A Study of Trastuzumab Deruxtecan (T-DXd) Versus Trastuzumab Emtansine (T-DM1) in High-risk HER2-positive Participants With Residual Invasive Breast Cancer Following Neoadjuvant Therapy (DESTINY-Breast05)
- Conditions
- HER2-Positive Primary Breast CancerResidual Invasive Breast Cancer
- Interventions
- Registration Number
- NCT04622319
- Lead Sponsor
- Daiichi Sankyo
- Brief Summary
Patients with HER2-positive primary breast cancer (BC) who do not achieve complete response after appropriate neoadjuvant therapy are at higher risk of disease recurrence. More effective treatment options are needed for this patient population. This study will examine the efficacy and safety of trastuzumab deruxtecan (T-DXd) compared with trastuzumab emtansine (T-DM1) in high-risk patients with residual invasive breast cancer following neoadjuvant therapy.
- Detailed Description
This study will examine trastuzumab deruxtecan (T-DXd) versus trastuzumab emtansine (T-DM1) in patients with HER2-positive primary BC who have residual invasive disease in breast or axillary lymph nodes with higher risk of recurrence, which includes patients who were inoperable at disease presentation or had pathological node-positive status after neoadjuvant therapy.
The primary objective is to compare invasive disease-free survival (IDFS) between T-DXd and T-DM1 treatment arms in this population. The key secondary objective of the study is to evaluate disease-free survival (DFS).
Recruitment & Eligibility
- Status
- ACTIVE_NOT_RECRUITING
- Sex
- All
- Target Recruitment
- 1600
-
Adults ≥18 years old (local regulatory requirements will apply if the legal age of consent for study participation is >18 years old).
-
Pathologically documented HER2-positive breast cancer (BC):
- HER2-positive expression defined as an immunohistochemistry (IHC) score of 3+ and/or positive by in situ hybridization (ISH) confirmed prior to study randomization.
-
Histologically confirmed invasive breast carcinoma.
-
Clinical stage at disease presentation: T1-4, N0-3, M0; patients presenting with T1N0 tumors are not eligible.
-
Pathologic evidence of residual invasive carcinoma in the breast and/or axillary lymph nodes following completion of neoadjuvant therapy meeting one of the following high-risk criteria:
- Inoperable breast cancer at presentation (prior to neoadjuvant therapy), defined as clinical stages T4, N0-3, M0 or T1-3, N2-3, M0.
- Operable at presentation, defined as clinical stages T1-3,N0-1,M0, with axillary node positive disease (ypN1-3) following neoadjuvant therapy.
-
Completion of neoadjuvant systemic therapy, including taxane-based chemotherapy and HER2-directed treatment prior to surgery.
- Systemic therapy must consist of at least 6 cycles of neoadjuvant therapy with a total duration of at least 16 weeks, including at least 9 weeks of trastuzumab (± pertuzumab) and at least 9 weeks of taxane-based chemotherapy to be completed prior to surgery. Patients may have received an anthracycline as part of neoadjuvant therapy in addition to taxane chemotherapy.
-
Adequate excision as confirmed per medical records: surgical removal of all clinically evident disease in the breast and axillary lymph nodes.
-
An interval of no more than 12 weeks between the date of last surgery and the date of randomization.
-
Known hormone receptor (HR) status, per local laboratory assessment, as defined by ASCO-CAP guidelines (≥1%): HR positive status defined by either positive estrogen receptor (ER) and/or positive progesterone receptor (PR).
status. HR-negative status defined by both known negative ER and known negative PR.
- Left ventricular ejection fraction (LVEF) ≥50% within 28 days prior to randomization.
- Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 at Screening.
- Has adequate organ function within 14 days before randomization.
Key
-
Stage IV (metastatic) BC.
-
History of any prior (ipsi- or contralateral) breast cancer except lobular carcinoma in situ (LCIS).
-
Evidence of clinically evident gross residual or recurrent disease following neoadjuvant therapy and surgery.
-
Prior treatment with T-DXd, T-DM1 or other anti-HER2 antibody-drug conjugate (ADC) or prior enrollment in a clinical study of T-DXd (regardless of treatment arm)
-
History of exposure to the following cumulative doses of anthracyclines:
- Doxorubicin > 240 mg/m^2
- Epirubicin or Liposomal Doxorubicin-Hydrochloride > 480 mg/m^2
- For other anthracyclines, exposure equivalent to doxorubicin > 240 mg/m^2
-
History of other malignancy within the last 5 years except for appropriately treated CIS of the cervix, nonmelanoma skin carcinoma, Stage I melanoma skin carcinoma, Stage I uterine cancer, or other appropriately treated non-breast malignancies with an outcome similar to those mentioned above.
-
History of (noninfectious) interstitial lung disease (ILD)/pneumonitis that required steroids and/or has ILD/pneumonitis noted on computed tomography (CT) scan of the chest at Screening (asymptomatic interstitial changes confined to recent radiation therapy fields are not excluded).
-
Known pulmonary compromise resulting from intercurrent pulmonary illnesses including, but not limited to, any underlying pulmonary disorder (eg, pulmonary emboli within three months prior to randomization, severe asthma, severe chronic obstructive pulmonary disease [COPD], restrictive lung disease).
-
Any autoimmune, connective tissue or inflammatory disorders (eg, Rheumatoid arthritis, Sjogren's, sarcoidosis, etc) where there is documented or a suspicion of pulmonary involvement or pneumonectomy at the time of screening.
-
Medical history of myocardial infarction (MI) within 6 months before randomization, symptomatic congestive heart failure (CHF) (New York Heart Association Class II to IV), troponin levels consistent with MI as defined according to the manufacturer 28 days prior to randomization.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Trastuzumab ematansine (T-DM1) T-DM1 Participants who will be randomized to receive trastuzumab ematansine (T-DM1) at a starting dose of 3.6 mg/kg. Trastuzumab deruxtecan (T-DXd) DS-8201a Participants who will be randomized to receive trastuzumab deruxtecan (T-DXd) at a starting dose of 5.4 mg/kg.
- Primary Outcome Measures
Name Time Method Invasive Disease-free Survival (IDFS) in Participants Who Were Administered Trastuzumab Deruxtecan (T-DXd) Compared With Trastuzumab Emtansine (T-DM1) Treatment Randomization to date of invasive local, axillary or distant recurrence, invasive contralateral breast cancer or death from any cause (whichever occurs first), up to approximately 57 months postdose
- Secondary Outcome Measures
Name Time Method Disease-free Survival (DFS) in Participants Who Were Administered Trastuzumab Deruxtecan (T-DXd) Compared With Trastuzumab Emtansine (T-DM1) Treatment Randomization to date of the first occurrence of an IDFS event including second primary non-breast cancer event or contralateral or ipsilateral ductal carcinoma in situ (whichever occurs first), up to approximately 81 months postdose Distant Recurrence-free Interval (DRFI) in Participants Who Were Administered Trastuzumab Deruxtecan (T-DXd) Compared With Trastuzumab Emtansine (T-DM1) Treatment Randomization to date of distant recurrence, up to approximately 81 months postdose Percentage of Treatment-emergent Adverse Events in Participants Who Were Administered Trastuzumab Deruxtecan (T-DXd) Compared With Trastuzumab Emtansine (T-DM1) Treatment Baseline up to approximately 81 months postdose Overall Survival (OS) in Participants Who Were Administered Trastuzumab Deruxtecan (T-DXd) Compared With Trastuzumab Emtansine (T-DM1) Treatment Randomization to date of death from any cause, up to approximately 81 months postdose Brain Metastases-free Interval (BMFI) in Participants Who Were Administered Trastuzumab Deruxtecan (T-DXd) Compared With Trastuzumab Emtansine (T-DM1) Treatment Randomization to date of brain metastasis, up to approximately 81 months postdose Serum Concentrations of Trastuzumab Deruxtecan (T-DXd), total anti-HER2 antibody, and Active Metabolite MAAA-1181a Pre-dose on Day 1 of Cycles 1, 4 and 10 and within 15 minutes post-dose on Day 1 of Cycles 1 and 4 (each cycle is 21 days) Percentage of Participants Positive for Treatment-emergent Anti-drug Antibodies (ADAs) in Participants Who Were Administered Trastuzumab Deruxtecan (T-DXd) Baseline up to approximately 81 months postdose
Trial Locations
- Locations (464)
Peter MacCallum Cancer Centre
🇦🇺Melbourne, Australia
Breast Cancer Research Centre - WA
🇦🇺Nedlands, Australia
Genesis Care Northern Cancer
🇦🇺Saint Leonards, Australia
Praxis Dr. med. J. Schilling
🇩🇪Berlin, Germany
MediOnko-Institut GbR, Praxisklinik Krebsheilkunde
🇩🇪Berlin, Germany
DRK Kliniken Berlin Köpenick
🇩🇪Berlin, Germany
Helios Klinikum Berlin-Buch
🇩🇪Berlin, Germany
Onkologische Schwerpunktpraxis
🇩🇪Dresden, Germany
Studien GbR Braunschweig
🇩🇪Braunschweig, Germany
Klinikum Bremen Mitte
🇩🇪Bremen, Germany
Frauenklinik DIAKO Bremen
🇩🇪Bremen, Germany
Institut für Versorgungsforschung in der Onkologie
🇩🇪Koblenz, Germany
Unifrauenklinik Köln - Studienzentrum Gynäkologie
🇩🇪Köln, Germany
St. Elisabeth Hospital
🇩🇪Köln, Germany
Kliniken der Stadt Köln / Brustzentrum Holweide
🇩🇪Köln, Germany
St. Vincenz KH Limburg
🇩🇪Limburg, Germany
UKSH Campus Lübeck
🇩🇪Luebeck, Germany
Universitäts-Frauenklinik
🇩🇪Magdeburg, Germany
Department of Obstetrics and Gynecology
🇩🇪Mainz, Germany
Clinica Oncologica, Ospedali Riuniti Umberto 1
🇮🇹Ancona, Italy
Policlinico S.Orsola-Malpighi SSD Oncologia Medica Addarii
🇮🇹Bologna, Italy
SSD Oncologia Medica
🇮🇹Bologna, Italy
Presidio Ospedaliero di Summa - Antonio Perrino
🇮🇹Brindisi, Italy
Istituto di Candiolo - IRCCS
🇮🇹Candiolo, Italy
Ospedale Poli SAN MARTINO
🇮🇹Genova, Italy
Area Vasta Sud Est Sede Operativa Grosseto
🇮🇹Grosseto, Italy
Azienda Usl Toscana sud est
🇮🇹Grosseto, Italy
IRCCS Ospedale San Raffaele
🇮🇹Milano, Italy
University Hospital of Modena
🇮🇹Modena, Italy
INT Fondazione Pascale
🇮🇹Napoli, Italy
Hospital MD Anderson Cancer Center Madrid
🇪🇸Madrid, Spain
Hospital da Luz
🇵🇹Lisboa, Portugal
Klinikum Dortmund gGmbH
🇩🇪Dortmund, Germany
Gynaekologie Arabella
🇩🇪Munich, Germany
Brustzentrum Niederrhein
🇩🇪Mönchengladbach, Germany
The University of Hong Kong (HKU) - Queen Mary Hospital (QMH)
🇭🇰Pok Fu Lam, Hong Kong
Niigata Cancer Center Hospital
🇯🇵Niigata City, Japan
Hyogo College of Medicine Hospital
🇯🇵Nishinomiya City, Japan
Hospital Nacional Arzobispo Loayza
🇵🇪Lima, Peru
Clinica Ricardo Palma
🇵🇪Lima, Peru
Instituto Nacional de Enfermedades Neoplasicas INEN
🇵🇪Lima, Peru
University Hospital Schleswig-Holstein
🇩🇪Kiel, Germany
Centro de Investigación Clinica Trujillo EIRL
🇵🇪Trujillo, Peru
Hospital CUF Descobertas
🇵🇹Lisboa, Portugal
Hospital Universitario San Pedro de Alcantara
🇪🇸Cáceres, Spain
ICO Girona
🇪🇸Girona, Spain
Hospital Universitario Clínico San Cecilio
🇪🇸Granada, Spain
Complejo Hospitalario de Jaen
🇪🇸Jaén, Spain
Complejo Asistencial Universitario de León
🇪🇸León, Spain
Hospital Arnau de Vilanova de Lleida
🇪🇸Lleida, Spain
Clinica Universidad De Navarra, Madrid
🇪🇸Madrid, Spain
Fundacao Pio XII-Hospital de Cancer de Barretos
🇧🇷Barretos, SP, Brazil
SIM CRC
🇨🇱Temuco, Chile
University Hospital Brno
🇨🇿Brno, Czechia
UPMC Washington
🇺🇸Washington, Pennsylvania, United States
Fakultni nemocnice Kralovske Vinohrady
🇨🇿Prague, Czechia
Peking University Cancer Hospital
🇨🇳Beijing, China
The Oncology Institute of Hope & Innovation
🇺🇸Anaheim, California, United States
Kaiser Permanente
🇺🇸Woodland Hills, California, United States
Orange Coast Blood and Cancer Care
🇺🇸Fountain Valley, California, United States
Long Beach Memorial TCI
🇺🇸Long Beach, California, United States
SCRI FCS North- Altamonte
🇺🇸Altamonte Springs, Florida, United States
SCRI FCS South- Bonita
🇺🇸Bonita Springs, Florida, United States
SCRI FCS North- Brandon Cancer Center
🇺🇸Brandon, Florida, United States
SCRI FCS South- North Fort Myers
🇺🇸Cape Coral, Florida, United States
SCRI FCS North- Mease/Clearwater
🇺🇸Clearwater, Florida, United States
SCRI FCS South
🇺🇸Fort Myers, Florida, United States
SCRI FCS South- Colonial
🇺🇸Fort Myers, Florida, United States
SCRI FCS South- Gladiolus
🇺🇸Fort Myers, Florida, United States
SCRI FCS North- Gainesville Cancer Center
🇺🇸Gainesville, Florida, United States
Baptist MD Anderson Cancer Center
🇺🇸Jacksonville, Florida, United States
SCRI FCS North- Villages East
🇺🇸Lady Lake, Florida, United States
SCRI FCS South- Lakewood Ranch
🇺🇸Lakewood Ranch, Florida, United States
SCRI FCS North- Largo/Highland
🇺🇸Largo, Florida, United States
SCRI FCS North- Lecanto
🇺🇸Lecanto, Florida, United States
SCRI FCS South- Naples West
🇺🇸Naples, Florida, United States
SCRI FCS South- Naples/Goodlette
🇺🇸Naples, Florida, United States
SCRI FCS North- New Port Richey
🇺🇸New Port Richey, Florida, United States
SCRI FCS North- Ocala
🇺🇸Ocala, Florida, United States
Orlando Health
🇺🇸Orlando, Florida, United States
SCRI FCS North- Orange City
🇺🇸Orange City, Florida, United States
SCRI FCS North- Orlando Downtown
🇺🇸Orlando, Florida, United States
SCRI FCS South- Port Charlotte
🇺🇸Port Charlotte, Florida, United States
SCRI FCS North- St. Anthony's/St. Petersburg
🇺🇸Saint Petersburg, Florida, United States
SCRI FCS North
🇺🇸Saint Petersburg, Florida, United States
SCRI FCS South- Sarasota-Cattleman
🇺🇸Sarasota, Florida, United States
SCRI FCS South-Sarasota-Downtown
🇺🇸Sarasota, Florida, United States
SCRI FCS North- Spring Hill
🇺🇸Spring Hill, Florida, United States
SCRI FCS North- Tampa Cancer Center
🇺🇸Tampa, Florida, United States
SCRI FCS North- Tavares
🇺🇸Tavares, Florida, United States
SCRI FCS South- Venice Healthpark
🇺🇸Venice, Florida, United States
Cleveland Clinic-Weston
🇺🇸Weston, Florida, United States
SCRI FCS North- Winter Park
🇺🇸Winter Park, Florida, United States
Elmhurst Memorial Hospital- Nancy W. Knowles Cancer Center
🇺🇸Elmhurst, Illinois, United States
Edward Cancer Center
🇺🇸Naperville, Illinois, United States
Edward Cancer Center Plainfield
🇺🇸Plainfield, Illinois, United States
University of Kentucky, Markey Cancer Center, Clinical Research Organization
🇺🇸Lexington, Kentucky, United States
Baptist Health Louisville
🇺🇸Louisville, Kentucky, United States
LSU Health Baton Rouge North Clinic
🇺🇸Baton Rouge, Louisiana, United States
Our Lady of the Lake Physician Group-Medical Oncology
🇺🇸Baton Rouge, Louisiana, United States
Mary Bird Perkins Cancer Center
🇺🇸Baton Rouge, Louisiana, United States
Ochsner Hematology Oncology North Shore - Covington (West Region)
🇺🇸Covington, Louisiana, United States
Ochsner Clinic Foundation
🇺🇸New Orleans, Louisiana, United States
MedStar Franklin Square Medical Center-Harry and Jeanette Weinberg Cancer Institute
🇺🇸Baltimore, Maryland, United States
MedStar Franklin Square Cancer Center at Loch Raven Campus
🇺🇸Baltimore, Maryland, United States
Frederick Health-James M Stockman Cancer Center
🇺🇸Frederick, Maryland, United States
Maryland Oncology Hematology
🇺🇸Silver Spring, Maryland, United States
Holy Cross Hospital
🇺🇸Silver Spring, Maryland, United States
Montefiore Medical Center
🇺🇸Bronx, New York, United States
Waverly Hematology Oncology
🇺🇸Cary, North Carolina, United States
UNC Cancer Care at Nash
🇺🇸Rocky Mount, North Carolina, United States
Reading Hospital, McGlinn Cancer Institute
🇺🇸West Reading, Pennsylvania, United States
Wake Forest Baptist Medical Center
🇺🇸Winston-Salem, North Carolina, United States
Cleveland Clinic - Hillcrest
🇺🇸Cleveland, Ohio, United States
Cleveland Clinic-Fairview
🇺🇸Cleveland, Ohio, United States
Cleveland Clinic
🇺🇸Cleveland, Ohio, United States
Cleveland Clinic South Pointe
🇺🇸Warrensville Heights, Ohio, United States
UPMC Upper St. Clair
🇺🇸Bethel Park, Pennsylvania, United States
UPMC Passavant Cranberry/North
🇺🇸Cranberry Township, Pennsylvania, United States
UPMC Erie
🇺🇸Erie, Pennsylvania, United States
AHN Cancer Inst at St Vincent
🇺🇸Erie, Pennsylvania, United States
UPMC Arnold Palmer-Mt View
🇺🇸Greensburg, Pennsylvania, United States
UPMC Pinnacle-Ortenzio Cancer Center
🇺🇸Harrisburg, Pennsylvania, United States
UMPC Pinnacle Pharmacy
🇺🇸Harrisburg, Pennsylvania, United States
AHN Cancer Insititute at Jefferson
🇺🇸Jefferson Hills, Pennsylvania, United States
AHN Cancer Institute at Forbes
🇺🇸Monroeville, Pennsylvania, United States
UPMC Monroeville
🇺🇸Monroeville, Pennsylvania, United States
UPMC Arnold Palmer-Mt Pleasant
🇺🇸Mount Pleasant, Pennsylvania, United States
UPMC Arnold Palmer-Norwin
🇺🇸N. Huntingdon, Pennsylvania, United States
Allegheny General Hospital
🇺🇸Pittsburgh, Pennsylvania, United States
Magee
🇺🇸Pittsburgh, Pennsylvania, United States
UPMC St. Margaret
🇺🇸Pittsburgh, Pennsylvania, United States
AHN Cancer Inst at West Penn
🇺🇸Pittsburgh, Pennsylvania, United States
UPMC Hillman Cancer Center
🇺🇸Pittsburgh, Pennsylvania, United States
UPMC Passavant HOA
🇺🇸Pittsburgh, Pennsylvania, United States
UPMC Passavant OHA
🇺🇸Pittsburgh, Pennsylvania, United States
UPMC Uniontown
🇺🇸Uniontown, Pennsylvania, United States
Centre Hosp Univ de Grenoble CHUG
🇫🇷La Tronche, France
AHN Cancer Institute at Wexford
🇺🇸Wexford, Pennsylvania, United States
UPMC Pinnacle-Memorial Cancer Center
🇺🇸York, Pennsylvania, United States
SCRI TO Nashville- Franklin Tennessee Oncology, PLLC
🇺🇸Franklin, Tennessee, United States
SCRI TO Nashville- Gallatin Tennessee Oncology, PLLC
🇺🇸Gallatin, Tennessee, United States
SCRI TO Nashville- Hendersonville Tennessee Oncology, PLLC
🇺🇸Hendersonville, Tennessee, United States
SCRI TO Nashville- Summit Tennessee Oncology, PLLC
🇺🇸Hermitage, Tennessee, United States
Regional Cancer Center at Indian Path Community Hospital
🇺🇸Kingsport, Tennessee, United States
SCRI TO Nashville- Lebanon Tennessee Oncology, PLLC
🇺🇸Lebanon, Tennessee, United States
SCRI TO Nashville- St. Thomas Midtown Tennessee Oncology, PLLC
🇺🇸Nashville, Tennessee, United States
Tennessee Oncology Nashville / Sarah Cannon
🇺🇸Nashville, Tennessee, United States
SCRI TO Nashville- St. Thomas West Tennessee Oncology, PLLC
🇺🇸Nashville, Tennessee, United States
SCRI TO Nashville- Skyline Tennessee Oncology, PLLC
🇺🇸Nashville, Tennessee, United States
SCRI TO Nashville- Southern Hills Tennessee Oncology, PLLC
🇺🇸Nashville, Tennessee, United States
SCRI TO Nashville- Smyrna Tennessee Oncology, PLLC
🇺🇸Smyrna, Tennessee, United States
Houston Methodist Baytown
🇺🇸Baytown, Texas, United States
Houston Methodist
🇺🇸Houston, Texas, United States
Houston Methodist Willowbrook
🇺🇸Houston, Texas, United States
Houston Methodist West
🇺🇸Houston, Texas, United States
Houston Methodist Clear Lake
🇺🇸Nassau Bay, Texas, United States
Houston Methodist Sugarland
🇺🇸Sugar Land, Texas, United States
Houston Methodist Woodlands
🇺🇸The Woodlands, Texas, United States
Wellmont Medical Associates Oncology & Hematology
🇺🇸Bristol, Virginia, United States
University of Virginia
🇺🇸Charlottesville, Virginia, United States
Virginia Commonwealth University Massey Cancer Center
🇺🇸Richmond, Virginia, United States
MultiCare Cancer Center Aurburn
🇺🇸Auburn, Washington, United States
MultiCare Regional Cancer Center - Gig Harbor
🇺🇸Gig Harbor, Washington, United States
MultiCare Cancer Center Puyallup
🇺🇸Puyallup, Washington, United States
MultiCare Institute for Research & Innovation
🇺🇸Spokane, Washington, United States
MultiCare Cancer Center Tacoma
🇺🇸Tacoma, Washington, United States
West Virginia University
🇺🇸Morgantown, West Virginia, United States
Centro Oncologico Riojano Integral
🇦🇷Capital, La Rioja, Argentina
Sanatorio Británico de Rosario
🇦🇷Rosario, Santa Fe, Argentina
Instituto de Oncología de Rosario
🇦🇷Rosario, Santa Fe, Argentina
COIBA
🇦🇷Buenos Aires, Argentina
Instituto Alexander Fleming
🇦🇷Caba, Argentina
CER San Juan
🇦🇷San Juan, Argentina
Royal Adelaide Hospital
🇦🇺Adelaide, Australia
Chris O Brien Lifehouse
🇦🇺Camperdown, Australia
Monash Health
🇦🇺Clayton, Australia
Austin Hospital- Olivia Newto-John Cancer and Wellness Centre
🇦🇺Heidelberg, Australia
St John of God Hospital - Bendat Family Comprehensive Cancer Centre (BFCCC)
🇦🇺Subiaco, Australia
Southern Medical Day Care Centre
🇦🇺Wollongong, Australia
Antwerp University Hospital
🇧🇪Edegem, Antwerpen, Belgium
UZ Gent
🇧🇪Gent, O. Vl., Belgium
Algemeen Ziekenhuis AZ Klina - Borstkliniek
🇧🇪Brasschaat, Belgium
Institut Jules Bordet Brussels Belgium
🇧🇪Brussels, Belgium
Cliniques Universitaires Saint-Luc
🇧🇪Brussels, Belgium
UZ Leuven - Campus Gasthuisberg
🇧🇪Leuven, Belgium
CHU Liege
🇧🇪Liège, Belgium
GZA Hospitals Campus Sint- Augustinus
🇧🇪Wilrijk, Belgium
Hospital Sirio-Libanes HSL - Centro de Oncologia - Brasilia
🇧🇷Brasília, Federal District, Brazil
Hospital Erasto Gaertner
🇧🇷Curitiba, Parana, Brazil
Fundação Universidade de Caxias do Sul Instituto de Pesquisas em Saúde IPS-UCS
🇧🇷Caxias Do Sul, Rio Grande Do Sul, Brazil
Hospital Sao Lucas PUCRS
🇧🇷Porto Alegre, RS, Brazil
CEPHO - Centro de Estudos e Pesquisas de Hematologia e Oncologia
🇧🇷Santo André, SP, Brazil
Hospital de Base de Sao Jose do Rio Preto
🇧🇷São José Do Rio Preto, SP, Brazil
INCA - Instituto Nacional do Cancer / Hospital do Cancer HCIII
🇧🇷Rio De Janeiro, Brazil
Instituto do Cancer do Estado de Sao Paulo (ICESP)
🇧🇷São Paulo, Brazil
Tom Baker Cancer Centre
🇨🇦Calgary, Alberta, Canada
The Ottawa Hospital Cancer Centre
🇨🇦Ottawa, Ontario, Canada
CIUSSSS de l'Est-de-l'Ile-de-Montréal - Installation Hôpital Maisonneuve-Rosemont
🇨🇦Montréal, Quebec, Canada
CHUM
🇨🇦Montréal, Quebec, Canada
Jewish General Hospital Segal Cancer Centre
🇨🇦Montréal, Quebec, Canada
McGill University Health Centre - Cedars Cancer Centre
🇨🇦Montréal, Quebec, Canada
CHU de Quebec - Hopital du Saint-Sacrement
🇨🇦Québec, Quebec, Canada
Hospital Clinico Universidad de Chile
🇨🇱Santiago, RM, Chile
Fundacion Arturo Lopez Perez
🇨🇱Santiago, Chile
Peking University Third Hospital
🇨🇳Beijing, China
Jilin University JLU - First Affiliated Hospital
🇨🇳Changchun, China
Sichuan University - West China Hospital
🇨🇳Chengdu, China
Chongqing Medical University - The First Affiliated Hospital
🇨🇳Chongqing, China
Union Hospital of Fujian Medical University
🇨🇳Fuzhou, China
Sun Yat-sen Memorial Hospital
🇨🇳Guangzhou, China
Guangdong Academy of Medical Science
🇨🇳Guangzhou, China
Zhejiang Cancer Hospital
🇨🇳Hangzhou, China
Second Affiliated Hospital of Zhejiang University
🇨🇳Hangzhou, China
Harbin Medical University Cancer Hospital
🇨🇳Harbin, China
Shandong Cancer Hospital
🇨🇳Jinan, China
Nanchang University - The First Affiliated Hospital
🇨🇳Nanchang, China
Nanjing Medical University NMU - Jiangsu Province Hospital
🇨🇳Nanjing, China
Fudan University Cancer Hospital
🇨🇳Shanghai, China
The 4th Hospital of Heibei Medical University
🇨🇳Shijiazhuang, China
The First Affiliated Hospital of Xiamen University
🇨🇳Xiamen, China
Aalborg University Hospital
🇩🇰Aalborg, Denmark
Aarhus University Hospital
🇩🇰Aarhus, Denmark
Rigshospitalet
🇩🇰Copenhagen, Denmark
Odense University Hospital
🇩🇰Odense, Denmark
Soenderborg sygehus
🇩🇰Syddanmark, Denmark
Clinique Tivoli Ducos - Centre dOncologie et de Radiotherapie a Bordeaux
🇫🇷Bordeaux, Gironde, France
Institut Claudius Regaud
🇫🇷Toulouse, Haute Garonne, France
Institut De Cancerologie De La Loire
🇫🇷Saint-Priest-en-Jarez, Loire, France
CHR Metz-Thionville
🇫🇷Metz cedex 03, Lorraine, France
Institut Bergonie
🇫🇷Bordeaux, France
Centre Georges François Leclerc
🇫🇷Dijon, France
CHD Vendee
🇫🇷La Roche-sur-Yon, France
Centre Oscar Lambret
🇫🇷Lille, France
Centre Leon Berard
🇫🇷Lyon, France
Institut Paoli-Calmettes
🇫🇷Marseille, France
Centre de Cancérologie du Grand Montpellier
🇫🇷Montpellier, France
The Sel of Centre dOncologie de Gentilly
🇫🇷Nancy, France
Centre Antoine Lacassagne
🇫🇷Nice, France
Hospital St Louis
🇫🇷Paris, France
Hopital Georges Pompidou
🇫🇷Paris, France
IUC AP-HP. Sorbonne Université, Hôpital Tenon
🇫🇷Paris, France
CHU de Poitiers
🇫🇷Poitiers, France
Centre Eugene Marquis
🇫🇷Rennes, France
Institut de cancerologie de l'ouest
🇫🇷Saint-Herblain, France
Strasbourg Europe Cancer Institute
🇫🇷Strasbourg, France
Gemeinschaftspraxis Dres. Halder / Bangerter
🇩🇪Augsburg, Germany
Cahrité Campus Mitte
🇩🇪Berlin, Germany
Klinikverbund Südwest Kliniken Böblingen Frauenklinik Böblingen
🇩🇪Böblingen, Germany
Klinikum Chemnitz gGmbH
🇩🇪Chemnitz, Germany
DONAUISAR Klinikum
🇩🇪Deggendorf, Germany
St.-Johannes-Hospital Dortmund, Dept. of Obstetrics/Gynecology
🇩🇪Dortmund, Germany
University Hospital Dresden
🇩🇪Dresden, Germany
Onkozentrum Dresden
🇩🇪Dresden, Germany
Universitätsklinikum Düsseldorf, Klinik für Frauenheilkunde & Geburtshilfe
🇩🇪Düsseldorf, Germany
Frauenklinik der Universität Erlangen
🇩🇪Erlangen, Germany
Kliniken Essen-Mitte, Klinik für Senologie/ Interdisziplinäres Brustzentrum
🇩🇪Essen, Germany
Universitätsklinikum Essen, Frauenklinik
🇩🇪Essen, Germany
Klinikum Esslingen GmbH
🇩🇪Esslingen, Germany
AGAPLESION Markus Krankenhaus
🇩🇪Frankfurt am main, Germany
Frankfurt University Department of Gynecology and Obstetrics
🇩🇪Frankfurt, Germany
Centrum for Haematology and Oncology
🇩🇪Frankurt am Main, Germany
Universitätsklinik Freiburg, Klinik für Frauenheilkunde
🇩🇪Freiburg, Germany
Evangelische Kliniken Gelsenkirchen
🇩🇪Gelsenkirchen, Germany
MVZ II der Niels-Stensen-Kliniken
🇩🇪Georgsmarienhütte, Germany
SRH Waldklinikum Gera, Brustzentrum Ostthüringen
🇩🇪Gera, Germany
MVZ Onkologische Kooperation Harz
🇩🇪Goslar, Germany
Krankenhaus St. Elisabeth und St. Barbara Halle/Saale
🇩🇪Halle/saale, Germany
University Medical Center
🇩🇪Hamburg, Germany
Mammazentrum HH am Krankenhaus Jerusalem
🇩🇪Hamburg, Germany
Albertinen Krankenhaus
🇩🇪Hamburg, Germany
Gynäkologisch-Ontologische Praxis Hannover
🇩🇪Hannover, Germany
DIAKOVERE Henriettenstift Frauenklinik
🇩🇪Hannover, Germany
Gemeinschaftspraxis Frauenärzte am Bahnhofsplatz
🇩🇪Hildesheim, Germany
Department of Gyencology and Obstetrics, Saarland University Hospital
🇩🇪Homburg, Germany
ViDia Christliche Kliniken Karlsruhe
🇩🇪Karlsruhe, Germany
Elisabethkrankenhaus Kassel, Brustzentrum
🇩🇪Kassel, Germany
Klinikum Kassel
🇩🇪Kassel, Germany
Medzinische Fakultät Mannheim, Universität Heidelberg
🇩🇪Mannheim, Germany
Klinikum Memmingen
🇩🇪Memmingen, Germany
Johannes Wesling Klinikum Minden, Hämatologie-Onkologie/Brustzentrum
🇩🇪Minden, Germany
Rotkreuzklinikum München, Frauenklinik
🇩🇪Muenchen, Germany
Medizinisches Versorgungszentrum für Hämatologie und Onkologie München MVZ GmbH
🇩🇪München, Germany
LMU Klinikum/ Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe
🇩🇪München, Germany
Dept. OB/GYN Johanna Etienne Krankenhaus
🇩🇪Neuss, Germany
Ortenau Klinikum Offenburg-Kehl
🇩🇪Offenburg, Germany
Klinikum Oldenburg AöR
🇩🇪Oldenburg, Germany
Frauenklinik St. Louise - St. Vincenz- Krankenhaus GmbH
🇩🇪Paderborn, Germany
Klinikum Ernst von Bergmann
🇩🇪Potsdam, Germany
Studienzentrum Onkologie Ravensburg
🇩🇪Ravensburg, Germany
Oncologianova GmbH
🇩🇪Recklinghausen, Germany
RoMed Klinikum Rosenheim
🇩🇪Rosenheim, Germany
Univ-Hospital, Dept Ob/Gyn
🇩🇪Rostock, Germany
CaritasKlinikum St. Theresia
🇩🇪Saarbrücken, Germany
Onkologische Schwerpunktpraxis Speyer
🇩🇪Speyer, Germany
G.SUND Gynäkologie Kompetenzzentrum
🇩🇪Stralsund, Germany
KKH Torgau
🇩🇪Torgau, Germany
Klinikum Mutterhaus
🇩🇪Trier, Germany
Praxisnetzwerk Hämatologie/Internistische Onkologie
🇩🇪Troisdorf, Germany
Frauenklinik
🇩🇪Tuebingen, Germany
Universitätsfrauenklinik Ulm
🇩🇪Ulm, Germany
Schwarzwald - Baar Klinikum Frauenklinik
🇩🇪Villingen-Schwenningen, Germany
Harzklinikum Dorothea Christiane Erxleben
🇩🇪Wernigerode, Germany
St. Anna Hospital Brustzentrum
🇩🇪Witten, Germany
Klinikum Worms gGmbH
🇩🇪Worms, Germany
General Hospital of Athens Alexandra Clinic
🇬🇷Athens, Attiki, Greece
University General Hospital of Heraklion
🇬🇷Heraklion, Crete, Greece
National Cancer Center
🇰🇷Gyeonggi-do, Korea, Republic of
University General Hospital of Patras
🇬🇷Patras, Western Greece, Greece
General Hospital of Patras Agios Andreas
🇬🇷Patras, Greece
Pamela Youde Nethersole Eastern Hospital PYNEH
🇭🇰Hong Kong, Hong Kong
The Chinese University of Hong Kong (CUHK) - Prince of Wales Hospital (PWH)
🇭🇰Hong Kong, Hong Kong
Saint Vincents University Hospital
🇮🇪Dublin, Ie-d, Ireland
St. James Hospital
🇮🇪Dublin, Leinster, Ireland
University College Cork
🇮🇪Cork, Ireland
Mater Misericordiae University Hospital
🇮🇪Dublin, Ireland
University Hospital Limerick
🇮🇪Limerick, Ireland
Soroka MC
🇮🇱Be'er Sheva, Hadarom, Israel
Sheba Medical Center
🇮🇱Ramat Gan, Tel Aviv, Israel
Hadassah Medical Center
🇮🇱Jerusalem, Israel
Rabin Medical Center
🇮🇱Petah tikva, Israel
Azienda Ospedaliera Garibaldi-Nesima
🇮🇹Catania, CT, Italy
Istituto Europeo di Oncologia
🇮🇹Milan, MI, Italy
Centro di Riferimento Oncologico di Aviano - SOC Oncologia Medica e Prevenzione Oncologica
🇮🇹Aviano, Italy
Istituto Oncologico di Bari
🇮🇹Bari, Italy
Azienda ULSS n. 1 Dolomiti
🇮🇹Belluno, Italy
Istituto Oncologico Veneto IRCCS
🇮🇹Padova, Italy
ICS Maugeri IRCCS
🇮🇹Pavia, Italy
Azienda Ospedaliera di Perugia
🇮🇹Perugia, Italy
A.O.U. Citta della Salute e della Scienza di Torino
🇮🇹Torino, Italy
Hyogo Cancer Center
🇯🇵Akashi City, Japan
National Cancer Center (NCC) - Tsukiji Campus - National Cancer Center Hospital (NCCH)
🇯🇵Chuo-Ku, Japan
National Hospital Organization - National Kyushu Cancer Center
🇯🇵Fukuoka City, Japan
Hiroshima City Hiroshima Citizens Hospital
🇯🇵Hiroshima City, Japan
Tokai University Hospital - Isehara Campus
🇯🇵Isehara City, Japan
Sagara Hospital
🇯🇵Kagoshima City, Japan
National Cancer Center Hospital East (NCCHE) - Kashiwa Campus
🇯🇵Kashiwa City, Japan
Japanese Foundation for Cancer Research (JFCR) - The Cancer Institute Hospital - Breast Oncology Center
🇯🇵Koto-Ku, Japan
Kyoto University Hospital
🇯🇵Kyoto, Japan
National Hospital Organization (NHO) - Shikoku Cancer Center
🇯🇵Matsuyama City, Japan
Aichi Cancer Center Hospital
🇯🇵Nagoya City, Japan
Okayama University Hospital
🇯🇵Okayama City, Japan
National Hospital Organization - Osaka National Hospital (ONH)
🇯🇵Osaka City, Japan
Osaka International Cancer Institute (OICI)
🇯🇵Osaka City, Japan
Saitama Cancer Center
🇯🇵Saitama, Japan
National Hospital Organization - Hokkaido Cancer Center
🇯🇵Sapporo City, Japan
Kindai University (Kinki University) - Faculty of Medicine (Kinki University School of Medicine (KUSM)) - Kindai University Hospital (Kinki University Hospital) - Cancer Center
🇯🇵Sayama City, Japan
Tohoku University Hospital (TUH) - Clinical Research, Innovation and Education Center (CRIETO)
🇯🇵Sendai City, Japan
Showa University Hospital - Breast Center
🇯🇵Shinagawa-Ku, Japan
Tokyo Medical University Hospital
🇯🇵Shinjuku-Ku, Japan
Shizuoka Cancer Center (SCC)
🇯🇵Shizuoka, Japan
Kanagawa Cancer Center Hospital - Kanagawa Cancer Center (Kanagawa Cancer Centre Research Institute)
🇯🇵Yokohama City, Japan
Kyungpook National University Hospital
🇰🇷Daegu, Korea, Republic of
CHA Bundang Medical Center CHA University
🇰🇷Gyeonggi-do, Korea, Republic of
Seoul National University Bundang Hospital
🇰🇷Gyeonggi-do, Korea, Republic of
Gachon University Gil Medical Center
🇰🇷Incheon, Korea, Republic of
Samsung Medical Center
🇰🇷Irwon-dong, Korea, Republic of
Korea University Anam Hospital
🇰🇷Seoul, Korea, Republic of
Seoul National University Hospital
🇰🇷Seoul, Korea, Republic of
Severance Hospital
🇰🇷Seoul, Korea, Republic of
Asan Medical Center
🇰🇷Songpa-gu, Korea, Republic of
Soon Chun Hyang Central Medical Center (SCHMC)
🇰🇷Yongsan, Korea, Republic of
CIMAB S.A. de C.V
🇲🇽Torreon, Coahuila, Mexico
Hospital Civil de Guadalajara Fray Antonio Alcalde
🇲🇽Guadalajara, JAL, Mexico
Consultorio del Dr. Joaqun Gabriel Reinoso Toledo
🇲🇽Monterrey, Nuevo Leon, Mexico
Amsterdam UMC - VU Medisch Centrum
🇳🇱Amsterdam, Noord-Holland, Netherlands
Amphia Hospital Breda
🇳🇱Breda, Netherlands
Erasmus MC - Daniel den Hoed Oncologisch Centrum
🇳🇱Rotterdam, Netherlands
SP Zoz Opolskie Centrum Onkologii IM
🇵🇱Opole, Opolskie, Poland
Uniwersyteckie Centrum Kliniczne
🇵🇱Gdańsk, Pomorskie, Poland
Centrum Medyczne HCP Sp. z o.o.
🇵🇱Poznań, Wielkopolskie, Poland
MSCM Cancer Center and Institute of Oncology Department of Breast Cancer and Reconstructive Surgery
🇵🇱Warsaw, Poland
Instytut Centrum Zdrowia Matki Polki
🇵🇱Łódź, Poland
Hospital da Senhora da Oliveira, Guimarães EPE
🇵🇹Guimarães, Portugal
Instituto Português de Oncologia de Lisboa Francisco Gentil, EPE
🇵🇹Lisboa, Portugal
Fundação Champalimaud
🇵🇹Lisboa, Portugal
Centro Hospitalar de Lisboa Ocidental, EPE
🇵🇹Lisboa, Portugal
Hospital Beatriz Ângelo
🇵🇹Loures, Portugal
Unidade Local de Saúde de Matosinhos, EPE
🇵🇹Matosinhos, Portugal
Instituto Português de Oncologia do Porto Francisco Gentil, EPE
🇵🇹Porto, Portugal
Centro Hospitalar de Vila Nova de Gaia/Espinho, EPE
🇵🇹Vila Nova De Gaia, Portugal
Institutul Oncologic Prof. Dr. Ion Chiricuta
🇷🇴Cluj-Napoca, Cluj, Romania
Onco Clinic Consult SA
🇷🇴Craiova, Dolj, Romania
Centrul de Oncologie Sfantu Nectarie
🇷🇴Craiova, Dolj, Romania
Institutul Oncologic Bucuresti IOB
🇷🇴Bucharest, Romania
SBHI Arkhangelsk Region - Arkhangelsk Clinical Oncological Dispensary
🇷🇺Arkhangel'sk, Russian Federation
State Budgetary Healthcare Institution Oncological Dispensary No. 2 of the Ministry of Health of Krasnodar Region
🇷🇺Sochi, Russian Federation
National University Cancer Institute
🇸🇬Singapore, Singapore
National Cancer Center Singapore
🇸🇬Singapore, Singapore
Hospital Universitario de Basurto
🇪🇸Bilbao, Bizkaia, Spain
Hospital Clínico Universitario Virgen de la Arrixaca
🇪🇸El Palmar, Murcia, Spain
Hospital Universitario Sant Joan Reus
🇪🇸Reus, Tarragona, Spain
Hospital Universitario Fundación Alcorcón
🇪🇸Alcorcón, Spain
Hospital General Universitario de Alicante
🇪🇸Alicante, Spain
Hospital de San Juan de Alicante
🇪🇸Alicante, Spain
Hospital Universitario de Badajoz
🇪🇸Badajoz, Spain
Hospital del Mar
🇪🇸Barcelona, Spain
IOB Institute Of Oncology-Hospital Quironsalud Barcelona
🇪🇸Barcelona, Spain
Hospital Universitari Vall d'Hebron
🇪🇸Barcelona, Spain
Hospital Clínic de Barcelona
🇪🇸Barcelona, Spain
Hospital Universitari Mútua Terrassa
🇪🇸Barcelona, Spain
ALTHAIA, Xarxa Assistencial Universitària de Manresa F.P.
🇪🇸Barcelona, Spain
Hospital de Mataró
🇪🇸Barcelona, Spain
ICO Hospitalet
🇪🇸Barcelona, Spain
ICO Badalona
🇪🇸Barcelona, Spain
Consorcio Hospitalario Provincial de Castelló
🇪🇸Castellón, Spain
Complejo Hospitalario Universitario A Coruña (CHUA)
🇪🇸Coruña, Spain
Hospital Universitario Ramón y Cajal
🇪🇸Madrid, Spain
Hospital Universitario Fundación Jiménez Díaz
🇪🇸Madrid, Spain
Hospital Universitario 12 de Octubre
🇪🇸Madrid, Spain
Hospital Universitario La Paz
🇪🇸Madrid, Spain
HM Sanchinarro (CIOCC)
🇪🇸Madrid, Spain
Hospital Universitario Puerta de Hierro de Majadahonda
🇪🇸Madrid, Spain
Hospital Universitario HM Puerta del Sur
🇪🇸Madrid, Spain
Hospital Universitario de Fuenlabrada
🇪🇸Madrid, Spain
Hospital General Universitario Morales Meseguer
🇪🇸Murcia, Spain
Hospital Universitario Virgen de la Victoria
🇪🇸Málaga, Spain
Hospital Universitario Rey Juan Carlos
🇪🇸Móstoles, Spain
Complejo Hospitalario de Navarra
🇪🇸Navarro, Spain
Hospital Universitari Son Espases
🇪🇸Palma De Mallorca, Spain
Hospital Son Llatzer
🇪🇸Palma De Mallorca, Spain
Hospital Universitario de Canarias
🇪🇸San Cristobal de la Laguna, Spain
Hospital General de Catalunya
🇪🇸Sant Cugat Del Vallès, Spain
Complejo Hospitalario Clínico Universitario de Santiago de Compostela (CHUS)
🇪🇸Santiago De Compostela, Spain
Hospital Universitario Virgen Macarena
🇪🇸Sevilla, Spain
Hospital Quirón Salud Sagrado Corazón
🇪🇸Sevilla, Spain
Hospital Universtiario Virgen del Rocio
🇪🇸Sevilla, Spain
Fundación Instituto Valenciano de Oncologia (IVO)
🇪🇸Valencia, Spain
Hospital Clínico Universitario de Valencia
🇪🇸Valencia, Spain
Hospital Arnau de Vilanova de Valencia
🇪🇸Valencia, Spain
Hospital Clínico Universitario Lozano Blesa
🇪🇸Zaragoza, Spain
E-Da Cancer Hospital
🇨🇳Kaohsiung, Yanchao District, Taiwan
Koo Foundation Sun Yat-Sen Cancer Center
🇨🇳Beitou, Taiwan
Changhua Christian Hospital (CCH)
🇨🇳Chang Hua, Taiwan
Kaohsiung Medical University Chung-Ho Memorial Hospital
🇨🇳Kaohsiung, Taiwan
China Medical University Hospital
🇨🇳Taichung, Taiwan
Taichung Veterans General Hospital
🇨🇳Taichung, Taiwan
National Cheng Kung University Hospital
🇨🇳Tainan, Taiwan
Chi Mei Medical Center CMMC - Yongkang Branch
🇨🇳Tainan, Taiwan
National Taiwan University Hospital NTUH
🇨🇳Taipei, Taiwan
MacKay Memorial Hospital
🇨🇳Taipei, Taiwan
Taipei Veterans General Hospital TPVGH
🇨🇳Taipei, Taiwan
Tri-Service General Hospital
🇨🇳Taipei, Taiwan
Chang Gung Memorial Hospital CGMH
🇨🇳Taipei, Taiwan
Hacettepe University Cancer Institute
🇹🇷Ankara, İç Anadolu, Turkey
Trakya University Medical Faculty
🇹🇷Edirne, Turkey
Istanbul Medeniyet University Medical Faculty
🇹🇷Istanbul, Turkey
Medical Park - Izmir Hastanesi
🇹🇷İzmir, Turkey
Peterborough City Hospital
🇬🇧Peterborough, Cambridgeshire, United Kingdom
Kent Oncology Centre Maidstone Hospital
🇬🇧Maidstone, Kent, United Kingdom
The Christie Hospital
🇬🇧Manchester, Lancashire, United Kingdom
Clatterbridge Cancer Centre
🇬🇧Wirral, Merseyside, United Kingdom
Nottingham University Hospitals
🇬🇧Nottingham, Nottinghamshire, United Kingdom
Royal United Hospital Bath NHS Trust - Royal United Hospital RUH
🇬🇧Bath, Somerset, United Kingdom
Somerset NHS Foundation Trust
🇬🇧Taunton, Somerset, United Kingdom
St. James University Hospital
🇬🇧Leeds, West Yorkshire, United Kingdom
Univeristy Hospitals Bristol NHS Foundation Trust
🇬🇧Bristol, United Kingdom
Colchester Hospital, East Suffolk & North Essex NHS Foundation Trust
🇬🇧Colchester, United Kingdom
Royal Devon Exeter NHS Foundation Trust
🇬🇧Exeter, United Kingdom
Beatson West of Scotland Cancer Centre
🇬🇧Glasgow, United Kingdom
Guys and St Thomas NHS Foundation Trust
🇬🇧London, United Kingdom
Charing Cross Hospital
🇬🇧London, United Kingdom
Oxford University Hospitals NHS Foundation Trust
🇬🇧Oxford, United Kingdom
Blackpool Victoria Hospital
🇬🇧Peterborough, United Kingdom