MedPath

First-line Palbociclib and Endocrine Therapy for Patients With HR+/HER2- Advanced Breast Cancer in the Real-world Setting.

Recruiting
Conditions
Breast Neoplasms
Interventions
Registration Number
NCT04767594
Lead Sponsor
Pfizer
Brief Summary

This is a prospective, single-arm, multi-center observational non-interventional study (NIS) in Germany and Austria.

Detailed Description

Patients diagnosed with HR+/HER2- locally advanced or metastatic breast cancer indicated by their treating physicians for first line endocrine-based palbociclib combination therapy and who meet eligibility criteria will be invited to participate in this study. The key objectives of this study are to describe clinical, scientific and patient reported outcomes for patients with HR+/HER2- locally advanced or metastatic breast cancer initiating treatment with first line endocrine-based palbociclib combination therapy in the real-world setting in Germany and Austria. Patient characteristics, real-world treatment patterns, treatment sequences and reasons for the physician's treatment decisions will be collected. Additional real-world research questions are to explore patient-focused parameters such as longitudinal follow-up data on patient-reported outcomes beyond disease progression and by treatment sequence or to analyze the time from the start of first line treatment to the first administered palliative chemotherapy. Clinical outcome by treatment sequences will be described. Routinely assessed biomarkers and diagnostic procedures applied for treatment sequence decisions will be collected.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
1900
Inclusion Criteria

Not provided

Read More
Exclusion Criteria

Not provided

Read More

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
First-line Palbociclib + endocrine therapyPalbociclib + endocrine therapyPalbociclib + letrozole, or Palbociclib + anastrozole, or Palbociclib + exemestane, or Palbociclib + fulvestrant after prior endocrine therapy
Primary Outcome Measures
NameTimeMethod
Progression-free survival (PFS)from date of start of first-line treatment until the date of first documented disease progression or date of death from any cause, whichever came first, assessed up to 7.5 years
Secondary Outcome Measures
NameTimeMethod
Time to first subsequent therapy (TFST)from date of start of first-line treatment until the date of start of first subsequent systemic antineoplastic treatment, assessed up to 7.5 years
Landmark progression-free survival rates (PFSR) of first- and second-line treatmentproportion of patients without documented disease progression or death due to any cause at defined intervals after start of first-/second-line treatment (at 6, 12, 18, 24, 30, 36 months)
Duration of response (DoR) of first- and second-line treatmentfrom the date of first documented tumor response during first-/ second-line treatment until to the date of first subsequent documented disease progression or to death due to any cause, whichever came first, assessed up to 7.5 years
Landmark overall survival rates (OSR)proportion of patients without documented death due to any cause at defined intervals (at 12, 24, 36, 48, 60 months after start of first-line treatment)
Objective response rate (ORR) of first- and second-line treatmentfrom date of start of first-/ second-line treatment until the date of first subsequent documented disease progression or date of death from any cause, whichever came first, assessed up to 7.5 years
Change from baseline in the FACT-B subscales scores: PWB, SWB, EWB, FWB and additional concerns for BCS.from the date of first questionnaire assessment until the date of last questionnaire assessment, assessed at baseline, thereafter 3-monthly until end of study, and at the end of palbociclib treatment, up to 7.5 years.

The FACT-B is a 37-item instrument designed to measure five domains of HRQOL in breast cancer patients: PWB, SWB, EWB, FWB as well as a BCS. Utilized with the 27 core FACT-G items, the FACT-B was developed with an emphasis on patients' values and brevity.

For all questions, participants are asked to respond to a 5-point Likert-type scale where 0=not at all, 1=a little bit, 2=somewhat, 3=quite a bit, and 4=very much. The higher the score, the better the QOL (PWB: minimum 0; maximum 28. SWB: minimum 0; maximum 28. EWB: minimum 0; maximum 24. FWB: minimum 0; maximum 28. BCS: minimum 0; maximum 40).

Cohort-specific PFS of second-line treatmentfrom date of start of second-line treatment until the date of first subsequent documented disease progression or date of death from any cause, whichever came first, assessed up to 7.5 years

Cohorts are defined by substance class of second-line therapy following first-line endocrine-based palbociclib therapy

Cohort-specific PFS2from date of start of first-line treatment until the date of documented disease progression on the respective second-line treatment or date of death from any cause, whichever came first, assessed up to 7.5 years
Disease control rate (DCR) of first- and second-line treatmentproportion of patients with documented tumor response during first-/second-line treatment (as assessed by local investigator in routine clinical practice) or stable disease (SD) over a period of at least 24 weeks after start of first-line treatment
Progression-free survival (PFS) of third-line treatmentfrom date of start of third-line treatment until the date of first subsequent documented disease progression or date of death from any cause, whichever came first, assessed up to 7.5 years
Change from baseline in the FACT-G total scorefrom the date of first questionnaire assessment until the date of last questionnaire assessment, assessed at baseline, thereafter 3-monthly until end of study, and at the end of palbociclib treatment, up to 7.5 years.

The FACT-G is a 27-item instrument designed to measure four domains of HRQOL in breast cancer patients: PWB, SWB, EWB, and FWB.

For all questions, participants are asked to respond to a 5-point Likert-type scale where 0=not at all, 1=a little bit, 2=somewhat, 3=quite a bit, and 4=very much. The higher the score, the better the QOL (minimum 0; maximum 108).

Landmark analyses of cohort-specific Area Under the Curve (AUC) in the Functional Assessment of Cancer Therapy - Breast (FACT-B) TOI-Physical/Functional/Breast (TOI-PFB)From the date of first questionnaire assessment until 12, 24, 36, 48 months thereafter (irrespective of disease or treatment situation at that time point)

Cohorts are defined by substance class of second-line therapy following first-line endocrine-based palbociclib therapy.

Overall survival (OS)from date of start of first-line treatment until the date of documented death from any cause, assessed up to 7.5 years
Change from baseline in the FACT-B total scorefrom the date of first questionnaire assessment until the date of last questionnaire assessment, assessed at baseline, thereafter 3-monthly until end of study, and at the end of palbociclib treatment, up to 7.5 years.

The FACT-B is a 37-item instrument designed to measure five domains of Health-Relaed Quality of Life (HRQOL) in breast cancer patients: Physical Well-being (PWB), Social/family Well-being (SWB), Emotional Well-being (EWB), Functional Well-being (FWB) as well as a Breast Cancer Subscale (BCS).

Utilized with the 27 core FACT-G items, the FACT-B was developed with an emphasis on patients' values and brevity.

For all questions, participants are asked to respond to a 5-point Likert-type scale where 0=not at all, 1=a little bit, 2=somewhat, 3=quite a bit, and 4=very much. The higher the score, the better the QOL (minimum 0; maximum 148).

Time to first subsequent chemotherapy (TFSC)from date of start of first-line treatment until the date of start of first subsequent systemic chemotherapy or chemotherapy-based antineoplastic treatment, assessed up to 7.5 years
Change from baseline in FACT-B Trial Outcome Index (TOI)from the date of first questionnaire assessment until the date of last questionnaire assessment, assessed at baseline, thereafter 3-monthly until end of study, and at the end of palbociclib treatment, up to 7.5 years.

The FACT-B is a 37-item instrument designed to measure five domains of HRQOL in breast cancer patients: PWB, SWB, EWB, FWB as well as a BCS. Utilized with the 27 core FACT-G items, the FACT-B was developed with an emphasis on patients' values and brevity. The TOI combines the PWB+FWB+BCS items, making it 24-items altogether.

For all questions, participants are asked to respond to a 5-point Likert-type scale where 0=not at all, 1=a little bit, 2=somewhat, 3=quite a bit, and 4=very much. The higher the score, the better the QOL (minimum 0; maximum 96).

Time to deterioration (TTD) in FACT-B total scoreFrom the date of first questionnaire assessment until the date of first subsequent questionnaire with a decrease of ≥ 7 points in FACT-B total score or death, whichever came first, assessed up to 7.5 years.

The FACT-B is a 37-item instrument designed to measure five domains of HRQOL in breast cancer patients: PWB, SWB, EWB, FWB as well as a BCS. Utilized with the 27 core FACT-G items, the FACT-B was developed with an emphasis on patients' values and brevity.

For all questions, participants are asked to respond to a 5-point Likert-type scale where 0=not at all, 1=a little bit, 2=somewhat, 3=quite a bit, and 4=very much. The higher the score, the better the QOL (minimum 0; maximum 148).

Trial Locations

Locations (205)

Hämatologisch Onkologisches Studieninstitut

🇩🇪

Mayen, Germany

Sankt Josef Hospital Braunau

🇦🇹

Braunau, Austria

Medizinische Universität Innsbruck

🇦🇹

Innsbruck, Austria

Klinikum Klagenfurt am Woerthersee

🇦🇹

Klagenfurt Am Woerthersee, Austria

Country Hospital Salzburg

🇦🇹

Salzburg, Austria

Universitaetsklinikum Sankt Poelten

🇦🇹

Sankt Poelten, Austria

Priv. Doz. OA Dr. Michael Hubalek

🇦🇹

Schwaz, Austria

Oesterreichische Gesundheitskasse Hanusch-Krankenhaus

🇦🇹

Vienna, Austria

Medizinische Universität Wien, Abteilung Innere Medizin I

🇦🇹

Wien, Austria

Medizinische Universität Wien

🇦🇹

Wien, Austria

Klinikum Nürnberg

🇩🇪

Nuernberg, Bavaria, Germany

Klinikum Bayreuth GmbH

🇩🇪

Bayreuth, Bayern, Germany

Onkologische Kooperation Harz

🇩🇪

Goslar, Niedersachsen, Germany

Caritas-Krankenhaus Bad Mergentheim

🇩🇪

Bad Mergentheim, Other, Germany

Mvz Etgo Gmbh

🇩🇪

Berlin, Other, Germany

Onkologisch-Hämatologische Schwerpunktpraxis

🇩🇪

Bremen, Other, Germany

ANregiomed gKU

🇩🇪

Ansbach, Germany

Klinikum Hochsauerland GmbH

🇩🇪

Arnsberg, Germany

Group practice Heinrich

🇩🇪

Augsburg, Germany

Group Practice Steinfeld-Birg

🇩🇪

Augsburg, Germany

Group practice Tanzer

🇩🇪

Bad Reichenhall, Germany

Group practice Seipelt

🇩🇪

Bad Soden a.T., Germany

Klinikum Mittelbaden Baden-Baden Balg

🇩🇪

Baden-Baden, Germany

Sozialstiftung Bamberg Klinikum am Bruderwald

🇩🇪

Bamberg, Germany

Private Practice Bayreuth

🇩🇪

Bayreuth, Germany

Charité - Universitaetsmedizin Berlin, Charité Campus Mitte

🇩🇪

Berlin, Germany

Charité Campus Mitte

🇩🇪

Berlin, Germany

Hämatologie Onkologie Berlin-Mitte

🇩🇪

Berlin, Germany

Private practice Schilling

🇩🇪

Berlin, Germany

MediOnko-Institut GbR

🇩🇪

Berlin, Germany

DRK Kliniken Berlin-Köpenick Brustzentrum

🇩🇪

Berlin, Germany

Private practice Ruhmland

🇩🇪

Berlin, Germany

Group practice Morack

🇩🇪

Berlin, Germany

Vivantes Netzwerk für Gesundheit GmbH

🇩🇪

Berlin, Germany

Frauenarzt-Zentrum-Zehlendorf

🇩🇪

Berlin, Germany

Dr. Leonid Basovski Hämatologikum Biberach

🇩🇪

Biberach an der Riss, Germany

Evangelisches Klinikum Bethel gGmbH, Klinik für Innere Medizin, Hämatologie, Onkologie

🇩🇪

Bielefeld, Germany

Group practice Bueckner

🇩🇪

Bochum, Germany

Kliniken Boeblingen

🇩🇪

Boeblingen, Germany

Praxiskooperation Onkologie Bonn / Euskirchen / Rheinbach / Wesseling GbR

🇩🇪

Bonn, Germany

Group practice Hannig

🇩🇪

Bottrop, Germany

Marienhospital Bottrop gGmbH

🇩🇪

Bottrop, Germany

ONKO DOK GbR

🇩🇪

Bottrop, Germany

Private practice Brandenburg a.d.H.

🇩🇪

Brandenburg a.d.H., Germany

Staedtisches Klinikum Brandenburg GmbH

🇩🇪

Brandenburg an der Havel, Germany

Klinikum Bremerhaven Reinkenheide gGmbH

🇩🇪

Bremerhaven, Germany

Fürst-Stirum-Klinik Bruchsal Klinik für Frauenheilkunde und Geburtshilfe

🇩🇪

Bruchsal, Germany

Group practice Schieder

🇩🇪

Buchholz, Germany

AKH-Gruppe-Allgemeines Krankenhaus Celle + MVZ gGmbH

🇩🇪

Celle, Germany

Klinikum Chemnitz gGmbH

🇩🇪

Chemnitz, Germany

Private Practice Jungberg

🇩🇪

Chemnitz, Germany

St. Vincenz-Krankenhaus

🇩🇪

Datteln, Germany

DONAUISAR Klinikum

🇩🇪

Deggendorf, Germany

Onkologiezentrum Donauwoerth

🇩🇪

Donauwoerth, Germany

Klinikum Dortmund Frauenklinik

🇩🇪

Dortmund, Germany

Studiengesellschaft Gefos Dortmund mbH

🇩🇪

Dortmund, Germany

Group practice Goehler

🇩🇪

Dresden, Germany

Gemeinschaftspraxis

🇩🇪

Dresden, Germany

Group practice Jacobasch

🇩🇪

Dresden, Germany

St. Marien-Hospital

🇩🇪

Dueren, Germany

MVZ Duisburg Süd GmbH

🇩🇪

Duisburg, Germany

Naedler GmbH

🇩🇪

Duisburg, Germany

Private Practice Groell

🇩🇪

Ebersberg, Germany

Studienzentrale für das MVZ Eggenfelde e.K.

🇩🇪

Eggenfelden, Germany

St. Georg Klinikum Eisenach gGmbH

🇩🇪

Eisenach, Germany

Group practice Weniger

🇩🇪

Erfurt, Germany

Group practice Haecker

🇩🇪

Erlangen, Germany

imland gGmbH

🇩🇪

Fockbek, Germany

Universitaetsklinikum Frankfurt Frauenheilkunde

🇩🇪

Frankfurt am Main, Germany

pioh Studien und Management GbR

🇩🇪

Frechen, Germany

Group Practice Dr. med. M. Zaiss

🇩🇪

Freiburg, Germany

private practice Freital

🇩🇪

Freital, Germany

KKH Landkreis Freudenstadt Frauenheilkunde und Geburtshilfe

🇩🇪

Freudenstadt, Germany

Krankenhaeuser Landkreis Freudenstadt

🇩🇪

Freudenstadt, Germany

Group practice Fuerth

🇩🇪

Fuerth, Germany

MVZ II der Niels Stensen Kliniken

🇩🇪

Georgsmarienhuette, Germany

Onkostudien Gera GbR

🇩🇪

Gera, Germany

Private practice Rabenbauer

🇩🇪

Grafenau, Germany

Private Practice Antje Kristina Belau

🇩🇪

Greifswald, Germany

Onkodok GmbH

🇩🇪

Guetersloh, Germany

Klinikum Oberberg KKH Gummersbach

🇩🇪

Gummersbach, Germany

Group practice Neumeister

🇩🇪

Haldensleben, Germany

Group practice Behlendorf

🇩🇪

Halle (Saale), Germany

Studiengesellschaft Haemato-Onkologie Hamburg GbR

🇩🇪

Hamburg, Germany

Praxisklinik Harburger Ring

🇩🇪

Hamburg, Germany

Katholisches Marienkrankenhaus gGmbH Frauenklinik

🇩🇪

Hamburg, Germany

Überörtliche Gemeinschaftspraxis

🇩🇪

Hamburg, Germany

Private Practice Rubanov

🇩🇪

Hameln, Germany

Klinikum Hanau Gynäkologisches Krebszentrum

🇩🇪

Hanau, Germany

Group Practice Kamal

🇩🇪

Hannover, Germany

Private Practice Fuxius

🇩🇪

Heidelberg, Germany

Private practice Petersen

🇩🇪

Heidenheim a.d.B., Germany

Westkuestenkliniken Heide und Brunsbuettel

🇩🇪

Heide, Germany

Gemeinschaftskrankenhaus Herdecke gGmbH

🇩🇪

Herdecke, Germany

Mathilden-Hospital

🇩🇪

Herford, Germany

cancer Center Zweiseenland GbR

🇩🇪

Herrsching, Germany

Private Practice Dr. med. Andreas Lorenz

🇩🇪

Hildburghausen, Germany

Gemeinschaftspraxis Dr.med. Ch. Uleer

🇩🇪

Hildesheim, Germany

Onkologie Hof MVZ GmbH

🇩🇪

Hof, Germany

Universitätsklinik des Saarlandes Ausführende Stelle: Universitätsklinikum Homburg,

🇩🇪

Homberg, Germany

Frauenarzt Toralf Baerens

🇩🇪

Ilsede, Germany

Klinikum Itzehoe

🇩🇪

Itzehoe, Germany

IDGGQ GbR

🇩🇪

Kaiserslautern, Germany

ViDia Christliche Kliniken Karlsruhe Vincentius-Diakonissen-Kliniken gAG

🇩🇪

Karlsruhe, Germany

Diakonissenkrankenhaus Karlsruhe

🇩🇪

Karlsruhe, Germany

Klinikum Kaufbeuren

🇩🇪

Kaufbeuren, Germany

Institut fuer Versorgungsforschung in der Onkologie GbR

🇩🇪

Koblenz, Germany

private practice Ziegler-Loehr

🇩🇪

Koeln, Germany

St. Elisabeth Krankenhaus GmbH

🇩🇪

Koeln, Germany

Group practice Koeln

🇩🇪

Koeln, Germany

group practice Krefeld

🇩🇪

Krefeld, Germany

Private practice Kronach

🇩🇪

Kronach, Germany

Klinikum Kulmbach

🇩🇪

Kulmbach, Germany

Klinikum Dahme-Spreewald GmbH

🇩🇪

Königs Wusterhausen, Germany

ÜBAG - MVZ Dr. Vehling-Kaiser GmbH Landshut

🇩🇪

Landshut, Germany

Group practice Koehler

🇩🇪

Langen, Germany

Onkologisches Zentrum Lebach

🇩🇪

Lebach, Germany

Group practice Mueller

🇩🇪

Leer, Germany

Group practice Knoblich

🇩🇪

Loerrach, Germany

Private practice Wierick

🇩🇪

Lohsa, Germany

Universitätsklinikum Schleswig Holstein

🇩🇪

Luebeck, Germany

Onkologie Zentrum Lüneburg Praxisgemeinschaft

🇩🇪

Lüneburg, Germany

Universitätsklinikum Magdeburg Frauenklinik, Brustzentrum

🇩🇪

Magdeburg, Germany

Klinikum Magdeburg Frauenheilkunde und Geburtshilfe

🇩🇪

Magdeburg, Germany

Group practice Prof. Dr. M. Hensel

🇩🇪

Mannheim, Germany

Klinikum Fichtelgebirge gGmbH

🇩🇪

Marktredwitz, Germany

Institut für Versorgungsforschung GbR

🇩🇪

Mayen, Germany

Brustzentrum-Rhein-Ruhr Servicegesellschaft mbH

🇩🇪

Moenchengladbach, Germany

OnkoLog Moers GbR

🇩🇪

Moers, Germany

Onko - Log Muelheim GbR

🇩🇪

Muehlheim, Germany

Klinikum Dritter Orden

🇩🇪

Muenchen, Germany

Group practice Schmidt

🇩🇪

Muenchen, Germany

MVZ GmbH-Muehlhausen

🇩🇪

Muhlhausen, Germany

Stauferklinikum Schwaebisch Gmuend

🇩🇪

Mutlangen, Germany

Private practice Naunhof

🇩🇪

Naunhof, Germany

Frauenärztin Neubrandenburg - Dr. m Ines Vanselow-Geßner

🇩🇪

Neubrandenburg, Germany

Group Practice Nacke

🇩🇪

Neuenahr-Ahrweller, Germany

Friedrich-Ebert-Krankenhaus

🇩🇪

Neumuenster, Germany

Augustinus Kliniken, JEK

🇩🇪

Neuss, Germany

TZN-Tumorzentrum Niederrhein GmbH

🇩🇪

Neuss, Germany

Group practice Tschechne

🇩🇪

Neustadt a.R., Germany

Group practice Hutzschenreuter

🇩🇪

Nordhorn, Germany

Spital 2 medizinisches Institut PartG mbB

🇩🇪

Nuernberg, Germany

medius Klinik Nürtingen

🇩🇪

Nuertingen, Germany

group practice Olbermann

🇩🇪

Oberhausen, Germany

ONSO GbR

🇩🇪

Oldenburg, Germany

Pius Hospital Oldenburg

🇩🇪

Oldenburg, Germany

Oberhavel Kliniken GmbH

🇩🇪

Oranienburg, Germany

Klinikum Osnabrueck GmbH

🇩🇪

Osnabrueck, Germany

Paracelsus-Klinik Osnabrueck

🇩🇪

Osnabrueck, Germany

St. Vincenz-Krankenhaus GmbH

🇩🇪

Paderborn, Germany

Klinikum Ernst von Bergmann gGmbH

🇩🇪

Potsdam, Germany

MVZ für Blut - und Krebserkrankungen Drs. Sauer / Gerhardt / Linde

🇩🇪

Potsdam, Germany

Group practice Decker

🇩🇪

Ravensburg, Germany

Oncologianova GmbH

🇩🇪

Recklinghausen, Germany

Group practice Remscheid

🇩🇪

Remscheid, Germany

Private practice Remscheid

🇩🇪

Remscheid, Germany

Private practice Kohnke

🇩🇪

Remscheid, Germany

Gemeinschaftspraxis für internistische Hämatologie und Onkologie

🇩🇪

Rheine, Germany

Private practice Markmann

🇩🇪

Rostock, Germany

Klinikum Suedstadt Rostock, Universitaetsfrauenklinik

🇩🇪

Rostock, Germany

Agaplesion Diakonieklinik Rotenburg gGmbH

🇩🇪

Rotenburg (Wuemme), Germany

GPR Klinikum Rüsselsheim

🇩🇪

Ruesselsheim, Germany

CaritasKlinikum St. Theresia

🇩🇪

Saarbrücken, Germany

Krankenhaus Saarlouis vom DRK

🇩🇪

Saarlouis, Germany

Private practice Schubert

🇩🇪

Scheibenberg, Germany

MedCenter Nordsachsen - Studien

🇩🇪

Schkeuditz, Germany

Onkster GbR

🇩🇪

Schorndorf, Germany

Diakoneo Diakonie-Klinikum Schwaebisch Hall gGmbH

🇩🇪

Schwaebisch Hall, Germany

Leopoldina Krankenhaus der Stadt Schweinfurt GmbH

🇩🇪

Schweinfurt, Germany

Marienkrankenhaus Schwerte

🇩🇪

Schwerte, Germany

Group Practice Esser

🇩🇪

Siegburg, Germany

Group practice Singen

🇩🇪

Singen (Hohentwiel), Germany

KMG Klinikum Sömmerda

🇩🇪

Soemmerda, Germany

Onkologiezentrum Soest/Iserlohn

🇩🇪

Soest, Germany

Staedtisches Klinikum Solingen gemeinützige GmbH, Klinik für Frauenheilkunde

🇩🇪

Solingen, Germany

Group practice Behringer

🇩🇪

Speyer, Germany

MVZ Klinik Dr. Hancken GmbH

🇩🇪

Stade, Germany

Private Practice Denck

🇩🇪

Stendal, Germany

Clinical Research Stohlberg GmbH

🇩🇪

Stohlberg, Germany

Private practice Stralsund

🇩🇪

Stralsund, Germany

Gynäkologie Kompetenzzentrum Praxis Dr. med. Carsten Hielscher

🇩🇪

Stralsund, Germany

Klinikum der Landeshauptstadt Stuttgart gKAoeR

🇩🇪

Stuttgart, Germany

Vinzenz von Paul Kliniken gGmbH Marienhospital

🇩🇪

Stuttgart, Germany

Frauenaerztliches Zentrum Suhl im medico Facharztzentrum MVZ GmbH Betriebsstaette Suhl

🇩🇪

Suhl, Germany

SRH Zentralklinikum Suhl GmbH

🇩🇪

Suhl, Germany

Group Practice Kronawitter

🇩🇪

Traunstein, Germany

Klinikum Traunstein

🇩🇪

Traunstein, Germany

Group practice Forstbauer

🇩🇪

Troisdorf, Germany

Private practice Weissenborn

🇩🇪

Twistringen, Germany

Private practice Wolf

🇩🇪

Ulm, Germany

Group practice Wagner

🇩🇪

Voelklingen, Germany

GRN Klinik Weinheim

🇩🇪

Weinheim, Germany

Asklepios Klinik Weissenfels Frauenheilkunde, Geburtshilfe Brustzentrum

🇩🇪

Weissenfels, Germany

MVZ Marien-Hospital Wesel GmbH

🇩🇪

Wesel, Germany

Medizinische Studiengesellschaft NORD-WEST GmbH

🇩🇪

Westerstede, Germany

Lahn-Dill-Kliniken GmbH

🇩🇪

Wetzlar, Germany

Helios Dr. Horst Schmidt Kliniken Wiesbaden

🇩🇪

Wiesbaden, Germany

Gruop practice Rodemer / Wismann / Distelrath

🇩🇪

Wilhelmshaven, Germany

Rems-Murr-Klinikum Winnenden Gynaekologie und Geburtshilfe

🇩🇪

Winnenden, Germany

GIM - Gemeinschaftspraxis Innere Medizin

🇩🇪

Witten, Germany

Group practice Wolfsburg

🇩🇪

Wolfsburg, Germany

Group practice Wuerzburg

🇩🇪

Wuerzburg, Germany

Universitätsklinikum Wuerzburg AoeR

🇩🇪

Wuerzburg, Germany

Helios Universitätsklinikum Wuppertal GmbH

🇩🇪

Wuppertal, Germany

© Copyright 2025. All Rights Reserved by MedPath