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A Trial to Learn Whether Regorafenib in Combination With Nivolumab Can Improve Tumor Responses and How Safe it is for Participants With Solid Tumors

A Multi-indication, Single-treatment Arm, Open-label Phase 2 Study of Regorafenib and Nivolumab in Combination in Patients With Recurrent or Metastatic Solid Tumors

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT04704154
Enrollment
175
Registered
2021-01-11
Start date
2021-02-03
Completion date
2024-03-29
Last updated
2025-04-18

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Solid Tumors

Keywords

Pancreatic Ductal Adenocarcinoma (PDAC), Head and Neck Squamous Cell Carcinoma (HNSCC), Esophageal Squamous Cell Carcinoma (ESCC), Glioblastoma Multiforme (GBM), Anaplastic Astrocytoma (AA), Biliary Tract Carcinoma (BTC), PD-1 inhibitor, nivolumab, regorafenib, multi-kinase inhibitor

Brief summary

Researchers are looking for a better way to treat people with solid tumors. Before a treatment can be approved for people to take, researchers do clinical trials to better understand its safety and how it works. In this trial, the researchers want to learn about regorafenib taken together with nivolumab in a small number of participants with different types of tumors. These include tumors in the head and neck, the esophagus, the pancreas, the brain, and the biliary tract. The biliary tract includes gall bladder and bile ducts. The trial will include about 200 participants who are at least 18 years old. All of the participants will take 90 mg of regorafenib as a tablet by mouth. The dose of regorafenib can be adjusted up to 120 mg or down to 60 mg by the doctor based on how well a participant tolerates treatment. All of the participants will receive 480 milligrams (mg) of nivolumab through a needle put into a vein (IV infusion). The participants will take treatments in 4-week periods called cycles. They will take regorafenib once a day for 3 weeks, then stop for 1 week. In each cycle, the participants will receive nivolumab one time. These 4-week cycles will be repeated throughout the trial. The participants can take nivolumab and regorafenib until their cancer gets worse, until they have medical problems, or until they leave the trial. The longest nivolumab can be given is up to 2 years. During the trial, the doctors will take pictures of the participants' tumors using CT or MRI and will take blood and urine samples. The doctors will also do physical examinations and check the participants' heart health using an electrocardiogram (ECG). They will ask questions about how the participants are feeling and if they have any medical problems.

Interventions

DRUGRegorafenib, (Stivarga, BAY73-4506)

Intake orally, starting with 3x 30 mg tablets every day (once daily.) for 21 days of every 28-day cycle (21 days on, 7 days off). If the starting dose is well tolerated dose can be escalated to 120 mg (4x30 mg tablets).

480 mg administered on Day 1 of each treatment cycle.

Sponsors

Bristol Myers Squibb Co. and Ono Pharmaceutical Co., Ltd
CollaboratorUNKNOWN
Bayer
Lead SponsorINDUSTRY

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* Histologically confirmed selected recurrent or metastatic solid tumor types that have progressed after treatment with standard therapies and for which there are no curative intent surgery or chemoradiation. * Cohort 1: subjects with HNSCC (Head and neck squamous-cell carcinoma) who have not received prior PD-1/PD-L1 inhibitor therapy. * Cohort 2: subjects with HNSCC who have progressed on or after prior systemic therapy, at least one of which included a PD-1/PD-L1 inhibitor alone or in combination with chemotherapy. * Cohort 3: subjects with ESCC (Esophageal Squamous Cell Carcinoma) who progressed on or after platinum and/or fluoropyrimidine based regimen. * Cohort 4: subjects with PDAC (Pancreatic ductal adenocarcinoma) who have progressed on or after gemcitabine or fluoropyrimidine based regimens. * Cohort 5: subjects with BTC (Biliary tract carcinoma) (intrahepatic or extrahepatic cholangiocarcinoma or gall bladder cancer) who have progressed on gemcitabine or fluoropyrimidine or platinum therapy or a combination of these agents. * Cohort 6: subjects with Grade IV GBM (Glioblastoma multiforme) or Grade III AA (Anaplastic astrocytoma) (World Health Organization \[WHO\] criteria) with unequivocal first progression after surgery followed by radiotherapy and temozolomide. * Documented HPV (Human papilloma virus) / p16 status for oropharyngeal cancer. * Capable of giving signed informed consent, including compliance with the requirements and restrictions listed in the informed consent form (ICF) and in the protocol. * Adult participants of legal maturity (18 years or older). * Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) 0 to 1. * Adequate hematologic and organ function as assessed by the following laboratory tests performed within 7 d before start of study treatment including: * Total bilirubin ≤1.5 x the upper limit of normal (ULN). Total bilirubin (≤3 x ULN) is allowed if Gilbert's syndrome is documented * Alanine transaminase (ALT) and aspartate aminotransferase (AST) ≤3 x ULN (≤5 x ULN for participants with liver involvement of their cancer) * Measurable disease by baseline CT or MRI per RECIST 1.1 or RANO. * Participants must consent to provide recent biopsy/tumor tissue of a primary tumor lesion or from metastases (e.g. liver, lung) for HNSCC (IO treated) for Stage 1 and 2 and in HNSCC (IO naïve) cohort for Stage 2. * Anticipated life expectancy greater than 3 months. * Be able to swallow and absorb oral tablets.

Exclusion criteria

* Presence of symptomatic central nervous system (CNS) metastases, leptomeningeal metastases or spinal cord compression. Previously-treated lesions should be stable for at least 6 weeks prior to study entry. * Participants with a condition requiring systemic treatment with either corticosteroids (\>10 mg daily prednisone equivalent) or other immunosuppressive medications within 14 days of start of study treatment. * Prior therapy with PD-1/PD-L1 or cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) inhibitors, or any form of immunotherapy to treat cancer (except cohort 2). * Cohort 2: More than one prior therapy with PD-1/PD-L1 or CTLA-4 inhibitors, or any other form of immunotherapy to treat cancer. * ESCC: * patients with apparent tumor invasion on organs located adjacent to the esophageal disease (e.g., the aorta or respiratory tract). * patients who have previously received taxane agents for recurrent/metastatic cancer. * GBM/AA * Primary tumors localized to the brainstem or spinal cord. * Presence of diffuse leptomeningeal disease or extracranial disease. * Participants requiring \> 4 mg of dexamethasone or biologic equivalent per day to control symptoms related to brain tumor and cerebral edema within 21 days of starting study treatment. * Participants who have known dMMR/MSI-H cancers or NTRK (tropomyosin receptor kinase) fusions. * Prior therapy with regorafenib. * Systemic anti-cancer treatment within 14 days or less than 5 half-lives (whichever is shorter) of the first dose of study treatment. * Participants who have permanent discontinuation of PD-1/PD-L1 therapy due to toxicity. * Arterial thrombotic or embolic events such as cerebrovascular accident (including transient ischemic attacks) within 6 months before the start of study treatment. Active pulmonary emboli or deep vein thrombosis that are significant or not adequately controlled on anticoagulation regimen as per investigator's judgement. * History of cardiac disorders as defined by: * Congestive heart failure ≥ New York Heart Association (NYHA) class 2: * Unstable angina (angina symptoms at rest), new-onset angina (begun within the last 3 months), myocardial infarction less than 6 months before start of study drug. * Uncontrolled cardiac arrhythmias. * Poorly controlled hypertension, defined as a blood pressure consistently above 140/90 mmHg despite optimal medical management. * Participants with an active, known or suspected autoimmune disease. * History of (non-infectious) pneumonitis that required steroids, current pneumonitis or interstitial lung disease. * Active infection \> NCI-CTCAE Grade 2. * Positive test (from historical data or tested during screening) for human immunodeficiency virus (HIV) or known acquired immunodeficiency syndrome (AIDS). * Any positive test result for hepatitis B virus (HBV) or hepatitis C virus (HCV) indicating presence of virus, e.g. Hepatitis B surface antigen (HBsAg, Australia antigen) positive (except for participants on anti-viral therapy for HBV with a viral load \< 100 IU/mL), or Hepatitis C antibody (anti-HCV) positive (except if HCV-ribonucleic acid \[RNA\] negative). * Pregnancy or breast feeding. * Known hypersensitivity to any of the study drugs, study drug classes, or excipients in the formulation. * History or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the trial or interfere with the participation for the full duration of the trial. * Participants with a current or past history of interstitial lung disease or pulmonary fibrosis diagnosed based on imaging or clinical findings.

Design outcomes

Primary

MeasureTime frameDescription
Overall Response Rate (ORR)From first participant enrolled to cut-off date (ie after the last participant has been followed for approximately 10 months) approximately 26 monthsTumor response was evaluated as ORR per RECIST 1.1 by local assessments for all tumor types, except for GBM/AA, where ORR per RANO by local assessment was used. ORR was defined as the proportion of participants with best overall response of complete response (CR) or partial response (PR). Participants for whom best overall tumor response was not CR or PR, as well as participants without any post-baseline tumor assessment were considered non-responders. Descriptive statistics were done, no inferential statistical analyses were performed.

Secondary

MeasureTime frameDescription
Disease Control Rate (DCR)From first participant enrolled to cut-off date (ie after the last participant has been followed for approximately 10 months) approximately 26 monthsCR = Complete response; PR = Partial response; SD = Stable disease
Progression Free Survival (PFS)From first participant enrolled to cut-off date (ie after the last participant has been followed for approximately 10 months) approximately 26 monthsPFS was defined as the time (in days) from the start of study intervention to the date of first objectively documented progressive disease (PD) or death from any cause (if no progression was documented).
6 Months PFSUp to last participant follow 6 months (approximately 22 months)6 Months PFS rate
Duration of Response (DOR)From first participant enrolled to cut-off date (ie after the last participant has been followed for approximately 10 months) approximately 26 monthsDefined as the time (in days) from the first documented objective response of PR or CR, whichever is noted earlier, to disease progression or death (if death occurs before progression is documented). DOR will be defined for responders only, i.e. participants with a CR or PR.
1 Year OSFrom first participant enrolled to cut-off date (ie after the last participant has been followed for approximately 10 months) approximately 26 month]
Number of Participants With Adverse EventsUp to the last participant has been followed for approximately 10 months, summed up to approximately 26 monthsAEs were considered to be treatment-emergent (TEAEs) if they started or worsened after the start of first study drug administration until 30 days after regorafenib treatment discontinuation or 100 days after the last dose of nivolumab, whatever occurred later.
Overall Survival (OS)From first participant enrolled to cut-off date (ie after the last participant has been followed for approximately 10 months) approximately 26 monthsOS was defined as the time (in days) from the start of study intervention to the date of death due to any cause.

Countries

Belgium, France, Italy, Japan, South Korea, Taiwan, United Kingdom, United States

Participant flow

Recruitment details

The study was conducted at 34 study centers in 8 countries/regions from 03 February 2021 (first patient first visit) to 29 March 2024 (last patient last visit)

Pre-assignment details

175 participants were enrolled and received study treatment. Participants were enrolled in 6 cohorts: HNSCC IO naïve (N=30), HNSCC IO treated (N=20), ESCC (N=30), PDAC (N=20), BTC (N=45), and GBM/AA (N=30)

Participants by arm

ArmCount
HNSCC (IO Naive)
Participants with confirmed recurrent or metastatic HNSCC and IO naive, received regorafenib in combination with nivolumab. (treatment details refers to Description under Participant Flow section above)
30
HNSCC (IO Treated)
Participants with confirmed recurrent or metastatic HNSCC and with IO treated, received regorafenib in combination with nivolumab. (treatment details refers to Description under Participant Flow section above)
20
ESCC
Participants with confirmed recurrent or metastatic ESCC received regorafenib in combination with nivolumab. (treatment details refers to Description under Participant Flow section above)
30
PDAC
Participants with confirmed recurrent or metastatic PADC received regorafenib in combination with nivolumab. (treatment details refers to Description under Participant Flow section above)
20
Biliary Tract Cancer (BTC)
Participants with confirmed recurrent or metastatic BTC received regorafenib in combination with nivolumab. (treatment details refers to Description under Participant Flow section above)
45
GBM/AA
Participants with GBM or AA received regorafenib in combination with nivolumab. (treatment details refers to Description under Participant Flow section above)
30
Total175

Withdrawals & dropouts

PeriodReasonFG000FG001FG002FG003FG004FG005
Overall StudyAdverse Event324230
Overall StudyCompleted max. allowed treatment. A max. of 24 infusions of Nivolumab were allowed for participants201010
Overall StudyDeath300030
Overall StudyParticipant Decision110000
Overall StudyPatient continued in rollover study for regorafenib104000
Overall StudyPhysician Decision101020
Overall StudyProgressive Disease191720183630

Baseline characteristics

CharacteristicHNSCC (IO Naive)TotalGBM/AABiliary Tract Cancer (BTC)PDACESCCHNSCC (IO Treated)
Age, Customized
65-<75 years
12 Participants63 Participants7 Participants22 Participants7 Participants11 Participants4 Participants
Age, Customized
<65 years
16 Participants95 Participants22 Participants17 Participants13 Participants17 Participants10 Participants
Age, Customized
75-<85 years
2 Participants17 Participants1 Participants6 Participants0 Participants2 Participants6 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Asian
15 Participants65 Participants2 Participants11 Participants5 Participants21 Participants11 Participants
Race (NIH/OMB)
Black or African American
0 Participants1 Participants0 Participants1 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
More than one race
0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
9 Participants24 Participants2 Participants6 Participants2 Participants2 Participants3 Participants
Race (NIH/OMB)
White
6 Participants85 Participants26 Participants27 Participants13 Participants7 Participants6 Participants
Sex: Female, Male
Female
5 Participants55 Participants10 Participants20 Participants11 Participants3 Participants6 Participants
Sex: Female, Male
Male
25 Participants120 Participants20 Participants25 Participants9 Participants27 Participants14 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
EG003
affected / at risk
EG004
affected / at risk
EG005
affected / at risk
deaths
Total, all-cause mortality
22 / 3017 / 2020 / 3017 / 2036 / 4527 / 30
other
Total, other adverse events
30 / 3020 / 2030 / 3020 / 2045 / 4529 / 30
serious
Total, serious adverse events
22 / 3015 / 2019 / 3013 / 2028 / 4513 / 30

Outcome results

Primary

Overall Response Rate (ORR)

Tumor response was evaluated as ORR per RECIST 1.1 by local assessments for all tumor types, except for GBM/AA, where ORR per RANO by local assessment was used. ORR was defined as the proportion of participants with best overall response of complete response (CR) or partial response (PR). Participants for whom best overall tumor response was not CR or PR, as well as participants without any post-baseline tumor assessment were considered non-responders. Descriptive statistics were done, no inferential statistical analyses were performed.

Time frame: From first participant enrolled to cut-off date (ie after the last participant has been followed for approximately 10 months) approximately 26 months

Population: FAS: all participants who received study treatment were included in the full analysis set

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
HNSCC (IO Naive)Overall Response Rate (ORR)6 Participants
HNSCC (IO Treated)Overall Response Rate (ORR)1 Participants
ESCCOverall Response Rate (ORR)15 Participants
PDACOverall Response Rate (ORR)0 Participants
Biliary Tract Cancer (BTC)Overall Response Rate (ORR)2 Participants
GBM/AAOverall Response Rate (ORR)1 Participants
Secondary

1 Year OS

Time frame: From first participant enrolled to cut-off date (ie after the last participant has been followed for approximately 10 months) approximately 26 month]

Population: FAS: all participants who received study treatment were included in the full analysis set

ArmMeasureValue (NUMBER)
HNSCC (IO Naive)1 Year OS0.415 Proportion of participants
HNSCC (IO Treated)1 Year OS0.444 Proportion of participants
ESCC1 Year OS0.764 Proportion of participants
PDAC1 Year OS0.281 Proportion of participants
Biliary Tract Cancer (BTC)1 Year OS0.422 Proportion of participants
GBM/AA1 Year OS0.337 Proportion of participants
Secondary

6 Months PFS

6 Months PFS rate

Time frame: Up to last participant follow 6 months (approximately 22 months)

Population: FAS: all participants who received study treatment were included in the full analysis set

ArmMeasureValue (NUMBER)
HNSCC (IO Naive)6 Months PFS0.455 Proportion of participants
HNSCC (IO Treated)6 Months PFS0.263 Proportion of participants
ESCC6 Months PFS0.533 Proportion of participants
PDAC6 Months PFS0.050 Proportion of participants
Biliary Tract Cancer (BTC)6 Months PFS0.148 Proportion of participants
GBM/AA6 Months PFS0.167 Proportion of participants
Secondary

Disease Control Rate (DCR)

CR = Complete response; PR = Partial response; SD = Stable disease

Time frame: From first participant enrolled to cut-off date (ie after the last participant has been followed for approximately 10 months) approximately 26 months

Population: FAS: all participants who received study treatment were included in the full analysis set

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
HNSCC (IO Naive)Disease Control Rate (DCR)16 Participants
HNSCC (IO Treated)Disease Control Rate (DCR)13 Participants
ESCCDisease Control Rate (DCR)22 Participants
PDACDisease Control Rate (DCR)7 Participants
Biliary Tract Cancer (BTC)Disease Control Rate (DCR)24 Participants
GBM/AADisease Control Rate (DCR)10 Participants
Secondary

Duration of Response (DOR)

Defined as the time (in days) from the first documented objective response of PR or CR, whichever is noted earlier, to disease progression or death (if death occurs before progression is documented). DOR will be defined for responders only, i.e. participants with a CR or PR.

Time frame: From first participant enrolled to cut-off date (ie after the last participant has been followed for approximately 10 months) approximately 26 months

Population: Subgroup of participants that had a best overall response of CR or PR that had received the study treatment

ArmMeasureValue (MEDIAN)
HNSCC (IO Naive)Duration of Response (DOR)NA Days
HNSCC (IO Treated)Duration of Response (DOR)NA Days
ESCCDuration of Response (DOR)420 Days
Biliary Tract Cancer (BTC)Duration of Response (DOR)432 Days
GBM/AADuration of Response (DOR)140 Days
Secondary

Number of Participants With Adverse Events

AEs were considered to be treatment-emergent (TEAEs) if they started or worsened after the start of first study drug administration until 30 days after regorafenib treatment discontinuation or 100 days after the last dose of nivolumab, whatever occurred later.

Time frame: Up to the last participant has been followed for approximately 10 months, summed up to approximately 26 months

Population: Safety analysis set (SAF): all participants who received study treatment were included in the safety analysis set. As the safety analysis set equals the full analysis, all safety related analysis were performed on the full analysis set.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
HNSCC (IO Naive)Number of Participants With Adverse EventsAny AE30 Participants
HNSCC (IO Naive)Number of Participants With Adverse EventsWorst grade: Grade 11 Participants
HNSCC (IO Naive)Number of Participants With Adverse EventsWorst grade: Grade 24 Participants
HNSCC (IO Naive)Number of Participants With Adverse EventsWorst grade: Grade 316 Participants
HNSCC (IO Naive)Number of Participants With Adverse EventsWorst grade: Grade 46 Participants
HNSCC (IO Naive)Number of Participants With Adverse EventsWorst grade: Grade 5 (death)3 Participants
HNSCC (IO Treated)Number of Participants With Adverse EventsWorst grade: Grade 10 Participants
HNSCC (IO Treated)Number of Participants With Adverse EventsWorst grade: Grade 316 Participants
HNSCC (IO Treated)Number of Participants With Adverse EventsWorst grade: Grade 5 (death)1 Participants
HNSCC (IO Treated)Number of Participants With Adverse EventsAny AE20 Participants
HNSCC (IO Treated)Number of Participants With Adverse EventsWorst grade: Grade 21 Participants
HNSCC (IO Treated)Number of Participants With Adverse EventsWorst grade: Grade 42 Participants
ESCCNumber of Participants With Adverse EventsWorst grade: Grade 5 (death)2 Participants
ESCCNumber of Participants With Adverse EventsWorst grade: Grade 42 Participants
ESCCNumber of Participants With Adverse EventsWorst grade: Grade 318 Participants
ESCCNumber of Participants With Adverse EventsWorst grade: Grade 26 Participants
ESCCNumber of Participants With Adverse EventsAny AE30 Participants
ESCCNumber of Participants With Adverse EventsWorst grade: Grade 12 Participants
PDACNumber of Participants With Adverse EventsWorst grade: Grade 311 Participants
PDACNumber of Participants With Adverse EventsWorst grade: Grade 10 Participants
PDACNumber of Participants With Adverse EventsWorst grade: Grade 22 Participants
PDACNumber of Participants With Adverse EventsWorst grade: Grade 5 (death)5 Participants
PDACNumber of Participants With Adverse EventsWorst grade: Grade 42 Participants
PDACNumber of Participants With Adverse EventsAny AE20 Participants
Biliary Tract Cancer (BTC)Number of Participants With Adverse EventsAny AE45 Participants
Biliary Tract Cancer (BTC)Number of Participants With Adverse EventsWorst grade: Grade 41 Participants
Biliary Tract Cancer (BTC)Number of Participants With Adverse EventsWorst grade: Grade 11 Participants
Biliary Tract Cancer (BTC)Number of Participants With Adverse EventsWorst grade: Grade 29 Participants
Biliary Tract Cancer (BTC)Number of Participants With Adverse EventsWorst grade: Grade 323 Participants
Biliary Tract Cancer (BTC)Number of Participants With Adverse EventsWorst grade: Grade 5 (death)11 Participants
GBM/AANumber of Participants With Adverse EventsWorst grade: Grade 311 Participants
GBM/AANumber of Participants With Adverse EventsWorst grade: Grade 28 Participants
GBM/AANumber of Participants With Adverse EventsWorst grade: Grade 42 Participants
GBM/AANumber of Participants With Adverse EventsWorst grade: Grade 5 (death)9 Participants
GBM/AANumber of Participants With Adverse EventsWorst grade: Grade 10 Participants
GBM/AANumber of Participants With Adverse EventsAny AE30 Participants
Secondary

Overall Survival (OS)

OS was defined as the time (in days) from the start of study intervention to the date of death due to any cause.

Time frame: From first participant enrolled to cut-off date (ie after the last participant has been followed for approximately 10 months) approximately 26 months

Population: FAS: all participants who received study treatment were included in the full analysis set

ArmMeasureValue (MEDIAN)
HNSCC (IO Naive)Overall Survival (OS)358 Days
HNSCC (IO Treated)Overall Survival (OS)355 Days
ESCCOverall Survival (OS)627 Days
PDACOverall Survival (OS)259 Days
Biliary Tract Cancer (BTC)Overall Survival (OS)246 Days
GBM/AAOverall Survival (OS)245 Days
Secondary

Progression Free Survival (PFS)

PFS was defined as the time (in days) from the start of study intervention to the date of first objectively documented progressive disease (PD) or death from any cause (if no progression was documented).

Time frame: From first participant enrolled to cut-off date (ie after the last participant has been followed for approximately 10 months) approximately 26 months

Population: FAS: all participants who received study treatment were included in the full analysis set

ArmMeasureValue (MEDIAN)
HNSCC (IO Naive)Progression Free Survival (PFS)79 Days
HNSCC (IO Treated)Progression Free Survival (PFS)105 Days
ESCCProgression Free Survival (PFS)259 Days
PDACProgression Free Survival (PFS)53 Days
Biliary Tract Cancer (BTC)Progression Free Survival (PFS)98 Days
GBM/AAProgression Free Survival (PFS)55 Days

Source: ClinicalTrials.gov · Data processed: Feb 8, 2026