ClinicalTrials.gg
CompletedNCT03009201Updated Aug 16, 2023

Ribociclib and Doxorubicin in Treating Patients With Metastatic or Advanced Soft Tissue Sarcomas That Cannot Be Removed by Surgery

A Phase 1 interventional study of Doxorubicin Hydrochloride and Laboratory Biomarker Analysis in Advanced Soft Tissue Sarcoma, Locally Advanced Angiosarcoma and Locally Advanced Leiomyosarcoma, sponsored by OHSU Knight Cancer Institute. Completed at 1 site in United States. Open to participants aged 12 Years and older. Per ClinicalTrials.gov, last updated 2023-08-16.

Sponsored by OHSU Knight Cancer Institute · Phase 1, Interventional, and Treatment

From the registry’s dates

  • Primary completion was Oct 2019, 7 years 1 month ago, and no results have been posted to the registry.
Phase
Phase 1
Study type
Interventional
Enrollment
16
Allocation
Not applicable
Ages
12 Years and older
Sex
All
01

Study summary

This phase Ib trial studies the side effects and best dose of ribociclib when giving together with doxorubicin hydrochloride in treating patients with soft tissue sarcomas that has spread to other places or that cannot be removed by surgery (advanced). Ribociclib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Drugs used in chemotherapy, such as doxorubicin hydrochloride, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Giving ribociclib and doxorubicin hydrochloride may work better in treating patients with soft tissue sarcoma.

Read the detailed description

PRIMARY OBJECTIVE:

I. To determine the recommended phase 2 dose (RP2D) of ribociclib in combination with doxorubicin in subjects with advanced soft tissue sarcomas.

SECONDARY OBJECTIVES:

I. To assess preliminary anti-tumor activity of ribociclib in combination with doxorubicin in subjects with advanced soft tissue sarcomas.

II. To characterize the safety and tolerability of ribociclib in combination with doxorubicin.

OUTLINE: This is a dose-escalation study of ribociclib.

Patients receive ribociclib orally (PO) daily on days 1-7, and doxorubicin hydrochloride intravenously (IV) on day 10. Treatment repeats every 21 days for up to 6 cycles in the absence of disease progression or unacceptable toxicity.

MAINTENANCE: Patients without disease progression after 6 cycles receive ribociclib PO daily on days 1-21. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed up within 30 days and then every 12 weeks for 12 months.

02

Conditions studied

  • Advanced Soft Tissue Sarcoma
  • Locally Advanced Angiosarcoma
  • Locally Advanced Leiomyosarcoma
  • Locally Advanced Liposarcoma
  • Locally Advanced Malignant Peripheral Nerve Sheath Tumor
  • Locally Advanced Myxofibrosarcoma
  • Locally Advanced Undifferentiated Pleomorphic Sarcoma
  • Metastatic Angiosarcoma
  • Metastatic Epithelioid Sarcoma
  • Metastatic Fibrosarcoma
  • Metastatic Liposarcoma
  • Metastatic Malignant Peripheral Nerve Sheath Tumor
  • Metastatic Myxofibrosarcoma
  • Metastatic Soft Tissue Sarcoma
  • Metastatic Synovial Sarcoma
  • Metastatic Undifferentiated Pleomorphic Sarcoma
  • Myxofibrosarcoma
  • Pleomorphic Rhabdomyosarcoma
  • Stage III Soft Tissue Sarcoma AJCC v7
  • Stage IV Soft Tissue Sarcoma AJCC v7
  • Undifferentiated (Embryonal) Sarcoma
  • Unresectable Leiomyosarcoma
  • Unresectable Liposarcoma
  • Unresectable Malignant Peripheral Nerve Sheath Tumor
  • Unresectable Soft Tissue Sarcoma
  • Unresectable Synovial Sarcoma
  • Unresectable Undifferentiated Pleomorphic Sarcoma
03

In context

Hemangiosarcoma

99 studies on the registry are indexed under Hemangiosarcoma; 16 are open to participants now.

This study's enrollment of 16 is below the median of 64 across 83 interventional studies indexed under Hemangiosarcoma.

Browse Hemangiosarcoma studies →

Lead sponsor

OHSU Knight Cancer Institute is the lead sponsor of 243 studies on the registry; 44 are open to participants now.

Of its 27 completed or terminated interventional studies of FDA-regulated products, 15 (56%) have results posted.

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

04

Who can participate

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

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • confirmed diagnosis of intermediate or high-grade soft tissue sarcoma for which single-agent doxorubicin is appropriate therapy, including but not limited to:

    • Synovial sarcoma
    • Fibrosarcoma
    • Undifferentiated sarcoma
    • Liposarcoma
    • Leiomyosarcoma
    • Angiosarcoma
    • Malignant peripheral nerve sheath tumor
    • Pleomorphic rhabdomyosarcoma
    • Myxofibrosarcoma
    • Epithelioid sarcoma
    • Undifferentiated pleomorphic sarcoma
  • Locally advanced unresectable or disease with no standard curative therapy available
  • retinoblastoma-associated protein (pRb) positive by immunohistochemistry (IHC)
  • by (RECIST) 1.1 criteria
  • All races and ethnic groups will be included; for subjects between the ages of 12-18 years only, body surface area (BSA) must be >= 1.28 m\^2
  • of >= 50% by echocardiogram or multi-gated acquisition (MUGA) scan
  • Female subjects of must have a negative urine beta-human chorionic gonadotropin (beta-hCG) pregnancy test at time of screening and within 14 days prior to planned first dose of ribociclib
  • Willing to use adequate throughout the study and for 3 weeks after study drug discontinuation
  • Meets the following standard 12-lead electrocardiography () parameters at screening (defined as the mean of the triplicate ECGs; ECGs done in triplicate do not have a defined interval between assessments):

    • using Fridericia's correction formula (QTcF) interval at screening \< 450 msec for males and \< 470 msec for females (using Fridericia's correction)
    • Resting heart rate =\< 100 beats per minute (bpm)
  • (ANC) >= 1.5 K/cu mm
  • (no transfusion within prior 7 days) >= 100 K/cu mm
  • (no transfusion within prior 7 days) >= 9.0 g/dL
  • Total \< institutional (ULN), except for subjects with documented Gilbert's syndrome, for which =\< 3.0 x ULN or direct bilirubin =\< 1.5 x ULN
  • (AST) (serum glutamic-oxaloacetic transaminase [SGOT]) and alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT) in the absence of liver metastases: =\< 2.5 x ULN; if the subject has liver metastases: \< 5 x ULN
  • Serum creatinine \< 1.7 mg/dL
  • Potassium within institutional normal limit (WNL)
  • Corrected calcium WNL
  • Magnesium WNL
  • (INR) =\< 1.5

    • Use of rivaroxaban, apixaban, edoxaban or warfarin is an exclusion criteria; therapy with heparin, low molecular weight heparin (LMWH), dabigatran or fondaparinux is allowed
  • All prior treatment-related toxicities resolved to =\< grade 1 or are determined to be clinically stable by the investigator
  • Has completed prior therapies according to the criteria below:

    • Cytotoxic chemotherapy - at least 21 days since last dose prior to first dose of ribociclib
    • Small molecule inhibitors - at least 14 days since last dose prior to first dose of ribociclib
    • Monoclonal antibodies - at least 3 half-lives since last dose prior to first dose of ribociclib; exception: denosumab for bony metastases is allowable
    • Immunotherapy (e.g. tumor vaccines) - at least 42 days since last dose prior to first dose of ribociclib
    • Radiation - at least 14 days since last dose prior to first dose of ribociclib
  • Able to swallow capsules
  • (ECOG) performance status =\< 2 ( >= 60%)
  • > 3 months
  • Ability to understand and the willingness to sign a written document; subject has signed the informed consent (ICF) prior to any screening procedures being performed and is able to comply with protocol requirements

Exclusion criteria

Exclusion Criteria:

  • Subjects with low grade tumors (histologic grade 1/3)
  • Histologic diagnosis for which single-agent doxorubicin is NOT appropriate therapy, including but not limited to:

    • Alveolar or embryonal rhabdomyosarcoma
    • Ewings sarcoma or primitive neuroectodermal tumor (PNET)
    • Osteosarcoma
    • Gastrointestinal stromal tumor (GIST)
  • Prior systemic therapy with an anthracycline for any indication
  • Known to any of the of ribociclib or doxorubicin (including to peanut and soy)
  • Currently receiving any of the following that cannot be discontinued at least 7 days prior to starting study drug:

    • Known strong inducers or inhibitors of /5, including grapefruit, grapefruit hybrids, pummelos, star-fruit, and Seville oranges
    • Medications with a narrow therapeutic window that are predominantly metabolized through CYP3A4/5
    • Herbal supplements, such as St. John's wort; the use of marijuana or its derivatives is allowed in States with statutes permitting the use of recreational or medical marijuana
  • Uncontrolled intercurrent medical condition including, but not limited to:

    • Uncontrolled infection
    • Symptomatic congestive heart failure ( [NYHA] class III-IV)
    • Acute coronary syndromes (including myocardial infarction, unstable angina, coronary artery bypass grafting, coronary angioplasty, or stenting) or symptomatic pericarditis within 6 months prior to screening
    • Uncontrolled cardiac arrhythmia or arrhythmia requiring medication other than beta blocker
    • Psychiatric illness/social situations that would limit compliance with study requirements
    • Any other concurrent severe and/or uncontrolled medical condition that would, in the investigator's judgment, cause unacceptable safety risks or compromise compliance with the protocol (e.g. chronic pancreatitis, chronic active hepatitis, etc.)
  • Concurrent or malignancy within 3 years prior to starting study drug, except:

    • Malignancies that have completed therapy and are considered by their physician to be at less than 30% risk of relapse, or
    • Malignancies not requiring treatment (e.g., RAI stage 0 chronic lymphocytic leukemia [CLL])
  • Central nervous system (CNS) involvement unless they meet ALL of the following criteria:

    • At least 4 weeks from prior therapy completion (including radiation and/or surgery) to starting the study treatment
    • Clinically stable CNS tumor at the time of screening and not receiving and/or enzyme-inducing anti-epileptic medications for
  • Impairment of gastrointestinal (GI) function or GI disease that may significantly alter the absorption of the study drugs (e.g., ulcerative diseases, uncontrolled nausea/vomiting/diarrhea, malabsorption syndrome, or major small bowel resection)
  • Known history of (HIV) infection (testing not mandatory); NOTE: HIV-positive subjects on combination antiretroviral therapy are ineligible because of the potential for pharmacokinetic interactions with ribociclib; in addition, these subjects are at increased risk of lethal infections when treated with marrow suppressive therapy; appropriate studies will be undertaken in subjects receiving combination antiretroviral therapy when indicated
  • Systolic blood pressure (SBP) > 160 mmHg or \< 90 mmHg at screening; if initial screening SBP is outside of the eligible range, blood pressure may be re-checked after intervention; SBP must be documented as stable and within the eligible range prior to starting study drug
  • Currently receiving rivaroxaban, apixaban, endoxaban, warfarin or other warfarin derived anticoagulant; therapy with heparin, low molecular weight heparin (LMWH), dabigatran or fondaparinux is allowed; if transitioning from a prohibited anticoagulant, a minimum of 7 days from last dose of the prohibited medication is required prior to ribociclib start
  • Participation in a prior interventional study within 30 days prior to enrollment or within 5 half-lives of the investigational product, whichever is longer
  • Major surgery within 14 days prior to starting study drug or has not recovered from surgical complications (tumor is not considered as major surgery)
  • History of congenital long syndrome or torsades de pointes
  • History of non-compliance to medical regimen or inability to grant consent
  • Pregnant or nursing (lactating) women; breastfeeding should be discontinued
Terms in these criteria, in plain language(31)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Histologically or cytologically confirmed

The diagnosis was confirmed by looking at a sample under a microscope: tissue from a biopsy or surgery (histology), or cells from a fluid or needle sample (cytology).

Your pathology report is the document that shows this.

Metastases

Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.

Biopsy and archival tissue

A biopsy takes a small piece of tissue to examine. “Archival tissue” is a sample already taken, for example at diagnosis, and kept by the hospital.

Whether a stored sample will do depends on when it was taken, how much there is and what the study needs. Ask whether the study accepts your stored sample or needs a new biopsy.

Measurable disease

The amount of disease can be tracked with a defined measurement, so the study can see whether it shrinks or grows. It might be a tumour measured on a scan or, in some blood cancers such as myeloma, a marker measured in blood or urine.

The criteria or the study team say which measurement counts — having no tumour visible on a scan does not by itself rule you out.

RECIST

The standard rules for measuring tumours on CT or MRI scans, to tell whether a cancer is shrinking, stable or growing during treatment.

“Measurable disease per RECIST 1.1” usually means at least one tumour 10 mm or more at its longest on a CT scan, or a lymph node 15 mm or more across its short axis.

LVEF (left ventricular ejection fraction)

The share of blood the heart’s main pumping chamber (the left ventricle) pushes out with each beat, measured by an echocardiogram (heart ultrasound) or a MUGA scan. About 50–70% is normal.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

ECG (electrocardiogram)

A recording of the heart’s electrical activity, taken with stickers on the chest, arms and legs. It takes a few minutes and does not hurt.

QT and QTc

On an ECG, the QT interval is the time the heart’s lower chambers take to activate electrically and recover in each beat. QTc is that time adjusted for heart rate (QTcF by Fridericia’s formula, QTcB by Bazett’s). Some medicines lengthen it, and a long QTc can raise the risk of a dangerous heart rhythm.

The study may name a correction formula and a limit in milliseconds, often around 450–480.

Absolute neutrophil count (ANC)

The number of neutrophils, white blood cells that help fight infection, in a given amount of blood. Too few raises the risk of infection.

It is a count, not a percentage of the white cells. Limits are written in units that mean the same: ≥ 1.5 × 10⁹/L is ≥ 1,500 per mm³ (µL). Each lab has its own reference range.

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

Hemoglobin (Hb)

The protein in red blood cells that carries oxygen. A low level is anaemia, which can cause tiredness and breathlessness. Measured in g/dL or g/L (9 g/dL is 90 g/L).

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

INR, PT and aPTT (clotting tests)

Blood tests of how long blood takes to clot. The INR is the prothrombin time (PT) put on a common scale; about 1 is usual for someone not taking a blood thinner.

Criteria often make an exception for people on a blood thinner such as warfarin, whose INR is raised on purpose.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

Karnofsky performance status (KPS)

A 0–100 scale of how well someone can carry out everyday activities. 100 is no complaints and no signs of illness; 70 is able to look after yourself but not to work or keep up normal activity; 50 is needing considerable help and frequent medical care.

Studies often ask for 60 or 70 and above. Your doctor gives the score.

Life expectancy

The study doctor’s estimate of how long someone is likely to live. Criteria use it so that people can stay in the study long enough for it to answer its question.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Excipients

The other ingredients in a medicine besides the active drug, such as fillers, colours or preservatives.

CYP3A (CYP3A4) inhibitors and inducers

CYP3A is a group of enzymes, mainly CYP3A4, in the liver and gut that break down many medicines. Some medicines, supplements and foods (grapefruit, St John’s wort) slow them down or speed them up, which changes how much of a study drug stays in the body.

Studies list them so they can be avoided or switched; bring a list of everything you take, including supplements.

NYHA class (heart failure)

The New York Heart Association’s four classes of how much heart failure limits physical activity.

I
No limits: ordinary activity causes no undue tiredness or breathlessness.
II
Slight limits: comfortable at rest, ordinary activity causes symptoms.
III
Marked limits: comfortable at rest, less than ordinary activity causes symptoms.
IV
Symptoms even at rest; any activity makes them worse.

Studies set their own limit — many outside heart failure leave out class III–IV, while heart failure studies may ask for a particular class. Check the class this study names.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

Brain metastases

Cancer deposits in the brain from a cancer that started elsewhere in the body (CNS metastases include the spinal cord).

Studies differ: some leave out any brain metastases, some accept ones treated and stable for some weeks. Check what this study allows.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Washout period

A planned gap after a treatment, so that its effects can lessen before the study treatment or a study assessment. Ask the study team and the doctor who prescribed it before changing any medicine.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

05

Study design

Phase
Phase 1
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
16 participants (actual)

Study arms

  • Experimental
    Treatment (ribociclib, doxorubicin hydrochloride)

    Patients receive ribociclib PO daily on days 1-7, and doxorubicin hydrochloride IV on day 10. Treatment repeats every 21 days for up to 6 cycles in the absence of disease progression or unacceptable toxicity. MAINTENANCE: Patients receive ribociclib PO daily on days 1-21. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity.

    Drug: Doxorubicin Hydrochloride · Other: Laboratory Biomarker Analysis · Other: Pharmacological Study · Drug: Ribociclib

Interventions

  • Given IV

    Also known as: 5,12-Naphthacenedione, 10-[(3-amino-2,3,6-trideoxy-alpha-L-lyxo-hexopyranosyl)oxy]-7,8, 9,10-tetrahydro-6,8,11-trihydroxy-8-(hydroxyacetyl)-1-methoxy-, hydrochloride, (8S-cis)- (9CI), ADM, Adriacin, Adriamycin, Adriamycin Hydrochloride, Adriamycin PFS, Adriamycin RDF, ADRIAMYCIN, HYDROCHLORIDE, Adriamycine, Adriblastina, Adriblastine, Adrimedac, Chloridrato de Doxorrubicina, DOX, DOXO-CELL, Doxolem, Doxorubicin HCl, Doxorubicin.HCl, Doxorubin, Farmiblastina, FI 106, FI-106, hydroxydaunorubicin, Rubex

  • OtherLaboratory Biomarker Analysis

    Correlative studies

  • OtherPharmacological Study

    Correlative studies

  • Given PO

    Also known as: Kisqali, LEE-011, LEE011

06

What researchers measure

Primary outcomes

  1. Incidence of dose limiting toxicities (DLTs) of adverse events

    Will be graded according to National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version (v) 4.03. All adverse events (AEs) will be tabulated and summarized by major organ category, grade, anticipation, and drug attribution. Serious adverse events (SAE) specific incidence and exact 95% confidence interval will be provided where appropriate.

    Time frame: Up to 21 days

Secondary outcomes

  1. Progression-free survival (PFS)

    The Kaplan-Meier product limit method will be used to estimate PFS of the median PFS and PFS rates at clinically relevant time points will be provided with the 90% confidence interval (CI).

    Time frame: From first dose of protocol therapy to time of documented radiographic and/or clinical disease progression or death from any cause, whichever occurs first, assessed up to 12 months

  2. Objective response rate (ORR)

    Will be defined as the proportion of patients who achieved a complete response or a partial response. Will be assessed based on Response Evaluation Criteria in Solid Tumors (RECIST) version (v)1. The ORR, along with exact two-sided 95% confidence intervals, will be reported for the study.

    Time frame: Up to 12 months

  3. Incidence of adverse events, SAEs

    Will be assessed by NCI CTCAE v 4.03. Analyses will be performed for all patients having received at least one dose of study drug. Serious adverse events, AEs will be summarized using descriptive statistics.

    Time frame: Up to 12 months

  4. Incidence of dose modifications (interruptions, reductions, intensity) due to adverse events

    Analyses will be performed for all patients having received at least one dose of study drug. AEs leading to withdrawal/dose interruptions/dose modification will be summarized using descriptive statistics.

    Time frame: Up to 12 months

07

Study locations

1 site
  • OHSU Knight Cancer Institute
    Portland, Oregon 97239, United States
08

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Aug 16, 2023, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT03009201
Responsible party
Lara Davis, MD (Principal Investigator, OHSU Knight Cancer Institute) — Principal investigator
First posted
Jan 4, 2017
Start date
Mar 10, 2017
Primary completion
Oct 8, 2019
Completion
Jun 30, 2023
Last update
Aug 16, 2023

Study contacts

Lara E Davis
principal investigator · OHSU Knight Cancer Institute

Oversight

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

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Studies of the drug tested here: Ribociclib

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