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Trial registered on ANZCTR
Registration number
ACTRN12612001069842
Ethics application status
Approved
Date submitted
11/09/2012
Date registered
5/10/2012
Date last updated
23/02/2018
Type of registration
Prospectively registered
Titles & IDs
Public title
EMOTIV Trial - Enhancing Melanoma Outcomes using a Timed Immunotherapy Vaccine
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Scientific title
The effect of timed co-ordinated vaccine and chemotherapy delivery on complete response rate and overall survival in patients with advanced melanoma
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Secondary ID [1]
281098
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Nil
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Universal Trial Number (UTN)
U1111-1133-8625
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Trial acronym
EMOTIV
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Advanced Stage IIIb/c and IV Melanoma
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Condition category
Condition code
Cancer
287582
287582
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0
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Malignant melanoma
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Arm 1 - Control Arm: 0.3 ml VMCL Vaccine Untimed, administered via intra-dermal injection. If progression occurs, then addition of oral chemotherapy (cyclophosphamide -100mg tablet) every 3 weeks, until disease regression/progression. Arm 1 therapies are administered on a regular, pre-determined basis per protocol schedule.
Arm 2 - Test Arm: 0.3 ml VMCL vaccine Timed, administered via intra-dermal injection. If progression occurs, then addition of timed oral chemotherapy (cyclophosphamide - 100mg tablet) as dictated by patients immune system cycle profile (approximately 3 weekly), until disease regression/progression. Arm 2 therapies are co-ordinated with the patient's own immune cycle, as determined by regular blood tests.
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Intervention code [1]
285551
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Treatment: Drugs
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Comparator / control treatment
See Arm 1 - Control Arm above.
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Control group
Active
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Outcomes
Primary outcome [1]
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Complete response rate as defined by WHO criteria, utilising laboratory markers and CT scans
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Assessment method [1]
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Timepoint [1]
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Assessments at 3, 6, 9 and 12 months for each patient and collectively 1, 2 and 5 years.
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Primary outcome [2]
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Overall survival
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Assessment method [2]
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Timepoint [2]
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Assessments at 3, 6, 9 and 12 months for each patient and collectively 1, 2 and 5 years.
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Secondary outcome [1]
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Toxicity as assessed by any reported SAE's.
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Assessment method [1]
298913
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Timepoint [1]
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Ongoing assessment for up to 18mo from enrollment and recorded at time of treatment or SAE.
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Secondary outcome [2]
299327
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Overall response rate as assessed by CT scans
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Assessment method [2]
299327
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Timepoint [2]
299327
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Assessments at 3, 6, 9 and 12 months for each patient and collectively 1, 2 and 5 years.
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Secondary outcome [3]
299328
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Disease progression as assessed by CT scans
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Assessment method [3]
299328
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Timepoint [3]
299328
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Assessments at 3, 6, 9 and 12 months for each patient and collectively 1, 2 and 5 years.
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Secondary outcome [4]
299329
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Immunologic parameters as assessed by laboratory markers
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Assessment method [4]
299329
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Timepoint [4]
299329
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Assessments at 3, 6, 9 and 12 months for each patient and collectively 1, 2 and 5 years.
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Eligibility
Key inclusion criteria
18 - 80 years of age. ECOG 0-2. Evaluable metastases. Primary cutaneous melanoma. Advanced surgically non-resectable AJCC Stage IIIB/IIIC or IV. Able to give informed consent. Tumour volume < 20cm diameter or <70% of organ replacement.
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Minimum age
18
Years
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Maximum age
80
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Presence of another primary invasive cancer (not BCC, SCC or resected in-situ malignancy)
Untreated brain mets
Extremely extensive disease
Bone mets only
High dose oral steroid therapy
Pregnancy or lactation
Severe atopia
Severe cachexia
Immunodeficiency
HIV
Hep B or C +ve
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Randomisation and allocation procedure being carried out by external party. (NHMRC)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Method is permuted block randomisation.
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
All participants receive the same initial intervention but at differing times. If disease progression occurs, each arm then proceeds to the same second intervention, also occurring at different times.
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Phase
Phase 2
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
The sample size was selected to ensure the standard error of the observed response rate was = 0.1 and to permit a satisfactory estimate of response rate. The pilot study design is in accordance with previous literature determining sample size for prediction of larger study testing (Hertzog 2008). The anticipated predicted difference is for an approximate doubling of the CR rate in the test (timed therapy) group, over the control (untimed therapy) group. An early stopping rule according to the method of Gehan (1961) was incorporated with the response rate of interest set at 15%. Descriptive statistics will be generated for response efficacy, toxicity and survival end-points. The median time to progression (TTP) will be estimated using Kaplan–Meier survival curves (STATA-1). Data between groups will be analysed by t-test or the Mann–Whitney U-test and Spearman’s method will be used for correlations. The log-rank test will be used to compare survival between patients with progressive and SD. Significance will be assumed if P < 0.05.
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Recruitment
Recruitment status
Stopped early
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Data analysis
Data collected is being analysed
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Reason for early stopping/withdrawal
Lack of funding/staff/facilities
Participant recruitment difficulties
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Date of first participant enrolment
Anticipated
3/09/2013
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Actual
1/04/2014
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Date of last participant enrolment
Anticipated
3/12/2017
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Actual
14/03/2017
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Date of last data collection
Anticipated
1/07/2019
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Actual
10/11/2017
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Sample size
Target
20
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Accrual to date
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Final
15
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Recruitment in Australia
Recruitment state(s)
SA
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Recruitment hospital [1]
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The Royal Adelaide Hospital - Adelaide
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Recruitment postcode(s) [1]
5608
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5000
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Recruitment postcode(s) [2]
5609
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5159
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Recruitment postcode(s) [3]
5610
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5010
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Recruitment postcode(s) [4]
5611
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5076
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Recruitment postcode(s) [5]
5612
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5042
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Recruitment postcode(s) [6]
5613
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5062
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Recruitment postcode(s) [7]
5614
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5066
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Recruitment postcode(s) [8]
5616
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5074
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Recruitment postcode(s) [9]
5617
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5038
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Recruitment postcode(s) [10]
5619
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5113
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Recruitment postcode(s) [11]
5621
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5112
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Recruitment postcode(s) [12]
5623
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5118
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Recruitment postcode(s) [13]
5624
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5035
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Recruitment postcode(s) [14]
5625
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5069
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Recruitment postcode(s) [15]
5631
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5037
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Recruitment postcode(s) [16]
5632
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5168
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Recruitment postcode(s) [17]
5633
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5040
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Recruitment postcode(s) [18]
5634
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5243
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Recruitment postcode(s) [19]
5636
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5043
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Recruitment postcode(s) [20]
5637
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5942
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Recruitment postcode(s) [21]
5638
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5033
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Recruitment postcode(s) [22]
5639
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5008
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Recruitment postcode(s) [23]
5640
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5108
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Recruitment postcode(s) [24]
5641
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5169
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Funding & Sponsors
Funding source category [1]
285883
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Government body
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Name [1]
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South Australian Health and Medical Research Institute
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Address [1]
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Level 9
121 King William St
Adelaide SA 5000
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Country [1]
285883
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Australia
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Primary sponsor type
Charities/Societies/Foundations
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Name
Australian Melanoma Research Foundation
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Address
AMRF
PO Box 574
Kent Town DC
SA 5071
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Country
Australia
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Secondary sponsor category [1]
284708
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None
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Name [1]
284708
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Address [1]
284708
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Country [1]
284708
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
287912
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Royal Adelaide Hospital HREC
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Ethics committee address [1]
287912
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Royal Adelaide Hospital Research Ethics Committee North Terrace Adelaide SA 5000
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Ethics committee country [1]
287912
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Australia
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Date submitted for ethics approval [1]
287912
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29/08/2012
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Approval date [1]
287912
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28/06/2013
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Ethics approval number [1]
287912
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120924
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Summary
Brief summary
This study is evaluating the effect of timed vaccine and chemotherapy delivery in advanced melanoma patients. You may be eligible to join this study if you are a male or female aged 18 years or above who has been diagnosed with advanced melanoma (Stage IV or IIIB/IIIC) that cannot be treated with surgery. Participants in this trial will be randomly allocated to one of two groups. Participants in groups one and two will both receive the VCML vaccine. Group one will receive regular, pre-determined vaccinations whereas Group two will have their vaccination times determined by blood test results. If disease progression occurs, then participants in group one will receive oral chemotherapy treatment on pre-determined dates, whereas participants in group 2 will receive oral chemotherapy at times determined by the results of blood tests. The treatment in group 1 will not be timed in this way. All participants will be assessed on a regular basis for a period of up to 5 years in order to determine whether treatment response and overall survival differ between groups. This will enable us to determine whether the timing of vaccine or chemotherapy administration can improve treatment response.
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Trial website
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Trial related presentations / publications
Coventry BJ etal Immuno-Chemotherapy Using Repeated Vaccine Treatment Can Produce Successful Clinical Responses in Advanced Metastatic Melanoma. Journal of Cancer Therapy, 2010, 1: 205-213.
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Public notes
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Contacts
Principal investigator
Name
34624
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A/Prof Brendon Coventry
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Address
34624
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Level 8 AHMS Building
North Terrace
Adelaide SA 5000
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Country
34624
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Australia
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Phone
34624
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+61 8 83136037
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Fax
34624
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Email
34624
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[email protected]
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Contact person for public queries
Name
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Brendon J Coventry
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Address
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Level 8 AHMS Building
North Terrace
Adelaide SA 5000
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Country
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Australia
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Phone
17871
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+61 8 83136037
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Fax
17871
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Email
17871
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[email protected]
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Contact person for scientific queries
Name
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Brendon J Coventry
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Address
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Level 8 AHMS Building
North Terrace
Adelaide SA 5000
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Country
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Australia
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Phone
8799
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+61 8 83136037
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Fax
8799
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Email
8799
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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