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Association details:
Evidence:
Evidence Level:
Sensitive: B - Late Trials
Title:

367P - High-dose aumolertinib in EGFR-mutant NSCLC patients with brain metastases: Primary data from ACHIEVE

Published date:
11/28/2022
Excerpt:
Treatment-naïve EGFR-mutant NSCLC patients with asymptomatic brain metastases received aumolertinib 165mg orally once daily….The overall ORR was 90.9% (20/22; 95% CI: 70.8-98.9). The CNS ORR was 86.3 (19/22; 95% CI: 65.1-97.1). The overall and CNS DCR were both 100%.
Trial ID:
Evidence Level:
Sensitive: B - Late Trials
Source:
Title:

Aumolertinib activity in patients with CNS metastases and EGFR-mutated NSCLC treated in the randomized double-blind phase III trial (AENEAS).

Published date:
05/26/2022
Excerpt:
Au also achieved longer CNS median PFS over G in cFAS (29.0 vs 8.3 months; HR = 0.323; 95% CI, 0.181-0.576; P< 0.0001)….Au demonstrated superior clinical efficacy against CNS metastases over G as first-line therapy in EGFR-mutated advanced NSCLC, and the safety profile was consistent with that reported previously.
DOI:
10.1200/JCO.2022.40.16_suppl.9096
Trial ID:
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Go to data
Title:

A Dose Exploration Study of Almonertinib for EGFRm NSCLC Patients With Brain/Leptomeningeal Metastasis (ARTISTRY)

Excerpt:
...Tumor tissue samples or blood are confirmed to be EGFR sensitive mutations (including exon 19 deletion or L858R) by ARMS; 6....
Trial ID:
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Title:

Almonertinib Plus Chemotherapy as First-line Treatment in Patients With EGFR Concomitant Non-EGFR Driver Gene Mutant, Locally Advanced or Metastatic NSCLC

Excerpt:
...- The tumour harbours one of the 2 common EGFR mutations known to be associated with EGFR-TKI sensitivity (Ex19del, L858R), in combination with non-EGFR driver genes mutations assessed by central testing using tumour tissue sample....
More C2 evidence
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Title:

Almonertinib With Chemotherapy in mEGFR NSCLC

Excerpt:
...The tumor harbors 1 of the 2 common epidermal growth factor receptor (EGFR) mutations known to be associated with Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKI) sensitivity (Ex19del or L858R), either alone or in combination with other epidermal growth factor receptor (EGFR) mutations, which may include T790M....
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Title:

Real-world protocol for first-line ematinib therapy in patients with locally advanced or metastatic NSCLC who are EGFR mutation-positive (21 L858R)

Excerpt:
...A tumor tissue sample or blood sample was confirmed as an EGFR-sensitive mutation (21 L858R) by an investigator-approved local laboratory test. ...
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Title:

In vitro antitumor activity and clinical efficacy of almonertinib in NSCLC with uncommon EGFR mutation

Excerpt:
...In vitro experiments (1) Aged 18 to 75 years; (2) NSCLC diagnosed by histopathology and expressing any rare EGFR mutation such as 20 insertion, G719X, L861Q, S768I or L747S; (3) Malignant pleural effusion exists, and pleural effusion treatment is required; (4) The subjects themselves participated voluntarily and signed the informed consent in writing. ...
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Title:

Combination of Almonertinib and Concurrent Chemoradiotherapy in Unresectable Stage III NSCLC

Excerpt:
...Patients must has sensitizing EGFR mutation (e.g....
Trial ID:
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Title:

A Phase III Study to Assess the Efficacy and Safety of Almonertinib Versus Platinum-based Chemotherapy as First-line Therapy in Patients With Locally Advanced or Metastatic NSCLC Harbouring Uncommon EGFR Mutation

Excerpt:
...The tumor harbors uncommon EGFR mutations (one of the following...
Trial ID:
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Title:

Almonertinib Combined With Cerebral Radiation Treat Brain Metastases From EGFR Positive NSCLC

Excerpt:
...Confirmed pathology of EGFR mutation positive(exon 19 deletion, L858R, T790M)NSCLC with brain metastases on enhanced MRI....
Trial ID:
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Title:

Almonertinib for Advanced NSCLC Patients With Rare Mutations in EGFR

Excerpt:
...Positive EGFR driver mutation (rare mutation other than 19 exon deletion or L858R) detected by tumor tissue or blood samples....
Trial ID:
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Title:

Almonertinib as Upfront Treatment for Uncommon EGFR Mutation Harboring Non-Small-Cell Lung Cancer Patients: A Multicenter, Open-Label, Phase II Trial

Excerpt:
...Cohort A: Patients with EGFR exon 20 insertion, failure of first-line standard chemotherapy, or intolerance to chemotherapy Cohort B: Patients with uncommen EGFR mutations but without exon 19 deletion, L858R, T790M, and exon 20 insertion 3....
Trial ID:
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Title:

Almonertinib Vs. Erlotinib/Chemotherapy for Neo-adjuVant Treatment of Stage IIIA-N2 EGFR-mutated NSCLC

Excerpt:
......
Trial ID:
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Title:

Clinical study of ametinib as neoadjuvant therapy in EGFR positive patients with stage IIB to IIIA non-small cell lung cancer

Excerpt:
...Patients with EGFR mutation positive stage IIB to IIIA NSCLC confirmed by histopathology and / or cytology; 3. ...
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Title:

A multicenter, open-label, single-arm clinical study of Aumolertinib mesylate as postoperative adjuvant treatment for patients with EGFRm positive stage IB and pure solid stage IA2-3 invasive Non-Small Cell Lung Cancer

Excerpt:
...Patients with primary non-small cell lung cancer with 2 common EGFR mutations(EGFR 19 Del or 21 L858R); 6. ...
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Title:

A prospective, open, randomized, controlled, multicenter trial of postoperative adjuvant chemoradical radiotherapy followed by sequential maintenance therapy with ametinib versus postoperative adjuvant chemoradical radiotherapy in patients with stage N2-III NSCLC with EGFR mutations

Excerpt:
......
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Title:

A multicenter, open-label, single-arm clinical study of Aumolertinib mesylate as postoperative adjuvant treatment for patients with EGFRm positive stage IB and pure solid stage IA2-3 invasive non-small cell lung cancer

Excerpt:
...The patient had a classical mutation of EGFR (EGFR 19 Del or 21 L858R) in primary non-small cell lung cancer; 6. ...
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Title:

Clinical observation of Aumolertinib in the treatment of residual ground glass nodules in patients with Ⅰ stage EGFR mutation positive after resection of lung cancer

Excerpt:
......
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Title:

Mechanism of resistance to second-line Aumolertinib and exploring combined treatment after resistance

Excerpt:
...Patients with locally advanced (stage IIIB) or metastatic (stage IV) NON-small cell lung cancer with positive EGFR-resistant mutations who are unable to undergo curative surgery or radiotherapy and whose T790M mutation is confirmed; 2. ...
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Title:

Almonertinib Plus Radiotherapy compared with Concurrent RadioChemotherapy in the treatment of unresectable EGFR-mutated stage III Non-Small Cell Lung Cancer: a Multicenter, Open-Label, Randomized, Control Phase III Study

Excerpt:
...Tumor tissue samples or blood samples of stage III NSCLC diagnosed as unresectable are confirmed to be EGFR sensitive mutations (including exon 19 deletion or L858R, both alone or coexist with other EGFR mutations). ...
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Title:

Almonertinib vs. Erlotinib / Chemotherapy for Neo-Adjuvant Treatment of Stage IIIA-N2 EGFR-Mutated NSCLC: a Multicenter, Open-Label, Phase II Randomized Controlled Trial

Excerpt:
......
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Title:

Almonertinib Plus Chemotherapy as First-line Treatment in Patients With EGFR Concomitant Tumor Suppressor Gene Mutation

Excerpt:
...- The tumour harbours one of the 2 common EGFR mutations known to be associated with EGFR-TKI sensitivity (Ex19del, L858R), in combination with tumor suppressor genes mutations assessed by central testing using tumour tissue sample....
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Title:

Aumolertinib in Treatment of Resectable Stage IA EGFRm+ NSCLC: a Multi-center, Single-arm Clinical Trial

Excerpt:
...Confirmation by the central laboratory that the tumour harbours one of the 2 common EGFR mutations known to be associated with EGFR-TKI sensitivity (Ex19del, L858R), either alone or in combination with other EGFR mutations including T790M....
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Title:

Aumolertinib With or Without Chemotherapy as 1st Line Treatment in Locally Advanced or Metastatic Non-Small Cell Lung Cancer With Sensitizing EGFR Mutations

Excerpt:
...The tumor harbors 1 of the 2 common EGFR mutations known to be associated with EGFR-TKI sensitivity (Ex19del, L858R), either alone or in combination with other EGFR mutations assessed by central testing using tumor tissue sample or blood sample....
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Title:

A Phase II Trial of Upfront Radiotherapy Plus Almonertinib for Epidermal Growth Factor Receptor(EGFR)-Mutant Non-small-cell Lung Cancer(NSCLC) Patients With Brain Metastases

Excerpt:
...EGFR-sensitive mutations (include 19del or L858R mutation or coexist with other types of EGFR mutation)....
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Title:

A Study to Evaluate Safety, PK and Efficacy of HS-10296 in Patients With NSCLC

Excerpt:
...- Confirmation that the tumor harbors an EGFR mutation known to be associated with EGFR TKI sensitivity (including G719X, exon 19 deletion, L858R, L861Q) OR must have experienced clinical benefit from EGFR TKI, according to the Jackman criteria (followed by systemic objective progression (RECIST or World Health Organization [WHO]) while on continuous treatment with an EGFR TKI....
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Title:

A Study to Evaluate Safety and Efficacy of HS-10296 as First-Line Treatment in Patients

Excerpt:
...The tumour harbours one of the 2 common EGFR mutations known to be associated with EGFR-TKI sensitivity (Ex19del, L858R), either or in combination with other EGFR mutations assessed by central testing using tumour tissue sample or blood sample....
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Title:

Almonertinib Therapy in Patients With Abnormal Liver Function After EGFR-TKI Treatment, or Almonertinib First-line Therapy in Patients With Basic Hepatopathy

Excerpt:
...- Tumor tissue samples or blood samples are confirmed to be EGFR sensitive mutations (including exon 19 deletion or L858R, both alone or coexist with other EGFR mutations)....
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Title:

A Phase III Study to Assess the Effects of Almonertinib Following Chemoradiation in Patients With Stage III Unresectable Non-small Cell Lung Cancer

Excerpt:
...The tumor harbours one of the two common EGFR mutations known to be associated with EGFR-TKI sensitivity (Ex19Del, L858R), either alone or in combination with other EGFR mutations including T790M, assessed by cobas® EGFR Mutation Test (Roche Diagnostics) or Xiamen AmoyDx EGFR (ADx-ARMS, Super-ARMS method) kit in site or central laboratory....
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Title:

Almonertinib Versus Placebo as Adjuvant Therapy in Resected Stage II-IIIB Non-Small Cell Lung Cancer With EGFR-sensitive Mutations

Excerpt:
...Confirmation by the central laboratory that the tumor harbors one of the 2 common EGFR mutations known to be associated with EGFR-TKI sensitivity (Ex19del, L858R), either alone or in combination with other EGFR mutations including T790M....
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Title:

Efficacy and Safety of Almonertinib Combined With or Without Chemotherapy as an Adjuvant Treatment for Stage II-IIIA Non-small Cell Lung Carcinoma Following Complete Tumour Resection

Excerpt:
...Confirmation by the central laboratory that the tumour harbours one of the 2 common EGFR mutations known to be associated with EGFR-TKI sensitivity (Ex19del, L858R), either alone or in combination with other EGFR mutations including T790M....
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Go to data
Title:

Almonertinib as First-line Treatment in Patients With EGFR Mutations Positive in Advanced NSCLC With Brain Metastases

Excerpt:
...Tumor tissue samples or blood samples are confirmed to be EGFR sensitive mutations (including exon 19 deletion or L858R, both alone or coexist with other EGFR mutations)....
Trial ID:
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Title:

Neoadjuvant HS-10296 (Almonertinib) Therapy for Potential Resectable Stage III EGFR Mutation-Positive Non-small Cell Lung Cancer

Excerpt:
...- Lung adenocarcinoma patient with EGFR sensitive mutation as confirmed by needle biopsy;...
Trial ID:
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Title:

Aumolertinib With Chemotherapy or Alone Compared With Osimertinib in Patients With Epidermal Growth Factor Receptor-Mutant Non-Small Cell Lung Cancer

Excerpt:
...Tumor harbors one of the 2 common EGFR mutations known to be associated with EGFR-TKI sensitivity-ex19del or L858R-either alone or in combination with other EGFR mutations (eg, G719X, exon 20 insertions, S7681, L861Q) 4....
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Title:

Almonertinib in the First-line Treatment of Patients of NSCLC With Poor Performance Status

Excerpt:
...NSCLC patients with EGFR mutation (19 deletion/21 L858R point mutation) or primary T790M mutation in pre-enrollment genetic testing....
Trial ID:
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Title:

Aumolertinib Combined Intrathecal Chemotherapy for Leptomeningeal Metastasis From EGFR-Mutated NSCLC and Prognostic Value of Dynamic Changes in cfDNA Profiles

Excerpt:
...- Tumor tissue samples or blood samples were tested and confirmed as EGFR sensitive mutations (including exon 19 deletion or L858R, both alone or coexisting with other EGFR site mutations)....
Trial ID:
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Title:

Armatinib Alone or in Combination With SRT for Brain Metastases EGFR-mutated Non-small Cell Lung Cancer

Excerpt:
...epidermal growth factor receptor (EGFR) exon 19 deletion or exon 21 (L858R) substitution mutation (alone or in combination with other EGFR mutations); 6....
Trial ID:
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Title:

Almonertinib Plus Microwave Ablation in Advanced Non-small Cell Lung Cancer

Excerpt:
...EGFR Exon 19del or Exon 21 L858R mutations; 4....
Trial ID:
Less C2 evidence
Evidence Level:
Sensitive: C3 – Early Trials
Title:

480P - Aumolertinib as adjuvant therapy for resectable stage I-III EGFR-mutant NSCLC: Also effective in EGFR co-mutation

Published date:
11/27/2023
Excerpt:
The 1-year DFS rate is 100%....This study demonstrated the significant efficacy of aumolertinib as adjuvant therapy for completely resected stage I-III EGFR-mutated NSCLC, and reported the consistent efficacy of aumolertinib in pts with co-mutation for the first time.
Evidence Level:
Sensitive: C3 – Early Trials
Title:

Almonertinib plus chemotherapy versus almonertinib alone in second-line treatment of advanced non-small cell lung cancer with mutated epidermal growth factor receptor: a retrospective study

Published date:
09/27/2023
Excerpt:
For advanced NSCLC patients with EGFR mutations, second-line treatment with almonertinib plus chemotherapy significantly improved PFS compared with almonertinib alone without a significant increase in adverse events, providing efficacy and safety.
Secondary therapy:
Chemotherapy
DOI:
10.3389/fonc.2023.1248690
Evidence Level:
Sensitive: C3 – Early Trials
Title:

Safety and Efficacy of Aumolertinib in Patients with advanced NSCLC Harboring Uncommon EGFR Mutations: Cohort 2 Updated

Published date:
08/08/2023
Excerpt:
In patients with advanced NSCLC harboring uncommon EGFR mutations, high-dose aumolertinib demonstrated a tolerable safety profile and encouraging antitumor activity in NSCLC pts harboring uncommon EGFR mutations.
Evidence Level:
Sensitive: C3 – Early Trials
Title:

A Study of Aumolertinib Monotherapy or Combination Treated EGFR-mutated NSCLC Patients with Symptomatic Brain Metastases

Published date:
08/08/2023
Excerpt:
The study retrospectively analyzed 33 patients with advanced EGFR-mutated positive NSCLC with symptomatic brain metastases….The confirmed partial response (PR) were 9 (40.9%) patients and stable disease (SD) were 13 (59.1%) patients, all the patients had progressed. The ORR was 40.9% (9/22) and the DCR was 100 % (22/22). The median PFS and OS were 12.1months and 32.0 months, respectively. The main treatment regimens are aumolertinib monotherapy (40.9%), aumolertinib combined with WBRT (36.4%)....This retrospective study first demonstrated aumolertinib monotherapy or combined with local therapy had prolong the survival time and also improve the BM-related neurological symptoms and quality of life, no matter the first-line or therapy.
Evidence Level:
Sensitive: C3 – Early Trials
Title:

Conversion to Aumolertinib in NSCLC Patients with EGFR Mutations Who Are Safety Intolerant after Osimertinib Treatment: A Retrospective Study

Published date:
08/08/2023
Excerpt:
We retrospectively collected data from NSCLC patients with EGFR-mutation who were intolerant after osimertinib treatment and received aumolertinib 110mg daily...15 patients subsequently received aumolertinib treatment. The 3-month conversion success rate was 100%, and overall ORR was 80% (2 CR, 10 PR, 95% CI: 51.9-95.7), DCR was 100%. ORR in subgroups with safety intolerance (rash and diarrhea) after treatment with osimertinib were respectively 87.5% (2 CR, 5 PR, 95% CI: 47.3-99.7) and 100% (2 CR, 4 PR).... This study confirmed safety and efficacy of aumolertinib in EGFR-mutation advanced NSCLC patients with safety intolerance after treatment with osimertinib...
Evidence Level:
Sensitive: C3 – Early Trials
Title:

The Safety and Efficacy of Aumolertinib in Advanced EGFR-mutant NSCLC Patients Who Were Intolerant to Osimertinib Treatment

Published date:
08/08/2023
Excerpt:
Aumolertinib is a safety and efficacy choice in locally advanced or metastatic EGFR-mutant NSCLC pts who were intolerant to osimertinib treatment.
Evidence Level:
Sensitive: C3 – Early Trials
Source:
Title:

18P - Stereotactic radiotherapy(SRT) in combination with Aumolertinib to treat intracranial oligometastatic Non-Small Cell Lung Cancer (NSCLC): An update of the phase II, prospective study

Published date:
03/23/2023
Excerpt:
Intracranial oligometastatic patients with EGFR sensitive mutations (EGFR-TKIs naive) were enrolled and received aumolertinib 110 mg daily until intracranial disease progression….After administration of aumolertinib, the best response of all patients in intracranial and extracranial lesions was partial response (PR), with an iORR of 100%.
Trial ID:
Evidence Level:
Sensitive: C3 – Early Trials
Title:

371P - Real-world data of first-line treatment with aumolertinib for elderly EGFR+ NSCLC patients

Published date:
11/28/2022
Excerpt:
This study enrolled pts with stage IIA-IVB EGFR+ NSCLC who received aumolertinib alone as first-line therapy...Overall, ORR and DCR were 74.2% and 97.0%, respectively...ORR was 71.4% and 77.4% for pts ≥65 and <65 yr, respectively, and DCR was 97.1% and 96.8%, respectively.
Evidence Level:
Sensitive: C3 – Early Trials
Title:

375P - Stereotactic radiotherapy (SRT) in combination with aumolertinib to treat intracranial oligometastatic non-small cell lung cancer (NSCLC): A phase II, prospective study

Published date:
11/28/2022
Excerpt:
Aumolertinib showed preliminary efficacy and good tolerability in intracranial oligometastatic EGFR mutated NSCLC.
Trial ID:
Evidence Level:
Sensitive: C3 – Early Trials
Title:

EP08.02-004 - Aumolertinib in Treatment-Naïve EGFR-mutant NSCLC Patients With Brain Metastases: Primary Efficacy and Safety Data from the ARTISTRY

Published date:
07/12/2022
Excerpt:
Aumolertinib showed preliminary antitumor activity with a manageable safety profile as first-line therapy in EGFR-mutant NSCLC patients with brain metastases.
Trial ID:
Evidence Level:
Sensitive: C3 – Early Trials
Title:

EP08.02-006 Data from Real World to Evaluate the Efficacy of Almonertinib in EGFR-mutant NSCLC Patients

Published date:
07/12/2022
Excerpt:
100 patients’ medical records were reviewed for EGFR mutated ANSCLC treated with almonertinib, Data from 2020/4/1 to 2021/3/1 in Henan Cancer Hospital were also collected and retrospectively analyzed…. The ORR of the patients who received almonertinib as first-line treatment (n=45) was 71%, mPFS was 16.7 months, and mOS was still not reached....Almonertinib has been shown good efficacy and safety in EGFR-mutant ANSCLC.... Elevated creatine kinase is an important predictor of longer mPFS.
Evidence Level:
Sensitive: C3 – Early Trials
Source:
Title:

86P-Aumolertinib as adjuvant therapy in postoperative EGFR-mutated non-small cell lung cancer

Published date:
03/23/2022
Excerpt:
At the data cutoff, all patients have no symptoms of tumor recurrence, 25 (37.9%) patients have been followed up for over 1 year. At 12 months, 100% patients were alive and disease-free...This is the first study to demonstrate that aumolertinib has preliminary efficacy and a tolerable safety profile in patients with completely resected stage I-III NSCLC harboring EGFR mutations.
DOI:
https://doi.org/10.1016/j.annonc.2022.02.09687
Evidence Level:
Sensitive: C4 – Case Studies
Title:

Intracranial complete remissions in an aumolertinib-treated EGFR mutation-positive non-small cell lung cancer (NSCLC) patient with symptomatic brain metastases and Eastern Cooperative Oncology Group performance status (ECOG PS) up to 4: a case report

Published date:
02/28/2023
Excerpt:
Further tissue and imaging analysis revealed EGFR-mutant stage IV (cT2N3M1) NSCLC...After 2 weeks of aumolertinib administration, the patient showed significant improvement...
DOI:
10.21037/tcr-22-1614
Evidence Level:
Sensitive: D – Preclinical
Title:

Sequence-dependent synergistic effect of aumolertinib-pemetrexed combined therapy on EGFR-mutant non-small-cell lung carcinoma with pre-clinical and clinical evidence

Published date:
05/03/2022
Excerpt:
Their inhibition effects on cell proliferation and metastasis were firstly compared upon three human NSCLC cell lines in vitro...Aumolertinib-pemetrexed combined therapy is promising for EGFR mutant NSCLC but only in right administration sequence.
Secondary therapy:
pemetrexed
DOI:
https://doi.org/10.1186/s13046-022-02369-3