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NCT05593094

A Phase 1 Trial of ZN-A-1041 Enteric Capsules or Combination in Participants With Human Epidermal Growth Factor Receptor 2 (HER2)-Positive Advanced Solid Tumors

Version 5 to 6 · Hoffmann-La Roche

Patch inspector

Version 5 to 6

36 operations 5 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
eligibility_criteria_changesecondary_outcome_any_change
Value signals
[
  {
    "path": "/protocolSection/statusModule/primaryCompletionDateStruct/date",
    "signal": "timeline_major_slip",
    "category": "timeline_major_slip",
    "new_type": "ESTIMATED",
    "old_type": "ESTIMATED",
    "severity": "medium",
    "direction": "later",
    "new_value": "2025-10-30",
    "old_value": "2023-10-30",
    "delta_days": 731,
    "date_struct": "primaryCompletionDateStruct",
    "new_precision": "day",
    "old_precision": "day"
  },
  {
    "path": "/protocolSection/statusModule/completionDateStruct/date",
    "signal": "timeline_major_slip",
    "category": "timeline_major_slip",
    "new_type": "ESTIMATED",
    "old_type": "ESTIMATED",
    "severity": "medium",
    "direction": "later",
    "new_value": "2026-10-30",
    "old_value": "2024-10-30",
    "delta_days": 730,
    "date_struct": "completionDateStruct",
    "new_precision": "day",
    "old_precision": "day"
  }
]
Provenance
Source
ctgov_internal_history
Fetched
2026-06-18 18:59:54+00
Raw hash
9aaa54c0f5f6b001f4ed26da9d90df2d6011d66a450c0ef95ae53cece10780db
Payload
Source URL
Eligibility Criteria and population definition changes. Triage: High 1 ops
replace /protocolSection/eligibilityModule/eligibilityCriteria
Triage: High
Eligibility Change Operation 18
Matched rules
  • eligibility_criteria_change Eligibility criteria changes can alter the studied population.
Before
<ul><li><p>Inclusion Criteria:</p><ol><li>ECOG performance status of 0 to 1</li><li>HER2 positive is defined as Immunohistochemistry (IHC) (++) and Fluorescence In Situ Hybridization (FISH) positive, or IHC (+++).</li><li><p>Phase 1a study will enroll patients with unresectable or metastatic HER2-positive advanced solid tumor.</p><p>For patients who have no brain metastases, the following criteria should be met:</p><ol><li>Patients should be relapsed or refractory to existing therapy(ies) or have been intolerant of such therapies</li><li>Patients with HER2-positive breast cancer should have previously received Trastuzumab, Pertuzumab, Trastuzumab emtansine(T-DM1) and a taxane.</li><li>Patients with HER2-positive gastric cancer must have previously received trastuzumab.</li><li>Have measurable or non-measurable disease assessable by RECIST 1.1.</li></ol><p>For patients with brain metastasis, the following criteria should be met:</p><ol><li>Patients with HER2-positive breast cancer must have received prior treatment with Trastuzumab, Pertuzumab and T-DM1, and a taxane or patient declined the above treatment.</li><li>Patients with HER2-positive gastric cancer must have previously received Trastuzumab</li><li>Do not require immediate local treatment during the trial period, and meet either of the following two criteria: i) For patients who have received previous local treatment (surgery, whole brain radiotherapy (WBRT) and stereotactic radiosurgery (SRS)) for brain metastases, stable or progression of intracranial lesions is required.
Interval from prior local therapy could be 3 weeks from WBRT and 2 weeks from SRS; ii) Symptomatic or not, patient has not received previous local treatment (surgery or radiotherapy) for brain metastases as long as no local therapy is needed during the trial period.</li></ol><p>For patients who have received previous tyrosine kinase inhibitor (TKI) treatment, chemotherapy, antibody, or antibody-drug conjugate (ADC), the interval between the last treatment and the first administration of the study drug in this trial should be at least 2 weeks.</p></li><li><p>Phase 1b and Phase 1c study will enroll patients with unresectable locally advanced or metastatic HER2+ breast cancer.</p><p>For patients who have no brain metastases, the following criteria should be met:</p><ol><li>For arm 1 and arm 2, patients should be relapsed or refractory to existing therapy(ies), with a history of prior treatment with trastuzumab and a taxane.
For arm3, patients have received 4-8 cycles (21-day cycles) of previous treatment with trastuzumab, pertuzumab, and taxane as first-line therapy for advanced HER2+ breast cancer with no evidence of disease progression.</li><li>Have measurable or non-measurable disease assessable by RECIST 1.1</li></ol><p>For patients with brain metastasis, the following criteria should be met:</p><ol><li>For arm 1 and arm 2, patients should be relapsed or refractory to existing therapy(ies), with a history of prior treatment with trastuzumab and a taxane.
For arm3, patients have received 4-8 cycles (21-day cycles) of previous treatment with trastuzumab, pertuzumab, and taxane as first-line therapy for advanced HER2+ breast cancer with no evidence of disease progression.</li><li>Do not require immediate local treatment during the trial period, and meet either of the following two criteria: i) For patients who have received previous local treatment (surgery, whole brain radiotherapy (WBRT) and stereotactic radiosurgery (SRS)) for brain metastases, stable or progression of intracranial lesions is required.
Interval from prior local therapy could be 3 weeks from WBRT, 2 weeks from SRS and 4 weeks from surgery; ii) Symptomatic or not, patient has not received previous local treatment (surgery or radiotherapy) for brain metastases as long as no local therapy is needed during the trial period.</li></ol></li><li>Suspected or confirmed leptomeningeal metastasis are allowed in Phase 1b, but not allowed in Phase 1c.</li><li>In Phase 1b arm1 and arm2, patients who have received previous tyrosine kinase inhibitor (TKI) treatment, chemotherapy, antibody, or antibody-drug conjugate (ADC), the interval between the last treatment and the first administration of the study drug in this trial should be at least 2 weeks.
For arm3, patients should not have prior treatment for unresectable locally-advanced or metastatic HER2+ breast cancer with and without brain metastasis, except for ongoing Herceptin, Perjeta or PHESGO and taxane.</li><li>In Phase 1c arm1 and arm2, Patients should not have received prior treatment with tucatinib, afatinib, or any other investigational anti-HER2, anti-EGFR, or HER2 TKI agent.
Prior treatment with lapatinib or neratinib within 12 months of starting study treatment (except in cases where they were given for ≤ 21 days and was discontinued for reasons other than disease progression or severe toxicity).
Prior treatment with pyrotinib for recurrent of mBC (except in cases where pyrotinib was given for ≤ 21 days and was discontinued for reasons other than disease progression or severe toxicity).
For arm3, patients should not have prior treatment for unresectable locally-advanced or metastatic HER2+ breast cancer with and without brain metastasis, except for ongoing Herceptin, Perjeta or PHESGO and taxane.</li></ol></li><li><p>Exclusion Criteria:</p><ol><li>Subjects who have participated in any clinical study or received any clinical study drug within 4 weeks prior to the first administration except for on-going Herceptin, Perjeta or PHESGO in arm3</li><li><p>CNS Exclusion - Based on screening brain MRI and clinical assessment</p><ol><li>Progressive neurologic impairment or increased intracranial pressure (including nausea, vomiting, blurred vision, headache, epilepsy, etc.)</li><li>Any intracranial lesion thought to require immediate local therapy</li><li>Require antiepileptic treatment (except for these patients with stable seizures require continuous Levetiracetam therapy).</li><li>Ongoing use of systemic corticosteroids for control of symptoms of brain metastases at a total daily dose of &gt; 2 mg of dexamethasone (or equivalent)</li></ol></li></ol></li></ul>
After
<ul><li><p>Inclusion Criteria:</p><ol><li>ECOG performance status of 0 to 1</li><li>HER2 positive is defined as Immunohistochemistry (IHC) (++) and Fluorescence In Situ Hybridization (FISH) positive, or IHC (+++).</li><li><p>Phase 1a study will enroll patients with unresectable or metastatic HER2-positive advanced solid tumor.</p><p>For patients who have no brain metastases, the following criteria should be met:</p><ol><li>Patients should be relapsed or refractory to existing therapy(ies) or have been intolerant of such therapies</li><li>Patients with HER2-positive breast cancer should have previously received Trastuzumab, Pertuzumab, Trastuzumab emtansine(T-DM1) and a taxane.</li><li>Patients with HER2-positive gastric cancer must have previously received trastuzumab.</li><li>Have measurable or non-measurable disease assessable by RECIST 1.1.</li></ol><p>For patients with brain metastasis, the following criteria should be met:</p><ol><li>Patients with HER2-positive breast cancer must have received prior treatment with Trastuzumab, Pertuzumab and T-DM1, and a taxane or patient declined the above treatment.</li><li>Patients with HER2-positive gastric cancer must have previously received Trastuzumab</li><li>Do not require immediate local treatment during the trial period, and meet either of the following two criteria: i) For patients who have received previous local treatment (surgery, whole brain radiotherapy (WBRT) and stereotactic radiosurgery (SRS)) for brain metastases, stable or progression of intracranial lesions is required.
Interval from prior local therapy could be 3 weeks from WBRT and 2 weeks from SRS; ii) Symptomatic or not, patient has not received previous local treatment (surgery or radiotherapy) for brain metastases as long as no local therapy is needed during the trial period.</li></ol><p>For patients who have received previous tyrosine kinase inhibitor (TKI) treatment, chemotherapy, antibody, or antibody-drug conjugate (ADC), the interval between the last treatment and the first administration of the study drug in this trial should be at least 2 weeks.</p></li><li><p>Phase 1b and Phase 1c study will enroll patients with unresectable locally advanced or metastatic HER2+ breast cancer.</p><p>For Phase 1b patients who have no brain metastases, the following criteria should be met:</p><ol><li>For arm 1 and arm 2, patients should be relapsed or refractory to existing therapy(ies), with a history of prior treatment with trastuzumab and a taxane.
For arm3, patients have received 4-8 cycles (21-day cycles) of previous treatment with trastuzumab, pertuzumab, and taxane as first-line therapy for advanced HER2+ breast cancer with no evidence of disease progression.</li><li>Have measurable or non-measurable disease assessable by RECIST 1.1</li></ol><p>For Phase 1c patients who have no brain metastases, the following criteria should be met:</p><ol><li>For arm 1 and arm 2, patients should be refractory to existing therapy(ies), with a history of prior treatment with trastuzumab.
For arm3, patients have received a pertuzumab plus trastuzumab or T-DXd based induction therapy as first-line therapy for advanced HER2+ breast cancer with no evidence of disease progression.</li><li>In arms 1 and 2, patients should have at least one measurable lesion either extracranially or intracranially per RECIST v1.1.
For patients in arm 3, they are permitted to have measurable and&#x2F;or non-measurable disease.</li></ol><p>For patients with brain metastasis, the following criteria should be met:</p><ol><li>For arm 1 and arm 2 of phase 1b, patients should be relapsed or refractory to existing therapy(ies), with a history of prior treatment with trastuzumab and a taxane.
For arm3, patients have received 4-8 cycles (21-day cycles) of previous treatment with trastuzumab, pertuzumab, and taxane as first-line therapy for advanced HER2+ breast cancer with no evidence of disease progression.
For arm 1 and arm 2 of phase 1c, patients should be refractory to existing therapy(ies), with a history of prior treatment with trastuzumab.
For arm3, patients have received previous treatment with a pertuzumab plus trastuzumab or T-DXd based induction therapy as first-line therapy for advanced HER2+ breast cancer with no evidence of disease progression (except brain metastases).
For patients with T-DXd based induction therapy the medical monitor must be consulted prior to screening</li><li>Do not require immediate local treatment during the trial period, and meet either of the following two criteria: i) For patients who have received previous local treatment (surgery, whole brain radiotherapy (WBRT) and stereotactic radiosurgery (SRS)) for brain metastases, stable or progression of intracranial lesions is required.
Interval from prior local therapy could be 3 weeks from WBRT, 2 weeks from SRS and 4 weeks from surgery; ii) Symptomatic or not, patient has not received previous local treatment (surgery or radiotherapy) for brain metastases as long as no local therapy is needed during the trial period.</li></ol></li><li>Suspected or confirmed leptomeningeal metastasis are allowed.</li><li>In Phase 1b arm1 and arm2, patients who have received previous tyrosine kinase inhibitor (TKI) treatment, chemotherapy, antibody, or antibody-drug conjugate (ADC), the interval between the last treatment and the first administration of the study drug in this trial should be at least 2 weeks.
For arm3, patients should not have prior treatment for unresectable locally-advanced or metastatic HER2+ breast cancer with and without brain metastasis, except for ongoing Herceptin, Perjeta or PHESGO and taxane.</li><li>In Phase 1c arm1 and arm2, Patients should not have received prior treatment with tucatinib, afatinib, or any other investigational anti-HER2, anti-EGFR, or HER2 TKI agent.
Prior treatment with lapatinib or neratinib within 12 months of starting study treatment (except in cases where they were given for ≤ 21 days and was discontinued for reasons other than disease progression or severe toxicity).
Prior treatment with pyrotinib for recurrent of mBC (except in cases where pyrotinib was given for ≤ 21 days and was discontinued for reasons other than disease progression or severe toxicity).
For arm3, patients should not have prior treatment for unresectable locally-advanced or metastatic HER2+ breast cancer with and without brain metastasis, except for ongoing Herceptin, Perjeta or PHESGO or T-Dxd based induction.</li></ol></li><li><p>Exclusion Criteria:</p><ol><li>Subjects who have participated in any clinical study or received any clinical study drug within 4 weeks prior to the first administration except for on-going Herceptin, Perjeta or PHESGO in arm3</li><li><p>CNS Exclusion - Based on screening brain MRI and clinical assessment</p><ol><li>Progressive neurologic impairment or increased intracranial pressure (including nausea, vomiting, blurred vision, headache, epilepsy, etc.)</li><li>Any intracranial lesion thought to require immediate local therapy</li><li>Require antiepileptic treatment (except for these patients with stable seizures require continuous Levetiracetam therapy).</li><li>Ongoing use of systemic corticosteroids for control of symptoms of brain metastases at a total daily dose of &gt; 2 mg of dexamethasone (or equivalent)</li></ol></li></ol></li></ul>
Secondary outcomes Additional endpoints and outcome descriptions. Triage: High 11 ops
replace /protocolSection/outcomesModule/secondaryOutcomes/0/measure
Triage: High
Secondary Outcome Change Operation 7
Matched rules
  • secondary_outcome_any_change Any add/remove/replace under secondary outcome measures is high review priority.
Before
AUC. Plasma level of ZN-A-1041 and its main metabolites Phase 1a, phase 1b and 1c
After
Plasma, urine and potentially CSF level of ZN-A-1041 and its main metabolites
replace /protocolSection/outcomesModule/secondaryOutcomes/0/description
Triage: High
Secondary Outcome Change Operation 8
Matched rules
  • secondary_outcome_any_change Any add/remove/replace under secondary outcome measures is high review priority.
Before
To assess the AUC of ZN-A-1041 and its major metabolites
After
To assess the PK of ZN-A-1041 and its major metabolites
replace /protocolSection/outcomesModule/secondaryOutcomes/0/timeFrame
Triage: High
Secondary Outcome Change Operation 9
Matched rules
  • secondary_outcome_any_change Any add/remove/replace under secondary outcome measures is high review priority.
Before
From baseline to Day 8
After
From baseline to Cycle 9 (each cycel is 21 days)
replace /protocolSection/outcomesModule/secondaryOutcomes/1/measure
Triage: High
Secondary Outcome Change Operation 10
Matched rules
  • secondary_outcome_any_change Any add/remove/replace under secondary outcome measures is high review priority.
Before
Cmax. Plasma level of ZN-A-1041 and its main metabolites Phase 1a, phase 1b and 1c
After
Serum level of combination drugs in phase 1c
replace /protocolSection/outcomesModule/secondaryOutcomes/1/description
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
To assess the Cmax of ZN-A-1041 and its major metabolites
After
To assess the serum concentration of combination drugs
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 baseline to Day 8
After
through study completion, an average of 2 year
replace /protocolSection/outcomesModule/secondaryOutcomes/2/measure
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
Tmax. Plasma level of ZN-A-1041 and its main metabolites Phase 1a, phase 1b and 1c
After
Anti-drug antibodies (ADAs) evaluation in Phase 1c
replace /protocolSection/outcomesModule/secondaryOutcomes/2/description
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
To assess the Tmax of ZN-A-1041 and its major metabolites
After
To assess the incidence of ADAs
replace /protocolSection/outcomesModule/secondaryOutcomes/2/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
From baseline to Day 8
After
through study completion, an average of 2 year
replace /protocolSection/outcomesModule/secondaryOutcomes/3/timeFrame
Triage: High
Secondary Outcome Change Operation 16
Matched rules
  • secondary_outcome_any_change Any add/remove/replace under secondary outcome measures is high review priority.
Before
through study completion, an average of 1 year
After
through study completion, an average of 2 year
replace /protocolSection/outcomesModule/secondaryOutcomes/4/timeFrame
Triage: High
Secondary Outcome Change Operation 17
Matched rules
  • secondary_outcome_any_change Any add/remove/replace under secondary outcome measures is high review priority.
Before
through study completion, an average of 1 year
After
through study completion, an average of 2 year
Timeline Start, primary completion, and completion date movement. Triage: Medium 2 ops
replace /protocolSection/statusModule/primaryCompletionDateStruct/date
Triage: Medium
Timeline Shift Operation 2
Matched rules
  • primary_completion_timeline_change Primary completion date changes are operational timeline signals.
Before
2023-10-30
After
2025-10-30
replace /protocolSection/statusModule/completionDateStruct/date
Triage: Medium
Timeline Shift Operation 3
Matched rules
  • completion_timeline_change Completion date changes are operational timeline signals.
Before
2024-10-30
After
2026-10-30
Contacts and locations Site, contact, and location updates that are usually operational. Triage: Uncategorized 18 ops
add /protocolSection/contactsLocationsModule/locations/1
Triage: Uncategorized
Uncategorized Operation 19
After
{
  "zip": "90703-2684",
  "city": "Cerritos",
  "state": "California",
  "status": "RECRUITING",
  "country": "United States",
  "contacts": [
    {
      "name": "Nawid Sarwari",
      "role": "CONTACT"
    },
    {
      "name": "Nawid Sarwari",
      "role": "PRINCIPAL_INVESTIGATOR"
    }
  ],
  "facility": "TOI Clinical Research",
  "geoPoint": {
    "lat": 33.85835,
    "lon": -118.06479
  }
}
remove /protocolSection/contactsLocationsModule/locations/4
Triage: Uncategorized
Uncategorized Operation 20
Before
{
  "zip": "48109",
  "city": "Ann Arbor",
  "state": "Michigan",
  "status": "RECRUITING",
  "country": "United States",
  "contacts": [
    {
      "name": "Caner AnswerLine",
      "role": "CONTACT",
      "email": "CancerAnswerLine@med.umich.edu",
      "phone": "800-865-1125"
    },
    {
      "name": "Aki Morikawa, MD",
      "role": "PRINCIPAL_INVESTIGATOR"
    }
  ],
  "facility": "University of Michigan",
  "geoPoint": {
    "lat": 42.27756,
    "lon": -83.74088
  }
}
add /protocolSection/contactsLocationsModule/locations/7
Triage: Uncategorized
Uncategorized Operation 21
After
{
  "zip": "3220",
  "city": "Geelong",
  "state": "Victoria",
  "status": "ACTIVE_NOT_RECRUITING",
  "country": "Australia",
  "facility": "Andrew Love Cancer Center",
  "geoPoint": {
    "lat": -38.14711,
    "lon": 144.36069
  }
}
add /protocolSection/contactsLocationsModule/locations/8
Triage: Uncategorized
Uncategorized Operation 22
After
{
  "zip": "3021",
  "city": "St Albans",
  "state": "Victoria",
  "status": "ACTIVE_NOT_RECRUITING",
  "country": "Australia",
  "facility": "Sunshine Hospital - Australia",
  "geoPoint": {
    "lat": -37.74496,
    "lon": 144.80049
  }
}
add /protocolSection/contactsLocationsModule/locations/9
Triage: Uncategorized
Uncategorized Operation 23
After
{
  "zip": "59000",
  "city": "Lille",
  "state": "Nord",
  "status": "ACTIVE_NOT_RECRUITING",
  "country": "France",
  "facility": "Centre Oscar Lambret - PPDS",
  "geoPoint": {
    "lat": 50.63391,
    "lon": 3.05512
  }
}
add /protocolSection/contactsLocationsModule/locations/10
Triage: Uncategorized
Uncategorized Operation 24
After
{
  "zip": "69373",
  "city": "Lyon",
  "status": "ACTIVE_NOT_RECRUITING",
  "country": "France",
  "facility": "Centre Léon Bérard Centre Régional de Lutte Contre Le Cancer Rhône Alpes",
  "geoPoint": {
    "lat": 45.74906,
    "lon": 4.84789
  }
}
add /protocolSection/contactsLocationsModule/locations/11
Triage: Uncategorized
Uncategorized Operation 25
After
{
  "zip": "31059",
  "city": "Toulouse",
  "status": "ACTIVE_NOT_RECRUITING",
  "country": "France",
  "facility": "Institut Claudius Regaud - PPDS",
  "geoPoint": {
    "lat": 43.60426,
    "lon": 1.44367
  }
}
add /protocolSection/contactsLocationsModule/locations/12
Triage: Uncategorized
Uncategorized Operation 26
After
{
  "zip": "1023",
  "city": "Auckland",
  "status": "ACTIVE_NOT_RECRUITING",
  "country": "New Zealand",
  "facility": "Auckland City Hospital",
  "geoPoint": {
    "lat": -36.84853,
    "lon": 174.76349
  }
}
add /protocolSection/contactsLocationsModule/locations/13
Triage: Uncategorized
Uncategorized Operation 27
After
{
  "zip": "8028",
  "city": "Barcelona",
  "status": "ACTIVE_NOT_RECRUITING",
  "country": "Spain",
  "facility": "Instituto Oncologico Dr. Rosell-Hospital Universitari Dexeus-Grupo Quironsalud",
  "geoPoint": {
    "lat": 41.38879,
    "lon": 2.15899
  }
}
add /protocolSection/contactsLocationsModule/locations/14
Triage: Uncategorized
Uncategorized Operation 28
After
{
  "zip": "8035",
  "city": "Barcelona",
  "status": "ACTIVE_NOT_RECRUITING",
  "country": "Spain",
  "facility": "Instituto de Investigacion Oncologica Vall dHebron (VHIO) - EPON",
  "geoPoint": {
    "lat": 41.38879,
    "lon": 2.15899
  }
}
add /protocolSection/contactsLocationsModule/locations/15
Triage: Uncategorized
Uncategorized Operation 29
After
{
  "zip": "8036",
  "city": "Barcelona",
  "status": "ACTIVE_NOT_RECRUITING",
  "country": "Spain",
  "facility": "Hospital Clinic de Barcelona",
  "geoPoint": {
    "lat": 41.38879,
    "lon": 2.15899
  }
}
add /protocolSection/contactsLocationsModule/locations/16
Triage: Uncategorized
Uncategorized Operation 30
After
{
  "zip": "23007",
  "city": "Jaén",
  "status": "ACTIVE_NOT_RECRUITING",
  "country": "Spain",
  "facility": "Hospital Universitario de Jaen",
  "geoPoint": {
    "lat": 37.76922,
    "lon": -3.79028
  }
}
add /protocolSection/contactsLocationsModule/locations/17
Triage: Uncategorized
Uncategorized Operation 31
After
{
  "zip": "28034",
  "city": "Madrid",
  "status": "RECRUITING",
  "country": "Spain",
  "contacts": [
    {
      "name": "Noelia Martínez Jáñez",
      "role": "CONTACT"
    },
    {
      "name": "Noelia Martínez Jáñez",
      "role": "PRINCIPAL_INVESTIGATOR"
    }
  ],
  "facility": "Hospital Universitario Ramon y Cajal",
  "geoPoint": {
    "lat": 40.4165,
    "lon": -3.70256
  }
}
add /protocolSection/contactsLocationsModule/locations/18
Triage: Uncategorized
Uncategorized Operation 32
After
{
  "zip": "28040",
  "city": "Madrid",
  "status": "ACTIVE_NOT_RECRUITING",
  "country": "Spain",
  "facility": "Hospital Clinico San Carlos",
  "geoPoint": {
    "lat": 40.4165,
    "lon": -3.70256
  }
}
add /protocolSection/contactsLocationsModule/locations/19
Triage: Uncategorized
Uncategorized Operation 33
After
{
  "zip": "15706",
  "city": "Santiago de Compostela",
  "status": "ACTIVE_NOT_RECRUITING",
  "country": "Spain",
  "facility": "Hospital Clinico Universitario de Santiago",
  "geoPoint": {
    "lat": 42.88052,
    "lon": -8.54569
  }
}
add /protocolSection/contactsLocationsModule/locations/20
Triage: Uncategorized
Uncategorized Operation 34
After
{
  "zip": "41009",
  "city": "Seville",
  "status": "ACTIVE_NOT_RECRUITING",
  "country": "Spain",
  "facility": "Hospital Universitario Virgen Macarena",
  "geoPoint": {
    "lat": 37.38283,
    "lon": -5.97317
  }
}
add /protocolSection/contactsLocationsModule/locations/21
Triage: Uncategorized
Uncategorized Operation 35
After
{
  "zip": "46026",
  "city": "Valencia",
  "status": "RECRUITING",
  "country": "Spain",
  "contacts": [
    {
      "name": "Angel Luis Guerrero-Zotano",
      "role": "CONTACT"
    },
    {
      "name": "Angel Luis Guerrero-Zotano",
      "role": "PRINCIPAL_INVESTIGATOR"
    }
  ],
  "facility": "Fundacion Instituto Valenciano de Oncologia",
  "geoPoint": {
    "lat": 39.47391,
    "lon": -0.37966
  }
}
add /protocolSection/contactsLocationsModule/locations/22
Triage: Uncategorized
Uncategorized Operation 36
After
{
  "zip": "M20 4BX",
  "city": "Manchester",
  "state": "Lancashire",
  "status": "ACTIVE_NOT_RECRUITING",
  "country": "United Kingdom",
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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
2023-07
After
2024-08
replace /protocolSection/statusModule/lastUpdateSubmitDate
Triage: Uncategorized
Uncategorized Operation 4
Before
2023-07-26
After
2024-08-27
replace /protocolSection/statusModule/lastUpdatePostDateStruct/date
Triage: Uncategorized
Uncategorized Operation 5
Before
2023-07-28
After
2024-08-30
replace /protocolSection/descriptionModule/detailedDescription
Triage: Uncategorized
Uncategorized Operation 6
Before
<p>Phase 1a of the study will adopt the &quot;modified 3+3&quot; dose escalation design with a total of 7 planned dose levels.
Patients with HER2-positive advanced solid tumor (including those with brain metastases) will be enrolled to receive a single-dose administration of ZN-A-1041 followed by multiple-dose administration of ZN-A-1041.Phase 1b of the study will adopt the &quot;traditional 3+3&quot; dose escalation design.
The dose levels will be based on the results of the Phase 1a study and the results of a food effect study.
In Phase 1b, patients with unresectable locally-advanced or metastatic HER2+ breast cancer with and without brain metastasis will be enrolled in three arms: Arm1 will receive multiple doses of ZN-A-1041 in combination with T-DM1; Arm2 will receive multiple doses of ZN-A-1041 in combination with T-DXd.
Arm 3 will receive multiple doses of ZN-A-1041 in combination with PHESGO or Herceptin plus Perjeta after Herceptin plus Perjeta and 4-8-cycle treatment of taxane Patients will be assigned to an appropriate arm by the sponsor and the investigator based on his&#x2F;her eligibility at the time of consent.
Patients with unresectable locally-advanced or metastatic HER2+ breast cancer with and without brain metastasis are planned to be enrolled in Phase 1c of the study: Arm1 will receive multiple doses of ZN-A-1041 in combination with T-DM1; Arm2 will receive multiple doses of ZN-A-1041 in combination with T-DXd; Arm 3 will receive multiple doses of ZN-A-1041 in combination with PHESGO or Herceptin plus Perjeta after Herceptin plus Perjeta and 4-8-cycle treatment of taxane.
Patients will be assigned to an appropriate arm by the sponsor and the investigator based on his&#x2F;her eligibility at the time of consent.
Arm1 of Phase 1c can start independently after the DLT observation period of the last patient in Phase 1b Arm1.
Arm 2 of Phase 1c can start independently after the DLT observation of the last patient in Phase 1b Arm 2. Arm 3 of Phase 1c can start independently after the DLT observation of the last patient in Phase 1b Arm 3. The dose levels used in Phase 1c will be based on the recommended doses obtained from the Phase 1b study.</p><p>Each phase of the study includes a screening period (from 28 days prior to the first administration of the study drug), a treatment period (until there are no clinical benefits as deemed by the Investigator, disease progression, death, intolerable toxicity, withdrawal of informed consent, loss of follow-up, or the start of new anti-tumor treatment), and a follow-up period (until 28 days after the last administration of the study drug).
During the trial, the safety, tolerability, PK and efficacy data of ZN-A-1041 as monotherapy and in combination in the subjects will be collected and analyzed, thereby providing RP2D for subsequent future clinical trials.</p>
After
<p>Phase 1a of the study will adopt the &quot;modified 3+3&quot; dose escalation design with a total of 7 planned dose levels.
Patients with HER2-positive advanced solid tumor (including those with brain metastases) will be enrolled to receive a single-dose administration of ZN-A-1041 followed by multiple-dose administration of ZN-A-1041.Phase 1b of the study will adopt the &quot;traditional 3+3&quot; dose escalation design.
The dose levels will be based on the results of the Phase 1a study and the results of a food effect study.
In Phase 1b, patients with unresectable locally-advanced or metastatic HER2+ breast cancer with and without brain metastasis will be enrolled in three arms: Arm1 will receive multiple doses of ZN-A-1041 in combination with T-DM1; Arm2 will receive multiple doses of ZN-A-1041 in combination with T-DXd.
Arm 3 will receive multiple doses of ZN-A-1041 in combination with PHESGO or Herceptin plus Perjeta after Herceptin plus Perjeta and 4-8-cycle treatment of taxane.
Patients will be assessed for an appropriate arm by the sponsor and the investigator at the time of consent.
Patients with unresectable locally-advanced or metastatic HER2+ breast cancer with and without brain metastasis are planned to be enrolled in Phase 1c of the study: Arm1 will receive multiple doses of ZN-A-1041 in combination with T-DM1; Arm2 will receive multiple doses of ZN-A-1041 in combination with T-DXd; Arm 3 will receive multiple doses of ZN-A-1041 in combination with PHESGO or Herceptin plus Perjeta after Herceptin plus Perjeta or T-DXd based induction regimen.
Patients will be assessed for an appropriate arm by the sponsor and the investigator at the time of consent.
Arm1 of Phase 1c can start independently after the DLT observation period of the last patient in Phase 1b Arm1.
Arm 2 of Phase 1c can start independently after the DLT observation of the last patient in Phase 1b Arm 2. Arm 3 of Phase 1c can start independently after the DLT observation of the last patient in Phase 1b Arm 3. The dose levels used in Phase 1c will be based on the recommended doses obtained from the Phase 1b study.</p><p>Each phase of the study includes a screening period (from 28 days prior to the first administration of the study drug), a treatment period (until there are no clinical benefits as deemed by the Investigator, disease progression, death, intolerable toxicity, withdrawal of informed consent, loss of follow-up, or the start of new anti-tumor treatment), and a follow-up period (until 28 days after the last administration of the study drug).
During the trial, the safety, tolerability, PK and efficacy data of ZN-A-1041 as monotherapy and in combination in the subjects will be collected and analyzed, thereby providing RP2D for subsequent future clinical trials.</p>
Raw JSON Patch
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    "value": "<p>Phase 1a of the study will adopt the &quot;modified 3+3&quot; dose escalation design with a total of 7 planned dose levels.\nPatients with HER2-positive advanced solid tumor (including those with brain metastases) will be enrolled to receive a single-dose administration of ZN-A-1041 followed by multiple-dose administration of ZN-A-1041.Phase 1b of the study will adopt the &quot;traditional 3+3&quot; dose escalation design.\nThe dose levels will be based on the results of the Phase 1a study and the results of a food effect study.\nIn Phase 1b, patients with unresectable locally-advanced or metastatic HER2+ breast cancer with and without brain metastasis will be enrolled in three arms: Arm1 will receive multiple doses of ZN-A-1041 in combination with T-DM1; Arm2 will receive multiple doses of ZN-A-1041 in combination with T-DXd.\nArm 3 will receive multiple doses of ZN-A-1041 in combination with PHESGO or Herceptin plus Perjeta after Herceptin plus Perjeta and 4-8-cycle treatment of taxane.\nPatients will be assessed for an appropriate arm by the sponsor and the investigator at the time of consent.\nPatients with unresectable locally-advanced or metastatic HER2+ breast cancer with and without brain metastasis are planned to be enrolled in Phase 1c of the study: Arm1 will receive multiple doses of ZN-A-1041 in combination with T-DM1; Arm2 will receive multiple doses of ZN-A-1041 in combination with T-DXd; Arm 3 will receive multiple doses of ZN-A-1041 in combination with PHESGO or Herceptin plus Perjeta after Herceptin plus Perjeta or T-DXd based induction regimen.\nPatients will be assessed for an appropriate arm by the sponsor and the investigator at the time of consent.\nArm1 of Phase 1c can start independently after the DLT observation period of the last patient in Phase 1b Arm1.\nArm 2 of Phase 1c can start independently after the DLT observation of the last patient in Phase 1b Arm 2. Arm 3 of Phase 1c can start independently after the DLT observation of the last patient in Phase 1b Arm 3. The dose levels used in Phase 1c will be based on the recommended doses obtained from the Phase 1b study.</p><p>Each phase of the study includes a screening period (from 28 days prior to the first administration of the study drug), a treatment period (until there are no clinical benefits as deemed by the Investigator, disease progression, death, intolerable toxicity, withdrawal of informed consent, loss of follow-up, or the start of new anti-tumor treatment), and a follow-up period (until 28 days after the last administration of the study drug).\nDuring the trial, the safety, tolerability, PK and efficacy data of ZN-A-1041 as monotherapy and in combination in the subjects will be collected and analyzed, thereby providing RP2D for subsequent future clinical trials.</p>"
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    "value": "From baseline to Cycle 9 (each cycel is 21 days)"
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    "value": "<ul><li><p>Inclusion Criteria:</p><ol><li>ECOG performance status of 0 to 1</li><li>HER2 positive is defined as Immunohistochemistry (IHC) (++) and Fluorescence In Situ Hybridization (FISH) positive, or IHC (+++).</li><li><p>Phase 1a study will enroll patients with unresectable or metastatic HER2-positive advanced solid tumor.</p><p>For patients who have no brain metastases, the following criteria should be met:</p><ol><li>Patients should be relapsed or refractory to existing therapy(ies) or have been intolerant of such therapies</li><li>Patients with HER2-positive breast cancer should have previously received Trastuzumab, Pertuzumab, Trastuzumab emtansine(T-DM1) and a taxane.</li><li>Patients with HER2-positive gastric cancer must have previously received trastuzumab.</li><li>Have measurable or non-measurable disease assessable by RECIST 1.1.</li></ol><p>For patients with brain metastasis, the following criteria should be met:</p><ol><li>Patients with HER2-positive breast cancer must have received prior treatment with Trastuzumab, Pertuzumab and T-DM1, and a taxane or patient declined the above treatment.</li><li>Patients with HER2-positive gastric cancer must have previously received Trastuzumab</li><li>Do not require immediate local treatment during the trial period, and meet either of the following two criteria: i) For patients who have received previous local treatment (surgery, whole brain radiotherapy (WBRT) and stereotactic radiosurgery (SRS)) for brain metastases, stable or progression of intracranial lesions is required.\nInterval from prior local therapy could be 3 weeks from WBRT and 2 weeks from SRS; ii) Symptomatic or not, patient has not received previous local treatment (surgery or radiotherapy) for brain metastases as long as no local therapy is needed during the trial period.</li></ol><p>For patients who have received previous tyrosine kinase inhibitor (TKI) treatment, chemotherapy, antibody, or antibody-drug conjugate (ADC), the interval between the last treatment and the first administration of the study drug in this trial should be at least 2 weeks.</p></li><li><p>Phase 1b and Phase 1c study will enroll patients with unresectable locally advanced or metastatic HER2+ breast cancer.</p><p>For Phase 1b patients who have no brain metastases, the following criteria should be met:</p><ol><li>For arm 1 and arm 2, patients should be relapsed or refractory to existing therapy(ies), with a history of prior treatment with trastuzumab and a taxane.\nFor arm3, patients have received 4-8 cycles (21-day cycles) of previous treatment with trastuzumab, pertuzumab, and taxane as first-line therapy for advanced HER2+ breast cancer with no evidence of disease progression.</li><li>Have measurable or non-measurable disease assessable by RECIST 1.1</li></ol><p>For Phase 1c patients who have no brain metastases, the following criteria should be met:</p><ol><li>For arm 1 and arm 2, patients should be refractory to existing therapy(ies), with a history of prior treatment with trastuzumab.\nFor arm3, patients have received a pertuzumab plus trastuzumab or T-DXd based induction therapy as first-line therapy for advanced HER2+ breast cancer with no evidence of disease progression.</li><li>In arms 1 and 2, patients should have at least one measurable lesion either extracranially or intracranially per RECIST v1.1.\nFor patients in arm 3, they are permitted to have measurable and&#x2F;or non-measurable disease.</li></ol><p>For patients with brain metastasis, the following criteria should be met:</p><ol><li>For arm 1 and arm 2 of phase 1b, patients should be relapsed or refractory to existing therapy(ies), with a history of prior treatment with trastuzumab and a taxane.\nFor arm3, patients have received 4-8 cycles (21-day cycles) of previous treatment with trastuzumab, pertuzumab, and taxane as first-line therapy for advanced HER2+ breast cancer with no evidence of disease progression.\nFor arm 1 and arm 2 of phase 1c, patients should be refractory to existing therapy(ies), with a history of prior treatment with trastuzumab.\nFor arm3, patients have received previous treatment with a pertuzumab plus trastuzumab or T-DXd based induction therapy as first-line therapy for advanced HER2+ breast cancer with no evidence of disease progression (except brain metastases).\nFor patients with T-DXd based induction therapy the medical monitor must be consulted prior to screening</li><li>Do not require immediate local treatment during the trial period, and meet either of the following two criteria: i) For patients who have received previous local treatment (surgery, whole brain radiotherapy (WBRT) and stereotactic radiosurgery (SRS)) for brain metastases, stable or progression of intracranial lesions is required.\nInterval from prior local therapy could be 3 weeks from WBRT, 2 weeks from SRS and 4 weeks from surgery; ii) Symptomatic or not, patient has not received previous local treatment (surgery or radiotherapy) for brain metastases as long as no local therapy is needed during the trial period.</li></ol></li><li>Suspected or confirmed leptomeningeal metastasis are allowed.</li><li>In Phase 1b arm1 and arm2, patients who have received previous tyrosine kinase inhibitor (TKI) treatment, chemotherapy, antibody, or antibody-drug conjugate (ADC), the interval between the last treatment and the first administration of the study drug in this trial should be at least 2 weeks.\nFor arm3, patients should not have prior treatment for unresectable locally-advanced or metastatic HER2+ breast cancer with and without brain metastasis, except for ongoing Herceptin, Perjeta or PHESGO and taxane.</li><li>In Phase 1c arm1 and arm2, Patients should not have received prior treatment with tucatinib, afatinib, or any other investigational anti-HER2, anti-EGFR, or HER2 TKI agent.\nPrior treatment with lapatinib or neratinib within 12 months of starting study treatment (except in cases where they were given for ≤ 21 days and was discontinued for reasons other than disease progression or severe toxicity).\nPrior treatment with pyrotinib for recurrent of mBC (except in cases where pyrotinib was given for ≤ 21 days and was discontinued for reasons other than disease progression or severe toxicity).\nFor arm3, patients should not have prior treatment for unresectable locally-advanced or metastatic HER2+ breast cancer with and without brain metastasis, except for ongoing Herceptin, Perjeta or PHESGO or T-Dxd based induction.</li></ol></li><li><p>Exclusion Criteria:</p><ol><li>Subjects who have participated in any clinical study or received any clinical study drug within 4 weeks prior to the first administration except for on-going Herceptin, Perjeta or PHESGO in arm3</li><li><p>CNS Exclusion - Based on screening brain MRI and clinical assessment</p><ol><li>Progressive neurologic impairment or increased intracranial pressure (including nausea, vomiting, blurred vision, headache, epilepsy, etc.)</li><li>Any intracranial lesion thought to require immediate local therapy</li><li>Require antiepileptic treatment (except for these patients with stable seizures require continuous Levetiracetam therapy).</li><li>Ongoing use of systemic corticosteroids for control of symptoms of brain metastases at a total daily dose of &gt; 2 mg of dexamethasone (or equivalent)</li></ol></li></ol></li></ul>"
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