{"id":18914,"date":"2023-05-24T20:47:54","date_gmt":"2023-05-24T20:47:54","guid":{"rendered":"https:\/\/msdconecta.co.cr\/en\/?page_id=18914"},"modified":"2023-05-24T20:49:30","modified_gmt":"2023-05-24T20:49:30","slug":"keynote-091-wp-0283","status":"publish","type":"page","link":"https:\/\/msdconecta.co.cr\/en\/keynote-091-wp-0283\/","title":{"rendered":"KEYNOTE-091-WP-0283"},"content":{"rendered":"<div class=\"mhh-mcn-columns mhh-mcn-columns--align-medium mhh-mcn-columns--vertical-alignment-center mhh-mcn-v1-columns--9a4617abc77d570231d5b50f0a890b7e mhh-mcn-v1-columns mhh-mcn-columns--gutter-custom\">\n    <div class=\"mhh-mcn-columns-inner\">\n        \n<div class=\"mhh-mcn-v1-column mhh-mcn-v1-column--73e7798a653638973ed0a2822b7e006c mhh-mcn-column mhh-mcn-column--12 mhh-mcn-column--m-12 mhh-mcn-column--l-12\">\n    \n<figure class=\"mhh-mcn-v1-image mhh-mcn-v1-image--ea143cae08200307507ea25e6bb520ab\">\n                    <img loading=\"lazy\" decoding=\"async\"\n        class=\"mhh-mcn-image mhh-mcn-image--full wp-image-18916\"\n        src=\"https:\/\/msdconecta.co.cr\/en\/wp-content\/uploads\/sites\/78\/2023\/05\/banner-091.png?quality=80&#038;lossy=1\"\n        width=\"1024\"\n        height=\"452\"\n                alt=\"\"\n            \/>\n            <\/figure>\n\n<\/div>\n\n\n<div class=\"mhh-mcn-v1-column mhh-mcn-v1-column--b7ff61559819c8912c6cdef5eeb39380 mhh-mcn-column mhh-mcn-column--2 mhh-mcn-column--m-2 mhh-mcn-column--l-2\">\n    \n<figure class=\"mhh-mcn-v1-image mhh-mcn-v1-image--1312a54fb883512b061a21b6d412df2b\">\n                    <img decoding=\"async\"\n        class=\"mhh-mcn-image mhh-mcn-image--full wp-image-18918\"\n        src=\"https:\/\/msdconecta.co.cr\/en\/wp-content\/uploads\/sites\/78\/2023\/05\/hand-091.png?quality=80&#038;lossy=1\"\n        width=\"300\"\n        height=\"697\"\n        loading=\"lazy\"        alt=\"\"\n            \/>\n            <\/figure>\n\n<\/div>\n\n\n<div class=\"mhh-mcn-v1-column mhh-mcn-v1-column--9f0fa3005d8f64a14c691440d8ee6681 mhh-mcn-column mhh-mcn-column--9 mhh-mcn-column--m-9 mhh-mcn-column--l-9\">\n    \n\n<h3 class=\"has-gray-800-color has-text-color has-object-object-font-size wp-block-heading  mhh-mcn-v1-heading mhh-mcn-v1-heading--130e8b14053945da414608fbd0d8d9f2\">KEYTRUDA<sup>\u00ae<\/sup>&nbsp;(pembrolizumab), as a single agent, is indicated for adjuvant treatment following resection and platinum-based chemotherapy for adult patients with stage IB (T2a \u22654 cm), II, or IIIA non\u2013small cell lung cancer (NSCLC).<\/h3>\n\n\n<figure class=\"mhh-mcn-v1-image mhh-mcn-v1-image--84ff9ddeede2f986bcb6532d112638a7\">\n                    <img decoding=\"async\"\n        class=\"mhh-mcn-image mhh-mcn-image--full wp-image-18919\"\n        src=\"https:\/\/msdconecta.co.cr\/en\/wp-content\/uploads\/sites\/78\/2023\/05\/key-091.png?quality=80&#038;lossy=1\"\n        width=\"800\"\n        height=\"138\"\n        loading=\"lazy\"        alt=\"\"\n            \/>\n            <\/figure>\n\n\n\n<p class=\"has-gray-800-color has-text-color has-object-object-font-size   mhh-mcn-v1-paragraph mhh-mcn-v1-paragraph--3b26fd1dd1a0825bddcc1737f3d4217d\">IO = immunotherapy; PD-L1 = programmed death ligand 1.<\/p>\n\n<\/div>\n\n    <\/div>\n\n    <\/div>\n\n\n<div class=\"mhh-mcn-columns mhh-mcn-columns--align-medium mhh-mcn-columns--vertical-alignment-center mhh-mcn-v1-columns--7f1cc833680b7d8c9cf67c2aa9cd01cd mhh-mcn-v1-columns mhh-mcn-columns--gutter-custom\">\n    <div class=\"mhh-mcn-columns-inner\">\n        \n<div class=\"mhh-mcn-v1-column mhh-mcn-v1-column--a85c2c433539cecc975c609741450b9f mhh-mcn-column mhh-mcn-column--12 mhh-mcn-column--m-12 mhh-mcn-column--l-12\">\n    \n\n<h3 class=\"has-text-color has-object-object-font-size wp-block-heading  mhh-mcn-v1-heading mhh-mcn-v1-heading--676360b798482d376943cba1c1d5a2a6\" style=\"color:#2b6e49\"><strong>DISEASE RECURRENCE CAN OCCUR, EVEN AFTER RESECTION, WITH OR WITHOUT CHEMOTHERAPY<\/strong><\/h3>\n\n\n\n<p class=\"has-gray-800-color has-text-color has-object-object-font-size   mhh-mcn-v1-paragraph mhh-mcn-v1-paragraph--405854c69dec935f54766639cb1ad6cb\">Rate of Recurrence or Death Within 5 Years by Stage<sup>1<\/sup><\/p>\n\n\n<figure class=\"mhh-mcn-v1-image mhh-mcn-v1-image--align-center mhh-mcn-v1-image--8b6fb68842bc34bc2dede147ca0a3b90\">\n                    <img decoding=\"async\"\n        class=\"mhh-mcn-image mhh-mcn-image--large wp-image-18924\"\n        src=\"https:\/\/msdconecta.co.cr\/en\/wp-content\/uploads\/sites\/78\/2023\/05\/stage-091.png?w=1024&#038;quality=80&#038;lossy=1\"\n        width=\"1024\"\n        height=\"367\"\n        loading=\"lazy\"        alt=\"\"\n            \/>\n            <\/figure>\n\n\n\n<p class=\"has-gray-800-color has-text-color has-object-object-font-size   mhh-mcn-v1-paragraph mhh-mcn-v1-paragraph--27d29a60f71a700a8f34dec086ac6493\">The rate of recurrence or death is based on a 2008 pooled analysis of 4,584 patients across 5 randomized trials, after complete resection, with or without adjuvant chemotherapy. The trials included in this pooled analysis occurred from 1994\u20132001.<\/p>\n\n\n<div class=\"mhh-mcn-columns mhh-mcn-columns--align-wide mhh-mcn-v1-columns--960d16be3a751a4dbd6e73169038b0bb mhh-mcn-v1-columns mhh-mcn-columns--gutter-m\">\n    <div class=\"mhh-mcn-columns-inner\">\n        \n<div class=\"mhh-mcn-v1-column mhh-mcn-v1-column--4676e42f31f193f4f543fde392125e68 mhh-mcn-column mhh-mcn-column--12 mhh-mcn-column--m-12 mhh-mcn-column--l-12\">\n    \n\n<p class=\"has-gray-800-color has-text-color   mhh-mcn-v1-paragraph mhh-mcn-v1-paragraph--915aee6bb2c2e7bb43fb58e387f3154b\"><strong>Lung Adjuvant Cisplatin Evaluation: A Pooled Analysis by the LACE Collaborative Group<sup>1<\/sup><\/strong><br>The Lung Adjuvant Cisplatin Evaluation study was a pooled analysis of 5 randomized trials conducted by the LACE Collaborative Group. The study evaluated the use of cisplatin-based chemotherapy as an adjuvant treatment for patients with NSCLC. The primary end point was overall survival (OS) and a secondary end point was disease-free survival (DFS).<\/p>\n\n\n\n<p class=\"has-gray-800-color has-text-color   mhh-mcn-v1-paragraph mhh-mcn-v1-paragraph--66af71edab2c683c55bee5d1cd6457dc\"><strong><em>Study population<sup>1<\/sup><\/em><\/strong><br>Individual patient data were collected and pooled from 5 trials including 4,584 patients who underwent complete resection. Of these patients, 2,281 received adjuvant chemotherapy. The interactions between patient subgroups or treatment types and chemotherapy effect on OS were analyzed using hazard ratios and log-rank tests stratified by trial.<\/p>\n\n\n\n<p class=\"has-gray-800-color has-text-color   mhh-mcn-v1-paragraph mhh-mcn-v1-paragraph--7d1f8367f99df7cb8e24933a5e18e71f\"><strong><em>Inclusion and exclusion criteria<sup>1<\/sup><\/em><\/strong><br>Trials eligible for inclusion were those that randomly assigned more than 300 patients with completely resected NSCLC to receive postoperative cisplatin-based chemotherapy versus no chemotherapy or cisplatin-based chemotherapy plus postoperative radiotherapy (administered sequentially) versus postoperative radiotherapy alone.<\/p>\n\n<\/div>\n\n    <\/div>\n\n    <\/div>\n\n<\/div>\n\n    <\/div>\n\n    <\/div>\n\n\n<div class=\"mhh-mcn-columns mhh-mcn-columns--align-medium mhh-mcn-columns--vertical-alignment-center mhh-mcn-v1-columns--d5c31bdae3f9d61d050e0c7f33bbde87 mhh-mcn-v1-columns mhh-mcn-columns--gutter-custom\">\n    <div class=\"mhh-mcn-columns-inner\">\n        \n<div class=\"mhh-mcn-v1-column mhh-mcn-v1-column--04278dc3e935e153281fc7b189ae777c mhh-mcn-column mhh-mcn-column--12 mhh-mcn-column--m-12 mhh-mcn-column--l-12\">\n    \n\n<h3 class=\"has-text-color wp-block-heading  mhh-mcn-v1-heading mhh-mcn-v1-heading--1bf473505329840f46dbbfa2a9569d2a\" style=\"color:#2b6e49\"><strong>KEYNOTE-091: A MULTICENTER, RANDOMIZED, TRIPLE-BLIND, PLACEBO-CONTROLLED TRIAL IN PATIENTS WITH RESECTED STAGE IB (T2a \u22654 cm), II, OR IIIA NSCLC<sup>a<\/sup><\/strong><\/h3>\n\n\n<figure class=\"mhh-mcn-v1-image mhh-mcn-v1-image--align-medium mhh-mcn-v1-image--4623807b92b58dd2f1bf6fe14c160999\">\n                    <img decoding=\"async\"\n        class=\"mhh-mcn-image mhh-mcn-image--full wp-image-18928\"\n        src=\"https:\/\/msdconecta.co.cr\/en\/wp-content\/uploads\/sites\/78\/2023\/05\/info-091.png?quality=80&#038;lossy=1\"\n        width=\"1024\"\n        height=\"311\"\n        loading=\"lazy\"        alt=\"\"\n            \/>\n            <\/figure>\n\n\n\n<ul class=\"mhh-mcn-v1-clist mhh-mcn-v1-clist--58bd1dfe17b1356e4190b05cd3794c9b mhh-mcn-v1-clist--order-starts-2-digits mhh-mcn-list list-style-type-dot\" start=\"1\">\n    <li><strong>Primary efficacy outcome measure:<\/strong> DFS<sup>d<\/sup>\u00a0in the overall population.<\/li><li>Additional efficacy outcome measure was OS in the overall population.<\/li><\/ul>\n\n\n\n<p class=\"has-gray-800-color has-text-color has-object-object-font-size   mhh-mcn-v1-paragraph mhh-mcn-v1-paragraph--a369696c21afee7fe1a9494bed1e4314\"><sup>a<\/sup>As defined per AJCC 7th ed.&nbsp;<sup>b<\/sup>&nbsp;Randomization was stratified by stage (IB vs II vs IIIA), adjuvant chemotherapy (no adjuvant chemotherapy vs adjuvant chemotherapy), PD-L1 status (TPS &lt; 1% [negative] vs TPS 1%\u201349% vs TPS \u226550%), and geographic region (Western Europe vs Eastern Europe vs Asia vs rest of world).<br><sup>c<\/sup>RECIST v1.1\u2013defined disease recurrence as determined by the investigator.<br><sup>d<\/sup>Investigator-assessed DFS was defined as the time between the date of randomization and the date of first recurrence (local\/regional recurrence, distant metastasis), appearance of a second NSCLC primary or other malignancy, or death from any cause, whichever occurred first.<sup>2<\/sup><br>AJCC = American Joint Committee on Cancer; Q3W = every 3 weeks; TPS = tumor proportion score; RECIST v1.1 = Response Evaluation Criteria In Solid Tumors v1.1.<\/p>\n\n<\/div>\n\n    <\/div>\n\n    <\/div>\n\n\n<div class=\"mhh-mcn-columns mhh-mcn-columns--align-medium mhh-mcn-columns--vertical-alignment-center mhh-mcn-v1-columns--ca1d2409a91865f5cc8d97f2a21ed5e1 mhh-mcn-v1-columns mhh-mcn-columns--gutter-custom\">\n    <div class=\"mhh-mcn-columns-inner\">\n        \n<div class=\"mhh-mcn-v1-column mhh-mcn-v1-column--33e6417ea2b1837a16767840fa4fd1eb mhh-mcn-column mhh-mcn-column--12 mhh-mcn-column--m-12 mhh-mcn-column--l-12\">\n    \n\n<h3 class=\"has-text-color wp-block-heading  mhh-mcn-v1-heading mhh-mcn-v1-heading--1bf473505329840f46dbbfa2a9569d2a\" style=\"color:#2b6e49\"><strong>KEYNOTE-091: A MULTICENTER, RANDOMIZED, TRIPLE-BLIND, PLACEBO-CONTROLLED TRIAL IN PATIENTS WITH RESECTED STAGE IB (T2a \u22654 cm), II, OR IIIA NSCLC<sup>a<\/sup><\/strong><\/h3>\n\n\n\n<p class=\"has-gray-800-color has-text-color has-object-object-font-size   mhh-mcn-v1-paragraph mhh-mcn-v1-paragraph--8442b2a0a9d557f4dd0712099666605f\"><strong>Of 1,177 patients randomized, 1,010 (86%) received adjuvant platinum-based chemotherapy following resection.<\/strong><\/p>\n\n\n<figure class=\"mhh-mcn-v1-image mhh-mcn-v1-image--align-center mhh-mcn-v1-image--b1a64c31d2f86155a3379ca5d7746e28\">\n                    <img decoding=\"async\"\n        class=\"mhh-mcn-image mhh-mcn-image--large wp-image-18930\"\n        src=\"https:\/\/msdconecta.co.cr\/en\/wp-content\/uploads\/sites\/78\/2023\/05\/table-091.png?w=749&#038;quality=80&#038;lossy=1\"\n        width=\"749\"\n        height=\"1024\"\n        loading=\"lazy\"        alt=\"\"\n            \/>\n            <\/figure>\n\n\n\n<p class=\"has-gray-800-color has-text-color has-object-object-font-size   mhh-mcn-v1-paragraph mhh-mcn-v1-paragraph--1d1717b3c40ebd2ffa7d757993513fc4\"><sup>a<\/sup>&nbsp;As defined per AJCC 7th ed.<br>ECOG PS = Eastern Cooperative Oncology Group performance status.<\/p>\n\n<\/div>\n\n    <\/div>\n\n    <\/div>\n\n\n<div class=\"mhh-mcn-columns mhh-mcn-columns--align-medium mhh-mcn-columns--vertical-alignment-center mhh-mcn-v1-columns--d1253baac2e798e32eda75476e214b74 mhh-mcn-v1-columns mhh-mcn-columns--gutter-custom\">\n    <div class=\"mhh-mcn-columns-inner\">\n        \n<div class=\"mhh-mcn-v1-column mhh-mcn-v1-column--4401eccc1ebcb9bfeb081af3db679e71 mhh-mcn-column mhh-mcn-column--12 mhh-mcn-column--m-12 mhh-mcn-column--l-12\">\n    \n\n<p class=\"has-gray-800-color has-text-color has-object-object-font-size   mhh-mcn-v1-paragraph mhh-mcn-v1-paragraph--72c656551be53b30202e4f6e092a3b26\"><strong>In patients with stage IB (T2a \u22654 cm), II, or IIIA NSCLC, after resection and adjuvant platinum-based chemotherapy, regardless of PD-L1 expression,<\/strong><\/p>\n\n\n\n<h3 class=\"has-text-color wp-block-heading  mhh-mcn-v1-heading mhh-mcn-v1-heading--a2531afafbf99793fa243502e751819b\" style=\"color:#2b6e49\"><strong>KEYTRUDA DEMONSTRATED A CLINICALLY MEANINGFUL IMPROVEMENT IN DFS COMPARED TO PLACEBO<\/strong><\/h3>\n\n\n<figure class=\"mhh-mcn-v1-image mhh-mcn-v1-image--align-center mhh-mcn-v1-image--576bd8be941458834de9ca8f4974c03a\">\n                    <img decoding=\"async\"\n        class=\"mhh-mcn-image mhh-mcn-image--large wp-image-18933\"\n        src=\"https:\/\/msdconecta.co.cr\/en\/wp-content\/uploads\/sites\/78\/2023\/05\/grafica1-091.png?w=1024&#038;quality=80&#038;lossy=1\"\n        width=\"1024\"\n        height=\"706\"\n        loading=\"lazy\"        alt=\"\"\n            \/>\n            <\/figure>\n\n\n\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<ul class=\"mhh-mcn-v1-clist mhh-mcn-v1-clist--025490d76dce454624e73fb7142165c7 mhh-mcn-v1-clist--order-starts-2-digits mhh-mcn-list list-style-type-dot\" start=\"1\">\n    <li>In an exploratory subgroup analysis of the 167 patients (14%) who did not receive adjuvant chemotherapy, the DFS HR was 1.25 (95% CI, 0.76\u20132.05).<\/li><li>At the time of the interim analysis, OS results were not mature (42% with events in the overall population).<\/li><\/ul>\n\n<\/div>\n\n    <\/div>\n\n    <\/div>\n\n\n<div class=\"mhh-mcn-columns mhh-mcn-columns--align-medium mhh-mcn-columns--vertical-alignment-center mhh-mcn-v1-columns--38caebc3142107812f8e08f54e265011 mhh-mcn-v1-columns mhh-mcn-columns--gutter-custom\">\n    <div class=\"mhh-mcn-columns-inner\">\n        \n<div class=\"mhh-mcn-v1-column mhh-mcn-v1-column--c3fda60343bc981f95fd54e046d5fb39 mhh-mcn-column mhh-mcn-column--12 mhh-mcn-column--m-12 mhh-mcn-column--l-12\">\n    \n\n<h3 class=\"has-white-color has-text-color wp-block-heading mhh-mcn-v1-heading--center mhh-mcn-v1-heading mhh-mcn-v1-heading--63d29145983c6cf665e209113c16ecf3\"><strong>Median DFS for Patients Who Received Adjuvant Chemotherapy<\/strong><\/h3>\n\n<\/div>\n\n\n<div class=\"mhh-mcn-v1-column mhh-mcn-v1-column--9db287967d8ad323754749263ff86d6e mhh-mcn-column mhh-mcn-column--12 mhh-mcn-column--m-12 mhh-mcn-column--l-12\">\n    \n<figure class=\"mhh-mcn-v1-image mhh-mcn-v1-image--align-center mhh-mcn-v1-image--60c0ebc3cb4eee997031c5ee23e2f74e\">\n                    <img decoding=\"async\"\n        class=\"mhh-mcn-image mhh-mcn-image--full wp-image-18936\"\n        src=\"https:\/\/msdconecta.co.cr\/en\/wp-content\/uploads\/sites\/78\/2023\/05\/grafica2-091.png?quality=80&#038;lossy=1\"\n        width=\"980\"\n        height=\"438\"\n        loading=\"lazy\"        alt=\"\"\n            \/>\n            <\/figure>\n\n\n\n<div style=\"height:40px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<p class=\"has-gray-800-color has-text-color has-object-object-font-size   mhh-mcn-v1-paragraph mhh-mcn-v1-paragraph--bfb84bd396a8a6984434d585e70c0090\"><sup>a<\/sup>HR based on the unstratified univariate Cox regression model.<br><sup>b<\/sup>4.891 years (58.7 months).<br><sup>c<\/sup>2.908 years (34.9 months).<br>HR = hazard ratio; CI = confidence interval; NR = not reached.<\/p>\n\n\n\n<div style=\"height:50px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<hr class=\"wp-block-separator has-text-color has-alpha-channel-opacity has-background\" style=\"background-color:#6cc04a;color:#6cc04a\"\/>\n\n<\/div>\n\n    <\/div>\n\n    <\/div>\n\n\n<div class=\"mhh-mcn-columns mhh-mcn-columns--align-medium mhh-mcn-columns--vertical-alignment-center mhh-mcn-v1-columns--58cbb76899469e77246fb13fcd76f75e mhh-mcn-v1-columns mhh-mcn-columns--gutter-custom\">\n    <div class=\"mhh-mcn-columns-inner\">\n        \n<div class=\"mhh-mcn-v1-column mhh-mcn-v1-column--cb82bdea59cdaaef0a9309faa093cc14 mhh-mcn-column mhh-mcn-column--12 mhh-mcn-column--m-12 mhh-mcn-column--l-12\">\n    \n<div class=\"mhh-mcn-columns mhh-mcn-v1-columns--b2a5d4c2f092049e1100f100cfb9e113 mhh-mcn-v1-columns mhh-mcn-columns--gutter-custom\">\n    <div class=\"mhh-mcn-columns-inner\">\n        \n<div class=\"mhh-mcn-v1-column mhh-mcn-v1-column--17336e32fc74fc18abb1eca72a455ebc mhh-mcn-column mhh-mcn-column--12 mhh-mcn-column--m-6 mhh-mcn-column--l-6\">\n    \n\n<p class=\" mhh-mcn-v1-paragraph--center  mhh-mcn-v1-paragraph mhh-mcn-v1-paragraph--563b70943412a48fb3abc01c2280ae97\">Before prescribing KEYTRUDA*, please refer to the full prescribing information by<\/p>\n\n\n<div class=\"mhh-mcn-v1-links mhh-mcn-v1-links--justified-center mhh-mcn-v1-links--b15ac48e70a3908d167915d169ec13a4\">\n    <a class=\"mhh-mcn-v1-link mhh-mcn-v1-link--875d340bb75a551c302b47665b7693b9 mhh-mcn-v1-link--is-variation mhh-mcn-v1-link--button-custom\" href=\"https:\/\/msdconecta.co.cr\/en\/wp-content\/uploads\/sites\/78\/2023\/03\/Keytruda-crt-uspi-mk3475-r062-Clean.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">\n                    <span class=\"mhh-mcn-v1-link__label\">CLICKING HERE<\/span>\n                <\/a><\/div>\n\n<\/div>\n\n\n<div class=\"mhh-mcn-v1-column mhh-mcn-v1-column--7473bc456299ffb174ab72f6cd4a50a9 mhh-mcn-column mhh-mcn-column--12 mhh-mcn-column--m-6 mhh-mcn-column--l-6\">\n    \n\n<p class=\" mhh-mcn-v1-paragraph--center  mhh-mcn-v1-paragraph mhh-mcn-v1-paragraph--2063e7ba66330ca06a7032758e190cd5\">Before prescribing KEYTRUDA*, please refer to the full selected safety information by<\/p>\n\n\n<div class=\"mhh-mcn-v1-links mhh-mcn-v1-links--justified-center mhh-mcn-v1-links--1720f9a228c1baf228c60e94511639fd\">\n    <a class=\"mhh-mcn-v1-link mhh-mcn-v1-link--b7079eee5467815f59680839de62ab29 mhh-mcn-v1-link--is-variation mhh-mcn-v1-link--button-custom\" href=\"https:\/\/msdconecta.co.cr\/en\/wp-content\/uploads\/sites\/78\/2023\/03\/SSI-Long-Version-Caribe-MAR-2023-updated-Rev.-RR-27Mar23.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">\n                    <span class=\"mhh-mcn-v1-link__label\">CLICKING HERE<\/span>\n                <\/a><\/div>\n\n<\/div>\n\n    <\/div>\n\n    <\/div>\n\n<\/div>\n\n    <\/div>\n\n    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