A Study of Neratinib Plus Capecitabine Versus Lapatinib Plus Capecitabine in Patients With HER2+ Metastatic Breast Cancer Who Have Received Two or More Prior HER2 Directed Regimens in the Metastatic Setting
- Conditions
- HER2+ Metastatic Breast Cancer (MBC)
- Interventions
- Registration Number
- NCT01808573
- Lead Sponsor
- Puma Biotechnology, Inc.
- Brief Summary
This is a randomized, multi-center, multinational, open-label, active-controlled, parallel design study of the combination of neratinib plus capecitabine versus the combination of lapatinib plus capecitabine in HER2+ MBC patients who have received two or more prior HER2 directed regimens in the metastatic setting.
- Detailed Description
This is a randomized, multi-center, multinational, open-label, active-controlled, parallel design study of the combination of neratinib plus capecitabine versus the combination of lapatinib plus capecitabine in HER2+ MBC patients who have received two or more prior HER2 directed regimens in the metastatic setting. Patients will be randomized in a 1:1 ratio to one of the following treatment arms:
* Arm A: neratinib (240 mg once daily) + capecitabine (1500 mg/m\^2 daily, 750 mg/m\^2 twice daily \[BID\])
* Arm B: lapatinib (1250 mg once daily) + capecitabine (2000 mg/m\^2 daily, 1000 mg/m\^2 BID)
Patients will receive either neratinib plus capecitabine combination or lapatinib plus capecitabine combination until the occurrence of death, disease progression, unacceptable toxicity, or other specified withdrawal criterion.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 621
- Aged ≥18 years at signing of informed consent.
- Histologically confirmed MBC, current stage IV.
- Documented HER2 overexpression or gene-amplified tumor immunohistochemistry 3+ or 2+, with confirmatory fluorescence in situ hybridization (FISH) +.
- Prior treatment with at least two (2) HER2-directed regimens for metastatic breast cancer.
- Received previous therapy with capecitabine, neratinib, lapatinib, or any other HER2 directed tyrosine kinase inhibitor.
Note: There are additional inclusion and exclusion criteria. The study center will determine if you meet all of the criteria.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description neratinib plus capecitabine capecitabine neratinib 240 mg orally, once daily with food, continuously in 21 day cycles, and capecitabine 1500 mg/m\^2 daily in 2 evenly divided doses, orally with water within 30 minutes after a meal, taken on days 1 to 14 of each 21 day cycle. neratinib plus capecitabine neratinib neratinib 240 mg orally, once daily with food, continuously in 21 day cycles, and capecitabine 1500 mg/m\^2 daily in 2 evenly divided doses, orally with water within 30 minutes after a meal, taken on days 1 to 14 of each 21 day cycle. lapatinib plus capecitabine capecitabine lapatinib 1250 mg orally, once daily, continuously in 21 day cycles, and capecitabine 2000 mg/m\^2 daily in 2 evenly divided doses, orally with water within 30 minutes after a meal, taken on days 1 to 14 of each 21 day cycle. lapatinib plus capecitabine lapatinib lapatinib 1250 mg orally, once daily, continuously in 21 day cycles, and capecitabine 2000 mg/m\^2 daily in 2 evenly divided doses, orally with water within 30 minutes after a meal, taken on days 1 to 14 of each 21 day cycle.
- Primary Outcome Measures
Name Time Method Centrally Assessed Progression Free Survival From randomization date to recurrence, progression or death, assessed up to 38 months. The result is based on primary analysis data cut. Progression Free Survival (PFS), Measured in Months, for Randomized Subjects of the Central Assessment. The time interval from the date of randomization until the first date on which recurrence, progression (per Response Evaluation Criteria in Solid Tumors Criteria (RECIST) v1.1), or death due to any cause, is documented. For subjects without recurrence, progression or death, it is censored at the last valid tumor assessment. Progression is defined using Response Evaluation Criteria in Solid Tumors Criteria (RECIST v1.1), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions. Here, the time to event was reported as the restricted mean survival time. The restricted mean survival time was defined as the area under the curve of the survival function up to 24 months.
Overall Survival From randomization date to death, assessed up to 59 months.The result is based on primary analysis data cut. Overall survival (OS) is defined as the time from randomization to death due to any cause, censored at the last date known alive on or prior to the data cutoff employed for the analysis, whichever was earlier. Here, the time to event was reported as the restricted mean survival time. The restricted mean survival time was defined as the area under the curve of the survival function up to 48 months.
- Secondary Outcome Measures
Name Time Method Percentage of Participants With Treatment-Emergent Adverse Events (Adverse Events and Serious Adverse Events) From first dose through last dose + 28 days, up to 41 months. The result is based on final data cut. Adverse Events to be measured are Treatment-Emergent and Serious AEs that occurred on or after first dose of investigational product and up to 28 days after the last dose
Intervention for Symptomatic Metastatic Central Nervous System Disease From randomization date to first intervention for symptomatic metastatic CNS disease, assessed up to 59 months.The result is based on primary analysis data cut. Intervention for symptomatic metastatic central nervous system disease is defined as the time from randomization to the first start date of an intervention for symptomatic metastatic CNS disease. Subjects that do not have an intervention for symptomatic metastatic CNS and do not die will be censored at the last date known alive on or prior to the data cutoff. Deaths are treated as competing events. Percentage of participants with intervention for CNS, estimated by cumulative incidence methods. Cumulative incidence methods are the standard way to estimate incidence of an endpoint in the presence of competing risks and censoring.
Objective Response Rate (ORR) - Central Assessment (ITT Population With Measurable Disease at Screening) From randomization date to first confirmed Complete or Partial Response, whichever came earlier, up to 42 months.The result is based on primary analysis data cut. Objective response rate is defined as the percentage of participants demonstrating an objective response during the study. Objective response includes confirmed complete responses (CR) and partial responses (PR) as defined in the RECIST criteria included in the study protocol. The ORR is for Central Assessment for subjects that had measurable disease at screening. Per Response Evaluation Criteria in Solid Tumors Criteria (RECIST v1.0) for target lesions and assessed by MRI: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), \>=30% decrease in the sum of the longest diameter of target lesions; Overall Response (OR) = CR + PR.
Clinical Benefit Rate (CBR) - Central Assessment (ITT Population With Measurable Disease at Screening) From randomization date to either first confirmed CR or PR or Stable Disease, whichever came earlier, up to 42 months.The result is based on primary analysis data cut. Clinical benefit rate is the percentage of participants who achieve overall tumor response (confirmed CR or PR) or stable disease (SD) lasting for at least 24 weeks from randomization. The CBR was for Central Assessment for subjects who had Measurable Disease at Screening.
Duration of Response (DOR) - Central Assessment (Population That Had a Response With Measurable Disease at Screening) From start date of response after randomization to first PD, up to 33 months.The result is based on primary analysis data cut. The Duration of Response (DOR) is for Central Assessment for the Population that Had a Response with Measurable Disease at Screening.
Duration of response is measured from the time at which measurement criteria are first met for CR or PR (whichever status is recorded first) until the first date of recurrence or progressive disease (PD) or death is objectively documented, taking as a reference for PD the smallest measurements recorded since enrollment, per RECIST v1.1. This value is censored at the last valid tumor assessment if PD or death has not been documented.
Trial Locations
- Locations (236)
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins Hospital
🇺🇸Baltimore, Maryland, United States
University of California San Diego Medical Center - Hillcrest
🇺🇸San Diego, California, United States
Sharp Memorial Hospital
🇺🇸San Diego, California, United States
Massachusetts General Hospital
🇺🇸Boston, Massachusetts, United States
Dana Farber Cancer Institute
🇺🇸Boston, Massachusetts, United States
Institut Jules Bordet - Medical Oncology
🇧🇪Brussels, Belgium
Taipei Tzu Chi General Hospital
🇨🇳New Taipei City, Taiwan
University Hospital of Geneva
🇨🇭Geneva, Switzerland
Canton Hospital Winterthur
🇨🇭Winterthur, Switzerland
Instituto de Pesquisas Clinicas para Estudos Multicentricos Hospital Geral de Caxias do Sul, Universidade de Caxias do Sul (IPCEM)
🇧🇷Caxias do Sul, Rio Grande Do Sul, Brazil
Ensino E Terapia de Inovação Clínica Assistência Multidiciplinar Em Oncologia Ética
🇧🇷Salvador, Bahia, Brazil
Hospital Sao Lucas da PUCRS
🇧🇷Porto Alegre, Rio Grande Do Sul, Brazil
Ege University
🇹🇷Bornova, Izmir, Turkey
Shaare Zedek Medical Center
🇮🇱Jerusalem, Israel
Sjaelland University Hospital
🇩🇰Naestved, Denmark
CHUM Notre Dame Hospital
🇨🇦Montreal, Quebec, Canada
Masaryk Memorial Cancer Institute
🇨🇿Brno, Czechia
Center Jean Perrin
🇫🇷Clermont-Ferrand, France
Saint-Louis Hospital
🇫🇷Paris, France
St. Jude Heritage Medical Group
🇺🇸Fullerton, California, United States
University Hospital Saint-Luc
🇧🇪Brussels, Belgium
University of California San Diego Moores Cancer Center
🇺🇸La Jolla, California, United States
Emad Ibrahim, MD
🇺🇸Redlands, California, United States
Breastlink Medical Group, Inc.
🇺🇸Santa Ana, California, United States
Royal Victoria Regional Health Centre
🇨🇦Barrie, Ontario, Canada
Compassionate Cancer Care Medical Group
🇺🇸Riverside, California, United States
Antwerp University Hospital
🇧🇪Edegem, Belgium
Sibley Memorial Hospital
🇺🇸Washington, District of Columbia, United States
Hillman Cancer Center
🇺🇸Pittsburgh, Pennsylvania, United States
Emory University Hospital Midtown
🇺🇸Atlanta, Georgia, United States
Leuven University Hospitals
🇧🇪Leuven, Belgium
St. Michael's Hospital
🇨🇦Toronto, Ontario, Canada
AZ Damiaan General Hospital, Sint-Jozef Oncology Center
🇧🇪Ostend, Belgium
Saint-Augustinus Hospital
🇧🇪Wilrijk, Belgium
Emory Clinic
🇺🇸Atlanta, Georgia, United States
Queen's Medical Center
🇺🇸Honolulu, Hawaii, United States
West Clinic PC
🇺🇸Memphis, Tennessee, United States
University of Texas Southwestern Medical Center at Dallas
🇺🇸Dallas, Texas, United States
Straub Clinic and Hospital
🇺🇸Honolulu, Hawaii, United States
Primary Health Oncology
🇺🇸Hobart, Indiana, United States
University of Hawaii Cancer Center
🇺🇸Honolulu, Hawaii, United States
North Shore Oncology-Hematology Associates, Ltd.
🇺🇸Libertyville, Illinois, United States
Resurrection Medical Group
🇺🇸Chicago, Illinois, United States
North Shore Hematology Oncology
🇺🇸Highland Park, Illinois, United States
St. Elizabeth Maternity Clinic
🇧🇪Namur, Belgium
Tom Baker Cancer Centre
🇨🇦Calgary, Alberta, Canada
Toronto East General Hospital
🇨🇦Toronto, Ontario, Canada
Núcleo de Oncologia da Bahia - NOB
🇧🇷Salvador, Bahia, Brazil
The Tweed Hospital
🇦🇺Tweed Heads, New South Wales, Australia
Sunnybrook Health Sciences Center, Odette Cancer Center
🇨🇦Toronto, Ontario, Canada
The Cancer Institute at University of Maryland St. Joseph Medical Center
🇺🇸Towson, Maryland, United States
Bankstown-Lidcombe Hospital
🇦🇺Bankstown, Australia
St. George Hospital
🇦🇺Kogarah, Australia
Liga Paranaense de Combate ao Cancer, Hospital Erasto Gaertner
🇧🇷Curitiba, Parana, Brazil
Karmanos Cancer Institute
🇺🇸Detroit, Michigan, United States
Washington University in St. Louis
🇺🇸Saint Louis, Missouri, United States
UCLA Hematology Oncology
🇺🇸Santa Monica, California, United States
Clinical Research Alliance, Inc.
🇺🇸New York, New York, United States
Ironwood Cancer and Research Centers
🇺🇸Scottsdale, Arizona, United States
CBCC Global Research, Inc. at Comprehensive Blood and Caner Center
🇺🇸Bakersfield, California, United States
Montreal General Hospital
🇨🇦Montreal, Quebec, Canada
University Hospital Motol, Comprehensive Oncology Center
🇨🇿Prague, Czechia
Practice for Oncology Bielefeld
🇩🇪Bielefeld, Germany
University Hospital Cologne, Breast Center, Clinic of Obstetrics and Gynecology
🇩🇪Cologne, Germany
Queen Mary Hospital, Department of Oncology
🇭🇰Hong Kong, Hong Kong
Soroka Medical Center
🇮🇱Beersheba, Israel
Hadassah Medical Center
🇮🇱Jerusalem, Israel
University Hospital Schleswig-Holstein
🇩🇪Kiel, Germany
Queen Mary Hospital, Department of Surgery
🇭🇰Hong Kong, Hong Kong
St. Vincent's University Hospital
🇮🇪Dublin, Ireland
Sourasky Medical Center, Department of Oncology
🇮🇱Tel-Aviv, Israel
Kaplan Medical Center, Department of Oncology
🇮🇱Rehovot, Israel
National Cancer Institute Regina Elena
🇮🇹Rome, Italy
IRCCS - Hospital San Raffaele, Department of Medical Oncology
🇮🇹Milan, Italy
European Institute of Oncology
🇮🇹Milan, Italy
Azienda Ospedaliera Regionale San Carlo
🇮🇹Potenza, Italy
Hospital Bianchi Melacrino Morelli
🇮🇹Reggio Calabria, Italy
Hospital Infermi Rimini, Unit of Oncology
🇮🇹Rimini, Italy
Chiba University Hospital
🇯🇵Chiba-shi, Chiba, Japan
Kobe City Medical Center General Hospital
🇯🇵Kobe-City, Hyôgo, Japan
Iwate Medical University Hospital
🇯🇵Morioka, Iwate, Japan
Hospital Universitario Vall d'Hebron
🇪🇸Barcelona, Spain
Johns Hopkins Singapore International Medical Center
🇸🇬Singapore, Singapore
Complejo Hospitalario Universitario Insular-Materno Infantil
🇪🇸Las Palmas de Gran Canaria, Spain
Uppsala University Hospital, Department of Oncology
🇸🇪Uppsala, Sweden
Hospital Engeried
🇨🇭Bern, Switzerland
Hospital Universitario Virgen Macarena
🇪🇸Sevilla, Spain
Raffles Hospital
🇸🇬Singapore, Singapore
Icon Singapore Oncology Consultants Farrer Park Medical Clinic
🇸🇬Singapore, Singapore
National Cheng Kung University Hospital
🇨🇳Tainan, Province Of China, Taiwan
Tambov Regional Oncological Center
🇷🇺Tambov, Russian Federation
National University Hospital
🇸🇬Singapore, Singapore
Hakuaikai Medical Corporation Sagara Hospital
🇯🇵Kagoshima-city, Japan
Toramonon Hospital
🇯🇵Tokyo, Japan
Chi Mei Medical Center - YK Branch
🇨🇳Tainan, Province Of China, Taiwan
Chi Mei Medical Center - LiouYing Branch
🇨🇳Tainan, Province Of China, Taiwan
Mackay Memorial Hospital
🇨🇳Taipei, Province Of China, Taiwan
National Taiwan University Hospital
🇨🇳Taipei, Taiwan
Calderdale Royal Hospital, Macmillan Unit
🇬🇧Halifax, United Kingdom
Huddersfield Royal Infirmary
🇬🇧Huddersfield, United Kingdom
Nottingham City Hospital Campus, Department of Oncology
🇬🇧Nottingham, United Kingdom
Siteman Cancer Center - West County
🇺🇸Saint Louis, Missouri, United States
Centro Oncologico MD Anderson
🇪🇸Madrid, Spain
OnCare Hawaii
🇺🇸Honolulu, Hawaii, United States
Compassionate Cancer Care Medical Group Inc.
🇺🇸Fountain Valley, California, United States
Marin Cancer Care, Inc.
🇺🇸Greenbrae, California, United States
UCLA Hematology/Oncology
🇺🇸Westlake Village, California, United States
Cancer Center of Santa Barbara
🇺🇸Solvang, California, United States
Central Coast Medical Oncology
🇺🇸Santa Maria, California, United States
Broward Medical Oncology Office
🇺🇸Plantation, Florida, United States
Florida Cancer Research Institute
🇺🇸Plantation, Florida, United States
UCLA Healthcare Santa Clarita Oncology
🇺🇸Valencia, California, United States
Emory University Winship Cancer Institute
🇺🇸Atlanta, Georgia, United States
St. Mary Medical Center
🇺🇸Hobart, Indiana, United States
Orchard Healthcare Research Inc
🇺🇸Skokie, Illinois, United States
Community Hospital
🇺🇸Munster, Indiana, United States
Sidney Kimmel Comprehensive Cancer Center at John Hopkins at Greenspring Station
🇺🇸Lutherville, Maryland, United States
Siteman Cancer Center - South County
🇺🇸Saint Louis, Missouri, United States
Cancer Institute of New Jersey
🇺🇸New Brunswick, New Jersey, United States
Clinical Research Alliance
🇺🇸Lake Success, New York, United States
Weill Cornell Medical College
🇺🇸New York, New York, United States
Cleveland Clinic Taussig Cancer Center
🇺🇸Cleveland, Ohio, United States
University Hospitals Case Medical Center
🇺🇸Orange Village, Ohio, United States
University of Texas Southwestern Medical Center
🇺🇸Dallas, Texas, United States
Fundación Investigar
🇦🇷Buenos Aires, Ciudad Autónoma De BuenosAires, Argentina
COIBA Centro de Oncología e Investigación Buenos Aires
🇦🇷Berazategui, Buenos Aires, Argentina
Sunshine Coast University Hospital
🇦🇺Birtinya, Queensland, Australia
Sydney Adventist Hospital
🇦🇺Wahroonga, Australia
Maroondah Hospital, Maroondah Breast Clinic
🇦🇺Melbourne, Australia
University Hospital Innsbruck - Tyrolean Hospital, Department of Gynecology
🇦🇹Innsbruck, Austria
Our Dear Lady Hospital, Aalst Campus
🇧🇪Aalst, Belgium
Clinic Saint-Joseph
🇧🇪Liege, Belgium
Hospital Araújo Jorge, Associação de Combate ao Câncer em Goiás
🇧🇷Goiânia, Goiás, Brazil
Hospital Do Cancer A C Camargo - Hospital
🇧🇷São Paulo, Brazil
Instituto Ribeiraopretano de Combate Ao Cancer - Clinic/Outpatient Facility
🇧🇷Ribeirao Preto, Sao Paulo, Brazil
Instituto Joinvillense de Hematologia e Oncologia
🇧🇷Joinville, Santa Catarina, Brazil
Instituto Brasileiro de Controle Do Câncer IBCC
🇧🇷São Paulo, Brazil
Fundação Faculdade Regional de Medicina de São José do Rio Preto, Hospital de Base
🇧🇷São José Do Rio Preto, São Paulo, Brazil
Abbotsford Regional Hospital and Cancer Care Centre
🇨🇦Abbotsford, British Columbia, Canada
Fraser Health Authority
🇨🇦Surrey, British Columbia, Canada
Ottawa Hospital, Cancer Center
🇨🇦Ottawa, Ontario, Canada
Grand River Hospital
🇨🇦Kitchener, Ontario, Canada
Centre hospitalier affilié universitaire de Québec - Hôpital du Saint-Sacrement
🇨🇦Québec City, Quebec, Canada
Hospital Novy Jicin
🇨🇿Novy Jicin, Czechia
South Lyon Hospital Center, Department of Clinical Hematology and Medical Oncology
🇫🇷Pierre-Benite, Lyon, France
Helsinki University Central Hospital, Department of Oncology
🇫🇮Helsinki, Finland
Clinic Sainte Anne, Center for Radiotherapy
🇫🇷Strasbourg, France
Hematology-Oncology Practice
🇩🇪Augsburg, Germany
Otto von Guericke University of Magdeburg
🇩🇪Magdeburg, Germany
University Hospital Ulm
🇩🇪Ulm, Germany
Onkologie Ravensburg
🇩🇪Ravensburg, Germany
St. Jame's Hospital
🇮🇪Dublin, Ireland
Tuen Mun Hospital
🇭🇰Hong Kong, Hong Kong
Meir Medical Center
🇮🇱Kfar-Saba, Israel
Rabin Medical Center, Belinson Hospital
🇮🇱Petah Tikva, Israel
Chaim Sheba Medical Center
🇮🇱Tel Hashomer, Israel
Hospital Cervesi di Cattolica, Department of Oncology
🇮🇹Cattolica, Italy
Hospital Papa Giovanni XXIII, Department of Medical Oncology
🇮🇹Bergamo, Italy
Ziv Medical Center
🇮🇱Zefat, Israel
Scientific Institute of Romagna of the Study and Treatment of Cancer
🇮🇹Meldola, Italy
University G. D'Annunzio Chieti Pescara
🇮🇹Chieti, Italy
National Cancer Institute - IRCCS "Fondazione G. Pascale"
🇮🇹Naples, Italy
Azienda Ospedaliero San Gerardo
🇮🇹Monza, Italy
Hospital Sacro Cuore Don Calabria, Department of Medical Oncology
🇮🇹Negrar, Italy
Institute of Cancer Research and Treatment
🇮🇹Torino, Italy
Hospital Desio and Vimercate, Department of Medical Oncology
🇮🇹Vimercate, Italy
Kumamoto University Hospital
🇯🇵Kumamoto-shi, Kumamoto, Japan
Saitama Cancer Centre
🇯🇵Kitaadachi-gun, Saitama, Japan
JCHO Kurume General Hospital
🇯🇵Fukuoka, Japan
Gunma University Hospital
🇯🇵Gunma, Japan
University Hospital Campus Bio-Medico
🇮🇹Rome, Italy
Hiroshima City Hospital
🇯🇵Hiroshima, Japan
Osaka International Cancer Institute
🇯🇵Osaka, Japan
National Hospital Organization Hokkaido Cancer Center
🇯🇵Hokkaido, Japan
National Hospital Organization Osaka National Hospital
🇯🇵Ôsaka, Japan
Severance Hospital
🇰🇷Seoul, Korea, Republic of
Centro de Investigação Clinica, Hospital da Luz
🇵🇹Lisboa, Portugal
Maastricht University Medical Centre (MUMC)
🇳🇱Maastricht, Netherlands
National Cancer Center
🇰🇷Gyeonggi-do, Korea, Republic of
Instituto Português de Oncologia do Porto Francisco Gentil, E.P.E.
🇵🇹Porto, Portugal
Asan Medical Center
🇰🇷Seoul, Korea, Republic of
Instituto Portugues de Oncologia de Lisboa Francisco Gentil, EPE
🇵🇹Lisbon, Portugal
Federal State Government-Financed Institution: City Clinical Hospital #40
🇷🇺Moscow, Moskva, Russian Federation
Russian Oncological Research Center n.a. N.N. Blokhin Russian Academy of Medical Sciences
🇷🇺Moscow, Russian Federation
National Cancer Centre Singapore, Department of Medical Oncology
🇸🇬Singapore, Singapore
Parkway Cancer Centre
🇸🇬Singapore, Singapore
Consorcio Hospitalario Provincial de Castellon
🇪🇸Castellon de la Plana, Spain
Gleneagles Medical Centre, Center for Medical Oncology
🇸🇬Singapore, Singapore
University Hospital 12 de Octubre, Servicio de Oncologia - Edificio Maternidad, 2ª planta
🇪🇸Madrid, Spain
Hospital Universitario Virgen de la Arrixaca, Servicio de Oncologia
🇪🇸Murcia, Spain
Centro Integral Oncologico Clara Campal
🇪🇸Madrid, Spain
University Hospital Quiron Madrid, Department of Oncology
🇪🇸Madrid, Spain
Hospital Universitario Son Espases
🇪🇸Palma de Mallorca, Spain
Hospital Son Llatzer, Servicio de Oncologia
🇪🇸Palma de Mallorca, Spain
Hospital Clinico Universitario de Valencia, Servicio de Oncologia
🇪🇸Valencia, Spain
Orebro University Hospital, Department of Oncology
🇸🇪Orebro, Sweden
Kaohsiung Chang Gung Memorial Hospital
🇨🇳Kaohsiung, Province Of China, Taiwan
Onkozentrum Zurich - Kinik im Park
🇨🇭Zurich, Switzerland
Taichung Veterans General Hospital, Breast Center
🇨🇳Taichung, Province Of China, Taiwan
Tri-Service General Hospital
🇨🇳Taipei, Province Of China, Taiwan
Chung-Ho Memorial Hospital
🇨🇳Kaohsiung, Taiwan, Province Of China, Taiwan
Changhua Christian Hospital
🇨🇳Changhua, Taiwan, Province Of China, Taiwan
Kuang Tien General Hospital
🇨🇳Taichung, Taiwan
Taipei Veterans General Hospital
🇨🇳Taipei, Taiwan
Marmara University Faculty of Medicine
🇹🇷Istanbul, Turkey
Colchester General Hospital
🇬🇧Colchester, Essex, United Kingdom
Queen Elizabeth Hospital Birmingham
🇬🇧Birmingham, West Midlands, United Kingdom
Velindre Cancer Centre
🇬🇧Cardiff, United Kingdom
University of California San Diego Medical Center
🇺🇸La Jolla, California, United States
Cancer Care Associates Medical Group, Inc
🇺🇸Redondo Beach, California, United States
North Shore Hematology Oncology Association PC
🇺🇸East Setauket, New York, United States
Rambam Medical Center
🇮🇱Haifa, Israel
Centro Regional Integrado de Oncologia
🇧🇷Fortaleza, Ceara, Brazil
NYU Langone Medical Center
🇺🇸Lake Success, New York, United States
Cancer Center of Santa Barbara Sansum Clinic
🇺🇸Santa Barbara, California, United States
Hershey Medical Center
🇺🇸Hershey, Pennsylvania, United States
Siteman Cancer Center - St. Peters
🇺🇸Saint Peters, Missouri, United States
Box Hill Hospital, Oncology Department
🇦🇺Melbourne, Australia
UPMC Cancer Pavillion
🇺🇸West Mifflin, Pennsylvania, United States
Magee Women's Hospital
🇺🇸Pittsburgh, Pennsylvania, United States
Hospital de Cancer de Barretos - Hospital
🇧🇷Barretos, Sao Paulo, Brazil
Gustave Roussy Oncology Institute, Department of Medicine
🇫🇷Villejuif, France
Hospital Universitari de Girona Dr. Josep Trueta (ICO Girona), Servicio de Oncologia
🇪🇸Girona, Spain
University of Tsukuba Hospital
🇯🇵Tsukuba, Ibaraki, Japan
Tokai University Hospital
🇯🇵Isehara, Kanagawa, Japan
University Hospital Clinic San Carlos, Servicio de Oncologia Medica
🇪🇸Madrid, Spain
University Hospital Virgen del Rocio, Servicio de Oncologia
🇪🇸Sevilla, Spain
Hospital Clinico Universitario Lozano Blesa, Servicio de Oncologia
🇪🇸Zaragoza, Spain
Kaohsiung Veterans General Hospital
🇨🇳Kaohsiung, Taiwan, Province Of China, Taiwan
University Hospitals Cleveland Medical Center
🇺🇸Cleveland, Ohio, United States
British Columbia Cancer Agency
🇨🇦Kelowna, British Columbia, Canada
Buddhist Tzu-Chi General Hospital
🇨🇳Hualien, Taiwan, Province Of China, Taiwan
Primary Healthcare Associates, SC
🇺🇸Harvey, Illinois, United States
Prince of Wales Hospital
🇭🇰Shatin, New Territories, Hong Kong
Queen Elizabeth Hospital, Department of Clinical Oncology
🇭🇰Hong Kong, Hong Kong
Queen Mary Hospital, Department of Clinical Oncology
🇭🇰Hong Kong, Hong Kong