Cabozantinib and Androgen Ablation in Patients With Androgen-Dependent Metastatic Prostate Cancer
Study Details
Study Description
Brief Summary
The goal of this clinical research study is learn if adding cabozantinib (also known as XL184) to hormonal therapy can help to control prostate cancer. The safety of this drug will also be studied.
Cabozantinib is designed to block certain proteins in your blood that cause cancer cells to grow. This may cause cancer cells to die.
Condition or Disease | Intervention/Treatment | Phase |
---|---|---|
|
Phase 2 |
Detailed Description
Study Drug Administration:
If you are found to be eligible to take part in this study, you will take 1 capsule of cabozantinib by mouth 1 time every day while you are on study. You should not eat or drink anything other than water for 2 hours before and 1 hour after taking the study drug. You should take the capsule with at least 1 cup (8 ounces) of water. You will also be given separate directions about how to take the study drug.
You will also receive hormone therapy. The hormone drug you receive will be standard of care hormone therapy. The study doctor will decide what hormone therapy you will receive and will explain when and how you should take the hormone therapy, as well as its risks.
You will be given a drug diary where you will record when you take cabozantinib. You should return this diary to the study staff when you come into the clinic.
Study Visits:
At every visit, you will be asked about any side effects you may have had and any other drugs you may be taking.
If you are receiving Coumadin, every week for the first 3 weeks, you will have blood drawn (about 1 teaspoon) to test your blood clotting function.
Every 3 weeks for the first 12 weeks of the study, and then every 6 weeks after that:
-
You will have a physical exam.
-
Blood (about 3-4 teaspoons) will be drawn for routine tests.
Every 3 weeks for the first 12 weeks of the study, and then every 12 weeks after that, blood (about 1 teaspoon) will be drawn to check your thyroid and pancreatic function. The frequency of the testing may change if the study doctor thinks it is needed.
Every 6 weeks, you will have the following tests performed:
-
Blood (about 2-3 teaspoons) will be drawn to measure your PSA levels and for biomarker testing.
-
Urine will be collected for routine tests.
-
You may have these test performed near your home if the study doctor thinks you are tolerating the treatment.
Every 12 weeks, you will have a bone scan and CT scans of the chest, abdomen, and pelvis to check the status of the disease.
Length of Study:
You may continue receiving the study drug for as long as the study doctor thinks it is in your best interest. You will be taken off study early if the disease gets worse, if you have intolerable side effects, or if your study doctor thinks it is in your best interest to stop.
Long-Term Follow-Up:
You will be contacted every 6 months after you stop taking the study drug to check on how you are feeling and the status of the disease. This will consist of a phone call, e-mail, or medical record review. If you are called, each call should last about 5 minutes.
This is an investigational study. Cabozantinib is FDA approved to treat patients with certain types of thyroid cancer. Its use in this study is investigational.
Up to 60 participants will take part in this study. All will be enrolled at MD Anderson.
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
---|---|
Experimental: Cabozantinib + Androgen Ablation Therapy Patients receive Cabozantinib at starting dose of 60 mg by mouth every day. Study cycles 3 weeks in duration. Patients stay on treatment as long as they are benefitting. Patients receive androgen ablation therapy, either by means of luteinizing hormone-releasing hormone super-agonist (of any formulation), LHRH antagonist, or surgical castration. Study doctor will decide what hormone therapy patient will receive. |
Drug: Cabozantinib
Starting dose of 60 mg by mouth every day of a 21 day cycle.
Other Names:
Drug: Androgen Ablation Therapy
Androgen ablation therapy, either by means of luteinizing hormone-releasing hormone super-agonist (of any formulation), LHRH antagonist, or surgical castration given upon decision of study doctor.
|
Outcome Measures
Primary Outcome Measures
- Progression Free Survival [31.2 months]
Progression defined by any of the following: (a) radiographic progression (using RECIST 1.1 for visceral disease and PCWG2 for Bone Scans), (b) receive additional anti-cancer therapy, or (c) clinical progression resulting in stopping the treatment.
- Serious Adverse Events and Other (Not Including Serious) Adverse Events [Start of treatment up to 30 days after study drug, up to 80 months]
Number of instances of Serious Adverse Events and Other (Not Including Serious) Adverse Events. Adverse events were monitored for 30 days beyond the last day of treatment. These adverse events are documented. The adverse events are reported as Serious Adverse Events and Adverse Events. Serious Adverse Events are defined as adverse events in which the participant dies, is hospitalized, is disabled, or is exposed to the medicine while pregnant resulting in and birth defect. Adverse events evaluated for all treated participants using the NCI CTCAE version 4.3.
Eligibility Criteria
Criteria
Inclusion Criteria:
-
Histologic proof of prostate adenocarcinoma
-
Newly diagnosed Androgen-Dependent Prostate Cancer. Patients already on ADT are eligible as long as the time from initiation of LHRH analog or antagonist is not greater than 3 months.
-
Metastatic disease on bone scan and/or involvement of soft tissues (lymph nodes and/or viscera) by CT scan, PET/CT, or MRI
-
PSA > 1 ng/ml, unless anaplastic features are present (according to eligibility 10)
-
Life expectancy from a co-morbid illness > 3 years
-
Eastern Cooperative Oncology Group (ECOG) performance status </= 2
-
Patients must have adequate organ function as defined by: Absolute Neutrophil Count (ANC) >/= 1,500/ul (unless due to bone marrow infiltration by tumor in which case ANC
/=500/ml are allowed) Hemoglobin (Hgb) >/= 9 gm/dL (unless due to bone marrow infiltration by tumor in which case Hgb>8 gm/dL); Total bilirubin </= 1.5times the upper limit of normal (ULN). For patients with known Gilbert's disease, total bilirubin should be </= 3mg/dL; platelet count >/= 100,000/mm^3 (unless due to bone marrow infiltration by tumor in which case >/=50,000/ml are allowed); Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) </= 3.0 x ULN if no liver involvement, or </= 5 x ULN with liver involvement; Lipase < 2 x the upper limit of normal; Urine protein/creatinine ratio (UPCR) </= 1; Serum phosphorus >/= lower limits of normal (LLN); estimated creatinine clearance of >/=40 ml/min.
-
Prior ADT is allowed if it was an adjunct to definite local therapy, was given for </=1 year and was completed at least 12 months before initiating therapy for metastatic disease.
-
Prior therapy with other tyrosine kinase inhibitors (TKI) inhibitors or any other type of investigational agent is allowed if it was an adjunct to definitive local therapy, was given for </=6 months, and was completed at least 12 months before initiating therapy for metastatic disease.
-
Patients with "anaplastic" features are eligible for this trial as defined by at least one of the following: a) Any of the following metastatic presentations: exclusive visceral metastases, radiographically predominant lytic bone metastases identified by plain X-ray or CT scan, bulky (>5 cm in longest dimension) lymphadenopathy or high-grade (gleason >8) tumor mass in the prostate/pelvis.; b) Low PSA (</= 10 ng/ml) at initial presentation (prior to androgen ablation or at symptomatic progression in the castrate-setting) plus high volume (>/=20) bone metastases.; c) Elevated serum LDH (>/= 2 x ULN) or elevated serum CEA (>/= 2 x ULN) in the absence of other etiologies.;
- Short interval (</= 180 days) to castrate-resistant progression following initiation of hormonal therapy.
- Sexually active fertile subjects, and their partners, must agree to use medically accepted methods of contraception (eg, barrier methods, including male condom, female condom, or diaphragm with spermicidal gel) during the course of the study and for 4 months after the last dose of study drug(s).
Exclusion Criteria:
-
Biological agents (antibodies, immune modulators, cytokines, or vaccines) or radionuclide treatment within 6 weeks of the first dose of study treatment.
-
Radiation therapy within 2 weeks prior to initiation of study treatment.
-
Symptomatic or uncontrolled brain metastasis or epidural disease requiring current treatment including steroids and anti-convulsant.
-
The subject has had another diagnosis of malignancy requiring systemic treatment within the last two years, unless non-melanoma skin cancer, or superficial bladder cancer.
-
The subject has uncontrolled or significant intercurrent illness including, but not limited to, the following conditions: Chronically uncontrolled hypertension, defined conventionally as consistent and repeated systolic pressures above 140 mmHg or diastolic pressures above 90 mmHg despite anti-hypertensive therapy. This may be better established with home BP readings than with clinic visit results. There is no criterion related to a specific BP result required for eligibility, nor are acute BP elevations that are related to iatrogenic causes, acute pain, or other transient reversible causes considered to be an exclusion criteria. The intent is to exclude patients with chronically uncontrolled hypertension that might be further exacerbated by Cabozantinib.
-
Continued from # 5) Other cardiovascular disorders such as symptomatic congestive heart failure (CHF), unstable angina pectoris, clinically-significant cardiac arrhythmias, history of stroke (including transient ischemic attack [TIA], or other ischemic event) within 6 months of study treatment, myocardial infarction within 6 months of study treatment, history of thromboembolic event requiring therapeutic anticoagulation within 6 months of study treatment or main portal vein or vena cava thrombosis or occlusion. ;Gastrointestinal (GI) disorders particularly those associated with a high risk of perforation or fistula formation including: Any of the following at the time of screening; a) intra-abdominal tumor/metastases invading GI mucosa b) active peptic ulcer disease, c) inflammatory bowel disease (including ulcerative colitis and Crohn's disease), diverticulitis, cholecystitis, symptomatic cholangitis or appendicitis
-
Continued from # 6) Any of the following within 6 months before the first dose of study treatment: a) history of abdominal fistula b) gastrointestinal perforation c) bowel obstruction or gastric outlet obstruction; d) intra-abdominal abscess. Note: Complete resolution of an intra-abdominal abscess must be confirmed prior to initiating treatment with cabozantinib even if the abscess occurred more that 6 months ago. GI surgery (particularly when associated with delayed or incomplete healing) within 28 days. Note: Complete healing following abdominal surgery must be confirmed prior to initiating treatment with cabozantinib even if surgery occurred more that 28 days ago. Other disorders associated with a high risk of fistula formation including PEG tube placement within 3 months before the first dose of study therapy or concurrent evidence of intraluminal tumor involving the trachea and esophagus.
-
The subject is unable to swallow capsules tablets
-
The subject has a previously-identified allergy or hypersensitivity to components of the study treatment formulation.
-
Oral corticosteroids >/= 7.5mg/day prednisone (or prednisone equivalents).
-
Prior treatment with cabozantinib.
-
The subject has a corrected QT interval calculated by the Fridericia formula (QTcF)
500 ms within 28 days before randomization.
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
---|---|---|---|---|---|
1 | University of Texas MD Anderson Cancer Center | Houston | Texas | United States | 77030 |
Sponsors and Collaborators
- M.D. Anderson Cancer Center
- Exelixis
- High Impact Clinical Research Support Program
Investigators
- Principal Investigator: Paul Corn, MD, PHD, M.D. Anderson Cancer Center
Study Documents (Full-Text)
More Information
Additional Information:
Publications
None provided.- 2012-0252
- NCI-2014-00934
Study Results
Participant Flow
Recruitment Details | Participants were enrolled from January 2014 - January 2016 at MD Anderson Cancer Center |
---|---|
Pre-assignment Detail |
Arm/Group Title | Cabozantinib + Androgen Ablation Therapy |
---|---|
Arm/Group Description | Patients receive Cabozantinib at starting dose of 60 mg by mouth every day. Study cycles 3 weeks in duration. Patients stay on treatment as long as they are benefitting. Patients receive androgen ablation therapy, either by means of luteinizing hormone-releasing hormone super-agonist (of any formulation), LHRH antagonist, or surgical castration. Study doctor will decide what hormone therapy patient will receive. Cabozantinib: Starting dose of 60 mg by mouth every day of a 21 day cycle. Androgen Ablation Therapy: Androgen ablation therapy, either by means of luteinizing hormone-releasing hormone super-agonist (of any formulation), LHRH antagonist, or surgical castration given upon decision of study doctor. |
Period Title: Overall Study | |
STARTED | 62 |
COMPLETED | 5 |
NOT COMPLETED | 57 |
Baseline Characteristics
Arm/Group Title | Cabozantinib + Androgen Ablation Therapy |
---|---|
Arm/Group Description | Patients receive Cabozantinib at starting dose of 60 mg by mouth every day. Study cycles 3 weeks in duration. Patients stay on treatment as long as they are benefitting. Patients receive androgen ablation therapy, either by means of luteinizing hormone-releasing hormone super-agonist (of any formulation), LHRH antagonist, or surgical castration. Study doctor will decide what hormone therapy patient will receive. Cabozantinib: Starting dose of 60 mg by mouth every day of a 21 day cycle. Androgen Ablation Therapy: Androgen ablation therapy, either by means of luteinizing hormone-releasing hormone super-agonist (of any formulation), LHRH antagonist, or surgical castration given upon decision of study doctor. |
Overall Participants | 62 |
Age (years) [Median (Full Range) ] | |
Median (Full Range) [years] |
62
|
Sex: Female, Male (Count of Participants) | |
Female |
0
0%
|
Male |
62
100%
|
Ethnicity (NIH/OMB) (Count of Participants) | |
Hispanic or Latino |
5
8.1%
|
Not Hispanic or Latino |
56
90.3%
|
Unknown or Not Reported |
1
1.6%
|
Race (NIH/OMB) (Count of Participants) | |
American Indian or Alaska Native |
0
0%
|
Asian |
0
0%
|
Native Hawaiian or Other Pacific Islander |
0
0%
|
Black or African American |
1
1.6%
|
White |
57
91.9%
|
More than one race |
0
0%
|
Unknown or Not Reported |
4
6.5%
|
Region of Enrollment (participants) [Number] | |
United States |
62
100%
|
Eastern Cooperative Oncology Group (ECOG) Performance Status (Count of Participants) | |
Grade 0 |
45
72.6%
|
Grade 1 |
17
27.4%
|
Grade 2 |
0
0%
|
Prior Treatment of Primary Tumor (Count of Participants) | |
No Prior Treatment |
46
74.2%
|
Yes Prior Treatment |
16
25.8%
|
Gleason Score (Count of Participants) | |
Gleason 6-7 |
10
16.1%
|
Gleason 7 + 5 |
2
3.2%
|
Gleason 8-10 |
45
72.6%
|
Unknown Gleason Score |
5
8.1%
|
Prostate Specific Antigen (PSA) Levels (ng/mL) [Median (Full Range) ] | |
Median (Full Range) [ng/mL] |
64.7
|
Bone Specific Alkaline Phosphatase Level (µg/L) [Median (Full Range) ] | |
Median (Full Range) [µg/L] |
61
|
Bone Metastases (Count of Participants) | |
Bone Metastases |
58
93.5%
|
Bone Only |
27
43.5%
|
Visceral Metastases (Count of Participants) | |
Count of Participants [Participants] |
8
12.9%
|
Soft-Tissue Metastases (Count of Participants) | |
None |
29
46.8%
|
Lymph Nodes |
33
53.2%
|
Liver |
2
3.2%
|
Lung |
6
9.7%
|
Volume of Metastases (Count of Participants) | |
Low |
8
12.9%
|
High |
54
87.1%
|
Outcome Measures
Title | Progression Free Survival |
---|---|
Description | Progression defined by any of the following: (a) radiographic progression (using RECIST 1.1 for visceral disease and PCWG2 for Bone Scans), (b) receive additional anti-cancer therapy, or (c) clinical progression resulting in stopping the treatment. |
Time Frame | 31.2 months |
Outcome Measure Data
Analysis Population Description |
---|
[Not Specified] |
Arm/Group Title | Cabozantinib + Androgen Ablation Therapy |
---|---|
Arm/Group Description | Patients receive Cabozantinib at starting dose of 60 mg by mouth every day. Study cycles 3 weeks in duration. Patients stay on treatment as long as they are benefitting. Patients receive androgen ablation therapy, either by means of luteinizing hormone-releasing hormone super-agonist (of any formulation), LHRH antagonist, or surgical castration. Study doctor will decide what hormone therapy patient will receive. Cabozantinib: Starting dose of 60 mg by mouth every day of a 21 day cycle. Androgen Ablation Therapy: Androgen ablation therapy, either by means of luteinizing hormone-releasing hormone super-agonist (of any formulation), LHRH antagonist, or surgical castration given upon decision of study doctor. |
Measure Participants | 62 |
Median (95% Confidence Interval) [months] |
16.1
|
Title | Serious Adverse Events and Other (Not Including Serious) Adverse Events |
---|---|
Description | Number of instances of Serious Adverse Events and Other (Not Including Serious) Adverse Events. Adverse events were monitored for 30 days beyond the last day of treatment. These adverse events are documented. The adverse events are reported as Serious Adverse Events and Adverse Events. Serious Adverse Events are defined as adverse events in which the participant dies, is hospitalized, is disabled, or is exposed to the medicine while pregnant resulting in and birth defect. Adverse events evaluated for all treated participants using the NCI CTCAE version 4.3. |
Time Frame | Start of treatment up to 30 days after study drug, up to 80 months |
Outcome Measure Data
Analysis Population Description |
---|
[Not Specified] |
Arm/Group Title | Cabozantinib + Androgen Ablation Therapy |
---|---|
Arm/Group Description | Patients receive Cabozantinib at starting dose of 60 mg by mouth every day. Study cycles 3 weeks in duration. Patients stay on treatment as long as they are benefitting. Patients receive androgen ablation therapy, either by means of luteinizing hormone-releasing hormone super-agonist (of any formulation), LHRH antagonist, or surgical castration. Study doctor will decide what hormone therapy patient will receive. Cabozantinib: Starting dose of 60 mg by mouth every day of a 21 day cycle. Androgen Ablation Therapy: Androgen ablation therapy, either by means of luteinizing hormone-releasing hormone super-agonist (of any formulation), LHRH antagonist, or surgical castration given upon decision of study doctor. |
Measure Participants | 62 |
Other (Not Including Serious) Adverse Events |
2105
|
Serious Adverse Events |
3
|
Adverse Events
Time Frame | From the first dose through 30 days after the last day of treatment, up to 80 months | |
---|---|---|
Adverse Event Reporting Description | ||
Arm/Group Title | Cabozantinib + Androgen Ablation Therapy | |
Arm/Group Description | Patients receive Cabozantinib at starting dose of 60 mg by mouth every day. Study cycles 3 weeks in duration. Patients stay on treatment as long as they are benefitting. Patients receive androgen ablation therapy, either by means of luteinizing hormone-releasing hormone super-agonist (of any formulation), LHRH antagonist, or surgical castration. Study doctor will decide what hormone therapy patient will receive. Cabozantinib: Starting dose of 60 mg by mouth every day of a 21 day cycle. Androgen Ablation Therapy: Androgen ablation therapy, either by means of luteinizing hormone-releasing hormone super-agonist (of any formulation), LHRH antagonist, or surgical castration given upon decision of study doctor. | |
All Cause Mortality |
||
Cabozantinib + Androgen Ablation Therapy | ||
Affected / at Risk (%) | # Events | |
Total | 24/62 (38.7%) | |
Serious Adverse Events |
||
Cabozantinib + Androgen Ablation Therapy | ||
Affected / at Risk (%) | # Events | |
Total | 3/62 (4.8%) | |
Gastrointestinal disorders | ||
Diarrhea | 1/62 (1.6%) | |
Renal and urinary disorders | ||
Proteinuria | 1/62 (1.6%) | |
Respiratory, thoracic and mediastinal disorders | ||
Dyspnea | 1/62 (1.6%) | |
Other (Not Including Serious) Adverse Events |
||
Cabozantinib + Androgen Ablation Therapy | ||
Affected / at Risk (%) | # Events | |
Total | 62/62 (100%) | |
Blood and lymphatic system disorders | ||
Anemia | 41/62 (66.1%) | 56 |
Endocrine disorders | ||
Hyperthyroidism | 6/62 (9.7%) | 7 |
Hypothyroidism | 41/62 (66.1%) | 57 |
Gastrointestinal disorders | ||
Abdominal Pain | 6/62 (9.7%) | 8 |
Bloating | 3/62 (4.8%) | 4 |
Constipation | 22/62 (35.5%) | 36 |
Diarrhea | 46/62 (74.2%) | 142 |
Dry Mouth | 8/62 (12.9%) | 8 |
Dyspepsia | 7/62 (11.3%) | 9 |
Flatulence | 5/62 (8.1%) | 5 |
Gastroesophageal Reflux Disease | 18/62 (29%) | 25 |
Mucositis Oral | 18/62 (29%) | 37 |
Nausea | 21/62 (33.9%) | 57 |
Oral Dysesthesia | 28/62 (45.2%) | 43 |
Oral Pain | 11/62 (17.7%) | 12 |
Stomach Pain | 3/62 (4.8%) | 7 |
Vomiting | 14/62 (22.6%) | 21 |
General disorders | ||
Edema | 54/62 (87.1%) | 120 |
Fatigue | 54/62 (87.1%) | 120 |
Non-cardiac Chest Pain | 4/62 (6.5%) | 4 |
Pain | 32/62 (51.6%) | 58 |
Hepatobiliary disorders | ||
Lactate Dehydrogenase Increase | 31/62 (50%) | 58 |
Investigations | ||
Alanine Aminotransferase Increase | 50/62 (80.6%) | 116 |
Alkaline Phosphatase Increase | 17/62 (27.4%) | 30 |
Aspartate Aminotransferase Increase | 52/62 (83.9%) | 148 |
Bilirubin Increase | 11/62 (17.7%) | 16 |
Lipase Increase | 15/62 (24.2%) | 21 |
Neutrophil Count Decrease | 21/62 (33.9%) | 45 |
Platelet Count Decrease | 23/62 (37.1%) | 29 |
Amylase Increase | 3/62 (4.8%) | 3 |
Weight Loss | 8/62 (12.9%) | 12 |
White Blood Cell Decrease | 29/62 (46.8%) | 61 |
Metabolism and nutrition disorders | ||
Anorexia | 18/62 (29%) | 26 |
Dehydration | 3/62 (4.8%) | 3 |
Hypercalcemia | 4/62 (6.5%) | 4 |
Hyperglycemia | 8/62 (12.9%) | 16 |
Hypernatremia | 4/62 (6.5%) | 4 |
Hyperkalemia | 8/62 (12.9%) | 8 |
Hypoalbuminemia | 18/62 (29%) | 36 |
Hypocalcemia | 8/62 (12.9%) | 12 |
Hypoglycemia | 3/62 (4.8%) | 3 |
Hypokalemia | 8/62 (12.9%) | 10 |
Hypomagnesemia | 31/62 (50%) | 67 |
Hyponatremia | 5/62 (8.1%) | 8 |
Musculoskeletal and connective tissue disorders | ||
Cramping in Extremities | 7/62 (11.3%) | 13 |
Myalgia | 3/62 (4.8%) | 3 |
Nervous system disorders | ||
Dizziness | 10/62 (16.1%) | 11 |
Dysgeusia | 37/62 (59.7%) | 49 |
Headache | 7/62 (11.3%) | 8 |
Memory Impairment | 3/62 (4.8%) | 3 |
Paresthesia | 17/62 (27.4%) | 22 |
Neuropathy | 4/62 (6.5%) | 7 |
Renal and urinary disorders | ||
Hematuria | 4/62 (6.5%) | 4 |
Proteinuria | 39/62 (62.9%) | 79 |
Respiratory, thoracic and mediastinal disorders | ||
Cough | 8/62 (12.9%) | 8 |
Dyspnea | 19/62 (30.6%) | 26 |
Hoarseness | 21/62 (33.9%) | 25 |
Sore Throat | 11/62 (17.7%) | 13 |
Upper Respiratory Infection | 4/62 (6.5%) | 4 |
Voice Alteration | 5/62 (8.1%) | 5 |
Skin and subcutaneous tissue disorders | ||
Alopecia | 15/62 (24.2%) | 17 |
Dry Skin | 20/62 (32.3%) | 21 |
Palmer Plantar Erythrodysesthesia | 33/62 (53.2%) | 82 |
Rash | 33/62 (53.2%) | 82 |
Skin Hypopigmentation | 6/62 (9.7%) | 7 |
Vascular disorders | ||
Flushing | 3/62 (4.8%) | 3 |
Hypertension | 25/62 (40.3%) | 37 |
Thromboembolic Event | 3/62 (4.8%) | 4 |
Limitations/Caveats
More Information
Certain Agreements
All Principal Investigators ARE employed by the organization sponsoring the study.
There is NOT an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed.
Results Point of Contact
Name/Title | Dr. Paul Corn, Chair Ad Interim, Genitourinary Medical Oncology |
---|---|
Organization | UT MD Anderson Cancer Center |
Phone | (713) 563-7208 |
pcorn@mdanderson.org |
- 2012-0252
- NCI-2014-00934