Neoplasms

Blood and Lymph Conditions

All Conditions

Immune System Diseases

Symptoms and General Pathology

Rare Diseases

Leukemia

Precursor Cell Lymphoblastic Leukemia-Lymphoma

Leukemia, Lymphoid

Philadelphia Chromosome

Neoplasms by Histologic Type

Hematologic Diseases

Acute Lymphoblastic Leukemia

Lymphoblastic Lymphoma

Acute Graft Versus Host Disease

Antineoplastic Agents

All Drugs and Chemicals

Amino Acids

Imatinib Mesylate

Flumatinib

Tyrosine Kinase Inhibitors

Protein Kinase Inhibitors

Enzyme Inhibitors

Tyrosine

600 mg QD oral administration, fasting (2 hours before administration and 1 hour after administration).

600 mg QD oral administration, with a meal

Flumatinib 600 mg qd will be given orally along with combination chemotherapy starting day 8 of induction chemotherapy. Flumatinib will be given continuously (if it's tolerable) for 2 years since achievement of complete remission (CR) as part of consolidation chemotherapy and maintenance therapy. Patients can receive allogeneic hematopoietic stem cell transplantation (HSCT),or patients in whom MCR was achieved within 3 months after treatment and continued until transplantation can receive autologous HSCT whenever possible during their first CR. Otherwise, they will finish the consolidation and maintenance chemotherapy.

Imatinib 600 mg qd will be given orally along with combination chemotherapy starting day 8 of induction chemotherapy. Imatinib will be given continuously (if it's tolerable) for 2 years since achievement of complete remission (CR) as part of consolidation chemotherapy and maintenance therapy. Patients can receive allogeneic hematopoietic stem cell transplantation (HSCT),or patients in whom MCR was achieved within 3 months after treatment and continued until transplantation can receive autologous HSCT whenever possible during their first CR. Otherwise, they will finish the consolidation and maintenance chemotherapy.

Imatinib

Jianxiang Wang, Dr.

Ying Wang, Dr.

Compared with patients with philadelphia chromosome-negative Acute Lymphoblastic Leukemia (Ph- ALL), patients with Ph-positive (Ph+) ALL exhibit a comparatively poor prognosis. Fortunately, significant improvements have been found in response rates, disease-free survival (DFS), and overall survival (OS) for patients with Ph+ ALL with the introduction of tyrosine kinase inhibitor (TKI) therapy to treatment regimens. Based on improvements in efficacy and tolerability, next-generation TKIs have been widely used in first-line treatment for chronic myeloid leukemia (CML). Flumatinib, a TKI with more potent binding affinity for BCR-ABL1 tyrosine kinase than imatinib, demonstrated higher rates of responses, faster and deeper responses in FESTnd trial, which suggested that flumatinib might show improved clinical efficacy for treating Ph+ ALL compared with imatinib. The investigators therefore hypothesized that the addition of flumatinib to combinatorial chemotherapy regimen would demonstrate greater efficacy compared with the prior use of imatinib in treating Ph+ ALL. This study explored the safety and efficacy of flumatinib versus imatinib when combined with multi-agent chemotherapy in patients with newly diagnosed Ph+ ALL.

Flumatinib Versus Imatinib Combined With Chemotherapy for de Novo Ph+ ALL

Flumatinib Versus Imatinib Combined With Multiagent Chemotherapy for Newly Diagnosed Philadelphia Chromosome-positive Acute Lymphoblastic Leukemia: A Prospective, Open-label，Randomized，Multi-center Clinical Trial

From the date of complete remission(CR) until the date of documented relapse or death due to any cause or the last follow-up day

The incidence and severity of neutropenia, anemia, rash, hypophosphatemia, edema, limb pain, and other adverse events.

Both CR and molecular CR are obtained at the end of induction

wang, jianxiang

Principal Investigator

Neoplasm, Residual

Lymphoma

Lymphoproliferative Disorders

Lymphatic Diseases

Immunoproliferative Disorders

Lymphosarcoma

Anti-Inflammatory Agents

Prednisone

Subjects aged 60 years or older are received flumatinib and dose-adjusted VDCP or prednisone regimen. Subjects younger than 60 years are received flumatinib and hyper-CVAD regimen

Flumatinib 600mg per day, taken on empty stomach

Zheng Ge, PhD. MD.

Zheng Ge, M.D, Ph.D

Philadelphia chromosome (BCR-ABL1, Ph) is the most common genetic abnormality in acute lymphoblastic leukemia (ALL) and an independent prognostic risk factor. With the increase of age, the incidence of patients over 60 years old can reach 50%, whose 5-year overall survival rate was less than 20%.

With the application of tyrosine kinase inhibitor (TKI), the prognosis of Ph positive ALL patients is greatly improved. At present, TKI combined with chemotherapy has become the first-line treatment recommended in the guideline of Ph positive ALL patients.

However, with the use of imatinib, more and more patients develop drug resistant to imatinib. In addition, the clinical data showed that the MRD negative rate in patients treated with imatinib combined with hyper CVAD was only 22% three months later, which was far lower than 31% of the second generation TKI and 52% of the third generation TKI.

Second generation TKI dasatinib and nilotinib can overcome most imatinib resistant kinase region mutations. However, patients with severe hemocytopenia, infection or other complications are often unable to tolerate the standard chemotherapy. In addition, due to the high cost, some patients can't afford the long-term use.

Flumatinib is the first approved second generation TKI in China and a derivative of imatinib. Compared with imatinib, it introduced trifluoromethyl, substituted pyridine ring for benzene ring, and kept the direction of amide bond, which made the inhibitory effect of flumatinib on common kinase mutations significantly better than that of imatinib. In addition, compared with the second-generation TKI recommended in the first line of current guidelines, the incidence of quality of life related adverse reactions of flumatinib is lower, and no specific adverse reactions of the second-generation TKI have been reported.

We plan to enroll 28 patients with Ph positive ALL. All patients are diagnosed by morphology, immunology, cytogenetics and molecular biology (MICM). According to subjects' age, we will divide them into two groups. Subjects aged 60 years or older are received flumatinib and dose-adjusted VDCP or prednisone regimen. Subjects younger than 60 years are received flumatinib and hyper-CVAD regimen. MRD are examined on the 8th, 15th and 29th day after chemotherapy. Then, MRD will be monitored in the third, 6th, 9th, 12th, 15th, 18th, 21th and 24th months after chemotherapy to evaluate the effect.

Flumatinib + hyper-CVAD (younger than 60):

Induction therapy: Flumatinib 600mg per day, on an empty stomach; For cycles 1, 3, 5, and 7: cyclophosphamide (CTX) 300 mg/m² is given intravenously over 3 h every 12 h for six doses on days 1-3; a continuous daily infusion of sodium mercaptoethanesulfonate (Mesna) at 600 mg/m² per day for 24h starting 1h before CTX and completed approximately 12h after the final CTX dose; doxorubicin 50 mg/m² is given intravenously over 24 h on day 4; vincristine (VCR) 1.4 mg/m² (Maximum daily dose 2 mg) is intravenously on days 4 and 11; dexamethasone (Dex) 40 mg is given intravenously or orally on days 1-4 and days 11-14. For cycles 2, 4, 6, and 8: methotrexate (MTX) is given intravenously at 200 mg/m² over 2 h, followed by 800 mg/m² over 22 h on day 1; cytarabine (Ara-C) 3 g/m² is given intravenously over 3 h every 12 h for four doses on days 2-3; citrovorum 50 mg is given intravenously, followed by 15 mg every 6 h for eight doses beginning 12 h after MTX completion. Prophylactic intrathecal therapy will be given after complete remission.

Maintenance therapy (given for 2 years): intravenous VCR 1.4 mg/m² on day 1 (Maximum daily dose 2 mg), every three months; oral dexamethasone 8mg/m² on days 1-7, every three months; oral 6-MP 60mg/m² on days 1-7, every month; oral MTX 20mg/m² on day 8, every month; and daily flumatinib at 600 mg. Months 6 and 13 of maintenance were intensification courses of hyper-CVAD and flumatinib.

Flumatinib + dose-adjusted VDCP (fit group, 60 years or older):

Induction therapy: flumatinib 600mg per day, on an empty stomach; vincristine (VCR) 1.4mg/m2/d (maximum daily dose 2mg) is given intravenously on day 1, 8, 15, 22; daunorubicin (DNR) 30mg/m2/d is given intravenously on day 1, 8, 15, 22 (if blasts of day 15 lower than 20%, DNR is not needed on day 15 and 22); cyclophosphamide (CTX) 400mg/m2/d is given intravenously on day 1,8,15 and 22; Prednisone 60mg/m2/d is given orally every other day for day 1-22. Prophylactic intrathecal therapy will be given after complete remission.

Consolidation therapy: flumatinib 600mg per day; daunorubicin (DNR) 40mg/m2 is given intravenously on day 1; cytarabine (Ara-C) 60mg/m2 is given intravenously on day 1-5; L-Asparaginasum (L-Asp) 500U/kg is given intravenously on day 6-10. If complete remission (CR) on day 28, a consolidation chemotherapy will be given on day 35; if not, we will give it as salvage therapy; And if CR is achieved after salvage therapy, another consolidation chemotherapy will be given.

Maintenance therapy (given for 2 years): intravenous VCR 1.4 mg/m² on day 1 (Maximum daily dose 2 mg), every three months; oral dexamethasone 8mg/m² on days 1-7, every three months; oral 6-MP 60mg/m² on days 1-7, every month; oral MTX 20mg/m² on day 8, every month; and daily flumatinib at 600 mg.

Flumatinib + Prednisone (unfit group, 60 years or older):

Prephase: Prednisone 60 mg/m2/d po, Day -7 to day -1. Induction therapy: flumatinib 600mg per day, on an empty stomach; Prednisone 60 mg/m2 per day day 1-24 and then tapered and stopped at day 32.

Maintenance therapy (given for 2 years): flumatinib 600mg per day.

Study of Efficacy and Safety of Flumatinib Combined With Chemotherapy in Ph Positive ALL

A Study of Efficacy and Safety of Flumatinib Combined With Chemotherapy in the Treatment of Ph Positive Acute Lymphoblastic Leukemia Based on Minimal Residual Disease Monitoring

MRD is measured by flow cytometry and qPCR

Number of participants with bone marrow suppression, nausea and vomiting, diarrhea, infection, and non-hematologic toxicity such as heart, liver, kidney and nervous system damage

Zhongda Hospital

Leukemia, Myeloid

Leukemia, Myelogenous, Chronic, BCR-ABL Positive

Myeloproliferative Disorders

Bone Marrow Diseases

Chronic Disease

Disease Attributes

Myeloid Leukemia

Chronic Graft Versus Host Disease

Chronic Myeloid Leukemia

Chronic Myeloproliferative Disorders

600 mg of Flumatinib orally daily for 24 months

Xin Du, Phd

The purpose of this study is to explore the efficacy and safety of flumatinib in chronic phase of chronic myeloid leukemia (CML-CP) patients With Ph+ post imatinib failure.

A multicenter, single-arm, prospective, open-label study to detect the efficacy and safety of flumatinib by measuring rates of major molecular response (MMR) at 12 months in CML-CP patients with Ph+ in China. Approximately 200 Patients will be recruited consecutively from the study sites during the enrollment period and will be given flumatinib 600 mg QD. The duration of patient participation will be 24 months.

Flumatinib in CML-CP Patients With Ph+ Post Imatinib Failure

Efficacy and the Safety of Flumatinib in Treatment of CML-CP Patients With Ph+ Post Imatinib Failure

Major molecular response (MMR) is defined as BCR-ABL1 ≤ 0.1 percent.

Molecular response (MR) 4.0 is defined as BCR-ABL transcripts ≤ 0.01 percent.

Molecular response (MR) 4.5 is defined as BCR-ABL transcripts ≤ 0.0032 percent.

Evaluation of adverse events (AEs), serious AEs (SAEs), and clinically relevant changes in laboratory tests according to laboratory reference ranges.

Hainan General Hospital

Sanya Central Hospital

First Affiliated Hospital of Shantou University Medical Collegeity

Peking University Shenzhen Hospital

Dongguan People's Hospital

Shenzhen Second People's Hospital

Leukemia, Myeloid, Chronic-Phase

Flumatinib 400mg +Placebo for flumatinib are administered orally daily. Patients are randomized to flumatinib 400mg QD.

Flumatinib mesylate tablets (400mg)

Flumatinib 600mg is administered orally daily. Patients are randomized to flumatinib 600mg QD.

Flumatinib mesylate tablets (600mg)

Jun Ma

It's a double-blind , randomized ,multi-center study. The purpose of this study is to explore the efficacy and safety of flumatinib 400mg once daily (QD) versus 600mg QD as the first line therapy in patients with chronic myleiod leukemia(CML) in chronic phase(CP).

This is a dose-optimization study of flumatinib in adult patient with newly diagnosed CML-CP. The objective of this study is to compare the efficacy and safety of flumatinib 400mg QD with that of 600mg QD. Eligible patients are randomized in a 1:1 ratio to receive either fluamtinib 400mg QD or flumatinib 600mg QD. Randomization is stratified based on Sokal risk score (\<0.8,0.8\~1.2,\>1.2). Patients will discontinue study therapy due to treatment failure, disease progression or intolerance to study medication or due to investigator's or participant's decision. The primary efficacy endpoint is the rate of early molecular response , as measured by RQ-PCR at 3 months. Hematologic response, molecular response and cytogenetic response will be assessed at baseline and a certain frequency after treatment, until study completion.

A Study of the Efficacy and Safety of Flumatinib in Patients With Newly Diagnosed Chronic Myeloid Leukemia in Chronic Phase.

A Double-blind , Randomized, Multicenter, Phase 4 Study to Evaluate Efficacy and Safety of Oral Flumatinib 400mg Versus 600mg in Patients With Newly Diagnosed Chronic Myeloid Leukemia in Chronic Phase.

Molecular response is assessed using BCR-ABL transcript levels and measured by realtime quantitative polymerase chain reaction(RQ-PCR). Early molecular response is defined as a ratio BCR-ABL/ABL ≤10% on the international scale (IS).

Major molecular response is defined as a ratio BCR-ABL/ABL ≤0.1% on the international scale as measured by RQ-PCR.

MR4.0 is defined as BCR-ABL/ABL ≤0.01% on the international scale.

MR4.5 is defined as BCR-ABL/ABL ≤0.0032% on the international scale.

Cytogenetic response (CyR) is based on the prevalence of Ph+ cells in metaphase from bone marrow (BM) sample . CCyR is defined as 0% Ph+ metaphases in the bone marrow.

Hematologic response will be assessed by complete blood count (CBC) and physical examination at each visit. CHR is defined as all of the following present:

1. white blood cell(WBC) count \<10×109/L
2. Platelet count \<450 ×109/L
3. Peripheral blood basophils \<5%
4. No blasts and no promyelocytes in peripheral blood
5. \< 5% myelocytes plus metamyelocytes in peripheral blood
6. No evidence of extramedullary disease, including no splenomegaly or hepatomegaly

Evaluate the time from the date of randomization to the date of first documented MMR during treatment.

Evaluate the time from the date of randomization to the date of first documented CCyR during treatment.

Duration of MMR is defined as the time from the date of first documented MMR to the earliest date of loss of MMR.

Duration of CCyR is defined as the time from the date of first documented CCyR to the earliest date of loss of CCyR.

EFS is defined as the time from the date of randomization to the earliest occurrence of the following events: death due to any cause ; loss of CHR ,loss of PCyR ;loss of CCyR ; discontinuation of study treatment due to AE or treatment failure ; progression to AP/BC

PFS is defined as the time from the date of randomization to the earliest occurrence of progression to AP/BC or death from any cause.

OS is defined as the time from the date of randomization to the date of death from any cause.

Assessed by number and severity of adverse events as recorded on the case report form NCI CTCAE v5.0.

Serum concentrations of HS-10096 will be collected and analyzed to evaluate the PK of HS-10096.Tmax is the time to reach maximum (peak) plasma drug concentration after dose administration (hr).

Jiangsu Hansoh Pharmaceutical Co., Ltd.

Dasatinib

Flumatinib 600mg QD orally form 1 to 12 months

Dasatinib 100mg QD orally form 1 to 12 months

Xin Du

Xin Du, MD

The purpose of this study is to explore the efficacy and safety of switching to flumatinib versus dasatinib after imatinib-related low-grade adverse events in patients with chronic myeloid leukemia in chronic phase (CML-CP) in China. This is a post-marketing, interventional, double-arm, prospective, open-label, randomized controlled study in CML-CP patients in China. Patients will be recruited consecutively from the study sites during the enrollment period. The enrolled patients will be given flumatinib or dasatinib under the conditions of informed consent and frequent monitoring according to the clinical guideline.

The Efficacy and Safety of Switching to Flumatinib Versus Dasatinib After Imatinib-related Low-grade Adverse Events in CML-CP Patients

The Efficacy and Safety of Switching to Flumatinib Versus Dasatinib After Imatinib-related Low-grade Adverse Events in Patients With Chronic Myeloid Leukemia in Chronic Phase: an Randomized Controlled Trial.

Imatinib 400mg orally daily (Reference drug instructions)

Flumatinib is an orally available TKI with high selectivity and potency against BCR-ABL1 kinase. It's a multi-center, open-label, real world study to explore the efficacy and safety of Flumatinib versus Imatinib as the first line therapy in patients with chronic myleiod leukemia(CML) in chronic phase(CP).

The purpose of this study is to investigate the long-term efficacy and safety of Flumatinib versus Imatinib in newly diagnosed CML-CP patients to the provide the real world evidence for the clinical treatment of CML-CP in China.

The overall design is a multicenter, prospective, observational study. The study plans to enroll 2,400 newly diagnosed CML-CP subjects.The primary efficacy endpoint is the rate of major molecular response (MMR) , as measured by RQ-PCR at 12 months. Hematologic response, molecular response and cytogenetic response will be assessed at baseline and a certain frequency after treatment, until study completion. (A month is defined as 28 days)

A Real World Study of the Efficacy and Safety of Flumatinib Versus Imatinib in Patients With Newly Diagnosed Chronic Myeloid Leukemia in Chronic Phase

Evaluating the Efficacy and Safety of Flumatinib Versus Imatinib for in Patients With Newly Diagnosed Chronic Myeloid Leukemia (CML)-in Chronic Phase (CP): A Multicenter, Open-label, Real World Study

MMR is defined as a ratio BCR-ABL/ABL ≤0.1% on the international scale as measured by RQ-PCR

* High-risk population：Sokal score\>1.2
* MMR is defined as a ratio BCR-ABL/ABL ≤0.1% on the international scale as measured by RQ-PCR.

MMR is defined as a ratio BCR-ABL/ABL ≤0.1% on the international scale as measured by RQ-PCR.

Cytogenetic response (CyR) is based on the prevalence of Ph+ cells in metaphase from bone marrow (BM) sample. CCyR is defined as 0% Ph+ metaphases in the bone marrow.

TFS was defined as the time between the first dose and the date of transition to AP/BP or the last efficacy assessment during treatment.

PFS is defined as the time from the first dose to the date of earliest transition to AP/BC, or the date of death from any cause.

OS was defined as the time between the first dose and the date of death from any cause.

Assessed by number and severity of adverse events as recorded on the case report form, vital signs, laboratory variables, physical examination, electrocardiogram, and NCI CTCAE v5.0.

Nilotinib

flumatinib 600mg QD, fasting administration

nilotinib 400mg BID, fasting administration

Flumatinib mesylate tablets 600mg qd for 24 months

Nilotinib Capsules 400mg bid for 24 months

Weiming Li

Ming Wei Li

Imatinib has revolutionized the treatment of chronic myeloid leukemia (CML) and is the current standard of care in the treatment of patients with newly diagnosed CML. However, about 30% of patients still show drug resistance or disease progression. Currently, the most widely studied mechanism of TKI resistance in CML patients is mutations in the ABL kinase region. So far, more than 100 kinase domain mutations have been found in disease progression and imatinib resistance. It is estimated that more than 25% of CML patients will change TKI at least once in their lifetime due to drug resistance or intolerance. The 2020 edition of the "Guidelines for the Diagnosis and Treatment of Chronic Myelogenous Leukemia in China" proposes that patients with F317L/V/I/C, V299L and T315A mutations are more likely to obtain clinical efficacy by switching to the second-generation TKI nilotinib; patients with Y253H, E255K/V and F359C/V/I mutations are more likely to obtain clinical efficacy by switching to the second-generation TKI dasatinib; patients with T315I mutations are resistant to both nilotinib and dasatinib. Flumatinib has been shown to be a more potent inhibitor of BCR-ABL1 tyrosine kinase than imatinib. In vitro studies, it has shown that flumatinib inhibits wild-type and common BCR-ABL mutations(Q252H, V299L, F317L/I, M351T, H396P, etc.) more potently, and the anti-mutation spectrum of flumatinib is similar to nilotinib. Therefore, this study is designed to provide clearer guidance for patients with suboptimal response or failure in the treatment of TKI as well as those who have specific ABL kinase domain mutations during CML treatment.

Evaluating Efficacy and Safety of Flumatinib for Chronic Phase Chronic Myeloid Leukemia(CML-CP) Without Optimal Response (Warning,Failure) to Imatinib or Dasatinib

Evaluating Efficacy and Safety of Flumatinib for Chronic Phase Chronic Myeloid Leukemia(CML-CP) Without Optimal Response (Warning or Failure) to Imatinib or Dasatinib: A Prospective, Multicenter, Pragmatic Clinical Trial

Major molecular response is defined as ≤ 0.1% BCR-ABL/ABL% by international scale

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Flumatinib Versus Imatinib Combined With Chemotherapy for de Novo Ph+ ALL	NCT05071482	Acute Leukemia	Flumatinib Imatinib	18 Years - 65 Years	Institute of Hematology & Blood Diseases Hospital, China
Study of Efficacy and Safety of Flumatinib Combined With Chemotherapy in Ph Positive ALL	NCT04375683	Acute Lymphocyt... BCR-ABL1 Fusion...	Flumatinib	18 Years - 80 Years	Zhongda Hospital
Flumatinib in CML-CP Patients With Ph+ Post Imatinib Failure	NCT04677439	Flumatinib Chronic Myeloid... Imatinib	Flumatinib	18 Years -	Shenzhen Second People's Hospital
Flumatinib in CML-CP Patients With Ph+ Post Imatinib Failure	NCT04677439	Flumatinib Chronic Myeloid... Imatinib	Flumatinib	18 Years -	Shenzhen Second People's Hospital
A Study of the Efficacy and Safety of Flumatinib in Patients With Newly Diagnosed Chronic Myeloid Leukemia in Chronic Phase.	NCT05353205	CML, Chronic Ph...	Flumatinib mesy... Flumatinib mesy...	18 Years - 74 Years	Jiangsu Hansoh Pharmaceutical Co., Ltd.
The Efficacy and Safety of Switching to Flumatinib Versus Dasatinib After Imatinib-related Low-grade Adverse Events in CML-CP Patients	NCT04933526	Chronic Myeloid...	Flumatinib Dasatinib	18 Years -	Shenzhen Second People's Hospital
Study of Efficacy and Safety of Flumatinib Combined With Chemotherapy in Ph Positive ALL	NCT04375683	Acute Lymphocyt... BCR-ABL1 Fusion...	Flumatinib	18 Years - 80 Years	Zhongda Hospital
A Real World Study of the Efficacy and Safety of Flumatinib Versus Imatinib in Patients With Newly Diagnosed Chronic Myeloid Leukemia in Chronic Phase	NCT05367765	CML, Chronic Ph...	Flumatinib Imatinib	18 Years -	Jiangsu Hansoh Pharmaceutical Co., Ltd.
Flumatinib in CML-CP Patients With Ph+ Post Imatinib Failure	NCT04677439	Flumatinib Chronic Myeloid... Imatinib	Flumatinib	18 Years -	Shenzhen Second People's Hospital
Evaluating Efficacy and Safety of Flumatinib for Chronic Phase Chronic Myeloid Leukemia(CML-CP) Without Optimal Response (Warning,Failure) to Imatinib or Dasatinib	NCT04681820	CML-CP; Mutatio...	Flumatinib Nilotinib	18 Years -	Wuhan Union Hospital, China

Spots Global Cancer Trial Database for flumatinib

Every month we try and update this database with for flumatinib cancer trials from around the world to help patients and their families find trials that might be right for them.
We offer this 100% free of charge and do not endorse any of the trials listed here, we hope it helps you or a loved one.

Spots Global Cancer Trial Database for flumatinib

Every month we try and update this database with for flumatinib cancer trials from around the world to help patients and their families find trials that might be right for them. We offer this 100% free of charge and do not endorse any of the trials listed here, we hope it helps you or a loved one.

Every month we try and update this database with for flumatinib cancer trials from around the world to help patients and their families find trials that might be right for them.
We offer this 100% free of charge and do not endorse any of the trials listed here, we hope it helps you or a loved one.