MedPath

Study of Novel Treatment Combinations in Patients With Lung Cancer

Phase 2
Recruiting
Conditions
Lung Cancer
Resectable Non-Small-Cell Lung Cancer
Advanced or Metastatic Non-Small-Cell Lung Cancer
Interventions
Registration Number
NCT05633667
Lead Sponsor
Gilead Sciences
Brief Summary

The goal of this platform clinical trial is to test how well novel treatment combinations work in participants with lung cancer. Substudy-01 will compare the different novel combinations versus standard of care in participants with metastatic (cancer that has spread) non-small-cell lung cancer (NSCLC) who have not been treated before. Substudy-02 will compare the different novel combination versus standard of care in participants with cancer that has progressed after receiving previous treatment for metastatic NSCLC. Substudy-03 will compare the different novel combinations versus standard of care in participants with resectable stage II-III NSCLC.

The primary objectives of this study are:

Substudy-01 and Substudy-02: To evaluate the objective response rate (ORR) assessed per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1).

Substudy-03: To evaluate the efficacy of treatment combinations based on complete pathological response (pCR) rate.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
593
Inclusion Criteria

All Substudies:

  • Histologically or cytologically documented non-small-cell lung cancer (NSCLC).
  • No known actionable genomic alterations for which targeted therapies are available.
  • Eastern cooperative oncology group (ECOG) performance status score of 0 or 1.
  • Measurable disease per response evaluation criteria in solid tumors.
  • Adequate hematologic and end-organ function.
  • Individuals of childbearing potential who engage in heterosexual intercourse must agree to use specified method(s) of contraception.

Substudy 01: All Experimental arms

  • Stage IV NSCLC.
  • For individuals with nonsquamous histology: Epidermal growth factor receptor (EGFR) or anaplastic lymphoma kinase (ALK) alteration negative.
  • PD-L1 status by central confirmation.
  • No prior systemic treatment for metastatic NSCLC.

Substudy 02: All Experimental arms

  • Stage IV NSCLC.
  • In individuals with nonsquamous histology and actionable EGFR, ALK, or other known genomic alterations must have received treatment with at least 1 targeted therapy to the appropriate genomic alteration.

Substudy 03: All Experimental arms

  • Previously untreated individuals with resectable (Stage II, IIIA, IIIB (T[3-4]N2) NSCLC (per American Joint Committee on Cancer (AJCC) Edition 8).
  • Planned surgery must comprise of lobectomy, sleeve lobectomy, or bi-lobectomy.
  • PD-L1 status by central confirmation.
  • For individuals with nonsquamous histology: Epidermal growth factor receptor (EGFR) or anaplastic lymphoma kinase (ALK) alteration negative.

Key

Exclusion Criteria

All Substudies:

  • Mixed small-cell lung cancer and NSCLC histology.
  • Active second malignancy.
  • Active autoimmune disease.
  • History of or current non-infectious pneumonitis/interstitial lung disease.
  • Active serious infection within 4 weeks prior to study treatment.

Substudy 01 and 02

  • Known active central nervous system (CNS) metastases and/or carcinomatous meningitis.
  • Received previous anticancer therapy within 4 weeks prior to enrollment.

Substudy 03: All Experimental arms

  • NSCLC previously treated with systemic therapy or radiotherapy.
  • Received prior treatment with any anti-PD-(L)-1 or other immune checkpoint inhibitors (CPIs).

Note: Other protocol defined inclusion/exclusion criteria may apply

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Substudy 01: Zimberelimab (ZIM) + Sacituzumab govitecan-hziy (SG) + Domvanalimab (DOM)Zimberelimab (ZIM)Participants will receive ZIM, SG and DOM until disease progression (PD), unacceptable toxicity, or protocol specified discontinuation criteria are met.
Substudy 03 - ZIM + DOM + Platinum-based ChemotherapyZimberelimab (ZIM)Participants will receive ZIM plus DOM and any one of the chemotherapy (choice of chemotherapy is dependent on histology). Platinum Based Chemotherapy will be carboplatin and pemetrexed (non-squamous histology) or carboplatin and paclitaxel (squamous histology).
Substudy 03 - ZIM + Platinum-based ChemotherapyZimberelimab (ZIM)Participants will receive ZIM plus any one of the chemotherapy (choice of chemotherapy is dependent on histology). Platinum Based Chemotherapy will be carboplatin and pemetrexed (non-squamous histology) or carboplatin and paclitaxel (squamous histology).
Substudy 01: Zimberelimab (ZIM) + Sacituzumab govitecan-hziy (SG) + Domvanalimab (DOM)Domvanalimab (DOM)Participants will receive ZIM, SG and DOM until disease progression (PD), unacceptable toxicity, or protocol specified discontinuation criteria are met.
Substudy 01: ZIM + Platinum Based ChemotherapyZimberelimab (ZIM)Expansion Stage Only: Participants will receive ZIM plus any one of the chemotherapy (choice of chemotherapy is dependent on histology). Platinum Based Chemotherapy will be cisplatin or carboplatin and pemetrexed (non-squamous histology) or carboplatin, paclitaxel and nabpaclitaxel (squamous histology).
Substudy 01: ZIM + Platinum Based ChemotherapyPemetrexedExpansion Stage Only: Participants will receive ZIM plus any one of the chemotherapy (choice of chemotherapy is dependent on histology). Platinum Based Chemotherapy will be cisplatin or carboplatin and pemetrexed (non-squamous histology) or carboplatin, paclitaxel and nabpaclitaxel (squamous histology).
Substudy 03 - ZIM + Platinum-based ChemotherapyCarboplatinParticipants will receive ZIM plus any one of the chemotherapy (choice of chemotherapy is dependent on histology). Platinum Based Chemotherapy will be carboplatin and pemetrexed (non-squamous histology) or carboplatin and paclitaxel (squamous histology).
Substudy 01: ZIM + DOM + Etrumadenant (ETRUMA)Zimberelimab (ZIM)Participants will receive ZIM, DOM and ETRUMA until PD, unacceptable toxicity, or protocol specified discontinuation criteria are met.
Substudy 01: ZIM + Platinum Based ChemotherapyNab-paclitaxelExpansion Stage Only: Participants will receive ZIM plus any one of the chemotherapy (choice of chemotherapy is dependent on histology). Platinum Based Chemotherapy will be cisplatin or carboplatin and pemetrexed (non-squamous histology) or carboplatin, paclitaxel and nabpaclitaxel (squamous histology).
Substudy 02: SG + ZIM + ETRUMASacituzumab govitecan-hziy (SG)Participants will receive SG, ZIM and ETRUMA until PD, unacceptable toxicity, or protocol specified discontinuation criteria are met.
Substudy 02: SG + ZIM + ETRUMAEtrumadenant (ETRUMA)Participants will receive SG, ZIM and ETRUMA until PD, unacceptable toxicity, or protocol specified discontinuation criteria are met.
Substudy 03 - ZIM + DOM + Platinum-based ChemotherapyDomvanalimab (DOM)Participants will receive ZIM plus DOM and any one of the chemotherapy (choice of chemotherapy is dependent on histology). Platinum Based Chemotherapy will be carboplatin and pemetrexed (non-squamous histology) or carboplatin and paclitaxel (squamous histology).
Substudy 01: Zimberelimab (ZIM) + Sacituzumab govitecan-hziy (SG) + Domvanalimab (DOM)Sacituzumab govitecan-hziy (SG)Participants will receive ZIM, SG and DOM until disease progression (PD), unacceptable toxicity, or protocol specified discontinuation criteria are met.
Substudy 01: ZIM + DOM + Etrumadenant (ETRUMA)Domvanalimab (DOM)Participants will receive ZIM, DOM and ETRUMA until PD, unacceptable toxicity, or protocol specified discontinuation criteria are met.
Substudy 01: ZIM + DOM + Etrumadenant (ETRUMA)Etrumadenant (ETRUMA)Participants will receive ZIM, DOM and ETRUMA until PD, unacceptable toxicity, or protocol specified discontinuation criteria are met.
Substudy 03 - ZIM + DOM + Platinum-based ChemotherapyPemetrexedParticipants will receive ZIM plus DOM and any one of the chemotherapy (choice of chemotherapy is dependent on histology). Platinum Based Chemotherapy will be carboplatin and pemetrexed (non-squamous histology) or carboplatin and paclitaxel (squamous histology).
Substudy 01: ZIM + ETRUMAZimberelimab (ZIM)Participants will receive ZIM and ETRUMA until PD, unacceptable toxicity, or protocol specified discontinuation criteria are met.
Substudy 01: ZIM + ETRUMAEtrumadenant (ETRUMA)Participants will receive ZIM and ETRUMA until PD, unacceptable toxicity, or protocol specified discontinuation criteria are met.
Substudy 01: Zimberelimab (ZIM) + Sacituzumab govitecan-hziy (SG)Zimberelimab (ZIM)Participants will receive ZIM and SG until disease progression (PD), unacceptable toxicity, or protocol specified discontinuation criteria are met.
Substudy 01: ZIM + Platinum Based ChemotherapyCarboplatinExpansion Stage Only: Participants will receive ZIM plus any one of the chemotherapy (choice of chemotherapy is dependent on histology). Platinum Based Chemotherapy will be cisplatin or carboplatin and pemetrexed (non-squamous histology) or carboplatin, paclitaxel and nabpaclitaxel (squamous histology).
Substudy 01: Zimberelimab (ZIM) + Sacituzumab govitecan-hziy (SG)Sacituzumab govitecan-hziy (SG)Participants will receive ZIM and SG until disease progression (PD), unacceptable toxicity, or protocol specified discontinuation criteria are met.
Substudy 02: SG + ZIM + ETRUMAZimberelimab (ZIM)Participants will receive SG, ZIM and ETRUMA until PD, unacceptable toxicity, or protocol specified discontinuation criteria are met.
Substudy 03 - ZIM + DOM + Platinum-based ChemotherapyPaclitaxelParticipants will receive ZIM plus DOM and any one of the chemotherapy (choice of chemotherapy is dependent on histology). Platinum Based Chemotherapy will be carboplatin and pemetrexed (non-squamous histology) or carboplatin and paclitaxel (squamous histology).
Substudy 02: Either Docetaxel or SG (Monotherapy Only)Sacituzumab govitecan-hziy (SG)Participants will receive either Docetaxel or SG until PD, unacceptable toxicity, or protocol specified discontinuation criteria are met.
Substudy 03 - ZIM + DOM + Platinum-based ChemotherapyCarboplatinParticipants will receive ZIM plus DOM and any one of the chemotherapy (choice of chemotherapy is dependent on histology). Platinum Based Chemotherapy will be carboplatin and pemetrexed (non-squamous histology) or carboplatin and paclitaxel (squamous histology).
Substudy 03: Nivolumab + Platinum-based ChemotherapyCarboplatinParticipants will receive nivolumab plus any one of the chemotherapy (choice of chemotherapy is dependent on histology). Platinum Based Chemotherapy will be carboplatin and pemetrexed (non-squamous histology) or carboplatin and paclitaxel (squamous histology).
Substudy 01: ZIM + Platinum Based ChemotherapyCisplatinExpansion Stage Only: Participants will receive ZIM plus any one of the chemotherapy (choice of chemotherapy is dependent on histology). Platinum Based Chemotherapy will be cisplatin or carboplatin and pemetrexed (non-squamous histology) or carboplatin, paclitaxel and nabpaclitaxel (squamous histology).
Substudy 01: ZIM + Platinum Based ChemotherapyPaclitaxelExpansion Stage Only: Participants will receive ZIM plus any one of the chemotherapy (choice of chemotherapy is dependent on histology). Platinum Based Chemotherapy will be cisplatin or carboplatin and pemetrexed (non-squamous histology) or carboplatin, paclitaxel and nabpaclitaxel (squamous histology).
Substudy 02: Either Docetaxel or SG (Monotherapy Only)DocetaxelParticipants will receive either Docetaxel or SG until PD, unacceptable toxicity, or protocol specified discontinuation criteria are met.
Substudy 03 - ZIM + Platinum-based ChemotherapyPemetrexedParticipants will receive ZIM plus any one of the chemotherapy (choice of chemotherapy is dependent on histology). Platinum Based Chemotherapy will be carboplatin and pemetrexed (non-squamous histology) or carboplatin and paclitaxel (squamous histology).
Substudy 03 - ZIM + Platinum-based ChemotherapyPaclitaxelParticipants will receive ZIM plus any one of the chemotherapy (choice of chemotherapy is dependent on histology). Platinum Based Chemotherapy will be carboplatin and pemetrexed (non-squamous histology) or carboplatin and paclitaxel (squamous histology).
Substudy 03: Nivolumab + Platinum-based ChemotherapyPemetrexedParticipants will receive nivolumab plus any one of the chemotherapy (choice of chemotherapy is dependent on histology). Platinum Based Chemotherapy will be carboplatin and pemetrexed (non-squamous histology) or carboplatin and paclitaxel (squamous histology).
Substudy 03: Nivolumab + Platinum-based ChemotherapyPaclitaxelParticipants will receive nivolumab plus any one of the chemotherapy (choice of chemotherapy is dependent on histology). Platinum Based Chemotherapy will be carboplatin and pemetrexed (non-squamous histology) or carboplatin and paclitaxel (squamous histology).
Substudy 03: Nivolumab + Platinum-based ChemotherapyNivolumabParticipants will receive nivolumab plus any one of the chemotherapy (choice of chemotherapy is dependent on histology). Platinum Based Chemotherapy will be carboplatin and pemetrexed (non-squamous histology) or carboplatin and paclitaxel (squamous histology).
Primary Outcome Measures
NameTimeMethod
Substudies 01 and 02: Objective Response Rate (ORR) as Assessed by the Investigator According to Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1Up to 5 years

ORR is defined as the proportion of participants achieving a complete response (CR) or partial response (PR) as confirmed at least 4 weeks after the first detection of response.

Substudy 03: Complete Pathological Response (pCR) RateUp to 5 years

pCR is defined as the percentage of participants having an absence of residual invasive cancer in resected lung specimens and lymph nodes as assessed by local pathology review.

Secondary Outcome Measures
NameTimeMethod
All Substudies: Percentage of Participants Experiencing Treatment-emergent Adverse Events (TEAEs) and Related TEAEsFirst dose date up to 24 months plus 100 days
All Substudies: Percentage of Participants Experiencing Clinical Laboratory AbnormalitiesFirst dose date up to 24 months plus 100 days
Substudies 01 and 02: Progression-free Survival (PFS) According to RECIST Version 1.1Up to 5 years

PFS is defined as the time from the date of randomization until disease progression (PD) or death, whichever comes first.

Substudies 01 and 02: Duration of response (DOR) According to RECIST Version 1.1Up to 5 years

DOR is defined as the time from the first response (CR or PR) until the first documented PD, or death, whichever comes first.

All Substudies: Overall survival (OS)Up to 5 years

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

Substudy 03: Event-Free Survival (EFS)Up to 5 years

Event-Free Survival (EFS) is defined as the time from randomization until any of the following events: any progression precluding surgery or preventing completion of surgery, progression or recurrence of disease after surgery (local or distant), as assessed by investigator per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1), or death due to any cause, whichever occurs first. Participants who do not undergo surgery for reasons other than progression will be considered to have had an event at progression or at death.

Substudy 03: Major Pathological Response (MPR) RateUp to 5 years

MPR rate is defined as the percentage of participants with ≤ 10% residual tumor in lung and lymph nodes at surgery as evaluated by local pathology review.

Trial Locations

Locations (87)

St. Bartholomew's Hospital,Substudy-01

🇬🇧

London, United Kingdom

St. Bartholomew's Hospital,Substudy-02

🇬🇧

London, United Kingdom

St. Bartholomew's Hospital,Substudy-03

🇬🇧

London, United Kingdom

Arizona Oncology Associates,Substudy-01

🇺🇸

Tucson, Arizona, United States

Arizona Oncology Associates,Substudy-02

🇺🇸

Tucson, Arizona, United States

Rocky Mountain Cancer Center,Substudy-01

🇺🇸

Denver, Colorado, United States

Rocky Mountain Cancer Center,Substudy-02

🇺🇸

Denver, Colorado, United States

Fort Wayne Medical Oncology and Hematology, Inc.,Substudy-03

🇺🇸

Fort Wayne, Indiana, United States

Baptist Health Lexington,Substudy-03

🇺🇸

Lexington, Kentucky, United States

Oncology Associates of Oregon, PC,Substudy-02

🇺🇸

Eugene, Oregon, United States

Texas Oncology - Central South,Substudy-01

🇺🇸

Austin, Texas, United States

Texas Oncology - Central South,Substudy-02

🇺🇸

Austin, Texas, United States

US Oncology Investigational Products Center (IPC),Substudy-01

🇺🇸

Fairfax, Virginia, United States

US Oncology Investigational Products Center (IPC),Substudy-02

🇺🇸

Fairfax, Virginia, United States

Fred Hutchinson Cancer Center,Substudy-01

🇺🇸

Seattle, Washington, United States

Fred Hutchinson Cancer Center,Substudy-02

🇺🇸

Seattle, Washington, United States

Centro Gaúcho Integrado de Oncologia Hematologia, Ensino e Pesquisa Ltda./Hospital Mãe de Deus,Substudy-03

🇧🇷

Porto Alegre, Brazil

Hospital Mae de Deus

🇧🇷

Porto Alegre, Brazil

Hospital Sao Lucas da PUC Rio Grande do Sul,Substudy-03

🇧🇷

Porto Alegre, Brazil

Fundação Antonio Prudente/A.C. Camargo Cancer Center,Substudy-03

🇧🇷

São Paulo, Brazil

Real e Benemérita Associação Portuguesa de Beneficência/Hospital Beneficência Portuguesa de São Paulo (Hospital BP),Substudy-03

🇧🇷

São Paulo, Brazil

Queen Mary Hospital,Substudy-01

🇭🇰

Hong Kong, Hong Kong

Queen Mary Hospital,Substudy-02

🇭🇰

Hong Kong, Hong Kong

Queen Elizabeth Hospital,Substudy-01

🇭🇰

Hong Kong, Hong Kong

Rambam Health Care Campus,Substudy-03

🇮🇱

Haifa, Israel

Shaare Zedek Medical Center,Substudy-01

🇮🇱

Jerusalem, Israel

Shaare Zedek Medical Center,Substudy-02

🇮🇱

Jerusalem, Israel

Shaare Zedek Medical Center,Substudy-03

🇮🇱

Jerusalem, Israel

Hadassah University Medical Center,Substudy-03

🇮🇱

Jerusalem, Israel

Rabin Medical Center,Substudy-03

🇮🇱

Petah Tiqva, Israel

Tel Aviv Sourasky Medical Center,Substudy-01

🇮🇱

Tel Aviv-Yafo, Israel

Tel Aviv Sourasky Medical Center,Substudy-02

🇮🇱

Tel Aviv-Yafo, Israel

Tel-Aviv Sourasky Medical Center,Substudy-03

🇮🇱

Tel Aviv-Yafo, Israel

Chungbuk National University Hospital,Substudy-01

🇰🇷

Cheongju-si, Korea, Republic of

Chungbuk National University Hospital,Substudy-02

🇰🇷

Cheongju-si, Korea, Republic of

National Cancer Center,Substudy-01

🇰🇷

Goyang, Korea, Republic of

National Cancer Center,Substudy-02

🇰🇷

Goyang, Korea, Republic of

National Cancer Center,Substudy-03

🇰🇷

Goyang, Korea, Republic of

Asan Medical Centre,Substudy-01

🇰🇷

Seoul, Korea, Republic of

Samsung Medical Center,Substudy-01

🇰🇷

Seoul, Korea, Republic of

Samsung Medical Center,Substudy-02

🇰🇷

Seoul, Korea, Republic of

Samsung Medical Center,Substudy-03

🇰🇷

Seoul, Korea, Republic of

Severance Hospital, Yonsei University Health System,Substudy-01

🇰🇷

Seoul, Korea, Republic of

Severance Hospital, Yonsei University Health System,Substudy-02

🇰🇷

Seoul, Korea, Republic of

Seoul National University,Substudy-01

🇰🇷

Seoul, Korea, Republic of

Seoul National University,Substudy-02

🇰🇷

Seoul, Korea, Republic of

Korea University Guro Hospital,Substudy-01

🇰🇷

Seoul, Korea, Republic of

Korea University Guro Hospital,Substudy-03

🇰🇷

Seoul, Korea, Republic of

Changhua Christian Hospital,Substudy-01

🇨🇳

Changhua City, Taiwan

Changhua Christian Hospital,Substudy-02

🇨🇳

Changhua City, Taiwan

Changhua Christian Hospital,Substudy-03

🇨🇳

Changhua City, Taiwan

Kaohsiung Medical University Chung-Ho Memorial Hospital,Substudy-01

🇨🇳

Kaohsiung City, Taiwan

Kaohsiung Medical University Chung-Ho Memorial Hospital,Substudy-02

🇨🇳

Kaohsiung City, Taiwan

Kaohsiung Medical University Chung-Ho Memorial Hospital,Substudy-03

🇨🇳

Kaohsiung City, Taiwan

Kaohsiung Chang Gung Memorial Hospital,Substudy-01

🇨🇳

Kaohsiung, Taiwan

Kaohsiung Chang Gung Memorial Hospital,Substudy-02

🇨🇳

Kaohsiung, Taiwan

Kaohsiung Chang Gung Memorial Hospital,Substudy-03

🇨🇳

Kaohsiung, Taiwan

National Taiwan University Hospital,Substudy-01

🇨🇳

Taipei City, Taiwan

National Taiwan University Hospital,Substudy-02

🇨🇳

Taipei City, Taiwan

Memorial Ankara Hospital,Substudy-03

🇹🇷

Ankara, Turkey

St James University Hospital,,Substudy-01

🇬🇧

Leeds, United Kingdom

Washington University School of Medicine - Siteman Cancer Center,Substudy-01

🇺🇸

Saint Louis, Missouri, United States

Washington University School of Medicine - Siteman Cancer Center,Substudy-02

🇺🇸

Saint Louis, Missouri, United States

Washington University School of Medicine - Siteman Cancer Center,Substudy-03

🇺🇸

Saint Louis, Missouri, United States

Washington University School of Medicine - Siteman Cancer Center

🇺🇸

Saint Louis, Missouri, United States

Oncology Hematology Care Clinical Trials, LLC,Substudy-01

🇺🇸

Cincinnati, Ohio, United States

Oncology Hematology Care Clinical Trials, LLC,Substudy-02

🇺🇸

Cincinnati, Ohio, United States

Oncology Associates of Oregon, PC,Substudy-01

🇺🇸

Eugene, Oregon, United States

Queen Elizabeth Hospital,Substudy-02

🇭🇰

Hong Kong, Hong Kong

Prince of Wales Hospital,Substudy-01

🇭🇰

New Territories, Hong Kong

Prince of Wales Hospital,Substudy-02

🇭🇰

New Territories, Hong Kong

Rambam Health Care Campus,Substudy-01

🇮🇱

Haifa, Israel

Rambam Health Care Campus,Substudy-02

🇮🇱

Haifa, Israel

Chonnam National University Hwasun Hospital,Substudy-01

🇰🇷

Gwangju, Korea, Republic of

Chonnam National University Hwasun Hospital,Substudy-03

🇰🇷

Gwangju, Korea, Republic of

Seoul National University Bundang Hospital,Substudy-01

🇰🇷

Gyeonggi-do, Korea, Republic of

Seoul National University Bundang Hospital,Substudy-03

🇰🇷

Gyeonggi-do, Korea, Republic of

Kosin University Gospel Hospital,Substudy-01

🇰🇷

Seo-gu, Korea, Republic of

Kosin University Gospel Hospital,Substudy-03

🇰🇷

Seo-gu, Korea, Republic of

Severance Hospital, Yonsei University Health System,Substudy-03

🇰🇷

Seoul, Korea, Republic of

Asan Medical Center,Substudy-02

🇰🇷

Seoul, Korea, Republic of

Asan Medical Center,Substudy-03

🇰🇷

Seoul, Korea, Republic of

Dicle University Medical Faculty,Substudy-03

🇹🇷

Diyarbakir, Turkey

Necmettin Erbakan Universitesi,Substudy-03

🇹🇷

Meram Konya, Turkey

Birmingham Heartlands Hospital,Substudy-03

🇬🇧

Birmingham, United Kingdom

University Hospitals Birmingham NHS Trust,Substudy-01

🇬🇧

Birmingham, United Kingdom

University Hospitals Birmingham NHS Trust,Substudy-02

🇬🇧

Birmingham, United Kingdom

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