4006-776-356 出国就医服务电话

免费获得国外相关药品,最快 1 个工作日回馈药物信息

出境医 / 临床实验 / First-in-human Single Agent Study of SAR442085 in Relapsed or Refractory Multiple Myeloma

First-in-human Single Agent Study of SAR442085 in Relapsed or Refractory Multiple Myeloma

Study Description
Brief Summary:

Primary Objectives:

  • Dose Escalation Part A: To determine the maximum tolerated dose (MTD) of SAR442085 administered as a single agent in patients with relapsed or refractory multiple myeloma (RRMM), and determine the recommended Phase 2 dose (RP2D) for the subsequent Expansion Part B
  • Dose Expansion Part B: To assess the antitumor activity of single agent of SAR442085 at the RP2D in patients with RRMM

Secondary Objectives:

  • To characterize the safety profile of SAR442085
  • To characterize the pharmacokinetics (PK) profile of SAR442085 when administered as a single agent
  • To evaluate the potential immunogenicity of SAR442085
  • To assess preliminary evidence of antitumor activity in the Dose Escalation Part A

Condition or disease Intervention/treatment Phase
Plasma Cell Myeloma Drug: SAR442085 Phase 1

Detailed Description:
Patient will continue to receive study medication until disease progression, unacceptable toxicity, withdrawal of informed consent, or other reason why investigator considers it appropriate to discontinue study medication. Once permanently discontinued, study medication cannot be restarted at later timepoint.
Study Design
Layout table for study information
Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 78 participants
Allocation: Non-Randomized
Intervention Model: Sequential Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: An Open-label, First-in-human, Single Agent, Dose-escalation and Expansion Study for the Evaluation of Safety, Pharmacokinetics, Pharmacodynamics and Anti-tumor Activity of SAR442085 in Patients With Relapsed or Refractory Multiple Myeloma (RRMM)
Actual Study Start Date : August 19, 2019
Estimated Primary Completion Date : May 2023
Estimated Study Completion Date : May 2023
Arms and Interventions
Arm Intervention/treatment
Experimental: Part A: SAR442085 dose escalation
SAR442085 will be given intravenously weekly for 4 weeks (Cycle 1) and on Day 1 and Day 15 of each subsequent cycle until the patient has progressive disease, unacceptable toxicity or other reasons to terminate study treatment. Each cycle will be approximately 28 days in duration.
Drug: SAR442085
Pharmaceutical form:Sterile lyophilized powder for reconstitution for infusion Route of administration: intravenous

Experimental: Part B: SAR442085 dose expansion
SAR442085 will be given intravenously weekly for 4 weeks (Cycle 1) and on Day 1 and Day 15 of each subsequent cycle until the patient has progressive disease, unacceptable toxicity or other reasons to terminate study treatment. Each cycle will be approximately 28 days in duration.
Drug: SAR442085
Pharmaceutical form:Sterile lyophilized powder for reconstitution for infusion Route of administration: intravenous

Outcome Measures
Primary Outcome Measures :
  1. The maximum tolerated dose (MTD) of SAR442085 (Part A) [ Time Frame: At the end of Cycle 1 (each cycle is approximately 28 days) ]
    MTD is defined as the dose level with highest probability of investigational medicinal product (IMP) related dose limiting toxicity (DLT) rate within the target range (16 to 33%) among dose levels with less than 0.25 probability of DLT rate above target (>33%)

  2. Recommended Phase 2 dose (RP2D) (Part A) [ Time Frame: At the end of Cycle 1 (each cycle is approximately 28 days) ]
    RP2D is defined as the dose selected for the further single agent testing - including in Phase 1 expansion part B.

  3. Overall response rate (Part B) [ Time Frame: approximately 6 months after the last patient has started treatment in Part B (approx. 2 years) ]
    Overall response rate (ORR): is defined as the proportion of patients with stringent complete response (sCR), complete response (CR), very good partial response (VGPR), and partial response (PR), using the International Myeloma Working Group (IMWG) criteria.


Secondary Outcome Measures :
  1. Treatment-emergent adverse events (AEs)/serious adverse events (SAE) (Both Part A and B) [ Time Frame: From baseline to end of treatment + 30 days (approx. 2 years) ]
    Number of participants with Treatment-Emergent Adverse events (TEAEs) from baseline to End of Study.

  2. PK parameters of SAR442085: Cmax (Both Part A and B) [ Time Frame: Cycle 1 Day 1 to Day 28 ]
    Maximum plasma concentration observed (Cmax).

  3. PK parameters of SAR442085: Tmax (Both Part A and B) [ Time Frame: Cycle 1 Day 1 to Day 28 ]
    First time to reach Cmax (tmax).

  4. PK parameters of SAR442085: AUC (Both Part A and B) [ Time Frame: Cycle 1 Day 1 to Day 28 ]
    Area under the plasma concentration versus time curve extrapolated to infinity (AUC).

  5. Anti-drug antibody (ADA) against SAR442085 (Both Part A and B) [ Time Frame: Cycle 1, 2, 3, 6 and 9 (each cycle is approximately 28 days) ]
    Number of participants with ADA against SAR442085.

  6. Progression-free survival (Part B) [ Time Frame: approximately 12 months after the last patient has started treatment in Part B (approx. 2 years) ]
    Progression-free survival (PFS) is defined as the time interval from the date of enrollment to the date of documented tumor progression as per IMWG or death (due to any cause), whichever comes first.

  7. Duration of response (Part B) [ Time Frame: approximately 12 months after the last patient has started treatment in Part B (approx. 2 years) ]
    Duration of response (DOR) is defined as the time from first documented evidence of CR or PR until progressive disease (PD) as per IMWG or death from any cause, whichever occurs first.


Eligibility Criteria
Layout table for eligibility information
Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion criteria :

  • Participant must be at least 18 years of age or of the country's legal age of majority if the legal age is >18 years old, at the time of signing the informed consent.
  • Participant has given voluntary written informed consent.
  • Participant has been previousy diagnosed with multiple myeloma based on standard criteria.
  • Part A: (1) participant has received at least 3 prior lines of therapy for multiple myeloma, or at least 2 prior lines of therapy if at least 1 of those lines consisted of 2 or more multi-agent regimens (eg, multi-agent induction regimen with autologous stem cell transplantation, followed by maintenance regimen). (2) Prior therapy for multiple myeloma has included at least 1 proteasome inhibitor (bortezomib, carfilzomib, ixazomib), at least 1 immunomodulatory agent (lenalidomide, thalidomide, pomalidomide), at least 1 anti-CD38 monoclonal antibody and at least 1 steroid. Applicable countries in EU and Asia can enroll anti-CD38 naive RRMM patients from DL4 and onwards. (3) Participant had at least a minimal response (MR) to the anti-CD38 antibody containing regimen and had last dose of anti-CD38 monoclonal antibody at least 9 months prior to study entry. Applicable countries in EU and Asia can enroll anti-CD38 naive RRMM patients from DL4 and onwards.
  • Part B and the last cohort(s) of Part A: (1) participant has received at least 3 prior lines of therapy for multiple myeloma, or at least 2 prior line of therapy if at least 1 of those lines consisted of 2 or more multi-agent regimens (eg, multi-agent induction regimen with autologous stem cell transplantation, followed by maintenance regimen). (2) Prior therapy for multiple myeloma has included at least 1 proteasome inhibitor (bortezomib, carfilzomib, ixazomib), at least 1 immunomodulatory agent (lenalidomide, thalidomide, pomalidomide) and at least 1 steroid. (3) Prior therapy has not included an anti-CD38 monoclonal antibody.
  • Participant has myeloma disease progression on or after last therapy.
  • Participant must have measurable disease as defined as at least one of the following:

    • Serum M protein ≥0.5 g/dL (≥5 g/L)
    • Urine M protein ≥200 mg/24 hours
    • Serum FLC assay: Involved FLC assay ≥10 mg/dL (≥100 mg/L) and an abnormal serum
    • FLC ratio (<0.26 or >1.65).
  • A male participant must agree to use contraception during the intervention period and for at least 150 days after the last dose of study drug and refrain from donating sperm during this period.
  • A female participant is eligible to participate if she is not pregnant, not breastfeeding, and at least one of the following conditions applies:

    • Not a woman of childbearing potential (WOCBP)
    • A WOCBP who agrees to follow the contraceptive guidance during the intervention period and for at least 150 days after the last dose of study intervention.

Exclusion criteria:

  • Participant is diagnosed or treated for another malignancy within 3 years prior to enrollment, with the exception of basal cell carcinoma or squamous cell carcinoma of the skin, an in situ malignancy, superficial bladder carcinoma or low risk prostate cancer.
  • Participant has an Eastern Cooperative Oncology Group (ECOG) performance status score >2.
  • Participant has a history of Chronic obstructive pulmonary disease (COPD) or asthma.
  • Participant has not recovered from adverse reactions to prior myeloma treatment or procedures (chemotherapy, immunotherapy, radiation therapy) to NCI CTCAE Grade ≤1 or baseline (exception: alopecia).
  • Participant has congestive heart failure (New York Heart Association) Grade ≥II; cardiac myopathy, active ischemia, or any other uncontrolled cardiac condition such as angina pectoris, clinically significant arrhythmia requiring therapy including anticoagulants, or clinically significant uncontrolled hypertension, QT interval corrected by the Fridericia method >480 msec (Grade ≥2).
  • Participant has had acute myocardial infarction within 6 months before first dose of study medication.
  • Participant has ongoing sensory or motor neuropathy of National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) Grade ≥3.
  • Participant has active autoimmune disease including autoimmune hemolytic anemia, idiopathic thrombocytopenic purpura, inflammatory bowel syndrome, pneumonitis or any chronic condition requiring a higher corticosteroid systemic equivalent than prednisone 10 mg daily.
  • Known acquired immunodeficiency syndrome (AIDS) or related illnesses or human immunodeficiency virus (HIV) disease requiring antiretroviral treatment, or to have active hepatitis A, B (defined as a known positive hepatitis B surface antigen (HBsAg) result or positive HepB DNA), or C (defined as a known quantitative hepatitis C [HCV] ribonucleic acid RNA results greater than the lower limits of detection of the assay or positive HCV antigen) infection.
  • Participant has positive Coombs test at baseline.

The above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.

Contacts and Locations

Contacts
Layout table for location contacts
Contact: Trial Transparency email recommended (Toll free number for US & Canada) 800-633-1610 ext Option 6 Contact-US@sanofi.com

Locations
Layout table for location information
United States, California
Investigational Site Number 8400002 Recruiting
Duarte, California, United States, 91010
United States, Massachusetts
Investigational Site Number 8400003 Recruiting
Boston, Massachusetts, United States, 02115
United States, Minnesota
Investigational Site Number 8400005 Recruiting
Rochester, Minnesota, United States, 55905
United States, New York
Investigational Site Number 8400001 Recruiting
New York, New York, United States, 10029-6504
United States, North Carolina
Investigational Site Number 8400006 Recruiting
Chapel Hill, North Carolina, United States, 27599
United States, Wisconsin
Investigational Site Number 8400004 Recruiting
Milwaukee, Wisconsin, United States, 53226
Czechia
Investigational Site Number 2030002 Recruiting
Brno, Czechia, 62500
Investigational Site Number 2030003 Recruiting
Ostrava - Poruba, Czechia, 70852
Investigational Site Number 2030001 Recruiting
Praha 2, Czechia, 12808
France
Investigational Site Number 2500001 Recruiting
Toulouse Cedex 9, France, 31059
Greece
Investigational Site Number 3000001 Recruiting
Athens, Greece, 11528
Spain
Investigational Site Number 7240002 Recruiting
Hospitalet De Llobregat, Spain, 08908
Investigational Site Number 7240001 Recruiting
Salamanca, Spain, 37007
Sponsors and Collaborators
Sanofi
Investigators
Layout table for investigator information
Study Director: Clinical Sciences & Operations Sanofi
Tracking Information
First Submitted Date  ICMJE June 11, 2019
First Posted Date  ICMJE June 27, 2019
Last Update Posted Date March 16, 2021
Actual Study Start Date  ICMJE August 19, 2019
Estimated Primary Completion Date May 2023   (Final data collection date for primary outcome measure)
Current Primary Outcome Measures  ICMJE
 (submitted: June 25, 2019)
  • The maximum tolerated dose (MTD) of SAR442085 (Part A) [ Time Frame: At the end of Cycle 1 (each cycle is approximately 28 days) ]
    MTD is defined as the dose level with highest probability of investigational medicinal product (IMP) related dose limiting toxicity (DLT) rate within the target range (16 to 33%) among dose levels with less than 0.25 probability of DLT rate above target (>33%)
  • Recommended Phase 2 dose (RP2D) (Part A) [ Time Frame: At the end of Cycle 1 (each cycle is approximately 28 days) ]
    RP2D is defined as the dose selected for the further single agent testing - including in Phase 1 expansion part B.
  • Overall response rate (Part B) [ Time Frame: approximately 6 months after the last patient has started treatment in Part B (approx. 2 years) ]
    Overall response rate (ORR): is defined as the proportion of patients with stringent complete response (sCR), complete response (CR), very good partial response (VGPR), and partial response (PR), using the International Myeloma Working Group (IMWG) criteria.
Original Primary Outcome Measures  ICMJE Same as current
Change History
Current Secondary Outcome Measures  ICMJE
 (submitted: June 25, 2019)
  • Treatment-emergent adverse events (AEs)/serious adverse events (SAE) (Both Part A and B) [ Time Frame: From baseline to end of treatment + 30 days (approx. 2 years) ]
    Number of participants with Treatment-Emergent Adverse events (TEAEs) from baseline to End of Study.
  • PK parameters of SAR442085: Cmax (Both Part A and B) [ Time Frame: Cycle 1 Day 1 to Day 28 ]
    Maximum plasma concentration observed (Cmax).
  • PK parameters of SAR442085: Tmax (Both Part A and B) [ Time Frame: Cycle 1 Day 1 to Day 28 ]
    First time to reach Cmax (tmax).
  • PK parameters of SAR442085: AUC (Both Part A and B) [ Time Frame: Cycle 1 Day 1 to Day 28 ]
    Area under the plasma concentration versus time curve extrapolated to infinity (AUC).
  • Anti-drug antibody (ADA) against SAR442085 (Both Part A and B) [ Time Frame: Cycle 1, 2, 3, 6 and 9 (each cycle is approximately 28 days) ]
    Number of participants with ADA against SAR442085.
  • Progression-free survival (Part B) [ Time Frame: approximately 12 months after the last patient has started treatment in Part B (approx. 2 years) ]
    Progression-free survival (PFS) is defined as the time interval from the date of enrollment to the date of documented tumor progression as per IMWG or death (due to any cause), whichever comes first.
  • Duration of response (Part B) [ Time Frame: approximately 12 months after the last patient has started treatment in Part B (approx. 2 years) ]
    Duration of response (DOR) is defined as the time from first documented evidence of CR or PR until progressive disease (PD) as per IMWG or death from any cause, whichever occurs first.
Original Secondary Outcome Measures  ICMJE Same as current
Current Other Pre-specified Outcome Measures Not Provided
Original Other Pre-specified Outcome Measures Not Provided
 
Descriptive Information
Brief Title  ICMJE First-in-human Single Agent Study of SAR442085 in Relapsed or Refractory Multiple Myeloma
Official Title  ICMJE An Open-label, First-in-human, Single Agent, Dose-escalation and Expansion Study for the Evaluation of Safety, Pharmacokinetics, Pharmacodynamics and Anti-tumor Activity of SAR442085 in Patients With Relapsed or Refractory Multiple Myeloma (RRMM)
Brief Summary

Primary Objectives:

  • Dose Escalation Part A: To determine the maximum tolerated dose (MTD) of SAR442085 administered as a single agent in patients with relapsed or refractory multiple myeloma (RRMM), and determine the recommended Phase 2 dose (RP2D) for the subsequent Expansion Part B
  • Dose Expansion Part B: To assess the antitumor activity of single agent of SAR442085 at the RP2D in patients with RRMM

Secondary Objectives:

  • To characterize the safety profile of SAR442085
  • To characterize the pharmacokinetics (PK) profile of SAR442085 when administered as a single agent
  • To evaluate the potential immunogenicity of SAR442085
  • To assess preliminary evidence of antitumor activity in the Dose Escalation Part A
Detailed Description Patient will continue to receive study medication until disease progression, unacceptable toxicity, withdrawal of informed consent, or other reason why investigator considers it appropriate to discontinue study medication. Once permanently discontinued, study medication cannot be restarted at later timepoint.
Study Type  ICMJE Interventional
Study Phase  ICMJE Phase 1
Study Design  ICMJE Allocation: Non-Randomized
Intervention Model: Sequential Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Condition  ICMJE Plasma Cell Myeloma
Intervention  ICMJE Drug: SAR442085
Pharmaceutical form:Sterile lyophilized powder for reconstitution for infusion Route of administration: intravenous
Study Arms  ICMJE
  • Experimental: Part A: SAR442085 dose escalation
    SAR442085 will be given intravenously weekly for 4 weeks (Cycle 1) and on Day 1 and Day 15 of each subsequent cycle until the patient has progressive disease, unacceptable toxicity or other reasons to terminate study treatment. Each cycle will be approximately 28 days in duration.
    Intervention: Drug: SAR442085
  • Experimental: Part B: SAR442085 dose expansion
    SAR442085 will be given intravenously weekly for 4 weeks (Cycle 1) and on Day 1 and Day 15 of each subsequent cycle until the patient has progressive disease, unacceptable toxicity or other reasons to terminate study treatment. Each cycle will be approximately 28 days in duration.
    Intervention: Drug: SAR442085
Publications * Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruitment Information
Recruitment Status  ICMJE Recruiting
Estimated Enrollment  ICMJE
 (submitted: June 25, 2019)
78
Original Estimated Enrollment  ICMJE Same as current
Estimated Study Completion Date  ICMJE May 2023
Estimated Primary Completion Date May 2023   (Final data collection date for primary outcome measure)
Eligibility Criteria  ICMJE

Inclusion criteria :

  • Participant must be at least 18 years of age or of the country's legal age of majority if the legal age is >18 years old, at the time of signing the informed consent.
  • Participant has given voluntary written informed consent.
  • Participant has been previousy diagnosed with multiple myeloma based on standard criteria.
  • Part A: (1) participant has received at least 3 prior lines of therapy for multiple myeloma, or at least 2 prior lines of therapy if at least 1 of those lines consisted of 2 or more multi-agent regimens (eg, multi-agent induction regimen with autologous stem cell transplantation, followed by maintenance regimen). (2) Prior therapy for multiple myeloma has included at least 1 proteasome inhibitor (bortezomib, carfilzomib, ixazomib), at least 1 immunomodulatory agent (lenalidomide, thalidomide, pomalidomide), at least 1 anti-CD38 monoclonal antibody and at least 1 steroid. Applicable countries in EU and Asia can enroll anti-CD38 naive RRMM patients from DL4 and onwards. (3) Participant had at least a minimal response (MR) to the anti-CD38 antibody containing regimen and had last dose of anti-CD38 monoclonal antibody at least 9 months prior to study entry. Applicable countries in EU and Asia can enroll anti-CD38 naive RRMM patients from DL4 and onwards.
  • Part B and the last cohort(s) of Part A: (1) participant has received at least 3 prior lines of therapy for multiple myeloma, or at least 2 prior line of therapy if at least 1 of those lines consisted of 2 or more multi-agent regimens (eg, multi-agent induction regimen with autologous stem cell transplantation, followed by maintenance regimen). (2) Prior therapy for multiple myeloma has included at least 1 proteasome inhibitor (bortezomib, carfilzomib, ixazomib), at least 1 immunomodulatory agent (lenalidomide, thalidomide, pomalidomide) and at least 1 steroid. (3) Prior therapy has not included an anti-CD38 monoclonal antibody.
  • Participant has myeloma disease progression on or after last therapy.
  • Participant must have measurable disease as defined as at least one of the following:

    • Serum M protein ≥0.5 g/dL (≥5 g/L)
    • Urine M protein ≥200 mg/24 hours
    • Serum FLC assay: Involved FLC assay ≥10 mg/dL (≥100 mg/L) and an abnormal serum
    • FLC ratio (<0.26 or >1.65).
  • A male participant must agree to use contraception during the intervention period and for at least 150 days after the last dose of study drug and refrain from donating sperm during this period.
  • A female participant is eligible to participate if she is not pregnant, not breastfeeding, and at least one of the following conditions applies:

    • Not a woman of childbearing potential (WOCBP)
    • A WOCBP who agrees to follow the contraceptive guidance during the intervention period and for at least 150 days after the last dose of study intervention.

Exclusion criteria:

  • Participant is diagnosed or treated for another malignancy within 3 years prior to enrollment, with the exception of basal cell carcinoma or squamous cell carcinoma of the skin, an in situ malignancy, superficial bladder carcinoma or low risk prostate cancer.
  • Participant has an Eastern Cooperative Oncology Group (ECOG) performance status score >2.
  • Participant has a history of Chronic obstructive pulmonary disease (COPD) or asthma.
  • Participant has not recovered from adverse reactions to prior myeloma treatment or procedures (chemotherapy, immunotherapy, radiation therapy) to NCI CTCAE Grade ≤1 or baseline (exception: alopecia).
  • Participant has congestive heart failure (New York Heart Association) Grade ≥II; cardiac myopathy, active ischemia, or any other uncontrolled cardiac condition such as angina pectoris, clinically significant arrhythmia requiring therapy including anticoagulants, or clinically significant uncontrolled hypertension, QT interval corrected by the Fridericia method >480 msec (Grade ≥2).
  • Participant has had acute myocardial infarction within 6 months before first dose of study medication.
  • Participant has ongoing sensory or motor neuropathy of National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) Grade ≥3.
  • Participant has active autoimmune disease including autoimmune hemolytic anemia, idiopathic thrombocytopenic purpura, inflammatory bowel syndrome, pneumonitis or any chronic condition requiring a higher corticosteroid systemic equivalent than prednisone 10 mg daily.
  • Known acquired immunodeficiency syndrome (AIDS) or related illnesses or human immunodeficiency virus (HIV) disease requiring antiretroviral treatment, or to have active hepatitis A, B (defined as a known positive hepatitis B surface antigen (HBsAg) result or positive HepB DNA), or C (defined as a known quantitative hepatitis C [HCV] ribonucleic acid RNA results greater than the lower limits of detection of the assay or positive HCV antigen) infection.
  • Participant has positive Coombs test at baseline.

The above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.

Sex/Gender  ICMJE
Sexes Eligible for Study: All
Ages  ICMJE 18 Years and older   (Adult, Older Adult)
Accepts Healthy Volunteers  ICMJE No
Contacts  ICMJE
Contact: Trial Transparency email recommended (Toll free number for US & Canada) 800-633-1610 ext Option 6 Contact-US@sanofi.com
Listed Location Countries  ICMJE Czechia,   France,   Greece,   Spain,   United States
Removed Location Countries  
 
Administrative Information
NCT Number  ICMJE NCT04000282
Other Study ID Numbers  ICMJE TED16132
2019-001018-40 ( EudraCT Number )
U1111-1223-4410 ( Other Identifier: UTN )
Has Data Monitoring Committee No
U.S. FDA-regulated Product
Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
IPD Sharing Statement  ICMJE
Plan to Share IPD: Yes
Plan Description: Qualified researchers may request access to patient level data and related study documents including the clinical study report, study protocol with any amendments, blank case report form, statistical analysis plan, and dataset specifications. Patient level data will be anonymized and study documents will be redacted to protect the privacy of trial participants. Further details on Sanofi's data sharing criteria, eligible studies, and process for requesting access can be found at: https://www.clinicalstudydatarequest.com/
Responsible Party Sanofi
Study Sponsor  ICMJE Sanofi
Collaborators  ICMJE Not Provided
Investigators  ICMJE
Study Director: Clinical Sciences & Operations Sanofi
PRS Account Sanofi
Verification Date March 2021

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP

治疗医院