NCT00073528

Brief Summary

This study evaluated and compared the efficacy and tolerability of lapatinib and letrozole, with letrozole and placebo in post-menopausal women with hormone receptor positive (ER positive and/or PgR positive) advanced or metastatic breast cancer, who had not received prior therapy for advanced or metastatic disease.

Trial Health

98
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Strong global presence with extensive site network
Enrollment
1,286

participants targeted

Target at P75+ for phase_3

Timeline
Completed

Started Dec 2003

Longer than P75 for phase_3

Geographic Reach
28 countries

274 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

November 24, 2003

Completed
2 days until next milestone

First Posted

Study publicly available on registry

November 26, 2003

Completed
13 days until next milestone

Study Start

First participant enrolled

December 9, 2003

Completed
4.5 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

June 3, 2008

Completed
4 years until next milestone

Results Posted

Study results publicly available

May 17, 2012

Completed
5.8 years until next milestone

Study Completion

Last participant's last visit for all outcomes

March 22, 2018

Completed
Last Updated

February 24, 2021

Status Verified

February 1, 2021

Enrollment Period

4.5 years

First QC Date

November 24, 2003

Results QC Date

April 19, 2012

Last Update Submit

February 8, 2021

Conditions

Keywords

LapatinibLetrozolebreast carcinomabreast cancerbreast lumpHER2 positive metastatic breast cancerbreast cancer positive for human epidermal growth factor receptor 2HER2breast cancer progressionestrogen-receptor positive breast cancerER

Outcome Measures

Primary Outcomes (2)

  • Number of Participants With Progression Free Survival (PFS) in the Human Epidermal Growth Factor Receptor 2 (HER2)-Positive Advanced or Metastatic Breast Cancer as Assessed by the Investigator

    PFS is defined as the time from randomization until the earliest date of disease progression (PD) or death due to any cause, if sooner. The date of documented PD is defined as the date of radiological PD as assessed by the investigator based on imaging data and also by the clinical assessment of symptomatic progression. Per Response Evaluation Criteria in Solid Tumors (RECIST 1.0), PD is defined as a 20% increase in the sum of the longest diameter (LD) of target lesions, taking as a reference the smallest sum LD recorded since the treatment started, or the appearance of 1 or more new lesions.

    From the date of randomization until the date of the first documented progression or date of death from any cause, whichever came first, assessed for up to 46 months

  • Progression Free Survival (PFS) of Participants in the HER2-Positive Population as Assessed by the Investigator

    PFS is defined as the time from randomization until the earliest date of disease progression or death due to any cause, if sooner. The date of documented disease progression is defined as the date of radiological disease progression as assessed by the investigator based on imaging data and also by the clinical assessment of symptomatic progression. Per RECIST 1.0, disease progression is defined as a 20% increase in the sum of the LD of target lesions, taking as a reference the smallest sum LD recorded since the treatment started, or the appearance of 1 or more new lesions.

    From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 46 months

Secondary Outcomes (31)

  • Number of Participants With PFS in the Intent-To-Treat (ITT) Population as Assessed by the Investigator

    From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 46 months

  • PFS in Participants in the ITT Population as Assessed by the Investigator

    From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 46 months

  • Overall Survival in the HER2-Positive Population

    From date of randomization until date of death due to any cause, assessed up to 46 months

  • Overall Tumor Response (OR) for Participants With Measurable and Non-measurable Disease, Including Bone Scans, in the HER2-Positive Population as Assessed by the Investigator

    Up to 46 months

  • Number of Participants With Overall Tumor Response (OR) by Stratification Factors With Measurable Disease, Including Bone Scans, in the HER2-Positive Population as Assessed by the Investigator

    Up to 46 months

  • +26 more secondary outcomes

Study Arms (2)

Placebo + Letrozole 2.5 mg

PLACEBO COMPARATOR

Letrozole (2.5 mg once daily orally) with Placebo (which matched with Lapatinib tablet)

Drug: LetrozoleDrug: Placebo

Lapatinib 1500 mg + Letrozole 2.5 mg

EXPERIMENTAL

Lapatinib (1500 mg once daily orally) with Letrozole (2.5 mg once daily orally)

Drug: LapatinibDrug: Letrozole

Interventions

1500 mg orally once a day

Also known as: GW572016
Lapatinib 1500 mg + Letrozole 2.5 mg

2.5 mg orally once a day

Lapatinib 1500 mg + Letrozole 2.5 mgPlacebo + Letrozole 2.5 mg

Placebo (which matched with lapatinib tablet)

Placebo + Letrozole 2.5 mg

Eligibility Criteria

Age18 Years+
Sexfemale
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Signed informed consent;
  • Subjects with histologically confirmed invasive breast cancer with stage IV disease at primary diagnosis or at relapse after curative-intent surgery;
  • Subjects with either measurable or non-measurable disease per Response Evaluation Criteria in Solid Tumors (RECIST).
  • If the disease was restricted to a solitary lesion, its neoplastic nature was confirmed by cytology or histology.
  • Tumors that were ER+ and/or PgR+;
  • Post-menopausal female subjects ≥ 18 years of age.
  • ECOG Performance Status of 0 or 1;
  • Subjects who had archived tumor tissue available to compare tumor response with intra-tumoral expression of ErbB1 and ErbB2.
  • Adjuvant therapy with an aromatase inhibitor and / or trastuzumab was allowed; however, treatment was to stop more than 1 year prior (\>12 months) to the first dose of randomized therapy.
  • Subjects must have ended hormonal replacement therapy (HRT) at least 1 month (30 days) prior to receiving the first dose of randomized therapy.

You may not qualify if:

  • Pre-menopausal, pregnant, or lactating;
  • Received prior chemotherapy, hormonal therapy, immunotherapy, biologic therapy, or anti-ErbB1/ErbB2 therapy for advanced or metastatic disease;
  • Bisphosphonate therapy for bone metastases was allowed; however, treatment was to be initiated prior to the first dose of randomized therapy. Prophylactic use of bisphosphonates in subjects without bone disease, except for the treatment of osteoporosis, was not permitted;
  • Used an investigational drug within 30 days or 5 half-lives, whichever is longer, preceding the first dose of randomized therapy (lapatinib or placebo);
  • Subjects with known history of/clinical evidence of CNS metastases or leptomeningeal carcinomatosis; and / or subjects on concurrent anti-cancer therapies other than letrozole; and / or who have not recovered from toxicities related to prior adjuvant therapy (surgery, radiotherapy, chemotherapy etc.)
  • Subjects with active or uncontrolled infection and/ or with history of uncontrolled or symptomatic angina, arrhythmias, or congestive heart failure.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (278)

Novartis Investigative Site

Tucson, Arizona, 85715, United States

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Novartis Investigative Site

Hot Springs, Arkansas, 71913, United States

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Novartis Investigative Site

Jonesboro, Arkansas, 72401, United States

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Alhambra, California, 91801, United States

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Bakersfield, California, 93309, United States

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Novartis Investigative Site

Duarte, California, 91010, United States

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Novartis Investigative Site

Fountain Valley, California, 92708, United States

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Fresno, California, 93710, United States

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Novartis Investigative Site

Fullerton, California, 92835, United States

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Novartis Investigative Site

La Jolla, California, 92093-0987, United States

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Long Beach, California, 90813, United States

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Los Angeles, California, 90095, United States

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Montebello, California, 90640, United States

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Northridge, California, 91325, United States

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Oxnard, California, 93030, United States

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Pleasant Hill, California, 94523, United States

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Porterville, California, 93257, United States

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Redondo Beach, California, 90277, United States

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San Diego, California, 92120, United States

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Santa Barbara, California, 93105, United States

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Santa Maria, California, 93454, United States

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Vallejo, California, 94589, United States

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Vista, California, 92081, United States

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Aurora, Colorado, 80045, United States

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Denver, Colorado, 80220, United States

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Longmont, Colorado, 80501, United States

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Wheat Ridge, Colorado, 80033, United States

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New Haven, Connecticut, 06520, United States

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Boca Raton, Florida, 33428, United States

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Boca Raton, Florida, 33486, United States

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Gainesville, Florida, 32605, United States

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Gainesville, Florida, 32610, United States

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Hollywood, Florida, 33021, United States

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Lakeland, Florida, 33805, United States

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Miami, Florida, 33136, United States

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Orlando, Florida, 32804, United States

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Port Saint Lucie, Florida, 34952, United States

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West Palm Beach, Florida, 33401, United States

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Atlanta, Georgia, 30341, United States

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Marietta, Georgia, 30060, United States

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Savannah, Georgia, 31406, United States

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Peoria, Illinois, 61615, United States

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Skokie, Illinois, 60076, United States

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Indianapolis, Indiana, 46202, United States

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Bettendorf, Iowa, 52722, United States

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Louisville, Kentucky, 40202, United States

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Metairie, Louisiana, 70006, United States

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New Orleans, Louisiana, 70121, United States

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Worcester, Massachusetts, 01608, United States

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Duluth, Minnesota, 55805, United States

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Minneapolis, Minnesota, 55407-3799, United States

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Robbinsdale, Minnesota, 55422, United States

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Saint Louis Park, Minnesota, 55426, United States

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Saint Charles, Missouri, 63304, United States

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St Louis, Missouri, 63141, United States

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Omaha, Nebraska, 68114, United States

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Las Vegas, Nevada, 89169, United States

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Voorhees Township, New Jersey, 08043, United States

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Santa Fe, New Mexico, 87505, United States

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Manhasset, New York, 11030, United States

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Rochester, New York, 14623, United States

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Chapel Hill, North Carolina, 27599-7305, United States

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Greenville, North Carolina, 27834, United States

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Fargo, North Dakota, 58103, United States

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Canton, Ohio, 44718, United States

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Hershey, Pennsylvania, 17033, United States

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Philadelphia, Pennsylvania, 19111, United States

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Pittsburgh, Pennsylvania, 15212, United States

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West Columbia, South Carolina, 29210, United States

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Germantown, Tennessee, 38138, United States

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Knoxville, Tennessee, 37916, United States

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Amarillo, Texas, 79106, United States

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Dallas, Texas, 75246, United States

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Dallas, Texas, 75390-9113, United States

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Houston, Texas, 77025, United States

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Irving, Texas, 75061, United States

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Ogden, Utah, 84403, United States

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Salt Lake City, Utah, 84106, United States

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Burlington, Vermont, 05401, United States

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Danville, Virginia, 24541, United States

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Richmond, Virginia, 23230, United States

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Seattle, Washington, 98104, United States

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Tacoma, Washington, 98405, United States

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Charleston, West Virginia, 25304, United States

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Capital Federal, Buenos Aires, C1426ANZ, Argentina

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Buenos Aires, 1425, Argentina

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Buenos Aires, C1405BWU, Argentina

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Garran, Australian Capital Territory, 2606, Australia

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Douglas, Queensland, 4814, Australia

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Herston, Queensland, 4029, Australia

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Redcliffe, Queensland, 4020, Australia

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Adelaide, South Australia, 5000, Australia

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Salvador, Estado de Bahia, 41825-010, Brazil

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Rio de Janeiro, 20560-120, Brazil

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Plovdiv, 4000, Bulgaria

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Sofia, 1527, Bulgaria

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Sofia, 1756, Bulgaria

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Winnipeg, Manitoba, R2H 2A6, Canada

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Greater Sudbury, Ontario, P3E 5J1, Canada

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London, Ontario, N6A 4L6, Canada

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Mississauga, Ontario, L5B 1B8, Canada

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Oshawa, Ontario, L1G 2B9, Canada

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Toronto, Ontario, M6R 1B5, Canada

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Montreal, Quebec, H1T 2M4, Canada

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Montreal, Quebec, H2L 4M1, Canada

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Montreal, Quebec, H3T 1E2, Canada

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Montreal, Quebec, H4J 1C5, Canada

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Québec, Quebec, G1S 4L8, Canada

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Sherbrooke, Quebec, J1H 5N4, Canada

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Santiago, Región Metro de Santiago, 7500921, Chile

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Santiago, Región Metro de Santiago, 7591046, Chile

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Bogotá, Colombia

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Osijek, 31000, Croatia

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Pula, 52100, Croatia

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Split, 21000, Croatia

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Brno, 656 53, Czechia

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České Budějovice, 370 87, Czechia

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Prague, 180 00, Czechia

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Aalborg, 9000, Denmark

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Hillerød, 3400, Denmark

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Koebenhavn Oe, 2100, Denmark

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Næstved, 4700, Denmark

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Odense C, 5000, Denmark

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Roskilde, 4000, Denmark

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Vejle, 7100, Denmark

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Angers, 49033, France

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Besançon, 25030, France

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Grenoble, 38043, France

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Lille, 59020, France

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Montpellier, 34298, France

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Paris, 75248, France

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Pierre-Bénite, 69495, France

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Toulouse Cedex9, 31059, France

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Villejuif, 94805, France

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Aalen, Baden-Wurttemberg, 73428, Germany

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Freiburg im Breisgau, Baden-Wurttemberg, 79106, Germany

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Heidelberg, Baden-Wurttemberg, 69115, Germany

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Heidenheim, Baden-Wurttemberg, 89518, Germany

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Schwetzingen, Baden-Wurttemberg, 68723, Germany

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Stuttgart, Baden-Wurttemberg, 70174, Germany

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Ulm, Baden-Wurttemberg, 89075, Germany

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Augsburg, Bavaria, 86150, Germany

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Bayreuth, Bavaria, 95445, Germany

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Erlangen, Bavaria, 91054, Germany

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Munich, Bavaria, 80335, Germany

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Munich, Bavaria, 80637, Germany

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Munich, Bavaria, 81377, Germany

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Regensburg, Bavaria, 93049, Germany

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Rehling, Bavaria, 86508, Germany

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Rosenheim, Bavaria, 83002, Germany

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Frankfurt am Main, Hesse, 60590, Germany

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Frankfurt am Main, Hesse, 60596, Germany

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Wiesbaden, Hesse, 65191, Germany

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Wiesbaden, Hesse, 65199, Germany

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Goslar, Lower Saxony, 38642, Germany

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Leer, Lower Saxony, 26789, Germany

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Bonn, North Rhine-Westphalia, 53127, Germany

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Coesfeld, North Rhine-Westphalia, 48653, Germany

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Düsseldorf, North Rhine-Westphalia, 40217, Germany

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Ibbenbueren, North Rhine-Westphalia, 49477, Germany

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Münster, North Rhine-Westphalia, 48149, Germany

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Troisdorf, North Rhine-Westphalia, 53840, Germany

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Velbert, North Rhine-Westphalia, 42551, Germany

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Altenkirchen, Rhineland-Palatinate, 57610, Germany

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Chemnitz, Saxony, 09009, Germany

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Dresden, Saxony, 01219, Germany

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Kiel, Schleswig-Holstein, 24103, Germany

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Kiel, Schleswig-Holstein, 24105, Germany

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Pinneberg, Schleswig-Holstein, 25421, Germany

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Jena, Thuringia, 07743, Germany

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Berlin, 10117, Germany

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Berlin, 10317, Germany

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Berlin, 12200, Germany

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Berlin, 14195, Germany

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Hamburg, 20095, Germany

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Hamburg, 20259, Germany

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Hamburg, 22081, Germany

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Hamburg, 22457, Germany

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Hamburg, 22767, Germany

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Budapest, 1032, Hungary

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Budapest, 1088, Hungary

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Budapest, 1096, Hungary

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Kecskemét, 6000, Hungary

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Kistarcsa, 2143, Hungary

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Szeged, 6720, Hungary

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Tatabánya, 2800, Hungary

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Cork, Ireland

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Dooradoyle, Ireland

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Dublin, 4, Ireland

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Dublin, 8, Ireland

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Dublin, 9, Ireland

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Galway, Ireland

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Tallaght, Dublin, 24, Ireland

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Wilton, Cork, Ireland

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Bologna, Emilia-Romagna, 40138, Italy

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Parma, Emilia-Romagna, 43100, Italy

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Rome, Lazio, 00133, Italy

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Rome, Lazio, 00152, Italy

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Genoa, Liguria, 16128, Italy

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Genoa, Liguria, 16132, Italy

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Crema, Lombardy, 26013, Italy

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Milan, Lombardy, 20162, Italy

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Acapulco de Juárez, Guerrero, 39670, Mexico

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Colima, 28010, Mexico

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Durango, 34000, Mexico

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Durango, 34079, Mexico

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Mexico City, 14050, Mexico

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Amersfoort, 3813 TZ, Netherlands

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Delft, 2625 AD, Netherlands

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Doetinchem, 7009 BL, Netherlands

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Eindhoven, 5623 EJ, Netherlands

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Heerlen, 6419 PC, Netherlands

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Leidschendam, 2262 BA, Netherlands

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Maastricht, 6229 HX, Netherlands

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Nieuwegein, 3435 CM, Netherlands

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Sittard-geleen, 6162 BG, Netherlands

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The Hague, 2512 VA, Netherlands

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The Hague, 2545 CH, Netherlands

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Utrecht, 3582 KE, Netherlands

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Utrecht, 3584 CX, Netherlands

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Christchurch, 8001, New Zealand

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Lahore, 54000, Pakistan

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Lahore, Pakistan

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Rawalpindi, 46000, Pakistan

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Callao, Callao 2, Peru

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Lima, Lima 34, Peru

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Bydogoszcz, 85-796, Poland

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Krakow, 31-115, Poland

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Poznan, 61-866, Poland

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Warsaw, 02-781, Poland

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Wroclaw, 53-413, Poland

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Moscow, 107005, Russia

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Moscow, 115 478, Russia

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Saint Petersburg, 197022, Russia

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Saint Petersburg, 197758, Russia

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Capital Park, 0002, South Africa

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Panorama, 7500, South Africa

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Parktown, 2193, South Africa

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Port Elizabeth, 6001, South Africa

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Gyeonggi-do, 411-769, South Korea

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Seodaemun-gu, Seoul, 03722, South Korea

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Seoul, 135-710, South Korea

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Alcala de Henares (Madrid), Spain

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Badalona, 08916, Spain

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Barcelona, 08036, Spain

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Donostia / San Sebastian, 20014, Spain

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Elche, 03203, Spain

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Girona, 17007, Spain

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Leganes, Madrid, 28911, Spain

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Madrid, 28007, Spain

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Madrid, 28034, Spain

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Madrid, 28035, Spain

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Madrid, 28040, Spain

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Madrid, 28041, Spain

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Málaga, 29010, Spain

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Móstoles, 28935, Spain

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Oviedo, 33006, Spain

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Palma de Mallorca, 07010, Spain

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Valencia, 46010, Spain

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Vigo ( Pontevedra), 36204, Spain

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Zaragoza, 50009, Spain

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Sfax, 3000, Tunisia

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Sousse, 4000, Tunisia

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Tunis, 1004, Tunisia

Location

Novartis Investigative Site

Tunis, 1007, Tunisia

Location

Novartis Investigative Site

Ankara, 06100, Turkey (Türkiye)

Location

Novartis Investigative Site

Istanbul, 34865, Turkey (Türkiye)

Location

Novartis Investigative Site

Istanbul, Turkey (Türkiye)

Location

Novartis Investigative Site

Chelmsford, Essex, CM1 7ET, United Kingdom

Location

Novartis Investigative Site

Manchester, Lancashire, M20 4BX, United Kingdom

Location

Novartis Investigative Site

Northwood, Middlesex, HA6 2RN, United Kingdom

Location

Novartis Investigative Site

Sutton, Surrey, SM2 5PT, United Kingdom

Location

Novartis Investigative Site

Birmingham, West Midlands, B18 7QH, United Kingdom

Location

Novartis Investigative Site

Huddersfield, HD3 3EA, United Kingdom

Location

Novartis Investigative Site

London, NW3 2QG, United Kingdom

Location

Novartis Investigative Site

London, SW17 0QT, United Kingdom

Location

Novartis Investigative Site

London, SW3 6JJ, United Kingdom

Location

Novartis Investigative Site

Sheffield, S10 2SJ, United Kingdom

Location

Related Publications (6)

  • Johnston S, Pippen J Jr, Pivot X, Lichinitser M, Sadeghi S, Dieras V, Gomez HL, Romieu G, Manikhas A, Kennedy MJ, Press MF, Maltzman J, Florance A, O'Rourke L, Oliva C, Stein S, Pegram M. Lapatinib combined with letrozole versus letrozole and placebo as first-line therapy for postmenopausal hormone receptor-positive metastatic breast cancer. J Clin Oncol. 2009 Nov 20;27(33):5538-46. doi: 10.1200/JCO.2009.23.3734. Epub 2009 Sep 28.

    PMID: 19786658BACKGROUND
  • Schwartzberg LS, Franco SX, Florance A, O'Rourke L, Maltzman J, Johnston S. Lapatinib plus letrozole as first-line therapy for HER-2+ hormone receptor-positive metastatic breast cancer. Oncologist. 2010;15(2):122-9. doi: 10.1634/theoncologist.2009-0240. Epub 2010 Feb 15.

    PMID: 20156908BACKGROUND
  • Sherrill B, Amonkar MM, Sherif B, Maltzman J, O'Rourke L, Johnston S. Quality of life in hormone receptor-positive HER-2+ metastatic breast cancer patients during treatment with letrozole alone or in combination with lapatinib. Oncologist. 2010;15(9):944-53. doi: 10.1634/theoncologist.2010-0012. Epub 2010 Aug 26.

    PMID: 20798196BACKGROUND
  • Finn RS, Press MF, Dering J, O'Rourke L, Florance A, Ellis C, Martin AM, Johnston S. Quantitative ER and PgR assessment as predictors of benefit from lapatinib in postmenopausal women with hormone receptor-positive, HER2-negative metastatic breast cancer. Clin Cancer Res. 2014 Feb 1;20(3):736-43. doi: 10.1158/1078-0432.CCR-13-1260. Epub 2013 Nov 6.

    PMID: 24198242BACKGROUND
  • Prat A, Cheang MC, Galvan P, Nuciforo P, Pare L, Adamo B, Munoz M, Viladot M, Press MF, Gagnon R, Ellis C, Johnston S. Prognostic Value of Intrinsic Subtypes in Hormone Receptor-Positive Metastatic Breast Cancer Treated With Letrozole With or Without Lapatinib. JAMA Oncol. 2016 Oct 1;2(10):1287-1294. doi: 10.1001/jamaoncol.2016.0922.

    PMID: 27281556BACKGROUND
  • Wedam SB, Beaver JA, Amiri-Kordestani L, Bloomquist E, Tang S, Goldberg KB, Sridhara R, Ibrahim A, Kim G, Kluetz P, McKee A, Pazdur R. US Food and Drug Administration Pooled Analysis to Assess the Impact of Bone-Only Metastatic Breast Cancer on Clinical Trial Outcomes and Radiographic Assessments. J Clin Oncol. 2018 Apr 20;36(12):1225-1231. doi: 10.1200/JCO.2017.74.6917. Epub 2018 Mar 9.

MeSH Terms

Conditions

Breast Neoplasms

Interventions

LapatinibLetrozole

Condition Hierarchy (Ancestors)

Neoplasms by SiteNeoplasmsBreast DiseasesSkin DiseasesSkin and Connective Tissue Diseases

Intervention Hierarchy (Ancestors)

QuinazolinesHeterocyclic Compounds, 2-RingHeterocyclic Compounds, Fused-RingHeterocyclic CompoundsNitrilesOrganic ChemicalsTriazolesAzolesHeterocyclic Compounds, 1-Ring

Results Point of Contact

Title
Study Director
Organization
Novartis Pharmaceuticals

Study Officials

  • Novartis Pharmaceuticals

    Novartis Pharmaceuticals

    STUDY DIRECTOR

Publication Agreements

PI is Sponsor Employee
No
Restriction Type
OTHER
Restrictive Agreement
Yes

Study Design

Study Type
interventional
Phase
phase 3
Allocation
RANDOMIZED
Masking
QUADRUPLE
Who Masked
PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
INDUSTRY
Responsible Party
SPONSOR

Study Record Dates

First Submitted

November 24, 2003

First Posted

November 26, 2003

Study Start

December 9, 2003

Primary Completion

June 3, 2008

Study Completion

March 22, 2018

Last Updated

February 24, 2021

Results First Posted

May 17, 2012

Record last verified: 2021-02

Data Sharing

IPD Sharing
Will share

Novartis is committed to sharing with qualified external researchers, access to patient-level data and supporting clinical documents from eligible studies. These requests are reviewed and approved by an independent review panel on the basis of scientific merit. All data provided is anonymized to respect the privacy of patients who have participated in the trial in line with applicable laws and regulations. This trial data availability is according to the criteria and process described on www.clinicalstudydatarequest.com

Locations