NCT04238819 · CITED IN SOURCE DOCUMENTS

A Study of Abemaciclib (LY2835219) in Combination With Other Anti-Cancer Treatments in Children and Young Adult Participants With Solid Tumors, Including Neuroblastoma

An NCI or FDA source cites this study. A citation does not establish that it applies to an individual diagnosis.

Phase: PHASE1, PHASE2
Status at capture: COMPLETED
Registry last update: 2026-03-02

The study's purpose is to see if the drug, abemaciclib, is safe and effective when given with other drugs to kill cancer cells. The study is open to children and young adults with solid tumors, including neuroblastoma, that did not respond or grew during other anti-cancer treatment. For each participant, the study is estimated to last up to 2 years.

Open the original ClinicalTrials.gov record → · Download preserved record

What did the study report?

Outcomes, safety and baseline populations are separate source sections. Quality-of-life measures appear under their original outcome titles.

flow

Participant flow

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baseline

Baseline characteristics

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outcome · POSTED

Recommended Phase 2 Dose (RP2D) of Abemaciclib in Combination With Irinotecan and Temozolomide (Part A)

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outcome · POSTED

Number or Participants With Dose Limiting Toxicities (DLTs) in Part A

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outcome · POSTED

Maximum Tolerated Dose (MTD) of Abemaciclib in Part A

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outcome · POSTED

Pharmacokinetics (PK): Area Under the Concentration Versus Time Curve From Time Zero to Tlast (AUC0-tlast) of Abemaciclib in Part A

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outcome · POSTED

PK: (AUC0-tlast) of Irinotecan in Part A

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outcome · POSTED

PK: (AUC0-tlast) of Temozolomide in Part A

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outcome · POSTED

RP2D of Abemaciclib in Combination With Temozolomide (Part B)

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outcome · POSTED

Number or Participants With DLTs in Part B

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outcome · POSTED

MTD of Abemaciclib in Part B

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outcome · POSTED

PK: AUC0-tlast of Abemaciclib in Part B

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outcome · POSTED

PK: AUC0-tlast of Temozolomide in Part B

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outcome · POSTED

Number of Participants With Overall Response Rate (ORR) in Part C.

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outcome · POSTED

Percentage of Participants With Overall Response Rate (ORR): Part A

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outcome · POSTED

Percentage of Participants With ORR: Part B

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outcome · POSTED

Duration of Response (DoR): Parts A and B.

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outcome · POSTED

Duration of Response (DoR): Part C

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outcome · POSTED

Percentage of Participants With Clinical Benefit Rate (CBR): Part A

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outcome · POSTED

Percentage of Participants With CBR: Part B

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outcome · POSTED

Percentage of Participants With Disease Control Rate (DCR): Part A

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outcome · POSTED

Percentage of Participants With DCR: Part B

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outcome · POSTED

Progression-Free Survival (PFS): Part C

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outcome · POSTED

Abemaciclib Tablet Acceptability

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adverse events

Adverse events

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more info

Limitations, agreements, and source contact

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Who could take part

eligibility Criteria: Inclusion Criteria: * Parts A and B only: * Participants must be less than or equal to (≤)18 years of age. * Body weight greater than or equal to (≥)10 kilograms and body surface area (BSA) ≥0.5 * Participants with any relapsed/refractory malignant solid tumor (excluding lymphoma), including central nervous system tumors, that have progressed on standard therapies. * For sites that are actively enrolling Parts B and C, participants with neuroblastoma who are eligible for Part C will be excluded from Part B unless approved by Lilly CRP/CRS. * Part C only: * Participants must be less than (\<) 21 years of age. * Participants have a BSA ≥0.2 m². * Participants with first relapse/refractory neuroblastoma. * All Parts * Participants must have measurable or evaluable disease by RECIST v1.1 or RANO. * A Lansky score ≥50 for participants \<16 years of age or Karnofsky score ≥50 for participants ≥16 years of age. * Participants must have discontinued all previous treatments for cancer or investigational agents and must have recovered from the acute effects to Grade ≤1 at the time of enrollment. * Able to swallow and/or have a gastric/nasogastric tube. * Adequate hematologic and organ function ≤2 weeks (14 days) prior to first dose of study drug. * Females of reproductive potential must have negative urine or serum pregnancy test at baseline (within 7 days prior to starting treatment). * Female participants of reproductive potential must agree to use highly effective contraceptive precautions during the trial. For abemaciclib, females should use contraception for at least 3 weeks following the last abemaciclib. For other study drugs, highly effective contraceptive precautions (and avoiding sperm donation) must be used according to their label. * Life expectancy of at least 8 weeks and able to complete at least 1 cycle of treatment. * Caregivers and participants willing to make themselves available for the duration of the trial. Exclusion Criteria: * Received allogenic bone marrow or solid organ transplant. * Received live vaccination. * Intolerability or hypersensitivity to any of the study treatments or its components. * Diagnosed and/or treated additional malignancy within 3 years prior to enrollment that may affect the interpretation of results, with the exception of curatively treated basal cell carcinoma of the skin, squamous cell carcinoma of the skin, and/or curatively resected in situ cervical and/or breast cancers. * Pregnant or breastfeeding. * Active systemic infections. * Serious and/or uncontrolled preexisting medical condition(s) that would preclude participation in this study. * Parts A and C only: Have a bowel obstruction. * Prior treatment with drugs known to be strong inhibitors or inducers of isoenzyme cytochrome P450 3A (CYP3A) or strong inhibitors of uridine diphosphate-glucuronosyl transferase 1A1 (UGT1A1) if the treatment cannot be discontinued or switched to a different medication at least 5 half-lives prior to starting study drug. * Received prior treatment with cyclin-dependent kinase (CDK) 4 \& 6 inhibitor. * Part C only: Received prior systemic therapy for relapsed/refractory neuroblastoma. * Part C only, have received prior anti-GD2 therapy during induction phase. * Currently enrolled in any other clinical study involving an investigational product or non-approved use of a drug or device. * Has received an experimental treatment in a clinical trial within the last 30 days or 5 half-lives, whichever is longer.
healthy Volunteers: false
maximum Age: 21 Years
sex: ALL
std Ages: CHILD
ADULT

Treatment arms and interventions

arm Groups

description
Participants received: * Abemaciclib: 70 mg/m², administered orally twice daily (BID). * Irinotecan: 50 mg/m²/day, administered IV on Days 1-5 of each cycle. * Temozolomide: 100 mg/m²/day, administered orally on Days 1-5 of each cycle. Treatment continued until progressive disease, a discontinuation criterion, or unacceptable toxicity. Each cycle lasted 21 days.
intervention Names
Drug: Abemaciclib
Drug: Irinotecan
Drug: Temozolomide
label
Part A Cohort A1
type
EXPERIMENTAL
description
Participants received: * Abemaciclib: 55 mg/m², administered orally BID. * Irinotecan: 50 mg/m²/day, administered IV on Days 1-5 of each cycle. * Temozolomide: 100 mg/m²/day, administered orally on Days 1-5 of each cycle. Treatment continued until progressive disease, a discontinuation criterion, or unacceptable toxicity. Each cycle lasted 21 days.
intervention Names
Drug: Abemaciclib
Drug: Irinotecan
Drug: Temozolomide
label
Part A Cohort A-1
type
EXPERIMENTAL
description
Participants received: * Abemaciclib: 70 mg/m², administered orally BID. * Temozolomide: 100 mg/m²/day, administered orally on Days 1-5 of each cycle. Treatment continued until progressive disease, a discontinuation criterion, or unacceptable toxicity. Each cycle lasted 21 days.
intervention Names
Drug: Abemaciclib
Drug: Temozolomide
label
Part B Cohort B1
type
EXPERIMENTAL
description
Participants received: * Abemaciclib: 90 mg/m², administered orally BID. * Temozolomide: 100 mg/m²/day, administered orally on Days 1-5 of each cycle. Treatment continued until progressive disease, a discontinuation criterion, or unacceptable toxicity. Each cycle lasted 21 days.
intervention Names
Drug: Abemaciclib
Drug: Temozolomide
label
Part B Cohort B2
type
EXPERIMENTAL
description
Participants received: * Abemaciclib: 115 mg/m², administered orally BID. * Temozolomide: 100 mg/m²/day, administered orally on Days 1-5 of each cycle. Treatment continued until progressive disease, a discontinuation criterion, or unacceptable toxicity. Each cycle lasted 21 days.
intervention Names
Drug: Abemaciclib
Drug: Temozolomide
label
Part B Cohort B3
type
EXPERIMENTAL
description
Participants received: * Abemaciclib: 115 mg/m², administered orally BID. * Temozolomide: 150 mg/m²/day, administered orally on Days 1-5 of each cycle. Treatment continued until progressive disease, a discontinuation criterion, or unacceptable toxicity. Each cycle lasted 21 days.
intervention Names
Drug: Abemaciclib
Drug: Temozolomide
label
Part B Cohort B5
type
EXPERIMENTAL
description
Participants received: * Abemaciclib: 55 mg/m², administered orally BID. * Irinotecan: 50 mg/m²/day, administered IV on Days 1-5 of each cycle. * Temozolomide: 100 mg/m²/day, administered orally on Days 1-5 of each cycle. * Dinutuximab: 17.5mg/m²/day, administered IV on Days 2-5 of each cycle. * Granulocyte-macrophage colony-stimulating factor (GM-CSF): 250 μg/m²/day, administered subcutaneously (SC) on Days 6-12 of each cycle. Treatment continued until progressive disease, a discontinuation criterion, or unacceptable toxicity. Each cycle lasted 21 days.
intervention Names
Drug: Abemaciclib
Drug: Irinotecan
Drug: Temozolomide
Drug: Dinutuximab
Drug: GM-CSF
label
Part C Cohort C1
type
EXPERIMENTAL

interventions

arm Group Labels
Part A Cohort A-1
Part A Cohort A1
Part B Cohort B1
Part B Cohort B2
Part B Cohort B3
Part B Cohort B5
Part C Cohort C1
description
Administered orally
name
Abemaciclib
other Names
LY2835219
type
DRUG
arm Group Labels
Part A Cohort A-1
Part A Cohort A1
Part C Cohort C1
description
Administered IV
name
Irinotecan
type
DRUG
arm Group Labels
Part A Cohort A-1
Part A Cohort A1
Part B Cohort B1
Part B Cohort B2
Part B Cohort B3
Part B Cohort B5
Part C Cohort C1
description
Administered orally
name
Temozolomide
type
DRUG
arm Group Labels
Part C Cohort C1
description
Administered IV
name
Dinutuximab
type
DRUG
arm Group Labels
Part C Cohort C1
description
Administered SC
name
GM-CSF
type
DRUG

Study design

allocation

NON_RANDOMIZED

intervention Model

SINGLE_GROUP

masking Info

masking: NONE

primary Purpose

TREATMENT

Enrollment

count: 47
type: ACTUAL

Registered outcome plans (not posted results)

primary Outcomes

description
The RP2D of abemaciclib was determined based on the totality of safety, tolerability, and pharmacokinetic results. RP2D of abemaciclib in combination with 50 mg/m²/day irinotecan and 100 mg/m²/day temozolomide on days 1-5 of 21-day cycles was reported.
measure
Recommended Phase 2 Dose (RP2D) of Abemaciclib in Combination With Irinotecan and Temozolomide (Part A)
time Frame
Cycles 1 and 2 (21 Day Cycles)
description
DLT was 1 of the following adverse events likely related to abemaciclib/combination and fulfils any 1 of the following criteria graded per National Cancer Institute-Common Terminology Criteria for Adverse Events (NCI-CTCAE) v5.0: * Any non-hematologic Grade (G) ≥3 toxicity, except: * G3 diarrhea lasting \<72 hour (h) * Acute irinotecan-associated diarrhea lasting \<7 days * G≥3 nausea, vomiting, constipation that lasts \<72 h * G3 mucositis/stomatitis lasting \<72 h * G3 fever/infection * G≥3 electrolyte abnormality that lasts \<72 h, is not complicated, and resolves spontaneously or responds to conventional medication; * G≥3 amylase/lipase that is not associated with symptoms/clinical manifestations of pancreatitis; or * AST/ALT elevation resolving to eligibility criteria within 7 days; * Hematologic toxicities considered a DLT: * A \>14-day Cycle 2 delay due to neutropenia/thrombocytopenia * G≥3 thrombocytopenia with significant bleeding; or * G≥ 4 neutropenic fever
measure
Number or Participants With Dose Limiting Toxicities (DLTs) in Part A
time Frame
Cycle 1 (21 Day Cycle)
description
The MTD was defined as the highest dose level at which less than 33% of participants experienced a DLT.
measure
Maximum Tolerated Dose (MTD) of Abemaciclib in Part A
time Frame
Cycle 1 (21 Days)
description
PK: (AUC0-tlast) was reported.
measure
Pharmacokinetics (PK): Area Under the Concentration Versus Time Curve From Time Zero to Tlast (AUC0-tlast) of Abemaciclib in Part A
time Frame
Pre-dose, 1, 2.5, 4, and 6 hours post Day 1 dose of Cycle 1 and Cycle 2 (21 Day Cycle)
description
PK: AUC0-tlast) was reported.
measure
PK: (AUC0-tlast) of Irinotecan in Part A
time Frame
2.5, 4, and 6 hours post Day 1 dose of Cycle 1 and Cycle 2 (21 Day Cycle)
description
PK: AUC0-tlast was reported.
measure
PK: (AUC0-tlast) of Temozolomide in Part A
time Frame
1, 2.5, 4, and 6 hours post Day 1 dose of Cycle 1 and Cycle 2 (21 Day Cycle)
description
The RP2D of abemaciclib was determined based on the totality of safety, tolerability, and pharmacokinetic results. RP2D of abemaciclib in combination with 150 mg/m²/day temozolomide on days 1-5 of 21-day cycles was reported.
measure
RP2D of Abemaciclib in Combination With Temozolomide (Part B)
time Frame
Cycles 1 and 2 (21 Day Cycles)
description
A DLT was 1 of the following adverse events likely related to abemaciclib/combination and fulfils any 1 of the following criteria graded as per National Cancer Institute-Common Terminology Criteria for Adverse Events (NCI-CTCAE) v5.0: * Any non-hematologic Grade (G) ≥3 toxicity, except: * G3 diarrhea lasting \<72 hr * Acute irinotecan-associated diarrhea lasting \<7 days * G≥3 nausea, vomiting, constipation that lasts \<72 hr * G3 mucositis/stomatitis lasting \<72 hr * G3 fever/infection * G≥3 electrolyte abnormality that lasts \<72 hr, is not complicated, and resolves spontaneously or responds to conventional medication; * G≥3 amylase/lipase that is not associated with symptoms/clinical manifestations of pancreatitis; or * AST/ALT elevation resolving to eligibility criteria within 7 days; * Hematologic toxicities considered a DLT: * A \>14-day Cycle 2 delay due to neutropenia/thrombocytopenia * G≥3 thrombocytopenia with significant bleeding; or * G≥ 4 neutropenic fever
measure
Number or Participants With DLTs in Part B
time Frame
Cycle 1 (21 Day Cycle)
description
The MTD was defined as the highest dose level at which less than 33% of participants experienced a DLT.
measure
MTD of Abemaciclib in Part B
time Frame
Cycle 1 (21 Days)
description
PK: AUC0-tlast was reported.
measure
PK: AUC0-tlast of Abemaciclib in Part B
time Frame
Pre-dose, 1, 2.5, 4, and 6 hours post Day 1 dose of Cycle 1 and Cycle 2 (21 Day Cycle)
description
PK: AUC0-tlast was reported.
measure
PK: AUC0-tlast of Temozolomide in Part B
time Frame
1, 2.5, 4, and 6 hours post Day 1 dose of Cycle 1 and Cycle 2 (21 Day Cycle)
description
ORR: Number of participants with best response of Complete Response (CR), Partial Response (PR), or Minor Response (MR) per International Neuroblastoma Response Criteria (INRC). * CR is defined as complete response in all response components: * Primary Tumor: \<10 mm residual soft tissue primary site and complete resolution of MIBG-avid tumors * Soft tissue and bone metastatic response: nonprimary target and nontarget lesions \<10 mm and nodes identified as targets decreased to short axis \<10mm and MIBG-avid update of nonprimary lesions completely resolved * Bone marrow response: no tumor infiltration on reassessment; disappearance of all target lesions; * PR is defined as PR in \>1component and all other components are either CR, minimal disease (MD) (bone marrow only), PR (soft tissue or bone), or not involved (NI) and no components with progressive disease (PD). * MR is defined PR or CR in \>1 component and SD in \>1 component and no component with PD
measure
Number of Participants With Overall Response Rate (ORR) in Part C.
time Frame
Date of first dose to disease progression or death (Up to 25 Months)

secondary Outcomes

description
ORR: Percentage of participants with best response of CR or PR per Response Evaluation Criteria in Solid Tumors (RECIST) or Response Assessment in Neuro-Oncology (RANO). RECIST was used for solid tumors and RANO was used for brain tumors. * CR is defined as the disappearance of all target lesions (RECIST) and disappearance of all enhancing measurable and non-measurable disease, no new lesions; stable or improved non-enhancing lesions; and patient must be off corticosteroids and stable or improved clinically (RANO). * PR is defined as a 30% decrease in the sum of diameters of target lesions (RECIST) and \>50% decrease in the sum of products of perpendicular diameters of all measurable enhancing lesions, no progression of non-measurable disease, no new lesions, stable/improved non-enhancing lesions on same or lower dose of corticosteroids and patient is stable or improved clinically (RANO).
measure
Percentage of Participants With Overall Response Rate (ORR): Part A
time Frame
Date of first dose to disease progression or death (Up to 25 Months)
description
ORR: Percentage of participants with best response of CR or PR per Response Evaluation Criteria in Solid Tumors (RECIST) or Response Assessment in Neuro-Oncology (RANO). RECIST was used for solid tumors and RANO was used for brain tumors. * CR is defined as the disappearance of all target lesions (RECIST) and disappearance of all enhancing measurable and non-measurable disease, no new lesions; stable or improved non-enhancing lesions; and patient must be off corticosteroids and stable or improved clinically (RANO). * PR is defined as a 30% decrease in the sum of diameters of target lesions (RECIST) and \>50% decrease in the sum of products of perpendicular diameters of all measurable enhancing lesions, no progression of non-measurable disease, no new lesions, stable/improved non-enhancing lesions on same or lower dose of corticosteroids and patient is stable or improved clinically (RANO).
measure
Percentage of Participants With ORR: Part B
time Frame
Date of first dose to disease progression or death (Up to 25 Months)
description
DoR is the time between first evidence of CR or PR and disease progression or death due to any cause. RECIST was used for solid tumors and RANO was used for brain tumors. * CR is defined as the disappearance of all target lesions (RECIST) and disappearance of all enhancing measurable and non-measurable disease, no new lesions; stable or improved non-enhancing lesions; and patient must be off corticosteroids and stable or improved clinically (RANO). * PR is defined as a 30% decrease in the sum of diameters of target lesions (RECIST) and \>50% decrease in the sum of products of perpendicular diameters of all measurable enhancing lesions, no progression of non-measurable disease, no new lesions, stable/improved non-enhancing lesions on same or lower dose of corticosteroids and patient is stable or improved clinically (RANO).
measure
Duration of Response (DoR): Parts A and B.
time Frame
Date of first evidence of a CR or PR to date of objective disease progression or death due to any cause (Up to 25 Months)
description
DoR is the time between first evidence of CR, PR or MR and disease progression or death due to any cause. CR, PR, and MR was as per International Neuroblastoma Response Criteria (INRC). \- CR is defined as complete response in all response components: Primary Tumor: \<10 mm residual soft tissue primary site and complete resolution of MIBG-avid tumors Soft tissue and bone metastatic response: nonprimary target and nontarget lesions \<10 mm and nodes identified as targets decreased to short axis \<10mm and MIBG-avid update of nonprimary lesions completely resolved Bone marrow response: no tumor infiltration on reassessment; disappearance of all target lesions; * PR is defined as PR in \>1 component and all other components are either CR, minimal disease (MD) (bone marrow only), PR (soft tissue or bone), or not involved (NI) and no components with progressive disease (PD). * MR is defined PR or CR in \>1 component and SD in \>1 component and no component with PD
measure
Duration of Response (DoR): Part C
time Frame
Date of first evidence of a CR, PR, or MR to date of objective disease progression or death due to any cause (Up to 25 Months)
description
The CBR is the percentage of participants with a best response of CR or PR, or Stable Disease (SD) for at least 6 months. RECIST was used for solid tumors and RANO was used for brain tumors. * CR is defined as the disappearance of all target lesions (RECIST) and disappearance of all enhancing measurable and non-measurable disease, no new lesions; stable or improved non-enhancing lesions; and patient must be off corticosteroids and stable or improved clinically (RANO). * PR is defined as a 30% decrease in the sum of diameters of target lesions (RECIST) and \>50% decrease in the sum of products of perpendicular diameters of all measurable enhancing lesions, no progression of non-measurable disease, no new lesions, stable/improved non-enhancing lesions on same or lower dose of corticosteroids and patient is stable or improved clinically (RANO). * SD is neither sufficient shrinkage nor sufficient increase in the size of the tumor.
measure
Percentage of Participants With Clinical Benefit Rate (CBR): Part A
time Frame
Date of first dose to disease progression or death due to any cause (Up to 25 Months)
description
The CBR is the percentage of participants with a best response of CR or PR, or SD for at least 6 months. RECIST was used for solid tumors and RANO was used for brain tumors. * CR is defined as the disappearance of all target lesions (RECIST) and disappearance of all enhancing measurable and non-measurable disease, no new lesions; stable or improved non-enhancing lesions; and patient must be off corticosteroids and stable or improved clinically (RANO). * PR is defined as a 30% decrease in the sum of diameters of target lesions (RECIST) and \>50% decrease in the sum of products of perpendicular diameters of all measurable enhancing lesions, no progression of non-measurable disease, no new lesions, stable/improved non-enhancing lesions on same or lower dose of corticosteroids and patient is stable or improved clinically (RANO). * SD is neither sufficient shrinkage nor sufficient increase in the size of the tumor.
measure
Percentage of Participants With CBR: Part B
time Frame
Date of first dose to disease progression or death due to any cause (Up to 25 Months)
description
DCR: Percentage of participants with a best overall response of CR, PR, and SD. RECIST was used for solid tumors and RANO was used for brain tumors. * CR is defined as the disappearance of all target lesions (RECIST) and disappearance of all enhancing measurable and non-measurable disease, no new lesions; stable or improved non-enhancing lesions; and patient must be off corticosteroids and stable or improved clinically (RANO). * PR is defined as a 30% decrease in the sum of diameters of target lesions (RECIST) and \>50% decrease in the sum of products of perpendicular diameters of all measurable enhancing lesions, no progression of non-measurable disease, no new lesions, stable/improved non-enhancing lesions on same or lower dose of corticosteroids and patient is stable or improved clinically (RANO). * SD is neither sufficient shrinkage nor sufficient increase in the size of the tumor.
measure
Percentage of Participants With Disease Control Rate (DCR): Part A
time Frame
Date of first dose to measured progressive disease (Up to 25 Months)
description
DCR: Percentage of participants with a best overall response of CR, PR, and SD. RECIST was used for solid tumors and RANO was used for brain tumors. * CR is defined as the disappearance of all target lesions (RECIST) and disappearance of all enhancing measurable and non-measurable disease, no new lesions; stable or improved non-enhancing lesions; and patient must be off corticosteroids and stable or improved clinically (RANO). * PR is defined as a 30% decrease in the sum of diameters of target lesions (RECIST) and \>50% decrease in the sum of products of perpendicular diameters of all measurable enhancing lesions, no progression of non-measurable disease, no new lesions, stable/improved non-enhancing lesions on same or lower dose of corticosteroids and patient is stable or improved clinically (RANO). * SD is neither sufficient shrinkage nor sufficient increase in the size of the tumor.
measure
Percentage of Participants With DCR: Part B
time Frame
Date of first dose to measured progressive disease (Up to 25 Months)
description
Progression-free survival is measured as the time from first dose of study drug to progressive disease or death, whichever occurs first. PFS for Part C was reported.
measure
Progression-Free Survival (PFS): Part C
time Frame
Date of first dose to progressive disease or death (Up to 25 Months)
description
Participants were evaluated for abemaciclib acceptability (palatability and ease of administration) by asking a question - " Was it easy or difficult for the study subject to swallow the abemaciclib today?" Participants or their caregivers or both could respond using the following possible answers: Very difficult, difficult, neither easy nor difficult, easy, or very easy.
measure
Abemaciclib Tablet Acceptability
time Frame
Cycle 1 Day 1, Cycle 1 Day 15, and Cycle 2 Day 1 (21 Day Cycles)

Full study description

brief Summary: The study's purpose is to see if the drug, abemaciclib, is safe and effective when given with other drugs to kill cancer cells. The study is open to children and young adults with solid tumors, including neuroblastoma, that did not respond or grew during other anti-cancer treatment. For each participant, the study is estimated to last up to 2 years.

Source references