<?xml version="1.0" encoding="UTF-8"?><?xml-stylesheet type="text/xsl" href="static/style.xsl"?><OAI-PMH xmlns="http://www.openarchives.org/OAI/2.0/" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/ http://www.openarchives.org/OAI/2.0/OAI-PMH.xsd"><responseDate>2026-04-29T06:15:57Z</responseDate><request verb="GetRecord" identifier="oai:repisalud.isciii.es:20.500.12105/16137" metadataPrefix="mets">https://repisalud.isciii.es/rest/oai/request</request><GetRecord><record><header><identifier>oai:repisalud.isciii.es:20.500.12105/16137</identifier><datestamp>2024-11-29T14:03:32Z</datestamp><setSpec>com_20.500.12105_2173</setSpec><setSpec>com_20.500.12105_2051</setSpec><setSpec>col_20.500.12105_19597</setSpec></header><metadata><mets xmlns="http://www.loc.gov/METS/" xmlns:doc="http://www.lyncode.com/xoai" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" ID="&#xa;&#x9;&#x9;&#x9;&#x9;DSpace_ITEM_20.500.12105-16137" TYPE="DSpace ITEM" PROFILE="DSpace METS SIP Profile 1.0" xsi:schemaLocation="http://www.loc.gov/METS/ http://www.loc.gov/standards/mets/mets.xsd" OBJID="&#xa;&#x9;&#x9;&#x9;&#x9;hdl:20.500.12105/16137">
   <metsHdr CREATEDATE="2026-04-29T08:15:57Z">
      <agent ROLE="CUSTODIAN" TYPE="ORGANIZATION">
         <name>Repisalud</name>
      </agent>
   </metsHdr>
   <dmdSec ID="DMD_20.500.12105_16137">
      <mdWrap MDTYPE="MODS">
         <xmlData xmlns:mods="http://www.loc.gov/mods/v3" xsi:schemaLocation="http://www.loc.gov/mods/v3 http://www.loc.gov/standards/mods/v3/mods-3-1.xsd">
            <mods:mods xsi:schemaLocation="http://www.loc.gov/mods/v3 http://www.loc.gov/standards/mods/v3/mods-3-1.xsd">
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>Rugo, Hope S</mods:namePart>
               </mods:name>
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>Kabos, Peter</mods:namePart>
               </mods:name>
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>Beck, J Thad</mods:namePart>
               </mods:name>
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>Jerusalem, Guy</mods:namePart>
               </mods:name>
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>Wildiers, Hans</mods:namePart>
               </mods:name>
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>Sevillano, Elena</mods:namePart>
               </mods:name>
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>Paz Ares, Luis Gonzaga</mods:namePart>
               </mods:name>
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>Chisamore, Michael J</mods:namePart>
               </mods:name>
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>Chapman, Sonya C</mods:namePart>
               </mods:name>
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>Hossain, Anwar M</mods:namePart>
               </mods:name>
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>Chen, Yanyun</mods:namePart>
               </mods:name>
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>Tolaney, Sara M</mods:namePart>
               </mods:name>
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">funder</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>Eli Lilly</mods:namePart>
               </mods:name>
               <mods:extension>
                  <mods:dateAccessioned encoding="iso8601">2023-06-05T10:53:52Z</mods:dateAccessioned>
               </mods:extension>
               <mods:extension>
                  <mods:dateAvailable encoding="iso8601">2023-06-05T10:53:52Z</mods:dateAvailable>
               </mods:extension>
               <mods:originInfo>
                  <mods:dateIssued encoding="iso8601">2022-11-05</mods:dateIssued>
               </mods:originInfo>
               <mods:identifier type="citation">NPJ Breast Cancer. 2022 ;8(1):118.</mods:identifier>
               <mods:identifier type="issn">2374-4677</mods:identifier>
               <mods:identifier type="uri">http://hdl.handle.net/20.500.12105/16137</mods:identifier>
               <mods:identifier type="pubmedID">36335120</mods:identifier>
               <mods:identifier type="doi">10.1038/s41523-022-00482-2</mods:identifier>
               <mods:identifier type="journal">NPJ breast cancer</mods:identifier>
               <mods:abstract>This nonrandomized, open-label, multi-cohort Phase 1b study (NCT02779751) investigated the safety and efficacy of abemaciclib plus pembrolizumab with/without anastrozole in patients with hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) metastatic breast cancer (MBC) without prior CDK4 and 6 inhibitor exposure. Patients were divided into two cohorts: treatment naïve (cohort 1) and pretreated (cohort 2). Patients received abemaciclib plus pembrolizumab with (cohort 1) or without (cohort 2) anastrozole over 21-day cycles. The primary objective was safety, and secondary objectives included efficacy and pharmacokinetics (PK). Cohort 1/2 enrolled 26/28 patients, respectively. Neutropenia (30.8/28.6%), AST increase (34.6/17.9%), ALT increase (42.3/10.7%), and diarrhea (3.8/10.7%) were the most frequent grade ≥3 adverse events in cohort 1/2, respectively. A total of two deaths occurred, which investigators attributed to treatment-related adverse events (AEs), both in cohort 1. Higher rates of all grade and grade ≥3 interstitial lung disease (ILD)/pneumonitis were observed compared to previously reported with abemaciclib and pembrolizumab monotherapy. The PK profiles were consistent between cohorts and with previous monotherapy studies. In cohorts 1/2, the overall response rate and disease control rate were 23.1/28.6% and 84.6/82.1%, respectively. Median progression-free survival and overall survivals were 8.9 (95% CI: 3.9-11.1) and 26.3 months (95% CI: 20.0-31.0) for cohort 2; cohort 1 data are immature. Abemaciclib plus pembrolizumab demonstrated antitumor activity, but high rates of ILD/pneumonitis and severe transaminase elevations occurred with/without anastrozole compared to the previous reporting. Benefit/risk analysis does not support further evaluation of this combination in the treatment of HR+, HER2- MBC.</mods:abstract>
               <mods:language>
                  <mods:languageTerm authority="rfc3066">eng</mods:languageTerm>
               </mods:language>
               <mods:accessCondition type="useAndReproduction"/>
               <mods:subject>
                  <mods:topic>INHIBITOR</mods:topic>
               </mods:subject>
               <mods:subject>
                  <mods:topic>EFFICACY</mods:topic>
               </mods:subject>
               <mods:subject>
                  <mods:topic>CRITERIA</mods:topic>
               </mods:subject>
               <mods:subject>
                  <mods:topic>CDK4</mods:topic>
               </mods:subject>
               <mods:titleInfo>
                  <mods:title>Abemaciclib in combination with pembrolizumab for HR+, HER2- metastatic breast cancer: Phase 1b study.</mods:title>
               </mods:titleInfo>
               <mods:genre>journal article</mods:genre>
            </mods:mods>
         </xmlData>
      </mdWrap>
   </dmdSec>
   <amdSec ID="TMD_20.500.12105_16137">
      <rightsMD ID="RIG_20.500.12105_16137">
         <mdWrap MIMETYPE="text/plain" MDTYPE="OTHER" OTHERMDTYPE="DSpaceDepositLicense">
            <binData>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</binData>
         </mdWrap>
      </rightsMD>
   </amdSec>
   <amdSec ID="FO_20.500.12105_16137_1">
      <techMD ID="TECH_O_20.500.12105_16137_1">
         <mdWrap MDTYPE="PREMIS">
            <xmlData xmlns:premis="http://www.loc.gov/standards/premis" xsi:schemaLocation="http://www.loc.gov/standards/premis http://www.loc.gov/standards/premis/PREMIS-v1-0.xsd">
               <premis:premis>
                  <premis:object>
                     <premis:objectIdentifier>
                        <premis:objectIdentifierType>URL</premis:objectIdentifierType>
                        <premis:objectIdentifierValue>https://repisalud.isciii.es/bitstreams/d6f4668a-b275-4ec6-ae9e-6f4bd1954b8e/download</premis:objectIdentifierValue>
                     </premis:objectIdentifier>
                     <premis:objectCategory>File</premis:objectCategory>
                     <premis:objectCharacteristics>
                        <premis:fixity>
                           <premis:messageDigestAlgorithm>MD5</premis:messageDigestAlgorithm>
                           <premis:messageDigest>3086093ae50a02bdab29ff9877b2b6bc</premis:messageDigest>
                        </premis:fixity>
                        <premis:size>623422</premis:size>
                        <premis:format>
                           <premis:formatDesignation>
                              <premis:formatName>application/pdf</premis:formatName>
                           </premis:formatDesignation>
                        </premis:format>
                     </premis:objectCharacteristics>
                     <premis:originalName>Abemaciclibincombinationwithpembrolizumab_2022.pdf</premis:originalName>
                  </premis:object>
               </premis:premis>
            </xmlData>
         </mdWrap>
      </techMD>
   </amdSec>
   <amdSec ID="FO_20.500.12105_16137_2">
      <techMD ID="TECH_O_20.500.12105_16137_2">
         <mdWrap MDTYPE="PREMIS">
            <xmlData xmlns:premis="http://www.loc.gov/standards/premis" xsi:schemaLocation="http://www.loc.gov/standards/premis http://www.loc.gov/standards/premis/PREMIS-v1-0.xsd">
               <premis:premis>
                  <premis:object>
                     <premis:objectIdentifier>
                        <premis:objectIdentifierType>URL</premis:objectIdentifierType>
                        <premis:objectIdentifierValue>https://repisalud.isciii.es/bitstreams/c9c58cfc-7d71-4709-a5cf-d64a25a51d36/download</premis:objectIdentifierValue>
                     </premis:objectIdentifier>
                     <premis:objectCategory>File</premis:objectCategory>
                     <premis:objectCharacteristics>
                        <premis:fixity>
                           <premis:messageDigestAlgorithm>MD5</premis:messageDigestAlgorithm>
                           <premis:messageDigest>7fdfb91cacec7663ac7edb1550ded31a</premis:messageDigest>
                        </premis:fixity>
                        <premis:size>83750</premis:size>
                        <premis:format>
                           <premis:formatDesignation>
                              <premis:formatName>application/pdf</premis:formatName>
                           </premis:formatDesignation>
                        </premis:format>
                     </premis:objectCharacteristics>
                     <premis:originalName>41523_2022_482_MOESM1_ESM.pdf</premis:originalName>
                  </premis:object>
               </premis:premis>
            </xmlData>
         </mdWrap>
      </techMD>
   </amdSec>
   <amdSec ID="FO_20.500.12105_16137_3">
      <techMD ID="TECH_O_20.500.12105_16137_3">
         <mdWrap MDTYPE="PREMIS">
            <xmlData xmlns:premis="http://www.loc.gov/standards/premis" xsi:schemaLocation="http://www.loc.gov/standards/premis http://www.loc.gov/standards/premis/PREMIS-v1-0.xsd">
               <premis:premis>
                  <premis:object>
                     <premis:objectIdentifier>
                        <premis:objectIdentifierType>URL</premis:objectIdentifierType>
                        <premis:objectIdentifierValue>https://repisalud.isciii.es/bitstreams/5749cb7b-49c0-4c4d-9a0e-f8218de45e2f/download</premis:objectIdentifierValue>
                     </premis:objectIdentifier>
                     <premis:objectCategory>File</premis:objectCategory>
                     <premis:objectCharacteristics>
                        <premis:fixity>
                           <premis:messageDigestAlgorithm>MD5</premis:messageDigestAlgorithm>
                           <premis:messageDigest>108862712537be7401a3f19a4215559f</premis:messageDigest>
                        </premis:fixity>
                        <premis:size>291228</premis:size>
                        <premis:format>
                           <premis:formatDesignation>
                              <premis:formatName>application/pdf</premis:formatName>
                           </premis:formatDesignation>
                        </premis:format>
                     </premis:objectCharacteristics>
                     <premis:originalName>41523_2022_482_MOESM2_ESM.pdf</premis:originalName>
                  </premis:object>
               </premis:premis>
            </xmlData>
         </mdWrap>
      </techMD>
   </amdSec>
   <amdSec ID="FO_20.500.12105_16137_4">
      <techMD ID="TECH_O_20.500.12105_16137_4">
         <mdWrap MDTYPE="PREMIS">
            <xmlData xmlns:premis="http://www.loc.gov/standards/premis" xsi:schemaLocation="http://www.loc.gov/standards/premis http://www.loc.gov/standards/premis/PREMIS-v1-0.xsd">
               <premis:premis>
                  <premis:object>
                     <premis:objectIdentifier>
                        <premis:objectIdentifierType>URL</premis:objectIdentifierType>
                        <premis:objectIdentifierValue>https://repisalud.isciii.es/bitstreams/43579da1-79f0-4654-ad0d-2451f165b7b2/download</premis:objectIdentifierValue>
                     </premis:objectIdentifier>
                     <premis:objectCategory>File</premis:objectCategory>
                     <premis:objectCharacteristics>
                        <premis:fixity>
                           <premis:messageDigestAlgorithm>MD5</premis:messageDigestAlgorithm>
                           <premis:messageDigest>075fab206ef771e567f46d1a3f22f687</premis:messageDigest>
                        </premis:fixity>
                        <premis:size>5676282</premis:size>
                        <premis:format>
                           <premis:formatDesignation>
                              <premis:formatName>application/pdf</premis:formatName>
                           </premis:formatDesignation>
                        </premis:format>
                     </premis:objectCharacteristics>
                     <premis:originalName>41523_2022_482_MOESM3_ESM.pdf</premis:originalName>
                  </premis:object>
               </premis:premis>
            </xmlData>
         </mdWrap>
      </techMD>
   </amdSec>
   <amdSec ID="FT_20.500.12105_16137_7">
      <techMD ID="TECH_T_20.500.12105_16137_7">
         <mdWrap MDTYPE="PREMIS">
            <xmlData xmlns:premis="http://www.loc.gov/standards/premis" xsi:schemaLocation="http://www.loc.gov/standards/premis http://www.loc.gov/standards/premis/PREMIS-v1-0.xsd">
               <premis:premis>
                  <premis:object>
                     <premis:objectIdentifier>
                        <premis:objectIdentifierType>URL</premis:objectIdentifierType>
                        <premis:objectIdentifierValue>https://repisalud.isciii.es/bitstreams/34f599d9-185d-4a60-bb52-63249246d4f1/download</premis:objectIdentifierValue>
                     </premis:objectIdentifier>
                     <premis:objectCategory>File</premis:objectCategory>
                     <premis:objectCharacteristics>
                        <premis:fixity>
                           <premis:messageDigestAlgorithm>MD5</premis:messageDigestAlgorithm>
                           <premis:messageDigest>d43bf9a1fb0b2c470bee2f5e96d3d9cb</premis:messageDigest>
                        </premis:fixity>
                        <premis:size>53237</premis:size>
                        <premis:format>
                           <premis:formatDesignation>
                              <premis:formatName>text/plain</premis:formatName>
                           </premis:formatDesignation>
                        </premis:format>
                     </premis:objectCharacteristics>
                     <premis:originalName>Abemaciclibincombinationwithpembrolizumab_2022.pdf.txt</premis:originalName>
                  </premis:object>
               </premis:premis>
            </xmlData>
         </mdWrap>
      </techMD>
   </amdSec>
   <amdSec ID="FT_20.500.12105_16137_9">
      <techMD ID="TECH_T_20.500.12105_16137_9">
         <mdWrap MDTYPE="PREMIS">
            <xmlData xmlns:premis="http://www.loc.gov/standards/premis" xsi:schemaLocation="http://www.loc.gov/standards/premis http://www.loc.gov/standards/premis/PREMIS-v1-0.xsd">
               <premis:premis>
                  <premis:object>
                     <premis:objectIdentifier>
                        <premis:objectIdentifierType>URL</premis:objectIdentifierType>
                        <premis:objectIdentifierValue>https://repisalud.isciii.es/bitstreams/acda6538-91e7-4963-95bc-1c6e192a4cee/download</premis:objectIdentifierValue>
                     </premis:objectIdentifier>
                     <premis:objectCategory>File</premis:objectCategory>
                     <premis:objectCharacteristics>
                        <premis:fixity>
                           <premis:messageDigestAlgorithm>MD5</premis:messageDigestAlgorithm>
                           <premis:messageDigest>fb2253fcc5b4d4396d9e8b7286356e0b</premis:messageDigest>
                        </premis:fixity>
                        <premis:size>8621</premis:size>
                        <premis:format>
                           <premis:formatDesignation>
                              <premis:formatName>text/plain</premis:formatName>
                           </premis:formatDesignation>
                        </premis:format>
                     </premis:objectCharacteristics>
                     <premis:originalName>41523_2022_482_MOESM1_ESM.pdf.txt</premis:originalName>
                  </premis:object>
               </premis:premis>
            </xmlData>
         </mdWrap>
      </techMD>
   </amdSec>
   <amdSec ID="FT_20.500.12105_16137_11">
      <techMD ID="TECH_T_20.500.12105_16137_11">
         <mdWrap MDTYPE="PREMIS">
            <xmlData xmlns:premis="http://www.loc.gov/standards/premis" xsi:schemaLocation="http://www.loc.gov/standards/premis http://www.loc.gov/standards/premis/PREMIS-v1-0.xsd">
               <premis:premis>
                  <premis:object>
                     <premis:objectIdentifier>
                        <premis:objectIdentifierType>URL</premis:objectIdentifierType>
                        <premis:objectIdentifierValue>https://repisalud.isciii.es/bitstreams/82de0bb1-d4b4-4987-88cc-b6bf925c59c3/download</premis:objectIdentifierValue>
                     </premis:objectIdentifier>
                     <premis:objectCategory>File</premis:objectCategory>
                     <premis:objectCharacteristics>
                        <premis:fixity>
                           <premis:messageDigestAlgorithm>MD5</premis:messageDigestAlgorithm>
                           <premis:messageDigest>722f34b24349c5b4c1505fdb56eb5090</premis:messageDigest>
                        </premis:fixity>
                        <premis:size>1998</premis:size>
                        <premis:format>
                           <premis:formatDesignation>
                              <premis:formatName>text/plain</premis:formatName>
                           </premis:formatDesignation>
                        </premis:format>
                     </premis:objectCharacteristics>
                     <premis:originalName>41523_2022_482_MOESM2_ESM.pdf.txt</premis:originalName>
                  </premis:object>
               </premis:premis>
            </xmlData>
         </mdWrap>
      </techMD>
   </amdSec>
   <amdSec ID="FT_20.500.12105_16137_13">
      <techMD ID="TECH_T_20.500.12105_16137_13">
         <mdWrap MDTYPE="PREMIS">
            <xmlData xmlns:premis="http://www.loc.gov/standards/premis" xsi:schemaLocation="http://www.loc.gov/standards/premis http://www.loc.gov/standards/premis/PREMIS-v1-0.xsd">
               <premis:premis>
                  <premis:object>
                     <premis:objectIdentifier>
                        <premis:objectIdentifierType>URL</premis:objectIdentifierType>
                        <premis:objectIdentifierValue>https://repisalud.isciii.es/bitstreams/bb4f418a-6164-4ed7-aa10-6da135027d1b/download</premis:objectIdentifierValue>
                     </premis:objectIdentifier>
                     <premis:objectCategory>File</premis:objectCategory>
                     <premis:objectCharacteristics>
                        <premis:fixity>
                           <premis:messageDigestAlgorithm>MD5</premis:messageDigestAlgorithm>
                           <premis:messageDigest>e2fcedae5c229a708f5695ecd631fa66</premis:messageDigest>
                        </premis:fixity>
                        <premis:size>200537</premis:size>
                        <premis:format>
                           <premis:formatDesignation>
                              <premis:formatName>text/plain</premis:formatName>
                           </premis:formatDesignation>
                        </premis:format>
                     </premis:objectCharacteristics>
                     <premis:originalName>41523_2022_482_MOESM3_ESM.pdf.txt</premis:originalName>
                  </premis:object>
               </premis:premis>
            </xmlData>
         </mdWrap>
      </techMD>
   </amdSec>
   <fileSec>
      <fileGrp USE="ORIGINAL">
         <file ID="BITSTREAM_ORIGINAL_20.500.12105_16137_1" MIMETYPE="application/pdf" SEQ="1" SIZE="623422" CHECKSUM="3086093ae50a02bdab29ff9877b2b6bc" CHECKSUMTYPE="MD5" ADMID="FO_20.500.12105_16137_1" GROUPID="GROUP_BITSTREAM_20.500.12105_16137_1">
            <FLocat LOCTYPE="URL" xlink:type="simple" xlink:href="https://repisalud.isciii.es/bitstreams/d6f4668a-b275-4ec6-ae9e-6f4bd1954b8e/download"/>
         </file>
         <file ID="BITSTREAM_ORIGINAL_20.500.12105_16137_2" MIMETYPE="application/pdf" SEQ="2" SIZE="83750" CHECKSUM="7fdfb91cacec7663ac7edb1550ded31a" CHECKSUMTYPE="MD5" ADMID="FO_20.500.12105_16137_2" GROUPID="GROUP_BITSTREAM_20.500.12105_16137_2">
            <FLocat LOCTYPE="URL" xlink:type="simple" xlink:href="https://repisalud.isciii.es/bitstreams/c9c58cfc-7d71-4709-a5cf-d64a25a51d36/download"/>
         </file>
         <file ID="BITSTREAM_ORIGINAL_20.500.12105_16137_3" MIMETYPE="application/pdf" SEQ="3" SIZE="291228" CHECKSUM="108862712537be7401a3f19a4215559f" CHECKSUMTYPE="MD5" ADMID="FO_20.500.12105_16137_3" GROUPID="GROUP_BITSTREAM_20.500.12105_16137_3">
            <FLocat LOCTYPE="URL" xlink:type="simple" xlink:href="https://repisalud.isciii.es/bitstreams/5749cb7b-49c0-4c4d-9a0e-f8218de45e2f/download"/>
         </file>
         <file ID="BITSTREAM_ORIGINAL_20.500.12105_16137_4" MIMETYPE="application/pdf" SEQ="4" SIZE="5676282" CHECKSUM="075fab206ef771e567f46d1a3f22f687" CHECKSUMTYPE="MD5" ADMID="FO_20.500.12105_16137_4" GROUPID="GROUP_BITSTREAM_20.500.12105_16137_4">
            <FLocat LOCTYPE="URL" xlink:type="simple" xlink:href="https://repisalud.isciii.es/bitstreams/43579da1-79f0-4654-ad0d-2451f165b7b2/download"/>
         </file>
      </fileGrp>
      <fileGrp USE="TEXT">
         <file ID="BITSTREAM_TEXT_20.500.12105_16137_7" MIMETYPE="text/plain" SEQ="7" SIZE="53237" CHECKSUM="d43bf9a1fb0b2c470bee2f5e96d3d9cb" CHECKSUMTYPE="MD5" ADMID="FT_20.500.12105_16137_7" GROUPID="GROUP_BITSTREAM_20.500.12105_16137_7">
            <FLocat LOCTYPE="URL" xlink:type="simple" xlink:href="https://repisalud.isciii.es/bitstreams/34f599d9-185d-4a60-bb52-63249246d4f1/download"/>
         </file>
         <file ID="BITSTREAM_TEXT_20.500.12105_16137_9" MIMETYPE="text/plain" SEQ="9" SIZE="8621" CHECKSUM="fb2253fcc5b4d4396d9e8b7286356e0b" CHECKSUMTYPE="MD5" ADMID="FT_20.500.12105_16137_9" GROUPID="GROUP_BITSTREAM_20.500.12105_16137_9">
            <FLocat LOCTYPE="URL" xlink:type="simple" xlink:href="https://repisalud.isciii.es/bitstreams/acda6538-91e7-4963-95bc-1c6e192a4cee/download"/>
         </file>
         <file ID="BITSTREAM_TEXT_20.500.12105_16137_11" MIMETYPE="text/plain" SEQ="11" SIZE="1998" CHECKSUM="722f34b24349c5b4c1505fdb56eb5090" CHECKSUMTYPE="MD5" ADMID="FT_20.500.12105_16137_11" GROUPID="GROUP_BITSTREAM_20.500.12105_16137_11">
            <FLocat LOCTYPE="URL" xlink:type="simple" xlink:href="https://repisalud.isciii.es/bitstreams/82de0bb1-d4b4-4987-88cc-b6bf925c59c3/download"/>
         </file>
         <file ID="BITSTREAM_TEXT_20.500.12105_16137_13" MIMETYPE="text/plain" SEQ="13" SIZE="200537" CHECKSUM="e2fcedae5c229a708f5695ecd631fa66" CHECKSUMTYPE="MD5" ADMID="FT_20.500.12105_16137_13" GROUPID="GROUP_BITSTREAM_20.500.12105_16137_13">
            <FLocat LOCTYPE="URL" xlink:type="simple" xlink:href="https://repisalud.isciii.es/bitstreams/bb4f418a-6164-4ed7-aa10-6da135027d1b/download"/>
         </file>
      </fileGrp>
   </fileSec>
   <structMap LABEL="DSpace Object" TYPE="LOGICAL">
      <div TYPE="DSpace Object Contents" ADMID="DMD_20.500.12105_16137">
         <div TYPE="DSpace BITSTREAM">
            <fptr FILEID="BITSTREAM_ORIGINAL_20.500.12105_16137_1"/>
         </div>
         <div TYPE="DSpace BITSTREAM">
            <fptr FILEID="BITSTREAM_ORIGINAL_20.500.12105_16137_2"/>
         </div>
         <div TYPE="DSpace BITSTREAM">
            <fptr FILEID="BITSTREAM_ORIGINAL_20.500.12105_16137_3"/>
         </div>
         <div TYPE="DSpace BITSTREAM">
            <fptr FILEID="BITSTREAM_ORIGINAL_20.500.12105_16137_4"/>
         </div>
      </div>
   </structMap>
</mets></metadata></record></GetRecord></OAI-PMH>