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Study of Ruxolitinib in Colorectal Cancer Patients

Primary Purpose

CRC (Colorectal Cancer)

Status
Terminated
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Ruxolitinib
Regorafenib
Placebo
Sponsored by
Incyte Corporation
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for CRC (Colorectal Cancer) focused on measuring Metastatic Colorectal Cancer, Colon Cancer, Ruxolitinib, adenocarcinoma, regorafenib, Jakavi ®, Jakafi ®, Stivarga ®

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Histologically or cytologically confirmed adenocarcinoma of the colon or rectum that is metastatic.
  • Previous treatment with fluoropyrimidine-, oxaliplatin- and irinotecan- based chemotherapy, an anti-VEGF therapy (if no contraindication) and if KRAS wild type and no contraindication, an anti-EGFR therapy.
  • Radiographically measurable or evaluable disease (per RECIST v1.1)
  • Life expectancy of ≥ 12 weeks.
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2
  • Three or more weeks have elapsed from the completion of previous treatment regimen and subjects must have recovered or be at a new stable baseline from any related toxicities.
  • Prior radiotherapy to disease sites is allowed with certain protocol-defined restrictions.

Exclusion Criteria:

  • Prior treatment with regorafenib.
  • Presence of active gastrointestinal disease or other condition that will interfere significantly with the absorption of drugs.
  • Active peptic ulcer disease, inflammatory bowel disease (eg, ulcerative colitis, Crohn's disease), diverticulitis, or other gastrointestinal conditions with increased risk of perforation or gastrointestinal bleeding.
  • Recent history (≤ 3 months) or ongoing partial or complete bowel obstruction unless due to disease under study and corrected with surgery.
  • Blood pressure ≥ 140/90 mmHg.
  • Active bleeding diathesis or history of any major bleeding (eg, requiring transfusion of red blood cells (RBCs), central nervous system (CNS) bleeding, or significant hemoptysis within 6 months of enrollment. Subjects with bleeding secondary to underlying disease (including gastrointestinal (GI) perforation or fistula) that has been corrected by surgery or alternative procedure may be included.
  • Clinically significant cardiac disease including unstable angina, acute myocardial infarction within 6 months from Day 1 of study drug administration, New York Heart Association Class II, III, or IV congestive heart failure, and arrhythmia requiring therapy.

Sites / Locations

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Ruxolitinib plus regorafenib

Placebo plus regorafenib

Arm Description

Outcomes

Primary Outcome Measures

Overall Survival (OS)
Overall survival is defined as the time from randomization to death due to any cause. Participants without death observed at the time of the analysis will be censored at last date known to be alive. The median overall survival time was estimated using the Kaplan-Meier method. Overall survival was compared between treatment groups using log-rank test.

Secondary Outcome Measures

Progression Free Survival (PFS)
Progressive Disease (PD) is defined using Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 at least a 20% increase in the sum of the Longest Diameter (LD) of target lesions, taking as reference the smallest sum LD recorded since the treatment started or the appearance of one or more new lesions, unequivocal progression of non-target lesions, or the appearance of new lesions.
Overall Response Rate (ORR)
Response defined per Response Evaluation Criteria In Solid Tumors (RECIST) criteria: Complete Response (CR)=disappearance of all target and non-target lesions without new lesion; Partial Response (PR)=30% decrease in sum of longest diameter of target lesions, non-target lesion not progressed, and no new lesion; Progressive Disease=20% increase in sum of longest diameter of target lesions, or non-target lesion progression, or identification of new lesion; Stable Disease=small changes that do not meet above criteria. ORR was defined as the proportion of participants who achieved a best response of either CR or PR. ORR=number of participants with CR or PR/number of participants randomized.
Duration of Response
Duration of response is defined as the time from response (CR/PR) until the earliest date of disease progression determined by investigator assessment of objective radiographic disease assessments per Response Evaluation Criteria in Solid Tumors (RECIST) v1.1, or death due to any cause.
Percentage of Participants Achieving Disease Control
Disease control as measured by the percentage of participants whose best response was complete response (CR), partial response (PR), or stable disease (SD) per RECIST v.1.1.
Percentage of Participants With Treatment-emergent Adverse Events (TEAEs)
TEAEs were defined as any adverse event (AE) during the study that began or worsened on or after the date of first dose of investigational product.

Full Information

First Posted
April 17, 2014
Last Updated
January 15, 2018
Sponsor
Incyte Corporation
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1. Study Identification

Unique Protocol Identification Number
NCT02119676
Brief Title
Study of Ruxolitinib in Colorectal Cancer Patients
Official Title
A Randomized, Double-Blind Study of Ruxolitinib or Placebo in Combination With Regorafenib in Subjects With Relapsed or Refractory Metastatic Colorectal Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
January 2018
Overall Recruitment Status
Terminated
Why Stopped
Substudy 1 was terminated for futility at interim analysis and Substudy 2 was terminated per sponsor decision.
Study Start Date
March 2014 (undefined)
Primary Completion Date
February 2016 (Actual)
Study Completion Date
December 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Incyte Corporation

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study was to determine if ruxolitinib, in combination with regorafenib, is safe and effective in the treatment of metastatic colorectal cancer.
Detailed Description
The study consisted of an open-label, Part 1 safety run-in (consisting of 1 to 3 cohorts of 9 subjects each), to confirm the safety of the regorafenib/ruxolitinib combination in subjects with relapsed or refractory metastatic colorectal cancer (CRC). If determined to be tolerable, Part 2 was to proceed as a randomized, double-blind study evaluating ruxolitinib or placebo in combination with regorafenib in subjects with relapsed or refractory metastatic CRC previously treated with fluoropyrimidine, oxaliplatin, and/or irinotecan based chemotherapy, an anti-vascular endothelial growth factor (VEGF) therapy and if Kirsten rat sarcoma (KRAS) wild type an anti-epidermal growth factor receptor (EGFR) therapy. Subjects in the safety run-in received open-label ruxolitinib and regorafenib; for the randomized, double-blind portion of the study all subjects received regorafenib and either ruxolitinib or placebo in a 1:1 blinded manner. Treatment for all subjects consisted of repeating 28-day cycles. Regorafenib was self-administered for the first 21 days of each cycle, and ruxolitinib/placebo was self-administered during the entire 28-day cycle. Treatment cycles continued as long as the regimen is tolerated, and the subject does not meet the discontinuation criteria. When subjects discontinued regorafenib, ruxolitinib or placebo they remained in the study and were followed for subsequent treatment regimens which were initiated and survival.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
CRC (Colorectal Cancer)
Keywords
Metastatic Colorectal Cancer, Colon Cancer, Ruxolitinib, adenocarcinoma, regorafenib, Jakavi ®, Jakafi ®, Stivarga ®

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
396 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Ruxolitinib plus regorafenib
Arm Type
Experimental
Arm Title
Placebo plus regorafenib
Arm Type
Active Comparator
Intervention Type
Drug
Intervention Name(s)
Ruxolitinib
Other Intervention Name(s)
Jakafi ®, Jakavi ®
Intervention Description
5 mg tablets to be administered by mouth Ruxolitinib 20 mg twice a day (BID) (Part 1) (NOTE: The starting dose for the randomized portion of study (Part 2) was 15 mg BID based on results from Part 1.)
Intervention Type
Drug
Intervention Name(s)
Regorafenib
Other Intervention Name(s)
Stivarga ®
Intervention Description
Regorafenib 160mg once daily for the first 21 days of each 28-day cycle. (NOTE: Dose interruptions and modifications for regorafenib are expected when toxicities occur in which dose interruptions or modifications are appropriate.)
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
5 mg matching placebo tablets to be administered by mouth
Primary Outcome Measure Information:
Title
Overall Survival (OS)
Description
Overall survival is defined as the time from randomization to death due to any cause. Participants without death observed at the time of the analysis will be censored at last date known to be alive. The median overall survival time was estimated using the Kaplan-Meier method. Overall survival was compared between treatment groups using log-rank test.
Time Frame
Baseline until death due to any cause; up to 16 months or data cut-off 11 FEB 2016.
Secondary Outcome Measure Information:
Title
Progression Free Survival (PFS)
Description
Progressive Disease (PD) is defined using Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 at least a 20% increase in the sum of the Longest Diameter (LD) of target lesions, taking as reference the smallest sum LD recorded since the treatment started or the appearance of one or more new lesions, unequivocal progression of non-target lesions, or the appearance of new lesions.
Time Frame
Baseline through disease progression, or death due to any cause if sooner; up to 16 months or data cut-off 11 FEB 2016.
Title
Overall Response Rate (ORR)
Description
Response defined per Response Evaluation Criteria In Solid Tumors (RECIST) criteria: Complete Response (CR)=disappearance of all target and non-target lesions without new lesion; Partial Response (PR)=30% decrease in sum of longest diameter of target lesions, non-target lesion not progressed, and no new lesion; Progressive Disease=20% increase in sum of longest diameter of target lesions, or non-target lesion progression, or identification of new lesion; Stable Disease=small changes that do not meet above criteria. ORR was defined as the proportion of participants who achieved a best response of either CR or PR. ORR=number of participants with CR or PR/number of participants randomized.
Time Frame
Baseline through end of study; up to 16 months or data cut-off 11 FEB 2016.
Title
Duration of Response
Description
Duration of response is defined as the time from response (CR/PR) until the earliest date of disease progression determined by investigator assessment of objective radiographic disease assessments per Response Evaluation Criteria in Solid Tumors (RECIST) v1.1, or death due to any cause.
Time Frame
Baseline through end of study; up to 16 months or data cut-off 11 FEB 2016.
Title
Percentage of Participants Achieving Disease Control
Description
Disease control as measured by the percentage of participants whose best response was complete response (CR), partial response (PR), or stable disease (SD) per RECIST v.1.1.
Time Frame
Baseline through end of study; up to 16 months or data cut-off 11 FEB 2016.
Title
Percentage of Participants With Treatment-emergent Adverse Events (TEAEs)
Description
TEAEs were defined as any adverse event (AE) during the study that began or worsened on or after the date of first dose of investigational product.
Time Frame
Baseline through approximately 30 days post treatment discontinuation;up to 16 months or data cut-off 27JAN 2016 for Substudy 1 and up to the data cut-off of 11FEB2016 for Substudy 2.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically or cytologically confirmed adenocarcinoma of the colon or rectum that is metastatic. Previous treatment with fluoropyrimidine-, oxaliplatin- and irinotecan- based chemotherapy, an anti-VEGF therapy (if no contraindication) and if KRAS wild type and no contraindication, an anti-EGFR therapy. Radiographically measurable or evaluable disease (per RECIST v1.1) Life expectancy of ≥ 12 weeks. Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2 Three or more weeks have elapsed from the completion of previous treatment regimen and subjects must have recovered or be at a new stable baseline from any related toxicities. Prior radiotherapy to disease sites is allowed with certain protocol-defined restrictions. Exclusion Criteria: Prior treatment with regorafenib. Presence of active gastrointestinal disease or other condition that will interfere significantly with the absorption of drugs. Active peptic ulcer disease, inflammatory bowel disease (eg, ulcerative colitis, Crohn's disease), diverticulitis, or other gastrointestinal conditions with increased risk of perforation or gastrointestinal bleeding. Recent history (≤ 3 months) or ongoing partial or complete bowel obstruction unless due to disease under study and corrected with surgery. Blood pressure ≥ 140/90 mmHg. Active bleeding diathesis or history of any major bleeding (eg, requiring transfusion of red blood cells (RBCs), central nervous system (CNS) bleeding, or significant hemoptysis within 6 months of enrollment. Subjects with bleeding secondary to underlying disease (including gastrointestinal (GI) perforation or fistula) that has been corrected by surgery or alternative procedure may be included. Clinically significant cardiac disease including unstable angina, acute myocardial infarction within 6 months from Day 1 of study drug administration, New York Heart Association Class II, III, or IV congestive heart failure, and arrhythmia requiring therapy.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Albert Assad
Organizational Affiliation
Incyte Corporation
Official's Role
Study Director
Facility Information:
City
Chandler
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Arizona
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United States
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Gilbert
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Mesa
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Scottsdale
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Los Angeles
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Pasadena
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Santa Barbara
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Aurora
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Colorado Springs
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Denver
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Altamonte Springs
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Miami
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Ocala
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Orlando
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Tampa
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Niles
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Lafayette
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Ames
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New Orleans
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Lincoln
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Henderson
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Las Vegas
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Albany
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Binghamton
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Bronx
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Hudson
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Johnson City
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New York
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Canton
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Portland
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Charleston
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Easley
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Greenville
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Greer
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Sumter
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Chattanooga
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Nashville
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Arlington
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Houston
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Plano
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Tyler
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American Fork
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Bountiful
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Murray
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Provo
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Salt Lake City
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West Jordan
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Roanoke
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Virginia
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Vancouver
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Washington
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United States
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Bentleigh East
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Australia
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Herston
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Australia
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Kurralta Park
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Australia
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New Lambton Heights
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Australia
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Randwick
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Australia
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Avignon Cedex 09
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France
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Besançon
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France
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Le Mans
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France
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Lille
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France
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Marseille Cedex 05
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France
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Paris
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France
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Augsburg
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Germany
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Halle
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Germany
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Hamburg
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Germany
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Beer Sheva
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Israel
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Haifa
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Israel
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Petah Tikva
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Israel
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Ramat Gan
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Israel
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Tel Aviv
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Soeul
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Korea, Democratic People's Republic of
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Oviedo
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Asturias
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Spain
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Barcelona
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Spain
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Madrid
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Spain
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Sevilla
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Spain
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Valencia
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Spain
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Birmingham
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United Kingdom
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Bournemouth
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United Kingdom
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London
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United Kingdom
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Sutton
Country
United Kingdom

12. IPD Sharing Statement

Learn more about this trial

Study of Ruxolitinib in Colorectal Cancer Patients

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