ClinicalTrials.gg
RecruitingNCT05106296Updated Nov 2, 2026

Chemo-immunotherapy Using Ibrutinib Plus Indoximod for Patients With Pediatric Brain Cancer

A Phase 1 interventional study of Indoximod and Ibrutinib in Ependymoma, Medulloblastoma and Glioblastoma, sponsored by Theodore S. Johnson. Recruiting at 1 site in United States. Open to participants aged 3 Years to 25 Years. Per ClinicalTrials.gov, last updated 2026-11-02.

Sponsored by Theodore S. Johnson · Phase 1, Interventional, and Treatment

From the registry’s dates

  • Started Feb 2022; still recruiting 4 years 9 months later.
Updated Nov 2, 2026Study completion movedSponsor changedGo to Updates ↓
Phase
Phase 1
Study type
Interventional
Enrollment
37
Allocation
Non-randomized
Ages
3 Years to 25 Years
Sex
All
01

Where this study stands

Counted across the records on this site · 2026-11-12

Among 182 studies in Ependymoma with a site in United States — 16 open to participants now, 42 under way, none of them phase 3. Ependymoma · United States.

Planned enrollment
60th of 155
37 · median 24
Started
2022
with 5 others
Phase 1
80 of 182
8 open now
Primary completion
2028-03
later than 29 of 40 live
Registered
169th of 182
by date

Among the 182 studies in Ependymoma with a site in United States, this one is the 60th largest by planned enrollment of the 155 interventional ones that give a count, is one of 6 that started in 2022, is one of 80 in phase 1, reaches primary completion later than 29 of the 40 other live ones, and was the 169th registered.

Ependymoma

224 studies on the registry are indexed under Ependymoma; 35 are open to participants now.

Browse Ependymoma studies →

Open to participants now

16 of the 182 studies in Ependymoma with a site in United States are open now. Recruiting first, the newest first:

10 more — sign in →

All 16 open studies →

A study can be open while its sites in United States have not opened yet or have stopped. Only those recruiting at a site in United States →

Who these studies take

Of the 24 Ependymoma studies recruiting now, 7 (29%) set no upper age limit and 15 (63%) stop at 75 or younger; 18 take children under 18; 1 take healthy volunteers.

This study: 3 Years to 25 Years · all sexes · no healthy volunteers.

The full table on the hub →

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Watch this landscapeDownload CSVNarrow it in search →With an account: a weekly mail of what changed among 182 studies in Ependymoma with a site in United States, or all of them as a file.
02

Study summary

Recent lab-based discoveries suggest that IDO (indoleamine 2,3-dioxygenase) and BTK (Bruton's tyrosine Kinase) form a closely linked metabolic checkpoint in tumor-associated antigen-presenting cells. The central clinical hypothesis for the GCC2020 study is that combining ibrutinib (BTK-inhibitor) with indoximod (IDO-inhibitor) during chemotherapy will synergistically enhance anti-tumor immune responses, leading to improvement in clinical response with manageable overlapping toxicity.

The GCC2020 trial is a prospective open-label phase 1 trial to determine the best safe dose of the BTK-inhibitor ibrutinib to use in combination with previously studied chemo-immunotherapy regimens comprised of the investigational IDO-inhibitor indoximod plus oral palliative chemotherapy for participants, age 6 to 25 years, with relapsed or refractory primary brain cancer. Those previously treated with indoximod-based therapy may be eligible, including prior treatment via the phase 2 indoximod study (GCC1949, NCT04049669), the now closed phase 1 study (NLG2105, NCT02502708), or any expanded access (compassionate use) protocols. Ibrutinib will be combined with either indoximod plus oral cyclophosphamide and etoposide (Regimen A) or indoximod plus oral temozolomide (Regimen B). No cross-over between these two regimens will be allowed. Dose-escalation cohorts will determine the best safe dose of ibrutinib for each of these regimens. This will be followed by expansion cohorts, using ibrutinib at the best safe dose for each regimen, to allow assessment of preliminary evidence of efficacy.

03

Conditions studied

  • Ependymoma
  • Medulloblastoma
  • Glioblastoma
  • Primary Brain Tumor

Keywords

  • IDO
  • indoleamine 2,3-dioxygenase
  • indoximod
  • BTK
  • Bruton's Tyrosine Kinase
  • ibrutinib
  • immunotherapy
  • pediatric
  • childhood
  • brain tumor
  • brain cancer
  • glioblastoma
  • medulloblastoma
  • ependymoma
  • PNET
  • cyclophosphamide
  • etoposide
  • immune
  • central nervous system
  • CNS
  • temozolomide
04

Who can participate

Ages eligible
3 Years to 25 Years
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

Diagnosis:

  • Patients must have prior documented progressive or disease with proven initial diagnosis of ependymoma, medulloblastoma, glioblastoma, or another type of primary cancer of the central nervous system with no curative conventional therapy options available.
  • disease is acceptable.
  • Patients must have MRI confirmation (with and without gadolinium contrast) of current active disease.

Patients must be able to swallow pills.

Lansky or performance status score must be ≥ 50%.

Adequate renal function:

  • (CLcr) > 25 mL/min (by calculated methods) AND Creatinine ≤ 1.5-times upper limit of age-adjusted normal for age of patient.

Adequate liver function:

  • (ALT) ≤ 3-times .
  • Aspartate aminotransferase (AST) ≤ 3-times upper limit of normal.
  • Total ≤ 1.5-times upper limit of normal unless bilirubin rise is due to Gilbert's syndrome or of non-hepatic origin.

Adequate bone marrow function:

  • (ANC) ≥ 1000/mm3 (independent of growth factor support).
  • ≥ 100,000/mm3 (independent of transfusion support).
  • ≥ 8 g/dL (independent of transfusion support).

Seizure disorders must be well controlled on antiepileptic medication.

Prior therapy:

  • Patients previously treated with chemotherapy drugs included in this protocol are eligible for enrollment.
  • At the time of Screening, patients must be at least 21 days from the administration of any agent (other than indoximod) or prior cytotoxic therapy (including chemotherapy).
  • At the time of Screening, patients must be at least 28 days from administration of antibody-based therapies (e.g., bevacizumab), tumor-directed vaccines, or cellular immune therapies (e.g., T cells, NK cells, etc.).
  • At the time of Screening, patients must be at least 56 days from administration of tumor-directed therapies using infectious agents (e.g., viruses, bacteria, etc.).
  • At the time of Screening, patients must be at least 90 days from any radiation or proton therapy (all modalities, including radiosurgery) that targeted all sites of known disease.
  • There is no lock-out window for patients who were treated with focal radiation or focal proton therapy (all modalities, including radiosurgery) that did not target all disease sites, if at least one site of active tumor is expected to persist and/or grow.

Concurrent anti-neoplastic therapy:

  • No investigational or commercial agents, including intrathecal drugs, other than that described by this clinical study protocol (GCC2020) may be administered with the intent to treat the patient's while they remain enrolled on this study.

, pregnancy, and breastfeeding:

  • Women of and men who are sexually active must be practicing a highly effective method of birth control during and after the study. Men must agree to not donate sperm during and for 3 months after the study.
  • Women who are pregnant or breastfeeding are ineligible for this study.
  • Patients who become pregnant while participating in this study will have to stop Study Therapy.

Patients, or their parent for patients less than 18 years of age, must sign an Document indicating that they understand the purpose of and procedures required for the study, including biomarkers, and are willing to participate in the study.

Exclusion criteria

.

Exclusion Criteria:

Patients who are unable to swallow pills.

Patients with known to any drugs in the treatment plan.

Patients with active disease that requires systemic therapy.

  • Allergies, allergic conditions, and reactive inflammatory conditions that are not autoimmune in nature would not exclude patients (e.g., eczema, asthma, etc.).

Pregnant or breastfeeding women.

Major surgery or a wound that has not fully healed within 4 weeks of Screening.

Known central nervous system lymphoma.

Patients with active bleeding or history of thrombotic or hemorrhagic stroke, or intracranial hemorrhage, within 6 months prior to Screening; with the exception of retained blood products from recent prior uncomplicated surgery (e.g., tumor , debulking, or resection; VP shunt placement, etc.).

Requires anticoagulation with warfarin or equivalent vitamin K antagonists (e.g., phenprocoumon).

Requires chronic treatment with strong inhibitor drugs.

cardiovascular disease such as uncontrolled or symptomatic arrhythmias, congestive heart failure, or myocardial infarction within 6 months of Screening, or any Class 3 (moderate) or Class 4 (severe) cardiac disease as defined by the Functional Classification.

Patients with baseline of more than 470 msec at the time of Screening, and patients with congenital long QT syndrome.

Vaccinated with live, attenuated vaccines within 4 weeks of Screening.

Known history of (HIV) or active Virus or active Virus infection or any uncontrolled active systemic infection.

Any life-threatening illness, medical condition, or organ system dysfunction which, in the investigator's opinion, could compromise the patient's safety, interfere with the absorption or metabolism of ibrutinib, indoximod, or chemotherapy, or put the study outcomes at undue risk.

Terms in these criteria, in plain language(26)

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.

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.

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.

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.

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.

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.

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.

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).

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

05

Study design

Phase
Phase 1
Primary purpose
Treatment
Allocation
Non-randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
37 participants (estimated)

Study arms

  • Experimental
    Regimen A

    Patients will be treated with ibrutinib plus indoximod, cyclophosphamide, and etoposide. Cycles are a minimum of 28 days.

    Drug: Indoximod · Drug: Ibrutinib · Drug: Cyclophosphamide · Drug: Etoposide

  • Experimental
    Regimen B

    Patients will be treated with ibrutinib plus indoximod and temozolomide. Cycles are a minimum of 28 days.

    Drug: Indoximod · Drug: Ibrutinib · Drug: Temozolomide

Interventions

  • Indoximod will be taken by mouth twice daily, throughout each treatment cycle.

  • For Regimen A, Ibrutinib will be taken by mouth once daily, on days 1-21 of each treatment cycle.

  • Cyclophosphamide will be taken by mouth once daily, on days 1-21 of each treatment cycle.

  • Etoposide will be taken by mouth once daily, on days 1-21 of each treatment cycle.

  • For Regimen B, Ibrutinib will be taken by mouth once daily, on days 1-14 of each treatment cycle.

  • Temozolomide will be taken by mouth once daily, on days 1-5 of each treatment cycle.

06

What researchers measure

Primary outcomes

  1. Incidence of regimen-limiting toxicity (RLT) for Regimen A

    To determine the pediatric recommended phase 2 dose (RP2D) of ibrutinib, when combined with indoximod-based chemo-immunotherapy (Regimen A)

    Time frame: First 90 days of treatment

  2. Objective Response Rate (ORR) for Regimen A

    Defined as the proportion of patients with a best objective response of either complete response (CR) or partial response (PR), using "immunotherapy Response Assessment for Neuro-Oncology" (iRANO) criteria

    Time frame: Up to 5 years

  3. Incidence of regimen-limiting toxicity (RLT) for Regimen B

    To determine the pediatric recommended phase 2 dose (RP2D) of ibrutinib, when combined with indoximod-based chemo-immunotherapy (Regimen B)

    Time frame: First 90 days of treatment

  4. Objective Response Rate (ORR) for Regimen B

    Defined as the proportion of patients with a best objective response of either complete response (CR) or partial response (PR), using "immunotherapy Response Assessment for Neuro-Oncology" (iRANO) criteria

    Time frame: Up to 5 years

Secondary outcomes

  1. Adverse events (AEs)

    To assess frequency, severity, and recoverability of AEs for the treatment regimen

    Time frame: Up to 19 months

  2. Frequency of cycle delays for toxicity

    To assess whether the immunotherapy contributes to delays in starting subsequent cycles of the chemotherapy drugs

    Time frame: Up to 18 months

  3. Frequency of dose-reductions of the chemotherapy regimen

    To assess whether the immunotherapy contributes to reductions in the doses of the chemotherapy drugs

    Time frame: Up to 18 months

  4. Complete Response Rate (CRR)

    Defined as the proportion of patients with a best objective response of CR using iRANO criteria

    Time frame: Up to 5 years

  5. Partial Response Rate (PRR)

    Defined as the proportion of patients with a best objective response of PR using iRANO criteria

    Time frame: Up to 5 years

  6. Modified Objective Response Rate (mORR)

    Defined as the proportion of patients with best objective response of complete response (CR), partial response (PR), or stable disease (SD, on at least 2 sequential study-timed MRIs) using iRANO criteria

    Time frame: Up to 5 years

  7. iRANO-PFS

    Time of Progression-Free Survival (PFS), defined as time from study entry to progression using iRANO criteria

    Time frame: Up to 5 years

  8. Overall Survival (OS)

    Time from study entry to death

    Time frame: Up to 5 years

07

Study locations

1 of 1 sites recruiting
08

References and documents

Publications

  • Johnson TS, MacDonald TJ, Pacholczyk R, Aguilera D, Al-Basheer A, Bajaj M, Bandopadhayay P, Berrong Z, Bouffet E, Castellino RC, Dorris K, Eaton BR, Esiashvili N, Fangusaro JR, Foreman N, Fridlyand D, Giller C, Heger IM, Huang C, Kadom N, Kennedy EP, Manoharan N, Martin W, McDonough C, Parker RS, Ramaswamy V, Ring E, Rojiani A, Sadek RF, Satpathy S, Schniederjan M, Smith A, Smith C, Thomas BE, Vaizer R, Yeo KK, Bhasin MK, Munn DH. Indoximod-based chemo-immunotherapy for pediatric brain tumors: A first-in-children phase I trial. Neuro Oncol. 2024 Feb 2;26(2):348-361. doi: 10.1093/neuonc/noad174. PubMed 37715730 ↗
  • Sharma MD, Pacholczyk R, Shi H, Berrong ZJ, Zakharia Y, Greco A, Chang CS, Eathiraj S, Kennedy E, Cash T, Bollag RJ, Kolhe R, Sadek R, McGaha TL, Rodriguez P, Mandula J, Blazar BR, Johnson TS, Munn DH. Inhibition of the BTK-IDO-mTOR axis promotes differentiation of monocyte-lineage dendritic cells and enhances anti-tumor T cell immunity. Immunity. 2021 Oct 12;54(10):2354-2371.e8. doi: 10.1016/j.immuni.2021.09.005. Epub 2021 Oct 5. PubMed 34614413 ↗
09

Timeline

1 registry update since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedDate before it movedWhere the date was before it movedSimilar 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 Feb 2022 (actual). Primary completion is estimated for Mar 2028, 73 months after the start.

Of 36 non-industry phase 1 interventional studies under Ependymoma, half reached primary completion within 65 months of starting (the median), counting those still running; a quarter within 39 and three quarters within 92. This study's planned 73 months is above that.

Counting every sponsor, half of 42 studies reached it within 62 months; a quarter within 39 and three quarters within 92.

Completion moved once since we started tracking on Sep 25, 2026: Sep 2028 → Dec 2029, on Nov 2, 2026.

Earlier changes are on the record history on ClinicalTrials.gov ↗

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

Registered
Oct 22, 2021
First posted
Nov 3, 2021
StartActual
Feb 8, 2022
Primary completionEst.
Mar 30, 2028
CompletionEst.
Dec 28, 2029was Sep 2028
Last update
Nov 2, 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.
Study completion
Sep 30, 2028→Dec 28, 2029
Nov 2, 2026
Sponsor
Collaborators added: CureSearch; collaborators removed: CureSearch for Children's Cancer
Nov 2, 2026
Show all 1 update
  1. Nov 2, 2026
    Study completion Sep 30, 2028→Dec 28, 2029
    Sponsor Collaborators added: CureSearch; collaborators removed: CureSearch for Children's Cancer
    + 1 other change: verification date

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

10

Registry details

Key details

Study ID
NCT05106296
Lead sponsor
Theodore S. Johnson
Collaborators
Augusta University, CureSearch, Rally Foundation for Childhood Cancer Research
Responsible party
Theodore S. Johnson (Professor of Pediatrics and Co-Director of the Pediatric Immunotherapy Program, Augusta University) — Sponsor-investigator
First posted
Nov 3, 2021
Start date
Feb 8, 2022
Primary completion
Mar 30, 2028 (estimated)
Completion
Dec 28, 2029 (estimated)
Last update
Nov 2, 2026

Study contacts

Theodore S. Johnson, MD, PhD
Contact
thjohnson@augusta.edu
706-721-4962
Robin Dobbins, RN
Contact
rdobbins@augusta.edu
706-721-2154
Theodore S. Johnson, MD, PhD
principal investigator · Augusta University

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 drugs tested here: Cyclophosphamide · Etoposide

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