AURELIA: A Study of Avastin (Bevacizumab) Added to Chemotherapy in Patients With Platinum-resistant Ovarian Cancer
- Conditions
- Ovarian Cancer
- Interventions
- Registration Number
- NCT00976911
- Lead Sponsor
- Hoffmann-La Roche
- Brief Summary
This randomized, open-label, 2-arm study will evaluate the efficacy and safety of Avastin added to chemotherapy versus chemotherapy alone in patients with epithelial ovarian, fallopian tube or primary peritoneal cancer with disease progression within 6 months of platinum therapy. All patients will receive standard chemotherapy with either paclitaxel or topotecan or liposomal doxorubicin. Patients randomized to Arm 2 of the study will receive Avastin (10 mg/kg iv 2-weekly or 15 mg/kg iv 3-weekly) concomitantly. Anticipated time on study treatment is until disease progression. Patients will then receive standard of care, those in Arm 1 (chemotherapy only) may opt to receive Avastin (15 mg/kg iv 3-weekly). Target sample size is 100-500 individuals.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- Female
- Target Recruitment
- 361
- female patients, >/=18 years of age
- epithelial ovarian, fallopian tube or primary peritoneal cancer
- platinum-resistant disease (disease progression within <6 months of platinum therapy)
- EOCG performance status of 0-2
- non-epithelial tumours
- ovarian tumours with low malignant potential
- previous treatment with >2 chemotherapy regimens
- prior radiotherapy to the pelvis or abdomen
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Chemotherapy liposomal doxorubicin Participants received one of the following chemotherapies at the discretion of the investigator: paclitaxel, 80 milligrams per square meter (mg/m\^2) as a 1-hour intravenous (IV) infusion on Days 1, 8, 15, and 22 every 4 weeks (q4w) OR topotecan 4 mg/m\^2 as a 30-minute IV infusion on Days 1, 8, and 15 q4w (alternatively, a 1.25 mg/m\^2 dose could have been administered over 30 minutes on Days 1-5 every 3 weeks \[q3w\]) OR pegylated liposomal doxorubicin (PLD) 40 mg/m\^2 as a 1 milligram per minute (mg/min) infusion on Day 1 q4w (after Cycle 1 the drug could have been administered as a 1 hour infusion). Depending on chosen chemotherapy, pre-medication was implemented according to local practices. Chemotherapy + Bevacizumab liposomal doxorubicin Participants received one of the following chemotherapies at the discretion of the investigator: paclitaxel, 80 mg/m\^2 as a 1-hour IV infusion on Days 1, 8, 15, and 22 q4w OR topotecan 4 mg/m\^2 as a 30-minute IV infusion on Days 1, 8, and 15 q4w (alternatively, a 1.25 mg/m\^2 dose could have been administered over 30 minutes on Days 1-5 q3w) OR PLD 40 mg/m\^2 as a 1 mg/min infusion on Day 1 q4w (after Cycle 1 the drug could have been administered as a 1 hour infusion. Depending on chosen chemotherapy, pre-medication was implemented according to local practices. The chosen chemotherapy was combined with bevacizumab 10 milligrams per kilogram (mg/kg) IV every 2 weeks (q2w; or bevacizumab 15 mg/kg q3w if used in combination with topotecan 1.25 mg/m\^2 on Days 1-5 on a q3w schedule). The initial bevacizumab infusion was over 90 minutes, with subsequent infusions over 60 minutes and then 30 minutes, as tolerated. Chemotherapy paclitaxel Participants received one of the following chemotherapies at the discretion of the investigator: paclitaxel, 80 milligrams per square meter (mg/m\^2) as a 1-hour intravenous (IV) infusion on Days 1, 8, 15, and 22 every 4 weeks (q4w) OR topotecan 4 mg/m\^2 as a 30-minute IV infusion on Days 1, 8, and 15 q4w (alternatively, a 1.25 mg/m\^2 dose could have been administered over 30 minutes on Days 1-5 every 3 weeks \[q3w\]) OR pegylated liposomal doxorubicin (PLD) 40 mg/m\^2 as a 1 milligram per minute (mg/min) infusion on Day 1 q4w (after Cycle 1 the drug could have been administered as a 1 hour infusion). Depending on chosen chemotherapy, pre-medication was implemented according to local practices. Chemotherapy topotecan Participants received one of the following chemotherapies at the discretion of the investigator: paclitaxel, 80 milligrams per square meter (mg/m\^2) as a 1-hour intravenous (IV) infusion on Days 1, 8, 15, and 22 every 4 weeks (q4w) OR topotecan 4 mg/m\^2 as a 30-minute IV infusion on Days 1, 8, and 15 q4w (alternatively, a 1.25 mg/m\^2 dose could have been administered over 30 minutes on Days 1-5 every 3 weeks \[q3w\]) OR pegylated liposomal doxorubicin (PLD) 40 mg/m\^2 as a 1 milligram per minute (mg/min) infusion on Day 1 q4w (after Cycle 1 the drug could have been administered as a 1 hour infusion). Depending on chosen chemotherapy, pre-medication was implemented according to local practices. Chemotherapy + Bevacizumab Bevacizumab Participants received one of the following chemotherapies at the discretion of the investigator: paclitaxel, 80 mg/m\^2 as a 1-hour IV infusion on Days 1, 8, 15, and 22 q4w OR topotecan 4 mg/m\^2 as a 30-minute IV infusion on Days 1, 8, and 15 q4w (alternatively, a 1.25 mg/m\^2 dose could have been administered over 30 minutes on Days 1-5 q3w) OR PLD 40 mg/m\^2 as a 1 mg/min infusion on Day 1 q4w (after Cycle 1 the drug could have been administered as a 1 hour infusion. Depending on chosen chemotherapy, pre-medication was implemented according to local practices. The chosen chemotherapy was combined with bevacizumab 10 milligrams per kilogram (mg/kg) IV every 2 weeks (q2w; or bevacizumab 15 mg/kg q3w if used in combination with topotecan 1.25 mg/m\^2 on Days 1-5 on a q3w schedule). The initial bevacizumab infusion was over 90 minutes, with subsequent infusions over 60 minutes and then 30 minutes, as tolerated. Chemotherapy + Bevacizumab paclitaxel Participants received one of the following chemotherapies at the discretion of the investigator: paclitaxel, 80 mg/m\^2 as a 1-hour IV infusion on Days 1, 8, 15, and 22 q4w OR topotecan 4 mg/m\^2 as a 30-minute IV infusion on Days 1, 8, and 15 q4w (alternatively, a 1.25 mg/m\^2 dose could have been administered over 30 minutes on Days 1-5 q3w) OR PLD 40 mg/m\^2 as a 1 mg/min infusion on Day 1 q4w (after Cycle 1 the drug could have been administered as a 1 hour infusion. Depending on chosen chemotherapy, pre-medication was implemented according to local practices. The chosen chemotherapy was combined with bevacizumab 10 milligrams per kilogram (mg/kg) IV every 2 weeks (q2w; or bevacizumab 15 mg/kg q3w if used in combination with topotecan 1.25 mg/m\^2 on Days 1-5 on a q3w schedule). The initial bevacizumab infusion was over 90 minutes, with subsequent infusions over 60 minutes and then 30 minutes, as tolerated. Chemotherapy + Bevacizumab topotecan Participants received one of the following chemotherapies at the discretion of the investigator: paclitaxel, 80 mg/m\^2 as a 1-hour IV infusion on Days 1, 8, 15, and 22 q4w OR topotecan 4 mg/m\^2 as a 30-minute IV infusion on Days 1, 8, and 15 q4w (alternatively, a 1.25 mg/m\^2 dose could have been administered over 30 minutes on Days 1-5 q3w) OR PLD 40 mg/m\^2 as a 1 mg/min infusion on Day 1 q4w (after Cycle 1 the drug could have been administered as a 1 hour infusion. Depending on chosen chemotherapy, pre-medication was implemented according to local practices. The chosen chemotherapy was combined with bevacizumab 10 milligrams per kilogram (mg/kg) IV every 2 weeks (q2w; or bevacizumab 15 mg/kg q3w if used in combination with topotecan 1.25 mg/m\^2 on Days 1-5 on a q3w schedule). The initial bevacizumab infusion was over 90 minutes, with subsequent infusions over 60 minutes and then 30 minutes, as tolerated.
- Primary Outcome Measures
Name Time Method Percentage of Participants With Disease Progression or Death (Data Cutoff 14 November 2011) Screening Visit, Every 8 weeks (or 9 weeks if receiving topotecan) until progression reported between day of first participant randomized (29 October 2009) until cutoff date of 14 November 2011 Progression free survival was defined as the time from the date of randomization to the first documented disease progression or death, whichever occurs first. Progression was based on tumour assessment made by the investigators according to the Response Evaluation Criteria In Solid Tumors (RECIST) criteria (for participants with measurable disease), and for those with non-measurable disease presence or absence of lesions was noted.
Progression Free Survival (PFS; Data Cutoff 14 November 2011) Screening Visit, Every 8 weeks (or 9 weeks if receiving topotecan) until progression reported between day of first participant randomized (29 October 2009) until cutoff date of 14 November 2011 PFS was defined as the time from the date of randomization to the first documented disease progression or death, whichever occurred first. Progression was based on tumor assessment made by the investigators according to the RECIST criteria (for participants with measurable disease), and for those with non-measurable disease presence or absence of lesions was noted. Time from randomization to occurrence of disease progression or death was measured in months. An event was defined as the earliest progressive disease or death that occurred on or before the cutoff date (14 November 2011), regardless of start of nonprotocol specified anti-cancer therapy or the bevacizumab monotherapy. Disease progression was assessed by investigator according to RECIST or by symptom deterioration, and could not be declared on the basis of rising cancer antigen 125 (CA125) levels alone. Kaplan-Meier methodology was used. 95% CI for median was computed using the method of Brookmeyer and Crowley.
- Secondary Outcome Measures
Name Time Method Percentage of Participants With Best Overall Confirmed Objective Response of Complete Response (CR) or Partial Response (PR) Per Modified RECIST (Data Cutoff 14 November 2011) Screening Visit, Every 8 weeks (or 9 weeks if receiving topotecan) until progression reported between day of first participant randomized (29 October 2009) until cutoff date of 14 November 2011 Objective Response was determined by the investigator using modified RECIST criteria, Version 1.0. An objective response was a complete or partial overall confirmed response as determined by investigators. CR defined as complete disappearance of all target and non-target lesions and no new lesions. PR defined as greater than or equal to (≥) 30 percent (%) decrease in the sum of appropriate diameters of all target measurable lesions, no progress in the non-measurable disease, and no new lesions. 95% CI computed using the normal approximation to the binomial distribution.
Duration of Objective Response (Data Cutoff 14 November 2011) Screening Visit, Every 8 weeks (or 9 weeks if receiving topotecan) until progression reported between day of first participant randomized (29 October 2009) until cutoff date of 14 November 2011 For randomized participants who achieved an objective response per modified RECIST, duration of objective response was defined as the time from the date of the first occurrence of a CR or PR (whichever occurred first) until the date that progressive disease or death was documented (whichever occurred first). Participants who had an objective response and did not experience disease progression or death by the time of analysis were censored at the time of the last tumor assessment. Summaries of duration of objective response (median and percentiles) were estimated from Kaplan-Meier curves. 95% CI for duration of objective response was computed using the method of Brookmeyer and Crowley.
Percentage of Participants Who Died (Data Cutoff 25 January 2013) Screening Visit, Every 8 weeks (or 9 weeks if receiving topotecan) until progression reported between day of first participant randomized (29 October 2009) until cutoff date of 25 January 2013 Overall Survival (Data Cutoff 25 January 2013) Screening Visit, Every 8 weeks (or 9 weeks if receiving topotecan) until progression reported between day of first participant randomized (29 October 2009) until cutoff date of 25 January 2013 Duration of overall survival was defined as the time from randomization to death of any cause. Kaplan-Meier methodology was used. The OS data for participants for whom no death was captured in the clinical database were censored at the last time they were known to be alive. 95% CI was computed using the method of Brookmeyer and Crowley.
European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ) Ovarian (OV) 28 Abdominal/Gastrointestinal (AB/GI) Symptom Scale - Percentage of Responders (Data Cutoff 14 November 2011) Baseline and Weeks 8, 9, 16, 18, 24 and 30 (Data Cutoff 14 November 2011) The EORTC OV-28 module is a questionnaire that focuses on issues specific to ovarian cancer. It assesses AB/GI symptoms, among others. Participants were asked to indicate the extent to which they experienced AB/GI symptoms in the week prior to assessment. Participants responded on a scale of 1-4 (1=not at all, 2=a little, 3=quite a bit, 4=very much) to the following: Did you have abdominal pain? Did you have a bloated feeling in your abdomen/stomach? Did you have problems with your clothes feeling too tight? Did you experience any change in bowel habit as a result of your disease or treatment? Were you troubled by passing wind/gas/flatulence? Have you felt full too quickly after beginning to eat? Have you had indigestion/heartburn? Data are transformed to a scale from 0 to 100. Lower scores represent better health (fewer symptoms). Participants were considered a responder if they had a 10 point or more reduction in EORTC QLQ-OV28 AB/GI symptom scale score from baseline.
Trial Locations
- Locations (117)
UZ Leuven Gasthuisberg
🇧🇪Leuven, Belgium
Klinikum Nord Frauenklinik
🇩🇪Nürnberg, Germany
UZ Antwerpen
🇧🇪Edegem, Belgium
University Hospital of Alexandra
🇬🇷Athens, Greece
HELIOS Klinikum Krefeld; Klinik für Frauenheilkunde und Geburtshilfe
🇩🇪Krefeld, Germany
UNI-Klinikum Campus Kiel Klinik für Gynäkologie und Geburtshilfe
🇩🇪Kiel, Germany
Oulu University Hospital; Gynaecology & Obstetrics Dept
🇫🇮Oulu, Finland
Catharina ZKHS; Inwendige Geneeskunde Afd.
🇳🇱Eindhoven, Netherlands
Örebro University Hospital; Department of Gynecologic Oncology
🇸🇪Örebro, Sweden
Adana Baskent University Hospital; Medical Oncology
🇹🇷Adana, Turkey
Istanbul Uni Cerrahpasa Medical Faculty Hospital; Medical Oncology
🇹🇷Istanbul, Turkey
Praxisgemeinschaft; Frauenärzte am Bahnhofsplatz
🇩🇪Hildesheim, Germany
Klinikum Kassel GmbH; Klinik für Frauenheilkunde und Geburtshilfe
🇩🇪Kassel, Germany
AZIENDA POLICLINICO UMBERTO I; Ginecologia ed Ostetricia
🇮🇹Roma, Lazio, Italy
Universitätsklinikum Schleswig-Holstein / Campus Lübeck; Klinik für Frauenheilkunde und Geburtshilfe
🇩🇪Lübeck, Germany
Universitätsklinikum Ulm Am Michelsberg; Frauenklinik
🇩🇪Ulm, Germany
Hopital Saint Louis ; Service d Oncologie Medicale Fougere 6 (Pr Misset)
🇫🇷Paris, France
Universitätsklinikum Erlangen; Frauenklinik
🇩🇪Erlangen, Germany
Kath.Marienkrankenhaus gGmbH Frauenklinik
🇩🇪Hamburg, Germany
Ospedale S.G.Calibita Fatebenefratelli; Unità Operativa Oncologia
🇮🇹Roma, Lazio, Italy
Istituto Nazionale dei Tumori; Divisione Oncologia Chirurgica e Ginecologica
🇮🇹Milano, Lombardia, Italy
Hospital Univ Vall d'Hebron; Servicio de Oncologia
🇪🇸Barcelona, Spain
Universitair Medisch Centrum Utrecht; Inwendige Geneeskunde Afd.
🇳🇱Utrecht, Netherlands
Az. Osp. Carlo Poma; Divisione Di Oncologia Medica
🇮🇹Mantova, Lombardia, Italy
Herlev Hospital; Afdeling for Kræftbehandling
🇩🇰Herlev, Denmark
Regionshospitalet Herning; Onkologisk afdeling
🇩🇰Herning, Denmark
Rigshospitalet; Onkologisk Klinik
🇩🇰København Ø, Denmark
Odense Universitetshospital, Onkologisk Afdeling R
🇩🇰Odense C, Denmark
Irccs Centro Di Riferimento Oncologico (CRO); Dipartimento Di Oncologia Medica
🇮🇹Aviano, Friuli-Venezia Giulia, Italy
University Clinical Center Tuzla; Clinic for Gynecology and Obstetrition
🇧🇦Tuzla, Bosnia and Herzegovina
The Norvegian Radium Hospital Montebello; Dept of Oncology
🇳🇴Oslo, Norway
University Clinical Centre of the Republic of Srpska
🇧🇦Banja Luka, Bosnia and Herzegovina
Kuopio University Hospital
🇫🇮Kuopio, Finland
St. Olavs Hospital; Kvinneklinikken
🇳🇴Trondheim, Norway
Clinic of Oncology, University Clinical Center Sarajevo
🇧🇦Sarajevo, Bosnia and Herzegovina
IPO de Lisboa; Servico de Oncologia Medica
🇵🇹Lisboa, Portugal
Hospital Son Llatzer; Servicio de Oncologia
🇪🇸Palma de Mallorca, Islas Baleares, Spain
Istituto Regina Elena; Oncologia Medica A
🇮🇹Roma, Lazio, Italy
IPO do Porto; Servico de Oncologia Medica
🇵🇹Porto, Portugal
Institut Curie; Oncologie Medicale
🇫🇷Paris, France
Centre Radiotherapie Etienne Dolet
🇫🇷Saint Nazaire, France
Evangelischen Krankenhauses Düsseldorf; Frauenklinik
🇩🇪Düsseldorf, Germany
Uni-Frauenklinik
🇩🇪Düsseldorf, Germany
Oncologianova GmbH
🇩🇪Recklinghausen, Germany
Robert-Bosch-Krankenhaus; Interdisziplinäres Zentrum; Tumorzentrum
🇩🇪Stuttgart, Germany
Dr. Horst-Schmidt-Kliniken; Frauenheilkunde & Geburtshilfe
🇩🇪Wiesbaden, Germany
Universitätsklinik Tübingen; Frauenklinik & Poliklinik
🇩🇪Tübingen, Germany
Institut Jules Bordet
🇧🇪Bruxelles, Belgium
Clinique Ste-Elisabeth
🇧🇪Namur, Belgium
Clinique Tivoli; Sce Radiotherapie
🇫🇷Bordeaux, France
Institut Bergonie; Gynecologie
🇫🇷Bordeaux, France
Clinique Sainte Catherine; Hopital De Semaine
🇫🇷Avignon, France
Centre Jean Perrin; Hopital De Jour
🇫🇷Clermont Ferrand, France
Polyclinique Bordeaux Nord Aquitaine; Chimiotherapie Radiotherapie
🇫🇷Bordeaux, France
Ch De Brive La Gaillarde; Radiotherapie Oncologie
🇫🇷Brive La Gaillarde, France
Centre Francois Baclesse; Urologie Gynecologie
🇫🇷Caen, France
Hopital Louis Pasteur; Medecine B
🇫🇷Colmar, France
Institut Daniel Hollard; Chimiotherapie Ambulatoire
🇫🇷Grenoble, France
Hopital La Source; Onco Med Hematologie Clinique
🇫🇷La Source, France
Centre Jean Bernard
🇫🇷Le Mans, France
Clin Mut De Lyon Eugene Andre; Medecine 3 A
🇫🇷Lyon, France
Hopital Andre Mignot; Hematologie - Oncologie
🇫🇷Le Chesnay, France
Centre Hospitalier Departemental Les Oudairies
🇫🇷La Roche Sur Yon, France
Hopital Layne; Medecine Ambulatoire
🇫🇷Mont-de-marsan, France
Centre Val Aurelle Paul Lamarque; Medecine A1 A2
🇫🇷Montpellier, France
Polyclinique Gentilly; CHIMIOTHERAPIE AMBULATOIRE
🇫🇷Nancy, France
Centre Oscar Lambret; Cancerologie Gynecologique
🇫🇷Lille, France
Centre Antoine Lacassagne; Hopital De Jour A2
🇫🇷Nice, France
Polyclinique Kenval ; Radiotherapie Oncologie
🇫🇷Nimes, France
Centre Catherine de Sienne; Chimiotherapie
🇫🇷Nantes, France
Hotel Dieu; Hematologie- Oncologie
🇫🇷Paris, France
HOPITAL TENON; Cancerologie Medicale
🇫🇷Paris, France
Clinique Francheville; Radiotherapie
🇫🇷Perigueux, France
Clinique Armoricaine Radiologie; Cons Externes
🇫🇷Saint Brieuc, France
Institut Jean Godinot; Oncologie Medicale
🇫🇷Reims CEDEX, France
Centre Rene Huguenin; Medecine B
🇫🇷St Cloud, France
Ico Rene Gauducheau; Oncologie
🇫🇷Saint Herblain, France
Centre Henri Becquerel; Oncologie Medicale
🇫🇷Rouen, France
Institut Claudius Regaud; Departement Oncologie Medicale
🇫🇷Toulouse, France
Centre Alexis Vautrin; Oncologie Medicale
🇫🇷Vandoeuvre-les-nancy, France
Hopital Civil; Expl Fonct Systeme Nerveux
🇫🇷Strasbourg, France
Hopitaux Du Leman Site Thonon; Maternite Gynecologie
🇫🇷Thonon Les Bains, France
HELIOS Klinikum Berlin-Buch; Klinik für Gynäkologie und Geburtshilfe
🇩🇪Berlin, Germany
Universitätsklinikum Essen; Zentrum Für Frauenheilkunde
🇩🇪Essen, Germany
Campus Virchow-Klinikum Charité; Centrum 17; Klinik für Gynäkologie
🇩🇪Berlin, Germany
Klinikum Essen-Mitte Ev. Huyssens-Stiftung / Knappschafts GmbH; Klinik für Senologie / Brustzentrum
🇩🇪Essen, Germany
Gynaekologisch-Onkologische Schwerpunktpraxis Prof. Dr. med. Lueck, Dr. Schrader und Dr. Noeding
🇩🇪Hannover, Germany
Klinik Johann Wolfgang von Goethe Uni; Klinik für Frauenheilkunde und Geburtshilfe
🇩🇪Frankfurt, Germany
Universitätsklinikum Mannheim; Frauenklinik
🇩🇪Mannheim, Germany
Klinikum der Universität München; Campus Großhadern; Klinik und Poliklinik für Frauenheilkunde
🇩🇪Muenchen, Germany
Sana Klinikum Offenbach GmbH; Klinik für Gynäkologie & Geburtshilfe
🇩🇪Offenbach, Germany
Universitätsfrauen- und Poliklinik am Klinikum Suedstadt
🇩🇪Rostock, Germany
Städtisches Klinikum Solingen; Klinik für Frauenheilkunde und Geburtshilfe
🇩🇪Solingen, Germany
A.O. Universitaria S. Maria Della Misericordia Di Udine; Oncologia
🇮🇹Udine, Friuli-Venezia Giulia, Italy
Ospedali Riuniti; Divisione Ostetricia e Ginecologia
🇮🇹Bergamo, Lombardia, Italy
Meander Mc, Locatie Lichtenberg; Dept of Lung Diseases
🇳🇱Amersfoort, Netherlands
Leyenburg Ziekenhuis; Internal Medecine
🇳🇱Den Haag, Netherlands
Martini Ziekenhuis; Dept of Internal Medicine
🇳🇱Groningen, Netherlands
Stichting St. Antonius Ziekenhuis
🇳🇱Nieuwegein, Netherlands
Hospital Universitario Reina Sofia; Servicio de Oncologia
🇪🇸Córdoba, Cordoba, Spain
Corporacio Sanitaria Parc Tauli; Servicio de Oncologia
🇪🇸Sabadell, Barcelona, Spain
Hospital de Terrassa; Servicio de Oncologia
🇪🇸Barcelona, Spain
Hospital Universitario Marques de Valdecilla; Servicio de Oncologia
🇪🇸Santander, Cantabria, Spain
Hospital de la Santa Creu i Sant Pau; Servicio de Oncologia
🇪🇸Barcelona, Spain
Hospital Universitari Arnau de Vilanova de Lleida; Servicio de Oncologia
🇪🇸Lerida, Spain
Hospital General Universitario Gregorio Marañon; Servicio de Oncologia
🇪🇸Madrid, Spain
Instituto Valenciano Oncologia; Oncologia Medica
🇪🇸Valencia, Spain
Centro Oncologico MD Anderson Internacional; Servicio de Oncologia
🇪🇸Madrid, Spain
Hospital General Universitario J.M Morales Meseguer; Servicio de Oncologia
🇪🇸Murcia, Spain
Hospital Universitario Miguel Servet; Servicio Oncologia
🇪🇸Zaragoza, Spain
Centro Integral Oncologico Clara Campal (CIOCC); Dirección Médica
🇪🇸Madrid, Spain
Hospital Universitario la Fe; Servicio de Oncologia
🇪🇸Valencia, Spain
Uni Hospital Linkoeping; Dept. of Oncology
🇸🇪Linköping, Sweden
Akademiska sjukhuset, Onkologkliniken
🇸🇪Uppsala, Sweden
Norrlands Uni Hospital; Onkologi Avd.
🇸🇪Umeå, Sweden
Ankara Baskent University Medicine Faculty; Gynaecology
🇹🇷Ankara, Turkey
Anadolu Health Center; Medical Oncology
🇹🇷Kocaeli, Turkey