A Study of Tiragolumab in Combination With Atezolizumab Plus Pemetrexed and Carboplatin/Cisplatin Versus Pembrolizumab Plus Pemetrexed and Carboplatin/Cisplatin in Participants With Previously Untreated Advanced Non-Squamous Non-Small Cell Lung Cancer

Phase 2

Active, not recruiting

• Conditions: Non-small Cell Lung Cancer (NSCLC)
• Interventions: Drug: Tiragolumab; Drug: Atezolizumab; Drug: Pemetrexed; Drug: Tiragolumab Matching Placebo; Drug: Carboplatin; Drug: Cisplatin; Drug: Pembrolizumab

• Registration Number: NCT04619797
• Lead Sponsor: Hoffmann-La Roche

Brief Summary

The purpose of this study is to evaluate the efficacy, safety, and pharmacokinetics of tiragolumab in combination with atezolizumab plus pemetrexed and carboplatin/cisplatin (Arm A) compared with placebo in combination with pembrolizumab plus pemetrexed and carboplatin/cisplatin (Arm B) in participants with previously untreated, locally advanced unresectable or metastatic non-squamous non-small cell lung cancer (NSCLC).

Eligible participants will be randomized in a 1:1 ratio to receive one of the following treatment regimens during the induction phase:

* Arm A: Tiragolumab plus atezolizumab plus pemetrexed and carboplatin or cisplatin

* Arm B: Placebo plus pembrolizumab plus pemetrexed and carboplatin or cisplatin

Following the induction phase, participants will continue maintenance therapy with either tiragolumab in combination with atezolizumab and pemetrexed (Arm A) or placebo in combination with pembrolizumab and pemetrexed (Arm B).

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2020-10-30
• Study First Submitted QC: 2020-11-05
• Study First Posted: 2020-11-06
• Study Start: 2020-12-14
• Status Verified: 2024-12
• Last Update Submitted: 2024-12-06
• Last Update Posted: 2024-12-11
• Primary Completion: 2025-12-29
• Study Completion: 2027-05-14

Recruitment & Eligibility

• Status: ACTIVE_NOT_RECRUITING
• Sex: All
• Target Recruitment: 542

Inclusion Criteria

• Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 or 1
• Histologically or cytologically documented locally advanced unresectable or metastatic non-squamous NSCLC that is not eligible for curative surgery and/or definitive chemoradiotherapy
• No prior systemic treatment for metastatic non-squamous NSCLC
• Known tumor programmed death-ligand 1 (PD-L1) status
• Measurable disease, as defined by Response Evaluation Criteria in Solid Tumors, version 1.1 (RECIST v1.1)
• Life expectancy >= 12 weeks
• Adequate hematologic and end-organ function
• Negative human immunodeficiency virus (HIV) test at screening
• Serology test negative for active hepatitis B virus or active hepatitis C virus at screening.

Key

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Exclusion Criteria

• Mutations in epidermal growth factor receptor (EGFR) gene or anaplastic lymphoma kinase (ALK) fusion oncogene
• Pulmonary lymphoepithelioma-like carcinoma subtype of NSCLC
• Symptomatic, untreated, or actively progressing central nervous system (CNS) metastases
• Active or history of autoimmune disease or immune deficiency
• History of idiopathic pulmonary fibrosis, organizing pneumonia, drug-induced pneumonitis, or idiopathic pneumonitis, or evidence of active pneumonitis
• History of malignancy other than NSCLC within 5 years prior to randomization, with the exception of malignancies with a negligible risk of metastasis or death
• Severe infection within 4 weeks prior to initiation of study treatment or any active infection that, in the opinion of the investigator, could impact patient safety
• Treatment with investigational therapy within 28 days prior to initiation of study treatment
• Prior treatment with CD137 agonists or immune checkpoint blockade therapies, including anti-cytotoxic T lymphocyte-associated protein 4, anti-TIGIT, anti-PD-1, and anti-PD-L1 therapeutic antibodies
• Treatment with systemic immunostimulatory agents within 4 weeks or 5 drug-elimination half-lives (whichever is longer) prior to initiation of study treatment
• Treatment with systemic immunosuppressive medication within 2 weeks prior to initiation of study treatment, or anticipation of need for systemic immunosuppressive medication during study treatment
• Known allergy or hypersensitivity or other contraindication to any component of the chemotherapy regimen the participant may receive during the study
• Women who are pregnant, or breastfeeding
• Known targetable c-ROS oncogene 1 (ROS1) or BRAFV600E genomic aberration.

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Tiragolumab+Atezolizumab+Pemetrexed+Carboplatin or Cisplatin	Tiragolumab	Induction treatment with tiragolumab in combination with atezolizumab plus pemetrexed and cisplatin or carboplatin will be administered to participants on Day 1 of each 21-day cycle for 4 cycles. Following the induction phase, participants will continue maintenance therapy with tiragolumab in combination with atezolizumab and pemetrexed on Day 1 of each 21-day cycle.
Placebo+Pembrolizumab+Pemetrexed+Carboplatin or Cisplatin	Tiragolumab Matching Placebo	Induction treatment with placebo in combination with pembrolizumab plus pemetrexed and cisplatin or carboplatin will be administered to participants on Day 1 of each 21-day cycle for 4 cycles. Following the induction phase, participants will continue maintenance therapy with placebo in combination with pembrolizumab and pemetrexed on Day 1 of each 21-day cycle.
Tiragolumab+Atezolizumab+Pemetrexed+Carboplatin or Cisplatin	Atezolizumab	Induction treatment with tiragolumab in combination with atezolizumab plus pemetrexed and cisplatin or carboplatin will be administered to participants on Day 1 of each 21-day cycle for 4 cycles. Following the induction phase, participants will continue maintenance therapy with tiragolumab in combination with atezolizumab and pemetrexed on Day 1 of each 21-day cycle.
Tiragolumab+Atezolizumab+Pemetrexed+Carboplatin or Cisplatin	Pemetrexed	Induction treatment with tiragolumab in combination with atezolizumab plus pemetrexed and cisplatin or carboplatin will be administered to participants on Day 1 of each 21-day cycle for 4 cycles. Following the induction phase, participants will continue maintenance therapy with tiragolumab in combination with atezolizumab and pemetrexed on Day 1 of each 21-day cycle.
Tiragolumab+Atezolizumab+Pemetrexed+Carboplatin or Cisplatin	Carboplatin	Induction treatment with tiragolumab in combination with atezolizumab plus pemetrexed and cisplatin or carboplatin will be administered to participants on Day 1 of each 21-day cycle for 4 cycles. Following the induction phase, participants will continue maintenance therapy with tiragolumab in combination with atezolizumab and pemetrexed on Day 1 of each 21-day cycle.
Tiragolumab+Atezolizumab+Pemetrexed+Carboplatin or Cisplatin	Cisplatin	Induction treatment with tiragolumab in combination with atezolizumab plus pemetrexed and cisplatin or carboplatin will be administered to participants on Day 1 of each 21-day cycle for 4 cycles. Following the induction phase, participants will continue maintenance therapy with tiragolumab in combination with atezolizumab and pemetrexed on Day 1 of each 21-day cycle.
Placebo+Pembrolizumab+Pemetrexed+Carboplatin or Cisplatin	Pemetrexed	Induction treatment with placebo in combination with pembrolizumab plus pemetrexed and cisplatin or carboplatin will be administered to participants on Day 1 of each 21-day cycle for 4 cycles. Following the induction phase, participants will continue maintenance therapy with placebo in combination with pembrolizumab and pemetrexed on Day 1 of each 21-day cycle.
Placebo+Pembrolizumab+Pemetrexed+Carboplatin or Cisplatin	Carboplatin	Induction treatment with placebo in combination with pembrolizumab plus pemetrexed and cisplatin or carboplatin will be administered to participants on Day 1 of each 21-day cycle for 4 cycles. Following the induction phase, participants will continue maintenance therapy with placebo in combination with pembrolizumab and pemetrexed on Day 1 of each 21-day cycle.
Placebo+Pembrolizumab+Pemetrexed+Carboplatin or Cisplatin	Cisplatin	Induction treatment with placebo in combination with pembrolizumab plus pemetrexed and cisplatin or carboplatin will be administered to participants on Day 1 of each 21-day cycle for 4 cycles. Following the induction phase, participants will continue maintenance therapy with placebo in combination with pembrolizumab and pemetrexed on Day 1 of each 21-day cycle.
Placebo+Pembrolizumab+Pemetrexed+Carboplatin or Cisplatin	Pembrolizumab	Induction treatment with placebo in combination with pembrolizumab plus pemetrexed and cisplatin or carboplatin will be administered to participants on Day 1 of each 21-day cycle for 4 cycles. Following the induction phase, participants will continue maintenance therapy with placebo in combination with pembrolizumab and pemetrexed on Day 1 of each 21-day cycle.

Primary Outcome Measures

Name	Time	Method
Investigator-Assessed Progression-Free Survival (PFS) (Phase 2 and Phase 3)	From randomization to the first occurrence of disease progression or death from any cause, whichever occurs first (up to approximately 5 years [Phase 2], up to approximately 7 years [Phase 3])
Investigator-Assessed Confirmed Objective Response Rate (ORR) (Phase 2)	Up to approximately 5 years
Overall Survival (Phase 3)	From randomization to death from any cause (up to approximately 7 years)

Secondary Outcome Measures

Name	Time	Method
Overall Survival (Phase 2)	From randomization to death from any cause (up to approximately 5 years)
TTCD in Participant-Reported Lung Cancer Symptoms for Cough, Dyspnea, and Chest Pain, as Measured by EORTC QLQ-LC13 (Phase 2 and Phase 3)	Up to approximately 5 years (Phase 2); up to approximately 7 years (Phase 3)	TTCD using EORTC Quality-of-Life Questionnaire Lung Cancer Module (QLQ-LC13) is an initial 10-point increase in symptom score from baseline that must be held for at least two consecutive assessments or an initial clinically meaningful decrease above baseline followed by death. EORTC QLQ-LC13 consists of 13 lung cancer specific items and includes 11 disease-specific scales/items (dyspnea, coughing, hemoptysis, sore mouth, dysphagia, peripheral neuropathy, alopecia, pain in chest, pain in arm or shoulder, pain in other parts, pain medication). Each item is scored on a 4-point scale of 1=Not at all to 4=Very much. Scores will be linearly transformed to a score range of 0 to 100. Higher score indicates worsening of symptoms.
PFS as Determined by an Independent Review Facility (IRF) (Phase 3)	From randomization to the first occurrence of disease progression or death from any cause, whichever occurs first (up to approximately 7 years)
Investigator-assessed PFS in Participants With PD-L1 Expression at TC ≥50% and TC ≥1% Cut-off, as Determined by Central Testing With Ventana PD-L1 (SP263) Assay (Phase 3)	From randomization to the first occurrence of disease progression or death from any cause, whichever occurs first (up to approximately 7 years)
OS in Participants With PD-L1 Expression at TC ≥50% and TC ≥1% Cut-off, as Determined by Central Testing With Ventana PD-L1 (SP263) Assay (Phase 3)	From randomization to death from any cause (up to approximately 7 years)
Investigator-Assessed PFS at 6 Months and 12 Months (Phase 3)	6 months, 12 months
Serum Concentration of Tiragolumab (Phase 2 and Phase 3)	Cycle 1 (each cycle=21 days), Day 1: predose, 0.5 hour (h) postdose; Cycles 2, 3, 4, 8, 12, 16, Day 1: predose and at treatment discontinuation (TD) visit (up to approximately 5 years [Phase 2]; up to approximately 7 years [Phase 3])
OS Rate at 12 Months and 24 Months (Phase 3)	12 months, 24 months
Investigator-Assessed Confirmed ORR (Phase 3)	Up to approximately 7 years
Investigator-Assessed Duration of Response (DOR) (Phase 2 and Phase 3)	From first occurrence of a documented confirmed objective response to the first occurrence of disease progression or death from any cause, whichever occurs first (up to approximately 5 years [Phase 2]; up to approximately 7 years [Phase 3])
Percentage of Participants With Adverse Events (AEs) (Phase 2 and Phase 3)	Up to approximately 5 years (Phase 2); up to approximately 7 years (Phase 3)
Participants' Response to Side Effects of Treatment as Assessed by EORTC IL46 (Phase 2 and Phase 3)	Up to approximately 5 years (Phase 2); up to approximately 7 years (Phase 3)	EORTC Item List 46 (IL46) is a validated single-item question that assesses overall side effect impact. Each item is scored on a 4-point scale of 1=Not at all to 4=Very much. Scores will be linearly transformed to a score range of 0 to 100. Higher score indicates a worse outcome.
Serum Concentration of Atezolizumab (Phase 2 and Phase 3)	Cycle 1 (each cycle=21 days), Day 1: predose, 0.5 hour (h) postdose; Cycles 2, 3, 4, 8, 12, 16, Day 1: predose and at TD visit (up to approximately 5 years [Phase 2]; up to approximately 7 years [Phase 3])
Time to Confirmed Deterioration (TTCD) in Participant-Reported Physical Functioning and Global Health Status (GHS)/Quality of Life (QoL) as Measured by European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 (Phase 2 and Phase 3)	Up to approximately 5 years (Phase 2); up to approximately 7 years (Phase 3)	TTCD using EORTC Quality-of-Life Questionnaire Core 30 (QLQ-C30) is an initial 10-point decrease in GHS and physical functioning from baseline that must be held for at least two consecutive assessments or an initial clinically meaningful decrease above baseline followed by death. EORTC QLQ-C30: a self-reported measure, consisting of 30 questions that assess 5 aspects of participants functioning (physical, emotional, role, cognitive and social), 3 symptom scales (fatigue, nausea/vomiting and pain), GHS and QoL, and 6 single items (dyspnea, insomnia, appetite loss, constipation, diarrhea and financial difficulties) with a recall period of the previous week. Functioning items are scored on a 4-point scale: 1=Not at all to 4=Very much, with higher score indicating worse outcome. Symptom items (GHS and QoL) are scored on a 7-point scale: 1=Very poor to 7=Excellent. Scores will be linearly transformed with a minimum score of 0 and maximum score of 100. Higher score indicates better outcome.
Percentage of Participants With Anti-Drug Antibodies (ADAs) to Tiragolumab (Phase 2 and Phase 3)	Predose on Day 1 of Cycles (each cycle=21 days) 1, 2, 3, 4, 8, 12, 16 and at TD visit (up to approximately 5 years [Phase 2]; up to approximately 7 years [Phase 3])
Percentage of Participants With ADAs to Atezolizumab (Phase 2 and Phase 3)	Predose on Day 1 of Cycles (each cycle=21 days) 1, 2, 3, 4, 8, 12, 16 and at TD visit (up to approximately 5 years [Phase 2]; up to approximately 7 years [Phase 3])

Trial Locations

Locations (140)

Vitaz; 🇧🇪 Sint Niklaas, Belgium

CHU Strasbourg - Nouvel Hopital Civil; 🇫🇷 Strasbourg, France

The Cancer Institute Hospital of JFCR; 🇯🇵 Tokyo, Japan

Hospital Clinic Barcelona; Servicio de oncologia; 🇪🇸 Barcelona, Spain

Hospital Lucus Augusti; Servicio de Oncologia; 🇪🇸 Lugo, Spain

The First Affiliated Hospital of Zhengzhou University; 🇨🇳 Zhengzhou, China

Rigshospitalet; Onkologisk Klinik; 🇩🇰 København Ø, Denmark

Odense Universitetshospital, Onkologisk Afdeling R; 🇩🇰 Odense C, Denmark

Royal Cornwall Hospital; Dept of Clinical Oncology; 🇬🇧 Cornwall, United Kingdom

Castle Hill Hospital; The Queen's Centre for Oncology & Haematology; 🇬🇧 Hull, United Kingdom

Barts & London School of Med; Medical Oncology; 🇬🇧 London, United Kingdom

Guy'S Hospital; Oncology Unit; 🇬🇧 London, United Kingdom

Nottingham City Hospital; 🇬🇧 Nottingham, United Kingdom

Sarah Cannon Research Institute / Tennessee Oncology; 🇺🇸 Nashville, Tennessee, United States

Cliniques Universitaires St-Luc; 🇧🇪 Bruxelles, Belgium

CHU UCL Mont-Godinne; 🇧🇪 Mont-godinne, Belgium

UCLA; 🇺🇸 Los Angeles, California, United States

Torrance Memorial Physician Network/Cancer Care; 🇺🇸 Torrance, California, United States

PIH Health Whittier Hospital; NC; 🇺🇸 Whittier, California, United States

SCRI Florida Cancer Specialists South; 🇺🇸 Fort Myers, Florida, United States

Advent Health Orlando; 🇺🇸 Orlando, Florida, United States

SCRI Florida Cancer Specialists North; Research Office North Region.; 🇺🇸 Saint Petersburg, Florida, United States

Northwest Georgia Oncology Centers PC - Marietta; 🇺🇸 Marietta, Georgia, United States

Fort Wayne Medical Oncology and Hematology, Inc; 🇺🇸 Fort Wayne, Indiana, United States

Cancer Center of Kansas; 🇺🇸 Wichita, Kansas, United States

Baptist Health Lexington; 🇺🇸 Lexington, Kentucky, United States

Memorial Sloan Kettering Cancer Center; 🇺🇸 New York, New York, United States

Tennessee Oncology Chattanooga; 🇺🇸 Chattanooga, Tennessee, United States

Inova Schar Cancer Institute; Inova Schar Cancer Institute Infusion Pharmacy; 🇺🇸 Fairfax, Virginia, United States

Onze Lieve Vrouwziekenhuis Aalst; 🇧🇪 Aalst, Belgium

Crio - Centro Regional Integrado de Oncologia; 🇧🇷 Fortaleza, CE, Brazil

Oncosite - Centro de Pesquisa Clinica Em Oncologia Ltda; 🇧🇷 Ijui, RS, Brazil

Hospital das Clinicas - UFRGS; 🇧🇷 Porto Alegre, RS, Brazil

Hospital Nossa Senhora da Conceicao; 🇧🇷 Porto Alegre, RS, Brazil

Hospital de Cancer de Barretos; 🇧🇷 Barretos, SP, Brazil

Cross Cancer Institute; 🇨🇦 Edmonton, Alberta, Canada

Royal Victoria Regional Health Centre; 🇨🇦 Barrie, Ontario, Canada

Lakeridge Health Oshawa; 🇨🇦 Oshawa, Ontario, Canada

Sault Area Hospital; Algoma District Cancer Program; 🇨🇦 Sault Ste. Marie, Ontario, Canada

Universite de Montreal - Hopital Maisonneuve-Rosemont; 🇨🇦 Montreal, Quebec, Canada

Beijing Cancer Hospital; 🇨🇳 Beijing, China

Jilin Cancer Hospital; 🇨🇳 Changchun, China

Xiangya Hospital Central South University; 🇨🇳 Changsha City, China

Changzhou First People's Hospital; Oncology; 🇨🇳 Changzhou, China

Affiliated Hospital of Chengde Medical University; 🇨🇳 Chengde City, China

Sichuan Cancer Hospital; 🇨🇳 Chengdu City, China

West China Hospital - Sichuan University; 🇨🇳 Chengdu City, China

Dongguan People's Hospital; 🇨🇳 Dongguan, China

Anhui Provincial Hospital; Respiratory Department; 🇨🇳 Hefei, China

Jinan Central Hospital; 🇨🇳 Jinan City, China

Linyishi Cancer Hospital; 🇨🇳 Linyi City, China

Pingxiang People Hospital; 🇨🇳 Pingxiang City, China

Qingdao Central Hospital; Department of Respiratory and Critical Care Medicine; 🇨🇳 Qingdao City, China

Weifang People's Hospital; 🇨🇳 Weifang City, China

Hubei Cancer Hospital; 🇨🇳 Wuhan, China

The First Affiliated Hospital of Xian Jiao Tong University; 🇨🇳 Xi'an City, China

The First Affiliated Hospital of Xinxiang Medical University; 🇨🇳 Xinxiang City, China

Sjællands Universitetshospital, Roskilde; Klinisk Onkologisk Afdeling og Palliativ Enhed; 🇩🇰 Roskilde, Denmark

Institut Bergonie; Pneumology; 🇫🇷 Bordeaux, France

Hopital Nord; Pneumologie; 🇫🇷 Marseille cedex 20, France

Hopital de Pontchaillou; Service de Pneumologie; 🇫🇷 Rennes, France

CHU de Toulouse - Hôpital Larrey; Service de pneumologie et oncologie pneumologique; 🇫🇷 Toulouse cedex 9, France

Helios Klinikum Emil von Behring GmbH; 🇩🇪 Berlin, Germany

Klinikum Chemnitz gGmbH; 🇩🇪 Chemnitz, Germany

St. Vincentius Kliniken Karlsruhe; 🇩🇪 Karlsruhe, Germany

Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Medizinische Klinik, Pneumologie; 🇩🇪 Mainz, Germany

Klinikum der Philipps-Universität Marburg; 🇩🇪 Marburg, Germany

Azienda Ospedaliero-Universitaria S.Orsola-Malpighi; Unità Operativa Oncologia Medica; 🇮🇹 Bologna, Emilia-Romagna, Italy

Centro Di Riferimento Oncologico; Struttura Operativa Complessa Di Oncologia Medica B; 🇮🇹 Aviano, Friuli-Venezia Giulia, Italy

A.O. Villa Scassi; Oncologia Medica; 🇮🇹 Genova, Liguria, Italy

Asst Papa Giovanni XXIII; Oncologia Medica; 🇮🇹 Bergamo, Lombardia, Italy

ASST Spedali Civili di Brescia; 🇮🇹 Brescia, Lombardia, Italy

Azienda Ospedaliero-Universitaria Careggi;S.C. Oncologia Medica 1; 🇮🇹 Firenze, Toscana, Italy

Kyushu University Hospital; 🇯🇵 Fukuoka, Japan

Kurume University Hospital; 🇯🇵 Fukuoka, Japan

Hiroshima University Hospital; 🇯🇵 Hiroshima, Japan

Takarazuka City Hospital; 🇯🇵 Hyogo, Japan

University Hospital Kyoto Prefectural University of Medicine; 🇯🇵 Kyoto, Japan

Sendai Kousei Hospital; 🇯🇵 Miyagi, Japan

Osaka International Cancer Institute; 🇯🇵 Osaka, Japan

Kansai Medical University Hospital; 🇯🇵 Osaka, Japan

Kindai University Hospital; 🇯🇵 Osaka, Japan

NHO Kinki Chuo Chest Medical Center; 🇯🇵 Osaka, Japan

Saitama Cancer Center; 🇯🇵 Saitama, Japan

Tokyo Medical University Hachioji Medical Center; 🇯🇵 Tokyo, Japan

Wakayama Medical University Hospital; 🇯🇵 Wakayama, Japan

Kosin University Gospel Hospital; 🇰🇷 Busan, Korea, Republic of

Kyungpook National University Chilgok Hospital; 🇰🇷 Daegu, Korea, Republic of

Chungnam National University Hospital; 🇰🇷 Daejeon, Korea, Republic of

St. Vincent's Hospital; 🇰🇷 Gyeonggi-do, Korea, Republic of

Samsung Changwon Hospital; 🇰🇷 Gyeongsangnam-do, Korea, Republic of

Seoul National University Hospital; 🇰🇷 Seoul, Korea, Republic of

Kangbuk Samsung Hospital; 🇰🇷 Seoul, Korea, Republic of

Severance Hospital, Yonsei University Health System; 🇰🇷 Seoul, Korea, Republic of

Asan Medical Center; 🇰🇷 Seoul, Korea, Republic of

Seoul St Mary's Hospital; 🇰🇷 Seoul, Korea, Republic of

Health Pharma Professional Research; 🇲🇽 Cdmx, Mexico CITY (federal District), Mexico

Cuidados oncologicos; 🇲🇽 Querétaro, Queretaro, Mexico

Oncologico Potosino; 🇲🇽 San Luis Potosí, SAN LUIS Potosi, Mexico

ARKE Estudios Clínicos S.A. de C.V.; 🇲🇽 Ciudad de México, Mexico

Auckland City Hospital, Cancer and Blood Research; 🇳🇿 Auckland, New Zealand

Waikato Hospital - Cancer and Blood Research Trials Unit; Regional Cancer Centre; 🇳🇿 Hamilton, New Zealand

Palmerston North Hospital; 🇳🇿 Palmerston North, New Zealand

Tauranga Hospital, Clinical Trials Unit; BOP Clinical School; 🇳🇿 Tauranga, New Zealand

Centrum Terapii Wspolczesnej J.M.Jasnorzewska Spolka Komandytowo-Akcyjna; 🇵🇱 ?ód?, Poland

Warminsko-Mazurskie Centrum Chorób P?uc w Olsztynie; Oddzial onkologii z pododdzialem chemioterapii; 🇵🇱 Olsztyn, Poland

ICO L'Hospitalet; Servicio de oncologia medica; 🇪🇸 L'Hospitalet de Llobregat, Barcelona, Spain

Hospital Son Llatzer; Servicio de Oncologia; 🇪🇸 Palma de Mallorca, Islas Baleares, Spain

Complejo Hospitalario Universitario A Coruña (CHUAC); Servicio de Oncologia; 🇪🇸 A Coruña, LA Coruña, Spain

Complejo Hospitalario Universitario Insular?Materno Infantil; Servicio de Oncologia; 🇪🇸 Las Palmas de Gran Canaria, LAS Palmas, Spain

Hospital del Mar; Servicio de Oncologia; 🇪🇸 Barcelona, Spain

Hospital General Universitario Gregorio Marañon; Servicio de Oncologia; 🇪🇸 Madrid, Spain

Hospital Universitario La Paz; Servicio de Oncologia; 🇪🇸 Madrid, Spain

Hospital Univ. Nuestra Señora de Valme; Servicio de Oncologia; 🇪🇸 Sevilla, Spain

Hospital Clinico Universitario de Valencia; Servicio de Onco-hematologia; 🇪🇸 Valencia, Spain

Kantonsspital Aarau; 🇨🇭 Aarau, Switzerland

Kantonsspital Graubünden Medizin Onkologie; Onkologie und Hämatologie; 🇨🇭 Chur, Switzerland

UniversitätsSpital Zürich; Zentrum für Hämatologie und Onkologie, Klinik für Onkologie; 🇨🇭 Zürich, Switzerland

Changhua Christian Hospital; 🇨🇳 Chang Hua, Taiwan

China Medical University Hospital; 🇨🇳 Taichung, Taiwan

Taipei Veterans General Hospital; 🇨🇳 Taipei City, Taiwan

Vajira Hospital; 🇹🇭 Bangkok, Thailand

Chulalongkorn Hospital; Medical Oncology; 🇹🇭 Bangkok, Thailand

Pramongkutklao Hospital; Medicine - Medical Oncology Unit; 🇹🇭 Bangkok, Thailand

Faculty of Med. Siriraj Hosp.; Med.-Div. of Med. Oncology; 🇹🇭 Bangkok, Thailand

Maharaj Nakorn Chiang Mai Hospital; Department of Medicine; 🇹🇭 ChiangMai, Thailand

Songklanagarind Hospital; Department of Internal Medicine, Division of Respiratory; 🇹🇭 Songkhla, Thailand

Adana Baskent University Medical Faculty; Oncology; 🇹🇷 Adana, Turkey

Ankara Bilkent City Hospital; 🇹🇷 Ankara, Turkey

Liv Hospital Ankara; Medical Oncology; 🇹🇷 Ankara, Turkey

Dicle University Faculty of Medicine; 🇹🇷 Diyarbakir, Turkey

Trakya University Medical Faculty; 🇹🇷 Edirne, Turkey

Istanbul University Cerrahpasa Medical Faculty; 🇹🇷 Istanbul, Turkey

Medeniyet University Goztepe Training and Research Hospital.; 🇹🇷 Kadiköy, Turkey

New Cross Hospital; 🇬🇧 Wolverhampton, United Kingdom

Queen Mary Hospital; Dept. of Clinical Oncology; 🇭🇰 Hong Kong, Hong Kong

Queen Mary Hospital; Medicine & Respiratory; 🇭🇰 Hong Kong, Hong Kong

Prince of Wales Hospital; Department of Clinical Onocology; 🇭🇰 Shatin, Hong Kong

Tuen Mun Hospital; Clinical Onc; 🇭🇰 Hong Kong, Hong Kong

Hong Kong United Oncology Centre; 🇭🇰 Hong Kong, Hong Kong