MedPath

Trial of Sacituzumab Govitecan in Participants With Refractory/Relapsed Metastatic Triple-Negative Breast Cancer (TNBC)

Registration Number
NCT02574455
Lead Sponsor
Gilead Sciences
Brief Summary

The primary objective of this study is to compare the efficacy of sacituzumab govitecan to the treatment of physician's choice (TPC) as measured by independently-reviewed Independent Review Committee (IRC) progression-free survival (PFS) in participants with locally advanced or metastatic triple-negative breast cancer (TNBC) previously treated with at least two systemic chemotherapy regimens for unresectable, locally advanced or metastatic disease, and without brain metastasis at baseline.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
529
Inclusion Criteria
  • Histologically or cytologically confirmed TNBC based on the most recent analyzed biopsy or other pathology specimen. Triple negative is defined as <1% expression for estrogen receptor (ER) and progesterone receptor (PR) and negative for human epidermal growth factor receptor 2 (HER2) by in-situ hybridization.
  • Refractory to or relapsed after at least two prior standard therapeutic regimens for advanced/metastatic TNBC.
  • Prior exposure to a taxane in localized or advanced/metastatic setting.
  • Eligible for one of the chemotherapy options listed as TPC (eribulin, capecitabine, gemcitabine, or vinorelbine) as per investigator assessment.
  • Eastern Cooperative Oncology Group (ECOG) performance score of 0 or 1.
  • Measurable disease by computed tomography (CT) or magnetic resonance imaging (MRI) as per Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1). Bone-only disease is not permitted.
  • At least 2 weeks beyond prior anti-cancer treatment (chemotherapy, endocrine therapy, radiotherapy, and/or major surgery), and recovered from all acute toxicities to Grade 1 or less (except alopecia and peripheral neuropathy).
  • At least 2 weeks beyond high dose systemic corticosteroids (however, low dose corticosteroids < 20 mg prednisone or equivalent daily are permitted provided the dose is stable for 4 weeks).
  • Adequate hematology without ongoing transfusional support (hemoglobin > 9 g/dL, absolute neutrophil count (ANC) > 1,500 per mm^3, platelets > 100,000 per mm^3).
  • Adequate renal and hepatic function (creatinine clearance [CrCL] > 60 mL/min, bilirubin ≤ 1.5 institutional upper limit of normal [IULN], aspartate aminotransferase [AST] and alanine aminotransferase [ALT] ≤ 2.5 x IULN or ≤ 5 x IULN if known liver metastases and serum albumin ≥3 g/dL).
  • Recovered from all toxicities to Grade 1 or less by National Cancer Institute common terminology criteria for adverse events (NCI CTCAE) v4.03 (except alopecia or peripheral neuropathy that may be Grade 2 or less) at the time of randomization. Participants with Grade 2 neuropathy are eligible but may not receive vinorelbine as TPC.
  • Participants with treated, non-progressive brain metastases, off high-dose steroids (>20 mg prednisone or equivalent) for at least 4 weeks can be enrolled in the trial.

Key

Exclusion Criteria
  • Women who are pregnant or lactating.
  • Women of childbearing potential or fertile men unwilling to use effective contraception during study and up to three months after treatment discontinuation in women of child-bearing potential and six months in males post last study drug.
  • Participants with Gilbert's disease.
  • Participants with non-melanoma skin cancer or carcinoma in situ of the cervix are eligible, while participants with other prior malignancies must have had at least a 3-year disease-free interval.
  • Participants known to be human immunodeficiency (HIV) positive, hepatitis B positive, or hepatitis C positive.
  • Infection requiring antibiotic use within one week of randomization.
  • Other concurrent medical or psychiatric conditions that, in the Investigator's opinion, may be likely to confound study interpretation or prevent completion of study procedures and follow-up examinations.

Note: Other protocol defined Inclusion/Exclusion criteria may apply.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Treatment of Physician's Choice (TPC)EribulinParticipants will receive TPC (ie, eribulin, capecitabine, gemcitabine, or vinorelbine), administered as a single-agent regimen that is selected by the investigator before participant randomization. Participants will continue treatment until progression of disease requiring treatment discontinuation or occurrence of unacceptable AEs.
Treatment of Physician's Choice (TPC)CapecitabineParticipants will receive TPC (ie, eribulin, capecitabine, gemcitabine, or vinorelbine), administered as a single-agent regimen that is selected by the investigator before participant randomization. Participants will continue treatment until progression of disease requiring treatment discontinuation or occurrence of unacceptable AEs.
Sacituzumab GovitecanSacituzumab govitecanParticipants will receive sacituzumab govitecan on Days 1 and 8 of a 21-day treatment cycle for up to 29.6 months. Participants will continue treatment until progression of disease requiring treatment discontinuation or occurrence of unacceptable adverse events (AEs).
Treatment of Physician's Choice (TPC)GemcitabineParticipants will receive TPC (ie, eribulin, capecitabine, gemcitabine, or vinorelbine), administered as a single-agent regimen that is selected by the investigator before participant randomization. Participants will continue treatment until progression of disease requiring treatment discontinuation or occurrence of unacceptable AEs.
Treatment of Physician's Choice (TPC)VinorelbineParticipants will receive TPC (ie, eribulin, capecitabine, gemcitabine, or vinorelbine), administered as a single-agent regimen that is selected by the investigator before participant randomization. Participants will continue treatment until progression of disease requiring treatment discontinuation or occurrence of unacceptable AEs.
Primary Outcome Measures
NameTimeMethod
Progression-Free Survival (PFS) by Independent Review Committee (IRC) Assessment in Brain Metastasis Negative (BM-ve) PopulationFrom randomization until objective tumor progression or death (assessed every 6 weeks for 9 months and then every 9 weeks thereafter until the occurrence of progression of disease; maximum exposure: 29.6 months)

PFS was defined as the time from randomization until objective tumor progression by Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 or death, whichever came first. The date of progression was date of the last observation or radiological assessment of target lesions that either showed a predefined increase (greater than or equal to \[≥\] 20%) in the sum of the target lesions or the appearance of new non-target lesions. PFS was estimated using Kaplan-Meier estimate.

Secondary Outcome Measures
NameTimeMethod
Objective Response Rate (ORR) by IRC and Investigator Assessment in BM-ve PopulationFrom randomization to the date of progression or death (assessed every 6 weeks for 9 months and then every 9 weeks thereafter until the occurrence of progression of disease; maximum exposure: 29.6 months)

ORR was defined as the percentage of participants who had the overall best response as either a confirmed complete response (CR) or partial response (PR) relative to the size of population under evaluation. CR: Disappearance of all target and non-target lesions; and normalization of tumor marker levels initially above upper limits of normal; and no new lesions. PR: ≥30% decrease in the sum of the longest diameter (LD) of target lesions, taking as reference the baseline sum LD; and no new lesions.

Duration of Response (DOR) by IRC and Investigator Assessment in BM-ve PopulationFrom the first date of documented response of CR or PR to the date of progression or death (assessed every 6 weeks for 9 months and then every 9 weeks thereafter until the occurrence of progression of disease; maximum exposure: 29.6 months)

DOR was defined as the number of days between the first date showing a documented response of CR or PR and the date of progression or death. CR: Disappearance of all target and non-target lesions; and normalization of tumor marker levels initially above upper limits of normal; and no new lesions. PR: ≥30% decrease in the sum of the LD of target lesions, taking as reference the baseline sum LD; and no new lesions. The date of progression was date of the last observation or radiological assessment of target lesions that either showed a predefined increase (≥20%) in the sum of the target lesions or the appearance of new non-target lesions.

Overall Survival (OS) in BM-ve PopulationFrom the randomization to death from any cause (maximum follow-up duration: 30.8 months)

Overall survival (OS) was defined as the time from the randomization to death from any cause. OS was estimated using Kaplan-Meier estimate.

Time to Objective Response by the IRC Assessment in BM-ve PopulationFrom randomization to the first recorded objective response (assessed every 6 weeks for 9 months and then every 9 weeks thereafter until the occurrence of progression of disease; maximum exposure: 29.6 months)

Time to response was defined as the time from randomization to the first recorded objective response (ie, CR or PR). CR: Disappearance of all target and non-target lesions; and normalization of tumor marker levels initially above upper limits of normal; and no new lesions. PR: ≥30% decrease in the sum of the LD of target lesions, taking as reference the baseline sum LD; and no new lesions.

Progression-Free Survival (PFS) by IRC Assessment in the ITT PopulationFrom randomization until objective tumor progression or death (assessed every 6 weeks for 9 months and then every 9 weeks thereafter until the occurrence of progression of disease; maximum exposure: 29.6 months)

PFS was defined as the time from randomization until objective tumor progression by RECIST v1.1 or death, whichever came first. The date of progression was date of the last observation or radiological assessment of target lesions that either showed a predefined increase (≥20%) in the sum of the target lesions or the appearance of new non-target lesions. PFS was estimated using Kaplan-Meier estimate.

Overall Survival (OS) in ITT PopulationFrom the randomization to death from any cause (maximum follow-up duration: 30.8 months)

Overall survival (OS) was defined as the time from the randomization to death from any cause. OS was estimated using Kaplan-Meier estimate.

Percentage of Participants Experiencing Any Treatment Emergent Adverse Events (TEAEs), Serious Adverse Events (SAEs), and TEAEs Leading to Discontinuation of Study DrugFirst dose date up to last follow-up (maximum up to 30.8 months)

Treatment-emergent adverse events (TEAEs) were defined as any adverse events (AEs) that begin or worsen on or after the start of study drug through 30 days after the last dose of study drug. The severity was graded based on the National Cancer Institute's Common Terminology Criteria for Adverse Events Version 4.03. An AE that met one or more of the following outcomes was classified as serious:

* Fatal

* Life-threatening

* Disabling/incapacitating

* Results in hospitalization or prolongs a hospital stay

* A congenital abnormality

* Other important medical events may also be considered serious AEs if they may require medical or surgical intervention to prevent one of the outcomes listed above

Change From Baseline in European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire Core 30 (EORTC QLQ-C30) ScoreBaseline; End of Treatment (EOT) (up to 29.6 months)

The EORTC QLQ-C30 is a questionnaire to assess quality of life (QoL), it is composed of 30 questions (items) resulting in 5 functional scales (physical functioning, role functioning, emotional functioning, cognitive functioning, social functioning), 1 global health status scale, 3 symptom scales (fatigue, nausea and vomiting, pain), and 6 single items (dyspnea, insomnia, loss of appetite, constipation, diarrhea, financial difficulties). All of the scales and single-item measures range in score from 0 to 100. Higher score for the functioning scales and global health status indicate a better quality of life; a positive change from baseline indicates improvement. Lower scores on the symptom and single-item scales indicate a better quality of life; a negative change from baseline indicates improvement.

Time to Progression (TTP) by Investigator Assessment in BM-ve PopulationFrom randomization until disease progression (assessed every 6 weeks for 9 months and then every 9 weeks thereafter until the occurrence of progression of disease; maximum exposure: 29.6 months)

Time to Progression (TTP) was defined as the time from the date of randomization to the date of the first evidence of disease progression as assessed using RECIST 1.1 criteria. The date of progression was date of the last observation or radiological assessment of target lesions that either showed a predefined increase (≥20%) in the sum of the target lesions or the appearance of new non-target lesions. Participants without progression were censored.

Time to Objective Response by the Investigator Assessment in BM-ve PopulationFrom randomization to the first recorded objective response (assessed every 6 weeks for 9 months and then every 9 weeks thereafter until the occurrence of progression of disease; maximum exposure: 29.6 months)

Time to response was defined as the time from randomization to the first recorded objective response (ie, CR or PR). CR: Disappearance of all target and non-target lesions; and normalization of tumor marker levels initially above upper limits of normal; and no new lesions. PR: ≥30% decrease in the sum of the LD of target lesions, taking as reference the baseline sum LD; and no new lesions.

Time to Progression (TTP) by IRC Assessment in BM-ve PopulationFrom randomization until disease progression (assessed every 6 weeks for 9 months and then every 9 weeks thereafter until the occurrence of progression of disease; maximum exposure: 29.6 months)

Time to Progression (TTP) was defined as the time from the date of randomization to the date of the first evidence of disease progression as assessed using RECIST 1.1 criteria. The date of progression was date of the last observation or radiological assessment of target lesions that either showed a predefined increase (≥20%) in the sum of the target lesions or the appearance of new non-target lesions. Participants without progression were censored.

Percentage of Participants Experiencing the Worst Laboratory Abnormalities Grade 3 or 4 Post-BaselineFirst dose date up to last follow-up (maximum up to 30.8 months)

Blood samples were collected for hematology, serum chemistry and the laboratory abnormalities were assessed. The most severe graded abnormality observed post-baseline for each graded test was counted for each participant. Safety as assessed by grading of laboratory values and AEs according to the National Cancer Institutes' Common Terminology Criteria for Adverse Events (NCI CTCAE) covering grades 0-5 (0=Normal, 1=Mild, 2=Moderate, 3=Severe, 4=Life-threatening, 5=Death). The percentage of participants with worst postbaseline grades 3 or 4 are reported.

Clinical Benefit Rate (CBR) by IRC and Investigator Assessment in BM-ve PopulationFrom randomization to the date of progression or death (assessed every 6 weeks for 9 months and then every 9 weeks thereafter until the occurrence of progression of disease; maximum exposure: 29.6 months)

CBR was defined as the percentage of participants with best response as either CR, PR, or stable disease (SD) with a duration of ≥6 months. CR: Disappearance of all target and non-target lesions; and normalization of tumor marker levels initially above upper limits of normal; and no new lesions. PR: ≥30% decrease in the sum of the LD of target lesions, taking as reference the baseline sum LD; and no new lesions. SD: Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for progressive disease (PD), taking as reference the smallest sum LD since the treatment started; and Persistence of one or more non-target lesion(s) or/and maintenance of tumor marker level above the normal limits. PD: ≥20% increase in the sum of LD of target lesions, taking as reference the smallest sum LD recorded since treatment started or appearance of one or more new lesions and/or unequivocal progression of existing non-target lesions.

Trial Locations

Locations (178)

Southern Cancer Center, 29653 Anchor Cross Blvd

🇺🇸

Daphne, Alabama, United States

Souther Cancer Center, 3719 Dauphin St., 5 Floor

🇺🇸

Mobile, Alabama, United States

Southern Cancer Center, 3 Mobile Infirmary Circle

🇺🇸

Mobile, Alabama, United States

UCLA Jonsson Comprehensive Cancer Center, 1411 S. Garfield Ave Suite 200

🇺🇸

Alhambra, California, United States

UCLA Jonsson Comprehensive Cancer Center, 201. S. Buena Vista St Suite 200

🇺🇸

Burbank, California, United States

UCLA Jonsson Comprehensive Cancer Center

🇺🇸

Laguna Hills, California, United States

UCLA Jonsson Comprehensive Cancer Center, 625 South Fair Oaks Avenue Suite 320

🇺🇸

Pasadena, California, United States

UCLA Jonsson Comprehensive Cancer Center, 200 UCLA Medical Plaza

🇺🇸

Los Angeles, California, United States

UCLA Jonsson Comprehensive Cancer Center, 2020 Santa Monica Boulevard

🇺🇸

Santa Monica, California, United States

Northside Hospital

🇺🇸

Atlanta, Georgia, United States

University of Colorado Hospital - Anschutz Cancer Pavilion, 1665 Aurora Court

🇺🇸

Aurora, Colorado, United States

Rocky Mountain Cancer Centers, 4715 Arapahoe Ave

🇺🇸

Boulder, Colorado, United States

Rocky Mountain Cancer Centers, 2312 N. Nevada Avenue, Suite 400

🇺🇸

Colorado Springs, Colorado, United States

Rocky Mountain Cancer Centers, 499 E Hampden Ave Suite 450

🇺🇸

Englewood, Colorado, United States

Rocky Mountain Cancer Centers, 11750 West 2nd Place, Suite 1-100

🇺🇸

Lakewood, Colorado, United States

Rocky Mountain Cancer Centers, 22 West Dry Creek Circle

🇺🇸

Littleton, Colorado, United States

Rocky Mountain Cancer Centers, 10103 Ridge Gate Parkway, Suite G-01

🇺🇸

Lone Tree, Colorado, United States

Rocky Mountain Cancer Centers, 9397 Crown Crest Blvd., Suite 421

🇺🇸

Parker, Colorado, United States

Rocky Mountain Cancer Centers, 3676 Parker Blvd., Suite 350

🇺🇸

Pueblo, Colorado, United States

Rocky Mountain Cancer Centers, 8820 Huron Street

🇺🇸

Thornton, Colorado, United States

Yale School Of Medicine

🇺🇸

New Haven, Connecticut, United States

Florida Cancer Specialists & Research Institute, 601 E. Altamonte Drive

🇺🇸

Altamonte Springs, Florida, United States

Florida Cancer Specialist

🇺🇸

Bonita Springs, Florida, United States

Florida Cancer Specialists

🇺🇸

Venice, Florida, United States

Florida Cancer Specialists & Research Institute, 403 S. King Ave

🇺🇸

Brandon, Florida, United States

Florida Cancer Specialists & Research Institute, 3280 McMullen Booth road

🇺🇸

Clearwater, Florida, United States

Sylvester Comprehensive Cancer Center

🇺🇸

Plantation, Florida, United States

Florida Cancer Specialists & Research Institute, 224 Memorial medical Parway

🇺🇸

Daytona Beach, Florida, United States

Florida Cancer Specialists & Research Institute, 6420 W Newberry Road Est Wing

🇺🇸

Gainesville, Florida, United States

Florida Cancer Specialists & Research Institute, 100 Highland Avenue

🇺🇸

Largo, Florida, United States

Florida Cancer Specialists & Research Institute, 521 N. Lecanto Highway

🇺🇸

Lecanto, Florida, United States

Florida Cancer Specialists & Research Institute, 8763 River Crossing Blvd

🇺🇸

New Port Richey, Florida, United States

Florida Cancer Specialists & Research Institute, 1630 SE 18th ST

🇺🇸

Ocala, Florida, United States

Florida Cancer Specialists & Research Institute, 765 Image Way

🇺🇸

Orange City, Florida, United States

Florida Cancer Specialists & Research Institute - 325 Clyde Morris

🇺🇸

Ormond Beach, Florida, United States

Orlando Regional Medical Center

🇺🇸

Orlando, Florida, United States

Florida Cancer Specialists & Research Institute, 70 W Gore Street

🇺🇸

Orlando, Florida, United States

Florida Cancer Specialists & Research Institute, 560 Jackson St

🇺🇸

Saint Petersburg, Florida, United States

Florida Cancer Specialists & Research Institute, 1201 Fifth Avenue North

🇺🇸

Saint Petersburg, Florida, United States

Florida Cancer Specialists & Research Institute, 7154 Medical Center Drive

🇺🇸

Spring Hill, Florida, United States

Florida Cancer Specialists & Research Institute, 3402 W Dr. Martin Luther King Jr Boulevard

🇺🇸

Tampa, Florida, United States

Florida Cancer Specialists & Research Institute, 1400 US highway 441 N

🇺🇸

The Villages, Florida, United States

Florida Cancer Specialists & Research Institute, 4100 Waterman Way

🇺🇸

Tavares, Florida, United States

Florida Cancer Specialists & Research Institute1309 N Flagler Dr

🇺🇸

West Palm Beach, Florida, United States

Florida Cancer Specialists & Research Institute - 3730 7th Terrace

🇺🇸

Vero Beach, Florida, United States

Florida Cancer Specialists & Research Institute, 2100 Glenwood Drive

🇺🇸

Winter Park, Florida, United States

University Cancer & Blood Center, 3320 Old Jefferson Rd

🇺🇸

Athens, Georgia, United States

Atlanta Cancer Care - Atlanta

🇺🇸

Atlanta, Georgia, United States

GCS/Annex

🇺🇸

Atlanta, Georgia, United States

GCS/Canton

🇺🇸

Canton, Georgia, United States

Atlanta Cancer Care - Conyers

🇺🇸

Conyers, Georgia, United States

Atlanta Cancer Care - Cumming

🇺🇸

Cumming, Georgia, United States

Atlanta Cancer Care - Decatur

🇺🇸

Decatur, Georgia, United States

GCS/Stemmer

🇺🇸

Decatur, Georgia, United States

Atlanta Cancer Care - Stockbridge

🇺🇸

Jonesboro, Georgia, United States

GCS/Macon

🇺🇸

Macon, Georgia, United States

GCS/Kennestone

🇺🇸

Marietta, Georgia, United States

GCS/Northside

🇺🇸

Sandy Springs, Georgia, United States

Illinois Cancer Specialists

🇺🇸

Niles, Illinois, United States

University of Chicago Comprehensive Cancer Center at Silver Cross Hospital 1900 Silver Cross Blvd

🇺🇸

New Lenox, Illinois, United States

MidAmerica Division Inc. c/o Menorah Medical Center

🇺🇸

Independence, Missouri, United States

Orland Park - UCMC Center for Advanced Care 14290 South LaGrange Rd

🇺🇸

Orland Park, Illinois, United States

Mass General - North Shore Cancer Center ( NSCC )

🇺🇸

Danvers, Massachusetts, United States

Mercy Hospital

🇺🇸

Coon Rapids, Minnesota, United States

Suburban Imaging Northwest

🇺🇸

Coon Rapids, Minnesota, United States

Suburban Imaging

🇺🇸

Coon Rapids, Minnesota, United States

Mercy Hospital - Unity Campus AHL

🇺🇸

Fridley, Minnesota, United States

Washington University School of Medicine in St. Louis

🇺🇸

Saint Louis, Missouri, United States

Research Medical Center

🇺🇸

Kansas City, Missouri, United States

New York Oncology Hematology, P.C.

🇺🇸

Clifton Park, New York, United States

North Shore Hematology Oncology Associates., PC, 235 North Belle Mead Road

🇺🇸

East Setauket, New York, United States

Columbia University Medical Center

🇺🇸

New York, New York, United States

Memorial Sloan Kettering Cancer Center

🇺🇸

New York, New York, United States

North Shore Hematology Oncology Associates., PC, 285 Sills Road Building 16

🇺🇸

Patchogue, New York, United States

UNC Health Care System

🇺🇸

Chapel Hill, North Carolina, United States

UPMC Hillman Cancer Center Mountainview Arnold Palmer Pavilion

🇺🇸

Greensburg, Pennsylvania, United States

UPMC Hillman Cancer Center UPMC East

🇺🇸

Monroeville, Pennsylvania, United States

Tennessee Oncology - Chattanooga Oncology & Hematology Associates

🇺🇸

Chattanooga, Tennessee, United States

West Cancer Center, 7945 Wolf River Blvd

🇺🇸

Germantown, Tennessee, United States

Tennessee Oncology, LLC

🇺🇸

Shelbyville, Tennessee, United States

Center for Cancer and Blood Disorders

🇺🇸

Weatherford, Texas, United States

Texas Oncology - Baylor Charles A. Sammons Cancer Center

🇺🇸

Dallas, Texas, United States

Texas Oncology

🇺🇸

Plano, Texas, United States

Texas Oncology-Longview Cancer Center

🇺🇸

Longview, Texas, United States

Virginia Cancer Specialists, PC

🇺🇸

Woodbridge, Virginia, United States

Oncology and Hematology Associates of Southwest Virginia, Inc., DBA Blue Ridge Cancer Care

🇺🇸

Wytheville, Virginia, United States

Virginia Oncology Associates, P.C.

🇺🇸

Norfolk, Virginia, United States

Oncology & Hematology Associates of Southwest Virginia, Inc., DBA Blue Ridge Cancer Care

🇺🇸

Salem, Virginia, United States

Universitair Zlekenhuis Brussel

🇧🇪

Brussels, Belgium

Institut Jules Bordet

🇧🇪

Bruxelles, Belgium

Maryland Oncology Hematology

🇺🇸

Silver Spring, Maryland, United States

Centre de Lutte Contre le Cancer - Institut de Cancerologie de l'Ouest - Paul Papin

🇫🇷

Angers, France

CHU Besançon - Hôpital Jean Minjoz

🇫🇷

Besançon, France

Institut Régional du Cancer de Montpellier

🇫🇷

Montpellier, France

Institut Curie

🇫🇷

Paris, France

Centre Eugène Marquis

🇫🇷

Rennes Cedex, France

Florence Lerebours

🇫🇷

Saint-Cloud, France

CHU de Nantes - Hôpital Nord Laennec

🇫🇷

Saint-Herblain, France

Institut Claudius Regaud

🇫🇷

Toulouse, France

Gustave Roussy

🇫🇷

Villejuif, France

Rocky Mountain Cancer Centers, 2030 W Mountain View Avenue, Ste. 210

🇺🇸

Longmont, Colorado, United States

Hämatologisch-Onkologische Gemeinschaftspraxis am Bethanien-Krankenhaus

🇩🇪

Frankfurt, Germany

Texas Oncology- Medical City Dallas Building D

🇺🇸

Dallas, Texas, United States

Virginia Oncology Associates

🇺🇸

Virginia Beach, Virginia, United States

Praxis für interdisziplinäre Onkologie & Hämatologie GbR

🇩🇪

Freiburg im Breisgau, Germany

Facharztzentrum Eppendorf

🇩🇪

Hamburg, Germany

Praxis für Hämatologie und Internistische Onkologie

🇩🇪

Velbert, Germany

Hospital Universitario Vall d'Hebron

🇪🇸

Barcelona, Spain

Hospital Teresa Herrera, As Xubias, 84

🇪🇸

A Coruña, Spain

Hospital Quirón Barcelona, Plaza Alfonso Comín 5

🇪🇸

Barcelona, Spain

Hospital de la Santa Creu i Sant Pau, Carrer del Mas Casanovas, 90

🇪🇸

Barcelona, Spain

Institut Catala d'Oncologia Hospitalet, Avenida Gran Via 199-203

🇪🇸

Hospitalet de Llobregat, Spain

Hospital Universitari Arnau de Vilanova de Lleida

🇪🇸

Lleida, Spain

Hospital Universitario Ramon y Cajal

🇪🇸

Madrid, Spain

Hospital Universitario 12 de Octubre

🇪🇸

Madrid, Spain

Complexo Hospitalario Universitario de Santiago (CHUS) - Hospital Clinco Universaitario

🇪🇸

Santiago De Compostela, Spain

Hospital Universitario Virgen del Rocío

🇪🇸

Sevilla, Spain

Colchester Hospital University NHS Foundation Trust - Colchester General Hospital, Turner Road

🇬🇧

Colchester, ESS, United Kingdom

The Arden Cancer Centre- University Hospital Coventry

🇬🇧

Coventry, United Kingdom

County Durham and Darlington NHS Foundation Trust - University Hospital of North Durham

🇬🇧

Durham, United Kingdom

The Royal Surrey County Hospital NHS Foundation Trust

🇬🇧

Guildford, United Kingdom

The County Hospital, Wye Valley NHS Trust

🇬🇧

Hereford, United Kingdom

The Royal Free London NHS Foundation Trust - The Royal Free Hospital, Pond Street Oncology & Haematology Clinical Trials Unit Dept. of Academic Oncology

🇬🇧

London, United Kingdom

The Christie NHS Foundation Trust

🇬🇧

Manchester, United Kingdom

Nottingham University Hospitals NHS Trust - City Hospital

🇬🇧

Nottingham, United Kingdom

Plymouth Hospitals NHS Trust - Derriford Hospital

🇬🇧

Plymouth, United Kingdom

Taunton and Somerset NHS Foundation Trust - Musgrove Park Hospital, Musgrove Park Hospital

🇬🇧

Taunton, United Kingdom

The Mid Yorkshire Hospitals NHS Trust - Pinderfields Hospital

🇬🇧

Wakefield, United Kingdom

University of Chicago Medical Center 5841 S. Maryland Ave

🇺🇸

Chicago, Illinois, United States

Dana-Farber Cancer Institute

🇺🇸

Boston, Massachusetts, United States

Massachusetts General Hospital

🇺🇸

Boston, Massachusetts, United States

Beth Israel Deaconess Medical Center (BIDMC)

🇺🇸

Boston, Massachusetts, United States

The Ohio State University Wexner Medical Center, 460 W 10th Ave

🇺🇸

Columbus, Ohio, United States

The Ohio State University Wexner Medical Center, 1145 Olentangy River Road

🇺🇸

Columbus, Ohio, United States

UPMC Hillman Cancer Center Upper Saint Clair

🇺🇸

Pittsburgh, Pennsylvania, United States

Magee-Womens Hospital of UPMC

🇺🇸

Pittsburgh, Pennsylvania, United States

Allegheny-Singer Research Institute, 320 East North Avenue

🇺🇸

Pittsburgh, Pennsylvania, United States

UPMC Hillman Cancer Center UPMC Passavant

🇺🇸

Pittsburgh, Pennsylvania, United States

Houston Methodist Hospital - 6565 Fannin St

🇺🇸

Houston, Texas, United States

Swedish Cancer Institute

🇺🇸

Seattle, Washington, United States

Baptist Health Medical Group Oncology, LLC

🇺🇸

Miami, Florida, United States

Virginia G. Piper Cancer Center at HonorHealth

🇺🇸

Minneapolis, Minnesota, United States

Minnesota Oncology Hematology P.A.

🇺🇸

Minneapolis, Minnesota, United States

Abbot Northwestern Hospital

🇺🇸

Minneapolis, Minnesota, United States

University of California, San Francisco (UCSF) - Innovation, Technology & Alliances, 1600 Divisadero Street

🇺🇸

San Francisco, California, United States

Tennessee Ocology, LLC

🇺🇸

Nashville, Tennessee, United States

Vanderbilt Breast Cancer Center at One Hundred Oaks 719 Thompson Lane, Suite 25000

🇺🇸

Nashville, Tennessee, United States

Henry-Joyce Cancer Clinic 1301 Medical Center Drive 1903 The Vanderbilt Clinic Nashville, TN 37232

🇺🇸

Nashville, Tennessee, United States

Vanderbilt-Ingram Cancer Center

🇺🇸

Nashville, Tennessee, United States

University of Kansas Cancer Center - The Richard and Annette Bloch Cancer Care Pavilion

🇺🇸

Westwood, Kansas, United States

Sarah Cannon Cancer Institute/Tennessee Oncology

🇺🇸

Nashville, Tennessee, United States

Tennesee Oncology - PLLC

🇺🇸

Chattanooga, Tennessee, United States

Mayo Clinic Hospital

🇺🇸

Scottsdale, Arizona, United States

Jewish General Hospital, 3755 Côte-Sainte-Catherine

🇨🇦

Québec, Quebec, Canada

Norwalk Hospital, 34 Maple Street

🇺🇸

Norwalk, Connecticut, United States

Georgetown Lombardi Comprehensive Cancer Center

🇺🇸

Washington, District of Columbia, United States

Clinique et Maternite Sainte-Elisabeth

🇧🇪

Namur, Belgium

Cross Cancer Institute, 11560 University Avenue

🇨🇦

Edmonton, Alberta, Canada

Tenessee Oncology

🇺🇸

Nashville, Tennessee, United States

UZ Leuven

🇧🇪

Leuven, Belgium

Nebraska Cancer Specialists- Midwest Cancer Center- Papillion

🇺🇸

Papillion, Nebraska, United States

Tenesse Oncology - PLLC

🇺🇸

Cleveland, Tennessee, United States

Rocky Mountain Cancer Centers, 4700 E. Hale Parkway, Suite 400

🇺🇸

Denver, Colorado, United States

Rocky Mountain Cancer Centers, 1800 Williams St.

🇺🇸

Denver, Colorado, United States

Providence Medical Group

🇺🇸

Portland, Oregon, United States

Sunnybrook Health Sciences Centre

🇨🇦

Toronto, Ontario, Canada

Nebraska Cancer Specialists - Midwest Cancer Center - Papillion

🇺🇸

Omaha, Nebraska, United States

Mayo Clinic - 200 First Street SW

🇺🇸

Rochester, Minnesota, United States

Nebraska Cancer Specialists - Midwest Cancer Center - Paillion

🇺🇸

Omaha, Nebraska, United States

Southern Cancer Center, 6701 Airport Blvd., Bldg B, Terace Level

🇺🇸

Mobile, Alabama, United States

Atlanta Cancer Center - Alpharetta

🇺🇸

Alpharetta, Georgia, United States

Institut für Versorgungsforschung in der Onkologie

🇩🇪

Koblenz, Germany

Hospital del Mar

🇪🇸

Barcelona, Spain

Florida Cancer Specialists & Research Institute, 1037 State Road 7 Bldg B

🇺🇸

Wellington, Florida, United States

Rocky Mountain Cancer Centers, 1700 South Potomac Street

🇺🇸

Aurora, Colorado, United States

Rutgers Cancer Institute of New Jersey

🇺🇸

New Brunswick, New Jersey, United States

US Oncology

🇺🇸

Tyler, Texas, United States

Queen Elizabeth II Health Sciences Centre

🇨🇦

Halifax, Nova Scotia, Canada

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