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NCT00879086

A Study Comparing Eribulin Mesylate and Ixabepilone in Causing or Exacerbating Neuropathy in Participants With Advanced Breast Cancer

Version 0 to 1 · Eisai Inc.

Patch inspector

Version 0 to 1

34 operations 7 path groups ctgov_internal_history
ClinicalTrials.gov
Severity is deterministic uncalibrated triage metadata, not validated review priority. Operation-level severity is inferred from deterministic path rules. Rule matches shown per operation are approximate previews (they skip the pipeline's suppression passes); the authoritative classification is the stored event record.
Plain-language summary

Manual review pending.

Rules fired
arms_or_interventions_changecontact_admin_changeeligibility_criteria_changeprimary_outcome_any_changesecondary_outcome_any_change
Value signals
[
  {
    "path": "/protocolSection/statusModule/completionDateStruct",
    "reason": "date_unparsed_or_missing",
    "signal": "timeline_shift",
    "category": "timeline_shift",
    "new_type": "ESTIMATED",
    "old_type": null,
    "severity": "medium",
    "direction": "unknown",
    "new_value": "2011-11",
    "old_value": null,
    "date_struct": "completionDateStruct"
  }
]
Provenance
Source
ctgov_internal_history
Fetched
2026-06-18 18:44:30+00
Raw hash
4bdb0e01238955744e10488ff54c852ae7ef3cd076fbf8dfc7acf5425fde9603
Payload
Source URL
Primary outcomes Outcome measures that define the trial's primary evidence target. Triage: Critical 2 ops
replace /protocolSection/outcomesModule/primaryOutcomes/0/measure
Triage: Critical
Primary Outcome Change Operation 9
Matched rules
  • primary_outcome_any_change Any add/remove/replace under primary outcome measures is critical review priority.
Before
Neuropathy adverse events (AEs) graded according to NCI CTCAE (version 3.0) and coded according to the current version of Medical Dictionary for Regulatory Activities (MedDRA).
After
Percent of subjects with neuropathy adverse events (AEs) graded according to NCI CTCAE (version 3.0) and coded according to the current version of Medical Dictionary for Regulatory Activities (MedDRA).
replace /protocolSection/outcomesModule/primaryOutcomes/0/timeFrame
Triage: Critical
Primary Outcome Change Operation 10
Matched rules
  • primary_outcome_any_change Any add/remove/replace under primary outcome measures is critical review priority.
Before
Neuropathy assessments are performed at the start of Cycles 2-6 and subsequently at every third cycle, end-of-treatment visit, and posttreatment follow-up.
After
Neuropathy assessments are performed at the start of Cycles 2-6 and subsequently at every third cycle, end-of-treatment visit, and post-treatment follow-up.
Design Trial model, phase, allocation, masking, arms, or interventions. Triage: High 3 ops
replace /protocolSection/armsInterventionsModule/armGroups/0/interventionNames/0
Triage: High
Arm Intervention Change Operation 6
Matched rules
  • arms_or_interventions_change Arms or interventions changes can alter treatment/comparator structure.
Before
Drug: eribulin mesylate (E7389)
After
Drug: eribulin mesylate
replace /protocolSection/armsInterventionsModule/interventions/0/name
Triage: High
Arm Intervention Change Operation 7
Matched rules
  • arms_or_interventions_change Arms or interventions changes can alter treatment/comparator structure.
Before
eribulin mesylate (E7389)
After
eribulin mesylate
replace /protocolSection/armsInterventionsModule/interventions/1/description
Triage: High
Arm Intervention Change Operation 8
Matched rules
  • arms_or_interventions_change Arms or interventions changes can alter treatment/comparator structure.
Before
<p>ixabepilone given at a starting dose of 32 or 40 mg&#x2F;m^2 (as per approved labeling) as a 3-hour IV infusion on Day 1 of a 21-day cycle.</p><p>The Treatment Phase will include six cycles.
Patients may enter the Extension Phase for additional cycles following the sixth cycle of treatment.</p>
After
<p>Ixabepilone given at a starting dose of 32 or 40 mg&#x2F;m^2 (as per approved labeling) as a 3-hour IV infusion on Day 1 of a 21-day cycle.</p><p>The Treatment Phase will include six cycles.
Patients may enter the Extension Phase for additional cycles following the sixth cycle of treatment.</p>
Eligibility Criteria and population definition changes. Triage: High 1 ops
replace /protocolSection/eligibilityModule/eligibilityCriteria
Triage: High
Eligibility Change Operation 16
Matched rules
  • eligibility_criteria_change Eligibility criteria changes can alter the studied population.
Before
<p>Inclusion criteria:</p><p>1. Female patients with locally recurrent or metastatic disease who have received prior taxane therapy and at least one prior cytotoxic chemotherapy regimen for advanced disease.</p><p>Exclusion criteria:</p><ol><li>Prior ixabepilone therapy.</li><li>Prior participation in an eribulin clinical study, even if not assigned to eribulin treatment.</li><li>Pre-existing neuropathy Grade ≥ 2.</li><li>Diabetes mellitus Type 1 or 2.</li><li>Bilateral mastectomy which included bilateral axillary lymph node dissection.
Missing digits required for vibration assessment.
Any other concurrent diseases or conditions that would be expected to interfere with neuropathy assessments, which may include vitamin deficiency, sequelae of cerebrovascular disease, thyroid insufficiency, lumbar or cervical radiculopathy, or alcoholic or inflammatory neuropathy.</li></ol>
After
<p>Inclusion criteria:</p><p>1. Female subjects with confirmed locally recurrent or metastatic carcinoma of the breast who have received prior taxane therapy and at least one prior cytotoxic chemotherapy regimen for advanced disease.</p><p>Exclusion criteria:</p><ol><li>Subjects who have received prior ixabepilone therapy.</li><li>Subjects with prior participation in an eribulin clinical study, even if not assigned to eribulin treatment.</li><li>Subjects with pre-existing neuropathy Grade ≥ 2.</li><li>Subjects with a history of diabetes mellitus Type 1 or 2.</li><li>Subjects with bilateral mastectomy which included bilateral axillary lymph node dissection.
Subjects with missing digits required for vibration assessment.
Subjects with any other concurrent diseases or conditions that would be expected to interfere with neuropathy assessments, which may include vitamin deficiency, sequelae of cerebrovascular disease, thyroid insufficiency, lumbar or cervical radiculopathy, or alcoholic or inflammatory neuropathy.</li></ol>
Secondary outcomes Additional endpoints and outcome descriptions. Triage: High 5 ops
replace /protocolSection/outcomesModule/secondaryOutcomes/0/timeFrame
Triage: High
Secondary Outcome Change Operation 11
Matched rules
  • secondary_outcome_any_change Any add/remove/replace under secondary outcome measures is high review priority.
Before
Assessments are performed at the start of Cycles 2-6 and every third cycle, end-of-treatment visit, and posttreatment follow-up.
After
Assessments are performed at the start of Cycles 2-6 and every third cycle, end-of-treatment visit, and post-treatment follow-up.
replace /protocolSection/outcomesModule/secondaryOutcomes/1/timeFrame
Triage: High
Secondary Outcome Change Operation 12
Matched rules
  • secondary_outcome_any_change Any add/remove/replace under secondary outcome measures is high review priority.
Before
From the time subject is consented to when she completes the either 21 day or 42 day posttreatment follow up visit.
After
From the time subject is consented to when she completes the either 21 day or 42 day post-treatment follow-up visit.
replace /protocolSection/outcomesModule/secondaryOutcomes/2/timeFrame
Triage: High
Secondary Outcome Change Operation 13
Matched rules
  • secondary_outcome_any_change Any add/remove/replace under secondary outcome measures is high review priority.
Before
Safety is assessed from the time subject is consented to when she completes the either 21 day or 42 day post treatment follow up visit.
After
Safety is assessed from the time subject is consented to when she completes the either 21 day or 42 day post-treatment follow-up visit.
replace /protocolSection/outcomesModule/secondaryOutcomes/3/measure
Triage: High
Secondary Outcome Change Operation 14
Matched rules
  • secondary_outcome_any_change Any add/remove/replace under secondary outcome measures is high review priority.
Before
Response rate, clinical benefit rate and progression-free survival based on investigator assessments according to Response Evaluation Criteria in Solid Tumors (RECIST).
After
Objective response rate, clinical benefit rate and progression-free survival based on investigator assessments according to Response Evaluation Criteria in Solid Tumors (RECIST).
replace /protocolSection/outcomesModule/secondaryOutcomes/3/timeFrame
Triage: High
Secondary Outcome Change Operation 15
Matched rules
  • secondary_outcome_any_change Any add/remove/replace under secondary outcome measures is high review priority.
Before
At Baseline, at the end of Cycles 2, 4 and 6, subsequently at the end of every third cycle, at the end-of-treatment, and at the posttreatment follow-up.
After
At Baseline, at the end of Cycles 2, 4 and 6, subsequently at the end of every third cycle, at the end-of-treatment, and at the post-treatment follow-up.
Timeline Start, primary completion, and completion date movement. Triage: Medium 1 ops
add /protocolSection/statusModule/completionDateStruct
Triage: Medium
Timeline Shift Operation 4
Matched rules
  • completion_timeline_change Completion date changes are operational timeline signals.
After
{
  "date": "2011-11",
  "type": "ESTIMATED"
}
Contacts and locations Site, contact, and location updates that are usually operational. Triage: Low 18 ops
replace /protocolSection/contactsLocationsModule/centralContacts/0/name
Triage: Low
Administrative Contact Change Operation 17
Matched rules
  • contact_admin_change Central contact updates are usually administrative.
Before
Eisai Medical Services
After
Eisai Eisai Medical Services
add /protocolSection/contactsLocationsModule/locations/0
Triage: Uncategorized
Uncategorized Operation 18
After
{
  "zip": "86336",
  "city": "Sedona",
  "state": "Arizona",
  "status": "RECRUITING",
  "country": "United States",
  "facility": "Northern AZ Hematology and Oncology Associates",
  "geoPoint": {
    "lat": 34.86974,
    "lon": -111.76099
  }
}
add /protocolSection/contactsLocationsModule/locations/2
Triage: Uncategorized
Uncategorized Operation 19
After
{
  "zip": "90250",
  "city": "Hawthorne",
  "state": "California",
  "status": "RECRUITING",
  "country": "United States",
  "facility": "Healing Hands Oncology and Medical Care",
  "geoPoint": {
    "lat": 33.9164,
    "lon": -118.35257
  }
}
add /protocolSection/contactsLocationsModule/locations/4
Triage: Uncategorized
Uncategorized Operation 20
After
{
  "zip": "33428",
  "city": "Boca Raton",
  "state": "Florida",
  "status": "NOT_YET_RECRUITING",
  "country": "United States",
  "facility": "Comprehensive Cancer Care Specialist of Boca",
  "geoPoint": {
    "lat": 26.35869,
    "lon": -80.0831
  }
}
add /protocolSection/contactsLocationsModule/locations/6
Triage: Uncategorized
Uncategorized Operation 21
After
{
  "zip": "34471",
  "city": "Ocala",
  "state": "Florida",
  "status": "RECRUITING",
  "country": "United States",
  "facility": "Ocala Oncology Center",
  "geoPoint": {
    "lat": 29.1872,
    "lon": -82.14009
  }
}
add /protocolSection/contactsLocationsModule/locations/9
Triage: Uncategorized
Uncategorized Operation 22
After
{
  "zip": "46219",
  "city": "Indianapolis",
  "state": "Indiana",
  "status": "RECRUITING",
  "country": "United States",
  "facility": "Central Indiana Cancer Centers",
  "geoPoint": {
    "lat": 39.76838,
    "lon": -86.15804
  }
}
add /protocolSection/contactsLocationsModule/locations/12
Triage: Uncategorized
Uncategorized Operation 23
After
{
  "zip": "07922",
  "city": "Berkeley Heights",
  "state": "New Jersey",
  "status": "RECRUITING",
  "country": "United States",
  "facility": "Summit Medical Group",
  "geoPoint": {
    "lat": 40.68343,
    "lon": -74.44265
  }
}
add /protocolSection/contactsLocationsModule/locations/13
Triage: Uncategorized
Uncategorized Operation 24
After
{
  "zip": "27607",
  "city": "Raleigh",
  "state": "North Carolina",
  "status": "RECRUITING",
  "country": "United States",
  "facility": "Cancer Center of North Carolina",
  "geoPoint": {
    "lat": 35.7721,
    "lon": -78.63861
  }
}
add /protocolSection/contactsLocationsModule/locations/14
Triage: Uncategorized
Uncategorized Operation 25
After
{
  "zip": "97213-2996",
  "city": "Portland",
  "state": "Oregon",
  "status": "RECRUITING",
  "country": "United States",
  "facility": "Northwest Cancer Specialists Hoyt",
  "geoPoint": {
    "lat": 45.52345,
    "lon": -122.67621
  }
}
add /protocolSection/contactsLocationsModule/locations/15
Triage: Uncategorized
Uncategorized Operation 26
After
{
  "zip": "97225",
  "city": "Portland",
  "state": "Oregon",
  "status": "RECRUITING",
  "country": "United States",
  "facility": "Northwest Cancer Specialists St. Vincent",
  "geoPoint": {
    "lat": 45.52345,
    "lon": -122.67621
  }
}
add /protocolSection/contactsLocationsModule/locations/16
Triage: Uncategorized
Uncategorized Operation 27
After
{
  "zip": "97227",
  "city": "Portland",
  "state": "Oregon",
  "status": "RECRUITING",
  "country": "United States",
  "facility": "Northwest Cancer Specialists Rose Quarter",
  "geoPoint": {
    "lat": 45.52345,
    "lon": -122.67621
  }
}
add /protocolSection/contactsLocationsModule/locations/20
Triage: Uncategorized
Uncategorized Operation 28
After
{
  "zip": "75230-2510",
  "city": "Dallas",
  "state": "Texas",
  "status": "RECRUITING",
  "country": "United States",
  "facility": "Texas Cancer Center at Medical City",
  "geoPoint": {
    "lat": 32.78306,
    "lon": -96.80667
  }
}
add /protocolSection/contactsLocationsModule/locations/21
Triage: Uncategorized
Uncategorized Operation 29
After
{
  "zip": "75231-4400",
  "city": "Dallas",
  "state": "Texas",
  "status": "RECRUITING",
  "country": "United States",
  "facility": "Texas Oncology, PA",
  "geoPoint": {
    "lat": 32.78306,
    "lon": -96.80667
  }
}
add /protocolSection/contactsLocationsModule/locations/22
Triage: Uncategorized
Uncategorized Operation 30
After
{
  "zip": "76033",
  "city": "Houston",
  "state": "Texas",
  "status": "RECRUITING",
  "country": "United States",
  "facility": "Texas Oncology, PA Bedford",
  "geoPoint": {
    "lat": 29.76328,
    "lon": -95.36327
  }
}
add /protocolSection/contactsLocationsModule/locations/23
Triage: Uncategorized
Uncategorized Operation 31
After
{
  "zip": "77024",
  "city": "Houston",
  "state": "Texas",
  "status": "RECRUITING",
  "country": "United States",
  "facility": "Texas Oncology, PA",
  "geoPoint": {
    "lat": 29.76328,
    "lon": -95.36327
  }
}
add /protocolSection/contactsLocationsModule/locations/24
Triage: Uncategorized
Uncategorized Operation 32
After
{
  "zip": "75075-7787",
  "city": "Plano",
  "state": "Texas",
  "status": "RECRUITING",
  "country": "United States",
  "facility": "North Texas Regional Cancer Center",
  "geoPoint": {
    "lat": 33.01984,
    "lon": -96.69889
  }
}
add /protocolSection/contactsLocationsModule/locations/25
Triage: Uncategorized
Uncategorized Operation 33
After
{
  "zip": "75702",
  "city": "Tyler",
  "state": "Texas",
  "status": "RECRUITING",
  "country": "United States",
  "facility": "Tyler Cancer Center",
  "geoPoint": {
    "lat": 32.35126,
    "lon": -95.30106
  }
}
add /protocolSection/contactsLocationsModule/locations/27
Triage: Uncategorized
Uncategorized Operation 34
After
{
  "zip": "98684",
  "city": "Vancouver",
  "state": "Washington",
  "status": "RECRUITING",
  "country": "United States",
  "facility": "Northwest Cancer Specialist Vancouver",
  "geoPoint": {
    "lat": 45.63873,
    "lon": -122.66149
  }
}
Other registry fields Changes outside the current high-signal rule families. Triage: Uncategorized 4 ops
replace /protocolSection/statusModule/statusVerifiedDate
Triage: Uncategorized
Uncategorized Operation 1
Before
2009-04
After
2009-06
replace /protocolSection/statusModule/lastUpdateSubmitDate
Triage: Uncategorized
Uncategorized Operation 2
Before
2009-04-08
After
2009-06-09
replace /protocolSection/statusModule/lastUpdatePostDateStruct/date
Triage: Uncategorized
Uncategorized Operation 3
Before
2009-04-09
After
2009-06-11
replace /protocolSection/descriptionModule/briefSummary
Triage: Uncategorized
Uncategorized Operation 5
Before
The purpose of this study is to compare the incidence and severity of neuropathy adverse events for the two treatment groups (eribulin versus ixabepilone) using National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE version 3) grading.
After
The purpose of this study in patients with advanced breast cancer is to compare the incidence and severity of neuropathy adverse events for the two treatment groups (eribulin versus ixabepilone) using National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE version 3.0) grading.
Raw JSON Patch
[
  {
    "op": "replace",
    "path": "/protocolSection/statusModule/statusVerifiedDate",
    "value": "2009-06"
  },
  {
    "op": "replace",
    "path": "/protocolSection/statusModule/lastUpdateSubmitDate",
    "value": "2009-06-09"
  },
  {
    "op": "replace",
    "path": "/protocolSection/statusModule/lastUpdatePostDateStruct/date",
    "value": "2009-06-11"
  },
  {
    "op": "add",
    "path": "/protocolSection/statusModule/completionDateStruct",
    "value": {
      "date": "2011-11",
      "type": "ESTIMATED"
    }
  },
  {
    "op": "replace",
    "path": "/protocolSection/descriptionModule/briefSummary",
    "value": "The purpose of this study in patients with advanced breast cancer is to compare the incidence and severity of neuropathy adverse events for the two treatment groups (eribulin versus ixabepilone) using National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE version 3.0) grading."
  },
  {
    "op": "replace",
    "path": "/protocolSection/armsInterventionsModule/armGroups/0/interventionNames/0",
    "value": "Drug: eribulin mesylate"
  },
  {
    "op": "replace",
    "path": "/protocolSection/armsInterventionsModule/interventions/0/name",
    "value": "eribulin mesylate"
  },
  {
    "op": "replace",
    "path": "/protocolSection/armsInterventionsModule/interventions/1/description",
    "value": "<p>Ixabepilone given at a starting dose of 32 or 40 mg&#x2F;m^2 (as per approved labeling) as a 3-hour IV infusion on Day 1 of a 21-day cycle.</p><p>The Treatment Phase will include six cycles.\nPatients may enter the Extension Phase for additional cycles following the sixth cycle of treatment.</p>"
  },
  {
    "op": "replace",
    "path": "/protocolSection/outcomesModule/primaryOutcomes/0/measure",
    "value": "Percent of subjects with neuropathy adverse events (AEs) graded according to NCI CTCAE (version 3.0) and coded according to the current version of Medical Dictionary for Regulatory Activities (MedDRA)."
  },
  {
    "op": "replace",
    "path": "/protocolSection/outcomesModule/primaryOutcomes/0/timeFrame",
    "value": "Neuropathy assessments are performed at the start of Cycles 2-6 and subsequently at every third cycle, end-of-treatment visit, and post-treatment follow-up."
  },
  {
    "op": "replace",
    "path": "/protocolSection/outcomesModule/secondaryOutcomes/0/timeFrame",
    "value": "Assessments are performed at the start of Cycles 2-6 and every third cycle, end-of-treatment visit, and post-treatment follow-up."
  },
  {
    "op": "replace",
    "path": "/protocolSection/outcomesModule/secondaryOutcomes/1/timeFrame",
    "value": "From the time subject is consented to when she completes the either 21 day or 42 day post-treatment follow-up visit."
  },
  {
    "op": "replace",
    "path": "/protocolSection/outcomesModule/secondaryOutcomes/2/timeFrame",
    "value": "Safety is assessed from the time subject is consented to when she completes the either 21 day or 42 day post-treatment follow-up visit."
  },
  {
    "op": "replace",
    "path": "/protocolSection/outcomesModule/secondaryOutcomes/3/measure",
    "value": "Objective response rate, clinical benefit rate and progression-free survival based on investigator assessments according to Response Evaluation Criteria in Solid Tumors (RECIST)."
  },
  {
    "op": "replace",
    "path": "/protocolSection/outcomesModule/secondaryOutcomes/3/timeFrame",
    "value": "At Baseline, at the end of Cycles 2, 4 and 6, subsequently at the end of every third cycle, at the end-of-treatment, and at the post-treatment follow-up."
  },
  {
    "op": "replace",
    "path": "/protocolSection/eligibilityModule/eligibilityCriteria",
    "value": "<p>Inclusion criteria:</p><p>1. Female subjects with confirmed locally recurrent or metastatic carcinoma of the breast who have received prior taxane therapy and at least one prior cytotoxic chemotherapy regimen for advanced disease.</p><p>Exclusion criteria:</p><ol><li>Subjects who have received prior ixabepilone therapy.</li><li>Subjects with prior participation in an eribulin clinical study, even if not assigned to eribulin treatment.</li><li>Subjects with pre-existing neuropathy Grade ≥ 2.</li><li>Subjects with a history of diabetes mellitus Type 1 or 2.</li><li>Subjects with bilateral mastectomy which included bilateral axillary lymph node dissection.\nSubjects with missing digits required for vibration assessment.\nSubjects with any other concurrent diseases or conditions that would be expected to interfere with neuropathy assessments, which may include vitamin deficiency, sequelae of cerebrovascular disease, thyroid insufficiency, lumbar or cervical radiculopathy, or alcoholic or inflammatory neuropathy.</li></ol>"
  },
  {
    "op": "replace",
    "path": "/protocolSection/contactsLocationsModule/centralContacts/0/name",
    "value": "Eisai Eisai Medical Services"
  },
  {
    "op": "add",
    "path": "/protocolSection/contactsLocationsModule/locations/0",
    "value": {
      "zip": "86336",
      "city": "Sedona",
      "state": "Arizona",
      "status": "RECRUITING",
      "country": "United States",
      "facility": "Northern AZ Hematology and Oncology Associates",
      "geoPoint": {
        "lat": 34.86974,
        "lon": -111.76099
      }
    }
  },
  {
    "op": "add",
    "path": "/protocolSection/contactsLocationsModule/locations/2",
    "value": {
      "zip": "90250",
      "city": "Hawthorne",
      "state": "California",
      "status": "RECRUITING",
      "country": "United States",
      "facility": "Healing Hands Oncology and Medical Care",
      "geoPoint": {
        "lat": 33.9164,
        "lon": -118.35257
      }
    }
  },
  {
    "op": "add",
    "path": "/protocolSection/contactsLocationsModule/locations/4",
    "value": {
      "zip": "33428",
      "city": "Boca Raton",
      "state": "Florida",
      "status": "NOT_YET_RECRUITING",
      "country": "United States",
      "facility": "Comprehensive Cancer Care Specialist of Boca",
      "geoPoint": {
        "lat": 26.35869,
        "lon": -80.0831
      }
    }
  },
  {
    "op": "add",
    "path": "/protocolSection/contactsLocationsModule/locations/6",
    "value": {
      "zip": "34471",
      "city": "Ocala",
      "state": "Florida",
      "status": "RECRUITING",
      "country": "United States",
      "facility": "Ocala Oncology Center",
      "geoPoint": {
        "lat": 29.1872,
        "lon": -82.14009
      }
    }
  },
  {
    "op": "add",
    "path": "/protocolSection/contactsLocationsModule/locations/9",
    "value": {
      "zip": "46219",
      "city": "Indianapolis",
      "state": "Indiana",
      "status": "RECRUITING",
      "country": "United States",
      "facility": "Central Indiana Cancer Centers",
      "geoPoint": {
        "lat": 39.76838,
        "lon": -86.15804
      }
    }
  },
  {
    "op": "add",
    "path": "/protocolSection/contactsLocationsModule/locations/12",
    "value": {
      "zip": "07922",
      "city": "Berkeley Heights",
      "state": "New Jersey",
      "status": "RECRUITING",
      "country": "United States",
      "facility": "Summit Medical Group",
      "geoPoint": {
        "lat": 40.68343,
        "lon": -74.44265
      }
    }
  },
  {
    "op": "add",
    "path": "/protocolSection/contactsLocationsModule/locations/13",
    "value": {
      "zip": "27607",
      "city": "Raleigh",
      "state": "North Carolina",
      "status": "RECRUITING",
      "country": "United States",
      "facility": "Cancer Center of North Carolina",
      "geoPoint": {
        "lat": 35.7721,
        "lon": -78.63861
      }
    }
  },
  {
    "op": "add",
    "path": "/protocolSection/contactsLocationsModule/locations/14",
    "value": {
      "zip": "97213-2996",
      "city": "Portland",
      "state": "Oregon",
      "status": "RECRUITING",
      "country": "United States",
      "facility": "Northwest Cancer Specialists Hoyt",
      "geoPoint": {
        "lat": 45.52345,
        "lon": -122.67621
      }
    }
  },
  {
    "op": "add",
    "path": "/protocolSection/contactsLocationsModule/locations/15",
    "value": {
      "zip": "97225",
      "city": "Portland",
      "state": "Oregon",
      "status": "RECRUITING",
      "country": "United States",
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