A Study of Sasanlimab in People With Non-muscle Invasive Bladder Cancer
- Conditions
- Non-muscle Invasive Bladder Cancer
- Interventions
- Drug: Bacillus Calmette-Guerin
- Registration Number
- NCT04165317
- Lead Sponsor
- Pfizer
- Brief Summary
The purpose of this study is to learn about the safety and effects of the study medicine (sasanlimab) in people with non-muscle invasive bladder cancer. This study is seeking participants whose bladder cancer is still in early stages, has not spread outside of the bladder, has been removed with surgery, and is high risk (Part A) or was previously treated with BCG (Bacillus Calmette Guerin), a standard treatment for bladder cancer (Part B).
In Part A (enrollment closed), each participant was assigned to one of three study treatment groups.
* One group is given sasanlimab and BCG at the study clinic.
* The second group is given sasanlimab and BCG at the study clinic. This group will receive BCG for the first six weeks only.
* The third group is given BCG only and will not receive sasanlimab.
In Part B of the study, each new participant will be assigned to a study treatment group based on the type of their bladder tumor.
- Both groups will be given sasanlimab at the study clinic.
On August 31, 2022, the Sponsor announced the discontinuation of enrollment to Part B. The decision to discontinue enrollment to Part B was not made for safety reasons.
- Detailed Description
CREST: Combination of sasanlimab and alternative BCG Regimens to Evaluate outcomes with Subcutaneous anti-PD-1 Treatment
Phase 3 Design with two Cohorts. Cohort A consists of 3 study Arms (A, B and C) of BCG naive participants. Arms A and B consist of two study drugs, PF-06801591 plus BCG. Arm C consists of one study drug, BCG. Cohort B consists of B1 and B2, which test PF-06801591 and include participants who have BCG unresponsive CIS (B1) or BCG unresponsive papillary only disease (B2).
The study is designed to demonstrate that PF-06801591 plus Bacillus Calmette Guerin (BCG) (induction and maintenance periods) is superior to BCG alone (induction and maintenance periods) in prolonging event free survival (EFS) in participants with high-risk naïve non-muscle invasive bladder cancer (NMIBC) and to demonstrate that PF-06801591 plus BCG (induction period only) is superior to BCG alone (induction and maintenance periods) in prolonging EFS in participants with high-risk NMIBC. The study is also designed to estimate the CR rate of PF-06801591 alone in participants with BCG unresponsive CIS and to evaluate the EFS of PF-06801591 alone in participants with BCG unresponsive NMIBC.
On August 31, 2022, the Sponsor announced the discontinuation of enrollment to Part B, which enrolled participants with BCG unresponsive NMIBC. The decision to discontinue enrollment to Part B was not made for safety reasons.
Recruitment & Eligibility
- Status
- ACTIVE_NOT_RECRUITING
- Sex
- All
- Target Recruitment
- 1070
- Histological confirmed diagnosis of high risk non-muscle invasive transitional cell carcinoma (TCC) of the urothelium of the urinary bladder (tumors of mixed transitional/non-transitional cell histology are allowed, but TCC must be the predominant histology)
- Complete resection of all Ta/T1 papillary disease (including participants with concurrent CIS), with most recent positive TURBT occurring within 12 weeks prior to randomization or study intervention. A second TURBT must have been performed if indicated according to the current locally applicable guidelines, ie, American Urological Association, European Association of Urology
- (Cohorts B1 and B2 only): Histological confirmed diagnosis of BCG-unresponsive high-risk, non-muscle invasive TCC of the urothelium within 12 months (CIS only) or 6 months (recurrent Ta/T1 disease) of completion of adequate BCG therapy.
- Have refused or are ineligible for radical cystectomy
- Evidence of muscle-invasive, locally advanced or metastatic urothelial cancer or concurrent extravesical, non-muscle invasive TCC of the urothelium
- (Cohort A only): Intravesical BCG therapy within 2 years prior to randomization. Prior intravesical chemotherapy for NMIBC is allowed.
(Cohorts B1 and B2 only): Any systemic or intravesical chemotherapy or immunotherapy from the time of most recent positive TURBT to initiation of study intervention.
- Prior immunotherapy with anti PD-1, anti PD-L1, anti PD-L2, or anti cytotoxic T-lymphocyte-associated antigen-4 (CTLA-4) antibody
- Prior treatment with immunostimulatory agents including interleukin (IL)-2, IL-15, interferon (INF)
- Prior radiation therapy to the bladder
- (Cohorts B1 and B2 only): Prior participation in Cohort A of this study.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description PF-06801591 + BCG induction and maintenance Bacillus Calmette-Guerin PF-06801591 in combination with Bacillus Calmette Guerin(induction+maintenance). PF-06801591 + BCG induction only Bacillus Calmette-Guerin PF-06801591 in combination with Bacillus Calmette Guerin (induction only). BCG induction and maintenance Bacillus Calmette-Guerin Bacillus Calmette Guerin (induction and maintenance). PF-06801591 + BCG induction and maintenance PF-06801591 PF-06801591 in combination with Bacillus Calmette Guerin(induction+maintenance). PF-06801591 + BCG induction only PF-06801591 PF-06801591 in combination with Bacillus Calmette Guerin (induction only). BCG Unresponsive CIS PF-06801591 PF-06801591 BCG Unresponsive NMIBC PF-06801591 PF-06801591
- Primary Outcome Measures
Name Time Method Event free survival (Cohort A: Arm A compared to Arm C) 55 months after first participant randomized Event free survival is defined as the time from randomization to date of EFS event.
Complete response rate (Cohort B1) (Obsolete after stopping enrollment in Cohort B) Registration to 12 months after last participant initially assessed Complete response (CR) rate defined as the proportion of participants in the analysis population with CR.
Event free survival (Cohort B2) (Obsolete after stopping enrollment in Cohort B) Registration to 12 months after last participant initially assessed Event free survival is defined as the time from first dose to date of EFS event.
- Secondary Outcome Measures
Name Time Method Event free survival (Cohort A: Arm B compared to Arm C) 55 months after first participant randomized Event free survival is defined as the time from randomization to date of EFS event.
Overall Survival (Cohort A: Arm A compared to Arm C) Randomization up to 60 months from last participant randomized Overall survival is defined as the time from the date of randomization to the date of death due to any cause.
Overall Survival (Cohort A: Arm B compared to Arm C) Randomization up to 60 months from last participant randomized Overall survival is defined as the time from the date of randomization to the date of death due to any cause.
Complete response rate in participants with CIS at randomization (Cohort A: Arm A, B, C) Randomization up to 60 months from last participant randomized Complete response (CR) rate defined as the proportion of participants in the analysis population with CR.
Disease-specific survival (Cohort A: Arm A, B, C) Randomization up to 60 months from last participant randomized Disease specific survival (DSS) is defined as the time from randomization to death resulting from bladder cancer.
Health-related quality of life as measured by EORTC QLQ-C30 (European Organization for Treatment of Cancer Quality of Life Questionnaire for cancer patients) (Obsolete for Cohort B after stopping enrollment) Randomization up to 60 months from last participant randomized EORTC QLQ-C30: included functional scales (physical, role, cognitive, emotional, and social), global health status, symptom scales (fatigue, pain, nausea/vomiting) and single items (dyspnoea, appetite loss, insomnia, constipation/diarrhea and financial difficulties).
ctrough of PF-06801591 when in combination with BCG (induction and maintenance or induction). Cohort A: Arms A and B only. Randomization up to 24 months Ctrough will be summarized in Cohort A Arms A and B only.
Incidence of ADA/Nab of PF-06801591 when in combination with BCG (induction and maintenance or induction). Cohort A: Arms A and B only. Randomization up to 24 months Immunogenicity will be evaluated for Cohort A Arms A and B only.
Tumor sample biomarker status based on PD-L1 expression (high or low) (Obsolete for Cohort B after stopping enrollment) Baseline Evaluate PD-L1 expression.
Duration of CR for participants with CIS at randomization (Obsolete for Cohort B after stopping enrollment) Randomization/registration up to 60 months from last participant randomized Duration of CR is defined as time from first CR to first recurrence or death due to any cause, whichever occurs first.
Time to recurrence of low grade disease (Cohort A: Arm A, B, C) Randomization up to 60 months from last participant randomized Time to recurrence defined as time from randomization to the date of first documentation of recurrence of low grade disease or death due to any cause, whichever occurs first.
Time to cystectomy (Obsolete for Cohort B after stopping enrollment) Randomization/registration to date of cystectomy (up to 5 years after last participant is randomized) Time to cystectomy is defined as time from randomization/registration to cystectomy in participants with NMIBC
Health-related quality of life as measured by PTAB (Patient Treatment Administration Burden Questionnaire) (Obsolete for Cohort B after stopping enrollment) Randomization/registration up to 24 months PTAB is a 2-item PRO designed to assess, from the patient perspective, any pain associated with the treatment administration and the burden of the amount of time required to complete the treatment administration procedures (1 item each).
Percentage of Participants With All Causality and Treatment-related Treatment-emergent Adverse Events (TEAEs), Serious Adverse Events (SAEs), and Withdrawals Due to TEAEs (Obsolete for Cohort B after stopping enrollment) Baseline up to 60 months from the last participant randomized An adverse event (AE) is any untoward medical occurrence attributed to study drug in a participant who received study drug. AEs comprised both SAEs and non-SAEs. Causality assessment is made by the investigator. Grading is per the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Event (CTCAE) version 3.0.
Percentage of Participants With Laboratory Abnormalities (Obsolete for Cohort B after stopping enrollment) Baseline up to 60 months from last participant randomized Percentage of participants with laboratory test abnormalities without regard to baseline abnormality. Grading is per the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Event (CTCAE) version 3.0.
Health-related quality of life as measured by EORTC QLQ-NMIBC24 (European Organization for Treatment of Cancer in patients with non-muscle invasion bladder cancer) (Obsolete for Cohort B after stopping enrollment) Randomization/registration up to 60 months from the last participant randomized EORTC-QLQ-NMIBC24 has 24 items which can be grouped into 6 subscales: urinary symptoms (7 items), malaise (2 items), future worries (4 items), bloating/flatulence (2 items), sexual functioning (2 items), and male sexual issues (2 items). The NMIBC24 also assesses intravesical treatment, female sexual issues, sexual intimacy, risk of contaminating a partner, and sexual enjoyment (1 item each).
Complete response rate at 12 months (Cohort B1) (Obsolete after stopping enrollment in Cohort B) 12 months after last participant's initial assessment Complete response (CR) rate defined as the proportion of participants in the analysis population with CR at 12 months.
Event Free Survival (Cohort B1) (Obsolete after stopping enrollment in Cohort B) Registration to 5 years after last participant randomized. Time from first dose to date of EFS event.
Overall Survival (Cohorts B1 and B2) (Obsolete after stopping enrollment in Cohort B) Registration to 5 years after last participant randomized. Time from the date of first dose to the date of death due to any cause.
ctrough of PF-06801591 (Cohorts B1 and B2) (Obsolete after stopping enrollment in Cohort B) Registration up to 24 months Ctrough will be summarized
Incidence of ADA/Nab of PF-06801591 (Cohorts B1 and B2) (Obsolete after stopping enrollment in Cohort B) Registration up to 24 months Immunogenicity will be evaluated for participants with BCG unresponsive NMIBC, including those with CIS.
cmax of PF-06801591 (Cohort B2 only) (Obsolete after stopping enrollment in Cohort B) Registration up to 24 months Cmax will be summarized in Cohort B2 only.
Trial Locations
- Locations (177)
Chesapeake Regional Surgery Center - Virginia Beach
🇺🇸Virginia Beach, Virginia, United States
Sulpizio Cardiovascular Center at UC San Diego Health
🇺🇸La Jolla, California, United States
Urological Associates of Southern Arizona, P.C .
🇺🇸Tucson, Arizona, United States
Urological Associates of Southern Arizona P.C.
🇺🇸Tucson, Arizona, United States
Arkansas Urology
🇺🇸Little Rock, Arkansas, United States
Urological Research Network Corp
🇺🇸Hialeah, Florida, United States
Koman Family Outpatient Pavilion
🇺🇸La Jolla, California, United States
UC San Diego Moores Cancer Center
🇺🇸La Jolla, California, United States
University of California Irvine Medical Center
🇺🇸Orange, California, United States
The Urology Center of Colorado
🇺🇸Denver, Colorado, United States
UC San Diego Medical Center - La Jolla (Jacobs Medical Center / Thornton Pavilion)
🇺🇸La Jolla, California, United States
Montefiore Medical Center - Montefiore Medical Park
🇺🇸Bronx, New York, United States
NYU Langone Medical Center (Tisch Hospital)
🇺🇸New York, New York, United States
NYU Langone Health Urology Associates
🇺🇸New York, New York, United States
UC San Diego Medical Center - Hillcrest
🇺🇸San Diego, California, United States
UF Health Jacksonville
🇺🇸Jacksonville, Florida, United States
UF Health North
🇺🇸Jacksonville, Florida, United States
John H. Stroger, Jr. Hospital of Cook County
🇺🇸Chicago, Illinois, United States
DuPage Medical Group
🇺🇸Lombard, Illinois, United States
DuPage Medical Group Ambulatory Surgery Center
🇺🇸Lombard, Illinois, United States
Edward Hospital
🇺🇸Naperville, Illinois, United States
Ochsner LSU Health Shreveport - Regional Urology
🇺🇸Shreveport, Louisiana, United States
Michigan Institute of Urology, PC
🇺🇸Troy, Michigan, United States
Laura & Isaac Perlmutter Cancer Center at NYU Langone Health
🇺🇸New York, New York, United States
Chesapeake Urology Research Associates
🇺🇸Hanover, Maryland, United States
Bellevue Hospital
🇺🇸New York, New York, United States
Icahn School of Medicine at Mount Sinai
🇺🇸New York, New York, United States
Mount Sinai Hospital
🇺🇸New York, New York, United States
Premier Medical Group of the Hudson Valley PC
🇺🇸Poughkeepsie, New York, United States
Associated Medical Professionals of New York, PLLC
🇺🇸Syracuse, New York, United States
VA Portland Healthcare System
🇺🇸Portland, Oregon, United States
Carolina Urologic Research Center
🇺🇸Myrtle Beach, South Carolina, United States
Parkway Surgery Center
🇺🇸Myrtle Beach, South Carolina, United States
Atlantic Urology Clinics South Strand Office
🇺🇸Myrtle Beach, South Carolina, United States
Urology Clinics of North Texas
🇺🇸Dallas, Texas, United States
Houston Metro Urology
🇺🇸Houston, Texas, United States
Houston Methodist Hospital
🇺🇸Houston, Texas, United States
Urology San Antonio PA
🇺🇸San Antonio, Texas, United States
Sentara Norfolk General Hospital
🇺🇸Norfolk, Virginia, United States
Urology of Virginia, PLLC
🇺🇸Virginia Beach, Virginia, United States
Southern Highlands Cancer Centre
🇦🇺Bowral, New South Wales, Australia
Chris O'Brien Lifehouse Hospital
🇦🇺Camperdown, New South Wales, Australia
Box Hill Hospital
🇦🇺Box Hill, Victoria, Australia
Eastern Clinical Research Unit
🇦🇺Box Hill, Victoria, Australia
Yarra Ranges Health
🇦🇺Lilydale, Victoria, Australia
UZ Gent
🇧🇪Gent, Belgium
Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-Saint-Jean
🇨🇦Chicoutimi, Quebec, Canada
Hunan Cancer Hospital
🇨🇳Changsha, Hunan, China
Vancouver Prostate Centre at the Vancouver General Hospital
🇨🇦Vancouver, British Columbia, Canada
Hotel-Dieu de Quebec - CHU de Quebec - Universite Laval
🇨🇦Quebec, Canada
Hamilton Regional Laboratory Medicine Program
🇨🇦Hamilton, Ontario, Canada
Kingston Health Sciences Centre - Kingston General Hospital
🇨🇦Kingston, Ontario, Canada
Centre for Applied Urological Research
🇨🇦Kingston, Ontario, Canada
Kingston Health Sciences Centre -- Hotel Dieu Hospital
🇨🇦Kingston, Ontario, Canada
University Health Network - Princess Margaret Cancer Centre
🇨🇦Toronto, Ontario, Canada
University Health Network - Toronto General Hospital
🇨🇦Toronto, Ontario, Canada
McGill University Health Centre
🇨🇦Montreal, Quebec, Canada
The First Affiliated Hospital of Anhui Medical University
🇨🇳Hefei, Anhui, China
Beijing Chao-yang Hospital
🇨🇳Beijing, Beijing, China
Peking University First Hospital
🇨🇳Beijing, Beijing, China
Beijing Cancer Hospital
🇨🇳Beijing, Beijing, China
Peking Union Medical College Hospital
🇨🇳Beijing, Beijing, China
Fujian Medical University Affiliated First Hospital
🇨🇳Fuzhou, Fujian, China
Nantong Tumor Hospital
🇨🇳Nantong, Jiangsu, China
West China Hospital of Sichuan University
🇨🇳Chengdu, Sichuan, China
The First Affiliated Hospital of Wenzhou Medical University
🇨🇳Wenzhou, Zhejiang, China
Fudan University Shanghai Cancer Center
🇨🇳Shanghai, China
Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
🇨🇳Wuhan, Hubei, China
Nanjing Drum Tower Hospital
🇨🇳Nanjing, Jiangsu, China
Second Affiliated Hospital of Suzhou University
🇨🇳Suzhou, Jiangsu, China
The First Affiliated Hospital of Nanchang University
🇨🇳Nanchang, Jiangxi, China
First Affiliated Hospital of Xi 'an Jiaotong University
🇨🇳Xi'an, Shaanxi, China
Chongqing University Cancer Hospital
🇨🇳Chongqing, China
Hôpital privé Antony (Pharmacy)
🇫🇷Antony, France
Zhejiang Provincial People's Hospital
🇨🇳Hangzhou, Zhejiang, China
Ningbo First Hospital
🇨🇳Ningbo, Zhejiang, China
Fudan University Cancer Hospital
🇨🇳Shanghai, China
The Second Hospital of Tianjin Medical University
🇨🇳Tianjin, China
Clinique Belharra
🇫🇷Bayonne, France
Clinique Saint-Augustin
🇫🇷BORDEAUX Cedex, France
Institut Bergonié
🇫🇷Bordeaux Cedex, France
CHU de Bordeaux Hôpital Pellegrin
🇫🇷Bordeaux, France
Groupe Vivalto Sante - Clinique Pasteur-Lanroze- CFRO
🇫🇷Brest Cedex 2, France
Cabinet Privé d'urologie
🇫🇷Brest, France
CHPB Keraudren
🇫🇷Brest, France
Polyclinique de Limoges Site Chenieux
🇫🇷Limoges, France
Polyclinique de Gentilly
🇫🇷Nancy, France
Hôpital Bichat - Claude-Bernard
🇫🇷Paris, France
Clinique Sainte Anne
🇫🇷Strasbourg, France
Urologicum Duisburg
🇩🇪Duisburg, Germany
Klinikum der Goethe-Universitaet Frankfurt
🇩🇪Frankfurt, Germany
Universitaetsklinikum Muenster, Urologie
🇩🇪Muenster, Germany
Studienpraxis Urologie
🇩🇪Nuertingen, Germany
Universitaetsklinikum Tuebingen
🇩🇪Tuebingen, Germany
Humanitas Istituto Clinico Catanese S.p.A - U.O. Oncologia Medica
🇮🇹Misterobianco (CT), Catania, Italy
UO Oncologia, ASST di Cremona - Istituti Ospitalieri - Ospedale di Cremona
🇮🇹Cremona, CR, Italy
IRCSS Istituto Clinico Humanitas - U.O. Oncologia Medica
🇮🇹Rozzano, Milano, Italy
Ospedale Area Aretina Nord - UOC Oncologia Medica
🇮🇹Arezzo, Italy
UO Oncologia Medica IRCCS Istituto Tumori "Giovanni Paolo II"
🇮🇹Bari, Italy
IRCCS Azienda Ospedaliera Universitaria Policlinico San Martino Urologia
🇮🇹Genova, Italy
Ospedale Generale Provinciale di Macerata - UOC Oncologia
🇮🇹Macerata, Italy
Medical Oncology Unit, AO Papardo
🇮🇹Messina, Italy
IRCCS Ospedale San Raffaele, URI (Urological Research Institute)
🇮🇹Milan, Italy
AUSL/IRCCS di Reggio Emilia
🇮🇹Reggio Emilia, Italy
AO Azienda Ospedaliera Ordine Mauriziano Di Torino
🇮🇹Turin, Italy
ASST Sette Laghi Ospedale di Circolo Fondazione Macchi
🇮🇹Varese, Italy
National Hospital Organization Shikoku Cancer Center
🇯🇵Matsuyama, Ehime, Japan
Ehime University Hospital
🇯🇵Toon, Ehime, Japan
National Hospital Organization Hokkaido Cancer Center
🇯🇵Sapporo, Hokkaido, Japan
Kanagawa cancer center
🇯🇵Yokohama, Kanagawa, Japan
Hamamatsu University Hospital
🇯🇵Hamamatsu, Shizuoka, Japan
National Hospital Organization Kumamoto Medical Center
🇯🇵Kumamoto, Japan
National Hospital Organization Kyushu Cancer Center
🇯🇵Fukuoka-shi, Fukuoka, Japan
Gunma Prefectural Cancer Center
🇯🇵Ota, Gunma, Japan
Keio University Hospital
🇯🇵Shinjuku-ku, Tokyo, Japan
Okayama Medical Center
🇯🇵Okayama, Japan
Yamagata University Hospital
🇯🇵Yamagata, Japan
Osaka International Cancer Institute
🇯🇵Osaka-shi, Osaka, Japan
Kindai University Hospital
🇯🇵Osakasayama, Osaka, Japan
Korea University Anam Hospital
🇰🇷Seoul, Korea, Republic of
Regionalny Szpital Specjalistyczny im. Dr. Wladyslawa Bieganskiego
🇵🇱Grudziadz, Poland
Kagoshima University Hospital
🇯🇵Kagoshima, Japan
Seoul National University Hospital
🇰🇷Seoul, Korea, Republic of
Severance Hospital, Yonsei University Health System
🇰🇷Seoul, Korea, Republic of
Clinical Research Center Spolka z ograniczona odpowiedzialnoscia MEDIC-R Spolka Komandytowa
🇵🇱Poznan, Poland
National Cancer Center
🇰🇷Goyang-si, Gyeonggi-do, Korea, Republic of
Seoul National University Bundang Hospital
🇰🇷Seongnam-si, Gyeonggi-do, Korea, Republic of
Samsung Medical Center
🇰🇷Seoul, Korea, Republic of
Provita Profamilia
🇵🇱Piotrkow Trybunalski, Poland
Kyungpook National University Chilgok Hospital
🇰🇷Daegu, Korea, Republic of
NZOZ AKMED Andrzej Kupilas
🇵🇱Gliwice, Poland
Provita 001
🇵🇱Warszawa, Poland
Niepubliczny Zaklad Opieki Zdrowotnej Centrum Urologiczne Sp. z o.o.
🇵🇱Mysłowice, Poland
ETG Skierniewice
🇵🇱Skierniewice, Poland
Medical Concierge Centrum Medyczne
🇵🇱Warszawa, Poland
Lexmedica
🇵🇱Wroclaw, Poland
A.Tsyb Medical Research Radiological Center of the Ministry of Health of the Russian Federation
🇷🇺Obninsk, Kaluzhskaya OBL., Russian Federation
State Budgetary Institution of Healthcare of the Republic of Mordovia
🇷🇺Saransk, Republic OF Mordovia, Russian Federation
Private Medical Institution "Euromedservice"
🇷🇺Pushkin, Saint-petersburg, Russian Federation
Klinika UZI 4D, LLC
🇷🇺Pyatigorsk, Stavropolskiy KRAI, Russian Federation
Leningrad Regional Clinical Hospital
🇷🇺Kuzmolovskiy Settlement, Vsevolozhsky District, Russian Federation
Evimed Llc
🇷🇺Chelyabinsk, Russian Federation
Regional Budgetary Healthcare Institution "Ivanovo Regional Oncology Dispensary"
🇷🇺Ivanovo, Russian Federation
Ars Medika Center, LLC
🇷🇺Kaliningrad, Russian Federation
Kaluga Regional Clinical Oncology Center
🇷🇺Kaluga, Russian Federation
P.A. Hertsen Moscow Oncology Research Center- branch of the National Medical Research
🇷🇺Moscow, Russian Federation
Federal Budgetary Institution of Healthcare "Privolzhsky District Medical Center of the Federal
🇷🇺Nizhny Novgorod, Russian Federation
Hospital Universitari Germans Trias i Pujol
🇪🇸Badalona, Barcelona, Spain
BHI of Omsk region "Clinical Oncological Dispensary"
🇷🇺Omsk, Russian Federation
State Budgetary Institution of Ryazan Region "Regional Clinical Oncology Center"
🇷🇺Ryazan, Russian Federation
Joint-Stock Company "North-Western Centre of Evidence-Based Medicine" ("NWCoEBM" JSC)
🇷🇺Saint Petersburg, Russian Federation
Federal State Budgetary Healthcare Institution Saint - Petersburg
🇷🇺Saint-Petersburg, Russian Federation
Hospital OrKli LLC
🇷🇺Saint-Petersburg, Russian Federation
Republican Clinical Oncology Dispensary of the Ministry of Health of Bashkortostan Republic
🇷🇺Ufa, Russian Federation
Budgetary Healthcare Institution of Vologda region "Vologda Regional Clinical Hospital"
🇷🇺Vologda, Russian Federation
SBHI YaR Regional clinical oncology hospital
🇷🇺Yaroslavl, Russian Federation
Hospital General de Granollers
🇪🇸Granollers, Barcelona, Spain
Hospital Universitari de Bellvitge
🇪🇸L'Hospitalet de Llobregat, Barcelona, Spain
Hospital Universitario Puerta de Hierro Majadahonda
🇪🇸Majadahonda, Madrid, Spain
Complejo Hospitalario de Navarra
🇪🇸Pamplona, Navarra, Spain
Salut Sant Joan de Reus-Baix Camp
🇪🇸Reus, Tarragona, Spain
Complejo Hospitalario Universitario A Coruna
🇪🇸A Coruna, Spain
Hospital del Mar
🇪🇸Barcelona, Spain
Fundacio Puigvert
🇪🇸Barcelona, Spain
Hospital de la Santa Creu i Sant Pau
🇪🇸Barcelona, Spain
Hospital San Pedro de Alcantara
🇪🇸Caceres, Spain
Hospital Universitari de Girona Doctor Josep Trueta
🇪🇸Girona, Spain
Hospital de Llíria
🇪🇸Llíria, Spain
Hospital Universitario Lucus Augusti
🇪🇸Lugo, Spain
Hospital Universitario de La Princesa
🇪🇸Madrid, Spain
Hospital Universitario La Princesa
🇪🇸Madrid, Spain
Hospital Clínico San Carlos
🇪🇸Madrid, Spain
Hospital Universitario 12 de Octubre
🇪🇸Madrid, Spain
Fundacion Instituto Valenciano de Oncologia
🇪🇸Valencia, Spain
Hospital Arnau de Vilanova
🇪🇸Valencia, Spain
Barts Health NHS Trust, St Bartholomew's Hospital
🇬🇧London, United Kingdom
Charing Cross Hospital
🇬🇧London, United Kingdom