Phase 3 Study of Nivolumab or Nivolumab Plus Ipilimumab Versus Ipilimumab Alone in Previously Untreated Advanced Melanoma (CheckMate 067)

Phase 3

Completed

• Conditions: Unresectable or Metastatic Melanoma
• Interventions: Biological: Nivolumab; Biological: Ipilimumab; Biological: Placebo for Nivolumab; Biological: Placebo for Ipilimumab

• Registration Number: NCT01844505
• Lead Sponsor: Bristol-Myers Squibb

Brief Summary

The purpose of this study is to show that Nivolumab and/or Nivolumab in combination with Ipilimumab will extend progression free survival and overall survival compared to Ipilimumab alone.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2013-04-29
• Study First Submitted QC: 2013-04-30
• Study First Posted: 2013-05-01
• Study Start: 2013-06-11
• Primary Completion: 2016-08-01
• Results First Submitted: 2017-07-14
• Results First Submitted QC: 2017-08-28
• Results First Posted: 2017-09-26
• Study Completion: 2024-04-19
• Status Verified: 2024-06
• Last Update Submitted: 2024-06-20
• Last Update Posted: 2024-07-03

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 1296

Inclusion Criteria

• Histologically confirmed stage III (unresectable) or stage IV melanoma
• Treatment naïve patients
• Measurable disease by computed tomography (CT) or Magnetic Resonance Imaging (MRI) per RECIST 1.1 criteria
• Tumor tissue from an unresectable or metastatic site of disease for biomarker analyses
• Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0 or 1

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Exclusion Criteria

• Active brain metastases or leptomeningeal metastases
• Ocular melanoma
• Subjects with active, known or suspected autoimmune disease
• Subjects with a condition requiring systemic treatment with either corticosteroids (>10 mg daily prednisone equivalents) or other immunosuppressive medications within 14 days of treatment
• Prior treatment with an anti-Programmed Death receptor-1 (PD-1), anti-Programmed Death-1 ligand-1 (PD-L1), anti-PD-L2, or anti-cytotoxic T lymphocyte associated antigen-4 (anti-CTLA-4) antibody

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Arm B: Nivolumab+Ipilimumab+Placebo for Nivolumab	Nivolumab	Nivolumab 1 mg/kg solution intravenously combined with Ipilimumab 3 mg/kg solution intravenously every 3 weeks for 4 doses then Nivolumab 3 mg/kg solution intravenously every 2 weeks plus Placebo matching with Nivolumab on weeks 3 and 5 for cycles 1 and 2, until documented disease progression, discontinuation due to toxicity, withdrawal of consent or the study ends
Arm B: Nivolumab+Ipilimumab+Placebo for Nivolumab	Placebo for Nivolumab	Nivolumab 1 mg/kg solution intravenously combined with Ipilimumab 3 mg/kg solution intravenously every 3 weeks for 4 doses then Nivolumab 3 mg/kg solution intravenously every 2 weeks plus Placebo matching with Nivolumab on weeks 3 and 5 for cycles 1 and 2, until documented disease progression, discontinuation due to toxicity, withdrawal of consent or the study ends
Arm A: Nivolumab+Placebo for Ipilimumab+Placebo for Nivolumab	Placebo for Nivolumab	Nivolumab 3 mg/kg solution intravenously every 2 weeks plus Placebo matching with Ipilimumab 0 mg/kg solution intravenously on weeks 1, 4 and Placebo matching with Nivolumab on weeks 4 for cycles 1 and 2, until documented disease progression, discontinuation due to toxicity, withdrawal of consent or the study ends
Arm A: Nivolumab+Placebo for Ipilimumab+Placebo for Nivolumab	Placebo for Ipilimumab	Nivolumab 3 mg/kg solution intravenously every 2 weeks plus Placebo matching with Ipilimumab 0 mg/kg solution intravenously on weeks 1, 4 and Placebo matching with Nivolumab on weeks 4 for cycles 1 and 2, until documented disease progression, discontinuation due to toxicity, withdrawal of consent or the study ends
Arm B: Nivolumab+Ipilimumab+Placebo for Nivolumab	Ipilimumab	Nivolumab 1 mg/kg solution intravenously combined with Ipilimumab 3 mg/kg solution intravenously every 3 weeks for 4 doses then Nivolumab 3 mg/kg solution intravenously every 2 weeks plus Placebo matching with Nivolumab on weeks 3 and 5 for cycles 1 and 2, until documented disease progression, discontinuation due to toxicity, withdrawal of consent or the study ends
Arm C: Ipilimumab+Placebo for Nivolumab	Placebo for Nivolumab	Ipilimumab 3 mg/kg solution intravenously every 3 weeks for a total of 4 doses plus Placebo matching with Nivolumab 0 mg/kg solution intravenously on weeks 3 and 5 for cycles 1 and 2, until documented disease progression, discontinuation due to toxicity, withdrawal of consent or the study ends (Placebo matching with Nivolumab is no longer required)
Arm A: Nivolumab+Placebo for Ipilimumab+Placebo for Nivolumab	Nivolumab	Nivolumab 3 mg/kg solution intravenously every 2 weeks plus Placebo matching with Ipilimumab 0 mg/kg solution intravenously on weeks 1, 4 and Placebo matching with Nivolumab on weeks 4 for cycles 1 and 2, until documented disease progression, discontinuation due to toxicity, withdrawal of consent or the study ends
Arm C: Ipilimumab+Placebo for Nivolumab	Ipilimumab	Ipilimumab 3 mg/kg solution intravenously every 3 weeks for a total of 4 doses plus Placebo matching with Nivolumab 0 mg/kg solution intravenously on weeks 3 and 5 for cycles 1 and 2, until documented disease progression, discontinuation due to toxicity, withdrawal of consent or the study ends (Placebo matching with Nivolumab is no longer required)

Primary Outcome Measures

Name	Time	Method
Rate of Overall Survival	6, 12, and 24 months	OS was defined as the time between the date of randomization and the date of death. For participants without documentation of death, OS was censored on the last date the participant was known to be alive. The overall survival rate at time T (6, 12, or 24 months) was defined as the probability that a participant was alive at time T following randomization.
Overall Survival (OS)	From randomization to date of death (Assessed up to September 2016, approximately 39 months)	OS was defined as the time between the date of randomization and the date of death. For participants without documentation of death, OS was censored on the last date the participant was known to be alive.
Rate of Progression-Free Survival	6, 12, and 24 months	PFS was defined as the time between the date of randomization and the first date of documented progression, as determined by the Investigator, or death due to any cause, whichever occurred first. Participants who died without a reported progression were considered to have progressed on the date of their death. Participants who did not progress or die were censored on the date of their last evaluable tumor assessment. Participants who did not have any on study tumor assessments and did not die were censored on their date of randomization. Participants treated beyond progression were considered to have progressive disease at the time of the initial progression event regardless of subsequent tumor response. Participants who started anti-cancer therapy without a prior reported progression were censored on the date of their last evaluable tumor assessment prior to the initiation of subsequent anti-cancer therapy.
Progression Free Survival (PFS)	From randomization until disease progression or death, whichever occurred first (assessed up to February 2015, approximately 20 months)	PFS was defined as the time between the date of randomization and the first date of documented progression, as determined by the Investigator, or death due to any cause, whichever occurred first. Progression is defined, using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.1), as a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study, and an absolute increase of at least 5 mm. Participants who died without a reported progression were considered to have progressed on the date of their death. Participants who did not progress or die were censored on the date of their last evaluable tumor assessment. Participants who did not have any on study tumor assessments and did not die were censored on their date of randomization. Participants who started anti-cancer therapy without prior reported progression were censored on the date of their last evaluable tumor assessment prior to the initiation of subsequent anti-cancer therapy.

Secondary Outcome Measures

Name	Time	Method
Progression-Free Survival Based on PD-L1 Expression Level	From randomization until disease progression or death from any cause, whichever occurs first (Assessed up to September 2016, approximately 39 months)	PD-L1 expression was defined as the percent of tumor cells demonstrating plasma membrane PD-L1 staining of any intensity using an IHC assay. Tumor biopsy specimens without measurable PD-L1 expression were classified as indeterminate if the staining was hampered for reasons attributed to the biology of the specimen and not because of improper specimen preparation or handling. Missing specimens, specimens that were not optimally collected (ie not evaluable), and all other specimens were classified as unknown. Participants must have been classified as PD-L1 \>=5% or PD-L1 \<5% per a verified IHC assay, or as indeterminate (ie not unknown), in order to be randomized.
Progression Free Survival (PFS)	From randomization until disease progression or death, whichever occurred first (assessed up to February 2015, approximately 20 months)	PFS data is presented as it was in Primary Outcome Measure #1. The statistical analysis following this outcome measure (#5) reports on a secondary objective comparing PFS between the Nivolumab and Nivolumab + Ipilimumab arms.
Overall Survival Based on PD-L1 Expression Level	From randomization until date of death (Assessed up to September 2016, approximately 39 months)	OS was defined as the time between the date of randomization and the date of death. For participants without documentation of death, OS was censored on the last date the participant was known to be alive.
Mean Change From Baseline in European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) Role Functioning	Baseline and weeks 5, 7, 11, 13, 17, 19, 23, 25, then every 6 weeks until treatment discontinuation	Health Related Quality of Life was assessed using the EORTC QLQ-C30 questionnaire Version 3. With the exception of 2 items included in the global health/quality of life scale, for which responses range from 1 (Very poor) to 7 (Excellent), item responses range from 1 (Not at all) to 4 (Very much). Raw scores for the EORTC QLQ-C30 are transformed to a 0-100 metric such that higher scores for all functional scales and Global Health Status indicate better HRQoL; an increase from baseline indicates improvement in HRQoL compared to baseline.
Mean Change From Baseline in European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) Physical Functioning	Baseline and weeks 5, 7, 11, 13, 17, 19, 23, 25, then every 6 weeks until treatment discontinuation	Health Related Quality of Life was assessed using the EORTC QLQ-C30 questionnaire Version 3. With the exception of 2 items included in the global health/quality of life scale, for which responses range from 1 (Very poor) to 7 (Excellent), item responses range from 1 (Not at all) to 4 (Very much). Raw scores for the EORTC QLQ-C30 are transformed to a 0-100 metric such that higher scores for all functional scales and Global Health Status indicate better HRQoL; an increase from baseline indicates improvement in HRQoL compared to baseline.
Overall Survival (OS)	From randomization to date of death (Assessed up to September 2016, approximately 39 months)	OS data is presented as it was in Primary Outcome Measure #2. The statistical analysis following this outcome measure (#6) reports on a secondary objective comparing OS between the Nivolumab and Nivolumab + Ipilimumab arms.
Mean Change From Baseline in European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) Global Health Status	Baseline and weeks 5, 7, 11, 13, 17, 19, 23, 25, then every 6 weeks until treatment discontinuation	Health Related Quality of Life was assessed using the EORTC QLQ-C30 questionnaire Version 3. With the exception of 2 items included in the global health/quality of life scale, for which responses range from 1 (Very poor) to 7 (Excellent), item responses range from 1 (Not at all) to 4 (Very much). Raw scores for the EORTC QLQ-C30 are transformed to a 0-100 metric such that higher scores for all functional scales and Global Health Status indicate better HRQoL; an increase from baseline indicates improvement in HRQoL compared to baseline. The mean score for all participants in an arm at a given week was subtracted from the mean score of the participants in that arm at baseline. Mean changes from baseline score is presented for all participants in an arm that remained on treatment and completed the EORTC-QLQ-C30 questionnaire at that time point.
Mean Change From Baseline in European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) Emotional Functioning	Baseline and weeks 5, 7, 11, 13, 17, 19, 23, 25, then every 6 weeks until treatment discontinuation	Health Related Quality of Life was assessed using the EORTC QLQ-C30 questionnaire Version 3. With the exception of 2 items included in the global health/quality of life scale, for which responses range from 1 (Very poor) to 7 (Excellent), item responses range from 1 (Not at all) to 4 (Very much). Raw scores for the EORTC QLQ-C30 are transformed to a 0-100 metric such that higher scores for all functional scales and Global Health Status indicate better HRQoL; an increase from baseline indicates improvement in HRQoL compared to baseline.
Objective Response Rate (ORR) Per Investigator Assessment	From randomization until date of disease progression or the date of subsequent anti-cancer therapy, whichever occurs first (Assessed up to February 2015, approximately 20 months)	The ORR was defined as the number of participants with a best overall response (BOR) of a complete response (CR) or partial response (PR) divided by the number of randomized participants for each arm. The BOR was defined as the best response designation, as determined by the Investigator, recorded between the date of randomization and the date of progression, as assessed by the Investigator per RECIST 1.1 or the date of subsequent anticancer therapy (including tumor-directed radiotherapy and tumor-directed surgery), whichever occurred first. For participants without evidence of RECIST 1.1 progression or subsequent anticancer therapy, all available response designations contributed to the BOR assessment. CR= Disappearance of all evidence of disease, confirmed by PET scan; PR= Regression of measureable disease and no new sites; Stable Disease (SD)= Failure to attain CR/PR or PD; Progressive Disease (PD)= Any new lesion or increase by \>=50% of previously involved sites from nadir.
Mean Change From Baseline in European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) Social Functioning	Baseline and weeks 5, 7, 11, 13, 17, 19, 23, 25, then every 6 weeks until treatment discontinuation	Health Related Quality of Life was assessed using the EORTC QLQ-C30 questionnaire Version 3. With the exception of 2 items included in the global health/quality of life scale, for which responses range from 1 (Very poor) to 7 (Excellent), item responses range from 1 (Not at all) to 4 (Very much). Raw scores for the EORTC QLQ-C30 are transformed to a 0-100 metric such that higher scores for all functional scales and Global Health Status indicate better HRQoL; an increase from baseline indicates improvement in HRQoL compared to baseline.
Mean Change From Baseline in European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) Cognitive Functioning	Baseline and weeks 5, 7, 11, 13, 17, 19, 23, 25, then every 6 weeks until treatment discontinuation	Health Related Quality of Life was assessed using the EORTC QLQ-C30 questionnaire Version 3. With the exception of 2 items included in the global health/quality of life scale, for which responses range from 1 (Very poor) to 7 (Excellent), item responses range from 1 (Not at all) to 4 (Very much). Raw scores for the EORTC QLQ-C30 are transformed to a 0-100 metric such that higher scores for all functional scales and Global Health Status indicate better HRQoL; an increase from baseline indicates improvement in HRQoL compared to baseline.

Trial Locations

Locations (150)

Maine Center For Cancer Medicine; 🇺🇸 Scarborough, Maine, United States

Local Institution - 0017; 🇦🇺 Camperdown, New South Wales, Australia

Local Institution - 0138; 🇦🇺 North Sydney, New South Wales, Australia

Local Institution - 0031; 🇦🇺 Coffs Harbour, New South Wales, Australia

Local Institution - 0069; 🇺🇸 Pittsburgh, Pennsylvania, United States

Local Institution - 0007; 🇺🇸 Cleveland, Ohio, United States

Local Institution - 0082; 🇺🇸 Boston, Massachusetts, United States

Local Institution - 0081; 🇺🇸 Boston, Massachusetts, United States

Local Institution - 0088; 🇺🇸 Houston, Texas, United States

Local Institution - 0054; 🇺🇸 Seattle, Washington, United States

Local Institution - 0045; 🇺🇸 Portland, Oregon, United States

Local Institution - 0037; 🇬🇧 Cambridge, United Kingdom

Local Institution - 0021; 🇦🇺 Nedlands, Western Australia, Australia

Comprehensive Cancer Center At Desert Regional Medical Ctr; 🇺🇸 Palm Springs, California, United States

Local Institution - 0042; 🇺🇸 Jacksonville, Florida, United States

Local Institution - 0053; 🇺🇸 Los Angeles, California, United States

Local Institution - 0065; 🇺🇸 Jackson, Mississippi, United States

Local Institution - 0051; 🇺🇸 Atlanta, Georgia, United States

Local Institution - 0046; 🇺🇸 La Jolla, California, United States

Local Institution - 0080; 🇺🇸 Lutherville, Maryland, United States

Local Institution - 0103; 🇧🇪 Leuven, Belgium

Local Institution - 0098; 🇺🇸 Washington, District of Columbia, United States

Local Institution - 0014; 🇺🇸 Los Angeles, California, United States

Local Institution - 0084; 🇺🇸 New Haven, Connecticut, United States

Local Institution - 0003; 🇧🇪 Brussels, Belgium

Local Institution - 0002; 🇧🇪 Bruxelles, Belgium

Local Institution - 0145; 🇦🇹 Wien, Austria

Local Institution - 0024; 🇦🇺 Box Hill, Victoria, Australia

Local Institution - 0004; 🇧🇪 Edegem, Belgium

Local Institution - 0005; 🇧🇪 Gent, Belgium

Local Institution - 0169; 🇫🇮 Tampere, Finland

Local Institution - 0176; 🇮🇹 Bergamo, Italy

Local Institution - 0040; 🇬🇧 Swansea, United Kingdom

Local Institution - 0187; 🇺🇸 Minneapolis, Minnesota, United States

Local Institution - 0048; 🇺🇸 Durham, North Carolina, United States

Local Institution - 0035; 🇮🇪 Dublin 9, Dublin, Ireland

California Pacific Medical Center Research Institute; 🇺🇸 San Francisco, California, United States

Local Institution - 0062; 🇺🇸 Nashville, Tennessee, United States

Local Institution - 0049; 🇺🇸 San Francisco, California, United States

Local Institution - 0089; 🇺🇸 Salt Lake City, Utah, United States

Local Institution - 0076; 🇩🇰 Aarhus, Denmark

Local Institution - 0026; 🇦🇺 Melbourne, Victoria, Australia

Local Institution - 0033; 🇮🇪 Cork, Ireland

Local Institution - 0168; 🇮🇪 Dublin, Ireland

Local Institution - 0013; 🇳🇱 Nijmegen, Netherlands

University of Arizona Cancer Center; 🇺🇸 Tucson, Arizona, United States

Local Institution - 0085; 🇺🇸 Gilbert, Arizona, United States

Local Institution - 0008; 🇺🇸 Orlando, Florida, United States

Local Institution - 0066; 🇺🇸 Rancho Mirage, California, United States

Local Institution - 0183; 🇺🇸 Washington, District of Columbia, United States

Local Institution - 0052; 🇺🇸 Aurora, Colorado, United States

Local Institution - 0083; 🇺🇸 Boston, Massachusetts, United States

Local Institution - 0087; 🇺🇸 Ann Arbor, Michigan, United States

Local Institution - 0130; 🇷🇺 Moscow, Russian Federation

Local Institution - 0151; 🇪🇸 Barcelona, Spain

Local Institution - 0015; 🇺🇸 Las Vegas, Nevada, United States

Local Institution - 0067; 🇺🇸 Saint Louis, Missouri, United States

Local Institution - 0188; 🇺🇸 Morristown, New Jersey, United States

Local Institution - 0047; 🇺🇸 Charlotte, North Carolina, United States

Local Institution - 0174; 🇺🇸 New York, New York, United States

Local Institution - 0068; 🇺🇸 Albuquerque, New Mexico, United States

Local Institution - 0070; 🇺🇸 New York, New York, United States

Local Institution - 0079; 🇺🇸 Albany, New York, United States

Local Institution - 0061; 🇺🇸 Allentown, Pennsylvania, United States

Local Institution - 0112; 🇺🇸 Bethlehem, Pennsylvania, United States

Local Institution - 0064; 🇺🇸 Nashville, Tennessee, United States

Local Institution - 0044; 🇺🇸 Dallas, Texas, United States

Local Institution - 0154; 🇺🇸 Greenville, South Carolina, United States

Texas Oncology; 🇺🇸 Dallas, Texas, United States

Local Institution - 0028; 🇦🇺 Gateshead, New South Wales, Australia

Local Institution - 0022; 🇦🇺 Southport, Queensland, Australia

Local Institution - 0023; 🇦🇺 Macquarie University, New South Wales, Australia

Local Institution - 0019; 🇦🇺 Brisbane, Queensland, Australia

Local Institution - 0018; 🇦🇺 Woolloongabba, Queensland, Australia

Local Institution - 0025; 🇦🇺 Kurralta Park, South Australia, Australia

Local Institution - 0020; 🇦🇺 Adelaide, South Australia, Australia

Local Institution - 0016; 🇦🇺 Heidelberg, Victoria, Australia

Local Institution - 0148; 🇦🇹 Salzburg, Austria

Local Institution - 0140; 🇨🇦 Edmonton, Alberta, Canada

Local Institution - 0141; 🇨🇦 London, Ontario, Canada

Local Institution - 0165; 🇨🇦 Vancouver, British Columbia, Canada

Local Institution - 0056; 🇫🇷 Nantes Cedex, France

Local Institution - 0166; 🇨🇦 Toronto, Ontario, Canada

Local Institution - 0143; 🇨🇦 Ottawa, Ontario, Canada

Local Institution - 0139; 🇨🇦 Montreal, Quebec, Canada

Local Institution - 0142; 🇨🇦 Quebec City, Quebec, Canada

Local Institution - 0092; 🇨🇿 Brno, Czechia

Local Institution - 0091; 🇨🇿 Hradec Kralove, Czechia

Local Institution - 0167; 🇨🇿 Praha 8, Czechia

Local Institution - 0090; 🇨🇿 Praha 2, Czechia

Local Institution - 0078; 🇩🇰 Herlev, Denmark

Local Institution - 0071; 🇫🇮 Helsinki, Uusimaa, Finland

Local Institution - 0077; 🇩🇰 Odense, Denmark

Local Institution - 0125; 🇫🇷 Boulogne Billancourt, France

Local Institution - 0126; 🇫🇷 Marseille Cedex 5, France

Local Institution - 0058; 🇫🇷 Paris Cedex 10, France

Local Institution - 0124; 🇫🇷 Pierre Benite, France

Local Institution - 0127; 🇫🇷 Rennes, France

Local Institution; 🇫🇷 Villejuif, France

Local Institution - 0162; 🇩🇪 Buxtehude, Germany

Local Institution - 0161; 🇩🇪 Erfurt, Germany

Local Institution - 0156; 🇩🇪 Essen, Germany

Local Institution - 0159; 🇩🇪 Hannover, Germany

Local Institution - 0171; 🇩🇪 Erlangen, Germany

Local Institution - 0157; 🇩🇪 Heidelberg, Germany

Local Institution - 0184; 🇸🇪 Stockholm, Sweden

Local Institution - 0178; 🇩🇪 Leipzig, Germany

Local Institution - 0160; 🇩🇪 Munchen, Germany

Local Institution - 0158; 🇩🇪 Kiel, Germany

Local Institution - 0134; 🇩🇪 Tuebingen, Germany

Local Institution - 0036; 🇮🇪 Dublin, Ireland

Local Institution - 0120; 🇮🇱 Jerusalem, Israel

Local Institution - 0034; 🇮🇪 Dublin, Ireland

Local Institution - 0032; 🇮🇪 Galway, Ireland

Local Institution - 0121; 🇮🇱 Tel Hashomer, Israel

Local Institution - 0115; 🇮🇹 Genova, Italy

Local Institution - 0113; 🇮🇹 Meldola (FC), Italy

Local Institution - 0172; 🇮🇹 Milano, Italy

Local Institution - 0114; 🇮🇹 Napoli, Italy

Local Institution - 0117; 🇮🇹 Milano, Italy

Local Institution - 0118; 🇮🇹 Padova, Italy

Local Institution - 0116; 🇮🇹 Siena, Italy

Local Institution - 0177; 🇮🇹 Roma, Italy

Local Institution - 0010; 🇳🇱 Amsterdam, Netherlands

Local Institution - 0012; 🇳🇱 Leiden, Netherlands

Local Institution - 0109; 🇵🇱 Gdansk, Poland

Local Institution - 0029; 🇳🇿 Auckland, New Zealand

Local Institution - 0123; 🇳🇴 Oslo, Norway

Local Institution - 0133; 🇵🇱 Krakow, Poland

Local Institution - 0060; 🇵🇱 Lodz, Poland

Local Institution - 0131; 🇷🇺 Samara, Russian Federation

Local Institution - 0059; 🇵🇱 Warszawa, Poland

Local Institution - 0132; 🇷🇺 Saint Petersburg, Russian Federation

Local Institution - 0175; 🇪🇸 Barcelona, Spain

Local Institution - 0128; 🇷🇺 St. Petersburg, Russian Federation

Local Institution - 0152; 🇪🇸 Badalona-Barcelona, Spain

Local Institution - 0150; 🇪🇸 Madrid, Spain

Local Institution - 0149; 🇪🇸 Madrid, Spain

Local Institution - 0147; 🇪🇸 Pamplona, Spain

Local Institution - 0182; 🇸🇪 Gothenberg, Sweden

Local Institution - 0153; 🇪🇸 Malaga, Spain

Local Institution - 0164; 🇨🇭 Geneva, Switzerland

Local Institution - 0189; 🇨🇭 Lausanne, Switzerland

Local Institution - 0163; 🇨🇭 Zuerich, Switzerland

Local Institution - 0039; 🇬🇧 Glasgow, Dumfries & Galloway, United Kingdom

Local Institution - 0186; 🇨🇭 St. Gallen, Switzerland

Local Institution - 0038; 🇬🇧 London, Greater London, United Kingdom

Local Institution - 0122; 🇬🇧 Nottingham, Nottinghamshire, United Kingdom

Local Institution - 0041; 🇬🇧 Northwood, Middlesex, United Kingdom

Local Institution - 0119; 🇬🇧 Manchester, Greater Manchester, United Kingdom