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Soria JC, Gan HK, Blagden SP, Plummer R, Arkenau HT, Ranson M, Evans TRJ, Zalcman G, Bahleda R, Hollebecque A, Lemech C, Dean E, Brown J, Gibson D, Peddareddigari V, Murray S, Nebot N, Mazumdar J, Swartz L, Auger KR, Fleming RA, Singh R, Millward M. A phase I, pharmacokinetic and pharmacodynamic study of GSK2256098, a focal adhesion kinase inhibitor, in patients with advanced solid tumors. Ann Oncol 2016; 27:2268-2274. [PMID: 27733373 DOI: 10.1093/annonc/mdw427] [Citation(s) in RCA: 97] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 08/30/2016] [Accepted: 08/31/2016] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Focal adhesion kinase (FAK) is important in cancer growth, survival, invasion, and migration. The purpose of this study was to determine the maximum tolerated dose (MTD), safety, pharmacokinetics (PK), and pharmacodynamics (PD) of the FAK inhibitor, GSK2256098, in cancer patients. PATIENTS AND METHODS The dose of GSK2256098 was escalated, in cohorts of patients with advanced cancer, from 80 to 1500 mg, oral twice daily (BID), until the MTD was determined. Serial blood samples were obtained from all patients, and the PK was determined. Paired tumor biopsies were obtained in select patients, and the level of phospho-FAK (pFAK) was determined. RESULTS Sixty-two patients (39 males, 23 females; median age 61 y.o., range 21-84) received GSK2256098. Dose-limiting toxicities of grade 2 proteinuria (1000 mg BID), grade 2 fatigue, nausea, vomiting (1250 mg BID), and grade 3 asthenia and grade 2 fatigue (1500 mg BID) were reported with the MTD identified as 1000 mg BID. The most frequent adverse events (AEs) were nausea (76%), diarrhea (65%), vomiting (58%), and decreased appetite (47%) with the majority of AEs being grades 1-2. The PK was generally dose proportional with a geometric mean elimination half-life range of 4-9 h. At the 750, 1000, and 1500 mg BID dose levels evaluated, the pFAK, Y397 autophosphorylation site, was reduced by ∼80% from baseline. Minor responses were observed in a patient with melanoma (-26%) and three patients with mesothelioma (-13%, -15%, and -17%). In the 29 patients with recurrent mesothelioma, the median progression-free survival was 12 weeks with 95% CI 9.1, 23.4 weeks (23.4 weeks merlin negative, n = 14; 11.4 weeks merlin positive, n = 9; 10.9 weeks merlin status unknown, n = 6). CONCLUSIONS GSK2256098 has an acceptable safety profile, has evidence of target engagement at doses at or below the MTD, and has clinical activity in patients with mesothelioma, particularly those with merlin loss.
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Affiliation(s)
- J C Soria
- Drug Development Department at Gustave Roussy Cancer Campus, University Paris-Sud, Paris, France
| | - H K Gan
- Olivia Newton-John Cancer Research Institute, Austin Health, Melbourne, Australia
- School of Cancer Medicine, Latrobe University, Melbourne, Australia
| | - S P Blagden
- Imperial College, Hammersmith Hospital, London
| | - R Plummer
- Northern Centre for Cancer Care, Newcastle
| | | | - M Ranson
- University of Manchester, Christie Hospital, Manchester
| | - T R J Evans
- University of Glasgow, Beatson West of Scotland Cancer Centre, Glasgow, UK
| | - G Zalcman
- Early Phases Clinical Trials Unit at Caen University Hospital, Caen, France
| | - R Bahleda
- Drug Development Department at Gustave Roussy Cancer Campus, University Paris-Sud, Paris, France
| | - A Hollebecque
- Drug Development Department at Gustave Roussy Cancer Campus, University Paris-Sud, Paris, France
| | - C Lemech
- Sarah Cannon Research Institute, London
| | - E Dean
- University of Manchester, Christie Hospital, Manchester
| | - J Brown
- University of Glasgow, Beatson West of Scotland Cancer Centre, Glasgow, UK
| | - D Gibson
- GlaxoSmithKline, Research Triangle Park, NC and Upper Providence, Collegeville, USA
| | - V Peddareddigari
- GlaxoSmithKline, Research Triangle Park, NC and Upper Providence, Collegeville, USA
| | - S Murray
- GlaxoSmithKline, Research Triangle Park, NC and Upper Providence, Collegeville, USA
| | - N Nebot
- GlaxoSmithKline, Research Triangle Park, NC and Upper Providence, Collegeville, USA
| | - J Mazumdar
- GlaxoSmithKline, Research Triangle Park, NC and Upper Providence, Collegeville, USA
| | - L Swartz
- GlaxoSmithKline, Research Triangle Park, NC and Upper Providence, Collegeville, USA
| | - K R Auger
- GlaxoSmithKline, Research Triangle Park, NC and Upper Providence, Collegeville, USA
| | - R A Fleming
- GlaxoSmithKline, Research Triangle Park, NC and Upper Providence, Collegeville, USA
| | - R Singh
- GlaxoSmithKline, Research Triangle Park, NC and Upper Providence, Collegeville, USA
| | - M Millward
- School of Medicine and Pharmacology, University of Western Australia, Sir Charles Gairdner Hospital, Perth, Australia
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Bylicki O, Gan HK, Joly F, Maillet D, You B, Péron J. Poor patient-reported outcomes reporting according to CONSORT guidelines in randomized clinical trials evaluating systemic cancer therapy. Ann Oncol 2015; 26:231-237. [PMID: 25355720 DOI: 10.1093/annonc/mdu489] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The Consolidated Standards of Reporting Trials (CONSORT) guidance was extended in 2013 to provide a set of specific recommendations regarding patient-reported outcomes (PROs) reporting in randomized clinical trials (RCTs). There is limited data regarding how well current publications of oncology RCTs report PROs if assessed using these guidelines. DESIGN All phase III medical oncology RCTs published between 2007 and 2011 were reviewed according to the 2013 PROs CONSORT recommendations and an 11-point PROs reporting quality score (PRORQS) was defined based on the criteria. RESULTS The majority of trials did not report on PROs at all (201 of 325; 62%). Of the remaining 124 trials, the mean PRORQS score was 5.0 on an 11-point scale. The items related to methods of PROs collection and analysis were poorly reported (Description of the prespecified PRO hypothesis: 26% of RCTs; methods for PRO data collection (paper, telephone, electronic, other): 16%; statistical approaches for managing missing data: 37%). The only factor significantly associated with improved PROs reporting was where PROs reporting was the subject of a dedicated secondary manuscript, as was the case in 36 of the 124 (29%) of RCTs. CONCLUSION Despite their clinical relevance, our findings show that some aspects of PROs reporting may greatly be improved, especially critical methodological aspects of PROs collection and analysis. The exceptions were where PROs were described in PROs-specific secondary publication. Use of the 2013 PROs CONSORT extensions should be encouraged and their effects on PROs reporting subsequently reassessed.
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Affiliation(s)
- O Bylicki
- Department of Pneumology, Desgenettes Hospital; Department of Medical Oncology, Centre Léon BERARD, University of Lyon, Lyon, France
| | - H K Gan
- Joint Austin-Ludwig Oncology Unit, Austin Hospital, Melbourne, Victoria, Australia
| | - F Joly
- INSERM, U1086, Caen; Clinical Research Unit, François Baclesse Center, Caen; Department of Medicine, CHU de Caen, Caen
| | - D Maillet
- Department of Medical Oncology, Lyon-Sud Hospital Center, Hospices Civils de Lyon, Pierre-Bénite
| | - B You
- Department of Medical Oncology, Lyon-Sud Hospital Center, Hospices Civils de Lyon, Pierre-Bénite; EMR UCBL/HCL 3738, Faculté de Médecine Lyon-Sud, Oullins; Department of Medical Oncology, University of Lyon, Lyon
| | - J Péron
- Department of Medical Oncology, Lyon-Sud Hospital Center, Hospices Civils de Lyon, Pierre-Bénite; Biostatistics Unit, Hospices Civils de Lyon, Lyon; Biometry and Evolutionary Biology Laboratory, Health and Biostatistics Team, CNRS UMR 5558, Villeurbanne, France.
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Gan HK, Fichtel L, Lassman AB, Merrell R, van den Bent M, Kumthekar P, Scott AM, Pedersen M, Gomez E, Fischer J, Ames W, Xiong H, Dudley M, Munasinghe W, Roberts-Rapp L, Ansell P, Holen K, Reardon DA. ET-19 * A PHASE 1 STUDY EVALUATING ABT-414 WITH TEMOZOLOMIDE (TMZ) OR CONCURRENT RADIOTHERAPY (RT) AND TMZ IN GLIOBLASTOMA (GBM). Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou255.19] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Wong SF, Mak G, Rosenthal MA, Cher L, Gan HK. Local perspective on a rare brain tumour: adult medulloblastoma. Intern Med J 2014; 43:567-72. [PMID: 23279053 DOI: 10.1111/imj.12060] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2012] [Accepted: 11/29/2012] [Indexed: 11/27/2022]
Abstract
BACKGROUND Little contemporary data are available regarding Australian patterns of care in adult medulloblastoma. It is unclear whether treatment, extrapolated from paediatric protocols despite known differences between the two groups, results in comparable efficacy. AIM To perform a retrospective review of patterns of care in adult medulloblastoma, especially with respect to adjuvant chemotherapy, in Australian patients. METHODS All medulloblastoma patients aged 15 years or older at two neuro-oncology institutions were identified from January 1995-May 2011. Patients with supratentorial or peripheral tumours were excluded. Standardised data were extracted from each institution regarding symptoms, disease staging, treatments received, toxicities and survival outcomes. RESULTS Seventeen eligible patients were identified. Median age was 37 years (range 20-67 years). All had good performance status (Eastern Cooperative Oncology Group 0-1). There were 11 standard-risk de novo patients, three high-risk de novo patients and three patients with recurrent disease. Median overall survival (OS) had not been reached for standard-risk patients with median follow up of 58 months. The median OS for high-risk de novo patients was 21 months, while the median OS was 15 months for patients with recurrent disease. Treatment was well tolerated, with haematological toxicities being most common. CONCLUSIONS Combined modality therapy (surgery followed by postoperative radiotherapy and adjuvant chemotherapy) was well tolerated and associated with good outcomes in standard-risk de novo patients. High-risk and recurrent disease patients do extremely poorly regardless of treatment and better treatment strategies are needed in these patients.
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Affiliation(s)
- S F Wong
- Medical Oncology, Royal Melbourne Hospital, Melbourne, Victoria, Australia.
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Wong SF, Mak G, Rosenthal MA, Cher L, Gan HK. Author reply. Intern Med J 2014; 44:210-1. [DOI: 10.1111/imj.12338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Accepted: 11/27/2013] [Indexed: 11/28/2022]
Affiliation(s)
- S. F. Wong
- Medical Oncology; Barwon Health; Geelong Victoria Australia
| | - G. Mak
- Prince of Wales Clinical School; University of New South Wales; Sydney New South Wales Australia
| | - M. A. Rosenthal
- Melbourne Comprehensive Cancer Centre; Royal Melbourne Hospital; Melbourne Victoria Australia
| | - L. Cher
- Medical Oncology; Austin Health; Melbourne Victoria Australia
| | - H. K. Gan
- Austin-Ludwig Oncology Unit; Melbourne Victoria Australia
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Wong SF, Gan HK, Cher L. A single centre study of the treatment of relapsed primary central nervous system lymphoma (PCNSL) with single agent temozolomide. J Clin Neurosci 2012; 19:1501-5. [PMID: 22995759 DOI: 10.1016/j.jocn.2012.04.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2012] [Accepted: 04/01/2012] [Indexed: 11/16/2022]
Abstract
Primary central nervous system lymphoma (PCNSL) is a rare form of extra-nodal non-Hodgkin lymphoma. Although recommendations for first-line treatment usually incorporate high-dose methotrexate, there is substantial heterogeneity in the types of salvage therapies used at relapse. Phase II data supported the use of temozolomide as a well-tolerated treatment modality in this setting. Therefore, we reviewed the treatment and outcomes of patients with relapsed PCNSL who were treated with salvage temozolomide at our institution. Seven patients were treated with salvage temozolomide between January 2000 and May 2011. The objective response rate was 14%. Progression-free survival was 2 months (95% confidence interval [CI]: 0-5.9) and median overall survival was 4 months (95% CI: 0-13). Toxicity was mild, with one episode of grade 3 neutropenia during 25 cycles of chemotherapy. Although these results are consistent with previous phase II results, the outcomes for these patients remain extremely poor. The low toxicity of temozolomide raises the possibility of combining temozolomide with other chemotherapeutic agents or targeted agents in future clinical trials.
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Affiliation(s)
- S F Wong
- Department of Medical Oncology, Austin Health, 145 Studley Road, Melbourne, Victoria 3084, Australia
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Gan HK, You B, Pond GR, Chen EX. Assumptions of Expected Benefits in Randomized Phase III Trials Evaluating Systemic Treatments for Cancer. J Natl Cancer Inst 2012; 104:590-8. [DOI: 10.1093/jnci/djs141] [Citation(s) in RCA: 77] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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Abdul Razak AR, Siu LL, Chan A, Pond GR, Tirona KM, Chen EX, Hope AJ, Ringash J, O'Sullivan B, Waldron JN, Chan K, Gan HK, Bernstein LJ. Neurocognitive function (NCF) in patients (pts) treated with chemo/bio-radiotherapy (C/B-RT) for head and neck cancers (HNC). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.5522] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Gan HK, You B, Pond GR, Chen EX. Expected benefits versus actual outcomes in oncology phase III randomized controlled trials (RCTs). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.2562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Richter S, Gan HK, MacKenzie MJ, Hotte SJ, Mukherjee SD, Kollmannsberger CK, Ivy SP, Fernandes K, Halford R, Massey C, Wang L, Moore MJ, Sridhar SS. Evaluation of second-line response to targeted therapy following progression on first-line cediranib, an oral pan-vascular endothelial growth factor receptor (VEGFR) tyrosine kinase inhibitor (TKI), in advanced renal cell carcinoma (RCC). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e15153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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You B, Gan HK, Pond GR, Chen EX. Consistency in reporting of primary endpoints (PEP) from registration to publication for modern randomized oncology phase III trials. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.6031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Bernstein LJ, Gan HK, Abdul Razak AR, Tirona KM, Ringash J, O'Sullivan B, Waldron JN, Hope AJ, Goldstein DP, Siu LL. Cognitive functioning pre- and postradiotherapy (RT), chemoradiotherapy (CRT), or bioradiotherapy (BRT) in patients with locally advanced squamous cell cancer of the head and neck (LA-SCCHN). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e19629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Gan HK, You B, Pond GR, Chen EX. Adequacy of data provision and analysis in oncology phase III trials over the past 5 years. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.6122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Gan HK, Bernstein LJ, Brown J, Ringash J, Vakilha M, Wang L, O'Sullivan B, Waldron J, Chen EX, Siu LL. Neurocognitive outcomes of head and neck chemoradiotherapy: A pilot study. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.6068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
6068 Background: Evidence suggests cancer-related treatments affect cognition. To our knowledge, no studies have systematically investigated cognitive impairment in head and neck cancer (HNC) patients (pts). We assessed ten relapse-free HNC pts after curative-intent radiotherapy (RT), half of whom received cisplatin (Cp). Methods: Pts completed a 2-hr battery of tests/questionnaires assessing objective cognitive function (CF), subjective CF, quality of life and affect. Objective measures of CF were transformed to Z-scores (mean=0, standard deviation=1) using age normative data. A negative value for the Difference Score (DS=Z-score minus IQ score) in each tested domain indicates cognitive deterioration as IQ is a pre-morbid estimate of pts’ CF. A Global Deficit Score (GDS) was obtained by averaging the DS of all tested CF domains. Results: Pt demographics were: M:F=8:2; mean age=58 yrs(range 47–66); mean smoking pack yrs=15(0–45); mean drinks/week=7(0–25); mean IQ Z-score=+1.2(-1.0 to +2.0), mean school yrs=15 (6–18) and mean time post treatment=20 mo(9–41). All pts completed the battery within 2 hr. Nine participants appeared to have impaired CF based on negative DS and GDS scores ( Table 1 ). Exploratory univariate analyses showed trends that higher RT dose and Cp use were associated with increased impairment but cytokines, anemia, hormonal status and affective state were not. Conclusions: This feasibility study suggests cancer-related treatment affects cognition in HNC survivors. A longitudinal study is underway. [Table: see text] No significant financial relationships to disclose.
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Affiliation(s)
- H. K. Gan
- Princess Margaret Hospital, University of Toronto, Toronto, ON, Canada
| | - L. J. Bernstein
- Princess Margaret Hospital, University of Toronto, Toronto, ON, Canada
| | - J. Brown
- Princess Margaret Hospital, University of Toronto, Toronto, ON, Canada
| | - J. Ringash
- Princess Margaret Hospital, University of Toronto, Toronto, ON, Canada
| | - M. Vakilha
- Princess Margaret Hospital, University of Toronto, Toronto, ON, Canada
| | - L. Wang
- Princess Margaret Hospital, University of Toronto, Toronto, ON, Canada
| | - B. O'Sullivan
- Princess Margaret Hospital, University of Toronto, Toronto, ON, Canada
| | - J. Waldron
- Princess Margaret Hospital, University of Toronto, Toronto, ON, Canada
| | - E. X. Chen
- Princess Margaret Hospital, University of Toronto, Toronto, ON, Canada
| | - L. L. Siu
- Princess Margaret Hospital, University of Toronto, Toronto, ON, Canada
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Ashley DM, Riffkin CD, Lovric MM, Mikeska T, Dobrovic A, Maxwell JA, Friedman HS, Drummond KJ, Kaye AH, Gan HK, Johns TG, Hawkins CJ. Erratum: In vitro sensitivity testing of minimally passaged and uncultured gliomas with TRAIL and/or chemotherapy drugs. Br J Cancer 2009. [PMCID: PMC2661787 DOI: 10.1038/sj.bjc.6604990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Gan HK, Cher L, Benson A, Dowling A, Rosenthal M. A phase II trial of temolozomide in patients with untreated high grade oligodengroglial brain tumours. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.13005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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