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Displaying 1 - 63 of 63
Condition: Neurological Disorders / Brain Tumors
Investigator: Maria Diaz Ordonez, MD
Status: Currently Recruiting
The main purpose of this study is to determine a dose of AZD9574 that is safe and tolerable (does not cause side effects that could prevent people from taking the drug) when given alone or in combination with temozolomide. The study will also evaluate how much of the study drug is in your blood at various times. In addition, the action of the study drug…
Condition: Neurological Disorders / Brain Tumors
Investigator: Andrew Lassman, MD
Status: Currently Recruiting
The purpose of this study is to evaluate multiple investigational treatments for either newly diagnosed or recurrent brain tumors to determine if any of these study treatment(s) improve overall survival as compared to standard treatments. Investigational means that these are new treatments sometimes called "study drugs" and are not approved by the…
Condition: Neurological Disorders / Brain Tumors
Investigator: James Hinkley Garvin Jr, MD
Status: Currently Recruiting
Children and young adults with diffuse midline glioma will be treated with Focused Ultrasound (FUS) with DEFINITY microbubbles and neuro-navigator-controlled sonication. The overall goal of this study is to see if the study treatment plan will improve the outcome of participants with diffuse midline glioma, for which no known cure exists, and determine…
Condition: Valve Disease / Tricuspid Valve Disease
Investigator: Susheel Kodali, MD
Status: Currently Recruiting
The Edwards Cardioband Tricuspid Valve Reconstruction FIT valve repair system is a prospective, single arm, multi-center study to evaluate the safety and performance of the Cardioband Tricuspid System. The Edwards Cardioband Tricuspid Valve Reconstruction System is intended for patients with tricuspid regurgitation deemed to be potential candidates for…
Condition: Neurological Disorders / Brain Tumors
Investigator: Mikhail Doubrovin, MD
Status: Currently Recruiting
The purpose of the study is to evaluate the safety of Lutathera alone in patients with recurrent glioblastoma and the combination of Lutathera with radiotherapy with temozolomide (TMZ) in patients with newly diagnosed glioblastoma (GB) and to establish the appropriate dose of this combination. Lutathera is a radioligand therapy, which is a targeted…
Condition: Neurological Disorders / Brain Tumors
Investigator: Fabio Iwamoto, MD
Status: Currently Recruiting
The purpose of this study is to compare the usual radiation therapy and usual chemotherapy, temozolomide, to using the usual radiation therapy and usual chemotherapy plus the chemotherapy drug lomustine (Gleostine). Lomustine (Gleostine) is already approved by the FDA for use in brain tumors but it is usually used alone and is not the first-line choice for…
Condition: Neurological Disorders / Brain Tumors
Investigator: Maria Diaz Ordonez, MD
Status: Currently Recruiting
The purpose of this study is to measure how safe eflornithine is in combination with temozolomide in patients with newly diagnosed glioblastoma multiforme (GBM) or astrocytoma following radiation therapy. Safety and tolerability will be determined on the basis of physical exams, laboratory tests, and questions about any problems you might experience during…
Condition: Neurological Disorders / Brain Tumors
Investigator: Brian Gill, MD
Status: Currently Recruiting
The purpose of this study is to see if the implantable device, Sonocloud 9, is effective getting chemotherapy to better reach your tumor compared to receiving standard-of-care chemotherapy Temozolomide and Lomustine and to see how safe and tolerable the device is. Sonocloud 9 works by making the blood-brain barrier (BBB) more permeable (allowing liquids or…
Condition: Allergy, Asthma, & Immunology / Allergy
Investigator: Joyce Yu, MD
Status: Currently Recruiting
The study population includes up to 110 adult male and female participants ages 18-55 years. Participants may have multiple food allergies but must be peanut allergic in order to be included. Safety assessments will include the following: physical examination, vital signs, laboratory evaluations, and ECG (electrocardiogram).
Condition: Neurological Disorders / Brain Tumors
Investigator: Aya Haggiagi, MD
Status: Currently Recruiting
The purpose of this study is to learn about the safety (the impact of the study drug on your body) and the effects of study drug PF-07799544 for specific types of cancer on the body and to find the best dose for treating certain cancers. For BRAF (B-raf proto-oncogene serine/threonine kinase) mutated solid tumors, PF-07799544 may be combined with…
Condition: Neurological Disorders / Brain Tumors
Investigator: Aya Haggiagi, MD
Status: Currently Recruiting
The purpose of this study is to see if ONC201 is effective in treating participants with glioma when given following radiation therapy, how safe and tolerable ONC201 as compared to using placebo (a capsule that looks like ONC201 but does not contain any active drug), and to see how well ONC201 can improve quality of life and brain functioning in patients…
Condition: Neurological Disorders / Brain Tumors
Investigator: Fabio Iwamoto, MD
Status: Currently Recruiting
The purpose of this study is to learn the effects of the investigational new drug, tirabrutinib, when given for the treatment of PCNSL. Investigational new drug means a drug that has not been approved as a marketed product (that is, available to be prescribed or sold) by the United States (US) Food and Drug Administration (FDA). Tirabrutinib acts by…
Condition: Valve Disease / Tricuspid Valve Disease
Investigator: Susheel Kodali, MD
Status: Currently Recruiting
The goal of this early feasibility study is to gain initial insight into the basic safety and performance of transluminal (through the blood vessels) implantation of the PASCAL System's implant (composed of man-made materials). We are trying to evaluate the safety and performance of the PASCAL System with Optimal Medical Therapy (OMT) (also known as…
TTVR Early Feasibility Study in Patients with Symptomatic Severe Tricuspid Regurgitation - Medtronic
Condition: Valve Disease / Tricuspid Valve Disease
Investigator: Susheel Kodali, MD
Status: Currently Recruiting
This is a research study for patients who have Tricuspid Regurgitation (TR), a condition that occurs when the three leaflets of the heart's tricuspid valve do not close properly causing blood to leak backward with each heartbeat. Since some of the blood leaks backward, the heart has to pump more blood with each beat to push the same amount of blood…
Condition: Neurological Disorders / Brain Tumors
Investigator: Aya Haggiagi, MD
Status: Closed
Phase 2, Treatment A: This study is being done to see if your recurrent brain tumor may respond to a combination of radiosurgery (a type of radiation therapy) with nivolumab (a type of immunotherapy drug). A small number of patients have already received this combination previously and have tolerated the treatment relatively well. However, we would like to…
Condition: Neurological Disorders / Brain Tumors
Investigator: Mary Welch, MD
Status: Closed
The purpose of this study is to test good and bad effects of these two different drugs against meningioma tumors with altered genes. Today, therapy for meningioma is the same for all patients and is not based on tumor genetic testing. This trial is trying to see if tumor genetic testing would be helpful at guiding treatment in patients with meningioma.…
Condition: Valve Disease / Tricuspid Valve Disease
Investigator: Susheel Kodali, MD
Status: Closed
This is a prospective, single-arm, multi-center, early feasibility study. This research study is for patients who have Tricuspid Regurgitation (TR), a condition that occurs when the three leaflets of the heart's tricuspid valve do not close properly causing blood to leak backward with each heartbeat. Since some of the blood leaks backward, the heart…
Condition: Neurological Disorders / Brain Tumors
Investigator: Gurcharanjeet Kaur, MD
Status: Closed
The purpose of this study is to find out if REC-2282, an investigational new drug, is an effective and safe treatment in patients with progressive NF2 mutated meningiomas who have either NF2 disease-related meningioma or recurrent sporadic meningiomas that have NF2 mutation. Investigational new drug means a drug that has not been approved as a marketed…
Condition: Neurological Disorders / Brain Tumors
Investigator: Fabio Iwamoto, MD
Status: Closed
The purpose of this study is to see how safe and effective Safusidenib erbumine, the study drug, is in treating brain glioma and to find the recommended dose of the study drug for clinical studies. Safusidenib is not Food and Drug Administration (FDA) approved.
Condition: Neurological Disorders / Brain Tumors
Investigator: Fabio Iwamoto, MD
Status: Closed
This study is being done to answer the following question: Can we shrink or stabilize your brain cancer by adding immune therapy drugs to the usual radiation therapy? We are doing this study because we want to find out if this approach is better or worse than the usual approach for your recurrent glioblastoma. The usual approach is defined as care most…
Condition: Neurological Disorders / Brain Tumors
Investigator: Andrew Lassman, MD
Status: Closed
The purpose of this study is to test the safety of a new vaccine, VBI-1901, and to know more about its ability to boost the response of the immune system against Cytomegalovirus. The reason for testing this vaccine in people with a brain tumor is that it might one day be used to boost the ability of the immune system to fight a certain type of brain tumor.…
Condition: Neurological Disorders / Brain Tumors
Investigator: Mary Welch, MD
Status: Closed
The purpose of this study is to evaluate how safe the investigational drug, DSP-0390, is at different doses and to identify a recommended dose that is safe for further study. Investigational means that the study drug is currently being tested and has not been approved for use alone or in combination with any drug by the U.S. Food and Drug Administration (…
Condition: Neurological Disorders / Brain Tumors
Investigator: Brian Gill, MD
Status: Closed
The purpose of this study is to see how safe the study medicine, IGV-001 plus standard of care (SOC), is and to compare IGV-001 with placebo see if it works in slowing glioblastoma multiforme (GBM) tumor regrowth. SOC refers to the usual medicine(s) or procedures used to treat your cancer. A placebo looks like the study medicine but does not contain any…
Condition: Valve Disease / Tricuspid Valve Disease
Investigator: Susheel Kodali, MD
Status: Closed
This is a research study for patients who have Tricuspid Regurgitation (TR), a condition that occurs when the three leaflets of the hearts tricuspid valve do not close properly causing blood to leak backward with each heartbeat. Since some of the blood leaks backward, the heart has to pump more blood with each beat to push the same amount of blood forward.…
Condition: Neurological Disorders / Brain Tumors
Investigator: Andrew Lassman, MD
Status: Closed
The purpose of this study is to evaluate and determine the efficacy of pemigatinib in participants with recurrent glioblastoma or other CNS tumors with changes in the FGFR1, FGFR2 or FGFR3 genes. Pemigatinib (also referred as INCB054828) is an investigational drug that is being studied by Incyte Corporation (Sponsor) for use in the treatment of previously…
Condition: Neurological Disorders / Brain Tumors
Investigator: Fabio Iwamoto, MD
Status: Closed
Optune is a portable, battery-operated device that generates TTFields at a specific frequency. The TTFields are delivered to the brain through 4 sticky bandages (which hold ceramic discs) that are placed on the surface of the head (called arrays). The arrays create electric forces within the brain that disrupt cancer cell division. Optunes TTFields are a…
Condition: Neurological Disorders / Brain Tumors
Investigator: James Hinkley Garvin Jr, MD
Status: Closed
The purpose of this study is to find the best dose of a drug called MTX110 and a contrast agent called gadolinium that can be given safely in children with newly diagnosed diffuse midline gliomas, which is a kind of brain tumor. All patients enrolled in the study will receive infusion of MTX110 and Gadolinium delivered with a pump directly into the tumor…
Condition: Neurological Disorders / Brain Tumors
Investigator: Andrew Lassman, MD
Status: Closed
The purpose of this research study is to see if the combination of medications approved for the treatment of glioblastoma, together with the study drug, selinexor (also known as XPOVIO), has any effects on your cancer. Selinexor works by trapping tumor suppressor proteins within the cell nucleus. This is expected to cause the cancer cells to die or stop…
Condition: Neurological Disorders / Brain Tumors
Investigator: Andrew Lassman, MD
Status: Closed
This study is being done to evaluate the safety and usefulness of the study drug, AG-881, as compared to placebo (a medically inactive substance) in residual or recurrent non-enhancing Grade 2 glioma (a type of brain cancer) that has a mutation in the IDH1 or IDH2 metabolic enzyme (a substance produced by the body to assist in breaking down chemicals).…
Condition: Neurological Disorders / Brain Tumors
Investigator: Andrew Lassman, MD
Status: Closed
The purpose of this research study is to test how safe and how well an investigational drug known as ONC201 works in treating high grade glioma (a type of brain cancer). The FDA (the U.S. Food and Drug Administration) has not approved ONC201 as a treatment for this condition.
Condition: Neurological Disorders / Brain Tumors
Investigator: Andrew Lassman, MD
Status: Closed
The purpose of this study is to measure how well and how safe eflornithine is in combination with lomustine, compared to lomustine taken alone, in treating patients whose anaplastic astrocytoma has come back after radiation and chemotherapy. Safety and how well you can tolerate the drug will be determined on the basis of physical exams, laboratory tests,…
Condition: Neurological Disorders / Brain Tumors
Investigator: Andrew Lassman, MD
Status: Closed
New data from the study of ABT-414 and ABBV-221 in patients with recurrent glioblastoma multiforme (GBM) have shown several examples where it seems evidence of disease progression (cancer that continues to grow and spread) was seen in MRI images, but examination of surgically removed tissue under the microscope did not agree with the MRI.
Condition: Neurological Disorders / Brain Tumors
Investigator: Mary Welch, MD
Status: Closed
The purpose of this study is to: See if taking the study agent, armodafinil, at a dose of 150mg or 250mg, will improve problems with fatigue in patients who have been diagnosed with cancer and are experiencing fatigue. See the effects (good and bad) of taking Armodafinil compared to placebo (an inactive agent) on cancer-related fatigue
Condition: Neurological Disorders / Brain Tumors
Investigator: Fabio Iwamoto, MD
Status: Closed
The purpose of this study is to find out if SL-701 is safe and tolerable for patients with recurrent glioblastoma multiforme (GBM). The study will also look at what effect SL-701 has on patient's brain tumor. SL-701 is a type of anti-cancer vaccine made up of parts 3 different short proteins called "peptides" which are frequently found on…
Condition: Neurological Disorders / Brain Tumors
Investigator: Andrew Lassman, MD
Status: Closed
The reason for this study is to find out if the experimental study drug, tesevatinib, is effective as a possible treatment for recurrent glioblastoma. Certain genetic information about your tumor will also be collected, by drawing blood, to help better understand why tesevatinib did or did not work in treating your recurrent glioblastoma. Although…
Condition: Neurological Disorders / Brain Tumors
Investigator: Yazmin Odia, MD
Status: Closed
The purpose of this study is to test whether the new drug, ABT-414, given either alone or with a drug called temozolomide, which is commonly used to treat brain tumors like yours, gives a better outcome than the standard therapy and is safe. The standard therapy can be one of two different regimens, either a drug called lomustine or temozolomide.
Condition: Neurological Disorders / Brain Tumors
Investigator: Andrew Lassman, MD
Status: Closed
Two different studies have been developed to treat people with anaplastic glioma brain tumors. Onetreatment research study requires a tumor that has the 1p/19q co-deletion tumor marker; the other does not. This treatment research study requires that the subject has a certain kind of tumor, one that is missing part of both chromosomes 1 and 19. These missing…
Condition: Neurological Disorders / Brain Tumors
Investigator: Fabio Iwamoto, MD
Status: Closed
The purpose of this study is to test how well the study drug works in recurrent or isocitratedehydrogenase (IDH) mutant high grade gliomas. The study drug is called Nivolumab. Nivolumab is an antibody (a type of human protein) that is being tested to see if it will allow your own body's immune system to work against tumor cells. Nivolumab is not…
Condition: Neurological Disorders / Brain Tumors
Investigator: Fabio Iwamoto, MD
Status: Closed
The purpose of this study is to find out whether an experimental drug, bevacizumab with temozolomide is safe when given to elderly patients with brain tumors and investigate the side effects of the drug combination and how often they occur. This study will also explore whether bevacizumab and temozolomide can be effective in shrinking tumors when given to…
Condition: Neurological Disorders / Brain Tumors
Investigator: Aya Haggiagi, MD
Status: Closed
This trial studies the side effects and best dose of nivolumab when given together with radiosurgery and to see how well they work with or without ipilimumab in treating participants with grade II-III meningioma that has come back. Nivolumab and ipilimumab (two different types of immunotherapy drugs), may interfere with the ability of tumor cells to grow…
Condition: Neurological Disorders / Brain Tumors
Investigator: Teri Kreisl, MD
Status: Closed
This is a research study to test the effects of VB-111 combined with Bevacizumab versus Bevacizumab alone on glioblastoma . This study will enroll 252 subjects age 18 years and older who have recurrent glioblastoma. All subjects will be randomly assigned in a 1:1 ratio to receive either VB-111 combined with Bevacizumab or Bevacizumab alone. Survival, tumor…
Condition: Neurological Disorders / Brain Tumors
Investigator: Jeffrey Bruce, MD
Status: Closed
The purpose of this study is to determine the safety of directly injecting a tumor chemotherapy drug called Topotecan and a contrast agent called Gadolinium into malignant brain tumors.
Condition: Neurological Disorders / Brain Tumors
Investigator: Andrew Lassman, MD
Status: Closed
The purpose of this research study is to learn about the effects of the study drug, PF-06840003,and to find the best dose for treating research subjects/participants with malignant glioblastoma or anaplastic glioma. PF-068400003 is a new investigational drug. A new investigational drug is one that is currently not approved for sale in this country. PF-…
Condition: Neurological Disorders / Brain Tumors
Investigator: Andrew Lassman, MD
Status: Closed
The main purpose of this study is to improve treatment of ocular side effects that result from depatuxizumab mafodotin (Depatux-M) use in patients with glioblastoma (GBM). Most people treated with Depatux-M will experience eye side effects. When these side effects are not tolerated, Depatux-M is usually interrupted until symptoms improve and then restarted…
Condition: Neurological Disorders / Brain Tumors
Investigator: Angela Lignelli-Dipple, MD
Status: Closed
The purpose of this research study is to test whether the advanced perfusion MRI done prior to starting Bevacizumab and a few weeks after starting Bevacizumab can determine your response to the treatment better than the standard MRI performed at typical time points. The researchers want to see if this type of advanced MRI is better or the same as what is…
Condition: Neurological Disorders / Brain Tumors
Investigator: Andrew Lassman, MD
Status: Closed
This is a Phase 2b/3 study to compare the effectiveness of the study drug ABT-414 against a placebo. Patients will be randomized to either receive the standard-of-care therapy which consists of radiation therapy/TMZ plus adjuvant TMZ which will be followed by eiter the study drug ABT-414 or a placebo monotherapy.
Condition: Neurological Disorders / Brain Tumors
Investigator: Tony J. Wang, MD
Status: Closed
The purpose of this study is to compare any good and bad effects of avoiding the hippocampus during whole-brain radiation plus memantine to using the usual whole-brain radiation plus memantine. The hippocampus is a brain structure that is important for memory. The addition of the hippocampal avoidance technique to the usual whole-brain radiation plus…
Condition: Neurological Disorders / Brain Tumors
Investigator: Mary Welch, MD
Status: Closed
The purpose of this clinical study is to evaluate safety of the study treatment, its effects on the immune system and on GBM. The study treatment includes several experimental therapies: INO-5401 + INO-9012 delivered by an electroporation device called CELLECTRA 2000 used for delivery of INO-5401 + INO-9012 into your muscle. You will also receive another…
Condition: Neurological Disorders / Brain Tumors
Investigator: Aya Haggiagi, MD
Status: Closed
This research study compares the effects (good and/or bad), of the study drug (ANG1005) with standard treatments currently available for leptomeningeal metastases to find out which is better. In this study, you will get either ANG1005 or standard treatment available for leptomeningeal metastases. You will not get both.
Condition: Neurological Disorders / Brain Tumors
Investigator: Fabio Iwamoto, MD
Status: Closed
This is a research study to test the effectiveness of ICT-107, an experimental drug, with the standard of care (SOC) for treatment of glioblastoma compared to enriched blood cells (PBMC) with the SOC. The study will enroll 400 subjects age 18 years and older with newly diagnosed glioblastoma. Following an initial SOC radiation treatment, patients will be…
Condition: Neurological Disorders / Brain Tumors
Investigator: Mary Welch, MD
Status: Closed
The purpose of this study is to see if the newly discovered vaccine drug, DSP-7888, will help your immune system to fight against cancer cells that have a protein called WT1. The study will also compare the effectiveness of treatment with DSP-7888 in combination with Bevacizumab versus Bevacizumab alone in patients with glioblastoma (GBM). Bevacizumab has…
Condition: Neurological Disorders / Brain Tumors
Investigator: Fabio Iwamoto, MD
Status: Closed
In this research study, we are looking for Information on how well nivolumab with or without ipilimumab works in combination with TTFields in adult patients with glioblastoma. You will receive the Nivolumab and/or Ipilimumab study treatment until you decide to stop study treatment or your study doctor decides to remove you from the study. This means that…
Condition: Neurological Disorders / Brain Tumors
Investigator: Fabio Iwamoto, MD
Status: Closed
The purpose of this study is to test the effectiveness (how well the drug works), safety, and tolerability of an investigational drug called nivolumab (also known as BMS-936558). Nivolumab is an antibody (a type of human protein) that is being tested to see if it will allow the bodys immune system to work against tumor cells. The effectiveness of BMS-936558…
Condition: Neurological Disorders / Brain Tumors
Investigator: Andrew Lassman, MD
Status: Closed
The purpose of this study is to look at the effects of an investigational anti-cancer drug (BGB-290) in combination with radiation therapy and/or temozolomide in patients with newly diagnosed or recurring glioblastoma. BGB-290 is expected to work by preventing cancer cells from repairing their damaged genes, causing the progression of cancer to slow down.
Condition: Neurological Disorders / Brain Tumors
Investigator: Mary Welch, MD
Status: Closed
The purpose of this study is to investigate a novel treatment regimen for patients with recurrent Glioblastomas (GBM). In this phase 2 trial, the potentially synergistic action of PARP inhibition and anti-angiogenesis on DNA repair and biomarkers of angiogenesis and DNA repair will be evaluated.
Condition: Neurological Disorders / Brain Tumors
Investigator: Teri Kreisl, MD
Status: Closed
The purpose of this study is to find out what effects, good or bad, the experimental device, NovoTTF-100A has on patients with meningioma. This study is being done because currently there are no proveneffective medical treatments for a progressive meningioma that has failed surgery and/or radiation. The NovoTTF-100A System is a portable medical device. It…
Condition: Neurological Disorders / Brain Tumors
Investigator: Andrew Lassman, MD
Status: Closed
The purpose of this research study is to see if Selinexor (KPT-330) has any effects against glioblastoma, a type of brain cancer. The study will be conducted at 3-5 sites in the United States and Europe and plan to enroll 30 patients with brain cancer. Patients will be screened prior to study participation. If their brain tumor is evaluated to require…
Condition: Neurological Disorders / Brain Tumors
Investigator: Fabio Iwamoto, MD
Status: Closed
The purpose of this study is to test the effectiveness (how well the drug works), safety, and tolerability of an investigational drug called nivolumab (also known as BMS-936558). Nivolumab is an antibody (a type of human protein) that is being tested to see if it will allow the body's immune system to work against tumor cells.
Condition: Neurological Disorders / Brain Tumors
Investigator: Andrew Lassman, MD
Status: Closed
The purpose of the research study is to see if selinexor has any effects against your cancer and toevaluate the side-effects of selinexor or selinexor in combination with temozolomide (TMZ ). One specific way cancer cells continue to grow is by getting rid of certain proteins called tumor suppressor proteins that would normally cause cancer cells to die.…
Condition: Neurological Disorders / Brain Tumors
Investigator: Andrew Lassman, MD
Status: Closed
The purpose of this study is to find out whether study drug bortezomib with radiation therapy and Temozolomide is safe when given to patients with brain tumors. This study will also evaluate the side effects and see whether the combination of bortezomib with radiation and Temozolomide can be effective in shrinking tumors. Bortezomib is the investigational…
Condition: Neurological Disorders / Brain Tumors
Investigator: Mary Welch, MD
Status: Closed
This research study is a Phase II clinical trial. Phase II clinical trials test the safety and effectiveness ofan investigational drug to learn whether the study drug works in treating a specific disease.Investigational means that the drug is being studied. In this research study, we are looking to compare the effects, good and bad, of the standard of care…
Condition: Neurological Disorders / Brain Tumors
Investigator: Andrew Lassman, MD
Status: Closed
This is a two-part research study of an investigational drug called ABBV-321 in subjects with glioblastoma (brain tumor). This study will be conducted in two-parts: 1) Dose Escalation Phase: The purpose of the first part, called a Dose Escalation Phase, is where we will increase the dose of ABBV-321 until we find the highest dose before unmanageable side…
A study for patients with recurrent glioblastoma or anaplastic astrocytoma using study drug Toca 511
Condition: Neurological Disorders / Brain Tumors
Investigator: Fabio Iwamoto, MD
Status: Closed
This is a research study to test the effectiveness of Toca 511/Toca FC, an experimental drug, for treatment of recurring brain tumors compared to current standard of care. The study will enroll 370 subjects age 18-85 years who choose to undergo removal of the tumor a second time. At the time of surgery patients will be randomly assigned in a 1:1 ratio to…
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