Oregovomab Plus Chemo in Newly Diagnosed Patients With Advanced Epithelial Ovarian Cancer Following Optimal Debulking Surgery
- Conditions
- Carcinoma, Ovarian EpithelialOvarian NeoplasmsOvarian CancerOvarian Serous AdenocarcinomaFallopian Tube NeoplasmsFallopian Tube AdenocarcinomaFallopian Tube Serous AdenocarcinomaPeritoneal CancerPeritoneal CarcinomaPeritoneal Neoplasms
- Interventions
- Registration Number
- NCT04498117
- Lead Sponsor
- CanariaBio Inc.
- Brief Summary
Study to compare the safety and efficacy of oregovomab versus placebo, administered in combination with specific cycles of a standard six-cycle chemotherapy regimen (paclitaxel and carboplatin), for the treatment of subjects with newly diagnosed advanced ovarian cancer who have undergone optimal debulking.
- Detailed Description
Phase 3 double-blind, placebo-controlled, multi-center study to compare the safety and efficacy of four administrations of oregovomab 2 mg IV versus placebo, administered in combination with specific cycles of a standard six-cycle chemotherapy regimen (paclitaxel and carboplatin), for the treatment of subjects with newly diagnosed ovarian cancer who have undergone optimal debulking surgery and are either pending initiation of chemotherapy (Cohort 1 - Primary Surgery) or resumption of another three cycles of chemotherapy, having already completed three cycles of neoadjuvant chemotherapy (Cohort 2 - NACT + Interval Surgery).
For Cohort 1 - Primary Surgery, approximately 372 subjects randomized in a 1:1 ratio (i.e., chemotherapy with oregovomab or chemotherapy with placebo). For Cohort 2 - NACT + Interval Surgery, approximately 230 subjects will be randomized in a 1:1 ratio (i.e., chemotherapy with oregovomab or chemotherapy and placebo).
Recruitment & Eligibility
- Status
- ACTIVE_NOT_RECRUITING
- Sex
- Female
- Target Recruitment
- 615
-
Adults 18 years old or older.
-
Newly diagnosed epithelial adenocarcinoma of ovarian, fallopian tube or peritoneal origin FIGO Stage III or IV disease.
-
Histologic epithelial cell types: high grade serous adenocarcinoma, high grade endometrioid adenocarcinoma, undifferentiated carcinoma, clear cell adenocarcinoma, mixed epithelial carcinoma, or adenocarcinoma not otherwise specified (N.O.S.).
-
Completed debulking surgery (either primary debulking surgery or interval debulking surgery at the discretion of the investigator). Debulking surgery must be optimal, R1 or R0 (defined as R1, macroscopic less than 1 cm in diameter, or R0, microscopic or no evidence of tumor). Assessment of debulking surgery will be determined at the time of the surgical procedure, not by post-surgical imaging.
- For Cohort 1, subject will undergo primary debulking surgery. Subject must receive initial dose of paclitaxel 175 mg/m^2 given intravenously and carboplatin AUC 6 IV every 3 weeks for 6 cycles. Carboplatin total dose given as 5 consecutive daily pulse doses, for subjects who experiences significant grade 3 or higher emesis. Subsequent dose modifications will be instituted per protocol. Cycle 1 of chemotherapy ± oregovomab/placebo must be anticipated to occur within 6 weeks after primary debulking surgery
- For Cohort 2, subject will undergo interval debulking surgery (IDS). Prior to IDS, subjects must have receive 3 cycles of paclitaxel and carboplatin as neoadjuvant treatment. After IDS, subjects must receive paclitaxel 175 mg/m^2 IV and carboplatin AUC 5-6 IV every 3 weeks, starting cycle 4. Cycle 4 of chemotherapy ± oregovomab/placebo must be anticipated to occur within 6 weeks after IDS.
-
Suitable venous access for the study-required procedures
-
Preoperative serum CA-125 levels ≥ 50 U/mL for Cohort 1, serum CA-125 levels ≥ 50 U/mL prior to first neoadjuvant chemotherapy for Cohort 2.
-
Adequate bone marrow function:
- Absolute neutrophil count (ANC) ≥ 1,500/µL
- Platelets ≥ 100,000/µL
-
Hemoglobin ≥ 8.0 g/dL (Note: Blood transfusion is permitted up to 48 hours before first dose of study treatment).
-
Adequate liver function:
- Bilirubin < 1.5 times upper limit normal (ULN)
- Lactate Dehydrogenase (LDH), SGOT/AST and SGPT/ALT < 2.5 times ULN
-
Adequate renal function:
a. Creatinine ≤ 1.5 times ULN
-
ECOG Performance Status of 0 or 1.
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For women of childbearing potential, must be willing to avoid pregnancy by using highly effective method of contraception from the first dose of study treatment to 6 months after last dose of study treatment as defined per protocol. Belgium and South Korea only: Use of a highly effective method of contraception from 28 days before first dose.
-
Signed informed consent and authorization permitting release of personal health information.
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Willingness and ability to complete patient quality of life questionnaires.
-
BRCA1 or BRCA2 germline gene mutation test result with:
- Pathogenic, ambiguous or inconclusive result available within 28 days prior to starting study treatment (subjects with BRCA1 or BRCA 2 variants of uncertain significance can enroll onto the study as long as there is no intent to administer PARP inhibitors for front-line maintenance therapy), or
- Known BRCA1 and BRCA2 somatic mutations, if testing is performed
-
Known Somatic Homologous Recombination Deficiency (HRD) who will receive PARP inhibitor front-line maintenance therapy. Subjects with somatic HRD are eligible as long as there is no intent to administer PARP inhibitor front-line maintenance therapy.
-
Subjects with mucinous adenocarcinoma, carcinosarcoma, tumors with neuroendocrine features and low-grade adenocarcinoma.
-
Female subjects who are lactating and breastfeeding, or have a positive serum pregnancy test within 7 days prior to the first dose of study treatment (C1D1 for Cohort 1 or C4D1 for Cohort 2).
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Any serious medical or psychiatric illness that could, in the investigator's opinion, potentially interfere with the completion of treatment according to this protocol.
-
Active autoimmune disease, such as rheumatoid arthritis, systemic lupus erythematosus (SLE), ulcerative colitis, Crohn's Disease, multiple sclerosis (MS), or ankylosing spondylitis requiring active disease modifying treatment.
-
Known allergy to murine proteins or hypersensitivity to any of the excipients of the oregovomab, paclitaxel, or carboplatin.
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Chronically treated with immunosuppressive drugs such as cyclosporine, adrenocorticotropic hormone (ACTH), etc.
-
Chronic therapeutic corticosteroid use, defined as > 5 days of prednisone or equivalent, with the exception of inhalers or those on a pre-planned steroid taper. (Note: Premedication with corticosteroids per institutional standard of care is allowed.)
-
Recognized acquired, hereditary, or congenital immunodeficiency disease, including cellular immunodeficiencies, hypogammaglobulinemia or dysgammaglobulinemia.
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Clinically significant active infection(s) at the time of screening.
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Any of the following conditions (on-study testing is not required unless it is required by a specific participating country):
- Known HIV-infected subjects unless on effective anti-retroviral therapy with an undetectable viral load within 6 months, or
- Known or suspected hepatitis B if active infection (subjects with chronic hepatitis B infection must have an undetectable HBV viral load on suppressive therapy, if indicated; positive surface antibody alone is not an exclusion), or
- Known or suspected hepatitis C infection which has not been treated and cured unless currently on treatment with an undetectable viral load).
-
Uncontrolled or life-threatening diseases compromising safety evaluation.
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Diagnosed or treated for another malignancy within 5 years before the first dose, or previously diagnosed with another malignancy and have any evidence of residual disease including ductal carcinoma in situ of the breast. Subjects with non-melanoma skin cancer, other carcinoma in situ if have undergone complete resection or cervix carcinoma in situ are not excluded if they have undergone complete resection. Synchronous endometrial and prior diagnosis of endometrial cancer within 5 years is not excluded if all of the following conditions are met: Stage IA, superficial myometrial invasion, without lymphovascular invasion, and not poorly differentiated subtypes including papillary serous, clear cell lesions.
-
Contraindications to the use of pressor agents.
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Undergone more than one surgical debulking or have not recovered from surgery.
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Anticipated treatment with any other anti-cancer medications, including bevacizumab, PARP inhibitors, or any investigational agent(s) during the study.
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History or evidence upon physical examination of CNS disease, seizures not controlled with standard medical therapy, or any brain metastases.
-
Any of the following cardiovascular conditions:
- Acute myocardial infarction within 6 months before the first dose of study treatment.
- Current history of New York Heart Association (NYHA) Class III or IV heart failure.
- Evidence of current uncontrolled cardiovascular conditions including cardiac arrhythmias, angina, pulmonary hypertension, or electrocardiographic clinically significant findings.
-
Unable to read or understand or unable to sign the necessary written consent before starting treatment.
-
May not receive any live, attenuated vaccine administered within 28 days (or 4 weeks) prior to enrollment, during the study, and for at least 90 days after the last dose of study treatment.
-
Subjects who receive Hyperthermic Intraperitoneal Chemotherapy (HIPEC), any other anti-cancer medications, including bevacizumab, PARP inhibitors, or any other investigational agent(s) with 3 cycles of paclitaxel and carboplatin neoadjuvant treatment prior to IDS.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Cohort 1- Surgery Active Oregovomab Six (6) 21-day cycles of chemotherapy with oregovomab given at four (4) cycles (Cycle 1, Cycle 3, Cycle 5, and Cycle 5 plus 12 weeks). Cohort 1- Surgery Active Carboplatin Six (6) 21-day cycles of chemotherapy with oregovomab given at four (4) cycles (Cycle 1, Cycle 3, Cycle 5, and Cycle 5 plus 12 weeks). Cohort 1 - Primary Surgery Control Placebo Six (6) 21-day cycles of chemotherapy with placebo comparator given with chemotherapy at four (4) cycles (Cycle 1, Cycle 3, Cycle 5, and Cycle 5 plus 12 weeks). Cohort 2 - NACT + Interval Surgery Active Oregovomab In Cohort 2 - NACT + Interval Surgery, subjects must already have received three (3) cycles of paclitaxel and carboplatin neoadjuvant therapy. Subjects in Cohort 2 - NACT + Interval Surgery will receive three (3) cycles of chemotherapy with oregovomab given at four (4) cycles (Cycle 4, Cycle 6, Cycle 6 plus 6 weeks and Cycle 6 plus 18 weeks). Cohort 2 - NACT + Interval Surgery Control Placebo In Cohort 2 - NACT + Interval Surgery, subjects must already have received three (3) cycles of paclitaxel and carboplatin neoadjuvant therapy. Subjects in Cohort 2 - NACT + Interval Surgery will receive three (3) cycles of chemotherapy with placebo comparator given at four (4) cycles (Cycle 4, Cycle 6, Cycle 6 plus 6 weeks and Cycle 6 plus 18 weeks). Cohort 1- Surgery Active Paclitaxel Six (6) 21-day cycles of chemotherapy with oregovomab given at four (4) cycles (Cycle 1, Cycle 3, Cycle 5, and Cycle 5 plus 12 weeks). Cohort 1 - Primary Surgery Control Paclitaxel Six (6) 21-day cycles of chemotherapy with placebo comparator given with chemotherapy at four (4) cycles (Cycle 1, Cycle 3, Cycle 5, and Cycle 5 plus 12 weeks). Cohort 1 - Primary Surgery Control Carboplatin Six (6) 21-day cycles of chemotherapy with placebo comparator given with chemotherapy at four (4) cycles (Cycle 1, Cycle 3, Cycle 5, and Cycle 5 plus 12 weeks). Cohort 2 - NACT + Interval Surgery Active Paclitaxel In Cohort 2 - NACT + Interval Surgery, subjects must already have received three (3) cycles of paclitaxel and carboplatin neoadjuvant therapy. Subjects in Cohort 2 - NACT + Interval Surgery will receive three (3) cycles of chemotherapy with oregovomab given at four (4) cycles (Cycle 4, Cycle 6, Cycle 6 plus 6 weeks and Cycle 6 plus 18 weeks). Cohort 2 - NACT + Interval Surgery Active Carboplatin In Cohort 2 - NACT + Interval Surgery, subjects must already have received three (3) cycles of paclitaxel and carboplatin neoadjuvant therapy. Subjects in Cohort 2 - NACT + Interval Surgery will receive three (3) cycles of chemotherapy with oregovomab given at four (4) cycles (Cycle 4, Cycle 6, Cycle 6 plus 6 weeks and Cycle 6 plus 18 weeks). Cohort 2 - NACT + Interval Surgery Control Paclitaxel In Cohort 2 - NACT + Interval Surgery, subjects must already have received three (3) cycles of paclitaxel and carboplatin neoadjuvant therapy. Subjects in Cohort 2 - NACT + Interval Surgery will receive three (3) cycles of chemotherapy with placebo comparator given at four (4) cycles (Cycle 4, Cycle 6, Cycle 6 plus 6 weeks and Cycle 6 plus 18 weeks). Cohort 2 - NACT + Interval Surgery Control Carboplatin In Cohort 2 - NACT + Interval Surgery, subjects must already have received three (3) cycles of paclitaxel and carboplatin neoadjuvant therapy. Subjects in Cohort 2 - NACT + Interval Surgery will receive three (3) cycles of chemotherapy with placebo comparator given at four (4) cycles (Cycle 4, Cycle 6, Cycle 6 plus 6 weeks and Cycle 6 plus 18 weeks).
- Primary Outcome Measures
Name Time Method Investigator Assessed Progression Free Survival Date of randomization until date of first documented disease progression or date of death from any cause, whichever comes first, at up to approximately 6 years. Date of randomization to radiographically-confirmed disease progression according to RECIST v1.1 as determined by the investigator or death
- Secondary Outcome Measures
Name Time Method Overall Survival Date of randomization up until date of death from any cause, up to approximately 11 years Date of randomization to the date of death
Safety and Tolerability Date of randomization up until date of discontinuation of treatment, date of significant physical examination changes, date of significant clinical changes, up to approximately 6 years Incidence of adverse events (AEs) leading to discontinuation of treatment, frequency/severity of vital signs measurements, physical examination findings, and changes in clinical laboratory parameters
Change in Quality of Life Changes from baseline assessment, until date of discontinuation, or up to approximately 6 years 1. Change from baseline in the global health status/QOL scale score of the Functional Assessment of Cancer Therapy-Ovarian (FACT-O TOI)
2. Three additional questions from the NFOSI-18 in each treatment group
Trial Locations
- Locations (145)
Minnesota Oncology Hematology - Mercy Hospital
🇺🇸Coon Rapids, Minnesota, United States
Kaiser Permanente Los Angeles Medical Center
🇺🇸Los Angeles, California, United States
University Hospitals of Cleveland
🇺🇸Cleveland, Ohio, United States
Cleveland Clinic Fairview Hospital
🇺🇸Cleveland, Ohio, United States
Cleveland Clinic
🇺🇸Cleveland, Ohio, United States
Tufts Medical Center
🇺🇸Boston, Massachusetts, United States
Memorial Herman Hospital
🇺🇸Houston, Texas, United States
ZNA Middelheim
🇧🇪Antwerpen, Belgium
Fortis Hospital Ltd
🇮🇳Bengaluru, India
Max Super Specialty Hospital
🇮🇳Mohali, India
Fondazione Policlinico Universitario Agostino Gemelli IRCCS
🇮🇹Rome, Italy
Del-pesti Centrumkorhaz - Orszagos Hematologiai es Infektologiai Intezet
🇭🇺Budapest, Hungary
Seoul National University Bundang Hospital
🇰🇷Seongnam, Korea, Republic of
MultiCare Institute for Research and Innovation
🇺🇸Puyallup, Washington, United States
Fortis Hospital
🇮🇳Noida, India
SMIQ S. de R.L. de C.V.
🇲🇽Querétaro, Mexico
Severance Hospital Yonsei University Health System
🇰🇷Soeul, Korea, Republic of
Hospital Clinic de Barcelona
🇪🇸Barcelona, Catalonia, Spain
Magyar Honvedseg Egeszsegugyi Kozpont
🇭🇺Budapest, Hungary
Hospital de la Santa Creu i Sant Pau
🇪🇸Barcelona, Spain
Asan Medical Center
🇰🇷Seoul, Korea, Republic of
Fakultni nemocnice Bulovka
🇨🇿Praha, Czechia
Sushrut Hospital
🇮🇳Mumbai, India
Deenanath Mangeshkar Hospital
🇮🇳Pune, India
Bacs-Kiskun Megyei Oktatokorhaz
🇭🇺Kecskemét, Hungary
Debreceni Egyetem
🇭🇺Debrecen, Hungary
Centro de Investigación Clínica Bradford Hill
🇨🇱Santiago, Chile
All India Institute of Medical Services
🇮🇳Delhi, India
Clinical Medical Research S.C.
🇲🇽Orizaba, Veracruz, Mexico
Fakultni nemocnice v Motole
🇨🇿Praha, Czechia
ICO l'Hospitalet-Hospital Duran i Reynals
🇪🇸L'Hospitalet De Llobregat, Spain
Clinique CHC MontLégia
🇧🇪Liège, Belgium
Sociedad de Investigaciones Medicas Limitada
🇨🇱Temuco, Chile
Investigacion Onco Farmaceutica S. de R.L. de C.V. (OncoTech)
🇲🇽La Paz, Mexico
National Cheng Kung University Hospital
🇨🇳Tainan, Taiwan
Fakultni nemocnice Hradec Kralove
🇨🇿Hradec Kralove, Czechia
Fakultni nemocnice Kralovske Vinohrady
🇨🇿Prague, Czechia
Samsung Medical Center
🇰🇷Seoul, Korea, Republic of
Severance Hospital, Yonsei University Health System
🇰🇷Seoul, Korea, Republic of
Korea University Guro Hospital
🇰🇷Seoul, Korea, Republic of
Azienda Socio Sanitaria Territoriale di Monza (Presidio San Gerardo)
🇮🇹Monza, Italy
Università Campus Bio-Medico di Roma
🇮🇹Rome, Italy
National Cancer Center
🇰🇷Goyang, Korea, Republic of
Taichung Veterans General Hospital
🇨🇳Taichung, Taiwan
Hospital Universitari Vall d'Hebron
🇪🇸Barcelona, Catalonia, Spain
Instituto Valenciano de Oncologia IVO
🇪🇸Valencia, Spain
Koo Foundation Sun Yat-Sen Cancer Center
🇨🇳Taipei, Taiwan
University of Oklahoma Health Sciences Center
🇺🇸Oklahoma City, Oklahoma, United States
Universidad Autonoma de Nuevo Leon, Hospital Universitario Dr. Jose Eleuterio Gonzalez
🇲🇽Monterrey, Mexico
National Taiwan University Hospital
🇨🇳Taipei, Taiwan
Taipei Veterans General Hospital
🇨🇳Taipei county, Taipei, Taiwan
Duke University
🇺🇸Durham, North Carolina, United States
Centro Potosino de Investigación Medica S.C.
🇲🇽San Luis Potosi, Mexico
Seoul National University Hospital
🇰🇷Seoul, Korea, Republic of
Nebraska Methodist Hospital
🇺🇸Omaha, Nebraska, United States
Vseobecna fakultni nemocnice v Praze
🇨🇿Praha, Czechia
Zala Megyei Szent Rafael Korhaz
🇭🇺Zalaegerszeg, Hungary
Metro Minnesota Community Oncology Research Consortium
🇺🇸Saint Louis Park, Minnesota, United States
Honor Health
🇺🇸Phoenix, Arizona, United States
The University of Arizona Cancer Center
🇺🇸Tucson, Arizona, United States
Moores UC San Diego Cancer Center
🇺🇸La Jolla, California, United States
John Muir Health Clinical Research Center
🇺🇸Concord, California, United States
Kaiser Permanente Southern California
🇺🇸Irvine, California, United States
Epic Care
🇺🇸Pleasant Hill, California, United States
Kaiser Permanente Riverside Medical Center
🇺🇸Riverside, California, United States
Contra Costa Oncology
🇺🇸Walnut Creek, California, United States
John Muir Health Gynecologic Cancer Services
🇺🇸Walnut Creek, California, United States
University of Connecticut Health Center
🇺🇸Farmington, Connecticut, United States
AdventHealth Orlando
🇺🇸Orlando, Florida, United States
Women's Cancer Florida/Women's Cancer Associates
🇺🇸Saint Petersburg, Florida, United States
Lewis Cancer & Research Pavilion at St. Joseph's Candler
🇺🇸Savannah, Georgia, United States
Parkview Research Center
🇺🇸Fort Wayne, Indiana, United States
Women's Cancer Care/Mary Bird Perkins Cancer Center
🇺🇸Covington, Louisiana, United States
Lahey Hospital and Medical Center
🇺🇸Burlington, Massachusetts, United States
MetroWest Medical Center
🇺🇸Framingham, Massachusetts, United States
Tufts Medical Center Cancer Center in Stoneham
🇺🇸Stoneham, Massachusetts, United States
UMass Memorial Medical Center
🇺🇸Worcester, Massachusetts, United States
Lowell General Hospital
🇺🇸Lowell, Massachusetts, United States
Sparrow Hospital
🇺🇸Lansing, Michigan, United States
Minnesota Oncology Hematology
🇺🇸Saint Paul, Minnesota, United States
University of Minnesota Health - Maple Grove Clinic
🇺🇸Maple Grove, Minnesota, United States
Portsmouth Regional Hospital
🇺🇸Portsmouth, New Hampshire, United States
Park Nicollet Frauenshuh Cancer Center
🇺🇸Saint Louis Park, Minnesota, United States
The Valley Hospital (Valley Health)
🇺🇸Paramus, New Jersey, United States
Rutgers Cancer Institute of New Jersey
🇺🇸New Brunswick, New Jersey, United States
Mount Sinai - PRIME
🇺🇸Lake Success, New York, United States
Mount Sinai The Blavatnik Family Chelsea Medical Center
🇺🇸New York, New York, United States
Stony Brook University Hospital
🇺🇸Stony Brook, New York, United States
Icahn School of Medicine at Mount Sinai
🇺🇸New York, New York, United States
Duke Women's Cancer Care Raleigh
🇺🇸Raleigh, North Carolina, United States
SCC at UH Geauga Medical Center
🇺🇸Chardon, Ohio, United States
Ohio State University Wexner Medical Center
🇺🇸Columbus, Ohio, United States
Cleveland Clinic Hillcrest Hospital
🇺🇸Mayfield Heights, Ohio, United States
Grandview Medical Center/Kettering Medical Center
🇺🇸Kettering, Ohio, United States
Oklahoma Cancer Specialist and Research Institution, LLC
🇺🇸Tulsa, Oklahoma, United States
SCC at St. John's Medical Center
🇺🇸Westlake, Ohio, United States
Willamette Valley Cancer Institute and Research Center
🇺🇸Eugene, Oregon, United States
UH Minoff Health Center - Seidman
🇺🇸Orange Village, Ohio, United States
Northwest Cancer Specialists, P.C.-Portland-Rose Quarter
🇺🇸Portland, Oregon, United States
Magee Women's Hospital of UPMC
🇺🇸Pittsburgh, Pennsylvania, United States
UPMC Hillman Cancer Center at UPMC Passavant
🇺🇸Pittsburgh, Pennsylvania, United States
Women & Infants Hospital of Rhode Island
🇺🇸Providence, Rhode Island, United States
Sanford Research/USD-Sioux Falls
🇺🇸Sioux Falls, South Dakota, United States
Texas Oncology, P.A.
🇺🇸Dallas, Texas, United States
Texas Oncology, P.A. - Fort Worth
🇺🇸Fort Worth, Texas, United States
Texas Oncology San Antonio Medical Center
🇺🇸San Antonio, Texas, United States
University of Virginia Health Systems
🇺🇸Charlottesville, Virginia, United States
Virginia Cancer Specialists
🇺🇸Fairfax, Virginia, United States
Virginia Oncology Associates - Hampton
🇺🇸Norfolk, Virginia, United States
Carilion Clinic Gynecological Oncology
🇺🇸Roanoke, Virginia, United States
MultiCare Regional Cancer Center - Auburn
🇺🇸Auburn, Washington, United States
MultiCare Regional Cancer Center-Gig Harbor Medical Park
🇺🇸Gig Harbor, Washington, United States
MultiCare Regional Cancer Center - Tacoma
🇺🇸Tacoma, Washington, United States
Clínica Universitaria Privada Reina Fabiola
🇦🇷Córdoba, Cordoba, Argentina
CEMAIC - Centro Medico Privado
🇦🇷Córdoba, Cordoba, Argentina
Sanatorio de la Mujer
🇦🇷Rosario, Argentina
Clinicas Viedma S.A.
🇦🇷Viedma, Argentina
CER San Juan Centro Polivalente de Asistencia e Inv. Clinica
🇦🇷San Juan, Argentina
Sanatorio Parque S.A
🇦🇷Salta, Argentina
Cliniques Universitaires Saint-Luc
🇧🇪Bruxelles, Belgium
Oncosite - Centro de Pesquisa Clinica e Oncologia
🇧🇷Guimaraes, Brazil
Centro de Pesquisas Clinica Reichow
🇧🇷Blumenau, Brazil
Centro Gaucho Integrado de Oncologia, Hematologia, Ensino e Pesquisa - Hospital Mae de Deus
🇧🇷Porto Alegre, Brazil
Fundação Doutor Amaral Carvalho
🇧🇷San Paolo, Brazil
CEPHO - Centro de Estudos e Pesquisas de Hematologia e Oncologia
🇧🇷Santo André, Brazil
Clínica São Germano - Oncologia
🇧🇷Sao Paulo, Brazil
City of Health Hospital at Laval (Cité de la Santé de Laval)
🇨🇦Laval, Quebec, Canada
CHUM Centre de Recherche (affiliated with University of Montreal)
🇨🇦Montréal, Quebec, Canada
McGill University Health Centre/Glen Site/ Royal Victoria Hospital
🇨🇦Montréal, Quebec, Canada
CHUS - Hôpital Fleurimont
🇨🇦Sherbrooke, Quebec, Canada
University of California, Davis Comprehensive Cancer Center
🇺🇸Sacramento, California, United States
St. Joseph Mercy Hospital
🇺🇸Ann Arbor, Michigan, United States
University of Colorado Health
🇺🇸Aurora, Colorado, United States
The Queens Medical Center
🇺🇸Honolulu, Hawaii, United States
Texas Oncology, P.A. - Austin
🇺🇸Austin, Texas, United States
VCU Massey Cancer Center
🇺🇸Richmond, Virginia, United States
The Catholic University of Korea, Seoul St. Mary's Hospital
🇰🇷Seoul, Korea, Republic of
Womens Cancer Care Associates
🇺🇸Albany, New York, United States
Smilow Cancer Hospital
🇺🇸New Haven, Connecticut, United States
Yale University School of Medicine
🇺🇸New Haven, Connecticut, United States
Montefiore Medical Center PRIME
🇺🇸Bronx, New York, United States
Kapiolani Medical Center for Women and Children/University of Hawaii
🇺🇸Honolulu, Hawaii, United States
University of Wisconsin
🇺🇸Madison, Wisconsin, United States
Ruby Hall Clinic
🇮🇳Pune, India
Queen Elizabeth II Health Sciences Centre
🇨🇦Halifax, Nova Scotia, Canada