Study Stopped
Study was terminated for lack of efficacy.
A Study of ASP1951 in Subjects With Advanced Solid Tumors
A Phase 1b Study of ASP1951, a GITR Agonistic Antibody, as a Single Agent and in Combination With Pembrolizumab in Subjects With Advanced Solid Tumors
4 other identifiers
interventional
119
4 countries
32
Brief Summary
The primary purpose of this study is to evaluate the tolerability and safety profile of ASP1951 when administered as a single agent and in combination with pembrolizumab in participants with locally advanced (unresectable) or metastatic solid tumors; characterize the pharmacokinetic profile of ASP1951 when administered as a single agent and in combination with pembrolizumab; and determine the recommended phase 2 dose (RP2D) of ASP1951 and/or maximum tolerated dose (MTD) when administered as a single agent and in combination with pembrolizumab. This study will also evaluate the anti-tumor effect of ASP1951 when administered as a single agent and in combination with pembrolizumab.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P75+ for phase_1
Started Jan 2019
Longer than P75 for phase_1
32 active sites
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
January 2, 2019
CompletedFirst Posted
Study publicly available on registry
January 10, 2019
CompletedStudy Start
First participant enrolled
January 14, 2019
CompletedPrimary Completion
Last participant's last visit for primary outcome
July 6, 2023
CompletedStudy Completion
Last participant's last visit for all outcomes
July 6, 2023
CompletedNovember 1, 2024
October 1, 2024
4.5 years
January 2, 2019
October 31, 2024
Conditions
Keywords
Outcome Measures
Primary Outcomes (38)
Safety and tolerability assessed by Dose Limiting Toxicity (DLT)
A DLT is defined as any of the prespecified Adverse Events (AEs) (graded using National Cancer Institute Common Terminology Criteria for Adverse Events \[NCI-CTCAE\] version 4.03) that the investigator (or sponsor) cannot clearly attribute to a cause other than study drug.
Up to 5 years
Safety and tolerability assessed by adverse events (AEs)
Initial and retreatment. An AE is any untoward medical occurrence in a participant administered a study drug, and which does not necessarily have to have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of a medicinal product whether or not considered related to the medicinal product. AEs will be coded using the medical dictionary for regulatory activities (MedDRA) and graded using NCI-CTCAE 4.03.
Up to 5 years
Safety and tolerability assessed by immune-related AEs (irAEs)
Initial and retreatment. Most frequent immune-related AEs include rash, oral mucositis, dry mouth, colitis/diarrhea, hepatitis, pneumonitis, and endocrinopathies (hypophysitis, hypothyroidism, hyperthyroidism, adrenal insufficiency and Type 1 diabetes mellitus). In the event a participant is diagnosed with an irAE, then it should be reported as an AE.
Up to 5 years
Safety and tolerability assessed by infusion-related reactions (IRRs)
Initial and retreatment. IRRs are considered AEs of special interest. In the event a participant is diagnosed with an IRR, then it should be reported as an AE.
Up to 5 years
Safety and tolerability assessed by serious adverse events (SAEs)
Initial and retreatment. An AE is considered "serious" if it results in any of the following outcomes: results in death; is life-threatening; results in persistent or significant disability/incapacity or substantial disruption of the ability to conduct normal life functions; results in congenital anomaly or birth defect; requires inpatient hospitalization (except for planned procedures as allowed per study) or leads to prolongation of hospitalization (except if prolongation of planned hospitalization is not caused by an AE). Hospitalization for treatment/observation/examination caused by AE is to be considered as serious; and other medically important events.
Up to 5 years
Number of participants with laboratory value abnormalities and/or adverse events related to treatment
Initial and retreatment. Number of participants with potentially clinically significant laboratory values.
Up to 5 years
Safety and tolerability assessed by 12- lead electrocardiogram (ECG)
Initial and retreatment. ECGs should be obtained after the participant has rested in supine position (or semi-recumbent, if supine is not tolerated) for 10 minutes. Any clinically significant adverse changes on the ECG will be reported as AEs.
Up to 5 years
Number of participants with vital signs abnormalities and/or adverse events related to treatment
Initial and retreatment. Number of participants with potentially clinically significant vital sign values.
Up to 5 years
Number of participants with Physical Exam abnormalities and/or adverse events related to treatment
Initial and retreatment. Number of participants with potentially clinically significant physical exam values.
Up to 5 years
Safety and tolerability assessed by ECOG performance status
Initial and retreatment. The Eastern Cooperative Oncology Group (ECOG) scale will be used to assess performance status. Grades range from 0 (fully active) to 4 (completely disabled). Negative change scores indicate an improvement. Positive scores indicate a decline in performance.
Up to 5 years
Pharmacokinetics (PK) of ASP1951 in serum: AUClast
Initial monotherapy escalation treatment only. Area under the concentration time curve from the time of dosing to the last measurable concentration (AUClast) will be recorded from the pharmacokinetic (PK) serum samples collected.
Up to 10 weeks
Pharmacokinetics (PK) of ASP1951 in serum: AUCinf
Initial monotherapy escalation treatment only. Area under the concentration time curve from the time of dosing extrapolated to time infinity (AUCinf) will be recorded from the pharmacokinetic (PK) serum samples collected.
Up to 10 weeks
Pharmacokinetics (PK) of ASP1951 in serum: AUCinf%extrap
Initial monotherapy escalation treatment only. Percentage of AUCinf due to extrapolation from time of the last measurable concentration to time infinity (AUCinf %extrap) will be recorded from the pharmacokinetic (PK) serum samples collected.
Up to 10 weeks
Pharmacokinetics (PK) of ASP1951 in serum: AUCtau
Initial monotherapy escalation treatment only. Area under the concentration time curve from the time of dosing to the start of next dosing interval (AUCtau) will be recorded from the pharmacokinetic (PK) serum samples collected.
Up to 10 weeks
Pharmacokinetics (PK) of ASP1951 in serum: Cmax
Initial monotherapy escalation treatment only. Maximum concentration (Cmax) will be recorded from the pharmacokinetic (PK) serum samples collected.
Up to 10 weeks
Pharmacokinetics (PK) of ASP1951 in serum: Ctrough
Initial monotherapy escalation and retreatment. Concentration immediately prior to dosing at multiple dosing (Ctrough) will be recorded from the pharmacokinetic (PK) serum samples collected.
Up to 48 weeks
Pharmacokinetics (PK) of ASP1951 in serum: tmax
Initial monotherapy escalation treatment only. Time of the maximum concentration (tmax) will be recorded from the pharmacokinetic (PK) serum samples collected.
Up to 10 weeks
Pharmacokinetics (PK) of ASP1951 in serum: t 1/2
Initial monotherapy escalation treatment only. Terminal elimination half-life (t1/2) will be recorded from the pharmacokinetic (PK) serum samples collected.
Up to 10 weeks
Pharmacokinetics (PK) of ASP1951 in serum: tlast
Initial monotherapy escalation treatment only. Time of last measurable concentration (tlast) will be recorded from the pharmacokinetic (PK) serum samples collected.
Up to 10 weeks
Pharmacokinetics (PK) of ASP1951 in serum: CL
Initial monotherapy escalation treatment only. Total clearance after intravenous dosing (CL) will be recorded from the pharmacokinetic (PK) serum samples collected.
Up to 10 weeks
Pharmacokinetics (PK) of ASP1951 in serum: Vz
Initial monotherapy escalation treatment only. Volume of distribution after intravenous dosing during the terminal elimination phase (Vz) will be recorded from the pharmacokinetic (PK) serum samples collected.
Up to 10 weeks
Pharmacokinetics (PK) of ASP1951 in serum: Vss
Initial monotherapy escalation treatment only. Volume of distribution at steady state after intravenous dosing (Vss) will be recorded from the pharmacokinetic (PK) serum samples collected.
Up to 10 weeks
Pharmacokinetics (PK) of ASP1951 in combination with pembrolizumab in serum: AUClast
Initial combination escalation treatment only. Area under the concentration time curve from the time of dosing to the last measurable concentration (AUClast) will be recorded from the pharmacokinetic (PK) serum samples collected.
Up to 10 weeks
Pharmacokinetics (PK) of ASP1951 in combination with pembrolizumab in serum: AUCinf
Initial combination escalation treatment only. Area under the concentration time curve from the time of dosing extrapolated to time infinity (AUCinf) will be recorded from the pharmacokinetic (PK) serum samples collected.
Up to 10 weeks
Pharmacokinetics (PK) of ASP1951 in combination with pembrolizumab in serum: AUCinf%extrap
Initial combination escalation treatment only. Percentage of AUCinf due to extrapolation from time of the last measurable concentration to time infinity (AUCinf %extrap) will be recorded from the pharmacokinetic (PK) serum samples collected.
Up to 10 weeks
Pharmacokinetics (PK) of ASP1951 in combination with pembrolizumab in serum: AUCtau
Initial combination escalation treatment only. Area under the concentration time curve from the time of dosing to the start of next dosing interval (AUCtau) will be recorded from the pharmacokinetic (PK) serum samples collected.
Up to 10 weeks
Pharmacokinetics (PK) of ASP1951 in combination with pembrolizumab in serum: Cmax
Initial combination escalation treatment only. Maximum concentration (Cmax) will be recorded from the pharmacokinetic (PK) serum samples collected.
Up to 10 weeks
Pharmacokinetics (PK) of ASP1951 in combination with pembrolizumab in serum: Ctrough
Initial combination escalation and retreatment. Concentration immediately prior to dosing at multiple dosing (Ctrough) will be recorded from the pharmacokinetic (PK) serum samples collected.
Up to 48 weeks
Pharmacokinetics (PK) of ASP1951 in combination with pembrolizumab in serum: tmax
Initial combination escalation treatment only. Time of the maximum concentration (tmax) will be recorded from the pharmacokinetic (PK) serum samples collected.
Up to 10 weeks
Pharmacokinetics (PK) of ASP1951 in combination with pembrolizumab in serum: t 1/2
Initial combination escalation treatment only. Terminal elimination half-life (t1/2) will be recorded from the pharmacokinetic (PK) serum samples collected.
Up to 10 weeks
Pharmacokinetics (PK) of ASP1951 in combination with pembrolizumab in serum: tlast
Initial combination escalation treatment only. Time of last measurable concentration (tlast) will be recorded from the pharmacokinetic (PK) serum samples collected.
Up to 10 weeks
Pharmacokinetics (PK) of ASP1951 in combination with pembrolizumab in serum: CL
Initial combination escalation treatment only. Total clearance after intravenous dosing (CL) will be recorded from the pharmacokinetic (PK) serum samples collected.
Up to 10 weeks
Pharmacokinetics (PK) of ASP1951 in combination with pembrolizumab in serum: Vz
Initial combination escalation treatment only. Volume of distribution after intravenous dosing during the terminal elimination phase (Vz) will be recorded from the pharmacokinetic (PK) serum samples collected.
Up to 10 weeks
Pharmacokinetics (PK) of ASP1951 in combination with pembrolizumab in serum: Vss
Initial combination escalation treatment only. Volume of distribution at steady state after intravenous dosing (Vss) will be recorded from the pharmacokinetic (PK) serum samples collected.
Up to 10 weeks
Recommended Phase 2 Dose (RP2D) of ASP1951
RP2D of ASP1951 as a single agent is determined using available data on safety, pharmacokinetics, pharmacodynamics and efficacy of ASP1951.
Up to 5 years
RP2D of ASP1951 in combination with pembrolizumab
RP2D of ASP1951 in combination with pembrolizumab is determined using available data on safety, pharmacokinetics, pharmacodynamics and efficacy of ASP1951.
Up to 5 years
Maximum Tolerated Dose (MTD) of ASP1951
MTD is defined as the dose level at which the posterior mean of DLT rate estimated using Bayesian CRM is closest but does not exceed the target DLT rate of 33%, based on the profile of DLTs collected.
Up to 5 years
MTD of ASP1951 in combination with pembrolizumab
MTD is defined as the dose level at which the posterior mean of DLT rate estimated using Bayesian CRM is closest but does not exceed the target DLT rate of 33%, based on the profile of DLTs collected.
Up to 5 years
Secondary Outcomes (4)
Objective Response Rate (ORR) per Response Evaluation Criteria In Solid Tumors (RECIST) V1.1 and modified RECIST 1.1 for immune-based therapeutics (iRECIST)
Up to 5 years
Duration of Response (DOR) per RECIST V1.1 and iRECIST
Up to 5 years
Persistence of response after discontinuation per RECIST V1.1 and iRECIST
Up to 5 years
Disease Control Rate (DCR) per RECIST V1.1 and iRECIST
Up to 5 years
Study Arms (11)
ASP1951 0.07 mg Monotherapy
EXPERIMENTALParticipants have received ASP1951 0.07 mg intravenously on day 1 of every 3-week cycle.
ASP1951 0.7 mg Monotherapy
EXPERIMENTALParticipants have received ASP1951 0.7 mg intravenously on day 1 of every 3-week cycle.
ASP1951 5 mg Monotherapy
EXPERIMENTALParticipants have received ASP1951 5 mg intravenously on day 1 of every 3-week cycle.
ASP1951 20 mg Monotherapy
EXPERIMENTALParticipants have received ASP1951 20 mg intravenously on day 1 of every 3-week cycle.
ASP1951 70 mg Monotherapy
EXPERIMENTALParticipants have received ASP1951 70 mg intravenously on day 1 of every 3-week cycle.
ASP1951 200 mg Monotherapy
EXPERIMENTALParticipants have received ASP1951 200 mg intravenously on day 1 of every 3-week cycle.
ASP1951 700 mg Monotherapy
EXPERIMENTALParticipants have received ASP1951 700 mg intravenously on day 1 of every 3-week cycle.
ASP1951 1400 mg Monotherapy
EXPERIMENTALParticipants have received ASP1951 1400 mg intravenously on day 1 of every 3-week cycle.
ASP1951 20 mg + pembrolizumab 200 mg Combination Therapy
EXPERIMENTALParticipants have received ASP1951 20 mg intravenously on day 1 of every 3-week cycle in combination with pembrolizumab 200 mg administered on day 1 of every 3-week cycle, at least 30 minutes after the end of infusion of ASP1951.
ASP1951 700 mg + pembrolizumab 200 mg Combination Therapy
EXPERIMENTALParticipants have received ASP1951 700 mg intravenously on day 1 of every 3-week cycle in combination with pembrolizumab 200 mg administered on day 1 of every 3-week cycle, at least 30 minutes after the end of infusion of ASP1951.
ASP1951 1400 mg + pembrolizumab 200 mg Combination Therapy
EXPERIMENTALParticipants have received ASP1951 1400 mg intravenously on day 1 of every 3-week cycle in combination with pembrolizumab 200 mg administered on day 1 of every 3-week cycle, at least 30 minutes after the end of infusion of ASP1951.
Interventions
Intravenously (IV)
Intravenously (IV)
Eligibility Criteria
You may qualify if:
- Subject has locally-advanced (unresectable) or metastatic solid tumor malignancy (no limit to the number of prior treatment regimens) that is confirmed by available pathology records or current biopsy as well as the following:
- Subject in the escalation cohort has received all standard therapies (unless the therapy is contraindicated or intolerable) felt to provide clinical benefit the subject's specific tumor type. OR
- Subject in an expansion cohort has received at least 1 standard therapy for the subject's specific tumor type.
- \[Taiwan only\]: Subject has locally-advanced (unresectable) or metastatic solid tumor malignancy (no limit to the number of prior treatment regimens) that is confirmed by available pathology records or current biopsy and has received all standard therapies (unless the therapy is contraindicated or intolerable) felt to provide clinical benefit in the opinion of the treating investigator for his/her specific tumor type. Note: Subjects in the combination expansion cohort with tumor types that pembrolizumab is not approved for can only enroll if their standard treatment is ineffective, unsuitable per investigator's judgment or if the subject is unwilling to receive the standard therapy.
- Subject has an Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 or 1.
- Subject's last dose of prior antineoplastic therapy, including any immunotherapy, was 21 days or 5-half-lives, whichever is shorter, prior to initiation of study drug administration. A subject with epidermal growth factor receptor (EGFR) or anaplastic lymphoma kinase (ALK) mutation-positive NSCLC is allowed to remain on EGFR tyrosine kinase inhibitor (TKI) or ALK inhibitor therapy until 4 days prior to the start of study drug administration.
- Subject has completed any radiotherapy (including stereotactic radiosurgery) at least 2 weeks prior to study drug administration. Subjects must have recovered from all radiation related toxicities, not require corticosteroids and not have had radiation pneumonitis. A 1-week washout is permitted for palliative radiation (≤ 2 weeks of radiotherapy) to noncentral nervous system \[CNS\] disease.
- Subject's AEs (excluding alopecia) from prior therapy have improved to grade 1 or baseline within 2 weeks prior to start of study treatment.
- Subject with metastatic castration-resistant prostate cancer (mCRPC) (positive bone scan and/or soft tissue disease documented by computed tomography \[CT\]/magnetic resonance imaging \[MRI\]) meets both of the following:
- Subject has serum testosterone ≤ 50 ng/dL at Screening.
- Subject has had a bilateral orchiectomy or plans to continue androgen deprivation therapy (ADT) for the duration of study treatment.
- Subject has adequate organ function prior to start of study treatment. If a subject has received a recent blood transfusion, the laboratory tests must be obtained ≥ 4 weeks after any blood transfusion. Subjects can be on stable dose of erythropoietin (≥ approximately 3 months).
- A female subject is eligible to participate if she is not pregnant and at least 1 of the following conditions applies:
- Not a woman of childbearing potential (WOCBP); OR
- WOCBP who agrees to follow the contraceptive guidance throughout the treatment period and for at least 6 months after the final study drug administration.
- +21 more criteria
You may not qualify if:
- Subject weighs \< 45 kg.
- Subject has received investigational therapy (other than an investigational EGFR TKI in a subject with EGFR activating mutations or ALK inhibitor in a subject with an ALK mutation) within 21 days or 5-half-lives, whichever is shorter, prior to start of study drug.
- Subject requires or has received systemic steroid therapy or any other immunosuppressive therapy within 14 days prior to study drug administration. Subjects using a physiologic replacement dose of hydrocortisone or its equivalent (defined as up to 30 mg per day of hydrocortisone, 2 mg per day of dexamethasone, or up to 10 mg per day of prednisone) are allowed.
- Subject has symptomatic CNS metastases or subject has evidence of unstable CNS metastases even if asymptomatic (e.g., progression on scans). Subjects with previously treated CNS metastases are eligible, if they are clinically stable and have no evidence of CNS progression by imaging for at least 4 weeks prior to start of study treatment and are not requiring immunosuppressive doses of systemic steroids (\> 30 mg per day of hydrocortisone, \> 2 mg per day of dexamethasone, or \> 10 mg per day of prednisone or equivalent) for longer than 2 weeks.
- Subject has leptomeningeal disease as a manifestation of the current malignancy.
- Subject has an active autoimmune disease that has required systemic treatment in the past 2 years. Subjects with type 1 diabetes mellitus, endocrinopathies stably maintained on appropriate replacement therapy, and skin disorders (e.g., vitiligo, psoriasis or alopecia) not requiring systemic treatment are allowed.
- Subject was discontinued from prior immunomodulatory therapy due to a grade ≥ 3 toxicity that was mechanistically related (e.g., immune related) to the agent.
- Subject has known history of serious hypersensitivity reaction (≥ grade 3) to a known ingredient of ASP1951 or pembrolizumab or severe hypersensitivity reaction to treatment with another monoclonal antibody.
- Subject with positive Hepatitis B virus (HBV) antibodies and surface antigen (indicating acute HBV or chronic HBV) or Hepatitis C (\[HCV\]; ribonucleic acid \[RNA\] detected by qualitative or quantitative assay). Hepatitis C RNA testing is not required in subjects with negative Hepatitis C antibody testing. HBV antibodies are not required in subjects with negative HBV surface antigen.
- Subject has received a live vaccine against infectious diseases within 4 weeks prior to initiation of study treatment.
- Subject has a history of drug-induced pneumonitis (interstitial lung disease), a history of (non-infectious) pneumonitis that required steroids, radiation pneumonitis or currently has pneumonitis.
- Subject has an infection requiring systemic therapy within 2 weeks prior to study drug administration.
- Subject has received a prior allogeneic bone marrow or solid organ transplant.
- Subject is expected to require another form of antineoplastic therapy while on study treatment.
- Subject has had a myocardial infarction or unstable angina within 6 months prior to the start of study treatment or currently has an uncontrolled illness including, but not limited to symptomatic congestive heart failure, clinically significant cardiac disease, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
- +8 more criteria
Contact the study team to confirm eligibility.
Sponsors & Collaborators
- Astellas Pharma Global Development, Inc.lead
- Merck Sharp & Dohme LLCcollaborator
Study Sites (32)
Arizona Clinical Research Cent
Tucson, Arizona, 85715, United States
University of California
Sacramento, California, 95817, United States
University of Florida, Davis C
Gainesville, Florida, 326102, United States
Emory University
Atlanta, Georgia, 30322, United States
Augusta University
Augusta, Georgia, 30912, United States
Northwestern University
Chicago, Illinois, 60611, United States
Rush University Medical Center
Chicago, Illinois, 60612, United States
University of Iowa Hospitals
Iowa City, Iowa, 52242, United States
Henry Ford Health System
Detroit, Michigan, 48202, United States
Nebraska Cancer Specialists
Omaha, Nebraska, 68130, United States
Comprehensive Cancer Nevada
Las Vegas, Nevada, 89169, United States
Rutgers Cancer Institute
New Brunswick, New Jersey, 08903, United States
Icahn school of Medicine at Mount Sinai
New York, New York, 10029, United States
Columbia University Medical Center
New York, New York, 10032, United States
Duke University Medical Center
Durham, North Carolina, 27705, United States
Hollings Cancer Center
Charleston, South Carolina, 29425, United States
South Texas Accelerated Research Therapeutics, LLC
San Antonio, Texas, 78229, United States
Huntsman Cancer Institute
Salt Lake City, Utah, 84112, United States
Virginia Cancer Specialists
Fairfax, Virginia, 22031, United States
Multicare Regional Cancer Center Tacoma
Tacoma, Washington, 98405, United States
Site CA15002
Montreal, Canada
Site CA15005
Montreal, Canada
Site CA15004
Ontario, Canada
Site KR82002
Chungcheongbukdo, South Korea
Site KR82005
Daegu, South Korea
Site KR82001
Gyeonggi-do, South Korea
Site KR82003
Seoul, South Korea
Site KR82004
Seoul, South Korea
Site KR82006
Seoul, South Korea
Site KR82007
Seoul, South Korea
Site TW88603
Taichung, Taiwan
Site TW88604
Taipei, Taiwan
Related Links
MeSH Terms
Conditions
Interventions
Condition Hierarchy (Ancestors)
Study Officials
- STUDY DIRECTOR
Medical Monitor
Astellas Pharma Global Development, Inc.
Study Design
- Study Type
- interventional
- Phase
- phase 1
- Allocation
- NON RANDOMIZED
- Masking
- NONE
- Purpose
- TREATMENT
- Intervention Model
- SEQUENTIAL
- Sponsor Type
- INDUSTRY
- Responsible Party
- SPONSOR
Study Record Dates
First Submitted
January 2, 2019
First Posted
January 10, 2019
Study Start
January 14, 2019
Primary Completion
July 6, 2023
Study Completion
July 6, 2023
Last Updated
November 1, 2024
Record last verified: 2024-10
Data Sharing
- IPD Sharing
- Will share
- Shared Documents
- STUDY PROTOCOL, SAP, CSR
- Time Frame
- Access to participant level data is offered to researchers after publication of the primary manuscript (if applicable) and is available as long as Astellas has legal authority to provide the data.
- Access Criteria
- Researchers must submit a proposal to conduct a scientifically relevant analysis of the study data. The research proposal is reviewed by an Independent Research Panel. If the proposal is approved, access to the study data is provided in a secure data sharing environment after receipt of a signed Data Sharing Agreement.
Access to anonymized individual participant level data collected during the study, in addition to study-related supporting documentation, is planned for studies conducted with approved product indications and formulations, as well as products terminated during development. Studies conducted with product indications or formulations that remain active in development are assessed after study completion to determine if Individual Participant Data can be shared. Further details on Astellas' data sharing policy can be found at https://www.clinicaltrials.astellas.com/transparency/.