Ignite Creation Date:
2025-12-24 @ 3:52 PM
Ignite Modification Date:
2025-12-25 @ 1:58 PM
Study NCT ID:
NCT00054392
Status:
WITHDRAWN
Last Update Posted:
2013-07-11
First Post:
2003-02-05
Is NOT Gene Therapy:
True
Has Adverse Events:
False
Brief Title:
Combination Chemotherapy in Treating Patients With Stage IIIB, Stage IV, or Recurrent Non-Small Cell Lung Cancer
Sponsor:
Organization:
Raw JSON
{'hasResults': False, 'derivedSection': {'miscInfoModule': {'versionHolder': '2025-12-24'}, 'conditionBrowseModule': {'meshes': [{'id': 'D008175', 'term': 'Lung Neoplasms'}, {'id': 'D002282', 'term': 'Adenocarcinoma, Bronchiolo-Alveolar'}, {'id': 'D002289', 'term': 'Carcinoma, Non-Small-Cell Lung'}, {'id': 'D000077192', 'term': 'Adenocarcinoma of Lung'}], 'ancestors': [{'id': 'D012142', 'term': 'Respiratory Tract Neoplasms'}, {'id': 'D013899', 'term': 'Thoracic Neoplasms'}, {'id': 'D009371', 'term': 'Neoplasms by Site'}, {'id': 'D009369', 'term': 'Neoplasms'}, {'id': 'D008171', 'term': 'Lung Diseases'}, {'id': 'D012140', 'term': 'Respiratory Tract Diseases'}, {'id': 'D000230', 'term': 'Adenocarcinoma'}, {'id': 'D002277', 'term': 'Carcinoma'}, {'id': 'D009375', 'term': 'Neoplasms, Glandular and Epithelial'}, {'id': 'D009370', 'term': 'Neoplasms by Histologic Type'}, {'id': 'D002283', 'term': 'Carcinoma, Bronchogenic'}, {'id': 'D001984', 'term': 'Bronchial Neoplasms'}]}, 'interventionBrowseModule': {'meshes': [{'id': 'D016190', 'term': 'Carboplatin'}, {'id': 'D000093542', 'term': 'Gemcitabine'}, {'id': 'D017239', 'term': 'Paclitaxel'}], 'ancestors': [{'id': 'D056831', 'term': 'Coordination Complexes'}, {'id': 'D009930', 'term': 'Organic Chemicals'}, {'id': 'D006571', 'term': 'Heterocyclic Compounds'}, {'id': 'D003841', 'term': 'Deoxycytidine'}, {'id': 'D003562', 'term': 'Cytidine'}, {'id': 'D011741', 'term': 'Pyrimidine Nucleosides'}, {'id': 'D011743', 'term': 'Pyrimidines'}, {'id': 'D006573', 'term': 'Heterocyclic Compounds, 1-Ring'}, {'id': 'D043823', 'term': 'Taxoids'}, {'id': 'D043822', 'term': 'Cyclodecanes'}, {'id': 'D003516', 'term': 'Cycloparaffins'}, {'id': 'D006840', 'term': 'Hydrocarbons, Alicyclic'}, {'id': 'D006844', 'term': 'Hydrocarbons, Cyclic'}, {'id': 'D006838', 'term': 'Hydrocarbons'}, {'id': 'D004224', 'term': 'Diterpenes'}, {'id': 'D013729', 'term': 'Terpenes'}]}}, 'protocolSection': {'designModule': {'phases': ['PHASE3'], 'studyType': 'INTERVENTIONAL', 'designInfo': {'allocation': 'RANDOMIZED', 'primaryPurpose': 'TREATMENT'}, 'enrollmentInfo': {'type': 'ACTUAL', 'count': 0}}, 'statusModule': {'whyStopped': 'Not opened at Fox Chase Cancer Center', 'overallStatus': 'WITHDRAWN', 'startDateStruct': {'date': '2001-09'}, 'expandedAccessInfo': {'hasExpandedAccess': False}, 'statusVerifiedDate': '2013-07', 'completionDateStruct': {'date': '2001-09', 'type': 'ACTUAL'}, 'lastUpdateSubmitDate': '2013-07-10', 'studyFirstSubmitDate': '2003-02-05', 'studyFirstSubmitQcDate': '2003-02-05', 'lastUpdatePostDateStruct': {'date': '2013-07-11', 'type': 'ESTIMATED'}, 'studyFirstPostDateStruct': {'date': '2003-02-06', 'type': 'ESTIMATED'}, 'primaryCompletionDateStruct': {'date': '2001-09', 'type': 'ACTUAL'}}, 'outcomesModule': {'primaryOutcomes': [{'measure': 'Survival'}], 'secondaryOutcomes': [{'measure': 'Tumor response rate'}, {'measure': 'Time to disease progression'}, {'measure': 'Quality of life as measured by the Functional Assessment of Cancer -Lung (FACT-L) questionnaire at baseline, every 6 weeks during study treatment, and then every 3 months thereafter'}]}, 'conditionsModule': {'keywords': ['adenosquamous cell lung cancer', 'bronchoalveolar cell lung cancer', 'large cell lung cancer', 'recurrent non-small cell lung cancer', 'squamous cell lung cancer', 'stage IIIB non-small cell lung cancer', 'stage IV non-small cell lung cancer', 'adenocarcinoma of the lung'], 'conditions': ['Lung Cancer']}, 'referencesModule': {'references': [{'pmid': '20035187', 'type': 'RESULT', 'citation': 'Edelman MJ, Belani CP, Socinski MA, Ansari RH, Obasaju CK, Chen R, Monberg MJ, Treat J; Alpha Oncology Research Network. Outcomes associated with brain metastases in a three-arm phase III trial of gemcitabine-containing regimens versus paclitaxel plus carboplatin for advanced non-small cell lung cancer. J Thorac Oncol. 2010 Jan;5(1):110-6. doi: 10.1097/JTO.0b013e3181c59a3a.'}, {'pmid': '20593535', 'type': 'RESULT', 'citation': 'Obasaju CK, Ansari RH, Socinski MA, Chen R, Monberg MJ, Catalano RB, Marinucci DM, Liles DK, Ribeiro MJ, Comis RL, Treat J; Alpha Oncology Research Network. A Comparison of white and African American outcomes from a three-arm, randomized, phase III multicenter trial of advanced or metastatic non-small cell lung cancer. J Thorac Oncol. 2010 Jul;5(7):993-1000. doi: 10.1097/jto.0b013e3181e29cf3.'}, {'pmid': '19833819', 'type': 'RESULT', 'citation': 'Treat JA, Gonin R, Socinski MA, Edelman MJ, Catalano RB, Marinucci DM, Ansari R, Gillenwater HH, Rowland KM, Comis RL, Obasaju CK, Belani CP; Alpha Oncology Research Network. A randomized, phase III multicenter trial of gemcitabine in combination with carboplatin or paclitaxel versus paclitaxel plus carboplatin in patients with advanced or metastatic non-small-cell lung cancer. Ann Oncol. 2010 Mar;21(3):540-547. doi: 10.1093/annonc/mdp352. Epub 2009 Oct 15.'}, {'pmid': '20347506', 'type': 'RESULT', 'citation': 'Treat J, Edelman MJ, Belani CP, Socinski MA, Monberg MJ, Chen R, Obasaju CK; Alpha Oncology Research Network. A retrospective analysis of outcomes across histological subgroups in a three-arm phase III trial of gemcitabine in combination with carboplatin or paclitaxel versus paclitaxel plus carboplatin for advanced non-small cell lung cancer. Lung Cancer. 2010 Dec;70(3):340-6. doi: 10.1016/j.lungcan.2010.02.011. Epub 2010 Mar 27.'}, {'type': 'RESULT', 'citation': 'Treat J, Belani CP, Edelman MJ, et al.: A randomized phase III trial of gemcitabine (G) in combination with carboplatin (C) or paclitaxel (P) versus paclitaxel plus carboplatin in advanced (Stage IIIB, IV) non-small cell lung cancer (NSCLC): update of the Alpha Oncology trial (A1-99002L). [Abstract] J Clin Oncol 23 (Suppl 16): A-LBA7025, 627s, 2005.'}]}, 'descriptionModule': {'briefSummary': 'RATIONALE: Drugs used in chemotherapy such as gemcitabine, carboplatin, and paclitaxel use different ways to stop tumor cells from dividing so they stop growing or die. Combining more than one drug may kill more tumor cells. It is not yet known which chemotherapy regimen is more effective in treating non-small cell lung cancer.\n\nPURPOSE: Randomized phase III trial to compare the effectiveness of different combination chemotherapy regimens in treating patients who have stage IIIB, stage IV, or recurrent non-small cell lung cancer.', 'detailedDescription': 'OBJECTIVES:\n\n* Compare the overall survival of patients with stage IIIB or IV or recurrent non-small cell lung cancer treated with gemcitabine and carboplatin vs gemcitabine and paclitaxel vs paclitaxel and carboplatin.\n* Compare the overall response rate and time to progression in patients treated with these regimens.\n* Compare the toxic effects of these regimens in these patients.\n* Compare the quality of life of patients treated with these regimens.\n\nOUTLINE: This is a randomized, multicenter study. Patients are stratified according to weight loss within the past 6 months (less than 5% vs at least 5%), disease stage (IIIB vs IV), and brain metastases (present vs absent). Patients are randomized to 1 of 3 treatment arms.\n\n* Arm I: Patients receive gemcitabine IV over 30 minutes on days 1 and 8 and carboplatin IV over 15-30 minutes on day 1.\n* Arm II: Patients receive gemcitabine IV over 30 minutes on days 1 and 8 and paclitaxel IV over 3 hours on day 1.\n* Arm III: Patients receive paclitaxel IV over 3 hours and carboplatin IV over 15-30 minutes on day 1.\n\nIn all arms, treatment repeats every 3 weeks for up to 6 courses in the absence of disease progression or unacceptable toxicity.\n\nQuality of life is assessed at baseline, every 6 weeks during study treatment, and then every 3 months until progressive disease is documented.\n\nPatients are followed every 3 months.\n\nPROJECTED ACCRUAL: A total of 1,134 patients (378 per treatment arm) will be accrued for this study within 2 years.'}, 'eligibilityModule': {'sex': 'ALL', 'stdAges': ['ADULT', 'OLDER_ADULT'], 'minimumAge': '18 Years', 'healthyVolunteers': False, 'eligibilityCriteria': 'DISEASE CHARACTERISTICS:\n\n* Histologically confirmed non-small cell lung cancer (NSCLC) of 1 of the following types:\n\n * Squamous cell\n * Adenocarcinoma\n * Large cell anaplastic\n * Bronchoalveolar\n * Non-small cell carcinoma not otherwise specified NOTE: Mixed tumors are categorized by the predominant cell type (tumors with small-cell anaplastic elements are ineligible)\n* Evidence of at least 1 of the following:\n\n * Clinically documented recurrent disease after prior radiation or surgery\n * Stage IV disease (distant metastases)\n * Stage IIIB disease presenting with 1 of the following:\n\n * Pleural or pericardial effusion by CT scan or chest x-ray\n * Pleural implants documented pathologically or seen on CT scan or x-ray\n* Measurable or evaluable disease\n* No brain metastases unless clinically stable after surgery and/or radiotherapy\n\nPATIENT CHARACTERISTICS:\n\nAge\n\n* 18 and over\n\nPerformance status\n\n* ECOG 0-1\n\nLife expectancy\n\n* Not specified\n\nHematopoietic\n\n* Absolute neutrophil count at least 1,500/mm\\^3\n* Platelet count at least 100,000/mm\\^3\n\nHepatic\n\n* Bilirubin no greater than 1.5 mg/dL\n* AST less than 5 times upper limit of normal\n\nRenal\n\n* Creatinine no greater than 1.5 mg/dL OR\n* Creatinine clearance at least 40 mL/min\n\nOther\n\n* Not pregnant or nursing\n* Negative pregnancy test\n* Fertile patients must use effective contraception\n* No hypersensitivity to agents that contain Cremophor EL (polyoxyethylated castor oil)\n\nPRIOR CONCURRENT THERAPY:\n\nBiologic therapy\n\n* Not specified\n\nChemotherapy\n\n* No prior chemotherapy for advanced NSCLC\n\nEndocrine therapy\n\n* Not specified\n\nRadiotherapy\n\n* See Disease Characteristics\n* Recovered from prior radiotherapy\n* No prior radiotherapy to the only site of measurable disease, unless the site had subsequent progression of disease documented by physical exam, radiography, or pathology\n* No concurrent radiotherapy (except for brain metastases)\n\nSurgery\n\n* See Disease Characteristics\n\nOther\n\n* No concurrent aminoglycoside antibiotics'}, 'identificationModule': {'nctId': 'NCT00054392', 'briefTitle': 'Combination Chemotherapy in Treating Patients With Stage IIIB, Stage IV, or Recurrent Non-Small Cell Lung Cancer', 'organization': {'class': 'OTHER', 'fullName': 'Fox Chase Cancer Center'}, 'officialTitle': 'A Randomized, Phase III Multicenter Trial Of Gemcitabine In Combination With Carboplatin Or Paclitaxel Plus Carboplatin In Patients With Metastatic (Stage IIIB, IV) Non-Small Cell Lung Cancer', 'orgStudyIdInfo': {'id': 'ALPHA-A1-99002L'}, 'secondaryIdInfos': [{'id': 'CDR0000270434', 'type': 'REGISTRY', 'domain': 'PDQ (Physician Data Query)'}]}, 'armsInterventionsModule': {'interventions': [{'name': 'carboplatin', 'type': 'DRUG'}, {'name': 'gemcitabine hydrochloride', 'type': 'DRUG'}, {'name': 'paclitaxel', 'type': 'DRUG'}]}, 'contactsLocationsModule': {'locations': [{'zip': '92354', 'city': 'Loma Linda', 'state': 'California', 'country': 'United States', 'facility': 'Loma Linda University Cancer Institute at Loma Linda University Medical Center', 'geoPoint': {'lat': 34.04835, 'lon': -117.26115}}, {'zip': '91767', 'city': 'Pomona', 'state': 'California', 'country': 'United States', 'facility': 'New Hope Cancer and Research Institute - Pomona', 'geoPoint': {'lat': 34.05529, 'lon': -117.75228}}, {'zip': '06320', 'city': 'New London', 'state': 'Connecticut', 'country': 'United States', 'facility': 'Lawrence and Memorial Hospital', 'geoPoint': {'lat': 41.35565, 'lon': -72.09952}}, {'zip': '32610-0383', 'city': 'Gainesville', 'state': 'Florida', 'country': 'United States', 'facility': 'University of Florida Shands Cancer Center', 'geoPoint': {'lat': 29.65163, 'lon': -82.32483}}, {'zip': '33805', 'city': 'Lakeland', 'state': 'Florida', 'country': 'United States', 'facility': 'Lakeland Regional Cancer Center at Lakeland Regional Medical Center', 'geoPoint': {'lat': 28.03947, 'lon': -81.9498}}, {'zip': '32405-4587', 'city': 'Panama City', 'state': 'Florida', 'country': 'United States', 'facility': 'Gulf Coast Cancer Treatment Center', 'geoPoint': {'lat': 30.15946, 'lon': -85.65983}}, {'zip': '30033', 'city': 'Decatur', 'state': 'Georgia', 'country': 'United States', 'facility': 'Veterans Affairs Medical Center - Atlanta (Decatur)', 'geoPoint': {'lat': 33.77483, 'lon': -84.29631}}, {'zip': '60426', 'city': 'Harvey', 'state': 'Illinois', 'country': 'United States', 'facility': 'Ingalls Cancer Care Center at Ingalls Memorial Hospital', 'geoPoint': {'lat': 41.61003, 'lon': -87.64671}}, {'zip': '61801', 'city': 'Urbana', 'state': 'Illinois', 'country': 'United States', 'facility': 'Carle Cancer Center at Carle Foundation Hospital', 'geoPoint': {'lat': 40.11059, 'lon': -88.20727}}, {'zip': '47150', 'city': 'New Albany', 'state': 'Indiana', 'country': 'United States', 'facility': 'Cancer Center of Indiana', 'geoPoint': {'lat': 38.28562, 'lon': -85.82413}}, {'zip': '46601', 'city': 'South Bend', 'state': 'Indiana', 'country': 'United States', 'facility': 'CCOP - 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Chapel Hill', 'geoPoint': {'lat': 35.9132, 'lon': -79.05584}}, {'zip': '28302-2000', 'city': 'Fayetteville', 'state': 'North Carolina', 'country': 'United States', 'facility': 'Cape Fear Valley Medical Center', 'geoPoint': {'lat': 35.05266, 'lon': -78.87836}}, {'zip': '27834', 'city': 'Greenville', 'state': 'North Carolina', 'country': 'United States', 'facility': 'Leo W. Jenkins Cancer Center at ECU Medical School', 'geoPoint': {'lat': 35.61266, 'lon': -77.36635}}, {'zip': '44710-1799', 'city': 'Canton', 'state': 'Ohio', 'country': 'United States', 'facility': 'Aultman Hospital Cancer Center at Aultman Health Foundation', 'geoPoint': {'lat': 40.79895, 'lon': -81.37845}}, {'zip': '44111', 'city': 'Cleveland', 'state': 'Ohio', 'country': 'United States', 'facility': 'Cleveland Clinic Cancer Center at Fairview Hospital', 'geoPoint': {'lat': 41.4995, 'lon': -81.69541}}, {'zip': '44195', 'city': 'Cleveland', 'state': 'Ohio', 'country': 'United States', 'facility': 'Cleveland Clinic Taussig Cancer Center', 'geoPoint': {'lat': 41.4995, 'lon': -81.69541}}, {'zip': '44129', 'city': 'Parma', 'state': 'Ohio', 'country': 'United States', 'facility': 'Parma Community General Hospital', 'geoPoint': {'lat': 41.40477, 'lon': -81.72291}}, {'zip': '19001', 'city': 'Abington', 'state': 'Pennsylvania', 'country': 'United States', 'facility': 'Rosenfeld Cancer Center at Abington Memorial Hospital', 'geoPoint': {'lat': 40.12067, 'lon': -75.11795}}, {'zip': '17201', 'city': 'Chambersburg', 'state': 'Pennsylvania', 'country': 'United States', 'facility': 'Falling Spring Medical Associates', 'geoPoint': {'lat': 39.93759, 'lon': -77.6611}}, {'zip': '18512', 'city': 'Dunmore', 'state': 'Pennsylvania', 'country': 'United States', 'facility': 'Hematology-Oncology Associates of Northeastern Pennsylvania', 'geoPoint': {'lat': 41.4198, 'lon': -75.63241}}, {'zip': '17110', 'city': 'Harrisburg', 'state': 'Pennsylvania', 'country': 'United States', 'facility': 'PinnacleHealth Regional Cancer Center at Polyclinic Hospital', 'geoPoint': {'lat': 40.2737, 'lon': -76.88442}}, {'zip': '16201', 'city': 'Kittanning', 'state': 'Pennsylvania', 'country': 'United States', 'facility': 'Richard G. Laube Cancer Center at ACMH', 'geoPoint': {'lat': 40.81645, 'lon': -79.52199}}, {'zip': '17605-0396', 'city': 'Lancaster', 'state': 'Pennsylvania', 'country': 'United States', 'facility': 'Lancaster Cancer Center', 'geoPoint': {'lat': 40.03788, 'lon': -76.30551}}, {'zip': '17043', 'city': 'Lemoyne', 'state': 'Pennsylvania', 'country': 'United States', 'facility': 'Central Pennsylvania Hematology and Medical Oncology Associates, PC', 'geoPoint': {'lat': 40.2412, 'lon': -76.89414}}, {'zip': '19301', 'city': 'Paoli', 'state': 'Pennsylvania', 'country': 'United States', 'facility': 'Paoli Hematology-Oncology PC at Paoli Memorial Hospital', 'geoPoint': {'lat': 40.04205, 'lon': -75.47631}}, {'zip': '19102-1192', 'city': 'Philadelphia', 'state': 'Pennsylvania', 'country': 'United States', 'facility': 'Hahnemann University Hospital', 'geoPoint': {'lat': 39.95238, 'lon': -75.16362}}, {'zip': '19102', 'city': 'Philadelphia', 'state': 'Pennsylvania', 'country': 'United States', 'facility': 'Drexel University College of Medicine - Center City Hahnemann Campus', 'geoPoint': {'lat': 39.95238, 'lon': -75.16362}}, {'zip': '19104-4283', 'city': 'Philadelphia', 'state': 'Pennsylvania', 'country': 'United States', 'facility': 'Fox Chase Cancer Center CCOP Research Base', 'geoPoint': {'lat': 39.95238, 'lon': -75.16362}}, {'zip': '19106', 'city': 'Philadelphia', 'state': 'Pennsylvania', 'country': 'United States', 'facility': 'Pennsylvania Oncology Hematology Associates, Incorporated - Philadelphia', 'geoPoint': {'lat': 39.95238, 'lon': -75.16362}}, {'zip': '19107-5541', 'city': 'Philadelphia', 'state': 'Pennsylvania', 'country': 'United States', 'facility': 'Kimmel Cancer Center at Thomas Jefferson University - Philadelphia', 'geoPoint': {'lat': 39.95238, 'lon': -75.16362}}, {'zip': '15212-4772', 'city': 'Pittsburgh', 'state': 'Pennsylvania', 'country': 'United States', 'facility': 'Allegheny Cancer Center at Allegheny General Hospital', 'geoPoint': {'lat': 40.44062, 'lon': -79.99589}}, {'zip': '15232', 'city': 'Pittsburgh', 'state': 'Pennsylvania', 'country': 'United States', 'facility': 'Hillman Cancer Center at University of Pittsburgh Cancer Institute', 'geoPoint': {'lat': 40.44062, 'lon': -79.99589}}, {'zip': '19464', 'city': 'Pottstown', 'state': 'Pennsylvania', 'country': 'United States', 'facility': 'Pottstown Memorial Regional Cancer Center', 'geoPoint': {'lat': 40.24537, 'lon': -75.64963}}, {'zip': '19603', 'city': 'Reading', 'state': 'Pennsylvania', 'country': 'United States', 'facility': 'St. Joseph Medical Center', 'geoPoint': {'lat': 40.33565, 'lon': -75.92687}}, {'zip': '19096', 'city': 'Wynnewood', 'state': 'Pennsylvania', 'country': 'United States', 'facility': 'Lankenau Cancer Center at Lankenau Hospital', 'geoPoint': {'lat': 40.00289, 'lon': -75.27074}}, {'zip': '29210', 'city': 'Columbia', 'state': 'South Carolina', 'country': 'United States', 'facility': 'South Carolina Oncology Associates, PA', 'geoPoint': {'lat': 34.00071, 'lon': -81.03481}}, {'zip': '29572', 'city': 'Myrtle Beach', 'state': 'South Carolina', 'country': 'United States', 'facility': 'Coastal Cancer Center - Myrtle Beach', 'geoPoint': {'lat': 33.68906, 'lon': -78.88669}}, {'zip': '38077', 'city': 'Collierville', 'state': 'Tennessee', 'country': 'United States', 'facility': 'Family Cancer Center, PLLC - Collierville', 'geoPoint': {'lat': 35.04204, 'lon': -89.66453}}, {'zip': '37901', 'city': 'Knoxville', 'state': 'Tennessee', 'country': 'United States', 'facility': 'Baptist Regional Cancer Center at Baptist Hospital of East Tennessee', 'geoPoint': {'lat': 35.96064, 'lon': -83.92074}}, {'zip': '22908', 'city': 'Charlottesville', 'state': 'Virginia', 'country': 'United States', 'facility': 'University of Virginia Cancer Center at UV Health System', 'geoPoint': {'lat': 38.02931, 'lon': -78.47668}}, {'zip': '25304-1297', 'city': 'Charleston', 'state': 'West Virginia', 'country': 'United States', 'facility': 'David Lee Outpatient Cancer Center at Charleston Area Medical Center', 'geoPoint': {'lat': 38.34982, 'lon': -81.63262}}, {'zip': '26505', 'city': 'Morgantown', 'state': 'West Virginia', 'country': 'United States', 'facility': 'Morgantown Internal Medicine Group, Incorporated', 'geoPoint': {'lat': 39.62953, 'lon': -79.9559}}, {'zip': '26506-9162', 'city': 'Morgantown', 'state': 'West Virginia', 'country': 'United States', 'facility': 'Mary Babb Randolph Cancer Center at West Virginia University Hospitals', 'geoPoint': {'lat': 39.62953, 'lon': -79.9559}}], 'overallOfficials': [{'name': 'Joseph A. Treat, MD', 'role': 'STUDY_CHAIR', 'affiliation': 'Fox Chase Cancer Center'}]}, 'sponsorCollaboratorsModule': {'leadSponsor': {'name': 'Fox Chase Cancer Center', 'class': 'OTHER'}, 'collaborators': [{'name': 'National Cancer Institute (NCI)', 'class': 'NIH'}]}}}