Sorafenib Tosylate in Treating Patients With Desmoid Tumors or Aggressive Fibromatosis

Last updated: June 6, 2023
Sponsor: National Cancer Institute (NCI)
Overall Status: Completed

Phase

3

Condition

N/A

Treatment

Quality-of-Life Assessment

Placebo Administration

Sorafenib Tosylate

Clinical Study ID

NCT02066181
NCI-2014-00264
R01FD005105
PA091105_A04PAMDREVW01
NCI-2014-00264
U10CA180821
U10CA031946
A091105
  • Ages > 18
  • All Genders

Study Summary

This randomized phase III trial compares the effects, good and/or bad, of sorafenib tosylate in treating patients with desmoid tumors or aggressive fibromatosis. Sorafenib tosylate may stop the growth of tumor cells by blocking some of the proteins needed for cell growth. [Funding Source - FDA OOPD]

Eligibility Criteria

Inclusion

Inclusion Criteria:

  • Patients must have confirmation of DT/DF by local pathologist prior to registration

  • Patients may have been treated with locoregional therapies such as major surgery, radiation, radiofrequency ablation, or cryosurgery provided this has been completed at least 4 weeks prior to registration and recovered from therapy related toxicity to less than CTCAE grade 2

  • Patients may have been treated with cytotoxic, biologic (antibody), immune or experimental therapy, tyrosine kinase inhibitors, hormone inhibitors or nonsteroidal anti-inflammatory drugs (NSAIDs) provided this has been completed at least 4 weeks prior to registration (6 weeks for mitomycin and nitrosoureas) and recovered from any therapy related toxicity to less than CTCAE grade 2

  • Patients with prior or current treatment of sorafenib are excluded

  • No concomitant treatment, in therapeutic doses, with anticoagulants such as warfarin or warfarin-related agents, heparin, thrombin or Factor Xa inhibitors, or antiplatelet agents (e.g., clopidogrel); low dose aspirin (=< 81 mg/day), low-dose warfarin (=< 1 mg/day), and prophylactic low molecular weight heparin (LMWH) are permitted; please note that drugs that strongly induce or inhibit cytochrome P450, family 3, subfamily A, polypeptide 4 (CYP3A4) or are associated with a risk of torsades are not allowed; chronic concomitant treatment of CYP3A4 inducers is not allowed (e.g., dexamethasone, phenytoin, carbamazepine, rifampin, rifabutin, rifapentin, phenobarbital, and St. John's wort); as part of the enrollment/informed consent procedures, the patient will be counseled on the risk of interactions with other agents, and what to do if new medications need to be prescribed or if the patient is considering a new over-the-counter medicine or herbal product; the following drugs are strong inhibitors of CYP3A4 and are not allowed during the treatment with sorafenib:

  • Boceprevir

  • Indinavir

  • Nelfinavir

  • Lopinavir/ritonavir

  • Saquinavir

  • Telaprevir

  • Ritonavir

  • Clarithromycin

  • Conivaptan

  • Itraconazole

  • Ketoconazole

  • Mibefradil

  • Nefazodone

  • Posaconazole

  • Voriconazole

  • Telithromycin

  • Drugs with possible or conditional risk of torsades should be used with caution knowing that sorafenib could prolong the QT interval

  • Chronic daily NSAID use as treatment for controlling desmoid tumors is not allowed, and should be stopped >= 3 days prior to registration; NSAIDS are allowed when used for desmoid tumor-related pain or for symptoms that are unrelated to desmoid disease (eg. headache, arthritis)

  • Patients must have measurable disease

  • Patients have to meet one of the following criteria to be eligible:

  • Disease determined unresectable or entailing unacceptably morbid surgery based on 1 or more of the following characteristics:

  • Multifocal disease

  • Disease in which there is involvement or inadequate plane from: neurovascular bundle, bone, skin, or viscera

  • Large size in relationship to location OR multi-compartment involvement

  • Progression by radiographic imaging (10% increase in size by RECIST v1.1 within 6 months of registration)

  • Patients with symptomatic disease which meets the following criteria Brief Pain Inventory (BPI) score greater than or equal to 3 AND one of the following:

  • Inability to control pain with NSAIDs and considering addition of narcotics OR

  • > 30% increase in current use of narcotics OR

  • Addition of a new opioid narcotic

  • Eastern Cooperative Oncology Group (ECOG) performance status =< 2

  • Patients who are pregnant or nursing are not eligible

  • No patients with a history of cardiac disease: congestive heart failure > class II New York Heart Association (NYHA); active coronary artery disease (CAD) (myocardial infarction or unstable angina within 6 months prior to study entry)

  • No patients with inadequately controlled hypertension (defined as a blood pressure of >= 150 mmHg systolic and/or >= 90 mmHg diastolic), or any prior history of hypertensive crisis or hypertensive encephalopathy

  • No patients with clinically significant gastrointestinal (GI) bleeding or bleeding diathesis within 30 days prior to registration

  • Absolute neutrophil count >= 1,500/mm^3

  • Hemoglobin >= 8 g/dl

  • Platelets >= 75,000/mm^3

  • Total bilirubin =< 1.5 x upper limits of normal (ULN)

  • Serum glutamic oxaloacetic transaminase (SGOT) (aspartate aminotransferase [AST])/serum glutamate pyruvate transaminase (SGPT) (aspartate aminotransferase [ALT]) =< 1.5 x ULN

  • Calculated creatinine clearance >= 50 mL/min using the Cockcroft-Gault equation

Study Design

Total Participants: 87
Treatment Group(s): 4
Primary Treatment: Quality-of-Life Assessment
Phase: 3
Study Start date:
March 21, 2014
Estimated Completion Date:
December 01, 2022

Study Description

PRIMARY OBJECTIVES:

I. To compare the progression-free survival (PFS) rates of patients with desmoid tumors (DT)/deep fibromatosis (DF) who receive either sorafenib (sorafenib tosylate) or placebo using a double-blinded randomized phase III study.

SECONDARY OBJECTIVES:

I. To assess toxicity. II. To assess time to surgical intervention. III. To assess tumor response rates and survival.

TERTIARY OBJECTIVES:

I. To evaluate changes in magnetic resonance imaging (MRI) Tesla (T)2 to predict (or correlate) with a biological effect such as tumor growth (by Response Evaluation Criteria in Solid Tumors [RECIST] version [v]1.1), and pain palliation. (Correlative companion study) II. The mechanism of action of sorafenib in DT/DF remains unknown. In patients consenting to undergo the paired tumor biopsies (A091105-ST1), treatment induced changes will be quantified by histology, gene expression profiling, proteomic changes and selected interrogation of key pathways by western blot and reverse transcription-polymerase chain reaction (RT-PCR). (Correlative companion study) III. To collect archival tissue, baseline (tumor, blood) and day 8 (tumor, blood) specimens for basic science research (A091105-ST1). (Correlative companion study) IV. To assess patient-reported adverse events and quality of life (QOL) as measured by the Patient-Reported Outcomes-Common Terminology Criteria for Adverse Events (PRO-CTCAE) and the single-item overall Linear Analogue Self-Assessment (LASA) (A091105-HO1). (Correlative companion study) V. To assess pain palliation measured by the "worst pain" item of the Brief Pain Inventory Short Form (A091105-HO1). (Correlative companion study)

OUTLINE: Patients are randomized to 1 of 2 treatment arms.

ARM I: Patients receive sorafenib tosylate orally (PO) once daily (QD) on days 1-28.

ARM II: Patients receive placebo PO QD on days 1-28. Patients may crossover to Arm I upon disease progression.

In both arms, courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed up annually for up to 3 years.

Connect with a study center

  • University Health Network-Princess Margaret Hospital

    Toronto, Ontario M5G 2M9
    Canada

    Site Not Available

  • University of Alabama at Birmingham Cancer Center

    Birmingham, Alabama 35233
    United States

    Site Not Available

  • University of Arkansas for Medical Sciences

    Little Rock, Arkansas 72205
    United States

    Site Not Available

  • PCR Oncology

    Arroyo Grande, California 93420
    United States

    Site Not Available

  • PCR Oncology

    Pismo Beach, California 93449
    United States

    Site Not Available

  • Yale University

    New Haven, Connecticut 06520
    United States

    Site Not Available

  • Beebe Medical Center

    Lewes, Delaware 19958
    United States

    Site Not Available

  • Christiana Care Health System-Christiana Hospital

    Newark, Delaware 19718
    United States

    Site Not Available

  • Christiana Gynecologic Oncology LLC

    Newark, Delaware 19713
    United States

    Site Not Available

  • Delaware Clinical and Laboratory Physicians PA

    Newark, Delaware 19713
    United States

    Site Not Available

  • Helen F Graham Cancer Center

    Newark, Delaware 19713
    United States

    Site Not Available

  • Medical Oncology Hematology Consultants PA

    Newark, Delaware 19713
    United States

    Site Not Available

  • Beebe Health Campus

    Rehoboth Beach, Delaware 19971
    United States

    Site Not Available

  • TidalHealth Nanticoke / Allen Cancer Center

    Seaford, Delaware 19973
    United States

    Site Not Available

  • Christiana Care Health System-Wilmington Hospital

    Wilmington, Delaware 19801
    United States

    Site Not Available

  • MedStar Georgetown University Hospital

    Washington, District of Columbia 20007
    United States

    Site Not Available

  • MedStar Washington Hospital Center

    Washington, District of Columbia 20010
    United States

    Site Not Available

  • Sibley Memorial Hospital

    Washington, District of Columbia 20016
    United States

    Site Not Available

  • MedStar Washington Hospital Center

    Washington, D.C., District of Columbia 20010
    United States

    Site Not Available

  • Mayo Clinic in Florida

    Jacksonville, Florida 32224-9980
    United States

    Site Not Available

  • John B Amos Cancer Center

    Columbus, Georgia 31904
    United States

    Site Not Available

  • Lewis Cancer and Research Pavilion at Saint Joseph's/Candler

    Savannah, Georgia 31405
    United States

    Site Not Available

  • Low Country Cancer Care

    Savannah, Georgia 31404
    United States

    Site Not Available

  • Pali Momi Medical Center

    'Aiea, Hawaii 96701
    United States

    Site Not Available

  • Queen's Cancer Center - Pearlridge

    'Aiea, Hawaii 96701
    United States

    Site Not Available

  • Hawaii Oncology Inc-Pali Momi

    Aiea, Hawaii 96701
    United States

    Site Not Available

  • Hawaii Cancer Care Inc - Waterfront Plaza

    Honolulu, Hawaii 96813
    United States

    Site Not Available

  • Hawaii Cancer Care Inc-Liliha

    Honolulu, Hawaii 96817
    United States

    Site Not Available

  • Kapiolani Medical Center for Women and Children

    Honolulu, Hawaii 96826
    United States

    Site Not Available

  • Kuakini Medical Center

    Honolulu, Hawaii 96817
    United States

    Site Not Available

  • Queen's Cancer Center - Kuakini

    Honolulu, Hawaii 96817
    United States

    Site Not Available

  • Queen's Medical Center

    Honolulu, Hawaii 96813
    United States

    Site Not Available

  • Straub Clinic and Hospital

    Honolulu, Hawaii 96813
    United States

    Site Not Available

  • University of Hawaii Cancer Center

    Honolulu, Hawaii 96813
    United States

    Site Not Available

  • Wilcox Memorial Hospital and Kauai Medical Clinic

    Lihue, Hawaii 96766
    United States

    Site Not Available

  • Northwestern University

    Chicago, Illinois 60611
    United States

    Site Not Available

  • Loyola University Medical Center

    Maywood, Illinois 60153
    United States

    Site Not Available

  • Good Samaritan Regional Health Center

    Mount Vernon, Illinois 62864
    United States

    Site Not Available

  • Reid Health

    Richmond, Indiana 47374
    United States

    Site Not Available

  • University of Iowa/Holden Comprehensive Cancer Center

    Iowa City, Iowa 52242
    United States

    Site Not Available

  • Siouxland Regional Cancer Center

    Sioux City, Iowa 51101
    United States

    Site Not Available

  • Oncology Hematology Care Inc-Crestview

    Crestview Hills, Kentucky 41017
    United States

    Site Not Available

  • Johns Hopkins University/Sidney Kimmel Cancer Center

    Baltimore, Maryland 21287
    United States

    Site Not Available

  • Brigham and Women's Hospital

    Boston, Massachusetts 02115
    United States

    Site Not Available

  • Dana-Farber Cancer Institute

    Boston, Massachusetts 02215
    United States

    Site Not Available

  • University of Michigan Comprehensive Cancer Center

    Ann Arbor, Michigan 48109
    United States

    Site Not Available

  • Fairview Ridges Hospital

    Burnsville, Minnesota 55337
    United States

    Site Not Available

  • Mercy Hospital

    Coon Rapids, Minnesota 55433
    United States

    Site Not Available

  • Fairview Southdale Hospital

    Edina, Minnesota 55435
    United States

    Site Not Available

  • Unity Hospital

    Fridley, Minnesota 55432
    United States

    Site Not Available

  • Hutchinson Area Health Care

    Hutchinson, Minnesota 55350
    United States

    Site Not Available

  • Minnesota Oncology Hematology PA-Maplewood

    Maplewood, Minnesota 55109
    United States

    Site Not Available

  • Saint John's Hospital - Healtheast

    Maplewood, Minnesota 55109
    United States

    Site Not Available

  • Abbott-Northwestern Hospital

    Minneapolis, Minnesota 55407
    United States

    Site Not Available

  • Health Partners Inc

    Minneapolis, Minnesota 55454
    United States

    Site Not Available

  • Hennepin County Medical Center

    Minneapolis, Minnesota 55415
    United States

    Site Not Available

  • New Ulm Medical Center

    New Ulm, Minnesota 56073
    United States

    Site Not Available

  • North Memorial Medical Health Center

    Robbinsdale, Minnesota 55422
    United States

    Site Not Available

  • Mayo Clinic in Rochester

    Rochester, Minnesota 55905
    United States

    Site Not Available

  • Metro Minnesota Community Oncology Research Consortium

    Saint Louis Park, Minnesota 55416
    United States

    Site Not Available

  • Park Nicollet Clinic - Saint Louis Park

    Saint Louis Park, Minnesota 55416
    United States

    Site Not Available

  • Regions Hospital

    Saint Paul, Minnesota 55101
    United States

    Site Not Available

  • United Hospital

    Saint Paul, Minnesota 55102
    United States

    Site Not Available

  • Saint Francis Regional Medical Center

    Shakopee, Minnesota 55379
    United States

    Site Not Available

  • Lakeview Hospital

    Stillwater, Minnesota 55082
    United States

    Site Not Available

  • Ridgeview Medical Center

    Waconia, Minnesota 55387
    United States

    Site Not Available

  • Rice Memorial Hospital

    Willmar, Minnesota 56201
    United States

    Site Not Available

  • Minnesota Oncology Hematology PA-Woodbury

    Woodbury, Minnesota 55125
    United States

    Site Not Available

  • Central Care Cancer Center - Bolivar

    Bolivar, Missouri 65613
    United States

    Site Not Available

  • Cox Cancer Center Branson

    Branson, Missouri 65616
    United States

    Site Not Available

  • Siteman Cancer Center at West County Hospital

    Creve Coeur, Missouri 63141
    United States

    Site Not Available

  • Freeman Health System

    Joplin, Missouri 64804
    United States

    Site Not Available

  • Mercy Hospital Joplin

    Joplin, Missouri 64804
    United States

    Site Not Available

  • Delbert Day Cancer Institute at PCRMC

    Rolla, Missouri 65401
    United States

    Site Not Available

  • Mercy Clinic-Rolla-Cancer and Hematology

    Rolla, Missouri 65401
    United States

    Site Not Available

  • Mercy Hospital Saint Louis

    Saint Louis, Missouri 63141
    United States

    Site Not Available

  • Saint Louis Cancer and Breast Institute-South City

    Saint Louis, Missouri 63109
    United States

    Site Not Available

  • Siteman Cancer Center-South County

    Saint Louis, Missouri 63129
    United States

    Site Not Available

  • Washington University School of Medicine

    Saint Louis, Missouri 63110
    United States

    Site Not Available

  • Siteman Cancer Center at Saint Peters Hospital

    Saint Peters, Missouri 63376
    United States

    Site Not Available

  • CoxHealth South Hospital

    Springfield, Missouri 65807
    United States

    Site Not Available

  • Mercy Hospital Springfield

    Springfield, Missouri 65804
    United States

    Site Not Available

  • Nebraska Cancer Research Center

    Lincoln, Nebraska 68510
    United States

    Site Not Available

  • Nebraska Hematology and Oncology

    Lincoln, Nebraska 68506
    United States

    Site Not Available

  • Southeast Nebraska Cancer Center - 68th Street Place

    Lincoln, Nebraska 68516
    United States

    Site Not Available

  • Faith Regional Health Services Carson Cancer Center

    Norfolk, Nebraska 68701
    United States

    Site Not Available

  • Great Plains Health Callahan Cancer Center

    North Platte, Nebraska 69101
    United States

    Site Not Available

  • Alegent Health Bergan Mercy Medical Center

    Omaha, Nebraska 68124
    United States

    Site Not Available

  • Alegent Health Immanuel Medical Center

    Omaha, Nebraska 68122
    United States

    Site Not Available

  • Alegent Health Lakeside Hospital

    Omaha, Nebraska 68130
    United States

    Site Not Available

  • Creighton University Medical Center

    Omaha, Nebraska 68131
    United States

    Site Not Available

  • Missouri Valley Cancer Consortium

    Omaha, Nebraska 68106
    United States

    Site Not Available

  • Nebraska Cancer Specialists - Omaha

    Omaha, Nebraska 68124
    United States

    Site Not Available

  • Oncology Hematology West PC

    Omaha, Nebraska 68130
    United States

    Site Not Available

  • Regional West Medical Center Cancer Center

    Scottsbluff, Nebraska 69361
    United States

    Site Not Available

  • Cancer and Blood Specialists-Henderson

    Henderson, Nevada 89052
    United States

    Site Not Available

  • Comprehensive Cancer Centers of Nevada - Henderson

    Henderson, Nevada 89052
    United States

    Site Not Available

  • Comprehensive Cancer Centers of Nevada-Southeast Henderson

    Henderson, Nevada 89074
    United States

    Site Not Available

  • GenesisCare USA - Henderson

    Henderson, Nevada 89074
    United States

    Site Not Available

  • Las Vegas Cancer Center-Henderson

    Henderson, Nevada 89052
    United States

    Site Not Available

  • Cancer Therapy and Integrative Medicine

    Las Vegas, Nevada 89121
    United States

    Site Not Available

  • Cancer and Blood Specialists-Shadow

    Las Vegas, Nevada 89106
    United States

    Site Not Available

  • Cancer and Blood Specialists-Tenaya

    Las Vegas, Nevada 89128
    United States

    Site Not Available

  • Comprehensive Cancer Centers of Nevada

    Las Vegas, Nevada 89148
    United States

    Site Not Available

  • Comprehensive Cancer Centers of Nevada - Central Valley

    Las Vegas, Nevada 89169
    United States

    Site Not Available

  • Comprehensive Cancer Centers of Nevada - Northwest

    Las Vegas, Nevada 89128
    United States

    Site Not Available

  • Comprehensive Cancer Centers of Nevada-Summerlin

    Las Vegas, Nevada 89144
    United States

    Site Not Available

  • GenesisCare USA - Fort Apache

    Las Vegas, Nevada 89148
    United States

    Site Not Available

  • GenesisCare USA - Las Vegas

    Las Vegas, Nevada 89109
    United States

    Site Not Available

  • GenesisCare USA - Vegas Tenaya

    Las Vegas, Nevada 89128
    United States

    Site Not Available

  • HealthCare Partners Medical Group Oncology/Hematology-Centennial Hills

    Las Vegas, Nevada 89149
    United States

    Site Not Available

  • HealthCare Partners Medical Group Oncology/Hematology-Maryland Parkway

    Las Vegas, Nevada 89109
    United States

    Site Not Available

  • HealthCare Partners Medical Group Oncology/Hematology-San Martin

    Las Vegas, Nevada 89113
    United States

    Site Not Available

  • HealthCare Partners Medical Group Oncology/Hematology-Tenaya

    Las Vegas, Nevada 89128
    United States

    Site Not Available

  • Las Vegas Cancer Center-Medical Center

    Las Vegas, Nevada 89148-2405
    United States

    Site Not Available

  • Nevada Cancer Research Foundation NCORP

    Las Vegas, Nevada 89169
    United States

    Site Not Available

  • OptumCare Cancer Care at Fort Apache

    Las Vegas, Nevada 89148
    United States

    Site Not Available

  • Radiation Oncology Centers of Nevada Central

    Las Vegas, Nevada 89106
    United States

    Site Not Available

  • Radiation Oncology Centers of Nevada Southeast

    Las Vegas, Nevada 89119
    United States

    Site Not Available

  • Summerlin Hospital Medical Center

    Las Vegas, Nevada 89144
    United States

    Site Not Available

  • Saint Mary's Regional Medical Center

    Reno, Nevada 89503
    United States

    Site Not Available

  • Hackensack University Medical Center

    Hackensack, New Jersey 07601
    United States

    Site Not Available

  • Memorial Sloan Kettering Cancer Center

    New York, New York 10065
    United States

    Site Not Available

  • NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center

    New York, New York 10032
    United States

    Site Not Available

  • Duke University Medical Center

    Durham, North Carolina 27710
    United States

    Site Not Available

  • Miami Valley Hospital South

    Centerville, Ohio 45459
    United States

    Site Not Available

  • Oncology Hematology Care Inc-Anderson

    Cincinnati, Ohio 45230
    United States

    Site Not Available

  • Oncology Hematology Care Inc-Blue Ash

    Cincinnati, Ohio 45242
    United States

    Site Not Available

  • Oncology Hematology Care Inc-Eden Park

    Cincinnati, Ohio 45202
    United States

    Site Not Available

  • Oncology Hematology Care Inc-Kenwood

    Cincinnati, Ohio 45236
    United States

    Site Not Available

  • Oncology Hematology Care Inc-Mercy West

    Cincinnati, Ohio 45211
    United States

    Site Not Available

  • Dayton NCI Community Oncology Research Program

    Dayton, Ohio 45459
    United States

    Site Not Available

  • Good Samaritan Hospital - Dayton

    Dayton, Ohio 45406
    United States

    Site Not Available

  • Miami Valley Hospital

    Dayton, Ohio 45409
    United States

    Site Not Available

  • Miami Valley Hospital North

    Dayton, Ohio 45415
    United States

    Site Not Available

  • Oncology Hematology Care Inc-Healthplex

    Fairfield, Ohio 45014
    United States

    Site Not Available

  • Blanchard Valley Hospital

    Findlay, Ohio 45840
    United States

    Site Not Available

  • Atrium Medical Center-Middletown Regional Hospital

    Franklin, Ohio 45005-1066
    United States

    Site Not Available

  • Wayne Hospital

    Greenville, Ohio 45331
    United States

    Site Not Available

  • Kettering Medical Center

    Kettering, Ohio 45429
    United States

    Site Not Available

  • Springfield Regional Cancer Center

    Springfield, Ohio 45504
    United States

    Site Not Available

  • Springfield Regional Medical Center

    Springfield, Ohio 45505
    United States

    Site Not Available

  • Upper Valley Medical Center

    Troy, Ohio 45373
    United States

    Site Not Available

  • Wright-Patterson Medical Center

    Wpafb, Ohio 45433-5529
    United States

    Site Not Available

  • Wright-Patterson Medical Center

    Wright-Patterson Afb, Ohio 45433-5529
    United States

    Site Not Available

  • Wright-Patterson Medical Center

    Wright-Patterson Air Force Base, Ohio 45433
    United States

    Site Not Available

  • University of Oklahoma Health Sciences Center

    Oklahoma City, Oklahoma 73104
    United States

    Site Not Available

  • Oklahoma Cancer Specialists and Research Institute-Tulsa

    Tulsa, Oklahoma 74146
    United States

    Site Not Available

  • Christiana Care Health System-Concord Health Center

    Chadds Ford, Pennsylvania 19317
    United States

    Site Not Available

  • Fox Chase Cancer Center

    Philadelphia, Pennsylvania 19111
    United States

    Site Not Available

  • M D Anderson Cancer Center

    Houston, Texas 77030
    United States

    Site Not Available

  • Huntsman Cancer Institute/University of Utah

    Salt Lake City, Utah 84112
    United States

    Site Not Available

  • Sovah Health Martinsville

    Martinsville, Virginia 24115
    United States

    Site Not Available

  • Medical College of Wisconsin

    Milwaukee, Wisconsin 53226
    United States

    Site Not Available

  • Cancer Center of Western Wisconsin

    New Richmond, Wisconsin 54017
    United States

    Site Not Available

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