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| ID | Type | Description | Link |
|---|---|---|---|
| 0906M68041 | Other Identifier | IRB, University of Minnesota | |
| Protocol #0907-991 | Other Identifier | NIH OBA |
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The working hypothesis is that oral administration of an attenuated strain of Salmonella typhimurium is safe and efficacious for patients with unresectable hepatic metastasis from a solid tumor cancer. The primary objective of the study is to determine the MTD of Salmonella typhimurium in the treatment.
This phase I study will be done to evaluate a dose escalation scheme of oral administration of an attenuated strain of Salmonella typhimurium expressing human interleukin-2 (IL-2) in patients with unresectable hepatic metastases from a solid tumor cancer. Standard Phase I dose escalation scheme will be used to determine the MTD of Salmonella Typhimurium. Six dose levels of Salmonella will be studied with a minimum of 3 patients enrolled in a dose level.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Salmonella typhimurium 10 to the 5th - Level 1 | Experimental | Patients will receive (a minimum of 3 patients) escalating doses of Salmonella typhimurium to achieve a maximum tolerated dose (MTD). |
|
| Salmonella typhimurium 10 to the 6th -- Level 2 | Experimental | Patients will receive (a minimum of 3 patients) escalating doses of Salmonella typhimurium to achieve a maximum tolerated dose (MTD). |
|
| Salmonella typhimurium 10 to the 7th -- Level 3 | Experimental | Patients will receive (a minimum of 3 patients) escalating doses of Salmonella typhimurium to achieve a maximum tolerated dose (MTD). |
|
| Salmonella typhimurium 10 to the 8th - Level 4 | Experimental | Patients will receive (a minimum of 3 patients) escalating doses of Salmonella typhimurium to achieve a maximum tolerated dose (MTD). |
|
| Salmonella typhimurium 10 to the 9th - Level 5 | Experimental | Patients will receive (a minimum of 3 patients) escalating doses of Salmonella typhimurium to achieve a maximum tolerated dose (MTD). |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Salmonella typhimurium | Biological | Attenuated Salmonella typhimurium (virulent strain x4550) will be given orally in escalating dose groups: Level 1 = 10^5, Level 2 = 10^6, Level 3 = 10^7, Level 4 = 10^8, Level 5 = 10^9, Level 6 = 10^10. |
| Measure | Description | Time Frame |
|---|---|---|
| Number of Participants With Dose Limiting Events to Determine the Maximum Tolerated Dose (MTD) of Salmonella Typhimurium | Maximum tolerated dose will be determined by the number of patients with Dose limiting toxicity (DLT) at a given dose level. DLT is defined as treatment related: Sepsis (salmonella) syndrome, Grade 4 vomiting or diarrhea, Other grade 3 or greater toxicity. If > or = 2 patients at a dose level has a DLT, this level will be declared the MTD. | Up to 24 Weeks After Dose of Salmonella typhimurium |
| Measure | Description | Time Frame |
|---|---|---|
| Number of Participants With Complete Response to Treatment | Evaluation is performed using Response Evaluation Criteria in Solid Tumors (RECIST). Each patient will be assigned one of the following categories: Complete response (CR) the disappearance of all target lesion; Partial response (PR) at least a 30% decrease; Progressive disease (PD) at least a 20% increase, or the appearance of one or more new lesions; Stable disease (SD) neither sufficient shrinkage to qualify for partial response nor sufficient increase to qualify for progressive disease; early death from malignant disease; unknown (insufficient evaluation to determine response status). |
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Inclusion Criteria:
Histologic documentation of malignancy (any solid tumor type) that has spread to the liver and deemed unresectable, and for which no effective standard therapies are available. Patients with additional disease outside of the liver will be allowed.
Patients may have received any number of other prior therapies; however at least 3 weeks must have passed since last dose of chemotherapy or radiotherapy (6 weeks for Nitrosoureas or Mitomycin C) prior to study entry.
Must have recovered from all acute toxicities (defined per National Cancer Institute's Common Toxicity Criteria for Adverse Events 3.0 ≤ grade 1) associated with previous treatment.
Eastern Cooperative Oncology Group (ECOG) performance status ≤2.
Life expectancy of greater than 2 months as determined by the enrolling investigator
Adequate organ function within 1 week of treatment start defined as:
Women of child-bearing potential and sexually active men must agree to use adequate contraception prior to study entry and for the duration of study participation. Should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately.
Voluntary written informed consent before performance of any study-related procedure not part of normal medical care, with the understanding that consent may be withdrawn by the subject at any time without prejudice to future medical care.
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Edward W. Greeno, MD | Masonic Cancer Center, University of Minnesota | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Edward W. Greeno, MD | Minneapolis | Minnesota | 55455 | United States |
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| ID | Title | Description |
|---|---|---|
| FG000 | Salmonella Typhimurium 10 to the 5 th - Level 1 | Patients received Level 1 = 10^5 dose of of Salmonella typhimurium |
| FG001 | Salmonella Typhimurium 10 to the 6 th - Level 2 | Patients received Level 2 = 10^6th dose of Salmonella typhimurium |
| FG002 | Salmonella Typhimurium 10 to the 7 th - Level 3 | Patients received Level 3 = 10^7th dose of Salmonella typhimurium |
| FG003 | Salmonella Typhimurium 10 to the 8 th - Level 4 | Patients received Level 4 = 10^7th dose of Salmonella typhimurium |
| FG004 | Salmonella Typhimurium 10 to the 9th - Level 5 | Patients received Level 5 = 10^9th dose of Salmonella typhimurium |
| FG005 | Salmonella Typhimurium 10 to the 10 th - Level 6 | Patients received Level 6 = 10^10th dose of Salmonella typhimurium |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Salmonella Typhimurium 10 to the 5 th - Level 1 | Patients received Level 1 = 10^5th dose of Salmonella typhimurium |
| BG001 | Salmonella Typhimurium 10 to the 6 th - Level 2 | Patients received Level 2 = 10^6th dose of Salmonella typhimurium |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Number of Participants With Dose Limiting Events to Determine the Maximum Tolerated Dose (MTD) of Salmonella Typhimurium | Maximum tolerated dose will be determined by the number of patients with Dose limiting toxicity (DLT) at a given dose level. DLT is defined as treatment related: Sepsis (salmonella) syndrome, Grade 4 vomiting or diarrhea, Other grade 3 or greater toxicity. If > or = 2 patients at a dose level has a DLT, this level will be declared the MTD. | Posted | Count of Participants | Participants | Up to 24 Weeks After Dose of Salmonella typhimurium |
|
6 months
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Salmonella Typhimurium 10 to the 5 th - Level 1 | Patients received Level 1 = 10^5th dose of Salmonella typhimurium |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| New compression fractures | Musculoskeletal and connective tissue disorders | CTCAE (Unspecified) | Systematic Assessment |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Anemia | Blood and lymphatic system disorders | CTCAE (Unspecified) | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Daniel Saltzman | Masonic Cancer Center, University of Minnesota | 612 626 4214 | saltz002@umn.edu |
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| ID | Term |
|---|---|
| D008113 | Liver Neoplasms |
| D006528 | Carcinoma, Hepatocellular |
| D001661 | Biliary Tract Neoplasms |
| ID | Term |
|---|---|
| D004067 | Digestive System Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D004066 | Digestive System Diseases |
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|
| Salmonella typhimurium 10 to the 10th - Level 1 | Experimental | Patients will receive (a minimum of 3 patients) escalating doses of Salmonella typhimurium to achieve a maximum tolerated dose (MTD). |
|
| 8 Weeks After Treatment with Salmonella Typhimurium |
| Peripheral Blood NK Cells Count | Patients receiving doses of 10^5 through 10^10 Colony forming units of Salmonella typhimurium had their peripheral blood flow cytometry performed to identify the NK (Natural killer) cells population (CD8-, CD4-, CD49b+) prior to administration and at 5 weeks post administration. The flow cytometry data below was gathered by gating on the lymphocyte population of cells in the patient's blood, as determined by FSC vs. SSC. The mean percentage of NK cells in sample's lymphocyte population is given. | Baseline and 5 Weeks After Dosing with Salmonella typhimurium |
| Peripheral Blood T Cells Count | Patients receiving doses of 10^5 through 10^10 Colony forming units of Salmonella typhimurium had their peripheral blood flow cytometry performed to identify the NK (Natural killer) cells population (CD25+, FoxP3+) prior to administration and at 5 weeks post administration. The flow cytometry data below was gathered by gating on the lymphocyte population of cells in the patient's blood, as determined by FSC vs. SSC. The mean percentage of T cells in sample's lymphocyte population is given. | Baseline and 5 Weeks After Dosing with Salmonella typhimurium |
| BG002 | Salmonella Typhimurium 10 to the 7 th - Level 3 | Patients received Level 3 = 10^7th dose of Salmonella typhimurium |
| BG003 | Salmonella Typhimurium 10 to the 8 th - Level 4 | Patients received Level 4 = 10^8th dose of Salmonella typhimurium |
| BG004 | Salmonella Typhimurium 10 to the 9 th - Level 5 | Patients received Level 5 = 10^9th dose of Salmonella typhimurium |
| BG005 | Salmonella Typhimurium 10 to the 10 th - Level 6 | Patients received Level 6 = 10^10th dose of Salmonella typhimurium |
| BG006 | Total | Total of all reporting groups |
| Participants |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Ethnicity (NIH/OMB) | Count of Participants | Participants |
|
| Race (NIH/OMB) | Count of Participants | Participants |
|
Patients received Level 2 = 10^6th dose of Salmonella typhimurium |
| OG002 | Salmonella Typhimurium 10 to the 7 th - Level 3 | Patients received Level 3 = 10^7th dose of Salmonella typhimurium |
| OG003 | Salmonella Typhimurium 10 to the 8 th - Level 4 | Patients received Level 4 = 10^8th dose of Salmonella typhimurium |
| OG004 | Salmonella Typhimurium 10 to the 9th - Level 5 | Patients received Level 5 = 10^9th dose of Salmonella typhimurium |
| OG005 | Salmonella Typhimurium 10 to the 10 th - Level 6 | Patients received Level 6 = 10^10th dose of Salmonella typhimurium |
|
|
| Secondary | Number of Participants With Complete Response to Treatment | Evaluation is performed using Response Evaluation Criteria in Solid Tumors (RECIST). Each patient will be assigned one of the following categories: Complete response (CR) the disappearance of all target lesion; Partial response (PR) at least a 30% decrease; Progressive disease (PD) at least a 20% increase, or the appearance of one or more new lesions; Stable disease (SD) neither sufficient shrinkage to qualify for partial response nor sufficient increase to qualify for progressive disease; early death from malignant disease; unknown (insufficient evaluation to determine response status). | Posted | Count of Participants | Participants | 8 Weeks After Treatment with Salmonella Typhimurium |
|
|
|
| Secondary | Peripheral Blood NK Cells Count | Patients receiving doses of 10^5 through 10^10 Colony forming units of Salmonella typhimurium had their peripheral blood flow cytometry performed to identify the NK (Natural killer) cells population (CD8-, CD4-, CD49b+) prior to administration and at 5 weeks post administration. The flow cytometry data below was gathered by gating on the lymphocyte population of cells in the patient's blood, as determined by FSC vs. SSC. The mean percentage of NK cells in sample's lymphocyte population is given. | One patient in 10 to the 6 th - Level 2 arm was not evaluable. One patient in 10 to the 7 th - Level 3 arm was not evaluable. Two patients in 10 to the 8 th - Level 4 arm were not evaluable. Two patients in 10 to the 9th - Level 5 arm were not evaluable. Two patients in 10 to the 10th - Level 6 arm were not evaluable. | Posted | Mean | Standard Deviation | peripheral NK cells percentage | Baseline and 5 Weeks After Dosing with Salmonella typhimurium |
|
|
|
| Secondary | Peripheral Blood T Cells Count | Patients receiving doses of 10^5 through 10^10 Colony forming units of Salmonella typhimurium had their peripheral blood flow cytometry performed to identify the NK (Natural killer) cells population (CD25+, FoxP3+) prior to administration and at 5 weeks post administration. The flow cytometry data below was gathered by gating on the lymphocyte population of cells in the patient's blood, as determined by FSC vs. SSC. The mean percentage of T cells in sample's lymphocyte population is given. | One patient in 10 to the 6 th - Level 2 arm was not evaluable. One patient in 10 to the 7 th - Level 3 arm was not evaluable. Two patients in 10 to the 8 th - Level 4 arm were not evaluable. Two patients in 10 to the 9th - Level 5 arm were not evaluable. Two patients in 10 to the 10th - Level 6 arm were not evaluable. | Posted | Mean | Standard Deviation | percent peripheral blood T cells | Baseline and 5 Weeks After Dosing with Salmonella typhimurium |
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|
|
| 4 |
| 6 |
| 2 |
| 6 |
| 4 |
| 6 |
| EG001 | Salmonella Typhimurium 10 to the 6 th - Level 2 | Patients received Level 2 = 10^6th dose of Salmonella typhimurium | 2 | 3 | 1 | 3 | 2 | 3 |
| EG002 | Salmonella Typhimurium 10 to the 7 th - Level 3 | Patients received Level 3 = 10^7th dose of Salmonella typhimurium | 3 | 3 | 3 | 3 | 3 | 3 |
| EG003 | Salmonella Typhimurium 10 to the 8 th - Level 4 | Patients received Level 4 = 10^8th dose of Salmonella typhimurium | 3 | 3 | 3 | 3 | 3 | 3 |
| EG004 | Salmonella Typhimurium 10 to the 9 th - Level 5 | Patients received Level 5 = 10^9th dose of Salmonella typhimurium | 2 | 3 | 2 | 3 | 2 | 3 |
| EG005 | Salmonella Typhimurium 10 to the 10 th - Level 6 | Patients received Level 6 = 10^10th dose of Salmonella typhimurium | 4 | 4 | 1 | 4 | 4 | 4 |
| Neoplasms benign | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | CTCAE (Unspecified) | Systematic Assessment |
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| GI bleeding | Gastrointestinal disorders | CTCAE (Unspecified) | Systematic Assessment |
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| Vomiting | Gastrointestinal disorders | CTCAE (Unspecified) | Systematic Assessment |
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| Tumor pain | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | CTCAE (Unspecified) | Systematic Assessment |
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| Intracranial hemorrhage | Nervous system disorders | CTCAE (Unspecified) | Systematic Assessment |
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| Gallbladder obstruction | Hepatobiliary disorders | CTCAE (Unspecified) | Systematic Assessment |
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| Creatinine increased | Investigations | CTCAE (Unspecified) | Systematic Assessment |
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| Anemia | Blood and lymphatic system disorders | CTCAE (Unspecified) | Systematic Assessment |
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| hyperkalemia | Hepatobiliary disorders | CTCAE (Unspecified) | Systematic Assessment |
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| Urosepsis | General disorders | CTCAE (Unspecified) | Systematic Assessment |
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| Pericardial effusion | Cardiac disorders | CTCAE (Unspecified) | Systematic Assessment |
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| Eye disorders - Other, specify | Eye disorders | CTCAE (Unspecified) | Systematic Assessment |
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| Abdominal pain | Gastrointestinal disorders | CTCAE (Unspecified) | Systematic Assessment |
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| Ascites | Gastrointestinal disorders | CTCAE (Unspecified) | Systematic Assessment |
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| Constipation | Gastrointestinal disorders | CTCAE (Unspecified) | Systematic Assessment |
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| Nausea | Gastrointestinal disorders | CTCAE (Unspecified) | Systematic Assessment |
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| Vomiting | Gastrointestinal disorders | CTCAE (Unspecified) | Systematic Assessment |
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| Edema limbs | General disorders | CTCAE (Unspecified) | Systematic Assessment |
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| Fatigue | General disorders | CTCAE (Unspecified) | Systematic Assessment |
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| Fever | General disorders | CTCAE (Unspecified) | Systematic Assessment |
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| Pain | General disorders | CTCAE (Unspecified) | Systematic Assessment |
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| Mucosal infection | Infections and infestations | CTCAE (Unspecified) | Systematic Assessment |
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| Alanine aminotransferase increased | Investigations | CTCAE (Unspecified) | Systematic Assessment |
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| Alkaline phosphatase increased | Investigations | CTCAE (Unspecified) | Systematic Assessment |
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| Aspartate aminotransferase increased | Investigations | CTCAE (Unspecified) | Systematic Assessment |
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| Blood bilirubin increased | Investigations | CTCAE (Unspecified) | Systematic Assessment |
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| Investigations - Other, specify | Investigations | CTCAE (Unspecified) | Systematic Assessment |
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| Anorexia | Metabolism and nutrition disorders | CTCAE (Unspecified) | Systematic Assessment |
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| Hyperkalemia | Metabolism and nutrition disorders | CTCAE (Unspecified) | Systematic Assessment |
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| Hypoalbuminemia | Metabolism and nutrition disorders | CTCAE (Unspecified) | Systematic Assessment |
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| Hyponatremia | Metabolism and nutrition disorders | CTCAE (Unspecified) | Systematic Assessment |
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| Metabolism and nutrition disorders - Other, specify | Metabolism and nutrition disorders | CTCAE (Unspecified) | Systematic Assessment |
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| Arthralgia | Musculoskeletal and connective tissue disorders | CTCAE (Unspecified) | Systematic Assessment |
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| Back pain | Musculoskeletal and connective tissue disorders | CTCAE (Unspecified) | Systematic Assessment |
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| Generalized muscle weakness | Musculoskeletal and connective tissue disorders | CTCAE (Unspecified) | Systematic Assessment |
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| Muscle weakness lower limb | Musculoskeletal and connective tissue disorders | CTCAE (Unspecified) | Systematic Assessment |
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| Tumor pain | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | CTCAE (Unspecified) | Systematic Assessment |
|
| Headache | Nervous system disorders | CTCAE (Unspecified) | Systematic Assessment |
|
| Peripheral sensory neuropathy | Nervous system disorders | CTCAE (Unspecified) | Systematic Assessment |
|
| Confusion | Psychiatric disorders | CTCAE (Unspecified) | Systematic Assessment |
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| Dyspnea | Respiratory, thoracic and mediastinal disorders | CTCAE (Unspecified) | Systematic Assessment |
|
| Skin and subcutaneous tissue disorders - Other, specify | Skin and subcutaneous tissue disorders | CTCAE (Unspecified) | Systematic Assessment |
|
| Hypertension | Vascular disorders | CTCAE (Unspecified) | Systematic Assessment |
|
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| D008107 |
| Liver Diseases |
| D000230 | Adenocarcinoma |
| D002277 | Carcinoma |
| D009375 | Neoplasms, Glandular and Epithelial |
| D009370 | Neoplasms by Histologic Type |
| D001660 | Biliary Tract Diseases |
| After administration |
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| After administration |
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