ClinicalTrials.gg
Active, not recruitingNCT03368729Updated Jan 23, 2026

Niraparib in Combination With Trastuzumab in Metastatic HER2+ Breast Cancer

A Phase 1/2 interventional study of Niraparib and Trastuzumab in Metastatic Breast Cancer and HER2 Positive Breast Carcinoma, sponsored by University of Alabama at Birmingham. Active, not recruiting at 7 sites in United States. Open to female participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-01-23.

Sponsored by University of Alabama at Birmingham · Phase 1/2, Interventional, and Treatment

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Phase
Phase 1/2
Study type
Interventional
Enrollment
46
Allocation
Non-randomized
Ages
18 Years and older
Sex
Female
01

Where this study stands

Counted across the records on this site · 2026-11-13

Among 20 studies testing niraparib in Breast Neoplasms — 6 open to participants now, 11 under way, 1 of them phase 3. niraparib · Breast Neoplasms.

Enrollment
7th of 20
46 · median 27
Started
2019
with 1 other
Phase 1/2
3 of 20
1 open now
Primary completion
2027-11
later than 8 of 10 live
Registered
7th of 20
by date

Among the 20 studies testing niraparib in Breast Neoplasms, this one is the 7th largest by enrollment, is one of 2 that started in 2019, is one of 3 in phase 1/2, reaches primary completion later than 8 of the 10 other live ones, and was the 7th registered.

Breast Neoplasms

14,829 studies on the registry are indexed under Breast Neoplasms; 3,318 are open to participants now.

Browse Breast Neoplasms studies →

Open to participants now

6 of the 20 studies testing niraparib in Breast Neoplasms are open now, in 9 countries. Recruiting first, the newest first:

1 more — sign in →

By country, each count listing its studies:

All 6 open studies →

About niraparib

niraparib: first FDA approval 2017 (ZEJULA), first EMA approval 2017. What it is approved for, and how studies give it, is on its page →

Who these studies take

Of the 2,398 Breast Neoplasms studies recruiting now, 1,569 (65%) set no upper age limit and 592 (25%) stop at 75 or younger; 103 take children under 18; 215 take healthy volunteers.

This study: 18 Years and older · female · no healthy volunteers.

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Watch this landscapeDownload CSVNarrow it in search →With an account: a weekly mail of what changed among 20 studies testing niraparib in Breast Neoplasms, or all of them as a file.
02

Study summary

The human epidermal growth factor receptor 2 (HER2) regulates cell growth and survival. Approximately 15-20% of all breast cancers are HER2-positive, which are an aggressive and fast-growing subtype of breast cancer. This study will evaluate a new treatment using a potent Poly polymerase (PARP) inhibitor known as Niraparib. Niraparib will be combined with trastuzumab, a HER2-targeted agent, to evaluate the safety and tolerability in patients with metastatic HER2 positive breast cancer. It is anticipated that the combination of drugs will improve survival and have few side effects.

Read the detailed description

Treatment will be administered on an outpatient basis. All patients in the phase 1 and 2 portion of the study will receive Niraparib by mouth on days 1-21 of each 21 day cycle as well as trastuzumab intravenously (IV) on day 1 of each cycle. Blood and tissue will be collected at pre-specified times to enable pharmacokinetic, biomarker, and toxicity studies. The drug dosage will then be determined for the phase 2 portion at a dose limiting level. Following treatment, patients will be followed every 6 weeks for 6 months until disease progression or an unacceptable adverse event.

03

Conditions studied

  • Metastatic Breast Cancer
  • HER2 Positive Breast Carcinoma

Browse trials for

Keywords

  • metastatic breast cancer
  • HER2 positive
  • Poly (ADP-Ribose) polymerase (PARP)
  • Niraparib
  • Trastuzumab
04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
Female
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

  • Women age ≥ 18 years
  • performance status 0-2 ( >60%).
  • Patients with breast cancer.
  • (human epidermal growth factor receptor 2)-positive breast cancer prospectively determined on the primary tumor by a local pathology laboratory and defined as: Immunohistochemistry (IHC) score of 3+ and/or positive by ISH (defined by In Situ Hybridization ratio of ≥ 2.0 for the number of HER2 gene copies to the number of chromosome 17 copies). Both IHC and ISH assays will be performed; however, only one positive result is required for eligibility.
  • Estrogen/progesterone receptor positive OR negative disease allowed.
  • Patients must have per the (RECIST) v1.1.
  • Patients that have failed at least one anti-HER2 therapy in the metastatic setting.
  • Patients must have normal organ and marrow function as defined below:

    • ≥1,500/mL
    • ≥100,000/mL
    • total ≤ institutional (ULN)
    • (AST)/alanine aminotransferase (ALT) 5 ≤ X institutional ULN
    • creatinine ≤ institutional ULN OR ≥ 60 mL/min/1.73 m2 for patients with creatinine levels above institutional normal.
  • Baseline (LVEF) ≥ 50% measured by echocardiogram (preferred) or multigated acquisition (MUGA) scans.
  • Willing and able to comply with the requirements of the protocol.
  • Patient is able to take oral medication.
  • Signed .
  • Female patients of must be willing to use one highly effective form of hormonal or two effective forms of nonhormonal contraception.
  • Contraception must continue for the duration of study treatment and for 7 months after the last dose of study treatment. The above contraception is not a requirement in the case of any of the following:

    • The patient, or partner of the patient, is surgically sterilized.
    • The female patient is >45 years of age and is (has not menstruated for at least 12 consecutive months
    • The patient truly abstains from sexual activity and when this is the preferred option to avoid conception and contraception and/or usual lifestyle of the patient.

Exclusion criteria

Exclusion Criteria:

  • breast cancer patients who are positive and have NOT progressed on at least one prior HER2-targeted therapies for metastatic disease
  • Patients who have not recovered from , v. 4.03 grade 2 or higher toxicities of prior therapy to the point that they would be appropriate for re-dosing will be ineligible for study treatment. Subjects receiving weekly therapy must have a from prior chemotherapy of as least one week. Washout period for chemotherapy administered every 2, 3, or 4 weeks will be 2, 3, and 4 weeks respectively, provided subject has recovered from toxicities of prior therapy such that retreatment is appropriate.
  • Patients must be at least two weeks from prior RT
  • Patients must have a one-week washout period from prior hormonal therapy (e.g. testosterone, estrogen, progestin, gonadotropin-releasing hormone antagonist).
  • Patient has known active central nervous system (CNS) metastases and/or carcinomatous meningitis.

Note: Patients with previously treated may participate provided they are stable (without evidence of progression by imaging [using the identical imaging modality for each assessment, either MRI or CT scan] for at least 4 weeks prior to the first dose of study treatment and any neurologic symptoms have returned to baseline), have no evidence of new or enlarging brain metastases, and have not been using for at least 7 days prior to study treatment. Carcinomatous meningitis precludes a patient from study participation regardless of clinical stability.

No concurrent anti-cancer treatment of any type

  • Patients with known germline BRCA 1 or BRCA 2 mutations
  • Patient has undergone prior treatment with a known poly(ADP-ribose) polymerase (PARP) inhibitor.
  • Prior treatment of a total doxorubicin >360 mg/m2 (or equivalent)
  • Patient has known active (eg, hepatitis B surface antigen [HBsAg] reactive) or (eg, hepatitis C virus ribonucleic acid [HCV RNA] [qualitative] is detected).
  • Patient has a known history of (HIV) (HIV 1/2 antibodies).
  • Chronic therapies including systemic corticosteroids or concurrent short-term use of immunosuppressive therapies is not allowed. Short- term corticosteroid use must be discontinued at least 2 weeks prior to study treatment.
  • Patients with known grade 2 or greater allergic reactions attributed to compounds of similar chemical or biological composition to niraparib are ineligible for study enrollment.
  • Patients with known grade 2 or greater allergic reactions attributed to compounds of similar chemical or biological composition to herceptin are ineligible for study enrollment.
  • Patient is pregnant or breastfeeding, or expecting to conceive children within the projected duration of the study, starting with the screening visit through 7 months after the last dose of study treatment.
  • History of non-breast within the 5 years prior to study entry, except for the following:

    • Carcinoma in situ (CIS) of the cervix
    • CIS of the colon
    • Melanoma in situ
    • Basal cell and squamous cell carcinomas of the skin
  • Patient is considered a poor medical risk due to a serious, uncontrolled medical disorder, nonmalignant systemic disease or active infection that requires systemic therapy. Specific examples include, but are not limited to, active, non-infectious pneumonitis; uncontrolled major seizure disorder; unstable spinal cord compression; superior vena cava syndrome; or any psychiatric or substance abuse disorders that would interfere with cooperation with the requirements of the study (including obtaining ).
  • Cardiopulmonary dysfunction as defined by any of the following prior to randomization:

    • History of National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE; Version 4.0) Grade ≥3 symptomatic congestive heart failure (CHF) or (NYHA) criteria Class ≥ II
    • Angina pectoris requiring anti-angina medication, serious cardiac arrhythmia not controlled by adequate medication, severe conduction abnormality, or valvular disease
    • High-risk uncontrolled arrhythmias (i.e. atrial tachycardia with a heart rate >100/min at rest, significant ventricular arrhythmia [ventricular tachycardia], or higher-grade atrioventricular [AV]-block [second degree AV-block Type 2 [Mobitz 2] or third degree AV-block])
    • Significant symptoms (Grade ≥2) relating to left ventricular dysfunction, cardiac arrhythmia, or cardiac ischemia
    • Myocardial infarction within 12 months prior to randomization
    • Uncontrolled hypertension (systolic blood pressure >180 mmHg and/or diastolic blood pressure >100 mmHg)
    • Evidence of transmural infarction on
    • Heart-rate interval (QTc) prolongation >470 msec at screening.
    • Requirement for oxygen therapy
Terms in these criteria, in plain language(30)

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.

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.

Metastases

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

HER2

HER2 is a protein, made from the ERBB2 gene, that drives the growth of some cancers. A study may look for a level of the protein, extra copies of the gene, or a particular change in it.

In breast cancer, protein tests are read as HER2-positive, HER2-low or HER2-negative; other cancers use their own rules. Check which test result the study requires.

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.

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.

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.

Creatinine clearance (CrCl)

How quickly the kidneys clear creatinine, a waste product, from the blood. A study may estimate it from a blood test with age, weight and sex (often by the Cockcroft–Gault formula), or measure it using blood and urine collected over a set time. Given in mL/min; higher is better.

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.

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.

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.

Postmenopausal

Periods have stopped for good: usually no period for 12 months in a row without another medical reason, sometimes confirmed by a blood test (FSH).

CTCAE grade

The US National Cancer Institute’s scale of how severe an adverse event is — any unwanted medical event during a study, such as a symptom, an illness or an abnormal test result, whether or not a treatment caused it. Whether it did is judged separately.

1
Mild.
2
Moderate.
3
Severe.
4
Life-threatening.
5
Death due to the event.

“Side effects of earlier treatment resolved to grade 1 or less” means they have settled to mild or gone.

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.

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.

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.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

Hepatitis C tests

Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.

After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.

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.

Immunosuppression

A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.

Read whether the line is about a condition or about medicines, and which medicines and doses it means.

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.

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.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

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.

05

Study design

Phase
Phase 1 / Phase 2
Primary purpose
Treatment
Allocation
Non-randomized
Intervention model
Sequential assignment
Masking
None (open label)
Enrollment
46 participants (actual)

Study arms

  • Experimental
    Phase 1: Niraparib 200 mg + Trastuzumab 6 mg/kg

    In phase 1 patients in this first arm will receive 200 mg Niraparib in combination with 6 mg/kg Trastuzumab given IV every 3 weeks.

    Drug: Niraparib · Drug: Trastuzumab

  • Experimental
    Phase 1: Niraparib 100 mg + Trastuzumab 6 mg/kg

    In phase 1 patients in this second arm will receive Niraparib 100 mg in combination with 6 mg/kg Trastuzumab given IV every 3 weeks.

    Drug: Niraparib · Drug: Trastuzumab

  • Experimental
    Phase 2: Niraparib 200 mg or 100 mg + Trastuzumab 6 mg/kg

    The dosage of Niraparib in phase 2 will be determined by the response of patients in Phase 1. A dosage of Niraparib 200 mg will be given along with Trastuzumab 6 mg/kg IV unless a dose limiting toxicity occurs in Phase 1. If so, Niraparib 100 mg will be given with Trastuzumab 6 mg/kg (instead of Niraparib 200 mg).

    Drug: Niraparib · Drug: Trastuzumab

Interventions

  • Niraparib is an oral PARP-1 and -2 inhibitor with high potency.

    Also known as: formerly MK-4827

  • Trastuzumab is a commercially available agent administered by intravenous infusion. A loading dose of 8 mg/kg will be given as the first dose followed with all subsequent doses of 6 mg/kg every 3 weeks.

06

What researchers measure

Primary outcomes

  1. Phase 1: Dose-limiting toxicity (DLT)

    A DLT is defined as hematological events \> or equal to grade 3 leukopenia, anemia, and thrombocytopenia and also non-hematological events \> or equal to grade 3 fatigue, nausea, constipation, vomiting, or diarrhea.

    Time frame: Baseline to 6 weeks

  2. Phase 2: Objective Response Rate

    Response and progression of disease will be evaluated using the international criteria proposed by the Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 Committee.

    Time frame: Baseline up to 100 weeks

Secondary outcomes

  1. Number of adverse events

    Toxicities will be graded using the Common Terminology Criteria for Adverse Events (CTCAE) v. 4.03.

    Time frame: Baseline up to 100 weeks

  2. Progression-free survival

    The RECIST v. 1.1 criteria will be used to evaluate progression-free survival as well as CT and MRI scans. Progression is indicative of existing target and non-target lesions.

    Time frame: Baseline to the date of first documented progression to date of death from any cause, whichever comes first, assessed up to 100 months

  3. Phase 1: Niraparib levels

    Plasma niraparib levels will be assessed at specific time points in participants blood during cycle 2 treatment in Phase I patients only. A population pharmacokinetic modeling approach will be used to describe area under the curve (AUC) plasma concentrations of niraparib and its metabolites in participants in this study.

    Time frame: Baseline to 25 days

07

Study locations

7 sites
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Started Sep 2019 (actual). Primary completion is estimated for Nov 2027, 97 months after the start.

Of 166 non-industry phase 1/2 interventional studies under Breast Neoplasms, half reached primary completion within 67 months of starting (the median), counting those still running; a quarter within 45 and three quarters within 95. This study's planned 97 months is above that.

Counting every sponsor, half of 327 studies reached it within 61 months; a quarter within 45 and three quarters within 88.

How these figures are worked out, and which studies are left out of them.

Registered
Nov 27, 2017
First posted
Dec 11, 2017
StartActual
Sep 6, 2019
Primary completionEst.
Nov 1, 2027
CompletionEst.
Dec 30, 2027
Last update
Jan 23, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Jan 23, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT03368729
Collaborators
Translational Breast Cancer Research Consortium, Tesaro, Inc., Susan G. Komen Breast Cancer Foundation, Breast Cancer Research Foundation of Alabama, The V Foundation
Responsible party
Erica Stringer-Reasor (Assistant Professor, University of Alabama at Birmingham) — Principal investigator
First posted
Dec 11, 2017
Start date
Sep 6, 2019
Primary completion
Nov 1, 2027 (estimated)
Completion
Dec 30, 2027 (estimated)
Last update
Jan 23, 2026

Study contacts

Erica Stringer-Reasor, M.D.
principal investigator · University of Alabama at Birmingham

Oversight

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

Not currently enrolling

This study is active, not recruiting, as verified in Jan 2026. You cannot join it, but the record below documents what was studied.

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Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

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Studies of the drugs tested here: Niraparib · Trastuzumab

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