Delving into the Latest Updates on Avasopasem manganese with Synapse

Overview

Basic Info

Drug Type

Small molecule drug

Synonyms

+ [2]

Target

SOD1

Action

stimulants

Mechanism

SOD1 stimulants(Superoxide dismutase stimulants)

Therapeutic Areas

Mouth and Tooth Diseases

Active Indication

radiation oral mucositis

Inactive Indication

COVID-19Critical IllnessEsophagitis+ [8]

Originator Organization

Galera Therapeutics, Inc.

Active Organization

Galera Therapeutics, Inc.

Inactive Organization-

License Organization

Blackstone Life Sciences, LLC

Galera Therapeutics, Inc.

Drug Highest PhasePhase 3

First Approval Date-

RegulationFast Track (United States), Breakthrough Therapy (United States), Priority Review (United States)

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Structure/Sequence

Molecular FormulaC21H35Cl2MnN5

InChIKeyPRILQUXQKPBDSR-NDOCQCNASA-N

CAS Registry435327-40-5

GTI-4419-203 will be an open-label, multi-center study to evaluate GC4419 (avasopasem manganese) administered intravenous (IV) for the reduction of radiation induced esophagitis in subjects receiving chemoradiotherapy for unresectable Stage 3A/3B or post-operative Stage 2B Non-Small Cell Lung Cancer (NSCLC) or Small Cell Lung Cancer (SCLC) treatable with chemoradiotherapy.

Start Date19 Dec 2019

Sponsor / Collaborator

Galera Therapeutics, Inc.

100 Clinical Results associated with Avasopasem manganese

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100 Translational Medicine associated with Avasopasem manganese

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100 Patents (Medical) associated with Avasopasem manganese

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37

Literatures (Medical) associated with Avasopasem manganese

01 Feb 2025·Cancer Treatment Reviews

Managing strategies of chemotherapy and radiotherapy-induced oral mucositis

Review

Author: Wu, Yuqi ; Qiu, Yan ; Shi, Wenjin ; Luo, Xiaobo ; Chen, Qianming ; Li, Chunyu ; Jiang, Yuchen ; Liu, Xiangfei

Radiotherapy and chemotherapy are widely employed as primary non-surgical cancer treatments; however, their non-selective cytotoxicity often leads to adverse events such as oral mucositis (OM), particularly in head and neck cancer therapies. International guidelines provide recommendations for managing chemoradiotherapy-induced OM in various clinical contexts. Subsequently, emerging researches have introduced evidence supporting novel approaches or existing regimens for OM prevention and treatment. The repurposing of established drugs has garnered significant interest due to its shorter development timeline, improved safety profiles, and lower costs compared to new drug development. For example, clinical trials assessing established drugs such as melatonin, clonidine, and pentoxifylline indicate promising potential for managing OM. Additionally, several emerging pharmacological interventions have demonstrated considerable efficacy; SAMITAL and rhIL-11 are supported by phase II clinical trials and prospective studies, while probiotics like Streptococcus salivarius K12 and curcumin have shown effectiveness in randomized clinical trials. Furthermore, recent high-level studies have reinforced the efficacy of non-pharmacological interventions, such as photobiomodulation (PBM) and cryotherapy, over the past two years. In all, given the evidence supporting different strategies, PBM and oral cryotherapy are highly recommended for managing OM when feasible. Topical clonidine, melatonin, oral pentoxifylline, topical SAMITAL or rhIL-11, oral SsK12, and curcumin may also be utilized but would benefit from validation in larger trials. Besides, Verbascoside, Palifermin, Amifostine, and Avasopasem manganese can be suggested for OM management, while the side effects should be monitored. The accessibility and cost/effectiveness of specific managing strategies of OM should be considered when selecting appropriate options.

01 Jan 2025·Advances in Radiation Oncology

Benefit of Avasopasem Manganese on Severe Oral Mucositis in Head and Neck Cancer in the ROMAN Trial: Unplanned Secondary Analysis

Article

Author: Walker, Gary ; Dunlap, Neal ; Lee, Christopher M ; Schoen, Benton ; Kennedy, Eugene ; Salvaggio, Samuel ; De Backer, Mickaël ; Buyse, Marc ; Saunders, Deborah ; Beardsley, Robert ; Chiem, Jean-Christophe ; Anderson, Carryn

PurposeOral mucositis (OM) is a debilitating side effect of cisplatin and intensity-modulated radiation therapy (IMRT) in patients with head and neck cancer. The phase 3 ROMAN trial showed avasopasem manganese (AVA) significantly decreased individual endpoints of incidence and duration of severe oral mucositis (SOM, World Health Organization [WHO] grade 3-4), with nominal decrease in severity (WHO grade 4) and significant increase in the delay in onset of SOM. We sought to determine the Net Treatment Benefit (NTB) of AVA versus placebo (PBO) using the generalized pairwise comparisons (GPC) method.Methods and MaterialsGPC is a statistical method that permits simultaneous analysis of several prioritized outcomes, comparing all possible pairs of a patient in the active (ie, AVA) group and a patient from the control (ie, PBO) group. NTB is the net benefit across all the outcomes for AVA compared to PBO. Key clinically relevant outcomes from ROMAN were prioritized: (1) WHO grade 4 OM incidence; (2) SOM incidence; (3) days of SOM; (4) days to SOM onset, with 7 days difference defined as the clinical relevance threshold for SOM days and SOM onset.ResultsGPC analysis of 407 patients (AVA = 241, placebo = 166) stratified by cisplatin schedule and treatment setting resulted in 13,969 pairwise comparisons. AVA showed statistically significant net benefit on all 4 key outcomes with a 53.9% probability that AVA would benefit patients versus a 35.0% probability that PBO would; the difference between these probabilities was a NTB of 18.9% (P = .0012), translating to an AVA number needed to treat of 5.3 patients. All outcomes contributed to NTB, reflecting improvements in SOM incidence, onset and duration, and in grade 4 OM incidence seen in the original ROMAN analysis.ConclusionsThis GPC analysis shows compelling evidence from the ROMAN trial of AVA's clinical benefit across key parameters of SOM burden.

01 May 2024·Drug Development Research

Comparisons of successful and failed Phase III trials of drugs and biologicals tested for mitigation of oral mucositis in patients being treated with radiotherapy with or without concomitant chemotherapy for cancers of the head and neck

Article

Author: Sonis, Stephen T. ; Liang, Lang

AbstractOral mucositis (OM) remains a significant toxicity among patients being treated with radiotherapy (RT) alone or with concomitant chemotherapy (CRT) for cancers of the head and neck (HNC). Given its clinical significance as an unmet need and its potential commercial viability, the pharmaceutical industry has been actively pursuing an effective intervention. Despite this interest and activity, only a few agents have been studied in Phase III trials (n = 6). The objective of this study was to identify common features that differentiate successful and failed Phase III OM trials. We used the United States Patent and Trademark Office Patent Public Search database to search patents with “oral mucositis” in the claims. We then searched ClinicalTrials.gov and PubMed to determine if Phase III or Phase II trial data for identified biologics/drugs had been published. We assessed each Phase III and Phase II trial for characteristics that may be associated with trial success or failure. We considered a study as a “success” if the primary endpoint reached statistical significance, and we considered a study as “failure” if the primary endpoint did not reach statistical significance. Of the three successful Phase III trials, one investigated avasopasem manganese (Galera Therapeutics) and two examined palifermin (Amgen). The three failed trials included those evaluating dusquetide (Soligenix), iseganan hydrochloride (IntraBiotics Pharmaceuticals), and clonidine (Monopar Therapeutics). We found that differences in the level of sponsor funding, patient inclusion criteria including radiation source and concomitant chemotherapy regimen, and concordance of primary efficacy outcomes between Phase II and Phase III trials influenced outcomes. To properly design clinical trials for OM in HNC patients, it is important that researchers and sponsors take note of specific study characteristics associated with success or failure, particularly with Phase III trials where the risks and costs are the highest.

56

News (Medical) associated with Avasopasem manganese

05 Jan 2025

·www.globenewswire.com

Galera Therapeutics completes acquisition of Nova Pharmaceuticals

Galera’s development strategy shifts from toxicity reduction to anti-cancer therapeutics, with three trials in patients with highly resistant subsets of advanced breast cancer. Lead program is Phase 1/2 trial of Nova Pharmaceutical’s Clinical Stage Nitric Oxide Synthase (NOS) Inhibitor on top of standard-of-care nab-paclitaxel and alpelisib in metaplastic breast cancer. Concurrent financing when added to Galera’s existing cash balance, is anticipated to fund operations through data readout of its lead program and into 2026. Galera intends to leverage NCI grants, academic partnerships and the I-SPY 2 network for efficient and cost-effective clinical dataset expansion. Dec. 31, 2024 -- Galera Therapeutics, Inc. (OTC: GRTX) announced today it has completed the acquisition of Nova Pharmaceuticals, Inc. (“Nova”), a privately held biotechnology company advancing a pan-NOS Inhibitor to treat patients with highly resistant forms of breast cancer, including metaplastic breast cancer and other refractory subsets of triple-negative breast cancer (“TNBC”). In support of the acquisition, a syndicate of investors led by Ikarian Capital has invested approximately $3 million to purchase Galera common stock. Galera’s new lead program is the Investigator-sponsored Phase 1/2 trial of a pan-NOS Inhibitor on top of standard-of-care nab-paclitaxel and alpelisib in metaplastic breast cancer. The Company’s cash balance at closing is anticipated to fund operations into 2026 and through data readout from its lead program in metaplastic breast cancer. A second trial is planned for this agent in TNBC in collaboration with the I-SPY 2 consortium. The Company intends to support a third trial of Avasopasem, one of its small molecule dismutase mimetics, in patients with hormone-receptor positive (HR+) advanced breast cancer who have become resistant to conventional therapy. This trial is expected to commence enrollment in the first half of 2025. “Dismutase Mimetics and NOS inhibitors involve complementary pathways that play important roles in cancer, in the tumor microenvironment, in resistance to conventional chemoradiotherapy and in immuno-oncology,” said Mel Sorensen, M.D., President & CEO of Galera. “Substantial mechanistic and preclinical rationale for both agents in solid tumors, especially in breast cancer, has been generated by the companies and their collaborators. Both product candidates are in clinical stage development, having been well-characterized in many patients both in oncologic and non-oncologic indications. Galera has decided to focus its near-term development on the hardest-to-treat subsets of advanced breast cancer.” The Company continues as Galera Therapeutics, Inc. (OTC:GRTX) and will be led by Dr. Sorensen, as President and Chief Executive Officer and Joel Sussman, as Chief Accounting Officer. A team of consultants comprising people from both Galera and Nova will manage the R&D of the company, in a capital efficient manner. “I am excited about the ability to combine our technologies to address the unmet need of many breast cancer patients,” said Par S Hyare CEO of Nova Pharmaceuticals. “This agreement allows Galera and our collaborators the opportunity to advance our product candidates to the next stage of clinical development. The investigators at Houston Methodist have presented data showing several responses in the ongoing trial and we look forward to the data readout in the next nine to fifteen months under the capable leadership of Galera’s team.” Under the terms of the merger agreement and the securities purchase agreement, Galera has issued approximately 21.1 million shares of common stock plus pre-funded warrants exercisable for approximately 23 million shares of common stock, and approximately 119,318 shares of Series B non-voting (1:1000) convertible preferred stock in a private placement. At the closing, Galera stockholders will own approximately 55.2% of the common shares (assuming that the pre-funded warrants are exercised in full). The shares of Series B non-voting convertible preferred stock will be convertible into shares of common stock, subject to stockholder approval at a subsequent meeting of the Company’s stockholders. Following that approval, on an as-converted basis, the pre-acquisition Galera stockholders will own approximately 25% of the combined Company and the new investors and Nova stockholders will own approximately 75% of the combined Company (assuming that the pre-funded warrants are exercised in full). The transaction was unanimously approved by the Board of Directors of both companies and by the stockholders of Nova. The Board of Directors includes three current Galera board members, Mr. Larry Alleva and Mr. Kevin Lokay and Dr. Sorensen, and two additional board members selected by Nova, Mr. Michael Friedman and Dr. Nancy T. Chang. Mr. Friedman has an MBA from the University of Chicago and brings over 20 years’ experience in investment banking, in finance and in the life science industry to the Board of Galera. Dr. Chang is a PhD biochemist who has spent her career in leadership roles in academia, in large and small pharma companies and in the venture capital world and she has extensive experience in biopharma boards. Stifel, Nicolaus & Company served as the financial advisor to Galera. Lucid Capital Markets, LLC has provided a fairness opinion to Galera's Board of Directors. Sidley Austin LLP is serving as legal counsel to Galera. Cooley LLP is serving as legal counsel to Nova. Galera Therapeutics, Inc. is a biopharmaceutical company with a portfolio of small molecule superoxide dismutase mimetics. It was historically focused on developing these agents in combination with chemoradiotherapy to reduce the toxicities of the conventional regimens in patients with head and neck cancer. The FDA has granted Fast Track and Breakthrough Therapy designations to avasopasem for the reduction of severe oral mucositis induced by radiotherapy and has demonstrated toxicity reduction in phase 2 and 3 trials. Dismutase mimetics also have a well-developed mechanistic role in anti-cancer therapeutics in preclinical studies, and Galera completed a pilot of avasopasem combined with stereotactic radiotherapy (SBRT) in patients with locally advanced pancreatic cancer (Taniguchi, Cullen M et al. The Lancet Oncology, Volume 24, Issue 12, 1387 – 1398). Nova Pharmaceuticals is a clinical stage biotechnology company focused on targeting the molecular mechanisms driving resistance to current treatments in triple negative and metaplastic breast cancer and improving outcomes for patients. Nova Pharmaceuticals’ pan-nitric oxide synthase (NOS) inhibitor is currently being studied in a Phase 1/2 study at Houston Methodist Hospital and has completed a Phase 1/2 study in triple negative breast cancer patients. The content above comes from the network. if any infringement, please contact us to modify.

Executive ChangeFast Track

30 Dec 2024

·investors.galeratx.com

Galera Therapeutics completes acquisition of Nova Pharmaceuticals

Galera’s development strategy shifts from toxicity reduction to anti-cancer therapeutics, with three trials in patients with highly resistant subsets of advanced breast cancer. Lead program is Phase 1/2 trial of Nova Pharmaceutical’s Clinical Stage Nitric Oxide Synthase (NOS) Inhibitor on top of standard-of-care nab-paclitaxel and alpelisib in metaplastic breast cancer. Concurrent financing when added to Galera’s existing cash balance, is anticipated to fund operations through data readout of its lead program and into 2026. Galera intends to leverage NCI grants, academic partnerships and the I-SPY 2 network for efficient and cost-effective clinical dataset expansion. MALVERN, Pa., Dec. 31, 2024 (GLOBE NEWSWIRE) -- Galera Therapeutics, Inc. (OTC: GRTX) announced today it has completed the acquisition of Nova Pharmaceuticals, Inc. (“Nova”), a privately held biotechnology company advancing a pan-NOS Inhibitor to treat patients with highly resistant forms of breast cancer, including metaplastic breast cancer and other refractory subsets of triple-negative breast cancer (“TNBC”). In support of the acquisition, a syndicate of investors led by Ikarian Capital has invested approximately $3 million to purchase Galera common stock. Galera’s new lead program is the Investigator-sponsored Phase 1/2 trial of a pan-NOS Inhibitor on top of standard-of-care nab-paclitaxel and alpelisib in metaplastic breast cancer. The Company’s cash balance at closing is anticipated to fund operations into 2026 and through data readout from its lead program in metaplastic breast cancer. A second trial is planned for this agent in TNBC in collaboration with the I-SPY 2 consortium. The Company intends to support a third trial of Avasopasem, one of its small molecule dismutase mimetics, in patients with hormone-receptor positive (HR+) advanced breast cancer who have become resistant to conventional therapy. This trial is expected to commence enrollment in the first half of 2025. “Dismutase Mimetics and NOS inhibitors involve complementary pathways that play important roles in cancer, in the tumor microenvironment, in resistance to conventional chemoradiotherapy and in immuno-oncology,” said Mel Sorensen, M.D., President & CEO of Galera. “Substantial mechanistic and preclinical rationale for both agents in solid tumors, especially in breast cancer, has been generated by the companies and their collaborators. Both product candidates are in clinical stage development, having been well-characterized in many patients both in oncologic and non-oncologic indications. Galera has decided to focus its near-term development on the hardest-to-treat subsets of advanced breast cancer. The Company continues as Galera Therapeutics, Inc. (OTC:GRTX) and will be led by Dr. Sorensen, as President and Chief Executive Officer and Joel Sussman, as Chief Accounting Officer. A team of consultants comprising people from both Galera and Nova will manage the R&D of the company, in a capital efficient manner. “I am excited about the ability to combine our technologies to address the unmet need of many breast cancer patients,” said Par S Hyare CEO of Nova Pharmaceuticals. “This agreement allows Galera and our collaborators the opportunity to advance our product candidates to the next stage of clinical development. The investigators at Houston Methodist have presented data showing several responses in the ongoing trial and we look forward to the data readout in the next nine to fifteen months under the capable leadership of Galera’s team.

AcquisitionExecutive Change

14 Aug 2024

·www.fiercebiotech.com

Gone are the days of Galera: Biotech says goodbye to staffers and initiates wind-down

The liquidation plans come almost exactly a year after the FDA denied approval for Galera’s radiotherapy complication drug avasopasem. Galera Therapeutics is shuttering, with the biotech’s board OK'ing a liquidation plan that whittles down the company’s workforce to just three people.The clinical-stage company—which was working on therapeutics designed to improve the radiotherapy process for oncology patients—will ask for stockholder approval of the dissolution in October, according to a second-quarter earnings release shared Aug. 14.The move follows “extensive consideration of potential strategic alternatives” over the past year, Galera President and CEO Mel Sorensen, M.D., said in the release.Back in August 2023, the FDA rejected approval for Galera’s radiotherapy complication drug, dubbed avasopasem. The agency deemed that the phase 3 results were “not sufficiently persuasive to establish substantial evidence of avasopasem’s effectiveness and safety for reducing severe oral mucositis in patients with head and neck cancer,” according to a Galera release last year. Instead, the FDA asked for a new trial to be conducted before Galera could resubmit the application for avasopasem, a selective dismutase mimetic. The investigational candidate had snagged both FDA fast-track and breakthrough designations for reducing severe oral mucositis tied to radiotherapy. The biotech, which had been building out a commercial leadership team in preparation for an anticipated U.S. drug launch, then jettisoned 70% of its employees. The company also stopped all clinical trial activity as it evaluated strategic alternatives—including partnering—for avasopasem and rucosopasem, a second asset designed to help patients receiving radiotherapy for non-small cell lung cancer or locally advanced pancreatic cancer. Galera will continue to assess possible sale options for its assets while preparing for the potential dissolution, according to the company. In the meantime, the business is shedding all staff but three by the end of August. The remaining workers will be current Chief Financial Officer Chris Degnan, Chief Legal and Compliance Officer Jennifer Stacey and Sorensen. The former two will transition out of their roles at the end of August and enter consulting agreements with Galera to guide the wind-down. As of June 30, Galera had $10.7 million on hand, money that’s expected to carry the company for at least 12 months, including through the dissolution process.

Phase 3Fast TrackDrug Approval

100 Deals associated with Avasopasem manganese

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KEGG	Wiki	ATC	Drug Bank
-	-	-	DB16354

R&D Status

10 top R&D records.

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Indication	Highest Phase	Country/Location	Organization	Date
radiation oral mucositis	Phase 1	United States	Galera Therapeutics, Inc.	12 Dec 2022
Esophagitis	Phase 1	United States	Galera Therapeutics, Inc.	19 Dec 2019
Small Cell Lung Cancer	Phase 1	United States	Galera Therapeutics, Inc.	19 Dec 2019
ulcerative oral mucositis due to radiation	Phase 1	United States	Galera Therapeutics, Inc.	-
Locally Advanced Head and Neck Squamous Cell Carcinoma	Preclinical	Switzerland	Galera Therapeutics, Inc.	30 Jun 2020
Locally Advanced Head and Neck Squamous Cell Carcinoma	Preclinical	Czechia	Galera Therapeutics, Inc.	30 Jun 2020
Locally Advanced Head and Neck Squamous Cell Carcinoma	Preclinical	Spain	Galera Therapeutics, Inc.	30 Jun 2020
Locally Advanced Head and Neck Squamous Cell Carcinoma	Preclinical	Poland	Galera Therapeutics, Inc.	30 Jun 2020
Locally Advanced Head and Neck Squamous Cell Carcinoma	Preclinical	Belgium	Galera Therapeutics, Inc.	30 Jun 2020
Locally Advanced Pancreatic Adenocarcinoma	Preclinical	United States	Galera Therapeutics, Inc.	12 Feb 2018

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Clinical Result

Indication

Phase

Evaluation

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Study	Phase	Population	Analyzed Enrollment	Group	Results	Evaluation	Publication Date


NCT03340974 (CTgov)	Phase 1/2	Locally Advanced Pancreatic Adenocarcinoma	42	Stereotactic Radiation Therapy (SBRT) 50 Gy	oikfkpcnyb(fbitopomoh) = mwnbdnzesy ulubsjdpth (vvugtaxrjf, heovureihb - cxkfdcrwoz) View more	-	15 Dec 2023
NCT02508389 \| NCT03689712 (ROMAN, GT-201, ESMO2023)	Phase 2/3	Locally Advanced Head and Neck Squamous Cell Carcinoma	551	Avasopasem manganese 90mg	eulzeiwyod(bdwcfughrt) = nsxmmqfcge fdmyvwnfgi (embotbwexs ) View more	Positive	22 Oct 2023
				Placebo	eulzeiwyod(bdwcfughrt) = vemuyygrpi fdmyvwnfgi (embotbwexs ) View more
NCT03689712 (ROMAN, ASCO 12023 \| ASCO 22023) Manual	Phase 3	Chronic Kidney Diseases	407	avasopasem manganese	lxlutagcku(swykogolrg) = kuefjicibr duvojytvjg (fkeckqnuwb ) View more	Positive	26 May 2023
				placebo	lxlutagcku(swykogolrg) = erxxlzqvvf duvojytvjg (fkeckqnuwb ) View more
NCT03689712 (ROMAN \| Phase IIb, CTgov)	Phase 3	radiation oral mucositis	455	Placebo	tnlcndcrpl(kjfgkqihsp) = jrkhuvxyph lsskcfcukp (ebexvontxa, ujnglzcwod - pxuofywtvz) View more	-	13 Apr 2023
NCT04225026 (AESOP, CTgov)	Phase 2	Lung Cancer \| Small Cell Lung Cancer \| Esophagitis	39	GC4419 (avasopasem manganese)	ivkpjdulzy(ibhtqwiizi) = pletatbaxw kkflguqqyk (gsytgwutai, xqedymeqqh - mqsbmkwalt) View more	-	23 Mar 2023
NCT04529850 (AESOP, CTgov)	Phase 2	Otitis Media With Effusion \| Stomatitis \| Locally Advanced Head and Neck Squamous Cell Carcinoma \| Head and Neck Neoplasms	38	Intensity-modulated radiation therapy (IMRT)+cisplatin+Drug: GC4419	(hbvfjdbddy) = aqhtuzikxg wbjsdgsydq (yziojczdrk, xohavrndul - ugjjzfnxtf) View more	-	16 Aug 2022
NCT03689712 (ROMAN, ASCO2022) Manual	Phase 3	Stomatitis \| Head and Neck Neoplasms	407	Intensity-modulated radiotherapy+Cisplatin+Avasopasem	jxnnbvtkhc(zurtouried) = jljbawgwis yfuobamrsv (vqvcqlmyyz ) View more	Positive	02 Jun 2022
				Intensity-modulated radiotherapy+Cisplatin+placebo	jxnnbvtkhc(zurtouried) = vqkgeyckut yfuobamrsv (vqvcqlmyyz ) View more
NCT04225026 (AESOP, GlobeNewswire) Manual	Phase 2	Esophagitis	39	Avasopasem manganese	(wkvqgeiucr) = 17% (grade 2)；3% (grade 3) lyihmirayu (tghtggyigz ) View more	Positive	02 May 2022
NCT04555096 (CTgov)	Phase 2	COVID-19 \| Critical Illness	16	GC4419 (Active GC4419)	drbktbjzvv(wkuaoypmol) = pncghwfero ccjqpwybnb (qpgwykqnen, nbcnwmsnrc - gbtadeiije) View more	-	18 Mar 2022
				Placebo (Placebo)	drbktbjzvv(wkuaoypmol) = wendtmyhkn ccjqpwybnb (qpgwykqnen, ieeykzszkp - xdqnumafhm) View more
NCT03689712 (ROMAN, Corporate Publications) Manual	Phase 3	Stomatitis	-	avasopasem manganese	rwyjwydvtr(eehfcphurq) = ilnrkdjojb qrucoxxfkf (hxxxaonmge ) View more	Negative	19 Oct 2021
				Placebo	rwyjwydvtr(eehfcphurq) = wfalstjrzt qrucoxxfkf (hxxxaonmge ) View more