Neoplasms

Blood and Lymph Conditions

All Conditions

Rare Diseases

Leukemia

Leukemia, Myeloid

Leukemia, Myeloid, Acute

Neoplasms by Histologic Type

Hematologic Diseases

Myeloid Leukemia

Acute Myeloid Leukemia

Acute Non Lymphoblastic Leukemia

Acute Graft Versus Host Disease

Anti-Infective Agents

Antineoplastic Agents

All Drugs and Chemicals

Cytarabine

Asparaginase

Eryaspase

patients will receive one injection of GRASPA (100 IU/kg) after each course of low-dose cytarabine (see Arm "Control")

patients will receive successive courses of low intensive chemotherapy, as subcutaneous low-dose cytarabine 20mg twice daily for 10 days per course (from day 1 to day 10), each course occurring every 28 days, for a duration up to 24 months

Patients receiving Intervention (experimental group) will be treated with one injection of graspa per cycle of treatment, each cycle during 28 days, for a duration up to 24 cycles maximum

GRASPA

X Thomas, Doctor

The protocol aims at adding GRASPA (L-asparaginase encapsulated in red blood cells, eryaspase) to standard chemotherapy (low-dose cytarabine) to treat patients older than 65 years diagnosed with AML and unfit for intensive chemotherapy.

L-asparaginase (ASNase) holds a key role in chemotherapy for Acute Lymphoblastic Leukemia (ALL) in children and young adults. In elderly patients, its efficacy is counterbalanced by its toxicity, which impairs its use. However, a study conducted with GRASPA (L-asparaginase encapsulated in red blood cells, eryaspase) in elderly ALL (study reference "GRASPALL-GRAAL SA2 2008") showed that efficacy/safety profile was positive, paving the way for introducing ASNase benefit into chemotherapy for elderly patients.

In adults, Capizzi (1988) reported a significant benefit of ASNase associated with high-dose cytarabine treatment (HiDAC) in Acute Myeloid Leukemia (AML). Indeed, there was an overall statistically superior complete remission rate for HiDAC/ASNase (40%) vs HiDAC (24%) and an overall survival benefit for patients treated with HiDAC/ASNase (19.6 weeks vs 15.9 weeks).

Another study in elderly patients also displayed positive results for ASNase treatment (Petti, 1989), as well as recent single case reports that point out the potential benefit of ASNase in different AML or mixed lineage leukemia (Horikoshi, 2009; Rubnitz, 2009).

Our preclinical results also showed that an AML cell line and blast cells from the bone marrow of AML patients were sensitive to ASNase in vitro.

However, up to now, the toxicity of ASNase for elderly had prevented its use in this population that represents the majority of AML patients.

Considering the promising results of ASNase for AML treatment and the better safety profile offered by GRASPA (L-aspariginase encapsulated in red blood cells, erysapase), a multicenter, randomized, controlled IIb trial is open for recruitment. Efficacy and tolerability of GRASPA plus low-dose cytarabine will be evaluated versus low-dose cytarabine alone in treatment of AML patients over 65 year-old, unfit for intensive chemotherapy.

One hundred and twenty-three patients (65-85 year-old) newly diagnosed for AML are planned for inclusion in the study.

A 2:1 randomization will be respected (82 patients treated with GRASPA® plus low-dose cytarabine and 41 patients treated with low-dose cytarabine alone). Each patient will be followed for 24 months.

GRASPA Treatment for Patients With Acute Myeloblastic Leukemia

A Multicenter, Open, Randomized, Controlled Phase IIb Trial Evaluating Efficacy and Tolerability of GRASPA (L-asparaginase Encapsulated in Red Blood Cells, Eryaspase) Plus Low-dose Cytarabine vs Low-dose Cytarabine Alone, in Treatment of Newly Diagnosed Acute Myeloid Leukemia (AML) Elderly Patients, Unfit for Intensive Chemotherapy

OS is defined as the time elapsed between randomization and death from any cause.

Percentage of patients with Complete remission (CR), Complete remission with incomplete recovery (neutrophil or platelet regeneration, CRi), Partial remission (PR)

Defined as the time elapsed between randomization and resistant disease or relapse or death from any cause

Collecting survey about patients quality of life

Number of incidences, type, severity and causality of adverse events / serious adverse events

Defined only for patients who achieve CR or CRi as the time elapsed between date of CR/CRi and date of disease relapse or death from any cause

Hospitalizations (except schedule protocol visit during the study)

Number of transfusions per patient (red blood cells and or platelets)

Plasma concentrations of asparagine, aspartate, glutamine, glutamate, whole blood L- asparaginase activity

Asparagine synthetase and in vitro sensitivity to aspariginase on the harvested bone marrow cells

ERYtech Pharma

Patients having received at least one injection of GRASPA (100 IU/kg) i.e. 81 in GRASPA arm

Patients having received at least one dose of study treatment i.e. 39 in control arm

Control

In the experimental group, the patients will receive one administration of GRASPA (100 IU/kg) at Day 11 in combination with subcutaneous low-dose cytarabine as 40 mg daily (either one single dose of 40 mg or 20 mg twice daily according to local practice) for 10 consecutive days, every 28 days, for duration up to 24 months

In the control arm, patients will be treated with subcutaneous low-dose cytarabine as 40 mg daily (either one single dose of 40 mg or 20 mg twice daily according to local practice) for 10 consecutive days, every 28 days, for duration up to 24 months. Each period of 28 days constitute a cycle of chemotherapy.

Total

Age, Categorical

Sex: Female, Male

Race and Ethnicity were not collected from any participant.

Race and Ethnicity Not Collected

Anne-Sophie Clermont

patients will receive one injection of GRASPA (100 IU/kg) after each course of low-dose cytarabine (see Arm "Control")

GRASPA: Patients receiving Intervention (experimental group) will be treated with one injection of graspa per cycle of treatment, each cycle during 28 days, for a duration up to 24 cycles maximum

OS was to be assessed by measuring time elapsed between randomisation and death for any cause. Any patient not known to have died at the time of analysis is censored based on the last recorded date on which the patient was known to be alive

Overall Survival

Response to Treatment

Progression Free Survival (PFS)

Patient Quality of Life

Safety of GRASPA Adverse Events and Serious Adverse Events

Relapse Free Survival

Number of Hospitalizations

Percentage of Patients Who Need Transfusions

Pharmacodynamic and Pharmacokinetic Parameters of GRASPA

Immunogenicity

Asparagine Synthetase (Optional)

Biomarker Cytogenetic Testing (Optional)

Overall Study

Immune System Diseases

Symptoms and General Pathology

Lymphoma

Precursor Cell Lymphoblastic Leukemia-Lymphoma

Leukemia, Lymphoid

Recurrence

Lymphoproliferative Disorders

Lymphatic Diseases

Immunoproliferative Disorders

Disease Attributes

Lymphosarcoma

Acute Lymphoblastic Leukemia

Lymphoblastic Lymphoma

10000UI/m2, 14 infusions during 4 chemotherapy cycle

native L asparaginase

Yves Bertrand, MD PhD

Primary objective :

* To explore the relation between 3 doses of GRASPA and duration of asparagine depletion (\< 2µmol/l)

Secondary objective :

* Pharmacokinetic / Pharmacodynamic parameters
* toxicity
* Study duration : 2 years
* Study treatment : Red blood cells loaded with L asparaginase versus native L asparaginase
* Associated treatments : COPRALL chemotherapy
* Randomization : centralised randomisation on scratching list

Administration of Allogenic Red Blood Cells Loaded L-asparaginase in Cases of Relapse of Acute Lymphoblastic Leukaemia

Administration of Allogenic of Red Blood Cells Loaded L Asparaginase in Acute Lymphoblastic Leukemia Relapse.

Centre Leon Berard

Hypersensitivity

Pegaspargase

GRASPA will replace remaining PEG-asparaginase doses in case of hypersensitivity.

Administration of 1-7 doses of 150 IU/kg IV infusion. (every 2 weeks for a maximum of 4 doses and every 6 weeks for maximum 3 doses).

Brigitte Klug Albertsen, MD, PhD

Pegylated-asparaginase (PEG-ASP) is an important part of the treatment of childhood acute lymphoblastic leukaemia (ALL). Unfortunately 13% of patients develops allergy and further treatment is impossible. Furthermore, 6% of patients have developed antibodies (silent inactivation) and have no effect of the PEG-ASP treatment. Truncated asparaginase therapy is associated with inferior event-free survival outcomes, in particular relapse in central nervous system (CNS).

Eryaspase is a new formulation of asparaginase encapsulated in erythrocytes. The erythrocyte membrane protects asparaginase against fast degradation and elimination processes. The encapsulation eliminates the direct somatic contact, and it is hypothesized that this provides the potential to prolong the activity of the enzyme and reduce toxicities.

Asparaginase Encapsulated in Erythrocytes for Patients With ALL and Hypersensitivity to PEG-asparaginase

Single-Arm PharmacoKinetic/PharmacoDynamic and Safety Study of Eryaspase (GRASPA®) for Patients With Hypersensitivity to PEG-Asparaginase, Diagnosed With Ph(-) Acute Lymphoblastic Leukemia

The primary endpoint was the percentage of patients with ASNase activity \>100 U/L at 14 days following the first infusion (nadir). ASNase activity \>100 U/L is considered adequate for complete asparagine depletion in the blood.

Percentage of patients with ASNase activity \>100 U/L at 14 days following the fourth infusion of the 2-week dosing intervals. ASNase activity \>100 U/L is considered adequate for complete asparagine depletion in the blood.

Birgitte Klug Albertsen

MD PhD

GRASPA will replace remaining PEG-asparaginase doses in case of hypersensitivity.

GRASPA: Administration of 1-7 doses of 150 U/kg IV infusion. (For patients coming from NOPHO 2008, eryaspase was administered every 2 weeks for a maximum of 4 doses and every 6 weeks for maximum 3 doses, for patients in the ALLTogether pilot protocol eryaspase was administered at a dose of 150 U/kg every 2 weeks for a maximum of 7 doses).

Intervention

Age, Continuous

Sweden

Norway

Finland

Denmark

Lithuania

Estonia

Region of Enrollment

Dr Birgitte Klug Albertsen

The primary Evaluable Patients (EP) Population was used for the analysis of the primary and key secondary endpoints, defined as all patients recruited into the study who provided data on ASNase level on Day 14 (±2 days) following the first administration of eryaspase.

All included patients (55) completed first infusion, only in 53 patients an ASNase activity measurement was available.

Pharmacokinetics ASNase Activity >100 U/L at 14 Days

A total of 12 patients completed 4 infusions with a 2-week interval of these 9 patients had an ASNase activity measurement 14 days following the fourth infusion.

Pharmacokinetic Parameters

GRASPA will replace remaining PEG-asparaginase doses in case of hypersensitivity.

GRASPA: Administration of 1-7 doses of 150 U/kg IV infusion. (For patients coming from NOPHO 2008 (NCT: NCT00819351), eryaspase was administered every 2 weeks for a maximum of 4 doses and every 6 weeks for maximum 3 doses, for patients in the ALLTogether pilot protocol (NCT: NCT03911128) eryaspase was administered at a dose of 150 U/kg every 2 weeks for a maximum of 7 doses).

Digestive System Diseases

Gland and Hormone Related Diseases

Carcinoma

Pancreatic Neoplasms

Gastrointestinal Neoplasms

Digestive System Neoplasms

Endocrine Gland Neoplasms

Gastrointestinal Diseases

Pancreatic Diseases

Endocrine System Diseases

Pancreatic Cancer

Each patient will receive one administration of GRASPA . A stepwise increase of 4 single doses of GRASPA will be administered to cohorts of 3 patients per dose

The interest in using L-asparaginase in pancreatic cancer arose from in vitro and in vivo studies data showing an anti-neoplastic effect on pancreatic tumor cell lines. Interestingly, these studies suggest an additional effect of L-asparaginase associated to gemcitabine.GRASPA is a suspension of red blood cells encapsulating L-asparaginase. The aim of this phase I clinical trial is to evaluate the Maximum Tolerated Dose (MTD) of GRASPA on locally advanced or metastatic pancreatic tumors, after therapy failure of first or second line chemotherapy using gemcitabine.

Administration of GRASPA (Suspension of Erythrocytes Encapsulating L-asparaginase)in Patients With Pancreatic Cancer

Phase I, Dose Escalation Clinical Trial of GRASPA (Red Blood Cells Encapsulating L-Asparaginase) in Patients With Pancreatic Carcinoma

Dose limiting toxicities were defined according to CTCAE v3.0 as follow:

Known toxicities related to asparaginase:

* Pancreatic grade 2, 3 or 4
* Allergic, Neurological, Hepatic, Coagulation grade 3 or 4 an any other toxicity of grade 4

Limiting toxicities were defined according to CTCAE v3.0 as follow:

Known toxicities related to asparaginase:

* Pancreatic grade 2, 3 or 4
* Allergic, Neurological, Hepatic, Coagulation grade 3 or 4 Any other toxicity of grade 4

Pharmacokinetic (PK) parameters were analyzed for encapsulated asparaginase concentration data using Phoenix® WinNonlin® 6.3.

Free and total L-asparaginase activity was measured during the study and encapsulated asparaginase was defined as the difference between total asparaginase and plasmatic asparaginase.

Duration of plasma asparagine depletion (less than or equal to 2 micromoles/Liter or deamination greater than 90% compared to baseline levels and serum concentrations of L-asparagine, L-aspartate, L-glutamine, and L-glutamate. For pharmacodynamic data, the administration date of the investigational treatment was considered as the reference date for duration calculation. All patients having received a single dose of studied drug GRASPA have been analyzed.

Titers of E. coli anti-asparaginase antibodies evaluated over time to assess immunogenicity

Assess tumor response, evaluated by carcinoembryonic antigen (CEA) tumor marker evolution

Tumor response Evaluation by cancer antigen (CA)19.9 evolution over time

Adverse events regardless of grade or causality are reported. Events are summarized by system organ class and footnote indicates the specific events reported for each class.

GRASPA: Each patient will receive one administration of GRASPA . A stepwise increase of 4 single doses of GRASPA will be administered to cohorts of 3 patients per dose

3 subjects enrolled; 0 subjects completed

GRASPA 25

GRASPA: Each patient will receive one administration of GRASPA . A stepwise increase of 4 single doses of GRASPA will be administered to cohorts of 3 patients per dose

3 subjects enrolled; 3 subjects completed

GRASPA 50

GRASPA: Each patient will receive one administration of GRASPA . A stepwise increase of 4 single doses of GRASPA will be administered to cohorts of 3 patients per dose

3 subjects enrolled; 1 subject completed

GRASPA 100

GRASPA 150

Participants received one administration of GRASPA . A stepwise increase of 4 single doses of GRASPA was administered to cohorts of 3 patients per dose

3 subjects enrolled; 0 subjects completed

Each patient will receive one administration of GRASPA . A stepwise increase of 4 single doses of GRASPA was administered to cohorts of 3 patients per dose

3 subjects enrolled; 3 subjects completed

Each patient will receive one administration of GRASPA . A stepwise increase of 4 single doses of GRASPA was administered to cohorts of 3 patients per dose

3 subjects enrolled; 1 subject completed

Each patient will receive one administration of GRASPA . A stepwise increase of 4 single doses of GRASPA was administered to cohorts of 3 patients per dose

3 subjects enrolled; 0 subjects completed

France

Director of Clinical Trials

Number of Patients With Dose-limiting Toxicities up to Week 4 After Treatment

AEs that met the following criteria were considered for the primary safety criterion:

1. Grade 2 to 4 of pancreatic toxicity - no symptomatic pancreatitis occurred for any patients
2. Grade 3 or 4 of hepatic toxicity - Two patients had antithrombin III decrease, but both cases were Grade 1; no cytolytic hepatitis
3. Other grade 4 toxicities

Number of Patients With Limiting Toxicities From Week 4 to Week 8 (End of Study)

Data were available for dose levels (no. of patients) of 25 IU/kg (n=1), 50 IU/kg (n=0), 100 IU/kg (n=0), and 150 IU/kg (n=3).

Encapsulated L-asparaginase Pharmacokinetic Parameters Terminal Half-life

Encapsulated L-asparaginase Pharmacokinetic Parameters Cmax

Encapsulated L-asparaginase Pharmacokinetic Parameters Area Under the Curve to Infinity

Day 0

Day 1

Day 3

Day 7

Day 14

Day 21

Day 28

Day 35

Day 42

Day 56

12 patients were included and analyzed corresponding to 1 cohort of 3 patients per dose. Data shown is a summary of the relative change of asparagine (%) from baseline over time (analysis set)

Change of Asparagine Levels From Baseline (Pharmacodynamics)

Summary of anti-L-asparaginase antibodies over time by number of patients

Number of Patient Positive for Anti-L-asparaginase Antibodies

GRASPA: Each patient will receive one administration of GRASPA . A stepwise increase of 4 single doses of GRASPA will be administered to cohorts of 3 patients per dose

Sample collection not completed at each timepoint for each patient. All data available presented below.

Summary of CEA Level Over Time

Summary of CA 19.9 Over Time

Philadelphia Chromosome

Each patient will receive GRASPA 50 IU/kg at day 3 of the induction 1 phase. If no toxicity related to investigational product is observed and if the patient's state of health allows it, a second injection, at the identical dose, will be administered at Day 6 of Induction 2 phase.

Each patient will receive GRASPA 100 IU/kg at day 3 of the induction 1 phase. If no toxicity related to investigational product is observed and if the patient's state of health allows it, a second injection, at the identical dose, will be administered at Day 6 of Induction 2 phase

Each patient will receive GRASPA 150 IU/kg at day 3 of the induction 1 phase. If no toxicity related to investigational product is observed and if the patient's state of health allows it, a second injection, at the identical dose, will be administered at Day 6 of Induction 2 phase

Each patient will receive GRASPA at day 3 of the induction 1 phase. If no toxicity related to investigational product is observed and if the patient's state of health allows it, a second injection, at the identical dose, will be administered at Day 6 of Induction 2 phase

Mathilde Hunault-Berger, Professor

The main purpose of this study is to determine the maximum tolerated and efficient dose of GRASPA® in combination with polychemotherapy treatment of elderly patients with ALL, 55 years and over, Philadelphia chromosome-negative (ALL Ph-).

This open label, non randomised, multicentric and national phase IIa study was designed to evaluate the safety and efficacy of GRASPA®, a suspension of red blood cells encapsulating E. Coli L-asparaginase, at different doses and in combination with the polychemotherapy regimen recommended by the European Working Group on Adult ALL (EWALL) for frontline therapy of patients with ALL Ph-, aged 55 years old and over. Patients with a good performance status (WHO score ≤2) and a newly diagnosed ALL Ph- were treated with the backbone polychemotherapy consisting of a first 4-week induction phase comprising dexamethasone, vincristine and idarubicin, a second 4-week induction phase including cyclophosphamide, cytarabine, a 6-month consolidation phase consisting of 6 alternating cycles with methotrexate, asparaginase and folinic acid (cycles 1, 3 and 5) and high-dose cytarabine (cycles 2, 4 and 6) with Granulocyte colony stimulating factor (G-CSF) support followed by a 16-month maintenance period with mercaptopurine, methotrexate and vincristine/dexamethasone pulses. GRASPA® was administered on day 3 of induction 1 and on day 6 of induction 2 of the chemotherapy regimen.

Administration of GRASPA (Suspension of Erythrocytes Encapsulating L-asparaginase) in Elderly Patients With First Line Acute Lymphoblastic Leukemia

An Escalating Dose Phase IIa Study of L-Asparaginase Encapsulated in Erythrocytes (GRASPA®) in Association With Polychemotherapy During Induction Phase for Treatment of Elderly Patients With Acute Lymphoblastic Leukaemia (ALL), Aged 55 Years and Over, With Philadelphia Chromosome-negative (ALL Ph-)

The main evaluation criterion is a composite efficacy/toxicity criterion. Efficacy, assessed during induction 1: percentage of patients responding to treatment, i.e. with plasma Asn concentration ≤2µM (depleted), for a duration of at least 7 days after the administration of GRASPA®

Safety: Toxicity, assessed during Induction 1 and Induction 2: according to NCI-CTCAE v3.0 August 2006, with Dose Limiting Toxicities (DLT) defined as: Grade 2 to 4 pancreatic toxicity, Grade 3 or 4 hepatic toxicity, allergic toxicity or deep cerebral thrombosis, known as potentially related to L-asparaginase; hematological toxicity defined as bone marrow blast free aplasia, 30 days following the last injection of chemotherapy, all other Grade 4 toxicities.

Mean plasma concentration of asparagine over time. Participants who were Below the Lower Limit of Quantification (BLLQ) were assigned a value of 0.51 μmol/L.

Mean plasma concentration of aspartic acid over time.

Mean glutamic acid concentration over time.

Mean cerebral spinal fluid asparagine concentration over time.

Mean cerebral spinal fluid aspartic acid concentration

Mean cerebral spinal fluid glutamine concentration

Mean cerebral spinal fluid glutamic acid concentration

Evaluation of the number of patients testing positive for anti-asparaginase antibodies.

CR was defined using:

* Clinical criteria: disappearance of clinical signs of acute lymphocytic leukemia (ALL)
* Blood criteria: neutrophils \> 1 G/L and platelets \>100 G/L
* Medullary criteria: normally rich bone marrow and percentage of blasts \<5%

Some Adverse Events were monitored/assessed without regard to the specific Adverse Event Term (i.e. "Gastrointestinal Disorder" and "General Disorder").

Each patient will receive GRASPA 50 IU/kg at day 3 of the induction 1 phase. If no toxicity related to investigational product is observed and if the patient's state of health allows it, a second injection, at the identical dose, will be administered at Day 6 of Induction 2 phase.

GRASPA: Each patient will receive GRASPA at day 3 of the induction 1 phase. If no toxicity related to investigational product is observed and if the patient's state of health allows it, a second injection, at the identical dose, will be administered at Day 6 of Induction 2 phase

GRASPA 50 IU/kg

Each patient will receive GRASPA 100 IU/kg at day 3 of the induction 1 phase. If no toxicity related to investigational product is observed and if the patient's state of health allows it, a second injection, at the identical dose, will be administered at Day 6 of Induction 2 phase

GRASPA: Each patient will receive GRASPA at day 3 of the induction 1 phase. If no toxicity related to investigational product is observed and if the patient's state of health allows it, a second injection, at the identical dose, will be administered at Day 6 of Induction 2 phase

GRASPA 100 IU/kg

Each patient will receive GRASPA 150 IU/kg at day 3 of the induction 1 phase. If no toxicity related to investigational product is observed and if the patient's state of health allows it, a second injection, at the identical dose, will be administered at Day 6 of Induction 2 phase

GRASPA: Each patient will receive GRASPA at day 3 of the induction 1 phase. If no toxicity related to investigational product is observed and if the patient's state of health allows it, a second injection, at the identical dose, will be administered at Day 6 of Induction 2 phase

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
GRASPA Treatment for Patients With Acute Myeloblastic Leukemia	NCT01810705	Acute Myeloid L...	GRASPA	65 Years - 85 Years	ERYtech Pharma
Administration of Allogenic Red Blood Cells Loaded L-asparaginase in Cases of Relapse of Acute Lymphoblastic Leukaemia	NCT00723346	Acute Lymphobla...	GRASPA GRASPA GRASPA native L aspara...	1 Year - 55 Years	ERYtech Pharma
Asparaginase Encapsulated in Erythrocytes for Patients With ALL and Hypersensitivity to PEG-asparaginase	NCT03267030	Acute Lymphobla...	GRASPA	1 Year - 45 Years	Aarhus University Hospital
Administration of GRASPA (Suspension of Erythrocytes Encapsulating L-asparaginase)in Patients With Pancreatic Cancer	NCT01523808	Pancreatic Canc...	GRASPA	18 Years - 70 Years	ERYtech Pharma
Administration of GRASPA (Suspension of Erythrocytes Encapsulating L-asparaginase) in Elderly Patients With First Line Acute Lymphoblastic Leukemia	NCT01523782	Acute Lymphobla...	GRASPA	55 Years -	ERYtech Pharma
Administration of Allogenic Red Blood Cells Loaded L-asparaginase in Cases of Relapse of Acute Lymphoblastic Leukaemia	NCT00723346	Acute Lymphobla...	GRASPA GRASPA GRASPA native L aspara...	1 Year - 55 Years	ERYtech Pharma
Administration of GRASPA (Suspension of Erythrocytes Encapsulating L-asparaginase)in Patients With Pancreatic Cancer	NCT01523808	Pancreatic Canc...	GRASPA	18 Years - 70 Years	ERYtech Pharma
Administration of Allogenic Red Blood Cells Loaded L-asparaginase in Cases of Relapse of Acute Lymphoblastic Leukaemia	NCT00723346	Acute Lymphobla...	GRASPA GRASPA GRASPA native L aspara...	1 Year - 55 Years	ERYtech Pharma

Spots Global Cancer Trial Database for graspa

Every month we try and update this database with for graspa 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 graspa

Every month we try and update this database with for graspa 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 graspa 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.