ClinicalTrials.gg
CompletedNCT04504669Updated Nov 5, 2024

First Time in Human Study of AZD8701 With or Without Durvalumab in Participants With Advanced Solid Tumours

A Phase 1 interventional study of AZD8701 and Durvalumab in Clear Cell Renal Cell Cancer, Non-Small-Cell Lung Cancer and Triple Negative Breast Neoplasms, sponsored by AstraZeneca. Completed at 13 sites in 4 countries. Open to participants aged 18 Years to 101 Years. Per ClinicalTrials.gov, last updated 2024-11-05.

Sponsored by AstraZeneca · Phase 1, Interventional, and Treatment

From the registry’s dates

  • Primary completion was Oct 2024, 2 years 1 month ago, and no results have been posted to the registry.

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Phase
Phase 1
Study type
Interventional
Enrollment
60
Allocation
Non-randomized
Ages
18 Years to 101 Years
Sex
All
01

Where this study stands

Counted across the records on this site · 2026-11-14

Among 15 studies in Carcinoma, Renal Cell by AstraZeneca — 2 open to participants now, 7 under way, 2 of them phase 3. Carcinoma, Renal Cell · AstraZeneca.

Enrollment
7th of 12
60 · median 64
Started
2020
with 1 other
Phase 1
5 of 15
none open now
Registered
8th of 15
by date

Among the 15 studies in Carcinoma, Renal Cell by AstraZeneca, this one is the 7th largest by enrollment of the 12 interventional ones that give a count, is one of 2 that started in 2020, is one of 5 in phase 1, and was the 8th registered.

Carcinoma, Renal Cell

2,038 studies on the registry are indexed under Carcinoma, Renal Cell; 395 are open to participants now.

Browse Carcinoma, Renal Cell studies →

Open to participants now

2 of the 15 studies in Carcinoma, Renal Cell by AstraZeneca are open now, in 4 countries. Recruiting first, the newest first:

By country, each count listing its studies:

All 2 open studies →

Who these studies take

Of the 307 Carcinoma, Renal Cell studies recruiting now, 254 (83%) set no upper age limit and 18 (6%) stop at 75 or younger; 20 take children under 18; 19 take healthy volunteers.

This study: 18 Years to 101 Years · all sexes · no healthy volunteers.

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02

Study summary

The purpose of this study is to Evaluate the Safety, Tolerability, Pharmacokinetics, Pharmacodynamics, Immunogenicity and Antitumor Activity of AZD8701 Alone and in Combination with Durvalumab (MEDI4736) in Adult Subjects with Select Advanced Solid Tumors

Read the detailed description

This is a Phase I, First in Human, multicentre, open-label, multiple arm study with dose escalations and expansions at selected doses. Dose-escalation will occur with AZD8701 in monotherapy (Part 1) and in combination with durvalumab (Part 3) in selected participants with HNSCC, TNBC, NSCLC, ccRCC, gastroesophageal cancer, melanoma, cervical cancer, small-cell lung cancer and/or participants with solid tumours who have demonstrated a response to prior PD-(L)1 treatment.

Disease specific expansions will occur with a selected dose of AZD8701 in participants with NSCLC (Part 2) and with a selected dose of AZD8701 and durvalumab in participants with TNBC and clear cell RCC (Part 4).

03

Conditions studied

  • Clear Cell Renal Cell Cancer
  • Non-Small-Cell Lung Cancer
  • Triple Negative Breast Neoplasms
  • Squamous Cell Cancer of Head and Neck
  • Small Cell Lung Cancer
  • Gastroesophageal Cancer
  • Melanoma
  • Cervical Cancer
  • Advanced Solid Tumours

Keywords

  • Solid Tumours
  • Durvalumab
  • MEDI4736
  • AZD8701
  • Non Small cell Lung cancer
  • ccRenal Cancer
  • TNBC
  • first time in human
  • PD-L1
  • T regulatory cells
  • FOXP3
04

Who can participate

Ages eligible
18 Years to 101 Years
Sexes eligible
All
Accepts healthy volunteers
No

Eligibility criteria

Inclusion Criteria:

The study is comprised of 2 main parts Monotherapy (AZD8701) and Combined Therapy (AZD8701 and Durvalumab).

Inclusion criteria Dose escalation stages:

  • Histological or cytological confirmation of a solid, malignant tumour including HNSCC, TNBC, NSCLC, ccRCC, gastroesophageal cancer, melanoma, cervical cancer, SCLC, and/or participants with other solid tumours who have demonstrated a response to prior anti-PD-(L)1 treatment
  • Participant with progressive disease that is to standard therapies or for which no standard therapies exist and a clinical trial is the best option for next treatment based on prior response and/or tolerability to standard of care

Inclusion Criteria Dose Expansions:

Non Small Lung Cancer Participants who have received prior PD(L)1 treatment. Clear Cell Renal Cancer Participants who have not received prior PD(L)1 treatment.

Triple negative Breast Cancer participants who have who have not received prior PD(L)1 treatment.

General inclusion criteria:

  • Must be 18 year old at the time of screening
  • Body weight > 35 kg
  • Male and Female participants of must use effective methods of
  • Capable of giving signed
  • performance status of 0 to 1
  • A serum albumin > 30g/L
  • of > 12 weeks
  • At least 1 lesion, that qualifies as a 1.1 target lesion at baseline. Tumour assessment by CT scan or MRI must be performed within 28 days prior to treatment.
  • Participants must provide a new or previous tumour sample
  • Adequate organ system functions

Exclusion Criteria:

  • A condition that, in the opinion of the Investigator, would interfere with evaluation of the study intervention or interpretation of participant safety or study results
  • History of allogeneic organ transplantation.
  • Active or prior documented or inflammatory disorders Uncontrolled intercurrent illness
  • Significant cardiac disease
  • History of another primary except for

    1. Malignancy treated with curative intent and with no known active disease ≥ 5 years
    2. non-melanoma skin cancer
    3. Adequately treated carcinoma in situ without evidence of disease.
  • Participant with previous or confirmed Covid 19 diagnosis requiring significant medical intervention
  • Current clinical signs and symptoms consistent with COVID-19 or confirmed current infection by appropriate laboratory test within the last 4 weeks prior to screening
  • Any major unresolved toxicity from previous anticancer therapy
  • Known allergy or to any of the study interventions or any of the study intervention .

Prior/Concomitant Therapy

  • Receipt of the last dose of anticancer therapy within 5 half-lives or ≤ 21 days prior to the first dose of study
  • Prior treatment with potential Treg depletion therapies including agents targeting OX40 or CD357 (GITR) for 90 days prior to enrolment on study.
  • Participants who have received prior , anti-PD-L1, or anti-CTLA-4:

    1. Must not have experienced a toxicity that led to permanent discontinuation of prior immunotherapy.
    2. All AEs while receiving prior immunotherapy must have completely resolved or resolved to baseline
    3. Must not have experienced a ≥ Grade 3 imAE or a neurologic or ocular imAE of any grade while receiving prior immunotherapy.
    4. Must not have required the use of additional other than for the management of an AE
  • Current or prior use of immunosuppressive medication within 14 days before the first dose of study drug. b. The following are exceptions to this criterion:

    1. Intranasal, inhaled, topical steroids, or local steroid injections (eg, intra-articular injection).
    2. Systemic corticosteroids at physiologic doses not to exceed 10 mg/day of prednisone or its equivalent
    3. Steroids as premedication for hypersensitivity reactions (eg, CT scan premedication)
  • Any concurrent chemotherapy, product, biologic, or hormonal therapy for cancer treatment
  • Radiotherapy treatment to more than 30% of the bone marrow or with a wide field of radiation within 4 weeks of the first dose of study intervention.
  • Major surgical procedure within 28 days prior to the first dose
  • Participants receiving anticoagulation therapy with vitamin K antagonists (eg warfarin)
  • Participation in another clinical study with study intervention administered in the last 30 days
  • Female participants who are pregnant or breastfeeding or male and female participants of who are not willing to employ effective birth control
Terms in these criteria, in plain language(16)

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.

Relapsed and refractory

Relapsed: the illness came back after treatment had worked. Refractory: it did not respond to treatment, or stopped responding while still on it.

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.

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.

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.

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.

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.

Autoimmune disease

A condition in which the immune system attacks the body’s own tissues, such as rheumatoid arthritis, lupus, psoriasis, type 1 diabetes or inflammatory bowel disease.

Immunotherapy studies often leave out active autoimmune disease, and some name exceptions, such as thyroid disease on replacement hormone. Check the exceptions this study lists.

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.

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.

PD-1, PD-L1 and checkpoint inhibitors

PD-1, PD-L1 and CTLA-4 are proteins that act as brakes on the immune system. Checkpoint inhibitors, such as pembrolizumab or nivolumab, block them so the immune system can attack a cancer.

PD-L1 can also be measured in a tumour sample. Some scores count stained tumour cells only (TPS); others also count certain immune cells (CPS). The study names the score and the minimum it uses.

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.

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.

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.

Reproductive potential

Able to have children. For women this usually means from the first period until menopause, unless permanently unable to through surgery; for men, unless permanently sterile. Read who the line is about — participants, women, men, or their partners.

Criteria about it usually ask for contraception during the study and for a time after it.

05

Study design

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

Study arms

  • Experimental
    Monotherapy

    Participants will receive AZD8701 intravenously, on Day 1, 3, 5 and 8 and then weekly for a maximum of 2 years.

    Drug: AZD8701

  • Experimental
    Combination Therapy

    Participants will receive AZD8701 (intravenously, on Day 1, 3, 5 and 8 and then weekly) and durvalumab (MEDI4736) intravenously monthly for a maximum of 2 years.

    Drug: AZD8701 · Biological: Durvalumab

Interventions

  • DrugAZD8701

    FOXP3 antisense oligonucleotide

  • BiologicalDurvalumab

    anti PDL-1 monoclonal antibody

    Also known as: MEDI4736

06

What researchers measure

Primary outcomes

  1. Maximum Tolerated dose (or optimal dose or maximum feasible dose) and RP2D of AZD8701 as monotherapy and in combination with Durvalumab assessed through evaluation of AEs and SAEs

    Determined according to Incidence and treatment related AEs and SAEs

    Time frame: From screening until 105 days after last dose of study treatment

  2. Maximum Tolerated dose (or optimal dose or maximum feasible dose) and RP2D of AZD8701 as monotherapy and in combination with Durvalumab assessed through evaluation of Dose Limiting Toxicities (DLTs)

    Determined according to Incidence of DLTs (during the first 28 day cycle)

    Time frame: First 28 day cycle

  3. Maximum Tolerated dose (or optimal dose or maximum feasible dose) and RP2D of AZD8701 as monotherapy and in combination with Durvalumab assessed through evaluation of vital signs and abnormal laboratory parameters

    Determined according to Incidence of abnormal vital signs and laboratory parameters

    Time frame: From screening until 105 days after last dose of study treatment

  4. Incidence of AEs and SAEs related to AZD8701 as monotherapy and in combination with Durvalumab in disease specific expansions treated at the MTD/OBD/MFD

    Safety and tolerability of the MTD/OBD/MFD assessed through incidence of AEs and SAEs

    Time frame: From screening until 105 days after last dose of study treatment

  5. Objective Response Rate according to RECIST 1.1 by investigator assessment in disease specific expansions treated at the MTD/OB/MFD

    The proportion of subjects achieving a confirmed complete or partial response according to RECIST 1.1 by investigator assessment

    Time frame: Every 8 weeks (first 48 weeks) and then every 12 weeks from start of treatment until the earlier of progression, death, start of subsequent anti-cancer therapy or end of study (for max 42 months)

Secondary outcomes

  1. Progression-free survival according to RECIST 1.1 by investigator assessment

    Time from start of study treatment to the date of objective disease progression or death (by any cause in the absence of progression)

    Time frame: every 8 weeks (first 48 weeks) and then every 12 weeks from start of treatment until the earlier of progression, death or end of study (for max 42 months)

  2. Duration of Response according to RECIST 1.1 by investigator assessment

    Time from first documented response (that is subsequently confirmed) to the date of objective disease progression or death (by any cause in the absence of progression)

    Time frame: every 8 weeks (first 48 weeks) and then every 12 weeks from start of treatment until the earlier of progression, death or end of study (for max 42 months)

  3. Disease Control Rate at 16 weeks according to RECIST 1.1 by investigator assessment

    The proportion of subjects with a best response of CR or PR in the first 16 weeks or SD for at least 16 weeks according to RECIST 1.1 by investigator assessment

    Time frame: Every 8 weeks from start of treatment until earlier of progression, death or start of subsequent anti-cancer therapy (for up to 24 weeks). Subjects followed to 24 weeks for assessment of SD for 16 weeks from first tumour assessment at 8 weeks

  4. Time to Response according to RECIST 1.1 by investigator assessment

    Time from the start of study treatment until the date of first documented response (which is subsequently confirmed)

    Time frame: Every 8 weeks (first 48 weeks) and then every 12 weeks from start of treatment until the earlier of progression, death or end of study (for max 42 months)

  5. Best percentage change in tumour size according to RECIST 1.1 by investigator assessment

    Best percentage change from baseline in sum of the diameters of target lesions

    Time frame: Every 8 weeks (first 48 weeks) and then every 12 weeks from start of treatment until the earlier of progression, death, start of subsequent anti-cancer therapy or end of study (for max 42 months)

  6. Overall Survival at 18 months

    The survival rate of subjects at 18 months from start of treatment

    Time frame: From start of treatment until the earlier of death or end of study (for max of 42 months). Each subject is followed for a minimum of 18 months and the landmark OS rate at 18 months will be estimated using a Kaplan-Meier analysis

  7. Maximum concentration (Cmax) of AZD8701 in plasma when administered as monotherapy and in combination with Durvalumab

    Maximum concentration (Cmax) of AZD8701 in plasma

    Time frame: Cycle 1: Day 1, 2, 3, 5, 8. Cycle 2: Day 1, 22, 23. Cycle 3 & 4: Day 1 and at 105 day follow up (up to 28 months)

  8. Time to maximum concentration (tmax) of AZD8701 in plasma when administered as monotherapy and in combination with Durvalumab

    Time to maximum concentration (tmax) of AZD8701 in plasma

    Time frame: Cycle 1: Day 1, 2, 3, 5, 8. Cycle 2: Day 1, 22, 23. Cycle 3 & 4: Day 1 and at 105 day follow up (up to 28 months)

  9. Exposure to AZD8701 through measurement of area under the curve (AUC) in plasma when administered as monotherapy and in combination with Durvalumab

    Exposure to AZD8701 through measurement of area under the curve (AUC) in plasma

    Time frame: Cycle 1: Day 1, 2, 3, 5, 8. Cycle 2: Day 1, 22, 23. Cycle 3 & 4: Day 1 and at 105 day follow up (up to 28 months)

  10. Maximum concentration (Cmax) of AZD8701 in urine when administered as monotherapy and in combination with Durvalumab

    Maximum concentration (Cmax) of AZD8701 in urine

    Time frame: Cycle 1: Day 1, 2. Cycle 2: Day 22, 23 (up to 2 months)

  11. Time to maximum concentration (tmax) of AZD8701 in urine when administered as monotherapy and in combination with Durvalumab

    Time to maximum concentration (tmax) of AZD8701 in urine

    Time frame: Cycle 1: Day 1, 2. Cycle 2: Day 22, 23 (up to 2 months)

  12. Exposure to AZD8701 through measurement of area under the curve (AUC) in urine when administered as monotherapy and in combination with Durvalumab

    Exposure to AZD8701 through measurement of area under the curve (AUC) in urine

    Time frame: Cycle 1: Day 1, 2. Cycle 2: Day 22, 23 (up to 2 months)

  13. Urine concentrations of AZD8701 to assess renal clearance when administered as monotherapy and in combination with Durvalumab

    Urine samples will be collected to assess urine concentrations of AZD8701 at a series of timepoints to derive renal clearance

    Time frame: Cycle 1: Day 1, 2. Cycle 2: Day 22, 23 (up to 2 months)

  14. Maximum concentration (Cmax) of Durvalumab in serum when administered in combination with AZD8701

    Maximum concentration (Cmax) of Durvalumab in serum

    Time frame: Cycle 1, 2, 3, 4 on Day 1 and 105 follow up (up to 28 months)

  15. Minimum concentration (Cmin) of Durvalumab in serum when administered in combination with AZD8701

    Minimum concentration (Cmin) of Durvalumab in serum

    Time frame: Cycle 1, 2, 3, 4 on Day 1 and 105 follow up (up to 28 months)

  16. Change in FOXP3 mRNA expression

    Percentage change in FOXP3 mRNA expression from pre-treatment (baseline) to post treatment

    Time frame: From day 1 to day 29

07

Study locations

13 sites
  • Research Site
    Baltimore, Maryland 21287, United States
  • Research Site
    Saint Louis, Missouri 63110, United States
  • Research Site
    Huntersville, North Carolina 28078, United States
  • Research Site
    Franklin, Tennessee 37067, United States
  • Research Site
    Houston, Texas 77030, United States
  • Research Site
    Madison, Wisconsin 53792, United States
  • Research Site
    Toronto, Ontario M5G 2M9, Canada
  • Research Site
    Rennes, 35000, France
  • Research Site
    Villejuif Cedex, 94805, France
  • Research Site
    Barcelona, 08035, Spain
  • Research Site
    L'Hospitalet de Llobregat, 08907, Spain
  • Research Site
    Madrid, 28027, Spain
  • Research Site
    Madrid, 28041, Spain
08

References and documents

Publications

  • Revenko A, Carnevalli LS, Sinclair C, Johnson B, Peter A, Taylor M, Hettrick L, Chapman M, Klein S, Solanki A, Gattis D, Watt A, Hughes AM, Magiera L, Kar G, Ireland L, Mele DA, Sah V, Singh M, Walton J, Mairesse M, King M, Edbrooke M, Lyne P, Barry ST, Fawell S, Goldberg FW, MacLeod AR. Direct targeting of FOXP3 in Tregs with AZD8701, a novel antisense oligonucleotide to relieve immunosuppression in cancer. J Immunother Cancer. 2022 Apr;10(4):e003892. doi: 10.1136/jitc-2021-003892. PubMed 35387780 ↗

Related links

Individual participant data

Plan to share: Yes — Qualified researchers can request access to anonymized individual patient-level data from AstraZeneca group of companies sponsored clinical trials via the request portal. All request will be evaluated as per the AZ disclosure commitment: https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure. Yes, indicates that AZ are accepting requests for IPD, but this does not mean all requests will be shared.

Time frame: AstraZeneca will meet or exceed data availability as per the commitments made to the EFPIA Pharma Data Sharing Principles. For details of our timelines, please rerefer to our disclosure commitment at https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure.

Access criteria: When a request has been approved AstraZeneca will provide access to the deidentified individual patient-level data in an approved sponsored tool . Signed Data Sharing Agreement (non-negotiable contract for data accessors) must be in place before accessing requested information. Additionally, all users will need to accept the terms and conditions of the SAS MSE to gain access. For additional details, please review the Disclosure Statements at https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure.

Data sharing details ↗ · astrazenecagroup-dt.pharmacm.com

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

Ran from Aug 2020 to primary completion in Oct 2024, 49 months.

Of 138 industry-sponsored phase 1 interventional studies under Carcinoma, Renal Cell, half reached primary completion within 49 months of starting (the median), counting those still running; a quarter within 32 and three quarters within 63. This study's 49 months is close to that.

Counting every sponsor, half of 219 studies reached it within 50 months; a quarter within 32 and three quarters within 72.

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

Registered
Jul 16, 2020
First posted
Aug 7, 2020
StartActual
Aug 18, 2020
Primary completionActual
Oct 7, 2024
CompletionActual
Oct 7, 2024
Last update
Nov 5, 2024
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 Nov 5, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT04504669
Lead sponsor
AstraZeneca
Responsible party
Sponsor
First posted
Aug 7, 2020
Start date
Aug 18, 2020
Primary completion
Oct 7, 2024
Completion
Oct 7, 2024
Last update
Nov 5, 2024

Oversight

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

Not currently enrolling

This study is completed, as verified in Nov 2024. You cannot join it, but the record below documents what was studied.

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Discussion

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