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| Name | Class |
|---|---|
| Merck Sharp & Dohme LLC | INDUSTRY |
| Phoenix Children's Hospital | OTHER |
| Milton S. Hershey Medical Center | OTHER |
| Johns Hopkins University |
The purpose of this study is to find out how safe and effective treatment with a new combination of drugs, vorinostat and etoposide, is in treating cancer. The medication etoposide is a standard medication used in the treatment of cancer in children. Vorinostat is an experimental drug which targets a protein(s) that control the way cancer cells grow and divide. Vorinostat is approved by the FDA in adults with certain cancers but not approved yet in children.
There are two parts to this study. In the first part of this study, the phase I portion, a safe dose of the combination, vorinostat and etoposide. The goal of second part of this study, the phase II portion, is to see how effective the combination of vorinostat and etoposide is in treating cancer.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Vorinostat and Etoposide | Experimental | This is a multi-center, open label, phase I/II trial of escalating doses of vorinostat in combination with etoposide. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Vorinostat and Etoposide | Drug | Patients will be assessed in 3-week cycles. Escalating doses of vorinostat will be administered orally on a daily x 4 schedule in combination with a fixed dose of etoposide. Etoposide will be administered intravenously daily x 3 days. Cohorts of 3-6 patients will be treated with vorinostat and etoposide. In the phase II component, patients will be treated at the RP2D established in the Phase I component of the study, which was found to be 270 mg/m2/dose of Vorinostat and 100 mg/m2/dose of Etoposide. |
| Measure | Description | Time Frame |
|---|---|---|
| To Establish the Dose Limiting Toxicity (DLT) | of the novel combination vorinostat and etoposide in pediatric patients with refractory solid tumors including tumors of the central nervous system. The Toxicity will be evaluated according to NCI CTCAE Version 4.0. | Patients will be assessed in 3-week cycles. |
| To Establish the Maximum Tolerated Dose (MTD) | of the novel combination vorinostat and etoposide in pediatric patients with refractory solid tumors including tumors of the central nervous system. | 1 year |
| To Establish the Efficacy (CR (Complete Response) + PR (Partial Response) Rate) | of the novel combination vorinostat and etoposide in pediatric patients with relapsed/refractory sarcoma. Evaluation for response will be determined by Revised RECIST guideline | 1 year |
| Measure | Description | Time Frame |
|---|---|---|
| To Evaluate the Efficacy (CR (Complete Response) + PR (Partial Response) Rate) | of the novel combination vorinostat and etoposide in pediatric patients enrolled in the phase I component of the study. Evaluation for response will be determined by Revised RECIST guideline. | 1 year |
| To Evaluate the Biologic Effects Using Histone Acetylation, Gene Expression Profiling, and Histone Phosphorylation Profiling. |
Not provided
Inclusion Criteria:
Phase I Component: Histologic confirmation of relapsed/refractory solid tumors, including tumors of the central nervous system that have failed to respond to standard therapy, progressed despite standard therapy, or for which standard therapy does not exist. Patients with diffuse pontine glioma are not required to have histologic confirmation of disease, and are eligible with radiologic confirmation. Phase II Component: the population will be restricted to relapsed/refractory sarcomas
Patient must be between 4-21 years of age at the time of study enrollment. Efforts will be made to enroll patients <13 years of age so that adequate information about the biologic effects of this agent in younger patients can be obtained.
Patient must have Karnofsky > or = to 60% for patients >10 years of age; Lansky Play Scale > or = to to 60 for children < or = to 10 years of age
Patient must have a life expectancy of > 8 weeks.
There is no limit to the number of prior treatment regimens provided that performance status and life expectancy meet the criteria above.
Absolute neutrophil count (ANC) ≥ 1000 / mcL
Platelets ≥100,000 / mcL (transfusion not permitted)
Hemoglobin ≥ 9 g/dL qualifications (transfusion permitted)
Coagulation Prothrombin Time or INR ≤ 1.5x upper limit of normal (ULN)
Serum creatinine ≤ 1.5x upper limit of normal (ULN) OR calculated creatinine clearance ≥ 60 mL/min for patients with creatinine levels > 1.5x institutional ULN. or calculated creatinine clearance Creatinine clearance should be calculated per institutional standard.
Serum total bilirubin ≤ 1.5 x ULN Patient's who don't meet this criteria must have a Direct bilirubin ≤ 1.5 x ULN
AST (SGOT) and ALT (SGPT) Alkaline Phosphatase (liver fraction)
≤ 2.5 x ULN. If AST or ALT is > 2.5 x ULN, then the liver fraction of Alkaline Phosphatase should be ≤ 2.5 x ULN
Phase I component: Patients may have measurable or non-measurable disease. Phase II component: Patients may only have measurable disease.
Patient must have no persistent toxicities from prior therapy > or = to Grade 2 with the exception of hematologic indices (i.e. hemoglobin, WBC, ANC, ALC).
For females of childbearing potential, a negative serum pregnancy test must be documented within 72 hours of receiving the first dose of vorinostat.
Patient, or the patient's legal representative, has voluntarily agreed to participate by giving written informed consent.
Female patients of childbearing potential must be willing to use 2 adequate barrier methods of contraception to prevent pregnancy or agree to abstain from heterosexual activity throughout the study, starting with visit 1.
Male patients must agree to use an adequate method of contraception for the duration of the study.
Prior Therapy: Patients must have fully recovered from the acute toxic effects of all prior chemotherapy, immunotherapy, or radiotherapy prior to entering this study.
Myelosuppressive chemotherapy: At least 2 weeks must have elapsed since the administration of previous therapy. Six weeks must have elapsed since administration of nitrosoureas or mitomycin C. Seven days must have elapsed since the administration of G-CSF and/or GM-CSF.
Biologic agents: At least 14 days must have elapsed since the completion of therapy with a biologic agent such as a monoclonal antibody. Seven days must have elapsed since the last dose of retinoids.
Radiation therapy (XRT): > or = to 2 weeks must have elapsed for local XRT (small port); > or = to 6 months must have elapsed if prior radiation to > or = to 50% of the pelvis or if other substantial bone marrow irradiation, including total body irradiation.
Patient must be able to swallow capsules.
Patient must have an available archival/pre-treatment block or fresh tumor biopsy for molecular profiling to be performed.
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Tanya Trippett, MD | Memorial Sloan Kettering Cancer Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Phoenix Children'S Hospital | Phoenix | Arizona | 85016 | United States | ||
| Children's Hospital Colorado |
Not provided
| Label | URL |
|---|---|
| Memorial Sloan Kettering Cancer Center | View source |
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| ID | Title | Description |
|---|---|---|
| FG000 | Dose Level 1 | 100 mg/m2 Etoposide, 125 mg/m2 Vorinostat + Data Migration |
| FG001 | Dose Level 2 | 100 mg/m2 Etoposide, 160 mg/m2 Vorinostat + Data Migration |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Mar 25, 2014 |
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| OTHER |
| Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins | OTHER |
| Children's Hospital Colorado | OTHER |
| University of Florida | OTHER |
| Alberta Children's Hospital | OTHER |
| M.D. Anderson Cancer Center | OTHER |
| Dana-Farber Cancer Institute | OTHER |
| Children's Mercy Hospital Kansas City | OTHER |
| Johns Hopkins All Children's Hospital | OTHER |
| Arnold Palmer Hospital for Children | OTHER |
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|
of the novel combination of vorinostat and etoposide in pediatric patients with refractory solid tumors including central nervous system tumors |
| 2 years |
| Aurora |
| Colorado |
| 80045 |
| United States |
| Arnold Palmer Hospital for Children/MD Anderson Cancer Center Orlando | Orlando | Florida | 32806 | United States |
| All Children's Hospital | St. Petersburg | Florida | 33701 | United States |
| John Hopkins Medical Center | Baltimore | Maryland | 21287 | United States |
| Dana Farber Cancer Institute | Boston | Massachusetts | 02115 | United States |
| Children's Mercy Hospital & Clinics | Kansas City | Missouri | 64108 | United States |
| Memorial Sloan Kettering Cancer Center | New York | New York | 10065 | United States |
| Pennsylvania State University College of Medicine | Hershey | Pennsylvania | 17110 | United States |
| Md Anderson Cancer Center | Houston | Texas | 77030 | United States |
| Alberta Children'S Hospital | Calgary | Alberta | T2N 1N4 | Canada |
| FG002 | Dose Level 3 | 100 mg/m2 Etoposide, 210 mg/m2 Vorinostat + Data Migration |
| FG003 | Dose Level 4 | 100 mg/m2 Etoposide, 270 mg/m2 Vorinostat + Data Migration |
| FG004 | Phase II | Vorinostat 270 mg/m2; Etoposide 100 mg/m2 + Data Migration |
| COMPLETED |
|
| NOT COMPLETED |
|
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Dose Level 1 | 100 mg/m2 Etoposide, 125 mg/m2 Vorinostat + Data Migration |
| BG001 | Dose Level 2 | 100 mg/m2 Etoposide, 160 mg/m2 Vorinostat + Data Migration |
| BG002 | Dose Level 3 | 100 mg/m2 Etoposide, 210 mg/m2 Vorinostat + Data Migration |
| BG003 | Dose Level 4 | 100 mg/m2 Etoposide, 270 mg/m2 Vorinostat + Data Migration |
| BG004 | Phase II Dose | Vorinostat 270 mg/m2; Etoposide 100 mg/m2 + Data Migration |
| BG005 | Total | Total of all reporting groups |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Median | Full Range | years |
| |||||||||||||||
| Sex: Female, Male | Count of Participants | Participants |
| ||||||||||||||||
| Ethnicity (NIH/OMB) | Count of Participants | Participants |
| ||||||||||||||||
| Race (NIH/OMB) | Count of Participants | Participants |
| ||||||||||||||||
| Region of Enrollment | Count of Participants | 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 | To Establish the Dose Limiting Toxicity (DLT) | of the novel combination vorinostat and etoposide in pediatric patients with refractory solid tumors including tumors of the central nervous system. The Toxicity will be evaluated according to NCI CTCAE Version 4.0. | Data were not collected | Posted | Patients will be assessed in 3-week cycles. |
|
| |||||||||||||||||||||||||||||||
| Primary | To Establish the Maximum Tolerated Dose (MTD) | of the novel combination vorinostat and etoposide in pediatric patients with refractory solid tumors including tumors of the central nervous system. | Data were not collected | Posted | 1 year |
| ||||||||||||||||||||||||||||||||
| Primary | To Establish the Efficacy (CR (Complete Response) + PR (Partial Response) Rate) | of the novel combination vorinostat and etoposide in pediatric patients with relapsed/refractory sarcoma. Evaluation for response will be determined by Revised RECIST guideline | Data were not collected | Posted | 1 year |
| ||||||||||||||||||||||||||||||||
| Secondary | To Evaluate the Efficacy (CR (Complete Response) + PR (Partial Response) Rate) | of the novel combination vorinostat and etoposide in pediatric patients enrolled in the phase I component of the study. Evaluation for response will be determined by Revised RECIST guideline. | Data were not collected | Posted | 1 year |
| ||||||||||||||||||||||||||||||||
| Secondary | To Evaluate the Biologic Effects Using Histone Acetylation, Gene Expression Profiling, and Histone Phosphorylation Profiling. | of the novel combination of vorinostat and etoposide in pediatric patients with refractory solid tumors including central nervous system tumors | Data were not collected | Posted | 2 years |
|
1 year
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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 | Dose Level 1 | 100 mg/m2 Etoposide, 125 mg/m2 Vorinostat (n=7) | 5 | 7 | 3 | 7 | 7 | 7 |
| EG001 | Dose Level 2 | 100 mg/m2 Etoposide, 160 mg/m2 Vorinostat (n=3) | 2 | 3 | 3 | 3 | 3 | 3 |
| EG002 | Dose Level 3 | 100 mg/m2 Etoposide, 210 mg/m2 Vorinostat (n=3) | 1 | 3 | 1 | 3 | 3 | 3 |
| EG003 | Dose Level 4 | 100 mg/m2 Etoposide, 270 mg/m2 Vorinostat (n=9) | 4 | 9 | 3 | 9 | 9 | 9 |
| EG004 | Phase II Dose | Vorinostat 270 mg/m2; Etoposide 100 mg/m2 (n=5) | 3 | 5 | 4 | 5 | 5 | 5 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Anemia | Blood and lymphatic system disorders | Systematic Assessment |
| ||
| Bone pain | Musculoskeletal and connective tissue disorders | Systematic Assessment |
| ||
| Catheter related infection | Infections and infestations | Systematic Assessment |
| ||
| Colitis | Gastrointestinal disorders | Systematic Assessment |
| ||
| Death NOS | General disorders | Systematic Assessment |
| ||
| Fever | General disorders | Systematic Assessment |
| ||
| Headache | Nervous system disorders | Systematic Assessment |
| ||
| Hypercalcemia | Metabolism and nutrition disorders | Systematic Assessment |
| ||
| Hypernatremia | Metabolism and nutrition disorders | Systematic Assessment |
| ||
| Infections and infestations - Other, specify | Infections and infestations | Systematic Assessment |
| ||
| Lymphocyte count decreased | Investigations | Systematic Assessment |
| ||
| Nausea | Gastrointestinal disorders | Systematic Assessment |
| ||
| Neutrophil count decreased | Investigations | Systematic Assessment |
| ||
| Platelet count decreased | Investigations | Systematic Assessment |
| ||
| Respiratory failure | Respiratory, thoracic and mediastinal disorders | Systematic Assessment |
| ||
| Sepsis | Infections and infestations | Systematic Assessment |
| ||
| Sinus tachycardia | Cardiac disorders | Systematic Assessment |
| ||
| Urinary tract obstruction | Renal and urinary disorders | Systematic Assessment |
| ||
| Vomiting | Gastrointestinal disorders | Systematic Assessment |
| ||
| White blood cell decreased | Investigations | Systematic Assessment |
|
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| White blood cell decreased | Investigations | Systematic Assessment |
| ||
| Neutrophil count decreased | Investigations | Systematic Assessment |
| ||
| Platelet count decreased | Investigations | Systematic Assessment |
| ||
| Anemia | Blood and lymphatic system disorders | Systematic Assessment |
| ||
| Fatigue | General disorders | Systematic Assessment |
| ||
| Lymphocyte count decreased | Investigations | Systematic Assessment |
| ||
| Nausea | Gastrointestinal disorders | Systematic Assessment |
| ||
| Vomiting | Gastrointestinal disorders | Systematic Assessment |
| ||
| Anorexia | Metabolism and nutrition disorders | Systematic Assessment |
| ||
| Alopecia | Skin and subcutaneous tissue disorders | Systematic Assessment |
| ||
| Diarrhea | Gastrointestinal disorders | Systematic Assessment |
| ||
| Aspartate aminotransferase increased | Investigations | Systematic Assessment |
| ||
| Headache | Nervous system disorders | Systematic Assessment |
| ||
| Alanine aminotransferase increased | Investigations | Systematic Assessment |
| ||
| Fever | General disorders | Systematic Assessment |
| ||
| Constipation | Gastrointestinal disorders | Systematic Assessment |
| ||
| Hypernatremia | Metabolism and nutrition disorders | Systematic Assessment |
| ||
| Hypocalcemia | Metabolism and nutrition disorders | Systematic Assessment |
| ||
| Hypokalemia | Metabolism and nutrition disorders | Systematic Assessment |
| ||
| Hyponatremia | Metabolism and nutrition disorders | Systematic Assessment |
| ||
| Hypophosphatemia | Metabolism and nutrition disorders | Systematic Assessment |
| ||
| Myalgia | Musculoskeletal and connective tissue disorders | Systematic Assessment |
| ||
| Abducens nerve disorder | Nervous system disorders | Systematic Assessment |
| ||
| Activated partial thromboplastin time prolonged | Investigations | Systematic Assessment |
| ||
| Anorectal infection | Infections and infestations | Systematic Assessment |
| ||
| Aspiration | Respiratory, thoracic and mediastinal disorders | Systematic Assessment |
| ||
| Ataxia | Nervous system disorders | Systematic Assessment |
| ||
| Back pain | Musculoskeletal and connective tissue disorders | Systematic Assessment |
| ||
| Blood bilirubin increased | Investigations | Systematic Assessment |
| ||
| Bone pain | Musculoskeletal and connective tissue disorders | Systematic Assessment |
| ||
| Catheter related infection | Infections and infestations | Systematic Assessment |
| ||
| Chills | General disorders | Systematic Assessment |
| ||
| Colitis | Gastrointestinal disorders | Systematic Assessment |
| ||
| Conjunctivitis | Infections and infestations | Systematic Assessment |
| ||
| Creatinine increased | Investigations | Systematic Assessment |
| ||
| Death NOS | General disorders | Systematic Assessment |
| ||
| Dehydration | Metabolism and nutrition disorders | Systematic Assessment |
| ||
| Depression | Psychiatric disorders | Systematic Assessment |
| ||
| Dizziness | Nervous system disorders | Systematic Assessment |
| ||
| Dry mouth | Gastrointestinal disorders | Systematic Assessment |
| ||
| Dysarthria | Nervous system disorders | Systematic Assessment |
| ||
| Dysgeusia | Nervous system disorders | Systematic Assessment |
| ||
| Facial nerve disorder | Nervous system disorders | Systematic Assessment |
| ||
| Febrile neutropenia | Blood and lymphatic system disorders | Systematic Assessment |
| ||
| Gastric hemorrhage | Gastrointestinal disorders | Systematic Assessment |
| ||
| Hearing impaired | Ear and labyrinth disorders | Systematic Assessment |
| ||
| Hyperglycemia | Metabolism and nutrition disorders | Systematic Assessment |
| ||
| Hypermagnesemia | Metabolism and nutrition disorders | Systematic Assessment |
| ||
| Hypertension | Vascular disorders | Systematic Assessment |
| ||
| Hypoalbuminemia | Metabolism and nutrition disorders | Systematic Assessment |
| ||
| Hypocalcemia | Metabolism and nutrition disorders | Systematic Assessment |
| ||
| Hypotension | Vascular disorders | Systematic Assessment |
| ||
| Hypoxia | Respiratory, thoracic and mediastinal disorders | Systematic Assessment |
| ||
| Infections and infestations - Other, specify | Infections and infestations | Systematic Assessment |
| ||
| INR increased | Investigations | Systematic Assessment |
| ||
| Insomnia | Psychiatric disorders | Systematic Assessment |
| ||
| Leukocytosis | Blood and lymphatic system disorders | Systematic Assessment |
| ||
| Mucositis oral | Gastrointestinal disorders | Systematic Assessment |
| ||
| Muscle weakness left-sided | Nervous system disorders | Systematic Assessment |
| ||
| Muscle weakness right-sided | Nervous system disorders | Systematic Assessment |
| ||
| Nervous system disorders - Other, specify | Nervous system disorders | Systematic Assessment |
| ||
| Nystagmus | Nervous system disorders | Systematic Assessment |
| ||
| Oculomotor nerve disorder | Nervous system disorders | Systematic Assessment |
| ||
| Optic nerve disorder | Eye disorders | Systematic Assessment |
| ||
| Pain | General disorders | Systematic Assessment |
| ||
| Pain in extremity | Musculoskeletal and connective tissue disorders | Systematic Assessment |
| ||
| Peripheral sensory neuropathy | Nervous system disorders | Systematic Assessment |
| ||
| Portal vein thrombosis | Hepatobiliary disorders | Systematic Assessment |
| ||
| Pyramidal tract syndrome | Nervous system disorders | Systematic Assessment |
| ||
| Respiratory failure | Respiratory, thoracic and mediastinal disorders | Systematic Assessment |
| ||
| Seizure | Nervous system disorders | Systematic Assessment |
| ||
| Sepsis | Infections and infestations | Systematic Assessment |
| ||
| Sinus tachycardia | Cardiac disorders | Systematic Assessment |
| ||
| Skin & subcutaneous tissue disorders Other, spec | Skin and subcutaneous tissue disorders | Systematic Assessment |
| ||
| Skin infection | Infections and infestations | Systematic Assessment |
| ||
| Somnolence | Nervous system disorders | Systematic Assessment |
| ||
| Upper respiratory infection | Infections and infestations | Systematic Assessment |
| ||
| Urinary tract obstruction | Renal and urinary disorders | Systematic Assessment |
| ||
| Urine output decreased | Investigations | Systematic Assessment |
| ||
| Vertigo | Ear and labyrinth disorders | Systematic Assessment |
| ||
| Weight loss | Investigations | Systematic Assessment |
|
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Tanya Trippett, MD | Memorial Sloan Kettering Cancer Center | 1-833-MSK-KIDS | trippet@mskcc.org |
| Aug 27, 2021 |
| Prot_SAP_000.pdf |
| ID | Term |
|---|---|
| D012509 | Sarcoma |
| ID | Term |
|---|---|
| D018204 | Neoplasms, Connective and Soft Tissue |
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
Not provided
Not provided
| ID | Term |
|---|---|
| D000077337 | Vorinostat |
| D005047 | Etoposide |
| ID | Term |
|---|---|
| D000813 | Anilides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D000814 | Aniline Compounds |
| D000588 | Amines |
| D006877 | Hydroxamic Acids |
| D006898 | Hydroxylamines |
| D006880 | Hydroxy Acids |
| D002264 | Carboxylic Acids |
| D011034 | Podophyllotoxin |
| D013764 | Tetrahydronaphthalenes |
| D009281 | Naphthalenes |
| D011084 | Polycyclic Aromatic Hydrocarbons |
| D006841 | Hydrocarbons, Aromatic |
| D006844 | Hydrocarbons, Cyclic |
| D006838 | Hydrocarbons |
| D011083 | Polycyclic Compounds |
| D005960 | Glucosides |
| D006027 | Glycosides |
| D002241 | Carbohydrates |
Not provided
Not provided
| Male |
|
| Not Hispanic or Latino |
|
| Unknown or Not Reported |
|
| Asian |
|
| Native Hawaiian or Other Pacific Islander |
|
| Black or African American |
|
| White |
|
| More than one race |
|
| Unknown or Not Reported |
|
| Units | Counts |
|---|---|
| Participants |
|
|
|
|