Multicenter, Phase 3 Study of Venetoclax and Azacitidine as Maintenance Therapy for Patients with Acute Myeloid Leukemia in First Remission After Conventional Chemotherapy

2023-507221-42-00 Protocol M19-708 Therapeutic confirmatory (Phase III) Ended

Start 3 Jun 2020 · End 18 Feb 2026 · Status Ended · 7 EU/EEA countries · 22 sites · Protocol M19-708

Overview

Sponsor-declared trial summary

Phase Therapeutic confirmatory (Phase III)
Status Ended
Participants planned 122
Countries 7
Sites 22

Acute Myeloid Leukemia in First Remission

Part I (Dose Confirmation): To determine the RPTD of venetoclax in combination with AZA as maintenance therapy in subjects with AML who have achieved CR or CRi with conventional induction and consolidation chemotherapy Part III (Dose Finding): To determine the RPTD of venetoclax in combination with oral AZA as maintena…

Key facts

Sponsor
AbbVie Deutschland GmbH & Co. KG
Participant type
Patients
Age range
18-64 years, 65+ years
Gender
Male and Female
Therapeutic area
Diseases [C] - Neoplasms [C04]
Trial duration
3 Jun 2020 → 18 Feb 2026
Decision date (initial)
2024-02-07
Transition trial
Yes
Low-intervention
No
Rare-disease indication
No
Vulnerable population
Yes
Funding sources
AbbVie Inc.

External identifiers

EU CT number
2023-507221-42-00
EudraCT number
2019-002217-19
ClinicalTrials.gov
NCT04102020

Trial design

CTIS Part I — objectives, methods, condition coding

Main objective

Scope: Therapy, Safety

Part I (Dose Confirmation): To determine the RPTD of venetoclax in combination with AZA as maintenance therapy in subjects with AML who have achieved CR or CRi with conventional induction and consolidation chemotherapy
Part III (Dose Finding): To determine the RPTD of venetoclax in combination with oral AZA as maintenance therapy in subjects with AML who have achieved CR or CRi with conventional induction and consolidation chemotherapy.
Part III (Randomization): Not applicable; Part 3 (Randomization) was removed from Version 6.0 of this protocol.

Secondary objectives 2

  1. Part 3 (Dose Finding) To characterize the safety, efficacy, pharmacokinetic (PK), and toxicity profiles of venetoclax in combination with oral AZA as maintenance therapy in subjects with AML who have achieved CR or CRi with conventional induction and consolidation chemotherapy.
  2. Part 3 (Randomization): Not applicable; Part 3 (Randomization) was removed from Version 6.0 of this protocol.

Conditions and MedDRA coding

Acute Myeloid Leukemia in First Remission

VersionLevelCodeTermSystem organ class
21.0 PT 10000881 Acute myeloid leukaemia (in remission) 100000004864

Study design 2 periods

#TitleAllocationBlindingRoles blindedArms
1 Part 1: Dose Confirmation
For Part 1, the dose-confirmation cohort will enroll at least 20 subjects to receive venetoclax + AZA at the following dose levels: venetoclax 400 mg once daily (QD; Days 1 –28) for each 28-day cycle up to 24 cycles and AZA 50 mg/m2 SC or IV, QD for 5 days beginning on Cycle 1, Day 1 (Days 1 –5) of each 28-day cycle up to 6 cycles. When at least 20 subjects have been treated for at least 28 days, an aggregate review of the toxicity data will be made by the sponsor. If fewer than 20% of the subjects experience DLTs during Cycle 1, the RPTD will have been established. However, if 20% or more have DLTs during Cycle 1, an additional cohort of approximately 20 subjects will be treated with a reduced dose of AZA (36 mg/m2 , QD for 5 days) without dose modification of venetoclax (400 mg, QD) for 28 days. If 20% or more of these additional subjects experience DLTs during Cycle 1, a subsequent cohort of approximately 20 subjects may be treated with a reduced dose of AZA and/or reduced dosing duration per cycle of venetoclax. The recommended dose of venetoclax in combination with AZA will be such that fewer than 20% of subjects experienced a DLT during Cycle 1 in Part 1. Subjects are considered to have completed the study treatment once they complete 24 treatment cycles. Subjects with controlled disease, who have not experienced a DLT, and who have tolerable side effects may continue to receive study drug for up to 48 cycles or until relapse, unacceptable toxicity occurs, or until the study closes. The investigator may discontinue a subject from the study as deemed appropriate. As of 26 August 2021, 66 subjects were enrolled in Part 1 (Dose Confirmation).
2 None
2 Part 3: Dose Finding
Part 3 (Dose Finding) will follow a Bayesian optimal interval (BOIN) design to guide dose-escalation and de-escalation decisions based on the cumulative number of subjects experiencing a DLT at the current dose level. Table 2 of the protocol gives the dose levels of venetoclax in combination with oral AZA to be explored. Venetoclax and oral AZA may be administered for up to 24 cycles. In the dose-escalation portion, each dose level will initially enroll at least 6 DLT-evaluable subjects. The first cohort of subjects will be assigned to receive dose Level 1 (venetoclax [400 mg] QD on Days 1 to 21 in combination with oral AZA [200 mg] QD on Days 1 to 14 of each 28-day cycle) with dose escalation or de-escalation for the subsequent cohort of subjects guided by a BOIN design. Table 3 of the protocol gives the BOIN dose-escalation decision rule for a target toxicity rate of 20% and optimal interval of (16.9%, 25.1%). Approximately 12 subjects will be assigned to receive the preliminary RPTD identified during dose escalation. The safety expansion portion will enroll at least 12 additional subjects to receive venetoclax in combination with oral AZA at the preliminary RPTD identified from dose-escalation portion of Part 3. Subjects will be assessed for potential evidence of AML relapse through medical history, physical examination, and hematological laboratory review as detailed in the Operations Manual Section 3.14. Subjects with controlled disease who have not experienced a DLT and who have tolerable side effects may continue to receive study drugs for 24 cycles or until relapse or unacceptable toxicity occurs. The investigator may discontinue a subject from the study as deemed appropriate. Subjects who discontinue study drug but have not had an event of documented relapse will return for post-treatment follow-up visits. Subjects in Part 3 (Dose Finding) will return for post-treatment follow-up visits every 3 months (± 28 days) for 1 year and then every 6 months (± 28 days) thereafter starting from study drug discontinuation until documented relapse or the study ends, whichever occurs first. After relapse, survival information will be collected (e.g., via telephone calls and/or clinical visits) every 3 months (± 28 days) or more frequently at the sponsor's discretion for up to 2 years after relapse or until the sponsor's decision to stop follow-up. As of 08 September 2022, 46 subjects were enrolled in Part 3 (Dose Finding).
2 None

Regulatory references

Scientific advice from competent authorities
European Medicines Agency, Food And Drug Administration
Plan to share IPD
Yes
IPD plan description
AbbVie is committed to responsible clinical trial data sharing. This includes access to anonymized, individual and trial-level data (analysis data sets), as well as other information. To learn more about the process, or to submit a request, visit the following link https://www.abbvieclinicaltrials.com/hcp/data-sharing/ For details on when studies are available for sharing visit https://vivli.org/ourmember/abbvie/

Eligibility criteria

Principal inclusion / exclusion criteria as submitted by sponsor

Inclusion criteria 2

  1. Subject must be ≥18 years old, have newly diagnosed AML with intermediate or poor risk cytogenetics, have confirmation of CR or CRi following completion of intensive Induction and Consolidation chemotherapies; subject should be within one of the following time windows: have achieved first CR or CRi (after induction) within 120 days of the first dose of study drug (Cycle 1 Day 1) or be no more than 75 days since last dose of intensive conventional (including both induction and consolidation) chemotherapies until enrollment (Cycle 1 Day 1), and have an Eastern Cooperative Oncology Group (ECOG) performance status of ≤2.
  2. The key laboratory requirements are as follows: Subject must meet the following laboratory parameters, per laboratory reference range within the screening period prior to study drug administration: - creatinine clearance ≥30 mL/minute; calculated by the Cockcroft Gault formula or measured by 24-hour urine collection; - bilirubin < 3.0 × upper limit of normal (ULN) (adequate liver function) for Parts 1 or bilirubin < 2.0 × ULN for Part 3; - absolute neutrophil count ≥1,500/μL; - platelets ≥100,000/μL.

Exclusion criteria 3

  1. History of APL.
  2. History of active central nervous system involvement with AML.
  3. History of autologous stem cell transplantation for AML.

Endpoints

Primary and secondary outcome measures (English text)

Primary endpoints 3

  1. Part I: The primary endpoint is dose-limiting toxicities of venetoclax in combination with AZA
  2. Part III (Dose Finding): The primary endpoint is DLTs of venetoclax in combination with oral AZA
  3. Part III (Randomization): Not applicable; Part 3 (Randomization) was removed from Version 6.0 of this protocol.

Secondary endpoints 1

  1. Part 3 (Randomization): Not applicable; Part 3 (Randomization) was removed from Version 6.0 of this protocol.

Investigational products

Investigational medicinal products (IMPs), comparators, placebo, auxiliary

Test 6

Venetoclax

PRD2186234 · Product

Active substance
Venetoclax
Pharmaceutical form
FILM-COATED TABLET
Route of administration
ORAL USE
Max daily dose
400 mg milligram(s)
Max total dose
403200 mg milligram(s)
Max treatment duration
48 Month(s)
Authorisation status
Not Authorised
MA holder
ABBVIE DEUTSCHLAND GMBH & CO. KG
Paediatric formulation
No
Orphan designation
No

Venetoclax

PRD2186236 · Product

Active substance
Venetoclax
Pharmaceutical form
FILM-COATED TABLET
Route of administration
ORAL USE
Max daily dose
400 mg milligram(s)
Max total dose
403200 mg milligram(s)
Max treatment duration
48 Month(s)
Authorisation status
Not Authorised
MA holder
ABBVIE DEUTSCHLAND GMBH & CO. KG
Paediatric formulation
No
Orphan designation
No

Venetoclax

PRD2186235 · Product

Active substance
Venetoclax
Pharmaceutical form
FILM-COATED TABLET
Route of administration
ORAL USE
Max daily dose
400 mg milligram(s)
Max total dose
403200 mg milligram(s)
Max treatment duration
48 Month(s)
Authorisation status
Not Authorised
MA holder
ABBVIE DEUTSCHLAND GMBH & CO. KG
Paediatric formulation
No
Orphan designation
No

azacitidine

PRD9836740 · Product

Active substance
Azacitidine
Pharmaceutical form
TABLET
Route of administration
ORAL USE
Max daily dose
300 mg milligram(s)
Max total dose
67200 mg milligram(s)
Max treatment duration
24 Month(s)
Authorisation status
Not Authorised
MA holder
BRISTOL-MYERS SQUIBB INTERNATIONAL CORPORATION
Paediatric formulation
No
Orphan designation
No

azacitidine

PRD9836742 · Product

Active substance
Azacitidine
Pharmaceutical form
TABLET
Route of administration
ORAL USE
Max daily dose
300 mg milligram(s)
Max total dose
100800 mg milligram(s)
Max treatment duration
24 Month(s)
Authorisation status
Not Authorised
MA holder
BRISTOL-MYERS SQUIBB INTERNATIONAL CORPORATION
Paediatric formulation
No
Orphan designation
No

Azacitidine

SUB05624MIG · Substance

Active substance
Azacitidine
Pharmaceutical form
POWDER FOR SUSPENSION FOR INJECTION
Route of administration
INTRAVENOUS (IV) OR SUBCUTANEOUS (SC)
Max daily dose
50 mg/m2 milligram(s)/sq. meter
Max total dose
12000 mg/m2 milligram(s)/sq. meter
Max treatment duration
6 Month(s)
Authorisation status
Authorised
ATC code
- — -
Marketing authorisation
-
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Sponsors and contacts

Sponsor organisations, regulatory contacts, third parties

AbbVie Deutschland GmbH & Co. KG

Sponsor organisation
AbbVie Deutschland GmbH & Co. KG
Address
Knollstrasse
City
Ludwigshafen Am Rhein
Postcode
67061
Country
Germany

Scientific contact point

Organisation
AbbVie Deutschland GmbH & Co. KG
Contact name
Global Clinical Trials Helpdesk

Public contact point

Organisation
AbbVie Deutschland GmbH & Co. KG
Contact name
Global Clinical Trials Helpdesk

Third parties 4

OrganisationCity, countryDuties
Signant Health Global LLC
ORG-100040604
Blue Bell, United States Other
Labcorp Central Laboratory Services S.a.r.l.
ORG-100011524
Meyrin, Switzerland Other
Endpoint Clinical Inc.
ORG-100040567
Wakefield, United States Interactive response technologies (IRT)
Medidata Solutions Inc.
ORG-100016256
New York, United States E-data capture

Locations

7 EU/EEA countries · 22 investigational sites

By country

CountryMS statusPlanned subjectsSites
Czechia Ended 14 3
France Ended 3 3
Germany Ended 2 1
Greece Ended 8 4
Hungary Ended 6 3
Italy Ended 3 3
Spain Ended 5 5
Rest of world
Russian Federation, United Kingdom, Japan, Canada, United States, Australia, Taiwan, Turkey, China
81

Investigational sites

Czechia

3 sites · Ended
Fakultni Nemocnice Ostrava
N/A, 17. Listopadu 1790/5, 708 00, Poruba
Institute Of Hematology And Blood Transfusion
N/A, U Nemocnice 2094/1, Nove Mesto, Prague 2
Fakultni Nemocnice Brno
N/A, Jihlavska 340/20, Bohunice, Brno

France

3 sites · Ended
Centre Hospitalier De La Cote Basque
N/A, 13 Avenue Interne Jacques Loeb, 64100, Bayonne
Institut Gustave Roussy
N/A, 114 Rue Edouard Vaillant, 94800, Villejuif
Centre Hospitalier Universitaire De Nice
N/A, 151 Route De Saint Antoine, 06200, Nice

Germany

1 site · Ended
Philipps-Universitaet Marburg
N/A, Baldingerstrasse, 35043, Marburg

Greece

4 sites · Ended
University General Hospital Of Alexandroupoli
Hematology, 6th Km Alex Polis Makris, Dragana, Alexandroupoli
Laiko General Hospital Of Athens
Hematology, Sevastoupoleos 16, 115 26, Athens
Evaggelismos Hospital
Haematology-Lymphomas Department and BMT Unit, Ipsiladou 45-47, 106 76, Athens
University General Hospital Attikon
Department of Internal Medicine - Propaedeutic, Hematology Unit, Rimini Street 1, 124 62, Athens

Hungary

3 sites · Ended
Szabolcs-Szatmar-Bereg Varmegyei Oktatokorhaz
N/A, Szent Istvan Utca 68, 4400, Nyiregyhaza
Somogy Varmegyei Kaposi Mor Oktato Korhaz
N/A, Tallian Gyula Utca 20-32, 7400, Kaposvar
University Of Debrecen
Belgyogyaszati Klinika Hematologiai Tanszek, Nagyerdei Korut 98, 4032, Debrecen

Italy

3 sites · Ended
Azienda Ospedaliera Universitaria Citta' Della Salute E Della Scienza Di Torino
N/A, Corso Bramante 88, 10126, Turin
ASST Grande Ospedale Metropolitano Niguarda
N/A, Piazza Dell'ospedale Maggiore 3, 20162, Milan
Azienda Ospedaliero Universitaria Ospedali Riuniti Umberto I G M Lancisi G Salesi
N/A, Via Filippo Corridoni 11, 60123, Ancona

Spain

5 sites · Ended
Hospital Universitario Virgen De La Victoria
Hematology, Calle Del Arroyo Teatinos Sn, 29010, Malaga
Hospital De La Santa Creu I Sant Pau
N/A, Carrer De San Quinti 89, 08041, Barcelona
Hospital Universitario Fundacion Jimenez Diaz
NA, Avenida De Los Reyes Catolicos 2, 28040, Madrid
Hospital Universitario 12 De Octubre
N/A, Bloque D, Avenida De Cordoba Sn, Madrid
Hospital Universitario Ramon Y Cajal
N/A, Carretera Del Colmenar Viejo Km 9 100, Por El Pardo, Madrid

Country notifications

Trial-start, recruitment-start, end and early-termination notifications submitted per Member State

Country Trial startTrial end Recruitment startRecruitment end Early termination
Czechia 2020-06-03 2026-01-22 2020-06-23 2022-08-29
France 2021-09-22 2026-01-21 2021-10-01 2022-08-29
Germany 2020-10-30 2026-01-28 2021-06-16 2022-08-29
Greece 2020-07-01 2026-02-04 2020-07-20 2022-08-04
Hungary 2020-06-11 2026-02-05 2020-10-22 2022-04-28
Italy 2020-06-15 2026-02-11 2022-02-21 2022-08-29
Spain 2020-07-07 2026-02-05 2020-12-15 2023-03-27

Results and documents

Annex IV summary of results, Annex V layperson summary, and all documents registered in CTIS for this trial

Documents 70 files

Public protocol annexes, IB summaries, regulatory submissions and post-authorisation documents registered in CTIS.

TypeTitleVersion
Protocol (for publication) D1_m19708-protocol-admin-change_EL-GR_Redacted 1
Protocol (for publication) D1_m19708-protocol-admin-change_redacted 1
Protocol (for publication) D1_m19708-protocol-redacted 8
Protocol (for publication) D1_m19708-protocol-redacted-EL-EL 8
Recruitment arrangements (for publication) EU-CTR blank document 2
Recruitment arrangements (for publication) EU-CTR blank document 1
Recruitment arrangements (for publication) K1_M19-708 CZ_Recruitment and ICF Procedures_blank document 2
Recruitment arrangements (for publication) K1_M19-708 EU CTR Blank Document_Recruitment and ICF Procedures 1
Recruitment arrangements (for publication) K1_M19-708 GR_Recruitment and ICF Procedures_blank document 1.0
Recruitment arrangements (for publication) K1_M19-708 HU_EU CTR Blank Document_Recruitment and ICF Procedures 2
Recruitment arrangements (for publication) K1_M19-708 IT_Recruitment and ICF Procedures_blank document 1
Recruitment arrangements (for publication) K1_M19-708_ES_Recruitment and ICF Procedures_Blank_public 1
Subject information and informed consent form (for publication) L1 M19-708 FR Addendum ICF_Public 1
Subject information and informed consent form (for publication) L1 M19-708_CZ GDPR_public 2
Subject information and informed consent form (for publication) L1 M19-708_CZ ICF Main PART 3 TC 6
Subject information and informed consent form (for publication) L1 M19-708_CZ ICF Main PART 3_public 6
Subject information and informed consent form (for publication) L1 M19-708_CZ ICF Main_PART 1 public 8
Subject information and informed consent form (for publication) L1 M19-708_CZ ICF Main_PART 1 TC 8
Subject information and informed consent form (for publication) L1 M19-708_CZ ICF Optional TC 3
Subject information and informed consent form (for publication) L1 M19-708_CZ ICF Optional_public 3
Subject information and informed consent form (for publication) L1 M19-708_CZ PPA_v2_4Jun2024 TC 2
Subject information and informed consent form (for publication) L1 M19-708_CZ PPA2 public 2
Subject information and informed consent form (for publication) L1_M19-708 GR - ICF Submission Informed Consent Main- Public 8.0
Subject information and informed consent form (for publication) L1_M19-708 HU PIS and ICF Main_Public redacted 9.0
Subject information and informed consent form (for publication) L1_M19-708 IT - 213946 ICF PregPart IRB Approved Public 02Aug2023
Subject information and informed consent form (for publication) L1_M19-708 IT_ICF Main_Clean_Public 2.1
Subject information and informed consent form (for publication) L1_M19-708 IT_ICF Optional PG_Clean_Public 2.1
Subject information and informed consent form (for publication) L1_M19-708_DE_ICF Main_German_public 7
Subject information and informed consent form (for publication) L1_M19-708_ES_ICF Main_public 8.0
Subject information and informed consent form (for publication) L1_M19-708_ES_ICF Pregnant partner_public 3.0
Subject information and informed consent form (for publication) M19-708 CZ - ICF Main Country Sample Czech_1_Public 5.0
Subject information and informed consent form (for publication) M19-708 CZ - ICF Main Country Sample Czech_2_Public 7.0
Subject information and informed consent form (for publication) M19-708 CZ - ICF Main Country Sample Czech_3_Public 7.0
Subject information and informed consent form (for publication) M19-708 CZ - ICF Main Country Sample Czech_Public 5.0
Subject information and informed consent form (for publication) M19-708 CZ - ICF Submission Informed Consent Main Czech_3_Public 7.0
Subject information and informed consent form (for publication) M19-708 CZ - ICF Submission Informed Consent Main Czech_4_Public 7.0
Subject information and informed consent form (for publication) M19-708 CZ - ICF Submission Informed Consent Main Czech_Public 5.0
Subject information and informed consent form (for publication) M19-708 CZ - ICF Submission Informed Consent PharmacoGenetic Czech_Public 2.0
Subject information and informed consent form (for publication) M19-708 CZ - ICF Submission Informed Consent Pregnant Partner Czech - Public 3.0
Subject information and informed consent form (for publication) M19-708 CZ - Informed Consent - Public 4.0
Subject information and informed consent form (for publication) M19-708 CZ - ICF Submission Informed Consent Main Czech_1_Public 5.0
Subject information and informed consent form (for publication) M19-708 DE - Informed Consent - Public 1.1
Subject information and informed consent form (for publication) M19-708 ES - Informed Consent - Public 1
Subject information and informed consent form (for publication) M19-708 FR - ICF Addend IRB Approved French - Public 2
Subject information and informed consent form (for publication) M19-708 FR - ICF Main IRB Approved French - Public 6.0
Subject information and informed consent form (for publication) M19-708 FR - Informed Consent Pregnant Partner - Public 3.0
Subject information and informed consent form (for publication) M19-708 GR - ICF Other IRB Approved Greek - Public 2
Subject information and informed consent form (for publication) M19-708 GR - Informed Consent - Public 1
Subject information and informed consent form (for publication) M19-708 HU - ICF Main IRB Approved Hungarian_Public 8.0
Subject information and informed consent form (for publication) M19-708 HU - Optional Genetic ICF_Public 1.0
Subject information and informed consent form (for publication) M19-708 HU - Optional Genetic PIS_Public Redacted 1
Subject information and informed consent form (for publication) M19-708 HU - PIS Main IRB Approved Hungarian_Public Redacted 8.0
Subject information and informed consent form (for publication) M19-708 HU - Pregnant Partner ICF_Public 1.1
Subject information and informed consent form (for publication) M19-708 HU - Pregnant Partner PIS_Public 1.1
Summary of Product Characteristics (SmPC) (for publication) E2_SmPC-Vidaza-25mgml-pow for sus for inj 2
Summary of Product Characteristics (SmPC) (for publication) E2_SmPC-Vidaza-25mgml-pow for sus for inj-redlines 2
Summary of Product Characteristics (SmPC) (for publication) onureg-epar-product-information_en_Public 1
Synopsis of the protocol (for publication) D1_m19708-protocol synops-is-FR-FR-redlines 8
Synopsis of the protocol (for publication) D1_m19708-protocol synopsis 8
Synopsis of the protocol (for publication) D1_m19708-protocol synopsis-CS-CZ 8
Synopsis of the protocol (for publication) D1_m19708-protocol synopsis-CS-CZ-redlines 8
Synopsis of the protocol (for publication) D1_m19708-protocol synopsis-EL-EL 8
Synopsis of the protocol (for publication) D1_m19708-protocol synopsis-EL-EL-redlines 8
Synopsis of the protocol (for publication) D1_m19708-protocol synopsis-ES-ES 8
Synopsis of the protocol (for publication) D1_m19708-protocol synopsis-ES-ES-redlines 8
Synopsis of the protocol (for publication) D1_m19708-protocol synopsis-FR-FR 8
Synopsis of the protocol (for publication) D1_m19708-protocol synopsis-HU-HU 8
Synopsis of the protocol (for publication) D1_m19708-protocol synopsis-HU-HU-redlines 8
Synopsis of the protocol (for publication) D1_m19708-protocol synopsis-IT-IT 8
Synopsis of the protocol (for publication) D1_m19708-protocol synopsis-IT-IT-redlines 8

Application history

4 submissions — initial application plus substantial / non-substantial modifications

#TypeCodeSubmittedReference MSConclusionDecision date
1 INITIAL IN 2023-12-18 Germany Acceptable
2024-02-06
2024-02-06
2 SUBSTANTIAL MODIFICATION SM-1 2024-08-07 Germany Acceptable
2024-11-11
2024-11-12
3 SUBSTANTIAL MODIFICATION SM-2 2025-03-31 Germany Acceptable
2025-05-26
2025-05-26
4 NON SUBSTANTIAL MODIFICATION NSM-1 2025-12-15 Acceptable
2025-05-26
2025-12-15