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A Study of Zilovertamab Vedotin (MK-2140) in Combination With Standard of Care in Participants With Relapsed or Refractory Diffuse Large B-Cell Lymphoma (rrDLBCL) (MK-2140-003)

Phase 2
Recruiting
Conditions
Diffuse Large B-Cell Lymphoma
DLBCL
Interventions
Registration Number
NCT05139017
Lead Sponsor
Merck Sharp & Dohme LLC
Brief Summary

The purpose of this Phase 2/3, randomized, multisite, open-label, dose confirmation, and expansion study is to evaluate the safety, and efficacy of zilovertamab vedotin (ZV) in combination with standard of care options for the treatment of rrDLBCL. This study will be divided into 2 parts: Dose Confirmation (Part 1) and Efficacy Expansion (Part 2) and will enroll participants who are at least 18 years of age with rrDLBCL. The hypotheses are: ZV in combination with rituximab, gemcitabine, and oxaliplatin (R-GemOx) is superior to R-GemOx with respect to progression-free survival (PFS) per Lugano response criteria by blinded independent review committee (BICR); and that ZV in combination with bendamustine rituximab (BR) is superior to BR with respect to PFS per Lugano response criteria by BICR.

With protocol amendment 4 (effective: 04-April-2024), enrollment in Cohort B (study arms Bendamustine Rituximab \[BR\] and ZV + BR) is discontinued. No efficacy outcome analysis and hypothesis testing will be conducted for Cohort B.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
290
Inclusion Criteria
  • Has a histologically confirmed diagnosis of Diffuse Large B-Cell Lymphoma (DLBCL).
  • Has radiographically measurable DLBCL per the Lugano Response Criteria, as assessed locally by the investigator.
  • Has an Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 to 2 within 7 days prior to study treatment initiation.
  • Has adequate organ function.
  • Is able to provide new or archival tumor tissue sample not previously irradiated.

Zilovertamab vedotin plus R-GemOx, or R-GemOx study arms:

  • Has relapsed or refractory DLBCL and is ineligible for or have failed autologous stem-cell transplant (ASCT) and have failed at least 1 line of prior therapy.
  • Has post-chimeric antigen receptor T (post-CAR-T) cell therapy failure or is ineligible for CAR-T cell therapy.

Not applicable with protocol amendment 4: Zilovertamab vedotin plus Bendamustine Rituximab (BR), and Bendamustine Rituximab study arms:

  • Has relapsed or refractory DLBCL and is ineligible for or have failed ASCT and have failed at least 2 lines of prior therapy.
  • Has post-CAR-T therapy failure or is ineligible for CAR-T cell therapy.
Exclusion Criteria
  • Not applicable with protocol amendment 4: Has history of transformation of indolent disease to DLBCL
  • Has received solid organ transplant at any time.
  • Has received a diagnosis of primary mediastinal B-cell lymphoma (PMBCL).
  • Has clinically significant (ie, active) cardiovascular disease or serious cardiac arrhythmia requiring medication.
  • Has ongoing graft-versus-host disease (GVHD) of any grade, or is receiving treatment for their GVHD.
  • Has clinically significant pericardial or pleural effusion.
  • Has ongoing Grade >1 peripheral neuropathy.
  • Has a history of a second malignancy, unless potentially curative treatment has been completed with no evidence of malignancy for 2 years.
  • Has a demyelinating form of Charcot-Marie-Tooth disease.
  • Has contraindication to any of the study intervention components including but not limited to prior anaphylactic reaction.
  • Has received prior systemic anticancer therapy, including investigational agents within 4 weeks prior to the first dose of study intervention.
  • Has received prior radiotherapy within 4 weeks of start of study intervention. Participants must have recovered from all radiation-related toxicities, not require corticosteroids, and not have had radiation pneumonitis.
  • Has ongoing corticosteroid therapy.
  • Has received a live or live-attenuated vaccine within 30 days before the first dose of study intervention.
  • Is currently participating in or has participated in a study of an investigational agent or has used an investigational device within 4 weeks before the first dose of study intervention.
  • Has known active central nervous system (CNS) lymphoma involvement or active CNS involvement by lymphoma. Participants with prior CNS involvement are eligible if their CNS disease is in radiographic, cytological (for cerebrospinal fluid disease), and clinical remission.
  • Has an active infection requiring systemic therapy.
  • Has a known history of human immunodeficiency virus (HIV) infection.
  • Has a known active Hepatitis C virus infection.
  • Has a known psychiatric or substance abuse disorder that would interfere with the participant's ability to cooperate with the requirements of the study.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SEQUENTIAL
Arm && Interventions
GroupInterventionDescription
ZV + R-GemOx (Part 1)Zilovertamab vedotinParticipants in this arm will receive doses of ZV (from 1.5 mg/Kg up to 2.5 mg/Kg) plus Rituximab 375 mg/m\^2, Gemcitabine 1000 mg/m\^2 and Oxaliplatin 100 mg/m\^2 (R-GemOx) given intravenously on Day 1 of repeated 21-day cycles. Treatment will continue for up to 6 cycles.
ZV + R-GemOx (Part 1)RituximabParticipants in this arm will receive doses of ZV (from 1.5 mg/Kg up to 2.5 mg/Kg) plus Rituximab 375 mg/m\^2, Gemcitabine 1000 mg/m\^2 and Oxaliplatin 100 mg/m\^2 (R-GemOx) given intravenously on Day 1 of repeated 21-day cycles. Treatment will continue for up to 6 cycles.
ZV + R-GemOx (Part 1)GemcitabineParticipants in this arm will receive doses of ZV (from 1.5 mg/Kg up to 2.5 mg/Kg) plus Rituximab 375 mg/m\^2, Gemcitabine 1000 mg/m\^2 and Oxaliplatin 100 mg/m\^2 (R-GemOx) given intravenously on Day 1 of repeated 21-day cycles. Treatment will continue for up to 6 cycles.
ZV + R-GemOx (Part 1)OxaliplatinParticipants in this arm will receive doses of ZV (from 1.5 mg/Kg up to 2.5 mg/Kg) plus Rituximab 375 mg/m\^2, Gemcitabine 1000 mg/m\^2 and Oxaliplatin 100 mg/m\^2 (R-GemOx) given intravenously on Day 1 of repeated 21-day cycles. Treatment will continue for up to 6 cycles.
ZV + R-GemOx (Part 1)Granulocyte Colony-Stimulating Factor (G-CSF)Participants in this arm will receive doses of ZV (from 1.5 mg/Kg up to 2.5 mg/Kg) plus Rituximab 375 mg/m\^2, Gemcitabine 1000 mg/m\^2 and Oxaliplatin 100 mg/m\^2 (R-GemOx) given intravenously on Day 1 of repeated 21-day cycles. Treatment will continue for up to 6 cycles.
ZV + R-GemOx (Part 2)Zilovertamab vedotinUsing the recommended Phase 2 dose (RP2D) dose of ZV plus R-GemOx from Part 1, participants will receive ZV plus R-GemOx given intravenously on Day 1 of repeated 21-day cycles. Treatment will continue for up to 6 cycles or until progressive disease or discontinuation.
ZV + R-GemOx (Part 2)RituximabUsing the recommended Phase 2 dose (RP2D) dose of ZV plus R-GemOx from Part 1, participants will receive ZV plus R-GemOx given intravenously on Day 1 of repeated 21-day cycles. Treatment will continue for up to 6 cycles or until progressive disease or discontinuation.
ZV + R-GemOx (Part 2)GemcitabineUsing the recommended Phase 2 dose (RP2D) dose of ZV plus R-GemOx from Part 1, participants will receive ZV plus R-GemOx given intravenously on Day 1 of repeated 21-day cycles. Treatment will continue for up to 6 cycles or until progressive disease or discontinuation.
ZV + R-GemOx (Part 2)OxaliplatinUsing the recommended Phase 2 dose (RP2D) dose of ZV plus R-GemOx from Part 1, participants will receive ZV plus R-GemOx given intravenously on Day 1 of repeated 21-day cycles. Treatment will continue for up to 6 cycles or until progressive disease or discontinuation.
ZV + R-GemOx (Part 2)Granulocyte Colony-Stimulating Factor (G-CSF)Using the recommended Phase 2 dose (RP2D) dose of ZV plus R-GemOx from Part 1, participants will receive ZV plus R-GemOx given intravenously on Day 1 of repeated 21-day cycles. Treatment will continue for up to 6 cycles or until progressive disease or discontinuation.
R-GemOx (active control for Part 2)RituximabParticipants will receive R-GemOx given intravenously on Day 1 of repeated 21-day cycles. Treatment will continue for up to 6 cycles or until progressive disease or discontinuation.
R-GemOx (active control for Part 2)GemcitabineParticipants will receive R-GemOx given intravenously on Day 1 of repeated 21-day cycles. Treatment will continue for up to 6 cycles or until progressive disease or discontinuation.
R-GemOx (active control for Part 2)OxaliplatinParticipants will receive R-GemOx given intravenously on Day 1 of repeated 21-day cycles. Treatment will continue for up to 6 cycles or until progressive disease or discontinuation.
ZV + BR (Part 2)Zilovertamab vedotinUsing RP2D from Part 1, participants will receive ZV plus Rituximab 375 mg/m\^2, given intravenously on Day 1 and Bendamustine 90 mg/m\^2 given intravenously on Day 1 and 2, of repeated 21-day cycles. Treatment will continue for up to 6 cycles or until progressive disease or discontinuation.
ZV + BR (Part 2)RituximabUsing RP2D from Part 1, participants will receive ZV plus Rituximab 375 mg/m\^2, given intravenously on Day 1 and Bendamustine 90 mg/m\^2 given intravenously on Day 1 and 2, of repeated 21-day cycles. Treatment will continue for up to 6 cycles or until progressive disease or discontinuation.
ZV + BR (Part 2)BendamustineUsing RP2D from Part 1, participants will receive ZV plus Rituximab 375 mg/m\^2, given intravenously on Day 1 and Bendamustine 90 mg/m\^2 given intravenously on Day 1 and 2, of repeated 21-day cycles. Treatment will continue for up to 6 cycles or until progressive disease or discontinuation.
ZV + BR (Part 2)Granulocyte Colony-Stimulating Factor (G-CSF)Using RP2D from Part 1, participants will receive ZV plus Rituximab 375 mg/m\^2, given intravenously on Day 1 and Bendamustine 90 mg/m\^2 given intravenously on Day 1 and 2, of repeated 21-day cycles. Treatment will continue for up to 6 cycles or until progressive disease or discontinuation.
Bendamustine Rituximab (BR)RituximabParticipants will receive Rituximab 375 mg/m\^2, given intravenously on Day 1 Bendamustine 90 mg/m\^2 given intravenously on Day 1 and 2 of repeated 21-day cycles. Treatment will continue for up to 6 cycles or until progressive disease or discontinuation.
Bendamustine Rituximab (BR)BendamustineParticipants will receive Rituximab 375 mg/m\^2, given intravenously on Day 1 Bendamustine 90 mg/m\^2 given intravenously on Day 1 and 2 of repeated 21-day cycles. Treatment will continue for up to 6 cycles or until progressive disease or discontinuation.
ZV + BR (Part 1)Zilovertamab vedotinParticipants in this arm will receive doses of ZV (from 1.5 mg/Kg up to 2.5 mg/Kg) plus Rituximab 375 mg/m\^2, Bendamustine 90 mg/m\^2 (BR) given intravenously on Day 1 and 2 of repeated 21-day cycles. Treatment will continue for up to 6 cycles.
ZV + BR (Part 1)RituximabParticipants in this arm will receive doses of ZV (from 1.5 mg/Kg up to 2.5 mg/Kg) plus Rituximab 375 mg/m\^2, Bendamustine 90 mg/m\^2 (BR) given intravenously on Day 1 and 2 of repeated 21-day cycles. Treatment will continue for up to 6 cycles.
ZV + BR (Part 1)BendamustineParticipants in this arm will receive doses of ZV (from 1.5 mg/Kg up to 2.5 mg/Kg) plus Rituximab 375 mg/m\^2, Bendamustine 90 mg/m\^2 (BR) given intravenously on Day 1 and 2 of repeated 21-day cycles. Treatment will continue for up to 6 cycles.
ZV + BR (Part 1)Granulocyte Colony-Stimulating Factor (G-CSF)Participants in this arm will receive doses of ZV (from 1.5 mg/Kg up to 2.5 mg/Kg) plus Rituximab 375 mg/m\^2, Bendamustine 90 mg/m\^2 (BR) given intravenously on Day 1 and 2 of repeated 21-day cycles. Treatment will continue for up to 6 cycles.
Primary Outcome Measures
NameTimeMethod
Number of participants who experienced an adverse event (AE)Up to ~68 months

An AE is any unfavorable and unintended sign, symptom, or disease temporally associated with the use of a medicinal product or protocol-specified procedure, whether or not considered related to the medicinal product or protocol-specified procedure. Any worsening of a preexisting condition that is temporally associated with the use of the Sponsor's product, is also an AE. The number of participants who experienced an AE will be reported.

Number of participants who discontinued study treatment due to an AEUp to ~68months

An AE is any unfavorable and unintended sign, symptom, or disease temporally associated with the use of a medicinal product or protocol-specified procedure, whether or not considered related to the medicinal product or protocol-specified procedure. Any worsening of a preexisting condition that is temporally associated with the use of the Sponsor's product, is also an AE. The number of participants who discontinued study treatment due to an AE will be reported.

Overall survival (OS)Up to ~35 months

OS, defined as the time from randomization to death due to any cause will be reported.

Progression-free survival (PFS)Up to ~26 months

PFS, defined as the time from randomization to the first documented disease progression per Lugano response criteria as assessed by BICR or death due to any cause, whichever occurs first will be presented.

Number of participants who experienced dose-limiting toxicities (DLTs) in Part 1Up to ~6 weeks

The CTCAE, Version 5.0 will be used to grade the severity of AEs in this study. DLTs will be reported for Part 1 of this study.

Secondary Outcome Measures
NameTimeMethod
Objective response rate (ORR)Up to ~26 months

ORR, defined as the percentage of participants who achieve a complete response (CR) or partial response (PR) per Lugano criteria as assessed by BICR will be presented.

Duration of response (DOR)Up to ~26 months

DOR, defined as the time from the first documented evidence of CR or PR until disease progression or death due to any cause, whichever occurs first, will be reported.

Trial Locations

Locations (95)

Carmel Hospital ( Site 1103)

🇮🇱

Haifa, Israel

Bass Medical Group ( Site 0166)

🇺🇸

Walnut Creek, California, United States

Innovative Clinical Research Institute ( Site 0122)

🇺🇸

Whittier, California, United States

Boca Raton Regional Hospital- Lynn Cancer Institute ( Site 0163)

🇺🇸

Boca Raton, Florida, United States

Saint Elizabeth Medical Center Edgewood ( Site 0165)

🇺🇸

Edgewood, Kentucky, United States

University of Kentucky Chandler Medical Center ( Site 0158)

🇺🇸

Lexington, Kentucky, United States

Norton Women's and Children's Hospital-Norton Cancer Institute - St. Matthews ( Site 0133)

🇺🇸

Louisville, Kentucky, United States

Louisiana State University Health Sciences Center New Orleans ( Site 0134)

🇺🇸

New Orleans, Louisiana, United States

University of Maryland ( Site 0123)

🇺🇸

Baltimore, Maryland, United States

Dana-Farber Cancer Institute-Lymphoma ( Site 0111)

🇺🇸

Boston, Massachusetts, United States

University of Massachusetts Medical School ( Site 0119)

🇺🇸

Worcester, Massachusetts, United States

St. Vincent Frontier Cancer Center-Research ( Site 0108)

🇺🇸

Billings, Montana, United States

Atlantic Health System ( Site 0116)

🇺🇸

Morristown, New Jersey, United States

Hadassah Medical Center ( Site 1100)

🇮🇱

Jerusalem, Israel

New York Medical College ( Site 0113)

🇺🇸

Valhalla, New York, United States

Vanderbilt University Medical Center-Vanderbilt-Ingram Cancer Center ( Site 0156)

🇺🇸

Nashville, Tennessee, United States

Hospital Aleman ( Site 2200)

🇦🇷

Buenos Aites, Caba, Argentina

Instituto Alexander Fleming ( Site 2201)

🇦🇷

Caba, Argentina

Hospital Privado Universitario de Córdoba ( Site 2202)

🇦🇷

Cordoba, Argentina

Townsville University Hospital ( Site 1800)

🇦🇺

Douglas, Queensland, Australia

Grampians Health ( Site 1802)

🇦🇺

Ballarat, Victoria, Australia

Liga Norte Riograndense Contra o Câncer ( Site 2305)

🇧🇷

Natal, Rio Grande Do Norte, Brazil

Princess Margaret Cancer Centre-Division of Medical Oncology and Hematology ( Site 0200)

🇨🇦

Toronto, Ontario, Canada

Biocenter ( Site 2401)

🇨🇱

Concepcion., Biobio, Chile

IC La Serena Research ( Site 2405)

🇨🇱

La Serena, Coquimbo, Chile

Oncocentro Valdivia ( Site 2407)

🇨🇱

Valdivia., Los Rios, Chile

Clínica Inmunocel ( Site 2404)

🇨🇱

Santiago, Region M. De Santiago, Chile

Clínica RedSalud Vitacura ( Site 2409)

🇨🇱

Santiago, Region M. De Santiago, Chile

Bradfordhill ( Site 2403)

🇨🇱

Santiago, Region M. De Santiago, Chile

Beijing Cancer hospital ( Site 3000)

🇨🇳

Beijing, Beijing, China

Chongqing University Cancer Hospital-Medical Oncology ( Site 3025)

🇨🇳

Chongqing, Chongqing, China

Chongqing University Three Gorges Hospital ( Site 3026)

🇨🇳

Chongqing, Chongqing, China

Sun Yat-sen University Cancer Center-Internal Medicine ( Site 3001)

🇨🇳

Guangzhou, Guangdong, China

Zhujiang Hospital ( Site 3002)

🇨🇳

Guangzhou, Guangdong, China

The First Affiliated Hospital of Henan University of Science &Technology ( Site 3029)

🇨🇳

Luoyang, Henan, China

Henan Cancer Hospital-hematology department ( Site 3013)

🇨🇳

Zhengzhou, Henan, China

Union Hospital Tongji Medical College Huazhong University of Science and Technology ( Site 3017)

🇨🇳

Wuhan, Hubei, China

The First Affiliated Hospital of Nanchang University ( Site 3004)

🇨🇳

Nanchang, Jiangxi, China

Jiangxi Provincial Cancer Hospital ( Site 3005)

🇨🇳

Nanchang, Jiangxi, China

The First Hospital of Jilin University-Hematology ( Site 3012)

🇨🇳

Changchun, Jilin, China

Fudan University Shanghai Cancer Center ( Site 3009)

🇨🇳

Shanghai, Shanghai, China

West China Hospital of Sichuan University-Head and Neck Oncology ( Site 3016)

🇨🇳

Cheng Du, Sichuan, China

Sichuan Cancer hospital-Oncology ( Site 3021)

🇨🇳

Chengdu, Sichuan, China

Zhejiang Cancer Hospital ( Site 3014)

🇨🇳

Hangzhou, Zhejiang, China

The First Affiliated Hospital Zhejiang University School of Medicine ( Site 3027)

🇨🇳

Hangzhou, Zhejiang, China

Hospital Pablo Tobon Uribe ( Site 0804)

🇨🇴

Medellin, Antioquia, Colombia

Instituto Médico de Alta Tecnologia S.A.S ( Site 0803)

🇨🇴

Monteria, Cordoba, Colombia

FUNDACION CTIC CENTRO DE TRATAMIENTO E INVESTIGACION SOBRE CANCER LUIS CARLOS SARMIENTO ANGULO ( Site 0801)

🇨🇴

Bogota, Distrito Capital De Bogota, Colombia

Oncologos del Occidente ( Site 0800)

🇨🇴

Pereira., Risaralda, Colombia

Fundacion Valle del Lili ( Site 0802)

🇨🇴

Cali, Valle Del Cauca, Colombia

Hospital Metropolitano - Sede Lindora ( Site 2500)

🇨🇷

Santa Ana, San Jose, Costa Rica

CIMCA ( Site 2501)

🇨🇷

San Jose, Costa Rica

centre hospitalier lyon sud-Service Hématologie ( Site 0702)

🇫🇷

Pierre-Bénite, Rhone, France

Pitie Salpetriere University Hospital-Clinical haematology ( Site 0700)

🇫🇷

Paris, France

University Hospital of Alexandroupolis ( Site 0903)

🇬🇷

Alexandroupolis, Anatoliki Makedonia Kai Thraki, Greece

Evangelismos General Hospital of Athens ( Site 0900)

🇬🇷

Athens, Attiki, Greece

Regional General Hospital of Athens "Laiko" ( Site 0901)

🇬🇷

Athens, Attiki, Greece

MEDI-K ( Site 2602)

🇬🇹

Guatemala, Guatemala

Private Practice- Dr. Rixci Augusto Lenin Ramírez ( Site 2601)

🇬🇹

Guatemala, Guatemala

CELAN,S.A ( Site 2603)

🇬🇹

Guatemala, Guatemala

Queen Mary Hospital ( Site 3100)

🇭🇰

Hong Kong, Hong Kong

Princess Margaret Hospital ( Site 3101)

🇭🇰

Hong Kong, Hong Kong

Emek Medical Center-Hematology Unit ( Site 1102)

🇮🇱

Afula, Israel

Humanitas-U.O di Oncologia medica ed Ematologia ( Site 1203)

🇮🇹

Rozzano, Milano, Italy

IRCCS - AOU di Bologna-Istituto di Ematologia "L. e A. Seragnoli" ( Site 1200)

🇮🇹

Bologna, Italy

Istituto Nazionale Tumori IRCCS Fondazione Pascale ( Site 1202)

🇮🇹

Napoli, Italy

Fondazione Policlinico Universitario Agostino Gemelli IRCCS -ISTITUTO DI EMATOLOGIA ( Site 1204)

🇮🇹

Roma, Italy

Seoul National University Hospital-Oncology ( Site 0302)

🇰🇷

Seoul, Korea, Republic of

Samsung Medical Center ( Site 0300)

🇰🇷

Seoul, Korea, Republic of

Aotearoa Clinical Trials ( Site 0501)

🇳🇿

Auckland, New Zealand

Clínica San Felipe ( Site 2805)

🇵🇪

Lima, Peru

Uniwersytecki Szpital Kliniczny-Klinika Hematologii, Nowotworow Krwi i Transplantacji Szpiku ( Site 1301)

🇵🇱

Wroclaw, Dolnoslaskie, Poland

Centrum Onkologii Ziemi Lubelskiej-Oddzial Hematologii i Transplantacji Szpiku ( Site 1304)

🇵🇱

Lublin, Lubelskie, Poland

Pratia MCM Krakow ( Site 1303)

🇵🇱

Krakow, Malopolskie, Poland

Narodowy Instytut Onkologii im. Marii Sklodowskiej-Curie - P-Klinika Nowotworów Układu Chłonnego ( Site 1300)

🇵🇱

Warszawa, Mazowieckie, Poland

Szpitale Pomorskie Sp. z o. o.-Hematology and Bone Marrow Transplantation Department ( Site 1302)

🇵🇱

Gdynia, Pomorskie, Poland

Wojewódzki Szpital Specjalistyczny im. J. Korczaka w Słupsku ( Site 1309)

🇵🇱

Słupsk, Pomorskie, Poland

Pratia Onkologia Katowice ( Site 1306)

🇵🇱

Katowice, Slaskie, Poland

Faculty of Medicine Siriraj Hospital-Division of Hematology, Department of Medicine ( Site 0400)

🇹🇭

Bangkok, Krung Thep Maha Nakhon, Thailand

Chulalongkorn University ( Site 0402)

🇹🇭

Pathumwan, Krung Thep Maha Nakhon, Thailand

Maharaj Nakorn Chiang Mai Hospital ( Site 0401)

🇹🇭

Chiang Mai, Thailand

Dr. Abdurrahman Yurtaslan Ankara Onkoloji Egitim ve Arastırma Hastanesi ( Site 1912)

🇹🇷

Yenimahalle, Ankara, Turkey

Ege University Medicine of Faculty ( Site 1902)

🇹🇷

Bornova, Izmir, Turkey

Ankara University Hospital Cebeci-hematology ( Site 1901)

🇹🇷

Ankara, Turkey

Mega Medipol-Hematology ( Site 1909)

🇹🇷

Istanbul, Turkey

Dokuz Eylül Üniversitesi-Hematology ( Site 1905)

🇹🇷

Izmir, Turkey

Ondokuz Mayıs Universitesi ( Site 1907)

🇹🇷

Samsun, Turkey

MNPE ClinCenter of Oncology,Hematology,Transplantology and Palliative Care of CherkasyRegCouncil ( Site 2000)

🇺🇦

Cherkasy, Cherkaska Oblast, Ukraine

Communal non-profit enterprise "Regional clinical hospital of Ivano-Frankivsk Regional Council" ( Site 2004)

🇺🇦

Ivano-Frankivsk, Ivano-Frankivska Oblast, Ukraine

Institute of Blood Pathology and Transfusion Medicine AMS Ukraine ( Site 2002)

🇺🇦

Lviv, Lvivska Oblast, Ukraine

State non-profit enterprise National Cancer Institute ( Site 2001)

🇺🇦

Kyiv, Ukraine

National Research Center for Radiation Medicine of National Academy of Medical Sciences of Ukraine ( Site 2005)

🇺🇦

Kyiv, Ukraine

Public Non-Profit Enterprise Kyiv City Clinical Hospital #9 under the Executive Body of Kyiv City Co ( Site 2003)

🇺🇦

Kyiv, Ukraine

Aberdeen Royal Infirmary ( Site 2104)

🇬🇧

Aberdeen, Aberdeen City, United Kingdom

University College London Hospital-Cancer Clinical Trials Unit ( Site 2100)

🇬🇧

London-Camden, London, City Of, United Kingdom

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