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Further enrollment was halted in November 2021, enrolled subjects completed the study. Sponsor stopped further recruitment in this intravenous study to focus on intra-articular route of administration in subjects with tenosynovial giant cell tumor.
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The purpose of this Phase 2, open-label, multiple-dose, dose-escalation study is to evaluate intravenous AMB-05X in the treatment of subjects with TGCT.
AMB-05X drug substance is a human monoclonal antibody against the colony-stimulating factor 1 receptor (CSF1R).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Cohort A | Experimental | Each subject will receive a low dose of AMB-05X every 2 weeks, for a total of 6 doses over the 12-week treatment period. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| AMB-05X | Biological | AMB-05X is a fully human antibody antagonist (immunoglobulin G, type 2 [IgG2]) specific to the extracellular domain of human CSF1R |
|
| Measure | Description | Time Frame |
|---|---|---|
| Treatment-emergent Adverse Events (TEAEs) | The frequency and severity of reported TEAEs in Subjects with Tenosynovial Giant Cell Tumor (TGCT) receiving Intravenous AMB 05X. | 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Overall Tumor Response (Objective Response) Per Response Evaluation Criteria in Solid Tumors (RECIST) v.1.1 | Response Evaluation Criteria in Solid Tumors (RECIST) v1.1; Per RECIST v1.0 for target lesions and assessed by MRI: A Complete Response (CR) is defined as disappearance of all tumors. A Partial Response (PR) is defined as at least a 30% decrease in the sum of diameters of target tumors from the baseline sum of diameters. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Dorothy Nguyen, MD | AmMax Bio, Inc. | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| AmMax Bio Clinical Site | Budapest | Hungary | ||||
| AmMax Bio Clinical Site |
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The original study design included multiple cohorts with an adaptive, dose escalation design. However, due to the early conclusion of the study, subjects were enrolled only in Cohort A, thus no additional dose cohorts were recruited.
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| ID | Title | Description |
|---|---|---|
| FG000 | Subjects With Tenosynovial Giant Cell Tumor | Cohort A: Received initial priming dose on Day 1 followed by 5 maintenance doses administered every 2 weeks (at Weeks 2, 4, 6, 8, and 10), for a total of 6 doses over the 12-week treatment period. |
| Title | Milestones | Reasons Not Completed | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
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A total of 48 subjects were planned. However, enrollment into the study was stopped in November 2021 after 4 subjects were enrolled to focus more on AMB-05X intra-articular administration.
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| ID | Title | Description |
|---|---|---|
| BG000 | Cohort A: Subjects With TGCT | Low-Dose AMB-05X Each subject will receive a low dose of AMB-05X every 2 weeks, for a total of 6 doses over the 12-week treatment period. AMB-05X is a fully human antibody antagonist (immunoglobulin G, type 2 [IgG2]) specific to the extracellular domain of human CSF1R |
| Units | Counts |
|---|---|
| Participants |
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| 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 | Treatment-emergent Adverse Events (TEAEs) | The frequency and severity of reported TEAEs in Subjects with Tenosynovial Giant Cell Tumor (TGCT) receiving Intravenous AMB 05X. | All enrolled patients | Posted | Count of Participants | Participants | No | 6 months |
|
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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 | Tenosynovial Giant Cell Tumor - Events During Initial Treatment Period | Cohort A: Received initial priming dose on Day 1 followed by 5 maintenance doses administered every 2 weeks (at Weeks 2, 4, 6, 8, and 10), for a total of 6 doses over the 12-week treatment period. |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| face edema | General disorders | MedDRA 23.1 and 25 | Non-systematic Assessment | Face Edema |
A decision was made in November 2021 to stop further enrollment into the study to allow development to focus on AMB-05X intra-articular administration for TGCT. A total of 4 subjects had been enrolled into the study at the time the decision to cease further enrollment was made, limiting the ability to interpret the resulting data.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dorothy Nguyen, MD | AmMax Bio., Inc. | (650)285-6560 | clinical@ammaxbio.com |
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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 | Aug 18, 2021 | Jun 9, 2023 | Prot_SAP_001.pdf |
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| ID | Term |
|---|---|
| D000070779 | Giant Cell Tumor of Tendon Sheath |
| D013586 | Synovitis, Pigmented Villonodular |
| ID | Term |
|---|---|
| D005870 | Giant Cell Tumors |
| D009372 | Neoplasms, Connective Tissue |
| D018204 | Neoplasms, Connective and Soft Tissue |
| D009370 | Neoplasms by Histologic Type |
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| 12 weeks |
| Overall Response Based on Tumor Volume Score (TVS) | Tumor Volume Score (TVS) calculates tumor volume as a percentage of the estimated volume of the maximally distended synovial cavity or tendon sheath and provides a score in 10% increments. A score of 0 indicates no evidence of tumor; a score of 10 indicates a tumor that is equal in volume to that of a maximally distended synovial cavity or tendon sheath. Complete response (CR): lesion is completely gone; Partial response (PR): >/=50% decrease in TVS relative to Baseline; Progressive disease (PD): >/= 30% increase in TVS relative to the lowest score during the study; Stable disease (SD): does not meet any of the other classifications. | 24 weeks or ET visit |
| Mean Change From Baseline Range of Motion (ROM) (Flexion, Knee) Scores | Mean Change from Baseline in Range of Motion (ROM) Scores - Flexion (knee only). ROM is assessed by qualified assessors and recorded in degrees. At Baseline, the plane of movement with the smallest (worst) relative ROM was identified; only this plane was used for evaluating change in ROM. Higher scores indicate greater range of motion. | week 12 |
| Mean Change From Baseline in the Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function Score | Mean change from Baseline in the Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function score is used to assess physical function. PROMIS is a 10-question patient reported outcome instrument used to assess physical functioning based on use of the upper extremities (dexterity), lower extremities (walking or mobility), and central regions (neck, back) and on instrumental activities of daily living. Five questions address the degree to which the subject's health limits activities, and subjects select a response that ranges from 1-"cannot do" to 5-"not at all". Five additional questions address the degree to which the subject is able to perform certain physical activities, and subjects select a response to each question that ranges from 1 ("cannot do") to 5 ("without any difficulty"). Raw scores are summarized. The score range is 10 to 50, higher scores = worse physical function | 12 weeks |
| Serum Cmax for AMB-05X at Week 10 Post Dose | The maximum concentration of AMB-05X in subject serum is measured at week 10 postdose, using sensitive enzyme-linked immunosorbent assay analyses (ELISA). | 10 weeks |
| Number of Subjects With Anti-Drug Antibodies to AMB-05X at Week 10 | AMB-05X Anti-drug Antibodies (ADA) in subject serum will be measured from pre-dose samples. | 10 weeks |
| Mean Change From Baseline in Worst Stiffness Numeric Rating Scale (NRS) Score | The mean changes from Baseline in the Worst Stiffness Numeric Rating Scale (NRS) score, a Patient-Reported Outcome (PRO) Measurement. The Worst Stiffness NRS is a single-item instrument designed to assess "worst" stiffness at the site of the tumor in the last 24 hours. The instrument uses an 11-point numeric rating scale that ranges from 0 ("no stiffness") to 10 ("stiffness as bad as you can imagine"). Higher scores indicate worse stiffness. | 12 weeks |
| Brief Pain Inventory Pain Severity Domain Score | The mean changes from Baseline in Brief Pain Inventory (BPI) Pain Severity Domain. (Score of 0-10, where a negative score from baseline indicates a better BPI score, less severe pain) Brief Pain Inventory (BPI) is a self-administered questionnaire used to evaluate the severity of a subject's pain and the impact of this pain on the subject's daily functioning. For the Pain Severity domain the subject is asked to rate their worst, least, average, and current pain intensity, and list current treatments and their perceived effectiveness on a scale from 0 to 10, where higher scores mean more severe pain. All of the 0-10 scores are averaged to obtain the total Domain (subscale) Score. | 12 weeks |
| Mean Change From Baseline in Brief Pain Inventory Severity Interference | The mean changes from Baseline in Brief Pain Inventory (BPI) Severity Interference domain. The BPI Short Form is a patient-reported outcome instrument used to evaluate the severity of a subject's pain and the impact of this pain on the subject's daily functioning. For this domain, the subject is asked to rate their worst, least, average, and current pain intensity, list current treatments and their perceived effectiveness, and rate the degree that pain interferes with general activity, mood, walking ability, normal work, relations with other persons, sleep, and enjoyment of life on a scale from 0 to 10, where higher scores mean more pain interference. The reported score is the mean of the seven interference items. Higher scores indicate greater levels of pain. | 12 weeks |
| Worst Pain Numeric Rating Scale Score | Mean change from Baseline in Worst Pain Numeric Rating Scale score. The Worst Pain Numeric Rating Scale is an item in the BPI that assesses a subject's "worst" pain in the last 24 hours. The 11-point Numeric Rating Scale for this item ranges from 0 ("no pain") to 10 ("pain as bad as you can imagine"). Higher scores indicate greater level of pain. | 12 weeks |
| EuroQol 5 Dimension 5 Level Health Assessment | Mean change from Baseline in the EuroQol 5 Dimension 5 Level (EQ-5D-5L) assessment Scale Score (5-25). This instrument is a self-report survey that measures quality of life across 5 domains: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Each dimension is scored on a 5-level severity ranking that ranges from "no problems" through "extreme problems". Higher scores indicate a lower quality of life. | 12 weeks |
| Colony-stimulating Factor 1 Levels | Serum colony-stimulating factor-1 (CSF-1) levels are measured in patient/subject serum. Samples were collected for measurement of CSF-1 at least once at specified visits. | 10 weeks |
| Mean Change From Baseline Rnge of Motion (Flexion, Ankle) Scores | Mean Change from Baseline in Range of Motion (ROM) Scores - Flexion (Ankle only). ROM is assessed by qualified assessors and recorded in degrees. At Baseline, the plane of movement with the smallest (worst) relative ROM was to be identified; only this plane was used for evaluating change in ROM. Higher scores indicate greater range of motion. | week 12 |
| Serum AMB-05X-Binding Anti-drug Antibody (ADA) Levels | Series analysis for anti-drug antibody detection and titer | Week 12 |
| Warsaw |
| Poland |
| AmMax Bio Clinical Site | Dnipro | Ukraine |
| AmMax Bio Clinical Site | Kharkiv | Ukraine |
| AmMax Bio Clinical Site | Kyiv | Ukraine |
| Participants |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Ethnicity (NIH/OMB) | Count of Participants | Participants |
|
| Race (NIH/OMB) | Count of Participants | Participants | No |
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| Region of Enrollment | Number | participants |
|
|
|
| Secondary | Overall Tumor Response (Objective Response) Per Response Evaluation Criteria in Solid Tumors (RECIST) v.1.1 | Response Evaluation Criteria in Solid Tumors (RECIST) v1.1; Per RECIST v1.0 for target lesions and assessed by MRI: A Complete Response (CR) is defined as disappearance of all tumors. A Partial Response (PR) is defined as at least a 30% decrease in the sum of diameters of target tumors from the baseline sum of diameters. | TGCT - Modified Intent-to-treat (ITT)- All TGCT subjects who received at least 1 dose of study drug and had both baseline and post-baseline data for at least 1 efficacy endpoint. | Posted | Count of Participants | Participants | 12 weeks |
|
|
|
| Secondary | Overall Response Based on Tumor Volume Score (TVS) | Tumor Volume Score (TVS) calculates tumor volume as a percentage of the estimated volume of the maximally distended synovial cavity or tendon sheath and provides a score in 10% increments. A score of 0 indicates no evidence of tumor; a score of 10 indicates a tumor that is equal in volume to that of a maximally distended synovial cavity or tendon sheath. Complete response (CR): lesion is completely gone; Partial response (PR): >/=50% decrease in TVS relative to Baseline; Progressive disease (PD): >/= 30% increase in TVS relative to the lowest score during the study; Stable disease (SD): does not meet any of the other classifications. | TGCT - Modified Intent-to-treat (ITT) - All TGCT subjects who received at least 1 dose of study drug and had both baseline and post-baseline data for at least 1 efficacy endpoint. | Posted | Count of Participants | Participants | 24 weeks or ET visit |
|
|
|
| Secondary | Mean Change From Baseline Range of Motion (ROM) (Flexion, Knee) Scores | Mean Change from Baseline in Range of Motion (ROM) Scores - Flexion (knee only). ROM is assessed by qualified assessors and recorded in degrees. At Baseline, the plane of movement with the smallest (worst) relative ROM was identified; only this plane was used for evaluating change in ROM. Higher scores indicate greater range of motion. | Modified intent-to-treat, 3 subjects with ROM data in right and left knee were analyzed | Posted | Count of Participants | Participants | No | week 12 |
|
|
|
| Secondary | Mean Change From Baseline in the Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function Score | Mean change from Baseline in the Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function score is used to assess physical function. PROMIS is a 10-question patient reported outcome instrument used to assess physical functioning based on use of the upper extremities (dexterity), lower extremities (walking or mobility), and central regions (neck, back) and on instrumental activities of daily living. Five questions address the degree to which the subject's health limits activities, and subjects select a response that ranges from 1-"cannot do" to 5-"not at all". Five additional questions address the degree to which the subject is able to perform certain physical activities, and subjects select a response to each question that ranges from 1 ("cannot do") to 5 ("without any difficulty"). Raw scores are summarized. The score range is 10 to 50, higher scores = worse physical function | Subjects with TGCT | Posted | Mean | Standard Deviation | score on a scale | 12 weeks |
|
|
|
| Secondary | Serum Cmax for AMB-05X at Week 10 Post Dose | The maximum concentration of AMB-05X in subject serum is measured at week 10 postdose, using sensitive enzyme-linked immunosorbent assay analyses (ELISA). | All enrolled subjects | Posted | Mean | Standard Deviation | ng/mL | 10 weeks |
|
|
|
| Secondary | Number of Subjects With Anti-Drug Antibodies to AMB-05X at Week 10 | AMB-05X Anti-drug Antibodies (ADA) in subject serum will be measured from pre-dose samples. | All enrolled subjects | Posted | Count of Participants | Participants | 10 weeks |
|
|
|
| Secondary | Mean Change From Baseline in Worst Stiffness Numeric Rating Scale (NRS) Score | The mean changes from Baseline in the Worst Stiffness Numeric Rating Scale (NRS) score, a Patient-Reported Outcome (PRO) Measurement. The Worst Stiffness NRS is a single-item instrument designed to assess "worst" stiffness at the site of the tumor in the last 24 hours. The instrument uses an 11-point numeric rating scale that ranges from 0 ("no stiffness") to 10 ("stiffness as bad as you can imagine"). Higher scores indicate worse stiffness. | TGCT subjects | Posted | Mean | Standard Deviation | score on a scale | 12 weeks |
|
|
|
| Secondary | Brief Pain Inventory Pain Severity Domain Score | The mean changes from Baseline in Brief Pain Inventory (BPI) Pain Severity Domain. (Score of 0-10, where a negative score from baseline indicates a better BPI score, less severe pain) Brief Pain Inventory (BPI) is a self-administered questionnaire used to evaluate the severity of a subject's pain and the impact of this pain on the subject's daily functioning. For the Pain Severity domain the subject is asked to rate their worst, least, average, and current pain intensity, and list current treatments and their perceived effectiveness on a scale from 0 to 10, where higher scores mean more severe pain. All of the 0-10 scores are averaged to obtain the total Domain (subscale) Score. | Posted | Mean | Standard Deviation | score on a scale | 12 weeks |
|
|
|
| Secondary | Mean Change From Baseline in Brief Pain Inventory Severity Interference | The mean changes from Baseline in Brief Pain Inventory (BPI) Severity Interference domain. The BPI Short Form is a patient-reported outcome instrument used to evaluate the severity of a subject's pain and the impact of this pain on the subject's daily functioning. For this domain, the subject is asked to rate their worst, least, average, and current pain intensity, list current treatments and their perceived effectiveness, and rate the degree that pain interferes with general activity, mood, walking ability, normal work, relations with other persons, sleep, and enjoyment of life on a scale from 0 to 10, where higher scores mean more pain interference. The reported score is the mean of the seven interference items. Higher scores indicate greater levels of pain. | TGCT subjects | Posted | Mean | Standard Deviation | score on a scale | 12 weeks |
|
|
|
| Secondary | Worst Pain Numeric Rating Scale Score | Mean change from Baseline in Worst Pain Numeric Rating Scale score. The Worst Pain Numeric Rating Scale is an item in the BPI that assesses a subject's "worst" pain in the last 24 hours. The 11-point Numeric Rating Scale for this item ranges from 0 ("no pain") to 10 ("pain as bad as you can imagine"). Higher scores indicate greater level of pain. | TGCT subjects | Posted | Mean | Standard Deviation | score on a scale | 12 weeks |
|
|
|
| Secondary | EuroQol 5 Dimension 5 Level Health Assessment | Mean change from Baseline in the EuroQol 5 Dimension 5 Level (EQ-5D-5L) assessment Scale Score (5-25). This instrument is a self-report survey that measures quality of life across 5 domains: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Each dimension is scored on a 5-level severity ranking that ranges from "no problems" through "extreme problems". Higher scores indicate a lower quality of life. | TGCT subjects | Posted | Mean | Standard Deviation | score on a scale | 12 weeks |
|
|
|
| Secondary | Colony-stimulating Factor 1 Levels | Serum colony-stimulating factor-1 (CSF-1) levels are measured in patient/subject serum. Samples were collected for measurement of CSF-1 at least once at specified visits. | TGCT subjects | Posted | Mean | Standard Deviation | pg/mL | 10 weeks |
|
|
|
| Secondary | Mean Change From Baseline Rnge of Motion (Flexion, Ankle) Scores | Mean Change from Baseline in Range of Motion (ROM) Scores - Flexion (Ankle only). ROM is assessed by qualified assessors and recorded in degrees. At Baseline, the plane of movement with the smallest (worst) relative ROM was to be identified; only this plane was used for evaluating change in ROM. Higher scores indicate greater range of motion. | Although the protocol allowed patients with TGCT of the ankle, no subjects with TGCT of the ankle were enrolled. | Posted | week 12 |
|
|
| Secondary | Serum AMB-05X-Binding Anti-drug Antibody (ADA) Levels | Series analysis for anti-drug antibody detection and titer | Measurement of serum AMB-05X-Binding anti-drug antibody (ADA) levels was a prespecified secondary outcome measure. ADA data for 4 subjects enrolled prior to study termination are provided. One of 4 subjects provided only a baseline sample. Three of 4 subjects provided both baseline (Visit 2) and Week 10 (Visit 7) samples. No conclusions were made based on the limited information collected at study termination (Sponsor stopped developing intravenous AMB-05X for patients with TGCT). | Posted | Count of Participants | Participants | Week 12 |
|
|
|
| 0 |
| 4 |
| 0 |
| 4 |
| 0 |
| 4 |
| EG001 | Tenosynovial Giant Cell Tumor - Events During Maintenance Treatment Period | Cohort A: Received initial priming dose on Day 1 followed by 5 maintenance doses administered every 2 weeks (at Weeks 2, 4, 6, 8, and 10), for a total of 6 doses over the 12-week treatment period. | 0 | 4 | 0 | 4 | 4 | 4 |
| hepatic enzyme increased | Investigations | MedDRA 23.1 and 25 | Non-systematic Assessment | elevated liver enzymes |
|
| epistaxis | Respiratory, thoracic and mediastinal disorders | MedDRA 23.1 and 25 | Non-systematic Assessment |
|
| hypertension | Vascular disorders | MedDRA 23.1 and 25 | Non-systematic Assessment |
|
| headache | Nervous system disorders | MedDRA 23.1 and 25 | Non-systematic Assessment |
|
| rash maculopapular | Skin and subcutaneous tissue disorders | MedDRA 23.1 and 25 | Non-systematic Assessment |
|
| skin hyperpigmentation | Skin and subcutaneous tissue disorders | MedDRA 23.1 and 25 | Non-systematic Assessment |
|
| blood lactate dehydrogenase increased | Investigations | MedDRA 23.1 and 25 | Non-systematic Assessment |
|
| diarrhea | Gastrointestinal disorders | MedDRA 23.1 and 25 | Non-systematic Assessment |
|
| aspartate aminotransferase increased | Investigations | MedDRA 23.1 and 25 | Non-systematic Assessment |
|
| pyelonephritis acute | Infections and infestations | MedDRA 23.1 and 25 | Non-systematic Assessment |
|
| urinary tract infection | Infections and infestations | MedDRA 23.1 and 25 | Non-systematic Assessment |
|
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| D009369 | Neoplasms |
| D013585 | Synovitis |
| D007592 | Joint Diseases |
| D009140 | Musculoskeletal Diseases |
| D052256 | Tendinopathy |
| D009135 | Muscular Diseases |
| Title | Measurements |
|---|---|
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| Title | Measurements |
|---|---|
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| Title | Measurements |
|---|---|
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| Visit 7 |
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