MedPath

Sacituzumab Tirumotecan (MK-2870) Versus Pemetrexed and Carboplatin Combination Therapy in Participants With Epidermal Growth Factor (EGFR)-Mutated, Advanced Nonsquamous Non-small Cell Lung Cancer (NSCLC) Who Have Progressed on Prior EGFR Tyrosine Kinase Inhibitors (MK-2870-009)

Phase 3
Recruiting
Conditions
Non-small Cell Lung Cancer (NSCLC)
Interventions
Drug: H1 Receptor Antagonist
Drug: H2 Receptor Antagonist
Drug: Steroid Mouthwash (dexamethasone or equivalent)
Registration Number
NCT06305754
Lead Sponsor
Merck Sharp & Dohme LLC
Brief Summary

The purpose of this study is to evaluate sacituzumab tirumotecan versus pemetrexed in combination with carboplatin for the treatment of epidermal growth factor receptor (EGFR)-mutated advanced non-squamous non-small cell lung cancer (NSCLC). Participants in this study have NSCLC that has continued to progress on prior treatment with EGFR tyrosine kinase inhibitors (TKIs).

The primary hypotheses of this study are that sacituzumab tirumotecan is better than platinum-based doublet chemotherapy (pemetrexed and carboplatin) in regard to progression-free survival (PFS) and overall survival (OS).

Detailed Description

Participants will be randomized 1:1 into two arms:

* Sacituzumab tirumotecan

* Pemetrexed plus Carboplatin

Participants will receive treatment until any of the criteria for discontinuation of study intervention are met.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
520
Inclusion Criteria
  • Histologically or cytologically confirmed diagnosis of advanced-stage nonsquamous non-small cell lung cancer (NSCLC).
  • Participants who have adverse events (AEs) due to previous anticancer therapies must have recovered to Grade ≤1 or baseline.
  • Participants who are Hepatitis B surface antigen (HBsAg) positive are eligible if they have received Hepatitis B virus (HBV) antiviral therapy for at least 4 weeks and have undetectable HBV viral load.
  • Participants with history of Hepatitis C virus (HCV) infection are eligible if HCV viral load is undetectable.
  • Human immunodeficiency virus (HIV)-infected participants must have well controlled HIV on antiretroviral therapy.
  • Life expectancy of at least 3 months.
Exclusion Criteria
  • Predominantly squamous cell histology NSCLC.
  • History of second malignancy, unless potentially curative treatment has been completed with no evidence of malignancy for 3 years.
  • Grade ≥2 peripheral neuropathy.
  • History of documented severe dry eye syndrome, severe Meibomian gland disease and/or blepharitis, or severe corneal disease that prevents/delays corneal healing.
  • Active inflammatory bowel disease requiring immunosuppressive medication or previous history of inflammatory bowel disease.
  • Uncontrolled, or significant cardiovascular disease or cerebrovascular disease.
  • Received prior radiotherapy within 2 weeks of start of study intervention, or radiation-related toxicities, requiring corticosteroids.
  • Received a live or live-attenuated vaccine within 30 days before the first dose of study intervention. Administration of killed vaccines is allowed.
  • Received radiation therapy to the lung that is >30 Gray within 6 months of the first dose of study intervention.
  • Known active central nervous system metastases and/or carcinomatous meningitis.
  • Active infection requiring systemic therapy.
  • History of (noninfectious) pneumonitis/interstitial lung disease that required steroids or has current pneumonitis/interstitial lung disease.
  • HIV-infected participants with a history of Kaposi's sarcoma and/or Multicentric Castleman's Disease.
  • Concurrent active HBV and HCV infection.
  • History of allogeneic tissue/solid organ transplant.
  • Participants who have not adequately recovered from major surgery or have ongoing surgical complications.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Sacituzumab tirumotecanSacituzumab tirumotecanParticipants receive 4 mg/kg sacituzumab tirumotecan via intravenous (IV) infusion every 2 weeks (Days 1, 15, and 29 of every 6-week cycle) until discontinuation criteria is met.
Sacituzumab tirumotecanH1 Receptor AntagonistParticipants receive 4 mg/kg sacituzumab tirumotecan via intravenous (IV) infusion every 2 weeks (Days 1, 15, and 29 of every 6-week cycle) until discontinuation criteria is met.
Sacituzumab tirumotecanH2 Receptor AntagonistParticipants receive 4 mg/kg sacituzumab tirumotecan via intravenous (IV) infusion every 2 weeks (Days 1, 15, and 29 of every 6-week cycle) until discontinuation criteria is met.
Sacituzumab tirumotecanAcetaminophen (or equivalent)Participants receive 4 mg/kg sacituzumab tirumotecan via intravenous (IV) infusion every 2 weeks (Days 1, 15, and 29 of every 6-week cycle) until discontinuation criteria is met.
Sacituzumab tirumotecanDexamethasone (or equivalent)Participants receive 4 mg/kg sacituzumab tirumotecan via intravenous (IV) infusion every 2 weeks (Days 1, 15, and 29 of every 6-week cycle) until discontinuation criteria is met.
Sacituzumab tirumotecanSteroid Mouthwash (dexamethasone or equivalent)Participants receive 4 mg/kg sacituzumab tirumotecan via intravenous (IV) infusion every 2 weeks (Days 1, 15, and 29 of every 6-week cycle) until discontinuation criteria is met.
Pemetrexed Plus CarboplatinPemetrexedParticipants receive, via IV infusion, 500 mg/m2 pemetrexed every 3 weeks (Days 1 and 22 of every 6-week cycle) plus area under the curve (AUC) 5 mg/mL\*min carboplatin every 3 weeks (Days 1 and 22 of every 6-week cycle for 4 doses), then 500 mg/m2 pemetrexed every 3 weeks until discontinuation criteria is met.
Pemetrexed Plus CarboplatinCarboplatinParticipants receive, via IV infusion, 500 mg/m2 pemetrexed every 3 weeks (Days 1 and 22 of every 6-week cycle) plus area under the curve (AUC) 5 mg/mL\*min carboplatin every 3 weeks (Days 1 and 22 of every 6-week cycle for 4 doses), then 500 mg/m2 pemetrexed every 3 weeks until discontinuation criteria is met.
Primary Outcome Measures
NameTimeMethod
Progression-Free Survival (PFS)Up to approximately 51 months

Progression-Free Survival is defined as the time from randomization to the first documented disease progression per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) based on blinded independent central review (BICR) or death due to any cause, whichever occurs first. PFS for all randomized participants will be reported.

Overall Survival (OS)Up to approximately 51 months

Overall survival is defined as the time from randomization to death due to any cause. Overall survival for all randomized participants will be reported.

Secondary Outcome Measures
NameTimeMethod
Objective Response Rate (ORR)Up to approximately 51 months

The objective response rate (ORR) is defined as a confirmed complete response (CR: disappearance of all target lesions) or partial response (PR: at least a 30% decrease in the sum of diameters of target lesions) per RECIST 1.1 as assessed by BICR. The overall response rate for all randomized participants will be reported.

Duration of Response (DOR)Up to approximately 51 months

For participants who demonstrate confirmed CR or PR per RECIST 1.1 as assessed by BICR, duration of response is defined as the time from the first documented evidence of CR or PR until disease progression or death due to any cause, whichever occurs first. CR is defined as the disappearance of all target lesions. PR is defined as at least a 30% decrease in the sum of diameters of target lesions.

Change from Baseline in European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) Global Health Status (Item 29) and Quality of Life (Item 30) Combined ScoreBaseline and up to approximately 6 years

The EORTC-QLQ-C30 is a 30-item questionnaire developed to assess the quality of life of cancer patients. Participant responses to the Global Health Status (GHS) question "How would you rate your overall health during the past week?" (Item 29) and the Quality of Life (QoL) question "How would you rate your overall quality of life during the past week?" (Item 30) are scored on a 7-point scale (1=Very Poor to 7=Excellent). Using linear transformation, raw scores are standardized so that scores range from 0 to 100. A higher value indicates a better level of function. The change from baseline in EORTC QLQ-C30 Items 29 and 30 combined score will be reported.

Change From Baseline in the Dyspnea (Item 8) Score, on the EORTC QLQ-C30Baseline and up to approximately 6 years

The EORTC QLQ-C30 is a cancer specific health-related quality-of life (QoL) questionnaire. Participant responses to the question "Were you short of breath?" are scored on a 4-point scale (1=Not at All to 4=Very Much). Using linear transformation, raw scores are standardized so that scores range from 0 to 100. A higher value indicates increased severity of symptoms. Change from baseline in dyspnea (EORTC QLQ-C30 Item 8) will be reported.

Change from Baseline in the Cough (Item 31) Score, on the EORTC Lung-Cancer specific Quality of Life Questionnaire (QLQ-LC13)Baseline and up to approximately 6 years

The EORTC QLQ-LC13 is a lung cancer-specific supplemental questionnaire used in combination with the EORTC QLQ-C30. Participant responses to the question "How much did you cough?" are scored on a 4-point scale (1=Not at All to 4=Very Much). Using linear transformation, raw scores are standardized, so that scores range from 0 to 100. A higher value indicates increased severity of symptoms. Change from baseline in cough (EORTC QLQ-LC13 Item 31) will be reported.

Change from Baseline in the Chest Pain (Item 40) Score, on the EORTC QLQ-LC13Baseline and up to approximately 6 years

The EORTC QLQ-LC13 is a lung cancer-specific supplemental questionnaire used in combination with the EORTC QLQ-C30. Participant responses to the question "Have you had pain in your chest?" are scored on a 4-point scale (1=Not at All to 4=Very Much). Using linear transformation, raw scores are standardized, so that scores range from 0 to 100. A higher value indicates increased severity of symptoms. Change from baseline in chest pain (EORTC QLQ-LC13 Item 40) score will be presented.

Time to Deterioration (TTD) in Global Health Status/Quality of Life (Items 29 and 30) Combined Score, on the EORTC QLQ-C30Baseline and up to approximately 6 years

EORTC-QLQ-C30 is a 30-item questionnaire developed to assess the QoL of cancer patients. Participant responses to Items 29 and 30 ("How would you rate your overall health during the past week?" and "How would you rate your overall quality of life during the past week?") are scored on a 7-point scale (1=Very Poor to 7=Excellent). Using linear transformation, raw scores are standardized, so that scores range from 0 to 100. TTD in Global Health Status (GHS)/Quality of Life (QoL) is defined as the time from baseline to the first onset of a ≥10-point decrease from baseline in combined GHS/QoL score. The TTD in GHS/QoL (Items 29 and 30) combined score will be reported.

TTD in the Dyspnea (Item 8) Score, on the EORTC QLQ-C30Baseline and up to approximately 6 years

EORTC-QLQ-C30 is a 30-item questionnaire developed to assess the QoL of cancer patients. Participant responses to the question for Item 8 "Were you short of breath?" are scored on a 4-point scale (1=Not at All to 4=Very Much). TTD is defined as the time from baseline to the first onset of a ≥10-point decrease from baseline in score. The TTD in dyspnea score (EORTC QLQ-C30 Item 8) will be reported.

TTD in the Cough (Item 31) Score, on the EORTC QLQ-LC13Baseline and up to approximately 6 years

The EORTC QLQ-LC13 is a lung cancer-specific supplemental questionnaire used in combination with the EORTC QLQ-C30. Participant responses to the question for Item 31 "How much did you cough?" are scored on a 4-point scale (1=Not at All to 4=Very Much). TTD is defined as the time from baseline to the first onset of a ≥10-point decrease from baseline in score. The TTD in cough score (EORTC QLQ-C30 Item 31) will be reported.

TTD in the Chest Pain (Item 40) Score, on the EORTC QLQ-LC13Baseline and up to approximately 6 years

The EORTC QLQ-LC13 is a lung cancer-specific supplemental questionnaire used in combination with the EORTC QLQ-C30. Participant responses to the question for Item 40 "Have you had pain in your chest?" are scored on a 4-point scale (1=Not at All to 4=Very Much). Using linear transformation, raw scores are standardized, so that scores range from 0 to 100. TTD is defined as the time from baseline to the first onset of a ≥10-point decrease from baseline in score. The TTD in chest pain score (EORTC QLQ-C30 Item 40) will be reported.

Number of Participants Who Experience One or More Adverse Events (AEs)Up to approximately 6 years

An AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. The number of participants who experience one or more AEs will be reported.

Number of Participants Who Discontinue Study Treatment Due to an AEUp to approximately 6 years

An AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. The number of participants who discontinue study treatment due to an AE will be reported.

Trial Locations

Locations (148)

Kaiser Permanente - Oakland ( Site 0054)

🇺🇸

Oakland, California, United States

Kaiser Permanente - Roseville ( Site 0055)

🇺🇸

Roseville, California, United States

Princess Margaret Cancer Centre ( Site 0203)

🇨🇦

Toronto, Ontario, Canada

Kaiser Permanente - San Francisco ( Site 0056)

🇺🇸

San Francisco, California, United States

Kaiser Permanente - Santa Clara ( Site 0057)

🇺🇸

Santa Clara, California, United States

Kaiser Permanente-Kaiser Permanente ( Site 0036)

🇺🇸

Vallejo, California, United States

Kaiser Permanente - Walnut Creek ( Site 0058)

🇺🇸

Walnut Creek, California, United States

Mid Florida Hematology and Oncology Center ( Site 0005)

🇺🇸

Orange City, Florida, United States

Northwest Georgia Oncology Centers, a Service of Wellstar Cobb Hospital-Research ( Site 0003)

🇺🇸

Marietta, Georgia, United States

University of Michigan ( Site 0009)

🇺🇸

Ann Arbor, Michigan, United States

Cox Medical Center North - Cox Medical Center/ Hematology/Medical Oncology ( Site 0051)

🇺🇸

Springfield, Missouri, United States

Astera Cancer Care ( Site 0032)

🇺🇸

East Brunswick, New Jersey, United States

Stony Brook University-Cancer Center ( Site 0038)

🇺🇸

Stony Brook, New York, United States

Sanford Fargo Medical Center ( Site 0028)

🇺🇸

Fargo, North Dakota, United States

Sanford Cancer Center ( Site 0024)

🇺🇸

Sioux Falls, South Dakota, United States

Millennium Research & Clinical Development ( Site 0035)

🇺🇸

Houston, Texas, United States

Clinica Adventista Belgrano-Oncology ( Site 0315)

🇦🇷

Caba., Buenos Aires, Argentina

Instituto Alexander Fleming ( Site 0307)

🇦🇷

Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina

Hospital Británico de Buenos Aires-Oncology ( Site 0304)

🇦🇷

Ciudad autónoma de Buenos Aires, Caba, Argentina

Centro Privado de RMI Río Cuarto S.A. II ( Site 0310)

🇦🇷

Río Cuarto, Cordoba, Argentina

Instituto de Oncología de Rosario ( Site 0301)

🇦🇷

Rosario, Santa Fe, Argentina

Fundación CORI para la Investigación y Prevención del Cáncer ( Site 0303)

🇦🇷

La Rioja, Argentina

Cross Cancer Institute ( Site 0201)

🇨🇦

Edmonton, Alberta, Canada

Grand River Hospital ( Site 0207)

🇨🇦

Kitchener, Ontario, Canada

McGill University Health Centre ( Site 0204)

🇨🇦

Montréal, Quebec, Canada

Anhui Provincial Cancer Hospital ( Site 3132)

🇨🇳

Hefei, Anhui, China

Beijing Cancer hospital ( Site 3100)

🇨🇳

Beijing, Beijing, China

Beijing Peking Union Medical College Hospital-pneumology department ( Site 3107)

🇨🇳

Beijing, Beijing, China

Chongqing University Cancer Hospital-Medical Oncology ( Site 3128)

🇨🇳

Chongqing, Chongqing, China

Fujian Cancer Hospital ( Site 3124)

🇨🇳

Fuzhou, Fujian, China

The First Affiliated hospital of Xiamen University ( Site 3125)

🇨🇳

XiaMen, Fujian, China

Southern Medical University Nanfang Hospital-Depatrment of Respiratory and Critical Care Medicine ( Site 3102)

🇨🇳

Guangzhou, Guangdong, China

Guangxi Medical University Affiliated Tumor Hospital-Respiratory Oncology ( Site 3103)

🇨🇳

Nanning, Guangxi, China

Harbin Medical University Cancer Hospital ( Site 3109)

🇨🇳

Harbin, Heilongjiang, China

Henan Cancer Hospital ( Site 3105)

🇨🇳

Zhengzhou, Henan, China

Tongji Hospital Tongji Medical,Science & Technology ( Site 3121)

🇨🇳

Wuhan, Hubei, China

Hubei Cancer Hospital ( Site 3122)

🇨🇳

Wuhan, Hubei, China

The Second Xiangya Hospital of Central South University-Oncology ( Site 3104)

🇨🇳

Changsha, Hunan, China

Nanjing Drum Tower Hospital JiangBei International Branch Hospital ( Site 3117)

🇨🇳

Nanjing, Jiangsu, China

The First Affiliated Hospital of Soochow University-Respiratory Department ( Site 3118)

🇨🇳

Suzhou, Jiangsu, China

The Second Affiliated Hospital of Nanchang University ( Site 3119)

🇨🇳

Nanchang, Jiangxi, China

The Second Affiliated Hospital of Xi'an Jiaotong University ( Site 3130)

🇨🇳

XI An, Shaanxi, China

Jinan Central Hospital ( Site 3113)

🇨🇳

Jinan, Shandong, China

Shandong Cancer Hospital ( Site 3112)

🇨🇳

Jinan, Shandong, China

Zhongshan Hospital of Fudan University ( Site 3133)

🇨🇳

Shanghai, Shanghai, China

Shanxi Cancer Hospital ( Site 3114)

🇨🇳

Taiyuan, Shanxi, China

West China Hospital, Sichuan University ( Site 3126)

🇨🇳

Cheng Du, Sichuan, China

Sichuan Cancer hospital. ( Site 3127)

🇨🇳

Chengdu, Sichuan, China

The first Affiliated Hospital, Zhejiang University School of Medicine ( Site 3101)

🇨🇳

Hangzhou, Zhejiang, China

Sir Run Run Shaw Hospital of Zhejiang University School of Medicine-Medical Oncology ( Site 3106)

🇨🇳

Hangzhou, Zhejiang, China

The First Affiliated Hospital of Wenzhou Medical University-Respiratory department ( Site 3120)

🇨🇳

Wenzhou, Zhejiang, China

Sociedad de Oncología Y Hematología del Cesar S.A.S. ( Site 0601)

🇨🇴

Valledupar, Cesar, Colombia

IMAT S.A.S ( Site 0602)

🇨🇴

Monteria, Cordoba, Colombia

FUNDACION CTIC CENTRO DE TRATAMIENTO E INVESTIGACION SOBRE CANCER LUIS CARLOS SARMIENTO ANGULO ( Site 0600)

🇨🇴

Bogota, Distrito Capital De Bogota, Colombia

Clinica Colsanitas S.A, Sede Clínica Universitaria Colombia-Center Investigator ( Site 0606)

🇨🇴

Bogota, Distrito Capital De Bogota, Colombia

Oncologos del Occidente ( Site 0604)

🇨🇴

Pereira., Risaralda, Colombia

Fundacion Valle del Lili- CIC-Oncology CIC ( Site 0605)

🇨🇴

Cali, Valle Del Cauca, Colombia

Nouvel Hôpital Civil (NHC) ( Site 1302)

🇫🇷

Strasbourg, Alsace, France

Clinique Clairval ( Site 1306)

🇫🇷

Marseille, Bouches-du-Rhone, France

Gustave Roussy ( Site 1303)

🇫🇷

Villejuif, Ile-de-France, France

Hopitaux Universitaires Paris Centre-Hopital Cochin-Unité d'Oncologie Thoracique ( Site 1304)

🇫🇷

Paris, France

All India Institute of Medical Sciences-Department of medical oncology ( Site 3303)

🇮🇳

New Delhi, Delhi, India

Indraprastha Apollo Hospitals-APOLLO RESEARCH INNOVATION ( Site 3301)

🇮🇳

New Delhi, Delhi, India

Rajiv Gandhi Cancer Institute And Research Centre ( Site 3300)

🇮🇳

New Delhi, Delhi, India

Artemis hospital ( Site 3307)

🇮🇳

Gurugram, Haryana, India

Kokilaben Dhirubhai Ambani Hospital & Medical Research Institute-Centre for cancer ( Site 3302)

🇮🇳

Mumbai, Maharashtra, India

Istituto Europeo di Oncologia IRCCS-Divisione di Oncologia Toracica ( Site 1803)

🇮🇹

Milano, Lombardia, Italy

Fondazione IRCCS Istituto Nazionale dei Tumori-Struttura Complessa Oncologia Medica 1 ( Site 1800)

🇮🇹

Milan, Lombardia, Italy

Instituto Tumori Giovanni Paolo II-SSD Oncologia Medica per la Patologia Toracica ( Site 1802)

🇮🇹

Bari, Puglia, Italy

Azienda Ospedaliera Universitaria Careggi-SOD ONCOLOGIA MEDICA ( Site 1804)

🇮🇹

Firenze, Toscana, Italy

Fondazione Policlinico Universitario Agostino Gemelli IRCCS - Università Cattolica del Sacro Cuore ( Site 1801)

🇮🇹

Roma, Italy

Fujita Health University Hospital ( Site 3409)

🇯🇵

Toyoake, Aichi, Japan

Ehime University Hospital ( Site 3411)

🇯🇵

Toon, Ehime, Japan

National Hospital Organization Kyushu Cancer Center ( Site 3401)

🇯🇵

Fukuoka,, Fukuoka, Japan

Gunma Prefectural Cancer Center ( Site 3413)

🇯🇵

Ota, Gunma, Japan

Kanazawa University Hospital ( Site 3402)

🇯🇵

Kanazawa, Ishikawa, Japan

St. Marianna University Hospital ( Site 3415)

🇯🇵

Kawasaki, Kanagawa, Japan

Kanagawa Cancer Center ( Site 3416)

🇯🇵

Yokohama, Kanagawa, Japan

Miyagi Cancer Center ( Site 3406)

🇯🇵

Natori, Miyagi, Japan

Kansai Medical University Hospital ( Site 3414)

🇯🇵

Hirakata, Osaka, Japan

Saitama Prefectural Cancer Center ( Site 3417)

🇯🇵

Kitaadachi-gun, Saitama, Japan

Shizuoka Cancer Center ( Site 3405)

🇯🇵

Sunto-gun, Shizuoka, Japan

National Cancer Center Hospital ( Site 3408)

🇯🇵

Chuo, Tokyo, Japan

Toho University Omori Medical Center ( Site 3407)

🇯🇵

Ota, Tokyo, Japan

Kyushu University Hospital ( Site 3400)

🇯🇵

Fukuoka, Japan

Hiroshima City Hiroshima Citizens Hospital ( Site 3419)

🇯🇵

Hiroshima, Japan

Niigata Cancer Center Hospital ( Site 3403)

🇯🇵

Niigata, Japan

Okayama University Hospital ( Site 3404)

🇯🇵

Okayama, Japan

Osaka International Cancer Institute ( Site 3410)

🇯🇵

Osaka, Japan

Osaka Metropolitan University Hospital ( Site 3412)

🇯🇵

Osaka, Japan

Chungbuk National University Hospital ( Site 3804)

🇰🇷

Cheongju-si, Chungbuk, Korea, Republic of

National Cancer Center ( Site 3803)

🇰🇷

Goyang-si, Kyonggi-do, Korea, Republic of

Seoul National University Bundang Hospital ( Site 3807)

🇰🇷

Seongnam, Kyonggi-do, Korea, Republic of

The Catholic University Of Korea St. Vincent's Hospital ( Site 3800)

🇰🇷

Suwon-si, Kyonggi-do, Korea, Republic of

Ajou University Hospital ( Site 3813)

🇰🇷

Suwon, Kyonggi-do, Korea, Republic of

Pusan National University Yangsan Hospital ( Site 3802)

🇰🇷

Pusan, Kyongsangnam-do, Korea, Republic of

Pusan National University Hospital ( Site 3805)

🇰🇷

Busan, Pusan-Kwangyokshi, Korea, Republic of

Keimyung University Dongsan Hospital CRC room 1 ( Site 3814)

🇰🇷

Daegu, Taegu-Kwangyokshi, Korea, Republic of

Chungnam national university hospital ( Site 3806)

🇰🇷

Jung-gu, Taejon-Kwangyokshi, Korea, Republic of

The Catholic University of Korea, Eunpyeong St. Mary's Hospital ( Site 3812)

🇰🇷

Seoul, Korea, Republic of

Asan Medical Center ( Site 3810)

🇰🇷

Seoul, Korea, Republic of

Samsung Medical Center ( Site 3811)

🇰🇷

Seoul, Korea, Republic of

Korea University Guro Hospital ( Site 3808)

🇰🇷

Seoul, Korea, Republic of

University Malaya Medical Centre ( Site 3507)

🇲🇾

Lembah Pantai, Kuala Lumpur, Malaysia

National Cancer Institute-Radiotherapy and Oncology ( Site 3504)

🇲🇾

Putrajaya, Kuala Lumpur, Malaysia

Hospital Tengku Ampuan Afzan ( Site 3506)

🇲🇾

Kuantan, Pahang, Malaysia

Hospital Pulau Pinang-Oncology, radiotherapy and palliat ( Site 3501)

🇲🇾

George Town, Pulau Pinang, Malaysia

Sarawak General Hospital-Radiotherapy Unit ( Site 3508)

🇲🇾

Kuching, Sarawak, Malaysia

Arké SMO S.A. de C.V. ( Site 0706)

🇲🇽

Mexico, Distrito Federal, Mexico

CIO - Centro de Inmuno-Oncología de Occidente ( Site 0700)

🇲🇽

Guadalajara, Jalisco, Mexico

Centro de Investigacion Clinica de Oaxaca ( Site 0704)

🇲🇽

Oaxaca de Juarez, Oaxaca, Mexico

Oaxaca Site Management Organization S.C. ( Site 0701)

🇲🇽

Oaxaca, Mexico

Centrum Onkologii im. Prof. Franciszka Lukaszczyka-Ambulatorium Chemioterapii ( Site 2003)

🇵🇱

Bydgoszcz, Kujawsko-pomorskie, Poland

Narodowy Instytut Onkologii im. Marii Sklodowskiej-Curie - P-Klinika Nowotworow Pluca i Klatki Pier ( Site 2000)

🇵🇱

Warszawa, Mazowieckie, Poland

Changhua Christian Hospital ( Site 3904)

🇨🇳

Changhua County, Changhua, Taiwan

Chang Gung Memorial Hospital at Kaohsiung ( Site 3905)

🇨🇳

Kaohsiung Niao Sung Dist, Kaohsiung, Taiwan

National Cheng Kung University Hospital ( Site 3901)

🇨🇳

Tainan City, Tainan, Taiwan

Chi Mei Hospital - Liouying Branch ( Site 3909)

🇨🇳

Tainan City, Tainan, Taiwan

National Taiwan University Cancer Center (NTUCC) ( Site 3907)

🇨🇳

Taipei City, Taipei, Taiwan

National Taiwan University Hospital - Hsinchu branch ( Site 3900)

🇨🇳

Hsinchu, Taiwan

Far Eastern Memorial Hospital ( Site 3912)

🇨🇳

New Taipei, Taiwan

Bialostockie Centrum Onkologii ( Site 2010)

🇵🇱

Bialystok, Podlaskie, Poland

Narodowy Instytut Onkologii - Oddzial w Gliwicach-II Klinika Radioterapi i Chemioterapii ( Site 2002)

🇵🇱

Gliwice, Slaskie, Poland

Institut Català d'Oncologia - L'Hospitalet-Medical Oncology ( Site 2321)

🇪🇸

LHospitalet de Llobregat, Barcelona, Spain

Taichung Veterans General Hospital-Chest ( Site 3910)

🇨🇳

Taichung, Taiwan

National Taiwan University Hospital-Oncology ( Site 3908)

🇨🇳

Taipei, Taiwan

Mackay Memorial Hospital-Chest Medicine ( Site 3902)

🇨🇳

Taipei, Taiwan

Taipei Medical University Hospital ( Site 3903)

🇨🇳

Taipei, Taiwan

Chang Gung Medical Foundation-Linkou Branch-Clinic of Chest Medicine ( Site 3911)

🇨🇳

Taoyuan, Taiwan

Maharaj Nakorn Chiang Mai Hospital ( Site 4005)

🇹🇭

Muang, Chiang Mai, Thailand

Faculty of Medicine - Khon Kaen University ( Site 4002)

🇹🇭

Muang, Khon Kaen, Thailand

CHUS - Hospital Clinico Universitario-Servicio de Oncologia ( Site 2322)

🇪🇸

Santiago de compostela, La Coruna, Spain

Hospital Universitario Juan Ramon Jimenez-Oncología Medica ( Site 2323)

🇪🇸

Huelva, Spain

Hospital Universitario Virgen Macarena-Unidad de Investigación Oncológica ( Site 2324)

🇪🇸

Sevilla, Spain

Karolinska Universitetssjukhuset Solna ( Site 2401)

🇸🇪

Stockholm, Stockholms Lan, Sweden

Faculty of Medicine Siriraj Hospital ( Site 4004)

🇹🇭

Bangkok, Krung Thep Maha Nakhon, Thailand

Bangkok Metropolitan Administration Medical College and Vajira Hospital ( Site 4006)

🇹🇭

Dusit, Krung Thep Maha Nakhon, Thailand

Ramathibodi Hospital ( Site 4001)

🇹🇭

Ratchathewi, Krung Thep Maha Nakhon, Thailand

Lampang Cancer Hospital ( Site 4000)

🇹🇭

Mueang Lampang, Lampang, Thailand

Songklanagarind hospital ( Site 4003)

🇹🇭

HatYai, Songkhla, Thailand

Adana Medical Park Seyhan Hastanesi-Medikal Onkoloji ( Site 2504)

🇹🇷

Adana, Turkey

Hacettepe Universite Hastaneleri-oncology hospital ( Site 2501)

🇹🇷

Ankara, Turkey

Memorial Ankara Hastanesi-Medical Oncology ( Site 2505)

🇹🇷

Ankara, Turkey

Ankara Bilkent Şehir Hastanesi ( Site 2500)

🇹🇷

Ankara, Turkey

I.E.U. Medical Point Hastanesi-Oncology ( Site 2503)

🇹🇷

Izmir, Turkey

Hanoi Oncology Hospital ( Site 4198)

🇻🇳

Hanoi, Ha Noi, Vietnam

Thong Nhat Hospital ( Site 4192)

🇻🇳

Tan Binh District, Ho Chi Minh, Vietnam

Ho Chi Minh City Oncology Hospital - Tan Phu Ward ( Site 4191)

🇻🇳

Ho Chi Minh, Vietnam

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