Study of DS-1062a Versus Docetaxel in Previously Treated Advanced or Metastatic Non-small Cell Lung Cancer With or Without Actionable Genomic Alterations (TROPION-LUNG01)
- Conditions
- Non-small Cell Lung Cancer
- Interventions
- Registration Number
- NCT04656652
- Lead Sponsor
- Daiichi Sankyo
- Brief Summary
This study will evaluate the efficacy, safety, and pharmacokinetics of DS-1062a versus docetaxel in participants with previously treated advanced or metastatic non-small cell lung cancer (NSCLC) with or without actionable genomic alterations.
- Detailed Description
This study will evaluate DS-1062a 6.0 mg/kg vs docetaxel 75 mg/m\^2 in participants with advanced or metastatic NSCLC with or without actionable genomic alterations (AGAs). Participants without actionable genomic alterations must have been previously treated with platinum-based chemotherapy and α (anti)-programmed cell death 1 (PD-1)/α-programmed cell death ligand 1 (PD-L1) monoclonal antibody, either in combination or sequentially. Participants with AGA must have progressed on or after 1 platinum-containing therapy and 1 to 2 prior lines of approved targeted therapy for the applicable genomic alteration. The study will be divided into 3 periods: Screening Period, Treatment Period, and Follow-up Period.
Recruitment & Eligibility
- Status
- ACTIVE_NOT_RECRUITING
- Sex
- All
- Target Recruitment
- 590
Participants eligible for inclusion in the study must meet all inclusion criteria within 28 days of randomization into the study.
-
Sign and date the inform consent form (ICF) prior to the start of any study specific qualification procedures.
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Adults ≥18 years (if the legal age of consent is >18 years old, then follow local regulatory requirements)
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Life expectancy ≥3 months
-
Has pathologically documented Stage IIIB, IIIC, or stage IV NSCLC disease with or without actionable genomic alterations (AGA) at the time of randomization (based on the American Joint Committee on Cancer, Eighth Edition) and meets following criteria for NSCLC:
-
Participants without AGA:
- Must have documented negative test results for epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK).
- Must have no known genomic alterations in ROS proto-oncogene 1 (ROS1), neurotrophic tyrosine receptor kinase (NTRK), proto oncogene B-raf (BRAF), mesenchymal-epithelial transition (MET) exon 14 skipping, or rearranged during transfection (RET).
-
Participants with AGA must have one or more documented actionable genomic alteration(s): EGFR, ALK, ROS1, NTRK, BRAF, MET exon 14 skipping, or RET.
-
Has documentation of radiographic disease progression while on or after receiving the most recent treatment regimen for advanced or metastatic NSCLC.
-
Participant without AGA must meet 1 of the following prior therapy requirements for advanced or metastatic NSCLC:
-
Received platinum-based chemotherapy in combination with α-PD-1/α-PD-L1 monoclonal antibody as the only prior line of therapy.
- Includes participants who received prior platinum-based/chemotherapy with or without radiotherapy with maintenance α-PD-1/α-PD-L1 monoclonal antibody for Stage III disease and relapsed/progressed within 6 months from the last dose of platinum-based chemotherapy.
- Includes participants who received prior platinum-based/chemotherapy with or without radiotherapy (with or without maintenance α-PD-1/α-PD-L1 monoclonal antibody) for Stage III disease and subsequently received α-PD-1/α-PD-L1 monoclonal antibody therapy (with or without platinum-based chemotherapy) for recurrent disease.
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Received platinum-based chemotherapy and α-PD-1/α-PD-L1 monoclonal antibody (in either order) sequentially as the only 2 prior lines of therapy.
-
-
Participants with AGA must meet the following for advanced or metastatic NSCLC:
-
Participants who have been treated with 1 or 2 prior lines of applicable targeted therapy that is locally approved for the participant's genomic alteration at the time of screening;
- Participants who have tumors with EGFR L858R or exon 19 deletion mutations must have received prior Osimertinib.
- Those who received a targeted agent as adjuvant therapy for early-stage disease must have relapsed or progressed while on the treatment or within 6 months of the last dose OR received at least one additional course of targeted therapy for the same genomic alteration (which may or may not be same agent used in the adjuvant setting) for relapsed/progressive disease.
- Participants who have been treated with a prior TKI must receive additional approved targeted therapy, if locally available and clinically appropriate, for the applicable genomic alteration, or the participant will not be allowed in the study.
-
Participants who have received platinum-based chemotherapy as the only prior line of cytotoxic therapy:
- One platinum-containing regimen for advanced disease
- Those who received a platinum-containing regimen as adjuvant therapy for early-stage disease must have relapsed or progressed while on the treatment or within 6 months of the last dose OR received at least one additional course of platinum-containing therapy (which may or may not be same as in the adjuvant setting) for relapsed/progressive disease.
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May have received up to one α-PD-1/α-PD-L1 monoclonal antibody alone or in combination with a cytotoxic agent.
-
-
Must undergo a pre-treatment tumor biopsy procedure or if available, tumor tissue previously retrieved from a biopsy procedure performed within 2 years prior to the participant signing informed consent and that has a minimum of 10 × 4 micron sections or a tissue block equivalent of 10 × 4 micron sections may be substituted for the pre-treatment biopsy procedure during Screening. If a documented law or regulation prohibits (or does not approve) sample collection, then such samples will not be collected/submitted
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Measurable disease based on local imaging assessment using RECIST v1.1
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Eastern Cooperative Oncology Group performance status (ECOG PS) of 0 or 1 at Screening
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Within 7 days before randomization, has adequate bone marrow, hepatic, and renal function
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Left ventricular ejection fraction (LVEF) ≥50% by either echocardiogram (ECHO) or multigated acquisition (MUGA) scan within 28 days before randomization
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Adequate blood clotting function defined as international normalized ratio/prothrombin time and either partial thromboplastin or activated partial thromboplastin time ≤1.5 × upper limit of normal (ULN)
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Adequate treatment washout period before randomization
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Females of childbearing potential must have a negative serum pregnancy test at screening and must be willing to use highly effective birth control from the time of enrollment up to 7 months after the last dose of DS-1062a or for at least 6 months after the last dose of docetaxel
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Males must be surgically sterile or must use a condom in addition to highly effective birth control if his partners are of reproductive potential from the time of enrollment and for at least 4 months after last dose of DS-1062a or for at least 6 months after the last dose of docetaxel
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Male participants must not freeze or donate sperm from the time of Screening and throughout the study period and for at least 4 months after the last dose of DS-1062a or for at least 6 months after the last dose of docetaxel
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Female participants must not donate, or retrieve for their own use, ova from the time of Screening and throughout the study period and for at least 7 months after the last dose of DS-1062a and for at least 6 months after the last dose of docetaxel
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Mixed small-cell lung cancer (SCLC) and NSCLC histology
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Has spinal cord compression or clinically active central nervous system metastases, defined as untreated and symptomatic, or requiring therapy with corticosteroids or anticonvulsants to control associated symptoms. Participants with clinically inactive brain metastases may be included in the study. Participants with treated brain metastases who are no longer symptomatic and who require no treatment with corticosteroids or anticonvulsants may be included in the study if they have recovered from the acute toxic effect of radiotherapy.
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Has leptomeningeal carcinomatosis or metastasis
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Had prior treatment with:
- Any agent including antibody drug conjugate (ADC) containing a chemotherapeutic agent targeting topoisomerase I
- TROP2-targeted therapy
- Docetaxel
-
Had prior treatment with platinum-based chemotherapy and prior immunotherapy for Stage II NSCLC disease (eg, in the neo-adjuvant or adjuvant setting) without subsequently meeting the prior therapy requirements for Stage III or metastatic NSCLC disease
-
Has NSCLC disease that is eligible for definitive local therapy alone
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Has uncontrolled or significant cardiac disease, including:
- Mean QT interval corrected for heart rate using Fridericia's formula >470 msec (based on the average of Screening triplicate 12-lead electrocardiogram [ECG] determinations).
- Myocardial infarction or uncontrolled/unstable angina within 6 months before randomization
- Congestive heart failure (CHF) (New York Heart Association Class II to IV) at Screening. Participants with a history of Class II to IV CHF prior to Screening, must have returned to Class I CHF and have LVEF ≥50% (by either an ECHO or MUGA scan within 28 days before randomization) in order to be eligible.
- Uncontrolled or significant cardiac arrhythmia
- LVEF <50% by ECHO or MUGA scan within 28 days before randomization
- Uncontrolled hypertension (resting systolic blood pressure >180 mmHg or diastolic blood pressure >110 mmHg) within 28 days before randomization
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Has a history of (non-infectious) interstitial lung disease (ILD)/pneumonitis that required steroids, has current ILD/pneumonitis, or where suspected ILD/pneumonitis cannot be ruled out by imaging at Screening
-
Clinically severe pulmonary compromise resulting from intercurrent pulmonary illnesses including, but not limited to, any underlying pulmonary disorder (ie, pulmonary emboli within 3 months before randomization, severe asthma, severe chronic obstructive pulmonary disease, restrictive lung disease, pleural effusion, etc.), or any autoimmune, connective tissue or inflammatory disorders with pulmonary involvement (ie, rheumatoid arthritis, Sjogren's syndrome, sarcoidosis, etc.), or prior pneumonectomy.
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Significant third-space fluid retention (for example ascites or pleural effusion) and is not amenable for required repeated drainage
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Clinically significant corneal disease
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Uncontrolled infection requiring IV antibiotics, antivirals, or antifungals; suspected infections (eg, prodromal symptoms); or inability to rule out infections
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Has known human immunodeficiency virus (HIV) infection that is not well controlled
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Has an active or uncontrolled hepatitis B and/or hepatitis C infection, is positive for hepatitis B or C virus based on the evaluation of results of tests for hepatitis B (hepatitis B surface antigen [HBsAg], anti-hepatitis B surface antibody [anti-HBs], anti-hepatitis B core antibody [anti-HBc], or hepatitis B virus [HBV] DNA), and/or hepatitis C infection (as per hepatitis C virus [HCV] RNA) within 28 days of randomization.
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Has a history of malignancy, other than NSCLC, except adequately resected non-melanoma skin cancer, curatively treated in situ disease, or other solid tumors curatively treated, with no evidence of disease for ≥3 years
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Toxicities from previous anticancer therapy, defined as toxicities (other than alopecia) not yet improved to NCI-CTCAE version 5.0 Grade ≤1 or baseline
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Has a history of severe hypersensitivity reactions to either the drug substances, inactive ingredients (including but not limited to polysorbate 80) of DS-1062a or docetaxel, or monoclonal antibodies
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Pregnant or breastfeeding
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Has substance abuse or any other medical conditions such as clinically significant cardiac or psychological conditions
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description DS-1062a 6.0 mg/kg DS-1062a Participants will be randomized to receive 6.0 mg/kg of DS-1062a. Docetaxel 75 mg/m^2 Docetaxel Participants will be randomized to receive 75 mg/m\^2 docetaxel.
- Primary Outcome Measures
Name Time Method Progression-free Survival (PFS) As Assessed by Blinded Independent Central Review (BICR) Per RECIST v1.1 Following DS-1062a Versus Docetaxel From randomization until disease progression or death (whichever occurs first), up to approximately 43 months PFS is defined as the time from randomization to the earlier of the dates of the first documentation of radiographic progressive disease or death due to any cause.
Overall Survival (OS) Following DS-1062a Versus Docetaxel From randomization until date of death due to any cause, up to approximately 43 months OS is defined as the time from randomization to the date of death due to any cause.
- Secondary Outcome Measures
Name Time Method Progression-free Survival (PFS) As Assessed by Investigator Per RECIST v1.1 Following DS-1062a Versus Docetaxel From randomization until disease progression or death (whichever occurs first), up to approximately 43 months PFS is defined as the time from randomization to the earlier of the dates of the first documentation of radiographic progressive disease or death due to any cause.
Disease Control Rate (DCR) As Assessed by Blinded Independent Central Review (BICR) and Investigator As Per RECIST v1.1 Following DS-1062a Versus Docetaxel From randomization until disease progression or death (whichever occurs first), up to approximately 43 months DCR is defined as the proportion of participants who achieved a best overall response (BOR) of CR, PR, or stable disease (SD).
Objective Response Rate (ORR) As Assessed by Blinded Independent Central Review (BICR) and Investigator As Per RECIST v1.1 Following DS-1062a Versus Docetaxel From randomization until disease progression or death (whichever occurs first), up to approximately 43 months ORR is defined as the proportion of participants with a best overall response of complete response (CR) or partial response (PR).
Duration of Response (DOR) As Assessed by Blinded Independent Central Review (BICR) and Investigator As Per RECIST v1.1 Following DS-1062a Versus Docetaxel From date of first objective response (CR or PR) to date of first radiographic disease progression or death due to any cause (whichever occurs first), up to approximately 43 months DOR is defined as the time from the date of the first documentation of objective response (confirmed CR or confirmed PR) to the date of the first documentation of radiographic PD or death due to any cause, whichever occurs first.
Time to Response (TTR) As Assessed by Blinded Independent Central Review (BICR) and Investigator As Per RECIST v1.1 Following DS-1062a Versus Docetaxel From randomization to date of first objective response (CR or PR), up to approximately 43 months TTR is defined as the time from randomization to the date of the first documentation of objective response (CR or PR) in responding participants.
Time to Deterioration (TTD) Following DS-1062a Versus Docetaxel Baseline and assessed on Day 15 of each cycle until disease progression or end of treatment (each cycle is 21 days) and then once more at +90 days end of treatment TTD is defined as the time from randomization to the first onset of a ≥10-point increase in cough, chest pain, or dyspnea, confirmed by a second ≥10-point increase from randomization in the same symptom at the next scheduled assessment, or confirmed by death within 21 days of the first ≥10-point increase from randomization.
Percentage of Participants Who Reported Treatment-emergent Adverse Events Following DS-1062a Versus Docetaxel Baseline up to 35 days after last study dose, up to approximately 43 months Reported treatment-emergent adverse events, serious adverse events, adverse events of special interest, and those considered related to the study drug or study procedures, or that are associated with study treatment reduction, interruption, or discontinuation.
Pharmacokinetic Parameter Maximum Plasma Concentration (Cmax) of DS-1062a, Total Anti-Trophoblast cell surface protein 2 (Anti-TROP2) Antibody, and Active Metabolite MAAA-1181a Cycle 1, Day 1: predose and 30 minutes, 3 hours, 5 hours, and 7 hours postdose and Days 2, 4, 8, and 15; Cycles 2, 3, 4, 6, and 8, Day 1: predose and 1 hour postdose (each cycle is 21 days) Pharmacokinetic Parameter Time to Maximum Plasma Concentration (Tmax) of DS-1062a, Total Anti-TROP2 Antibody, and Active Metabolite MAAA-1181a Cycle 1, Day 1: predose and 30 minutes, 3 hours, 5 hours, and 7 hours postdose and Days 2, 4, 8, and 15; Cycles 2, 3, 4, 6, and 8, Day 1: predose and 1 hour postdose (each cycle is 21 days) Pharmacokinetic Parameter Area Under the Plasma Concentration-Time Curve (AUC) of DS-1062a, Total Anti-TROP2 Antibody, and Active Metabolite MAAA-1181a Cycle 1, Day 1: predose and 30 minutes, 3 hours, 5 hours, and 7 hours postdose and Days 2, 4, 8, and 15; Cycles 2, 3, 4, 6, and 8, Day 1: predose and 1 hour postdose (each cycle is 21 days) Area under the plasma concentration-time curve up to last quantifiable time (AUClast) and area under the plasma concentration-time curve during dosing interval (AUCtau) will be assessed.
Proportion of Participants Who Are Anti-Drug Antibody (ADA)-Positive (Baseline and Post-Baseline) and Proportion of Participants Who Have Treatment-emergent ADA Cycle 1, Day 1 predose; Cycle 1, Day 8; Cycles 2, 4, and subsequent cycles, Day 1 predose; end of treatment; 28-day safety follow up; and long-term survival follow up every 3 months, up to approximately 43 months (each cycle is 21 days)
Trial Locations
- Locations (209)
Northwestern University
🇺🇸Chicago, Illinois, United States
University Hospitals Cleveland Medical Center
🇺🇸Cleveland, Ohio, United States
Szpital Specjalistyczny w Prabutach Sp. z o.o.
🇵🇱Prabuty, Poland
Maria Sklodowska-Curie National Research Institute of Oncology
🇵🇱Warsaw, Poland
FDI Clinical Research
🇵🇷San Juan, Puerto Rico
Ironwood Cancer and Research Center
🇺🇸Chandler, Arizona, United States
Messino Cancer Centers
🇺🇸Asheville, North Carolina, United States
Roger Williams Medical Center
🇺🇸Providence, Rhode Island, United States
Astera Cancer Care
🇺🇸Somerset, New Jersey, United States
Baton Rouge General
🇺🇸Baton Rouge, Louisiana, United States
UCLA
🇺🇸Los Angeles, California, United States
Virginia Cancer Specialist
🇺🇸Fairfax, Virginia, United States
Meridian Hematology and Oncology
🇺🇸Manahawkin, New Jersey, United States
CER San Juan
🇦🇷Buenos Aires, Argentina
Gaston Martinengo
🇦🇷Rosario, Argentina
The Center for Cancer and Blood Disorders
🇺🇸Fort Worth, Texas, United States
Austin Hospital
🇦🇺Heidelberg, Australia
Instituto de OncologÃÂ-a de Rosario
🇦🇷Rosario, Argentina
Centro de Investigacion Pergamino S.A.
🇦🇷Pergamino, Argentina
Macquarie Hospital
🇦🇺North Ryde, Australia
Crown Princess Mary Cancer Centre Westmead Hospital
🇦🇺Sydney, Australia
Blacktown Hosital
🇦🇺Blacktown, Australia
Hospital Sao Lucas da Pucrs
🇧🇷Porto Alegre, Brazil
Instituto do Cancer do Ceara - ICC
🇧🇷Fortaleza, Brazil
Hopital Foch
🇫🇷Sureesnes, France
Centre Hospitalier Universitaire de Grenoble
🇫🇷Grenoble, France
Universitaet zu Koeln - Uniklinik Koeln
🇩🇪Koeln, Germany
Institut Curie
🇫🇷Paris, France
Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico
🇮🇹Milano, Italy
Okayama University Hospital
🇯🇵Okayama, Japan
National Cancer Center Hospital East
🇯🇵Kashiwa, Japan
NHO Hokkaido Cancer Center
🇯🇵Shiroishi, Japan
National Cheng Kung University Hospital NCKUH
🇨🇳Tainan, Taiwan
Chungbuk National University Hospital
🇰🇷Cheongju-si, Korea, Republic of
Hospital Medica Sur Tlalpan
🇲🇽Ciudad de mexico, Mexico
Asan Medical Center
🇰🇷Seoul, Korea, Republic of
VitaMed LLC
🇷🇺Moscow, Russian Federation
Institute of Oncology Hadassah Moscow
🇷🇺Moscow, Russian Federation
Hospital Clinic i Provincial de Barcelona
🇪🇸Barcelona, Spain
The James Cook University Hospital
🇬🇧Middlesbrough, United Kingdom
Taichung Veterans General Hospital
🇨🇳Taichung, Taiwan
Chi Mei Medical Center CMMC - Liouying Branch
🇨🇳Tainan, Taiwan
E-Da Hospital
🇨🇳Kaohsiung City, Taiwan
Chung Shan Medical University Hospital
🇨🇳Taichung, Taiwan
LinKou Chang Gung Memorial Hospital
🇨🇳Taoyuan, Taiwan
Dana-Farber Cancer Institute
🇺🇸Boston, Massachusetts, United States
OptumCare Cancer Care
🇺🇸Las Vegas, Nevada, United States
CHR site de la Citadelle
🇧🇪Liège, Belgium
Erasmus MC
🇳🇱Amsterdam, Netherlands
St. Jansdal Ziekenhuis
🇳🇱Rotterdam, Netherlands
Queen Mary Hospital
🇭🇰Hong Kong, Hong Kong
Sf Nectarie Oncology Center
🇷🇴Craiova, Romania
ICON Cancer Centre Farrer Park Hospital
🇸🇬Singapore, Singapore
Kantonsspital St. Gallen
🇨🇭Saint Gallen, Switzerland
Hospital Civil de Guadalajara Fray Antonio Alcalde
🇲🇽Guadalajara, Mexico
Prince of Wales Hospital / The Chinese University of Hong Kong
🇭🇰Hong Kong, Hong Kong
Oncolab SRL
🇷🇴Craiova, Romania
National Taiwan University Hospital NTUH
🇨🇳Taipei, Taiwan
Hospital Universitario Jose Eleuterio Gonzalez
🇲🇽Monterrey, Mexico
SC Oncopremium Team SRL
🇷🇴Baia Mare, Romania
Inselspital Universitätsspital Bern
🇨🇭Bern, Switzerland
Chang Gung Memorial Hospital CGMH - Kaohsiung Branch
🇨🇳Niaosong, Taiwan
University of California San Diego
🇺🇸La Jolla, California, United States
Onco Clinic Consult SA
🇷🇴Craiova, Romania
Stadtspital Waid ; Triemli, Site Triemli - clinic for Medical oncology & hematology
🇨🇭Zürich, Switzerland
Hunan Cancer Hospital
🇨🇳Changsha, China
Fudan University Shanghai Cancer Center
🇨🇳Henan, China
Beijing Cancer Hospital
🇨🇳Beijing, China
Henan Cancer Hospital
🇨🇳Shanghai Sheng, China
Zhejiang Cancer Hospital
🇨🇳Shanxi, China
West China Hospital, Sichuan University
🇨🇳Sichuan Province, China
Tianjin Medical University Cancer Institute and Hospital
🇨🇳Tianjin, China
Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology
🇨🇳Wuhan, China
National Cancer Center Hospital
🇯🇵Tokyo, Japan
University College Hospital
🇬🇧London, United Kingdom
St. Vincents Hospital The Catholic University of Korea
🇰🇷Gyeonggi-do, Korea, Republic of
Hospital Universitario de Valme
🇪🇸Sevilla, Spain
Florida Cancer Specialists
🇺🇸Tallahassee, Florida, United States
CHU Louis Pradel
🇫🇷Lyon, France
St. Joseph Heritage Healthcare
🇺🇸Anaheim, California, United States
The Oncology Institute of Hope and Innovation
🇺🇸Glendale, California, United States
PIH Health
🇺🇸Whittier, California, United States
Memorial Healthcare System- Memorial Cancer Institute
🇺🇸Hollywood, Florida, United States
University of Chicago
🇺🇸Chicago, Illinois, United States
Ft. Wayne Medical Oncology and Hematology
🇺🇸Fort Wayne, Indiana, United States
Avera Cancer Institute
🇺🇸Sioux Falls, South Dakota, United States
Kadlec Clinic Hematology and Oncology
🇺🇸Kennewick, Washington, United States
University of Virginia Health System
🇺🇸Charlottesville, Virginia, United States
Flinders Medical Centre
🇦🇺Bedford Park, Australia
Southern Medical Day Care Centre
🇦🇺Wollongong, Australia
CHA Centre Hospitalier de l Ardenne
🇧🇪Libramont, Belgium
Centre Hospitalier Jolimont-Lobbes
🇧🇪Haine-Saint-Paul, Belgium
CHU UCL Namur
🇧🇪Yvoir, Belgium
Instituto Nacional de Cancer-INCA
🇧🇷Rio De Janeiro, Brazil
Hospital Nossa Senhora da Conceição
🇧🇷Porto Alegre, Brazil
Hospital de Base de Sao Jose do Rio Preto
🇧🇷São José Do Rio Preto, Brazil
University Health Network - Princess Margaret Hospital
🇨🇦Toronto, Ontario, Canada
MUHC-Glen Site and MUHC Research Institute
🇨🇦Montréal, Quebec, Canada
Sunnbrook Health Sciences Centre
🇨🇦Toronto, Ontario, Canada
Xiangya Hospital central south university
🇨🇳Changsha, China
Linyi Cancer Hospital
🇨🇳Hangzhou, China
The First Affiliated Hospital of Zhejiang University
🇨🇳Hangzou, China
Harbin Medical University Cancer Hospital
🇨🇳Heilongjiang, China
Jiamusi Cancer Tuberculosis Hospital
🇨🇳Heilongjiang, China
Hubei Cancer Hospital
🇨🇳Hubei, China
Jiangsu Province Hospital
🇨🇳Nanjing, China
The First Affiliated Hospital of Xi'an Jiaotong University
🇨🇳Shandong, China
Shanghai Chest Hospital
🇨🇳Shanghai, China
Affiliated Cancer Hospital of Xinjiang Medical University
🇨🇳Urumqi, China
Sir Run Run Shaw Hospital Zhejiang University School of Medicine
🇨🇳Zhejiang, China
Vseobecna Fakultni Nemocnice VFN
🇨🇿Praha, Czechia
Hopital Jean Minjoz
🇫🇷Besançon, France
CHU de Poitier Pole regional de Cancerologie
🇫🇷Poitiers, France
Centre Leon Berard
🇫🇷Lyon, France
APHM - Hopital Nord
🇫🇷Marseille, France
University Hospital of Nantes - Thoracic Oncology
🇫🇷Nantes, France
Hopitaux Universitaire de Strasbourg
🇫🇷Strasbourg, France
CHU Toulouse Hopital Larrey
🇫🇷Toulouse, France
Gustav Roussy Cancer Campus Grand Paris
🇫🇷Villejuif, France
Klinikverbund Allgäu
🇩🇪Kempten, Germany
Charite - Universitaetsmedizin Berlin
🇩🇪Berlin, Germany
IKF Krankenhaus Nordwest
🇩🇪Frankfurt am main, Germany
Evangelische Lungenklinik Berlin
🇩🇪Berlin, Germany
Thoraxklinik Heidelberg gGmbH
🇩🇪Heidelberg, Germany
Asklepios Fachklinik Muenchen-Gauting
🇩🇪Gauting, Germany
Universitaetsklinikum Freiburg
🇩🇪Freiburg, Germany
Lungenklinik Hemer
🇩🇪Hemer, Germany
Medizinische Klinik V
🇩🇪Standort Gießen, Germany
Klinikum Traunstein
🇩🇪Traunstein, Germany
Szent Borbala Korhaz
🇭🇺Tatabánya, Hungary
Uzsoki Utcai Korhaz
🇭🇺Budapest, Hungary
Orszagos Koranyi TBC es Pulmonologiai Intezet
🇭🇺Budapest, Hungary
Azienda Ospedaliero- Universitaria Policlinico S. Orsola-Malpighi
🇮🇹Bologna, Italy
Tudogyogyintezet Torokbalint
🇭🇺Torokbalint, Hungary
Tolna Megyei Balassa Janos Korhaz
🇭🇺Tolna, Hungary
Azienda Ospedaliera Universitaria Policlinico G Rodolico San Marco
🇮🇹Catania, Italy
ASL 3 Genovese Oncologia Medica Villa Scassi
🇮🇹Genova, Italy
Fondazione IRCCS Istituto Nazionale Tumori
🇮🇹Milan, Italy
IRCCS Istituto Europeo di Oncologia
🇮🇹Milano, Italy
Azienda Ospedaliero-Universitaria San Luigi Gonzaga
🇮🇹Orbassano, Italy
Fondazione Policlinico Universitario Agostino Gemelli IRCCS
🇮🇹Roma, Italy
Instituicao de Fisioterapeutas Ocupacionais
🇮🇹Roma, Italy
Kyushu University Hospital
🇯🇵Fukuoka, Japan
Hyogo Cancer Center
🇯🇵Akashi, Japan
Saitama Medical University International Medical Center
🇯🇵Hidaka, Japan
Kanazawa University Hospital
🇯🇵Kanazawa, Japan
Kansai Medical University Hospital
🇯🇵Hirakata, Japan
Niigata Cancer Center Hospital
🇯🇵Chuo Ku, Japan
The Cancer Institute Hospital of JFCR
🇯🇵Koto-Ku, Japan
Kyoto University Hospital
🇯🇵Kyoto, Japan
NHO Shikoku Cancer Center
🇯🇵Matsuyama, Japan
Shizuoka Cancer Center
🇯🇵Nagaizumi-chō, Japan
Osaka City General Hospital
🇯🇵Osaka-shi, Japan
Osaka International Cancer Institute
🇯🇵Osaka, Japan
Saitama Cancer Center
🇯🇵Saitama, Japan
Tokushima University Hospital
🇯🇵Tokushima, Japan
Fujita Health University Hospital
🇯🇵Toyoake, Japan
Kindai University Hospital
🇯🇵Ōsaka-sayama, Japan
Seoul National University Bundang Hospital
🇰🇷Seongnam-si, Korea, Republic of
Kangbuk Samsung Hospital
🇰🇷Seoul, Korea, Republic of
Samsung Medical Center
🇰🇷Seoul, Korea, Republic of
The Catholic University of Korea, Seoul St. Marys Hospital
🇰🇷Seoul, Korea, Republic of
Seoul National University Boramae Medical Center
🇰🇷Seoul, Korea, Republic of
San Peregrino Cancer Center
🇲🇽Aguascalientes, Mexico
Amphia Ziekenhuis
🇳🇱Breda, Netherlands
II Klinika Chorob Pluc i Gruzlicy
🇵🇱Białystok, Poland
Szpitale Pomorskie Sp.zo.o
🇵🇱Gdynia, Poland
Ms Pneumed
🇵🇱Lublin, Poland
Isala Klinieken
🇳🇱Harderwijk, Netherlands
SP Zespol Gruzlicy i Chorob Pluc
🇵🇱Olsztyn, Poland
Oddział Onkologii Wojewódzki Szpital Specjalistyczny Słupsk
🇵🇱Słupsk, Poland
Magodent Sp. z.o.o Szpital Elblaska
🇵🇱Warsaw, Poland
Centrul Medical Sanador
🇷🇴Bucharest, Romania
Institutul Oncologic Profesor Doctor Alexandru Trestioreanu
🇷🇴Bucuresti, Romania
Clinical Emergency Hospital
🇷🇴Constanţa, Romania
Kursk Regional Clinical Oncology Dispensary
🇷🇺Kursk, Russian Federation
SC Oncomed SRL
🇷🇴Timişoara, Romania
University Headache Clinic LLC
🇷🇺Moscow, Russian Federation
Federal State Budgetary Institution - N.N. Blokhin National Medical Research Center of Oncology
🇷🇺Moscow, Russian Federation
LLC MSCH "Klinitsist"
🇷🇺Novosibirsk, Russian Federation
N.N. Petrov Research Institute of Oncology
🇷🇺Saint Petersburg, Russian Federation
National Cancer Centre Singapore
🇸🇬Singapore, Singapore
OncoCare Cancer Centre - Gleneagles Medical Centre Location
🇸🇬Singapore, Singapore
Hospital de la Santa Creu i Sant Pau
🇪🇸Barcelona, Spain
Hospital Universitario Vall d'Hebron
🇪🇸Barcelona, Spain
Hospital Puerte de Hierro de Majadahonda
🇪🇸Madrid, Spain
Hospital Universitario 12 de Octubre
🇪🇸Madrid, Spain
Hospital Universitario Fundacion Jimenez Diaz
🇪🇸Madrid, Spain
Hospital Regional Universitario Málaga
🇪🇸Málaga, Spain
CHUO
🇪🇸Ourense, Spain
Hospital Clinico Universitario Lozano Bleza
🇪🇸Zaragoza, Spain
The Christie Hospital
🇬🇧Manchester, United Kingdom
Northwest Medical Specialties
🇺🇸Tacoma, Washington, United States
Hospital General Universitario de Valencia
🇪🇸Valencia, Spain
Hospital Universitari i Politecnic La Fe
🇪🇸Valencia, Spain
Sendai Kousei Hospital
🇯🇵Sendai-shi, Japan
Yonsei University Health System - Severance Hospital
🇰🇷Seoul, Korea, Republic of
Hopital Pontchaillou
🇫🇷Rennes, France
Hospital Virgen Macarena
🇪🇸Sevilla, Spain
Kyungpook National University Chilgok Hospital
🇰🇷Daegu, Korea, Republic of
Med Polonia Sp. z o.o.
🇵🇱Poznań, Poland
Orlando Health
🇺🇸Orlando, Florida, United States
Karmanos Cancer Institute
🇺🇸Detroit, Michigan, United States
Sarah Cannon Research Institute
🇺🇸Nashville, Tennessee, United States
Baptist Health Louisville
🇺🇸Louisville, Kentucky, United States
American Oncology Partners of Maryland
🇺🇸Bethesda, Maryland, United States
Utah Cancer Specialists
🇺🇸Salt Lake City, Utah, United States
Cross Cancer Institute
🇨🇦Edmonton, Alberta, Canada
Montefiore Medical Center
🇺🇸Bronx, New York, United States