Mirvetuximab Soravtansine With Bevacizumab Versus Bevacizumab as Maintenance in Platinum-sensitive Ovarian, Fallopian Tube, or Peritoneal Cancer (GLORIOSA)

Phase 3

Recruiting

• Conditions: Ovarian Cancer; Peritoneal Cancer; Fallopian Tube Cancer
• Interventions: Drug: Mirvetuximab soravtansine plus Bevacizumab; Drug: Bevacizumab

• Registration Number: NCT05445778
• Lead Sponsor: AbbVie

Brief Summary

GLORIOSA is a Phase 3 multicenter, open label study designed to evaluate the safety and efficacy of mirvetuximab Soravtansine as maintenance therapy in participants with platinum-sensitive ovarian, primary peritoneal or fallopian tube cancers with high folate receptor-alpha (FRα) expression.

Detailed Description

Mirvetuximab Soravtansine (MIRV) is an investigational antibody drug conjugate designed to selectively kill cancer cells. The antibody (protein) part of MIRV targets tumors by delivering a cell-killing drug to the tumor cells carrying a tumor-associated protein called folate receptor alpha (FRα). It is being developed as maintenance therapy for the treatment of subjects with recurrent platinum-sensitive, highgrade epithelial ovarian, primary peritoneal, or fallopian tube cancers with high folate receptor-alpha expression. Patients must have confirmation of FRα positivity by the Ventana FOLR1 Assay.

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Study Timeline

• Study First Submitted: 2022-06-30
• Study First Submitted QC: 2022-06-30
• Study First Posted: 2022-07-06
• Study Start: 2022-12-27
• Status Verified: 2024-11
• Last Update Submitted: 2024-11-22
• Last Update Posted: 2024-11-25
• Primary Completion: 2027-03
• Study Completion: 2029-04

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 418

Inclusion Criteria

1. Patients must be ≥ 18 years of age

2. Patients must have an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.

3. Patients must have a confirmed diagnosis of high-grade serous epithelial ovarian, primary peritoneal, or fallopian tube cancer.

4. Patients must be willing to provide an archival tumor tissue block or slides, or must undergo a procedure to obtain a new biopsy using a low-risk, medically routine procedure for IHC confirmation of high FRα expression (reported as "positive") as defined by the Ventana FOLR1 Assay. Patients must be confirmed FRα-high as defined by FRα positivity of ≥ 75% of tumor membrane staining at ≥ 2+ intensity (PS2+) for entry into the study.

5. Prior BRCA testing on the tumor or prior germline testing is required for eligibility. If not done prior, tumor or germline testing will need to be done before study entry. Somatic and germline BRCA-positive patients must have received prior treatment with a PARPi in maintenance following first-line treatment.

   Note: Local tumor or germline BRCA testing will be acceptable for stratification. If the patient has not been tested, recommend archival tumor samples to be assessed for tissue BRCA. All patients who have received prior first line PARPi maintenance and/or bevacizumab are eligible.

6. Patients' disease must have relapsed after 1 line (first line) of platinum-based chemotherapy and must be platinum-sensitive defined as progression greater than 6 months from last dose of primary platinum therapy.

7. Patients must be appropriate for, currently be on, or have completed platinum-based triplet therapy in the second line (recurrent PSOC).

8. After completion of triplet therapy and before randomization, patients must have received no less than 4 and no greater than 8 cycles of platinum-based triplet therapy in the second line, to include no less than 3 cycles of bevacizumab in combination with platinum-based chemotherapy. If the number of cycles received is less than 6 due to toxicity, this must be documented and toxicity assessed as unlikely related to bevacizumab.

   Note: A minimum of 4 cycles of combination chemotherapy is required. If carboplatin, paclitaxel, gemcitabine, or pegylated liposomal doxorubicin (PLD) is stopped due to toxicity, up to 4 additional cycles of single agent in combination with bevacizumab is acceptable if appropriately documented.

9. After completion of triplet therapy and before randomization: In the case of interval secondary cytoreductive surgery, patients are permitted to have received only 2 cycles of bevacizumab if given in combination with the last 3 cycles of platinum-based triplet therapy in the second line. In the case of primary cytoreductive surgery before secondline platinum-based triplet therapy, patients must have received no fewer than 3 cycles of bevacizumab in combination with platinum-based chemotherapy after their surgery and before randomization.

10. Patients either will receive (per investigator's choice), must be receiving, or have received paclitaxel, gemcitabine, or pegylated liposomal doxorubicin as the partner drug to platinum-based triplet therapy in the second line.

11. After completion of triplet therapy and before randomization, patients must have achieved a CR, PR, or SD, per the investigator, in the second line to be eligible for randomization into the study population. All patients will have CT or MRI scans and CA-125 measurements at least 3 weeks but no more than 8 weeks after their last planned dose of triplet therapy and before randomization.

12. Patients must be randomized no later than 8 weeks from the last dose of platinum-based triplet therapy in the second line.

13. After completion of triplet therapy and before randomization, patients must meet one of the following criteria:

    1. Have at least 1 lesion that meets the definition of measurable disease by Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 (radiologically measured by the investigator), and determined by the investigator to either have SD or a PR to their treatment; or
    2. Have persistently elevated CA-125 without measurable disease and determined by the investigator to have either SD or a PR to their treatment; or
    3. Have clinically no evidence of disease by both radiographic interpretation by the investigator and normalization of their CA-125, determined to be a CR.

14. Patients must have stabilized or recovered (to Grade 1 or baseline) from all prior therapy-related toxicities (except alopecia).

15. Patients must have completed any major surgery at least 4 weeks before the first dose of study treatment (either Run-In or maintenance therapy) and have recovered or stabilized from the side effects of prior surgery before the first dose of treatment on study.

16. Patients must have adequate hematologic, liver, and kidney functions defined as follows:

    1. Absolute neutrophil count (ANC) ≥ 1.5 × 109/L (1500/μL) without granulocyte colony-stimulating factor in the prior 10 days or long-acting white blood cell (WBC) growth factors in the prior 10 days of C1D1 of maintenance treatment.
    2. Platelet count ≥ 100 × 109/L (100,000/μL) without platelet transfusion in the prior 10 days of C1D1 of maintenance treatment
    3. Hemoglobin ≥ 9.0 g/dL without packed red blood cell (PRBC) transfusion in the prior 10 days of C1D1 of maintenance treatment
    4. Serum creatinine ≤ 1.5 × upper limit of normal (ULN)
    5. Aspartate aminotransferase and alanine aminotransferase ≤ 3.0 × ULN
    6. Serum bilirubin ≤ 1.5 × ULN (patients with documented diagnosis of Gilbert syndrome are eligible if total bilirubin < 3.0 × ULN)
    7. Serum albumin ≥ 2 g/dL

17. Patients must be willing and able to sign the informed consent form (ICF) and to adhere to the protocol requirements.

18. Females of childbearing potential (FCBP) must agree to use highly effective contraceptive method(s) (as defined in Section 5.10.7) while on study medication and for at least 3 months after the last dose.

19. FCBP must have a negative pregnancy test within 4 days before the first dose of therapy.

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Exclusion Criteria

1. Patients with endometrioid, clear cell, mucinous, or sarcomatous histology; mixed tumors containing any of the above histologies; or low-grade/borderline ovarian tumor

2. More than one line of prior chemotherapy before current/planned triplet therapy. Lines of prior anticancer therapy are counted with the following considerations:

   1. Neoadjuvant ± adjuvant therapies are considered 1 line of therapy if the neoadjuvant and adjuvant correspond to 1 fully predefined regimen; otherwise, they are counted as 2 prior regimens.
   2. Maintenance therapy (eg, bevacizumab, PARPi) will be considered part of the preceding line of therapy (ie, not counted independently).
   3. Change due to toxicity will be considered part of the proceeding line of therapy.

3. Patients with PD while on or following platinum-based triplet therapy

4. After completion of triplet therapy and prior to randomization: Patients who receive an intervening dose of bevacizumab after the last dose of triplet therapy before randomization

5. Patients with prior wide-field radiotherapy affecting at least 20% of the bone marrow

6. Patients with > Grade 1 peripheral neuropathy per Common Terminology Criteria for Adverse Events (CTCAE)

7. 7. Patients with active or chronic corneal disorders, history of corneal transplantation, or active ocular conditions requiring ongoing treatment/monitoring, such as uncontrolled glaucoma, wet age-related macular degeneration requiring intravitreal injections, active diabetic retinopathy with macular edema, macular degeneration, presence of papilledema, and/or monocular vision

8. Patients with serious concurrent illness or clinically relevant active infection, including but not limited to the following:

   1. Active hepatitis B or C infection (whether or not on active antiviral therapy)
   2. HIV infection
   3. Active cytomegalovirus infection
   4. Any other concurrent infectious disease requiring intravenous (IV) antibiotics within 2 weeks before the first dose of maintenance therapy Note: Testing at screening is not required for the above infections unless clinically indicated.

9. Patients with a history of multiple sclerosis or other demyelinating diseases and/or Lambert-Eaton syndrome (paraneoplastic syndrome)

10. Patients with clinically significant cardiac disease including, but not limited to, any of the following:

    1. Myocardial infarction ≤ 6 months prior to C1D1 of maintenance treatment
    2. Unstable angina pectoris
    3. Uncontrolled congestive heart failure (New York Heart Association > class II)
    4. Uncontrolled ≥ Grade 3 hypertension (per CTCAE)
    5. Uncontrolled cardiac arrhythmias

11. Patients with a history of hemorrhagic or ischemic stroke within 6 months before enrollment

12. Patients with a history of cirrhotic liver disease (Child-Pugh Class B or C)

13. Patients with a previous clinical diagnosis of noninfectious interstitial lung disease, including noninfectious pneumonitis (exception: Grade 1 noninfectious pneumonitis diagnosed on or within 6 weeks after treatment with an immunotherapeutic agent used in the treatment of their malignancy that has resolved per investigator or resolution of the radiologic findings)

14. History of bowel obstruction (including sub-occlusive disease) related to underlying disease within 6 months before the start of maintenance study treatment (triplet therapy for Run-In patients).

15. History of abdominal fistula or gastrointestinal perforation

16. Intra-abdominal abscess, evidence of rectosigmoid involvement by pelvic examination, bowel involvement on CT scan, or clinical symptoms of bowel obstruction within 4 weeks prior to randomization (or within 4 weeks prior to starting triplet therapy for Run- In patients)

17. Clinically significant proteinuria: urine-protein to creatinine (UPC) ratio ≥ 1.0 or urine dipstick result ≥ 2+; patients with UPC ratio ≥ 1.0 or ≥ 2+ proteinuria should undergo 24-hour urine collection and must show result ≤ 1 g of protein in a 24-hour period.

18. History of Grade 4 thromboembolic events

19. Patients not appropriate for bevacizumab 15 mg/kg dosing at the start of maintenance therapy as per the treating physician

20. Patients requiring use of folate-containing supplements (eg, folate deficiency)

21. Patients with prior hypersensitivity to monoclonal antibodies (mAbs)

22. Women who are pregnant or breastfeeding

23. Patients who received prior treatment with MIRV or other FRα-targeting agents

24. Patients with untreated or symptomatic central nervous system metastases

25. Patients with a history of other malignancy within 3 years prior to signing study consent

    Note: Patients with tumors with a negligible risk for metastasis or death (eg, controlled basal cell carcinoma or squamous cell carcinoma of the skin, or carcinoma in situ of the cervix or breast) are eligible.

26. Prior known hypersensitivity reactions to study drugs or any of their excipients

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Arm 1	Mirvetuximab soravtansine plus Bevacizumab	Mirvetuximab Soravtansine (MIRV) plus Bevacizumab
Arm 2	Bevacizumab	Bevacizumab monotherapy

Primary Outcome Measures

Name	Time	Method
Assess Progression-free survival (PFS)	Up to 4 years	Progression-free survival defined as the time from date of randomization until investigator-assessed progressive disease (PD) or death, whichever occurs first.

Secondary Outcome Measures

Name	Time	Method
CA-125 response	Up to 7 years	Serum CA-125 response determined using the GCIG criteria
Patient-reported outcome health-related quality of life (HRQoL) of disease-related symptoms using the NCCN-FACT Ovarian Symptom Index (NFOSI-18) DRS-P (disease-related symptom subscale - physical).	Up to 7 years	A questionnaire assessing the health of patients with ovarian cancer.
Assess Overall survival (OS)	Up to 7 years	Overall survival (OS), defined as the time from randomization to death
Assess Safety and tolerability	Up to 7 years	Adverse events (AEs) will be evaluated according to the NCI CTCAE v5.0
Assess second disease progression (PFS2)	Up to 7 years	Second disease progression (PFS2)defined as the time from date of randomization until second disease progression or death, whichever occurs first
Assess Objective Response Rate (ORR)	Up to 7 years	Objective response includes best response of complete response (CR) or partial response (PR).
Assess Duration of response (DOR)	Up to 7 years	Measured only in patients who achieved a confirmed best overall response of CR or PR upon completion of platinum-based combination chemotherapy with bevacizumab (triplet therapy)
Assess Disease-free survival (DFS)	Up to 7 years	Measured only in patients who have no measurable disease per RECIST v1.1 at randomization

Trial Locations

Locations (272)

Indiana University; 🇺🇸 Indianapolis, Indiana, United States

University of Cincinnati; 🇺🇸 Cincinnati, Ohio, United States

Texas Oncology - San Antonio (USOR); 🇺🇸 San Antonio, Texas, United States

OU Health Stephenson Cancer Center; 🇺🇸 Oklahoma City, Oklahoma, United States

Northwest Cancer Specialists, P.C. (USOR); 🇺🇸 Portland, Oregon, United States

Bejing Obstetrics and Gynecology Hospital, Capital Medical University; 🇨🇳 Beijing, China

Bejing Cancer Hospital; 🇨🇳 Beijing, China

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

The First Hospital of Jilin University; 🇨🇳 Changchun, China

Hunan Cancer Hospital; 🇨🇳 Changsha, China

West China Second University Hospital, Sichuan University; 🇨🇳 Chengdu, China

Woman's Hospial School of Medicine ZheJiang University; 🇨🇳 Hangzhou, China

Fujian Cancer Hospital; 🇨🇳 Fuzhou, China

Harbin medical university Cancer Hospital; 🇨🇳 Harbin, China

The First Affliliated Hospital, Sun Yat-sen University; 🇨🇳 Guangzhou, China

Cancer Hospital of Shandong First Medical University (Shandong Cancer Institute, Shandong Cancer Hospital); 🇨🇳 Jinan, China

Sun Yat-Sen Memorial Hospital,Sun Yat-sen University; 🇨🇳 Guangzhou, China

Zhejiang Cancer Hospital; 🇨🇳 Hangzhou, China

Qilu Hospital of Shandong University; 🇨🇳 Jinan, China

Yunnan Cancer Hospital (The Third Affiliated Hospital of Kunming Medical University ); 🇨🇳 Kunming, China

Linyi Cancer Hospital; 🇨🇳 Linyi, China

Guangxi Cancer Hospital (Guangxi Medical University Cancer Hospital); 🇨🇳 Naning, China

Fudan University shanghai Cancer Center; 🇨🇳 Shanghai, China

Liaoning Cancer Hospital; 🇨🇳 Shenyang, China

Shanxi Cancer Hospital; 🇨🇳 Taiyuan, China

Tianjin Medical University Cancer Institute&Hospital; 🇨🇳 Tianjin, China

Cancer Hospital Affiliated to Xinjiang Medical University; 🇨🇳 Urumqi, China

Hubei Cancer Hospital; 🇨🇳 Wuhan, China

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

Henan Cancer Hospital; 🇨🇳 Zhengzhou, China

The First Affiliated Hospital of Xi'an Jiaotong University; 🇨🇳 Xian, China

Humanitas San Pio X; 🇮🇹 Milan, Italy

USA Mitchell Cancer Institute; 🇺🇸 Mobile, Alabama, United States

Baystate Gynecologic Oncology - Tolosky Center; 🇺🇸 Springfield, Massachusetts, United States

Center of Hope at Renown Medical Center; 🇺🇸 Reno, Nevada, United States

Northwell Health Cancer Institute; 🇺🇸 New York, New York, United States

The West Clinic, PLLC dba West Cancer Center; 🇺🇸 Germantown, Tennessee, United States

Instituto Alexander Fleming; 🇦🇷 Caba, Argentina

Hospital Italiano de Buenos Aires; 🇦🇷 Caba, Argentina

Instituto de Oncologia Angel Roffo; 🇦🇷 Caba, Argentina

Hospital Italiano de Cordoba; 🇦🇷 Córdoba, Argentina

Sanatorio de la Mujer; 🇦🇷 Rosario, Argentina

AZ Delta apotheek, Tav Klinische studies, Kwadestraat 78; 🇧🇪 Roeselare, Belgium

Westmead Hospital; 🇦🇺 Westmead, New South Wales, Australia

Isis Centro Especializado; 🇦🇷 Santa Fe, Argentina

Peter Maccallum Cancer Centre; 🇦🇺 Melbourne, Victoria, Australia

Gold Coast University Hospital; 🇦🇺 Southport, Queensland, Australia

Monash Health; 🇦🇺 Clayton, Victoria, Australia

Grampians Health Service; 🇦🇺 Ballarat, Victoria, Australia

Epworth Health; 🇦🇺 Richmond, Victoria, Australia

Cabrini Health; 🇦🇺 Brighton, Victoria, Australia

Bendat Family Comprehensive Cancer Centre St John of God - Subiaco Hospital; 🇦🇺 Subiaco, Australia

Imeldaziekenhuis, Apotheek Klinische Studies, Imeldalaan 9 Centraal Magazjin; 🇧🇪 Bonheiden, Belgium

Cliniques Universitaires St-Luc Woluwe-Saint-Lambert; 🇧🇪 Brussel, Belgium

AZ Sint Lucas Gent, Groenebriel 1; 🇧🇪 Gent, Belgium

UZ Leuven, Apotheek Klinische studies, Herestraat, 49; 🇧🇪 Leuven, Belgium

CHU UCL Namur - Site Sainte-Elisabeth, Route (Road) 471 Place Louise Godin 15, Oncology Day Hospital, 3rd Floor; 🇧🇪 Namur, Belgium

Fundacao Pio XII - Hospital de Amor de Barretos; 🇧🇷 Barretos, Brazil

Clinica Oncolog; 🇧🇷 Cuiabá, Brazil

Instituo de Ensino e Pesquisa (IEP) Oncocentro; 🇧🇷 Fortaleza, Brazil

Oncocentro; 🇧🇷 Belo Horizonte, Brazil

Catarina Pesquisa Clinica; 🇧🇷 Itajaí, Brazil

Santa Casa Misericordia Porto Alegre; 🇧🇷 Porto Alegre, Brazil

IMIP; 🇧🇷 Recife, Brazil

Instituto Nacional de Cancer; 🇧🇷 Rio De Janeiro, Brazil

Instituto COI; 🇧🇷 Rio De Janeiro, Brazil

Hospital Santa Izabel; 🇧🇷 Salvador, Brazil

Ensino e Terapia de Inovacao Clinica AMO-ETICA; 🇧🇷 Salvador, Brazil

BP A Beneficencia Portuguesa de Sao Paulo; 🇧🇷 São Paulo, Brazil

Dasa; 🇧🇷 São Paulo, Brazil

Ac camargo Cancer center; 🇧🇷 São Paulo, Brazil

Complex Oncology Center - Shumen Ltd; 🇧🇬 Shumen, Bulgaria

Comprehensive Cancer Center - Vratsa; 🇧🇬 Vratsa, Bulgaria

University Hospital Brno; 🇨🇿 Brno, Czechia

Nemocnice AGEL Nový Jicín a.s.; 🇨🇿 Nový Jicín, Czechia

General University Hospital in Prague; 🇨🇿 Prague, Czechia

University Hospital Ostrava; 🇨🇿 Ostrava Poruba, Czechia

Rigshospitalet (Copenhagen University Hospital); 🇩🇰 Copenhagen, Denmark

Onkologisk Afd, Aalborg Universitets hospital; 🇩🇰 Aalborg, Denmark

Kuopio University Hospital; 🇫🇮 Kuopio, Finland

Oulu University hospital; 🇫🇮 Oulu, Finland

Turku University Hospital; 🇫🇮 Turku, Finland

Institut de cancérologie et d'imagerie (ICI) CHU BREST; 🇫🇷 Brest, France

CHU Dijon; 🇫🇷 Dijon, France

Centre Leon Berard; 🇫🇷 Lyon, France

Institut Curie; 🇫🇷 Paris, France

Hôpital Timone; 🇫🇷 Marseille, France

ICANS; 🇫🇷 Strasbourg, France

Studiengesellschaft Onkologie Bielefeld; 🇩🇪 Bielefeld, Germany

Universitaetsklinikum Bonn; 🇩🇪 Bonn, Germany

Klinikum Dortmund; 🇩🇪 Dortmund, Germany

Universitaetsklinikum Carl Gustav Carus; 🇩🇪 Dresden, Germany

Universitaetsklinikum Essen; 🇩🇪 Essen, Germany

Universitaetsklinik Erlangen; 🇩🇪 Erlangen, Germany

Klinikum Esslingen GmbH; 🇩🇪 Esslingen, Germany

UKGM Giessen; 🇩🇪 Giesen, Germany

Universitaetsklinikum Hamburg-Eppendorf; 🇩🇪 Hamburg, Germany

Mammazentrum Hamburg am Krankenhaus Jerusalem; 🇩🇪 Hamburg, Germany

Universitaetsklinikum Heidelberg; 🇩🇪 Heidelberg, Germany

Universitätsmedizin Mainz Frauenklinik; 🇩🇪 Mainz, Germany

Klinikum Kassel; 🇩🇪 Kassel, Germany

LMU Klinikum Großhadern; 🇩🇪 Munich, Germany

Alexandra Hospital; 🇬🇷 Athens, Greece

IASO Hospital; 🇬🇷 Athens, Greece

Hygeia Hospital; 🇬🇷 Maroúsi, Greece

Bon Secours; 🇮🇪 Cork, Ireland

St. Luke's Hospital S.A.; 🇬🇷 Thessaloníki, Greece

Cork University Hospital; 🇮🇪 Cork, Ireland

Beaumont Hospital; 🇮🇪 Dublin, Ireland

St. James's Hospital; 🇮🇪 Dublin, Ireland

University Hospital Galway; 🇮🇪 Galway, Ireland

Sligo University Hospital; 🇮🇪 Sligo, Ireland

University Hospital Waterford; 🇮🇪 Waterford, Ireland

Carmel Medical Centre; 🇮🇱 Haifa, Israel

Shaare Zedek Medical Centre; 🇮🇱 Jerusalem, Israel

Wolfson Medical Centre; 🇮🇱 Holon, Israel

Hadassah Medical Ctr. Ein Kerem. Sharett Institute of oncology; 🇮🇱 Jerusalem, Israel

Meir Medical Centre; 🇮🇱 Kefar Sava, Israel

Rabin Medical Centre; 🇮🇱 Petah Tikva, Israel

Sheba Medical Centre; 🇮🇱 Ramat Gan, Israel

Kaplan Medical Center; 🇮🇱 Reẖovot, Israel

Tel Aviv Sourasky Medical Center; 🇮🇱 Tel Aviv Yaffo, Israel

Ziv Medical Centre; 🇮🇱 Safed, Israel

Policlinico S. Orsola-Malpighi; 🇮🇹 Bologna, Italy

Ospedale Cannizzaro; 🇮🇹 Catania, Italy

Ente Ospedaliero Ospedali Galliera; 🇮🇹 Genova, Italy

AOU Careggi; 🇮🇹 Firenze, Italy

IRCCS AOU San Martino; 🇮🇹 Genova, Italy

ASST Ospedale Alessandro Manzoni; 🇮🇹 Lecco, Italy

AOU di Parma; 🇮🇹 Parma, Italy

Azienda USL Toscana Nord Ovest Ospedale San Luca; 🇮🇹 Lucca, Italy

IRST - Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori; 🇮🇹 Meldola, Italy

IRCCS San Raffaele; 🇮🇹 Milano, Italy

Fondazione IRCCS Istituto Nazionale dei Tumori; 🇮🇹 Milano, Italy

Ospedale di Mirano; 🇮🇹 Mirano, Italy

Naples, Ist. Naz. Tumori-Fondazione Pascale; 🇮🇹 Napoli, Italy

AUSL Piacenza Ospedale Guglielmo da Saliceto; 🇮🇹 Piacenza, Italy

Nuovo Ospedale di Prato - Santo Stefano; 🇮🇹 Prato, Italy

AUSL RE Arcispedale Santa Maria Nuova; 🇮🇹 Reggio Emilia, Italy

Fondazione IRCCS Policlinico San Matteo; 🇮🇹 Pavia, Italy

AOU Policlinico Umberto I; 🇮🇹 Roma, Italy

National Cancer Center; 🇰🇷 Goyang, Gyeonggi-do, Korea, Republic of

CHA University - Bundang CHA General Hospital; 🇰🇷 Seongnam, Gyeonggi-do, Korea, Republic of

Fondazione Policlinico Universitario A. Gemelli IRCCS; 🇮🇹 Rome, Italy

IRCCS Istituto Clinico Humanitas; 🇮🇹 Rozzano, Italy

Seoul National University Bundang Hospital; 🇰🇷 Seongnam, Gyeonggi-do, Korea, Republic of

Keimyung Dongsan University Hospital; 🇰🇷 Daegu, Korea, Republic of

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

The Medical City -Ortigas; 🇵🇭 Pasig, Metro Manila, Philippines

Cardinal Santos Medical Center; 🇵🇭 San Juan, Metro Manila, Philippines

Oslo University Hospital, Radiumhospitalet; 🇳🇴 Oslo, Norway

Stavanger University Hospital; 🇳🇴 Stavanger, Norway

East Avenue Medical Centre; 🇵🇭 Quezon City, Philippines

University Hospital of North Norway; 🇳🇴 Tromsø, Norway

Szpitale Pomorskie Sp. z o.o.; 🇵🇱 Gdynia, Poland

Swietokrzyskie Centrum Onkologii; 🇵🇱 Kielce, Poland

Centrum Badan Klinicznych JCI Jagiellonskie Centrum Innowacji Sp. z o.o.; 🇵🇱 Kraków, Poland

Samodzielny publiczny szpital kliniczny nr 1; 🇵🇱 Lublin, Poland

Hospital Universitario Vall d'Hebron, CT Pharm General Building-Floor B, Passeig Vall d'Hebron; 🇪🇸 Barcelona, Spain

Szpital Kliniczny im. Heliodora Swiecickiego; 🇵🇱 Poznań, Poland

Wielkopolskie Centrum Onkologii; 🇵🇱 Poznań, Poland

Mazowiecki Szpital Wojewódzki im. sw. Jana Pawla II w Siedlcach Sp. z o.o.; 🇵🇱 Siedlce, Poland

Hospital Universitario de A Coruña (CHUAC); 🇪🇸 Coruña, Spain

Instituto Catalán de Oncologia, 199-203 Av Gra Via CT Pharmacy, Hospital Duran i Reynals; 🇪🇸 Barcelona, Spain

Hospital Clinic de Barcelona (Hospital Clinic i Provincial); 🇪🇸 Barcelona, Spain

Hospital Clinico Universitario de Valencia; 🇪🇸 Valencia, Spain

Clínica Universidad de Navarra; 🇪🇸 Madrid, Spain

Hospital Universitario Reina Sofia; 🇪🇸 Córdoba, Spain

ICO-Hospital Universitario de Girona; 🇪🇸 Girona, Spain

Hospital Universitario Virgen de la Victoria; 🇪🇸 Málaga, Spain

Clinica Universitaria Navarra Pamplona; 🇪🇸 Pamplona, Spain

Karolinska University Hospital; 🇸🇪 Stockholm, Sweden

Baskent University Hospital; 🇹🇷 Adana, Turkey

Uppsala University Hospital, Akademiske Sjukhuset; 🇸🇪 Uppsala, Sweden

Cukurova University Balcali Hospital Application and Research Center; 🇹🇷 Adana, Turkey

Ege University Hospital; 🇹🇷 İzmir, Turkey

Hacettepe University Hospital, Hacettepe Mahallesi; 🇹🇷 Ankara, Turkey

Ankara Baskent University; 🇹🇷 Ankara, Turkey

Istanbul University-Cerrahpasa Medical Faculty Gynecologic Oncology Department; 🇹🇷 Istanbul, Turkey

Singleton Hospital; 🇬🇧 Swansea, Wales, United Kingdom

Cheltenham General Hospital; 🇬🇧 Cheltenham, United Kingdom

The Royal Marsden Hospital - Chelsea; 🇬🇧 Fulham, London, United Kingdom

The Royal Marsden Hospital - Sutton; 🇬🇧 Sutton, Surrey, United Kingdom

Mount Vernon Cancer Centre East and North Hertfordshire NHS Trust Site; 🇬🇧 Northwood, United Kingdom

Southampton University NHS Trust; 🇬🇧 Southampton, United Kingdom

Hospital La Paz CT Pharmacy, 261 Paseo Castellana, North Building Ground Floor; 🇪🇸 Madrid, Spain

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

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

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

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

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

The Catholic University of Korea, Seoul St. Mary's Hospital; 🇰🇷 Seoul, Korea, Republic of

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

Mount Sinai Hospital; 🇺🇸 New York, New York, United States

John Muir Health; 🇺🇸 Concord, California, United States

Kaiser Permanente Irvine Medical Center, 6650 Alton Pkwy; 🇺🇸 Irvine, California, United States

CHUS - Hôpital Fleurimont; 🇨🇦 Sherbrooke, Quebec, Canada

LSUHSC; 🇺🇸 New Orleans, Louisiana, United States

The Christie / The Christie NHS Foundation Trust; 🇬🇧 Manchester, United Kingdom

Guy's and St Thomas' NHS Foundation Trust; 🇬🇧 London, United Kingdom

Rush University Medical Center, 1725 West Harrison Street; 🇺🇸 Chicago, Illinois, United States

University of Chicago Medicine, 5841 S Maryland Ave, MC 2115; 🇺🇸 Chicago, Illinois, United States

Ochsner Clinic Foundation; 🇺🇸 New Orleans, Louisiana, United States

Greater Baltimore Medical Center; 🇺🇸 Baltimore, Maryland, United States

Tufts Medical Center; 🇺🇸 Boston, Massachusetts, United States

Nebraska Methodist Hospital; 🇺🇸 Omaha, Nebraska, United States

Holy Name Medical Center; 🇺🇸 Teaneck, New Jersey, United States

Perlmutter Cancer Center at NYU Langone Health-Long Island; 🇺🇸 Mineola, New York, United States

Perlmutter Cancer Center at NYU Langone Health; 🇺🇸 New York, New York, United States

GHDC Grand Hôpital de Charleroi, Site Notre-Dame, Grand Rue 3; 🇧🇪 Charleroi, Belgium

Hospital Moinhos de Vento; 🇧🇷 Porto Alegre, Brazil

BC Cancer - Vancouver; 🇨🇦 Vancouver, British Columbia, Canada

New York Oncology Hematology, P.C. (USOR); 🇺🇸 Albany, New York, United States

Oklahoma Cancer Specialists and Research Institute; 🇺🇸 Tulsa, Oklahoma, United States

Kinston Health Sciences Center - KGH Site; 🇨🇦 Kingston, Ontario, Canada

Texas Oncology, P.A. (USOR); 🇺🇸 Austin, Texas, United States

St Vincent Gynecologic Oncology; 🇺🇸 Indianapolis, Indiana, United States

Kaiser Permanente Zion Medical Center, 4647 Zion Ave; 🇺🇸 San Diego, California, United States

Mount Sinai Comprehensive Cancer Center; 🇺🇸 Miami, Florida, United States

Sinai Hospital of Baltimore, Inc.; 🇺🇸 Baltimore, Maryland, United States

UNC-Chapel Hill; 🇺🇸 Chapel Hill, North Carolina, United States

Womens Cancer Care Associates; 🇺🇸 New York, New York, United States

Ohio State University; 🇺🇸 Columbus, Ohio, United States

Corewell Health; 🇺🇸 Grand Rapids, Michigan, United States

Minnesota Oncology Hematology, P.A. (USOR); 🇺🇸 Maplewood, Minnesota, United States

John Theurer Cancer Center, University Medical Center, 92 Second Street; 🇺🇸 Hackensack, New Jersey, United States

Kettering Health; 🇺🇸 Kettering, Ohio, United States

Tom Baker Cancer Centre, Alberta Health Services; 🇨🇦 Calgary, Alberta, Canada

Centre Hospitalier de L'Universite de Montreal - Centre de Recherche; 🇨🇦 Montreal, Quebec, Canada

McGill University Health Centre; 🇨🇦 Montreal, Quebec, Canada

Honor Health Cancer Care, Biltmore, 2222 E. Highland Ave, #400; 🇺🇸 Phoenix, Arizona, United States

Allegheny Health Network; 🇺🇸 Pittsburgh, Pennsylvania, United States

Princess Margaret Cancer Centre; 🇨🇦 Toronto, Ontario, Canada

Kaiser Permanente Los Angeles Medical Center, 4950 Sunset Blvd., 6th Floor; 🇺🇸 Los Angeles, California, United States

Johns Hopkins Medical Institute; 🇺🇸 Baltimore, Maryland, United States

OHSU Center for Health & Healing, Building 2 (CHH2), 3485 S Bond Ave; 🇺🇸 Portland, Oregon, United States

UC San Diego Health - Moores Cancer Center; 🇺🇸 La Jolla, California, United States

Kaiser Permanente Riverside Medical Center, 10800 Magnolia Ave; 🇺🇸 Riverside, California, United States

The Valley Hospital -Luckow Pavilion; 🇺🇸 Paramus, New Jersey, United States

Willamette Valley Cancer Institute and Research Center (USOR); 🇺🇸 Eugene, Oregon, United States

Sidney Kimmel Cancer Center Asplundh Cancer Pavilion; 🇺🇸 Willow Grove, Pennsylvania, United States

Sanford Gynecologic Oncology, 1309 W. 17th street; 🇺🇸 Sioux Falls, South Dakota, United States

Texas Oncology - DFWW (USOR); 🇺🇸 Bedford, Texas, United States

Texas Oncology-Dallas Presbyterian Hospital (USOR); 🇺🇸 Dallas, Texas, United States

Texas Oncology (USOR); 🇺🇸 Fort Worth, Texas, United States

University of Virginia; 🇺🇸 Charlottesville, Virginia, United States

Virginia Oncology Associates (USOR); 🇺🇸 Norfolk, Virginia, United States

University of Alberta - Cross Cancer Institute (CCI); 🇨🇦 Edmonton, Alberta, Canada

BC Cancer Surrey; 🇨🇦 Surrey, British Columbia, Canada

Juravinski Cancer Centre; 🇨🇦 Hamilton, Ontario, Canada

The Ottawa Hospital Cancer Centre; 🇨🇦 Ottawa, Ontario, Canada

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

Dartmouth Hitchcock Medical, One Medical Center Drive; 🇺🇸 Lebanon, New Hampshire, United States

Swedish Cancer Institute; 🇺🇸 Seattle, Washington, United States

Duke Cancer Center; 🇺🇸 Durham, North Carolina, United States

Magee Women's Hospital - UPMC; 🇺🇸 Pittsburgh, Pennsylvania, United States

City of Hope; 🇺🇸 Irvine, California, United States

UCI Health- Chao Family Comprehensive Cancer Center; 🇺🇸 Orange, California, United States

Kaiser Permanente San Marcos Medical Offices, 400 Craven Road; 🇺🇸 San Marcos, California, United States

Olive View UCLA Medical Center Inpatient Pharmacy, 14445 Olive View Dr, Rm 1C101; 🇺🇸 Sylmar, California, United States

Broward Health Medical Center; 🇺🇸 Fort Lauderdale, Florida, United States

Baptist MD Anderson Cancer Center; 🇺🇸 Jacksonville, Florida, United States

Northside Hospital; 🇺🇸 Atlanta, Georgia, United States

Virginia Commonwealth University (VCU)- Massey Comprehensive Cancer Center; 🇺🇸 Richmond, Virginia, United States

Stanford University; 🇺🇸 Palo Alto, California, United States

Regional Cancer Center/ Florida Gynecologic Oncology; 🇺🇸 Fort Myers, Florida, United States

Sarasota Memorial Health Care System; 🇺🇸 Sarasota, Florida, United States

University of Iowa Health Care; 🇺🇸 Iowa City, Iowa, United States

University of Kansas Cancer Center; 🇺🇸 Westwood, Kansas, United States

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

University of Kentucky; 🇺🇸 Lexington, Kentucky, United States

Maine Medical Center; 🇺🇸 Scarborough, Maine, United States