Mucinous Adenocarcinoma of the RectumPhase 2NCT01871571
Bevacizumab, Fluorouracil, Leucovorin Calcium, and Oxaliplatin Before Surgery in Treating Patients With Stage II-III Rectal Cancer
A Phase 2 study testing bevacizumab, oxaliplatin and leucovorin calcium in people with Mucinous Adenocarcinoma of the Rectum and Signet Ring Adenocarcinoma of the Rectum, run by University of Southern California at 1 site in United States.
Trial summary
This phase II trial studies how well bevacizumab, fluorouracil, leucovorin calcium, and oxaliplatin before surgery works in treating patients with stage II-III rectal cancer. Monoclonal antibodies, such as bevacizumab, can block tumor growth in different ways. Some block the ability of tumor to grow and spread. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Mucinous Adenocarcinoma of the Rectum, Signet Ring Adenocarcinoma of the Rectum, Stage IIA Rectal Cancer
- What is being tested?
- bevacizumab, oxaliplatin and leucovorin calcium
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 17 participants
- Where
- 1 siteUnited States
- Study dates
- 2 Aug 2013to 24 Jun 2020
- Phase
- Phase 2
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Histologically confirmed adenocarcinoma of the rectum in patients with no prior therapy who are candidate for surgical resection
- Tumor lesion is 5-15 cm from anal verge
- cT2 N+ or cT3-T4 N0 or N+ as assessed by endorectal ultrasound scan (US)
- No evidence of distant metastatic disease
- Signed informed consent prior to initiation of any study-specific procedure or treatment
- Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
Show all 19Show fewer
- Able to comply with the protocol, including tissue sampling, imaging studies and surgical intervention
- Life expectancy more than 12 weeks
- Absolute neutrophil count >= 1500 per mm^3
- Platelet count >= 100,000 per mm^3
- Hemoglobin >= 9 g/dL (may be transfused to maintain or exceed this level)
- Total bilirubin < 1.5 x upper limit of normal (ULN)
- Aspartate aminotransferase and alanine aminotransferase < 2.5 x ULN
- Calculated creatinine clearance according to Cockroft and Gault formula >= 50 mL/min
- Urine for proteinuria should be < 2 +; patients discovered to have >= 2 + proteinuria on dipstick urinalysis at baseline should undergo a 24-hour urine collection and must demonstrate < 1 g of protein in 24 hours
- International normalized ratio =< 1.5 and activated prothrombin time =< 1.5 x ULN within 7 days prior to enrollment; the use of full-dose oral or parenteral anticoagulants is permitted as long as the international normalized ratio (INR) or activated partial thromboplastin time (aPTT) is within therapeutic limits (according to the medical standard of the enrolling institution) and the patient has been on a stable dose of anticoagulants for at least two weeks prior to the first study treatment
- Female patients should not be pregnant or breast-feeding. Female patients, if not postmenopausal (< 12 months of amenorrhea) or surgically sterile, should agree to use effective, non-hormonal means of contraception (intrauterine contraceptive device, barrier method of contraception in conjunction with spermicidal jelly or surgically sterile) during the study and for a period of at least 6 months following the last administration of study drugs. Female patients with an intact uterus (unless amenorrheic for the last 24 months) must have a negative serum pregnancy test within 7 days prior to randomization into the study
- Fertile male patients must agree to use a highly effective contraceptive method (i.e., with a failure rate of < 1 % per year, such as vasectomy, sexual abstinence, or female partner's use of hormonal implants or combined oral contraceptives) during the trial and for a period of at least 6 months after the last dose of study drug
- Archival tumor tissue sample must be requested and available prior to study entry; a copy of the local pathology report must be submitted along with the specimens; patients without available archival tissue are excluded
Who cannot join
- Prior chemotherapy or radiotherapy for colorectal cancer
- Clinical evidence of bleeding diathesis or coagulopathy
- Pregnancy or lactation
- Sensory peripheral neuropathy >= grade 2
- Known positivity for human immunodeficiency virus (HIV)
- Malignancies other than rectal cancer within 5 years prior to randomization, except for adequately treated carcinoma in situ of the cervix, basal or squamous cell skin cancer, localized prostate cancer treated surgically with curative intent, and ductal carcinoma in situ treated surgically with curative intent
Show all 17Show fewer
- Radiotherapy to any site for any reason within 28 days prior to study entry
- Treatment with any other investigational agent, or participation in another investigational drug trial within 28 days prior to randomization
- Evidence of any other disease, neurological or metabolic dysfunction, physical examination finding, or laboratory finding giving reasonable suspicion of a disease or condition that contraindicates the use of bevacizumab or puts the patient at high risk for treatment-related complications
- Surgery (including open biopsy), significant traumatic injury within 28 days prior to randomization, minor surgery, including insertion of an indwelling catheter, within 24 hours prior to the first bevacizumab infusion is allowed
- Current or recent (within 10 days prior to first dose of bevacizumab) use of aspirin (> 325 mg/day)
- History or evidence of inherited bleeding diathesis or coagulopathy with a risk of bleeding
- Inadequately controlled hypertension (blood pressure: systolic > 150 mmHg and/or diastolic > 100 mmHg)
- Clinically significant (i.e., active) cardiovascular disease (e.g., cerebrovascular accident or myocardial infarction within 6 months prior to randomization), unstable angina, congestive heart failure (New York Heart Association Class >= II) or serious cardiac arrhythmia that is uncontrolled by medication or may interfere with administration of study treatment
- Serious non-healing wound, active peptic ulcer, or untreated bone fracture
- History of abdominal fistula, gastrointestinal (GI) perforation, or intra-abdominal abscess within 6 months of randomization
- Known hypersensitivity to bevacizumab or any of its excipients or any other study drug
Trial locations and contacts
1 site in 1 country.
United States1 site
USC Norris Comprehensive Cancer Center
Los Angeles, California, 90033
About this study
Official title: Phase II Trial Of Neoadjuvant Bevacizumab With Modified FOLFOX7 In Patients With Stage II And III Rectal Cancer
This phase II trial studies how well bevacizumab, fluorouracil, leucovorin calcium, and oxaliplatin before surgery works in treating patients with stage II-III rectal cancer. Monoclonal antibodies, such as bevacizumab, can block tumor growth in different ways. Some block the ability of tumor to grow and spread. Others find tumor cells and help kill them or carry tumor-killing substances to them. Drugs used in chemotherapy, such as fluorouracil, leucovorin calcium, and oxaliplatin, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving bevacizumab together with fluorouracil, leucovorin calcium, and oxaliplatin may be an effective treatment for rectal cancer.
Read the detailed description
PRIMARY OBJECTIVES:
- To determine if six cycles of modified fluorouracil, leucovorin calcium, and oxaliplatin (mFOLFOX7) plus bevacizumab (Avastin) will yield complete pathologic response (cPR) of 25% or more in the primary tumor of patients with stage II and III rectal cancer.
SECONDARY OBJECTIVES:
- To assess the rate of tumor regression (pathologic stage lower than clinical stage) after 6 cycles of mFOLFOX7 and bevacizumab in the primary rectal cancer.
II. To assess local recurrence rate over 3 years after 6 cycles of mFOLFOX7 and bevacizumab.
TERTIARY OBJECTIVES:
- Correlation of the following marker with response (defined as CPR or down staging):
- Intratumoral Gene expression and germline polymorphism of genes involved in the vascular endothelial growth factor (VEGF) and VEGF independent pathways (VEGF, vascular endothelial growth factor receptor 1 [VEGFR1], VEGFR2, interleukin-8 [IL8], chemokine (C-X-C motif) receptor 2 [CXCR2], intercellular adhesion molecule [ICAM], VEGFR1 and VEGFR2, neuropilin 1 or 2 [NRP1,2], cluster of differentiation [CD] 44, aldehyde dehydrogenase [ALDH], leucine-rich repeats and immunoglobulin-like [LRIG].
- Circulating tumor cells (CTC) and VEGF-factor A (A) on the CTC.
II. Prediction of surgical resection margin by pretreatment magnetic resonance imaging (MRI).
OUTLINE:
Patients receive bevacizumab intravenously (IV) over 30-90 minutes, oxaliplatin IV over 2 hours, leucovorin calcium IV, and fluorouracil IV continuously over 46-48 hours on day 1. Treatment repeats every 14 days for 6 courses in the absence of disease progression or unacceptable toxicity. Within 6-8 weeks after treatment, patients undergo surgery.
After completion of study treatment, patients are followed up every 3 months for 2 years and then every 6 months for 3 years.
- Conditions
- Mucinous Adenocarcinoma of the Rectum, Signet Ring Adenocarcinoma of the Rectum, Stage IIA Rectal Cancer, Stage IIB Rectal Cancer, Stage IIC Rectal Cancer, Stage IIIA Rectal Cancer
- Being tested
- bevacizumab, oxaliplatin, leucovorin calcium, fluorouracil, laboratory biomarker analysis
- Medical subject headings
- Rectal Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
bevacizumabBiological
Also called anti-VEGF humanized monoclonal antibody, anti-VEGF monoclonal antibody, Avastin, rhuMAb VEGF
Given IV
oxaliplatinDrug
Also called 1-OHP, Dacotin, Dacplat, Eloxatin
Given IV
Also called CF, CFR, LV
Given IV
fluorouracilDrug
Also called 5-fluorouracil, 5-Fluracil, 5-FU
Given IV
laboratory biomarker analysisOther
Correlative studies
| Study group | Role | What they receive |
|---|---|---|
| Treatment (bevacizumab, mFOLFOX7) | Experimental | Patients receive bevacizumab IV over 30-90 minutes, oxaliplatin IV over 2 hours, leucovorin calcium IV, and fluorouracil IV continuously over 46-48 hours on day 1. Treatment repeats every 14 days for 6 courses in the absence of disease progression or unacceptable toxicity. Within 6-8 weeks after treatment, patients undergo surgery. Receives: Biological: bevacizumab; Drug: oxaliplatin; Drug: leucovorin calcium; Drug: fluorouracil; Other: laboratory biomarker analysis |
What is being measured
The primary outcome is the main question the study is designed to answer.
Number of Participants With Pathological Complete Response (pCR) to Neoadjuvant Therapy
Pathological Complete Response (pCR) after neoadjuvant therapy in pathological specimen. Pathological Complete Response (pCR) is the absence of all invasive cancer in the breast and lymph nodes after neoadjuvant therapy, meaning all cancer cells are eliminated. This outcome is a strong predictor of improved survival. Evaluating pCR provides a rapid assessment of a patient's likely response to therapy and can help guide future treatment decisions.
Measured: Up to 3 years
Secondary outcomes (5)
Tumor Regression on Mesorectal Margins (Pathologic Stage Lower Than Clinical Stage)
Measured: Up to 3 years
Rate of Locoregional Recurrence
Number of cancer patients who experience a return of their cancer in the original tumor site or in the nearby lymph nodes following initial treatment. It is a measure of how often cancer returns to the local area where it started, rather than spreading to distant organs.
Measured: Up to 3 years
Number of Participants With Adverse Events (AEs)
Incidence and nature of adverse events (AEs) according to National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 4.0 ( v4)
Measured: Up to 3 years
Number of Participants With Serious AEs (SAEs) According to NCI CTCAE v4.0
Measured: Up to 3 years
Number of Participants of AEs of Special Interest for Bevacizumab (Grades) According to NCI CTCAE v4.0
Measured: Up to 3 years
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted6 Jun 2013 (estimated)
- Study start2 Aug 2013
- Primary completion14 Mar 2018
- Study completion24 Jun 2020
Why it stopped: Insufficient Accrual
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Mucinous Adenocarcinoma of the RectumStudies of the same condition, open and under way.
- More trials run by University of Southern CaliforniaThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 2
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 17 participants (actual)
Sponsor and investigators
- Lead sponsor
- University of Southern California
- Sponsor type
- University, hospital or other
- Collaborators
- National Cancer Institute (NCI)
- Responsible party
- Sponsor
- Investigators
- Afsaneh Barzi, Principal investigator, University of Southern California
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01871571
- Sponsor's protocol ID
- 3R-12-2
- Other IDs
- NCI-2013-01069, ML28263, P30CA014089
- Status last verified
- Jun 2026
- First submitted
- 4 Jun 2013
- Last updated
- 1 Jul 2026
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
Publications
Barzi A, Choi A, Tsao-Wei D, Iqbal S, El-Khoueiry A, Agafitei DR, Cologne KG, Lenz HJ. Phase II Trial of Neoadjuvant Bevacizumab with Modified FOLFOX7 in Patients with Stage II and III Rectal Cancer. Oncologist. 2020 Dec;25(12):e1879-e1885. doi: 10.1634/theoncologist.2020-0642. Epub 2020 Aug 27.
PubMed 32649004
Study at a glance
From the registry record, last updated by the sponsor on 1 Jul 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Phase II Trial Of Neoadjuvant Bevacizumab With Modified FOLFOX7 In Patients With Stage II And III Rectal Cancer
- ClinicalTrials.gov ID
- NCT01871571
- Acronym / sponsor ID
- 3R-12-2
- Conditions
- Mucinous Adenocarcinoma of the Rectum, Signet Ring Adenocarcinoma of the Rectum, Stage IIA Rectal Cancer, Stage IIB Rectal Cancer, Stage IIC Rectal Cancer, Stage IIIA Rectal Cancer
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- TerminatedReason stopped: Insufficient Accrual
- Enrolment
- 17 participants (actual)
- Lead sponsor
- University of Southern CaliforniaUniversity, hospital or other
- Collaborators
- National Cancer Institute (NCI)
- Study start
- 2 Aug 2013 (actual)
- Primary completion
- 14 Mar 2018 (actual)
- Study completion
- 24 Jun 2020 (actual)
- First posted
- 6 Jun 2013 (estimated)
- Results
- Posted 1 Jul 2026
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This phase II trial studies how well bevacizumab, fluorouracil, leucovorin calcium, and oxaliplatin before surgery works in treating patients with stage II-III rectal cancer. Monoclonal antibodies, such as bevacizumab, can block tumor growth in different ways. Some block the ability of tumor to grow and spread. Others find tumor cells and help kill them or carry tumor-killing substances to them. Drugs used in chemotherapy, such as fluorouracil, leucovorin calcium, and oxaliplatin, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving bevacizumab together with fluorouracil, leucovorin calcium, and oxaliplatin may be an effective treatment for rectal cancer.
Detailed description
PRIMARY OBJECTIVES:
- To determine if six cycles of modified fluorouracil, leucovorin calcium, and oxaliplatin (mFOLFOX7) plus bevacizumab (Avastin) will yield complete pathologic response (cPR) of 25% or more in the primary tumor of patients with stage II and III rectal cancer.
SECONDARY OBJECTIVES:
- To assess the rate of tumor regression (pathologic stage lower than clinical stage) after 6 cycles of mFOLFOX7 and bevacizumab in the primary rectal cancer.
II. To assess local recurrence rate over 3 years after 6 cycles of mFOLFOX7 and bevacizumab.
TERTIARY OBJECTIVES:
- Correlation of the following marker with response (defined as CPR or down staging):
- Intratumoral Gene expression and germline polymorphism of genes involved in the vascular endothelial growth factor (VEGF) and VEGF independent pathways (VEGF, vascular endothelial growth factor receptor 1 [VEGFR1], VEGFR2, interleukin-8 [IL8], chemokine (C-X-C motif) receptor 2 [CXCR2], intercellular adhesion molecule [ICAM], VEGFR1 and VEGFR2, neuropilin 1 or 2 [NRP1,2], cluster of differentiation [CD] 44, aldehyde dehydrogenase [ALDH], leucine-rich repeats and immunoglobulin-like [LRIG].
- Circulating tumor cells (CTC) and VEGF-factor A (A) on the CTC.
II. Prediction of surgical resection margin by pretreatment magnetic resonance imaging (MRI).
OUTLINE:
Patients receive bevacizumab intravenously (IV) over 30-90 minutes, oxaliplatin IV over 2 hours, leucovorin calcium IV, and fluorouracil IV continuously over 46-48 hours on day 1. Treatment repeats every 14 days for 6 courses in the absence of disease progression or unacceptable toxicity. Within 6-8 weeks after treatment, patients undergo surgery.
After completion of study treatment, patients are followed up every 3 months for 2 years and then every 6 months for 3 years.
Study design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Treatment (bevacizumab, mFOLFOX7) | Experimental | Biological: bevacizumab, Drug: oxaliplatin, Drug: leucovorin calcium, Drug: fluorouracil, Other: laboratory biomarker analysisPatients receive bevacizumab IV over 30-90 minutes, oxaliplatin IV over 2 hours, leucovorin calcium IV, and fluorouracil IV continuously over 46-48 hours on day 1. Treatment repeats every 14 days for 6 courses in the absence of disease progression or unacceptable toxicity. Within 6-8 weeks after treatment, patients undergo surgery. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (19 listed)
- Histologically confirmed adenocarcinoma of the rectum in patients with no prior therapy who are candidate for surgical resection
- Tumor lesion is 5-15 cm from anal verge
- cT2 N+ or cT3-T4 N0 or N+ as assessed by endorectal ultrasound scan (US)
- No evidence of distant metastatic disease
- Signed informed consent prior to initiation of any study-specific procedure or treatment
Key exclusion criteria (17 listed)
- Prior chemotherapy or radiotherapy for colorectal cancer
- Clinical evidence of bleeding diathesis or coagulopathy
- Pregnancy or lactation
- Sensory peripheral neuropathy >= grade 2
- Known positivity for human immunodeficiency virus (HIV)
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| bevacizumabAlso: anti-VEGF humanized monoclonal antibody, anti-VEGF monoclonal antibody, Avastin, rhuMAb VEGFGiven IV | Biological | Treatment (bevacizumab, mFOLFOX7) |
| oxaliplatinAlso: 1-OHP, Dacotin, Dacplat, EloxatinGiven IV | Drug | Treatment (bevacizumab, mFOLFOX7) |
| leucovorin calciumAlso: CF, CFR, LVGiven IV | Drug | Treatment (bevacizumab, mFOLFOX7) |
| fluorouracilAlso: 5-fluorouracil, 5-Fluracil, 5-FUGiven IV | Drug | Treatment (bevacizumab, mFOLFOX7) |
| laboratory biomarker analysisCorrelative studies | Other | Treatment (bevacizumab, mFOLFOX7) |
Primary outcome
Number of Participants With Pathological Complete Response (pCR) to Neoadjuvant Therapy
Time frame: Up to 3 years
Pathological Complete Response (pCR) after neoadjuvant therapy in pathological specimen. Pathological Complete Response (pCR) is the absence of all invasive cancer in the breast and lymph nodes after neoadjuvant therapy, meaning all cancer cells are eliminated. This outcome is a strong predictor of improved survival. Evaluating pCR provides a rapid assessment of a patient's likely response to therapy and can help guide future treatment decisions.
5 secondary outcomes
Tumor Regression on Mesorectal Margins (Pathologic Stage Lower Than Clinical Stage)
Time frame: Up to 3 years
Rate of Locoregional Recurrence
Time frame: Up to 3 years
Number of Participants With Adverse Events (AEs)
Time frame: Up to 3 years
Number of Participants With Serious AEs (SAEs) According to NCI CTCAE v4.0
Time frame: Up to 3 years
Number of Participants of AEs of Special Interest for Bevacizumab (Grades) According to NCI CTCAE v4.0
Time frame: Up to 3 years
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 1 Jul 2026.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 32649004Barzi A, Choi A, Tsao-Wei D, Iqbal S, El-Khoueiry A, Agafitei DR, Cologne KG, Lenz HJ. Phase II Trial of Neoadjuvant Bevacizumab with Modified FOLFOX7 in Patients with Stage II and III Rectal Cancer. Oncologist. 2020 Dec;25(12):e1879-e1885. doi: 10.1634/theoncologist.2020-0642. Epub 2020 Aug 27.
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Afsaneh Barzi principal investigator
University of Southern California
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing bevacizumab, oxaliplatin and leucovorin calcium in people with Mucinous Adenocarcinoma of the Rectum and Signet Ring Adenocarcinoma of the Rectum, run by University of Southern California at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 19 inclusion and 17 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: stopped early, as of the sponsor's last update on 1 Jul 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 1 Jul 2026). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Number of Participants With Pathological Complete Response (pCR) to Neoadjuvant Therapy (time frame: Up to 3 years). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT01871571, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 1 Jul 2026.