Metastatic Pancreatic Ductal AdenocarcinomaPhase 2NCT05630183
A Study of Botensilimab in Participants With Metastatic Pancreatic Cancer
A Phase 2 study testing Botensilimab, Gemcitabine and Nab-paclitaxel in people with Metastatic Pancreatic Ductal Adenocarcinoma, run by Agenus Inc. at 36 sites in United States.
Trial summary
The goal of this clinical trial is to test if the addition of botensilimab to standard chemotherapy improves the efficacy compared to just chemotherapy alone in participants with metastatic pancreatic cancer. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Metastatic Pancreatic Ductal Adenocarcinoma
- What is being tested?
- Botensilimab, Gemcitabine and Nab-paclitaxel
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 81 participants
- Where
- 36 sitesUnited States
- Study dates
- 27 Mar 2023to 5 Jan 2026
- Phase
- Phase 2
- Are there results?
- None posted in the registry
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 diagnosis of pancreatic ductal adenocarcinoma. Note: fine needle aspirate/cytology of tumor in the presence of a pancreatic mass that confirms ductal adenocarcinoma is acceptable.
- Must have had disease progression on any version of FOLFIRINOX for metastatic disease (including onivyde + oxaliplatin + 5-fluorouracil [5-FU] + leucovorin [NALIRIFOX]). Clarification: Participant with initial diagnosis of locally advanced disease may be eligible if upon retrospective review of initial scans, previously unappreciated metastases are able to be identified; Investigator must provide documentation that participant had metastatic disease at the time the participant received FOLFIRINOX. Notes: Progression on a reduced or maintenance fluoropyrimidine based regimen in the metastatic setting is allowed (for example, leucovorin + 5-FU + oxaliplatin [FOLFOX], leucovorin + 5-FU + irinotecan [FOLFIRI], 5-FU, or capecitabine), provided the participant received at least 1 dose of all of the drugs in a FOLFIRINOX regimen.
- Eastern Cooperative Oncology Group performance status of 0 or 1.
- Life expectancy of at least 3 months.
- Measurable disease on baseline imaging per RECIST 1.1 criteria.
- A < Grade 2 pre-existing peripheral neuropathy per National Cancer Institute Common Terminology Criteria for Adverse Events, Version 5.0 (NCI CTCAE v5.0). Because NCI CTCAE v5.0 grading for peripheral neuropathy does not include guidance for "mild" neuropathy, these cases can be graded per the NCI CTCAE v5.0 grading for general adverse events which includes "mild" under Grade 1.
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- Acceptable coagulation status as indicated by an international normalized ratio ≤ 1.5 x institutional ULN, except participants on anticoagulation who can be included at the discretion of the investigator.
- Adequate organ function.
- Women of childbearing potential must have a negative urine or serum pregnancy test at screening (within 72 hours of first dose of study drugs).
- Male participants with a female partner(s) of childbearing potential must agree to use highly effective contraceptive measures throughout the study.
Who cannot join
- Received more than one prior regimen (that is, FOLFIRINOX) for their metastatic disease. (Progression on a reduced or maintenance fluoropyrimidine-based regimen in the metastatic setting is allowed. [for example, FOLFOX, FOLFIRI, 5-FU, or capecitabine], provided the participant received at least 1 dose of all of the drugs in a FOLFIRINOX regimen.)
- History of central nervous system (CNS) metastasis or active CNS metastasis.
- Concurrent malignancy (present during screening) requiring treatment or history of prior malignancy active within 2 years prior to the first dose of study drugs (that is, participants with a history of prior malignancy are eligible if treatment was completed at least 2 years prior to first dose of study drugs and the participant has no evidence of disease). Participants with history of prior early-stage basal/squamous cell skin cancer or noninvasive or in situ cancers who have undergone definitive treatment at any time are also eligible.
- Uncontrolled intercurrent illness, including but not limited to clinically significant (that is, active) cardiovascular disease.
- Active, uncontrolled infections, requiring systemic intravenous anti-infective treatment within 2 weeks prior to first dose of study drugs.
- Major surgery within 4 weeks prior to signing of informed consent form (ICF).
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- Prior treatment with an immune checkpoint inhibitor.
- Refractory ascites.
- Partial or complete bowel obstruction within the last 3 months prior to signing of ICF, signs/symptoms of bowel obstruction, or known radiologic evidence of impending obstruction.
- Clinically significant gastrointestinal disorders.
- Treatment with one of the following classes of drugs within the delineated time window prior to first dose of study drugs:
- Cytotoxic agent within 3 weeks or 5 half-lives (whichever is greater).
- Monoclonal antibodies, antibody-drug conjugates, radioimmunoconjugates, or investigational drug, within 4 weeks, or 5 half-lives, whichever is shorter.
- Small molecule targeted therapies/tyrosine kinase inhibitors within 14 days or 5 half-lives (whichever is greater).
- Radiotherapy within 7 days.
- Previous severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection within 10 days for mild or asymptomatic infections or 20 days for severe/critical illness prior to first dose of study drugs.
- Received a vaccine, including SARS-CoV-2 vaccine, < 7 days prior to first dose of study drugs.
- Known allergy or hypersensitivity to any of the study drugs or any of the study drug excipients.
- Symptomatic interstitial lung disease (ILD), history of ILD, or any lung disease which may interfere with detection and management of new immune-mediated pulmonary toxicity.
- History of allogeneic organ transplant.
- Psychiatric or substance abuse disorders that would interfere with cooperation with the requirements of the study.
- Participants with a condition requiring systemic treatment with either corticosteroids (> 10 milligrams [mg] daily prednisone equivalent) within 14 days or another immunosuppressive medication within 30 days prior to the first dose of study drugs. Inhaled or topical steroids, and adrenal replacement steroid doses (≤ 10 mg daily prednisone equivalent), are permitted in the absence of active autoimmune disease.
- Active autoimmune disease or history of autoimmune disease that required systemic treatment within 2 years prior to first dose of study drugs (that is, with use of disease-modifying agents or immunosuppressive drugs).
- Pregnant or breastfeeding participants.
- Uncontrolled infection with human immunodeficiency virus.
- Known to be positive for hepatitis B (HBV) surface antigen, or any other positive test for HBV indicating acute or chronic infection.
- Known active hepatitis C as determined by positive serology and confirmed by polymerase chain reaction.
- Dependence on total parenteral nutrition.
- Participants with concurrent diarrhea > grade 1 at time of randomization despite optimal treatment with standard of care pancreatic enzymes.
- Known active or latent tuberculosis.
- Any condition in the opinion of the principal investigator that might interfere with the participant's participation in the study or in the evaluation of the study results.
- Unwillingness or inability to comply with procedures required in this protocol.
Trial locations and contacts
36 sites in 1 country.
36 sites in 1 country
United States36 sites
Rogel Cancer Center, University of Michigan Medicine
Ann Arbor, Michigan, 48109
Illinois Cancer Specialists
Arlington Heights, Illinois, 60005
Massachusetts General Hospital
Boston, Massachusetts, 02114
Beth Israel Deaconess Medical Center
Boston, Massachusetts, 02215
Texas Oncology
Carrollton, Texas, 75010
Oncology Hematology Care - Eastgate
Cincinnati, Ohio, 45245
Sarah Cannon Research Institute at Tennessee Oncology
Cincinnati, Ohio, 45245
Maryland Oncology Hematology
Columbia, Maryland, 21044
Baylor Charles A. Sammons Cancer Center
Dallas, Texas, 75247
TxO - Denison Cancer Center
Denison, Texas, 75020
Virginia Cancer Specialists
Fairfax, Virginia, 22031
Florida Cancer Specialist South
Fort Myers, Florida, 33901
The Center for Cancer & Blood Disorders: Fort Worth
Fort Worth, Texas, 76104
John Theurer Cancer Center at Hackensack
Hackensack, New Jersey, 07601
Comprehensive Cancer Centers of Nevada - Summerlin Medical Center II*
Las Vegas, Nevada, 89144
USC Norris Comprehensive Cancer Center
Los Angeles, California, 90033
Minnesota Oncology
Minneapolis, Minnesota, 55404
Atlantic Health Systems, Morristown
Morristown, New Jersey, 07960
Sarah Cannon Research Institute at Tennessee Oncology
Nashville, Tennessee, 37203
Weill Cornell Medicine-New York Presbyterian Hospital
New York, New York, 10021
Memorial Sloan Kettering Cancer Center
New York, New York, 10065
Weill Cornell Medicine Sandra and Edward Meyer Cancer Center
New York, New York, 10065
Icahn School of Medicine at Mount Sinai Tisch Cancer Institute
New York, New York, 10128
Medical Oncology Hematology Consultants (MOHC) - Helen F. Graham Cancer Center
Newark, Delaware, 19713
USC Norris Oncology
Newport Beach, California, 92663
Virginia Oncology Associates - Brock Cancer Center
Norfolk, Virginia, 23502
Nebraska Medicine-Nebraska Medical Center
Omaha, Nebraska, 68198
Cancer Care Centers of Brevard
Palm Bay, Florida, 32909
Lifespan
Providence, Rhode Island, 02903
UCLA Health - Santa Monica Cancer Care
Santa Monica, California, 90404
HonorHealth
Scottsdale, Arizona, 85258
Swedish Cancer Institute
Seattle, Washington, 98104
Florida Cancer Specialist North
St. Petersburg, Florida, 22705
Overlook Medical Center
Summit, New Jersey, 07901
Northeast Texas Cancer & Research Institute
Tyler, Texas, 75702
Shenandoah Oncology
Winchester, Virginia, 22601
About this study
Official title: A Randomized, Open-Label, Phase II Trial of Nab-paclitaxel + Gemcitabine With or Without Botensilimab (AGEN1181) in Patients With Metastatic Pancreatic Cancer Who Have Progressed on Prior 5FU + Leucovorin + Irinotecan + Oxaliplatin (FOLFIRINOX)
The goal of this clinical trial is to test if the addition of botensilimab to standard chemotherapy improves the efficacy compared to just chemotherapy alone in participants with metastatic pancreatic cancer. One group of participants will only receive chemotherapy while a second group of participants will receive botensilimab and chemotherapy.
Read the detailed description
This will be a prospective, multicenter, clinical trial of botensilimab in combination with nab-paclitaxel + gemcitabine or nab-paclitaxel + gemcitabine alone. The trial will be conducted in 2 parts. Part 1 will be a safety lead-in to establish the safety and dose of botensilimab for Part 2. Part 2 will be a randomized, open-label assessment of botensilimab (at the dose level determined in Part 1).
- Being tested
- Botensilimab, Gemcitabine, Nab-paclitaxel
- Keywords
- BOT, 1181, Immunotherapy, Pancreas, Gemcitabine, Nab-paclitaxel
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
BotensilimabDrug
Also called AGEN1181
A fully human fragment crystallizable-enhanced monoclonal cytotoxic T lymphocyte antigen 4 antibody administered intravenously.
GemcitabineDrug
Standard-of-care chemotherapy administered intravenously.
Nab-paclitaxelDrug
Standard-of-care chemotherapy administered intravenously.
| Study group | Role | What they receive |
|---|---|---|
| Part 1: Combination (Safety Lead-in Phase) | Experimental | Participants will receive botensilimab in combination with standard-of-care chemotherapy (nab-paclitaxel + gemcitabine). Receives: Drug: Botensilimab; Drug: Gemcitabine; Drug: Nab-paclitaxel |
| Part 2: Combination | Experimental | Participants will receive botensilimab in combination standard-of-care chemotherapy (nab-paclitaxel + gemcitabine). Receives: Drug: Botensilimab; Drug: Gemcitabine; Drug: Nab-paclitaxel |
| Part 2: Standard of Care | Active comparator | Participants will receive standard-of-care chemotherapy (nab-paclitaxel + gemcitabine). Receives: Drug: Gemcitabine; Drug: Nab-paclitaxel |
What is being measured
The primary outcome is the main question the study is designed to answer.
Progression-free Survival as Assessed by Investigator
Progression-free survival will be defined as the time from the date of randomization to the date of the first objectively documented tumor progression, assessed by investigator per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1), or death, whichever occurs first.
Measured: Up to 2 years
Secondary outcomes (7)
Number of Participants with Treatment-emergent Adverse Events
Measured: First study dose through up 1 year
Overall Survival
Overall survival will be defined as the time from the date of randomization to the date of death due to any cause.
Measured: Up to 2 years
Complete Response
Complete response will be defined by RECIST 1.1 criteria and carbohydrate antigen 19-9 down to normal limits (from at least > 2 x upper limit of normal [ULN]). Cancer antigen 125 or carcinoembryonic antigen will be evaluated for non-expressors of carbohydrate antigen 19-9.
Measured: Up to 2 years
Overall Response Rate
Overall response rate will be defined as the proportion of participants whose best overall response is complete response or partial response assessed by investigator per RECIST v1.1.
Measured: Up to 2 years
Duration of Response
Duration of response will be defined as the time from the first determination of an objective response assessed by investigator per RECIST v1.1, until the first documentation of progression or death, whichever occurs first.
Measured: Up to 2 years
Change From Baseline in Carbohydrate Antigen 19-9
Change in carbohydrate antigen 19-9 will be evaluated until progressive disease, death, date of last tumor assessment, or start of new anti-cancer therapy. Cancer antigen 125 or carcinoembryonic antigen will be evaluated for non-expressors of carbohydrate antigen 19-9.
Measured: Baseline, 2 years
Rates of Normalization of Carbohydrate Antigen 19-9
Carbohydrate antigen 19-9 normalization will be defined as a value of carbohydrate antigen 19-9 down to normal limits (from at least > 2 x ULN). Cancer antigen 125 or carcinoembryonic antigen will be evaluated for non-expressors of carbohydrate antigen 19-9.
Measured: Up to 2 years
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted29 Nov 2022
- Study start27 Mar 2023
- Primary completion5 Jan 2026
- Study completion5 Jan 2026
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Metastatic Pancreatic Ductal AdenocarcinomaStudies of the same condition, open and under way.
- 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
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 81 participants (actual)
Sponsor and investigators
- Lead sponsor
- Agenus Inc.
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Medical Director, Study director, Agenus Inc.
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05630183
- Sponsor's protocol ID
- C-800-22
- Status last verified
- Jun 2026
- First submitted
- 18 Nov 2022
- Last updated
- 11 Jun 2026
- Results posted
- No
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 11 Jun 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Randomized, Open-Label, Phase II Trial of Nab-paclitaxel + Gemcitabine With or Without Botensilimab (AGEN1181) in Patients With Metastatic Pancreatic Cancer Who Have Progressed on Prior 5FU + Leucovorin + Irinotecan + Oxaliplatin (FOLFIRINOX)
- ClinicalTrials.gov ID
- NCT05630183
- Acronym / sponsor ID
- C-800-22
- Keywords
- BOT, 1181, Immunotherapy, Pancreas, Gemcitabine, Nab-paclitaxel
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 81 participants (actual)
- Lead sponsor
- Agenus Inc.Industry (pharma, biotech, devices)
- Study start
- 27 Mar 2023 (actual)
- Primary completion
- 5 Jan 2026 (actual)
- Study completion
- 5 Jan 2026 (actual)
- First posted
- 29 Nov 2022 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The goal of this clinical trial is to test if the addition of botensilimab to standard chemotherapy improves the efficacy compared to just chemotherapy alone in participants with metastatic pancreatic cancer. One group of participants will only receive chemotherapy while a second group of participants will receive botensilimab and chemotherapy.
Detailed description
This will be a prospective, multicenter, clinical trial of botensilimab in combination with nab-paclitaxel + gemcitabine or nab-paclitaxel + gemcitabine alone. The trial will be conducted in 2 parts. Part 1 will be a safety lead-in to establish the safety and dose of botensilimab for Part 2. Part 2 will be a randomized, open-label assessment of botensilimab (at the dose level determined in Part 1).
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Part 1: Combination (Safety Lead-in Phase) | Experimental | Drug: Botensilimab, Drug: Gemcitabine, Drug: Nab-paclitaxelParticipants will receive botensilimab in combination with standard-of-care chemotherapy (nab-paclitaxel + gemcitabine). |
| Part 2: Combination | Experimental | Drug: Botensilimab, Drug: Gemcitabine, Drug: Nab-paclitaxelParticipants will receive botensilimab in combination standard-of-care chemotherapy (nab-paclitaxel + gemcitabine). |
| Part 2: Standard of Care | Active comparator | Drug: Gemcitabine, Drug: Nab-paclitaxelParticipants will receive standard-of-care chemotherapy (nab-paclitaxel + gemcitabine). |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (10 listed)
- Histologically confirmed diagnosis of pancreatic ductal adenocarcinoma. Note: fine needle aspirate/cytology of tumor in the presence of a pancreatic mass that confirms ductal adenocarcinoma is acceptable.
- Must have had disease progression on any version of FOLFIRINOX for metastatic disease (including onivyde + oxaliplatin + 5-fluorouracil [5-FU] + leucovorin [NALIRIFOX]). Clarification: Participant with initial diagnosis of locally advanced disease may be eligible if upon retrospective review of initial scans, previously unappreciated metastases are able to be identified; Investigator must provide documentation that participant had metastatic disease at the time the participant received FOLFIRINOX. Notes: Progression on a reduced or maintenance fluoropyrimidine based regimen in the metastatic setting is allowed (for example, leucovorin + 5-FU + oxaliplatin [FOLFOX], leucovorin + 5-FU + irinotecan [FOLFIRI], 5-FU, or capecitabine), provided the participant received at least 1 dose of all of the drugs in a FOLFIRINOX regimen.
- Eastern Cooperative Oncology Group performance status of 0 or 1.
- Life expectancy of at least 3 months.
- Measurable disease on baseline imaging per RECIST 1.1 criteria.
Key exclusion criteria (32 listed)
- Received more than one prior regimen (that is, FOLFIRINOX) for their metastatic disease. (Progression on a reduced or maintenance fluoropyrimidine-based regimen in the metastatic setting is allowed. [for example, FOLFOX, FOLFIRI, 5-FU, or capecitabine], provided the participant received at least 1 dose of all of the drugs in a FOLFIRINOX regimen.)
- History of central nervous system (CNS) metastasis or active CNS metastasis.
- Concurrent malignancy (present during screening) requiring treatment or history of prior malignancy active within 2 years prior to the first dose of study drugs (that is, participants with a history of prior malignancy are eligible if treatment was completed at least 2 years prior to first dose of study drugs and the participant has no evidence of disease). Participants with history of prior early-stage basal/squamous cell skin cancer or noninvasive or in situ cancers who have undergone definitive treatment at any time are also eligible.
- Uncontrolled intercurrent illness, including but not limited to clinically significant (that is, active) cardiovascular disease.
- Active, uncontrolled infections, requiring systemic intravenous anti-infective treatment within 2 weeks prior to first dose of study drugs.
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 |
|---|---|---|
| BotensilimabAlso: AGEN1181A fully human fragment crystallizable-enhanced monoclonal cytotoxic T lymphocyte antigen 4 antibody administered intravenously. | Drug | Part 1: Combination (Safety Lead-in Phase), Part 2: Combination |
| GemcitabineStandard-of-care chemotherapy administered intravenously. | Drug | Part 1: Combination (Safety Lead-in Phase), Part 2: Combination, Part 2: Standard of Care |
| Nab-paclitaxelStandard-of-care chemotherapy administered intravenously. | Drug | Part 1: Combination (Safety Lead-in Phase), Part 2: Combination, Part 2: Standard of Care |
Primary outcome
Progression-free Survival as Assessed by Investigator
Time frame: Up to 2 years
Progression-free survival will be defined as the time from the date of randomization to the date of the first objectively documented tumor progression, assessed by investigator per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1), or death, whichever occurs first.
7 secondary outcomes
Number of Participants with Treatment-emergent Adverse Events
Time frame: First study dose through up 1 year
Overall Survival
Time frame: Up to 2 years
Complete Response
Time frame: Up to 2 years
Overall Response Rate
Time frame: Up to 2 years
Duration of Response
Time frame: Up to 2 years
Change From Baseline in Carbohydrate Antigen 19-9
Time frame: Baseline, 2 years
Rates of Normalization of Carbohydrate Antigen 19-9
Time frame: Up to 2 years
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 11 Jun 2026.
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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.
Medical Director study director
Agenus Inc.
36 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing Botensilimab, Gemcitabine and Nab-paclitaxel in people with Metastatic Pancreatic Ductal Adenocarcinoma, run by Agenus Inc. at 36 sites 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 10 inclusion and 32 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: finished, as of the sponsor's last update on 11 Jun 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 36 sites 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?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
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?
Progression-free Survival as Assessed by Investigator (time frame: Up to 2 years). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 11 Jun 2026.