and treatment arm at each time point for which an assessment is performed. Response rates will be presented with their corresponding 95% confidence interval estimates calculated using the score test method. Fisher's exact tests will be used to compare cohort 1 and cohort 2 at the peak time point, with a significant difference declared if the 1-sided P value is =\< 0.10.

Time frame:
Up to 12 weeks after final vaccination
Reported as:
Count of participants · Participants
T Cell Responses to Other Ongoing and Nascent Antitumor Response Antigens Associated With Melanoma (e.g. PRAME, MAGE-A3, p53, and gp1000) as Well as Memory and Chronic Viral Responses (CMV, EBV)
ParticipantsArm I (CDX-301, CDX-1401, and Poly-ICLC)Arm II (CDX-1401 and Poly-ICLC)
T Cell Responses to Other Ongoing and Nascent Antitumor Response Antigens Associated With Melanoma (e.g. PRAME, MAGE-A3, p53, and gp1000) as Well as Memory and Chronic Viral Responses (CMV, EBV)77
SecondaryFrequency and Phenotypic Character of PBMC Subsets Including DCs, Monocyte Populations, T Cells, and NK Cells - Highest Peak Fold Change Over Baseline (Log 2 Fold)

Graphical and tabular summaries of the assay data will be made. Linear mixed effects model and possibly weighted generalized estimating equation methods will be considered for a supportive analysis of the longitudinal data over time.

Time frame:
Up to 12 weeks after final vaccination
Reported as:
Mean · log 2 fold change
Frequency and Phenotypic Character of PBMC Subsets Including DCs, Monocyte Populations, T Cells, and NK Cells - Highest Peak Fold Change Over Baseline (Log 2 Fold)
log 2 fold changeArm I (CDX-301, CDX-1401, and Poly-ICLC)Arm II (CDX-1401 and Poly-ICLC)
cDCs30.4 ± 16.980.9 ± 0.26
Monocytes6.1 ± 2.111.0 ± 0.18
CD4 T cells1.2 ± 0.281.1 ± 0.27
NK CD56br cells5.8 ± 2.841.26 ± 0.32
CD8 T cells1.3 ± 0.361.0 ± .26
pDC16.5 ± 7.270.8 ± 0.24
SecondaryTumor Recurrence

Time to first recurrence from first vaccine among subjects who have experienced recurrence. (days)

Time frame:
Up to 600 days from first vaccine
Reported as:
Mean · days
Tumor Recurrence
daysArm I (CDX-301, CDX-1401, and Poly-ICLC)Arm II (CDX-1401 and Poly-ICLC)
Tumor Recurrence360.3 ± 191.1389.2 ± 223.2
SecondaryOverall Survival

Overall survival not assessed

Time frame:
Up to 1 year after patient's 12 week visit

No measurements were reported for this outcome.

Adverse events

Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Arm I (CDX-301, CDX-1401, and Poly-ICLC)—0/30 (0%)30/30 (100%)
Arm II (CDX-1401 and Poly-ICLC)—4/30 (13.3%)30/30 (100%)
Most frequent serious events
Most frequent serious events
EventArm I (CDX-301, CDX-1401, and Poly-ICLC)Arm II (CDX-1401 and Poly-ICLC)
General disorders and administration site conditionsGeneral disorders0/301/30
Infections and infestationsInfections and infestations—1/30
Nervous system disordersNervous system disorders—1/30
Pregnancy, puerperium and perinatal conditionsPregnancy, puerperium and perinatal conditions—1/30
Most frequent other events
Showing 10 of 22
Most frequent other events
EventArm I (CDX-301, CDX-1401, and Poly-ICLC)Arm II (CDX-1401 and Poly-ICLC)
General disorders and administration site conditionsGeneral disorders30/3030/30
Musculoskeletal and connective tissue disordersMusculoskeletal and connective tissue disorders20/3018/30
Nervous system disordersNervous system disorders17/3019/30
Gastrointestinal disordersGastrointestinal disorders15/3017/30
Skin and subcutaneous tissue disordersSkin and subcutaneous tissue disorders15/3014/30
Metabolism and nutrition disordersMetabolism and nutrition disorders15/3012/30
InvestigationsInvestigations14/3014/30
Respiratory, thoracic and mediastinal disordersRespiratory, thoracic and mediastinal disorders13/3013/30
Blood and lymphatic system disordersBlood and lymphatic system disorders13/3010/30
Injury, poisoning and procedural complicationsInjury, poisoning and procedural complications10/301/30

Baseline characteristics

Age, Categorical
Age, Categorical(Participants)Arm I (CDX-301, CDX-1401, and Poly-ICLC)Arm II (CDX-1401 and Poly-ICLC)Total
<=18 years000
Between 18 and 65 years222547
>=65 years8513
Age, Continuous
Age, Continuous(years)Arm I (CDX-301, CDX-1401, and Poly-ICLC)Arm II (CDX-1401 and Poly-ICLC)Total
Mean54.6 ± 13.451.6 ± 14.553.1 ± 13.9
Sex: Female, Male
Sex: Female, Male(Participants)Arm I (CDX-301, CDX-1401, and Poly-ICLC)Arm II (CDX-1401 and Poly-ICLC)Total
Female10919
Male202141
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)Arm I (CDX-301, CDX-1401, and Poly-ICLC)Arm II (CDX-1401 and Poly-ICLC)Total
Hispanic or Latino011
Not Hispanic or Latino302858
Unknown or Not Reported011
Race (NIH/OMB)
Race (NIH/OMB)(Participants)Arm I (CDX-301, CDX-1401, and Poly-ICLC)Arm II (CDX-1401 and Poly-ICLC)Total
American Indian or Alaska Native000
Asian000
Native Hawaiian or Other Pacific Islander000
Black or African American011
White302858
More than one race000
Unknown or Not Reported011
08

Study locations

7 sites
  • University of Chicago Comprehensive Cancer Center
    Chicago, Illinois 60637, United States
  • Laura and Isaac Perlmutter Cancer Center at NYU Langone
    New York, New York 10016, United States
  • Mount Sinai Hospital
    New York, New York 10029, United States
  • Duke University Medical Center
    Durham, North Carolina 27710, United States
  • Cleveland Clinic Foundation
    Cleveland, Ohio 44195, United States
  • Providence Portland Medical Center
    Portland, Oregon 97213, United States
  • University of Wisconsin Hospital and Clinics
    Madison, Wisconsin 53792, United States
09

References and documents

Publications

  • Bhardwaj N, Friedlander PA, Pavlick AC, Ernstoff MS, Gastman BR, Hanks BA, Curti BD, Albertini MR, Luke JJ, Blazquez AB, Balan S, Bedognetti D, Beechem JM, Crocker AS, D'Amico L, Danaher P, Davis TA, Hawthorne T, Hess BW, Keler T, Lundgren L, Morishima C, Ramchurren N, Rinchai D, Salazar AM, Salim BA, Sharon E, Vitale LA, Wang E, Warren S, Yellin MJ, Disis ML, Cheever MA, Fling SP. Flt3 ligand augments immune responses to anti-DEC-205-NY-ESO-1 vaccine through expansion of dendritic cell subsets. Nat Cancer. 2020 Dec;1(12):1204-1217. doi: 10.1038/s43018-020-00143-y. Epub 2020 Nov 16. PubMed 35121932 ↗
10

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Nov 16, 2021, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT02129075
Lead sponsor
National Cancer Institute (NCI)
Responsible party
Sponsor
First posted
May 2, 2014
Start date
Apr 9, 2014
Primary completion
Mar 28, 2016
Completion
May 18, 2018
Results posted
Nov 16, 2021
Last update
Nov 16, 2021

Study contacts

Nina Bhardwaj
principal investigator · Cancer Immunotherapy Trials Network

Oversight

Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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