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| Name | Class |
|---|---|
| Eisai Inc. | INDUSTRY |
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The investigators propose a randomized phase II study evaluating the pCR and toxicity profiles of combination eribulin/cyclophosphamide (ErC) and docetaxel /cyclophosphamide (TC) as neoadjuvant therapy for locally advanced HER2-negative breast cancer.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Eribulin+Cyclophosphamide (ErC) | Experimental | Eribulin (Er): 1.4mg/m2 IV (Days 1 and 8) given short (≤1.5 minutes) IV infusion, per institutional standard Cyclophosphamide (C): 600 mg/m2 IV (Day 1), given by IV infusion, per institutional standard |
|
| Docetaxel+Cyclophosphamide (TC) | Experimental | Docetaxel (T): 75 mg/m2 IV (Day 1), given by 1-hour IV infusion Cyclophosphamide (C): 600 mg/m2 IV (Day 1), given by IV infusion, per institutional standard |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Eribulin | Drug | 1.4 mg/m2 IV (Days 1 & 8), given short (≤15 minute) IV infusion, per institutional standard |
|
| Measure | Description | Time Frame |
|---|---|---|
| Pathologic Complete Response (pCR) Rate in Patients Treated With ErC for 6 Cycles Prior to Surgery | One cycle = 21 days. Pathologic CR is defined as the absence of invasive tumor in the breast and lymph node tissue removed at the time of definitive surgery as judged by the local pathologist. | 18 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| The Number of Adverse Events as a Measure of Safety and Tolerability. | Treatment-Related Adverse Events occurring in >= 15% of treated patients | 43 months |
| Clinical Response Rate (cRR) of ErC as Neoadjuvant Therapy |
Not provided
Inclusion Criteria:
Histologically confirmed invasive adenocarcinoma of the breast.
Primary palpable disease confined to the breast and axilla on physical examination (clinical Stage II or III disease). For patients without clinically suspicious axillary adenopathy, the primary must be >2 cm in diameter by physical examination or imaging studies (clinical T2-3, N0-2, M0). For patients with clinically suspicious axillary adenopathy, the primary breast tumor can be any size (clinical T1-3, N1-2, M0). Patients who have had axillary node dissection and have pN3a (i.e. ≥10 involved axillary nodes) are also eligible.
Patients entering the trial after undergoing an axillary node dissection will be eligible if they meet other entry criteria.
Estrogen receptor (ER) and progesterone receptor (PR) status in the primary tumor known or pending at the time of study registration.
Resolution of all acute effects of surgical procedures to ≤ grade 1. For patients who had or will have, a sentinel node and/or axillary node dissection, completion at least 1 week prior to the initiation of study treatment with a well-healed wound is required.
Bilateral, synchronous breast cancer is allowed if both primary tumors are HER2-negative and at least one meets the specified qualifying tumor or nodal inclusion criteria.
Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) score of 0-2.
Patients entering this study must be willing to provide release of tumor tissue collected at baseline during a diagnostic procedure if available, and at the time of future surgical procedure(s) for correlative testing. If tissue is not available, the patient will still be eligible for enrollment to the study.
No evidence of metastatic disease, as documented by complete staging workup ≤8 weeks prior to initiation of study treatment.
No prior treatment for this breast cancer with the exception of criterion #3.
HER2-negative tumor status defined as:
Adequate hematologic function defined as:
Adequate liver function defined as:
Adequate renal function defined as:
GRF =(140-age) x (weight/kg) x (0.85 if female) (72 x serum creatinine mg/dL)
Other laboratory testing:
Female and ≥18 years of age.
Negative serum pregnancy test within <7 days prior to initial trial treatment.
Female patients who are not of child-bearing potential, and female patients of child-bearing potential who agree to use adequate contraceptive measures that are approved by their study physician while receiving study treatment and continuing for 3 weeks after the last dose of study drug treatment, who are not breastfeeding, and who have a negative serum pregnancy test prior to start of dosing.
Willingness and ability to comply with trial and follow-up procedures.
Ability to understand the nature of this trial and give written informed consent.
Exclusion Criteria:
Clinical T4 lesions, including inflammatory breast cancer. Clinical N3 involvement (e.g., ipsilateral, infraclavicular, supraclavicular, and internal mammary nodes).
Peripheral neuropathy (motor or sensory) > grade 1 according to Common Terminology Criteria for Adverse Events version 4.0 (CTCAE v4.0).
Patient has received radiotherapy for treatment of previous cancer that included ≥30% of major bone marrow containing areas (e.g., pelvis, lumbar, spine).
Known or suspected allergy or hypersensitivity to any of the study drugs (i.e., eribulin, cyclophosphamide, docetaxel) or known hypersensitivity to polysorbate 80.
Patients with acute or chronic liver or renal disease or pancreatitis.
Known diagnosis of human immunodeficiency virus (HIV), Hepatitis B (HBV) or Hepatitis C (HCV).
Concurrent treatment with an ovarian hormonal replacement therapy or with hormonal agents such as raloxifene, tamoxifen or other selective estrogen receptor modulator (SERM). Patients must have discontinued use of such agents prior to beginning study treatment. However, use of GNRH agonists for the purpose of fertility preservation or suppression of heavy menses is permitted (see Section 5.4.1).
Patient has any of the following cardiac diseases currently or within the last 6 months:
Chronic use of drugs that cause QTc prolongation. Patients must discontinue use of these drugs 7 days prior to the start of study treatment.
Presence of other active cancers, or history of treatment for invasive cancer ≤5 years. Patients with stage I cancer who have received definitive local treatment at least 3 years previously, and are considered unlikely to recur are eligible. All patients with previously treated in situ carcinoma (i.e. non-invasive) are eligible, as are patients with history of non-melanoma skin cancer.
Patients may not receive any other investigational or anti-cancer treatments while participating in this trial.
Psychological, familial, sociological, or geographical conditions that do not permit compliance with the protocol.
Inability or unwillingness to comply with study and/or follow-up procedures outlined in the protocol.
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| Name | Affiliation | Role |
|---|---|---|
| Denise A Yardley, MD | SCRI Development Innovations, LLC | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Florida Cancer Specialists South | Fort Myers | Florida | 33916 | United States | ||
| Memorial Cancer Institute |
After a 10-patient lead-in to confirm safety and feasibility of ErC, subsequent patients (66) were randomized 2 to 1 for treatment with: (1) ErC (44 patients) or (2) TC (22 patients). Both regimens were administered every 21 days for 6 cycles followed by surgery.
This neoadjuvant trial evaluated the combination of eribulin/cyclophosphamide (ErC) versus docetaxel/cyclophosphamide (TC) in women with clinical stage II-III breast cancers. Between JUN 2012 and APR 2014, 76 patients were enrolled.
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| ID | Title | Description |
|---|---|---|
| FG000 | Eribulin+Cyclophosphamide: ErC | Eribulin (Er): 1.4 mg/m^2 by IV infusion (Days 1 and 8); Cyclophosphamide (C): 600 mg/m^2 by IV infusion (Day 1) Administered every 21 days for 6 cycles followed by surgery. |
| FG001 | Docetaxel+Cyclophosphamide: TC |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| Cyclophosphamide | Drug | Cyclophosphamide will be given as an IV infusion (600 mg/m2) on Day 1 of each treatment cycle over approximately 30 minutes, or per institutional standard. |
|
|
| Docetaxel | Drug | Patients assigned to Treatment Arm 2 will receive docetaxel 75 mg/m2 IV on Day 1 of each treatment cycle every 3 weeks. |
|
|
Defined as the number of patients with a best response of clinical complete or partial response (cCR or cPR) divided by the number of patients qualified for tumor response analysis per Response Evaluation Criteria in Solid Tumors Criteria (RECIST) v1.1 for target lesions and assessed by MRI or CT. Complete Response (CR) defined as disappearance of all target lesions; Partial Response (PR) defined as at least a 30% decrease in the sum of the longest diameter (LD) of target lesions, taking as reference the baseline sum LD;
| 43 months |
| Disease-Free Survival (DFS) at 2 Years | Defined as the percent probability that participants had not experienced disease recurrence or died from any cause at 2 years post-surgery, analyzed by Kaplan-Meier methodology. | 24 months |
| Hollywood |
| Florida |
| 33021 |
| United States |
| Woodlands Medical Specialists | Pensacola | Florida | 32503 | United States |
| Florida Cancer Specialists North | St. Petersburg | Florida | 33705 | United States |
| Northeast Georgia Medical Center | Gainesville | Georgia | 30501 | United States |
| Mercy Hospital | Portland | Maine | 04102 | United States |
| Center for Cancer and Blood Disorders | Bethesda | Maryland | 20817 | United States |
| Grand Rapids Oncology Program | Grand Rapids | Michigan | 49503 | United States |
| Research Medical Center | Kansas City | Missouri | 64132 | United States |
| Nebraska Methodist Cancer Center | Omaha | Nebraska | 68114 | United States |
| Oncology Hematology Care, Inc | Cincinnati | Ohio | 45242 | United States |
| South Carolina Oncology Associates | Columbia | South Carolina | 29210 | United States |
| Tennessee Oncology | Nashville | Tennessee | 37203 | United States |
| The Center for Cancer and Blood Disorders | Fort Worth | Texas | 76104 | United States |
| Virginia Cancer Institute | Richmond | Virginia | 23230 | United States |
Docetaxel (T): 75 mg/m^2 by IV infusion (Day 1); Cyclophosphamide (C): 600 mg/m^2 by IV infusion (Day 1)tandard. Administered every 21 days for 6 cycles followed by surgery. |
| COMPLETED |
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| NOT COMPLETED |
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Analysis population for ErC includes 10 lead-in and 44 randomized patients.
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| ID | Title | Description |
|---|---|---|
| BG000 | Eribulin+Cyclophosphamide (ErC) | Eribulin (Er): 1.4mg/m2 IV (Days 1 and 8) given short (≤1.5 minutes) IV infusion, per institutional standard; Cyclophosphamide (C): 600 mg/m2 IV (Day 1), given by IV infusion, per institutional standard |
| BG001 | Docetaxel+Cyclophosphamide (TC) | Docetaxel (T): 75 mg/m2 IV (Day 1), given by 1-hour IV infusion; Cyclophosphamide (C): 600 mg/m2 IV (Day 1), given by IV infusion, per institutional standard |
| BG002 | 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 |
| ||||||||||||||||
| Region of Enrollment | Number | participants |
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| 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 | Pathologic Complete Response (pCR) Rate in Patients Treated With ErC for 6 Cycles Prior to Surgery | One cycle = 21 days. Pathologic CR is defined as the absence of invasive tumor in the breast and lymph node tissue removed at the time of definitive surgery as judged by the local pathologist. | Patients who completed 6 cycles and proceeded to surgery. | Posted | Number | percentage of surgical patients | 18 weeks |
|
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| |||||||||||||||||||||||||||||
| Secondary | The Number of Adverse Events as a Measure of Safety and Tolerability. | Treatment-Related Adverse Events occurring in >= 15% of treated patients | Posted | Number | participants | 43 months |
|
| |||||||||||||||||||||||||||||||
| Secondary | Clinical Response Rate (cRR) of ErC as Neoadjuvant Therapy | Defined as the number of patients with a best response of clinical complete or partial response (cCR or cPR) divided by the number of patients qualified for tumor response analysis per Response Evaluation Criteria in Solid Tumors Criteria (RECIST) v1.1 for target lesions and assessed by MRI or CT. Complete Response (CR) defined as disappearance of all target lesions; Partial Response (PR) defined as at least a 30% decrease in the sum of the longest diameter (LD) of target lesions, taking as reference the baseline sum LD; | All patients evaluated/evaluable per RECIST v1.1 | Posted | Number | percentage of participants | 43 months |
|
| ||||||||||||||||||||||||||||||
| Secondary | Disease-Free Survival (DFS) at 2 Years | Defined as the percent probability that participants had not experienced disease recurrence or died from any cause at 2 years post-surgery, analyzed by Kaplan-Meier methodology. | Includes all patients that completed surgery. | Posted | Number | 95% Confidence Interval | percent probability of survival | 24 months |
|
|
43 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 | Eribulin+Cyclophosphamide (ErC) | Eribulin (Er): 1.4mg/m2 IV (Days 1 and 8) given short (≤1.5 minutes) IV infusion, per institutional standard Cyclophosphamide (C): 600 mg/m2 IV (Day 1), given by IV infusion, per institutional standard Eribulin: 1.4 mg/m2 IV (Days 1 & 8), given short (≤15 minute) IV infusion, per institutional standard Cyclophosphamide: Cyclophosphamide will be given as an IV infusion (600 mg/m2) on Day 1 of each treatment cycle over approximately 30 minutes, or per institutional standard. | 4 | 54 | 44 | 54 | ||
| EG001 | Docetaxel+Cyclophosphamide (TC) | Docetaxel (T): 75 mg/m2 IV (Day 1), given by 1-hour IV infusion Cyclophosphamide (C): 600 mg/m2 IV (Day 1), given by IV infusion, per institutional standard Cyclophosphamide: Cyclophosphamide will be given as an IV infusion (600 mg/m2) on Day 1 of each treatment cycle over approximately 30 minutes, or per institutional standard. Docetaxel: Patients assigned to Treatment Arm 2 will receive docetaxel 75 mg/m2 IV on Day 1 of each treatment cycle every 3 weeks. | 2 | 22 | 22 | 22 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Febrile Neutropenia | Blood and lymphatic system disorders | CTCAE (4.0) | Systematic Assessment |
| |
| Sepsis | Infections and infestations | CTCAE (4.0) | Systematic Assessment |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| ABDOMINAL PAIN | Gastrointestinal disorders | CTCAE (4.0) | Systematic Assessment |
| |
| ALANINE AMINOTRANSFERASE INCREASED | Investigations | CTCAE (4.0) | Systematic Assessment |
| |
| ALOPECIA | Skin and subcutaneous tissue disorders | CTCAE (4.0) | Systematic Assessment |
| |
| ANEMIA | Blood and lymphatic system disorders | CTCAE (4.0) | Systematic Assessment |
| |
| ANOREXIA | Metabolism and nutrition disorders | CTCAE (4.0) | Systematic Assessment |
| |
| ARTHRALGIA | Musculoskeletal and connective tissue disorders | CTCAE (4.0) | Systematic Assessment |
| |
| ASPARTATE AMINOTRANSFERASE INCREASED | Investigations | CTCAE (4.0) | Systematic Assessment |
| |
| ASTHENIA | General disorders | CTCAE (4.0) | Systematic Assessment |
| |
| CHILLS | General disorders | CTCAE (4.0) | Systematic Assessment |
| |
| CONSTIPATION | Gastrointestinal disorders | CTCAE (4.0) | Systematic Assessment |
| |
| DIARRHEA | Gastrointestinal disorders | CTCAE (4.0) | Systematic Assessment |
| |
| DIZZINESS | Nervous system disorders | CTCAE (4.0) | Systematic Assessment |
| |
| DRY SKIN | Skin and subcutaneous tissue disorders | CTCAE (4.0) | Systematic Assessment |
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| DYSGEUSIA | Nervous system disorders | CTCAE (4.0) | Systematic Assessment |
| |
| DYSPEPSIA | Gastrointestinal disorders | CTCAE (4.0) | Systematic Assessment |
| |
| DYSPNEA | Respiratory, thoracic and mediastinal disorders | CTCAE (4.0) | Systematic Assessment |
| |
| EDEMA | General disorders | CTCAE (4.0) | Systematic Assessment |
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| FATIGUE | General disorders | CTCAE (4.0) | Systematic Assessment |
| |
| FEBRILE NEUTROPENIA | Blood and lymphatic system disorders | CTCAE (4.0) | Systematic Assessment |
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| FEVER | General disorders | CTCAE (4.0) | Systematic Assessment |
| |
| HEADACHE | Nervous system disorders | CTCAE (4.0) | Systematic Assessment |
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| HOT FLASHES | General disorders | CTCAE (4.0) | Systematic Assessment |
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| INSOMNIA | Nervous system disorders | CTCAE (4.0) | Systematic Assessment |
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| LEUKOPENIA | Blood and lymphatic system disorders | CTCAE (4.0) | Systematic Assessment |
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| LYMPHOCYTE COUNT DECREASED | Investigations | CTCAE (4.0) | Systematic Assessment |
| |
| MALAISE | General disorders | CTCAE (4.0) | Systematic Assessment |
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| MUCOSITIS | Gastrointestinal disorders | CTCAE (4.0) | Systematic Assessment |
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| MYALGIA | Musculoskeletal and connective tissue disorders | CTCAE (4.0) | Systematic Assessment |
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| NAIL CHANGES | Skin and subcutaneous tissue disorders | CTCAE (4.0) | Systematic Assessment |
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| NAIL DISCOLORATION | Skin and subcutaneous tissue disorders | CTCAE (4.0) | Systematic Assessment |
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| NAUSEA | Gastrointestinal disorders | CTCAE (4.0) | Systematic Assessment |
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| NEUTROPENIA | Blood and lymphatic system disorders | CTCAE (4.0) | Systematic Assessment |
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| PARESTHESIA | Nervous system disorders | CTCAE (4.0) | Systematic Assessment |
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| PERIPHERAL NEUROPATHY | Nervous system disorders | CTCAE (4.0) | Systematic Assessment |
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| POST NASAL DRIP | Respiratory, thoracic and mediastinal disorders | CTCAE (4.0) | Systematic Assessment |
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| PRURITUS | Skin and subcutaneous tissue disorders | CTCAE (4.0) | Systematic Assessment |
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| RASH | Skin and subcutaneous tissue disorders | CTCAE (4.0) | Systematic Assessment |
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| SCALP PAIN | Skin and subcutaneous tissue disorders | CTCAE (4.0) | Systematic Assessment |
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| TASTE ALTERATION | Nervous system disorders | CTCAE (4.0) | Systematic Assessment |
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| THROMBOCYTOPENIA | Blood and lymphatic system disorders | CTCAE (4.0) | Systematic Assessment |
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| URINARY TRACT INFECTION | Renal and urinary disorders | CTCAE (4.0) | Systematic Assessment |
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| VOMITING | Gastrointestinal disorders | CTCAE (4.0) | Systematic Assessment |
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| WATERING EYES | Eye disorders | CTCAE (4.0) | Systematic Assessment |
|
The sponsor can review/embargo results communications prior to public release for a period that is >60 but =180 days from date submitted to sponsor, who may require changes to the communication in order to remove specifically identified confidential information (other than study data) and/or delay the proposed publication to enable the sponsor to seek patent protection for inventions. The PI may not publish its results until 18 mos. after the trial has been completed at all sites
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| John D Hainsworth, MD | Sarah Cannon Research Institute | 1-877-691-7274 | asksarah@scresearch.net |
| ID | Term |
|---|---|
| D001943 | Breast Neoplasms |
| ID | Term |
|---|---|
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D001941 | Breast Diseases |
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
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| ID | Term |
|---|---|
| C490954 | eribulin |
| D003520 | Cyclophosphamide |
| D000077143 | Docetaxel |
| ID | Term |
|---|---|
| D010752 | Phosphoramide Mustards |
| D009588 | Nitrogen Mustard Compounds |
| D009150 | Mustard Compounds |
| D006846 | Hydrocarbons, Halogenated |
| D006838 | Hydrocarbons |
| D009930 | Organic Chemicals |
| D063088 | Phosphoramides |
| D009943 | Organophosphorus Compounds |
| D043823 | Taxoids |
| D043822 | Cyclodecanes |
| D003516 | Cycloparaffins |
| D006840 | Hydrocarbons, Alicyclic |
| D006844 | Hydrocarbons, Cyclic |
| D004224 | Diterpenes |
| D013729 | Terpenes |
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| Male |
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| Participants |
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