A Study of Atezolizumab Plus Cobimetinib and Vemurafenib Versus Placebo Plus Cobimetinib and Vemurafenib in Previously Untreated BRAFv600 Mutation-Positive Patients With Metastatic or Unresectable Locally Advanced Melanoma
- Conditions
- Melanoma
- Interventions
- Registration Number
- NCT02908672
- Lead Sponsor
- Hoffmann-La Roche
- Brief Summary
This is a Phase III, double-blinded, placebo-controlled, randomized, multicenter study designed to evaluate the efficacy, safety, and pharmacokinetics of atezolizumab + cobimetinib + vemurafenib compared with placebo + cobimetinib + vemurafenib in patients with previously untreated BRAFv600 mutation-positive metastatic or unresectable locally advanced melanoma.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 514
- Females of child bearing potential and males with female partners must and use of contraceptive methods with a failure rate of less than or equal to (</=)1% per year is required during treatment and for 6 months post treatment. Males should not expose pregnant partners to sperm and refrain from donating sperm for 6 months post treatment. Women must refrain from donating eggs during this same period
- Histologically confirmed Stage IV (metastatic) or unresectable Stage IIIc (locally advanced) melanoma
- Naive to prior systemic anti-cancer therapy for melanoma (example: chemotherapy, hormonal therapy, targeted therapy, immunotherapy, or other biologic therapies) except adjuvant treatment with interferon (IFN), interleukin (IL)-2, or vaccine therapies or herbal therapies
- Documentation of BRAFv600 mutation-positive status in melanoma tumor tissue (archival or newly obtained) through use of a clinical mutation test approved by the local health authority
- Eastern Cooperative Oncology Group Performance (ECOG) Status of 0 or 1
- Measurable disease according to RECIST v1.1 (must be outside central nervous system (CNS))
- Life expectancy >/=18 weeks
- For participants not receiving therapeutic anticoagulation: International normalized ratio (INR) or activated partial thromboplastin time (aPTT) less than or equal to (</=) 1.5*upper limit of normal (ULN) within 28 days prior to initiation of study treatment
- For participants receiving therapeutic anticoagulation: stable anticoagulant regimen and stable INR during the 28 days immediately preceding initiation of study treatment
Cancer-Related Exclusion Criteria:
- Major surgical procedure within 4 weeks prior study treatment initiation
- Traumatic injury or palliative radiotherapy within 2 weeks prior study treatment initiation
- Active malignancy (other than BRAFv600 mutation-positive melanoma) or malignancy within 3 years prior to screening are excluded, with the exception of resected melanoma, resected basal cell carcinoma (BCC), resected cutaneous squamous cell carcinoma (SCC), resected carcinoma in situ of the cervix, resected carcinoma in situ of the breast, in situ prostate cancer, limited-stage bladder cancer, or any other curatively treated malignancies from which the participant has been disease-free for at least 3 years
Ocular Exclusion Criteria:
- History of or evidence of retinal pathology on ophthalmologic examination that is considered a risk factor for neurosensory retinal detachment, central serous chorioretinopathy, retinal vein occlusion (RVO), or neovascular macular degeneration
Cardiac Exclusion Criteria:
- History of clinically significant cardiac dysfunction
- Left ventricular ejection fraction (LVEF) below the institutional lower limit of normal or below 50%
Central Nervous System (CNS) Exclusion Criteria:
- Untreated or actively progressing CNS lesions (carcinomatous meningitis)
- History of metastases to brain stem, midbrain, pons, or medulla, or within 10 millimeter (mm) of the optic apparatus (optic nerves and chiasm); or leptomeningeal metastatic disease; or intracranial hemorrhage
Additional Exclusion Criteria:
- Uncontrolled diabetes or symptomatic hyperglycemia
- Current severe, uncontrolled systemic disease (including, but not limited to, clinically significant cardiovascular, pulmonary, or renal disease) other than cancer
- History of malabsorption or other clinically significant metabolic dysfunction
- Pregnant or breastfeeding, or intending to become pregnant during the study
- Prior allogeneic stem cell or solid organ transplantation
- History of idiopathic pulmonary fibrosis, organizing pneumonia (example: bronchiolitis obliterans), drug-induced pneumonitis, or idiopathic pneumonitis, or evidence of active pneumonitis on screening chest computed tomography (CT) scan
- Active or history of autoimmune disease or immune deficiency
- Known clinically significant liver disease, inherited liver disease and active viral disease
- Active tuberculosis
- Treatment with therapeutic oral or intravenous (IV) antibiotics; or with a live, attenuated vaccine; or systemic immunosuppressive medication
- Known hypersensitivity to biopharmaceutical agents produced in Chinese hamster ovary cells or any component of the atezolizumab, cobimetinib, or vemurafenib formulations
- Any grade >/=3 hemorrhage or bleeding event within 4 weeks prior to initiation of study treatment
- History of stroke, reversible ischemic neurological defect, or transient ischemic attack within 6 months prior to initiation of study treatment
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Atezolizumab Placebo + Cobimetinib + Vemurafenib Atezolizumab Placebo Run-In Period (Cycle1=28 days): Participants will receive vemurafenib 960 milligrams (mg) (four, 240 mg tablets) orally (PO) twice a day (BID) along with cobimetinib 60 mg (three, 20 mg tablets) PO once a day (QD) on Days 1 to 21 followed by vemurafenib 960 mg (four, 240 mg tablets) PO BID on Days 22 to 28. Triple Combination Period (Cycle 1 onwards): Participants will receive ATZ placebo by intravenous (IV) infusion on Day 1 and 15, cobimetinib 60 mg (three, 20 mg tablets) PO QD on Days 1 to 21, and vemurafenib 960 mg (four, 240 mg tablets) PO BID on Days 1 to 28 of each 28-day cycle. Study treatment will continue until investigator-determined disease progression, death, unacceptable toxicity, withdrawal of consent, or pregnancy, whichever occurs first. Atezolizumab + Cobimetinib + Vemurafenib + Vemurafenib Placebo Vemurafenib Run-In Period (Cycle 1=28 days): Participants will receive vemurafenib 960 mg (four, 240 mg tablets) PO BID along with cobimetinib 60 mg (three, 20 mg tablets) PO QD on Days 1 to 21 followed by vemurafenib 720 mg (three, 240 mg tablets) PO BID on Days 22 to 28 and vemurafenib placebo (1 tablet) PO BID on Days 22 to 28. Triple Combination Period (Cycle 1 onwards): Participants will receive atezolizumab 840 mg IV infusion on Day 1 and 15, cobimetinib 60 mg (three, 20 mg tablets) PO QD on Days 1 to 21, vemurafenib 720 mg (three, 240 mg tablets) PO BID on Days 1 to 28, and vemurafenib placebo (1 tablet) PO BID on Days 1 to 28 of each 28-day cycle. Study treatment will continue until investigator-determined disease progression, death, unacceptable toxicity, withdrawal of consent, or pregnancy, whichever occurs first. Atezolizumab + Cobimetinib + Vemurafenib + Vemurafenib Placebo Cobimetinib Run-In Period (Cycle 1=28 days): Participants will receive vemurafenib 960 mg (four, 240 mg tablets) PO BID along with cobimetinib 60 mg (three, 20 mg tablets) PO QD on Days 1 to 21 followed by vemurafenib 720 mg (three, 240 mg tablets) PO BID on Days 22 to 28 and vemurafenib placebo (1 tablet) PO BID on Days 22 to 28. Triple Combination Period (Cycle 1 onwards): Participants will receive atezolizumab 840 mg IV infusion on Day 1 and 15, cobimetinib 60 mg (three, 20 mg tablets) PO QD on Days 1 to 21, vemurafenib 720 mg (three, 240 mg tablets) PO BID on Days 1 to 28, and vemurafenib placebo (1 tablet) PO BID on Days 1 to 28 of each 28-day cycle. Study treatment will continue until investigator-determined disease progression, death, unacceptable toxicity, withdrawal of consent, or pregnancy, whichever occurs first. Atezolizumab + Cobimetinib + Vemurafenib + Vemurafenib Placebo Vemurafenib Placebo Run-In Period (Cycle 1=28 days): Participants will receive vemurafenib 960 mg (four, 240 mg tablets) PO BID along with cobimetinib 60 mg (three, 20 mg tablets) PO QD on Days 1 to 21 followed by vemurafenib 720 mg (three, 240 mg tablets) PO BID on Days 22 to 28 and vemurafenib placebo (1 tablet) PO BID on Days 22 to 28. Triple Combination Period (Cycle 1 onwards): Participants will receive atezolizumab 840 mg IV infusion on Day 1 and 15, cobimetinib 60 mg (three, 20 mg tablets) PO QD on Days 1 to 21, vemurafenib 720 mg (three, 240 mg tablets) PO BID on Days 1 to 28, and vemurafenib placebo (1 tablet) PO BID on Days 1 to 28 of each 28-day cycle. Study treatment will continue until investigator-determined disease progression, death, unacceptable toxicity, withdrawal of consent, or pregnancy, whichever occurs first. Atezolizumab Placebo + Cobimetinib + Vemurafenib Cobimetinib Run-In Period (Cycle1=28 days): Participants will receive vemurafenib 960 milligrams (mg) (four, 240 mg tablets) orally (PO) twice a day (BID) along with cobimetinib 60 mg (three, 20 mg tablets) PO once a day (QD) on Days 1 to 21 followed by vemurafenib 960 mg (four, 240 mg tablets) PO BID on Days 22 to 28. Triple Combination Period (Cycle 1 onwards): Participants will receive ATZ placebo by intravenous (IV) infusion on Day 1 and 15, cobimetinib 60 mg (three, 20 mg tablets) PO QD on Days 1 to 21, and vemurafenib 960 mg (four, 240 mg tablets) PO BID on Days 1 to 28 of each 28-day cycle. Study treatment will continue until investigator-determined disease progression, death, unacceptable toxicity, withdrawal of consent, or pregnancy, whichever occurs first. Atezolizumab + Cobimetinib + Vemurafenib + Vemurafenib Placebo Atezolizumab Run-In Period (Cycle 1=28 days): Participants will receive vemurafenib 960 mg (four, 240 mg tablets) PO BID along with cobimetinib 60 mg (three, 20 mg tablets) PO QD on Days 1 to 21 followed by vemurafenib 720 mg (three, 240 mg tablets) PO BID on Days 22 to 28 and vemurafenib placebo (1 tablet) PO BID on Days 22 to 28. Triple Combination Period (Cycle 1 onwards): Participants will receive atezolizumab 840 mg IV infusion on Day 1 and 15, cobimetinib 60 mg (three, 20 mg tablets) PO QD on Days 1 to 21, vemurafenib 720 mg (three, 240 mg tablets) PO BID on Days 1 to 28, and vemurafenib placebo (1 tablet) PO BID on Days 1 to 28 of each 28-day cycle. Study treatment will continue until investigator-determined disease progression, death, unacceptable toxicity, withdrawal of consent, or pregnancy, whichever occurs first. Atezolizumab Placebo + Cobimetinib + Vemurafenib Vemurafenib Run-In Period (Cycle1=28 days): Participants will receive vemurafenib 960 milligrams (mg) (four, 240 mg tablets) orally (PO) twice a day (BID) along with cobimetinib 60 mg (three, 20 mg tablets) PO once a day (QD) on Days 1 to 21 followed by vemurafenib 960 mg (four, 240 mg tablets) PO BID on Days 22 to 28. Triple Combination Period (Cycle 1 onwards): Participants will receive ATZ placebo by intravenous (IV) infusion on Day 1 and 15, cobimetinib 60 mg (three, 20 mg tablets) PO QD on Days 1 to 21, and vemurafenib 960 mg (four, 240 mg tablets) PO BID on Days 1 to 28 of each 28-day cycle. Study treatment will continue until investigator-determined disease progression, death, unacceptable toxicity, withdrawal of consent, or pregnancy, whichever occurs first.
- Primary Outcome Measures
Name Time Method Progression-Free Survival (PFS), as Determined by Investigator Using Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1 Baseline up to disease progression or death due to any cause, whichever occurs first (up to approximately 33 months) PFS is defined as the time from randomization to the first occurrence of disease progression, as determined by the investigator according to RECIST v1.1, or death from any cause, whichever occurs first
- Secondary Outcome Measures
Name Time Method Progression-Free Survival (PFS), as Determined by Independent Review Committee Using RECIST v1.1 Baseline up to disease progression or death due to any cause, whichever occurs first (up to approximately 33 months) PFS is defined as the time from randomization to the first occurrence of disease progression, as determined by an IRC according to RECIST v1.1, or death from any cause, whichever occurs first
Duration of Response, as Determined by Investigator Using RECIST v1.1 Baseline up to disease progression or death due to any cause, whichever occurs first (up to approximately 33 months) DOR, defined as the time from the first occurrence of a documented objective response to disease progression, as determined by the investigator according to RECIST v1.1, or death from any cause, whichever occurs first
Overall Survival Baseline up to disease progression or death due to any cause, whichever occurs first (up to approximately 33 months) OS is defined as the time from randomization to death from any cause
Percentage of Participants Who Have Survived at 2 Years 2 years 2-year landmark survival, defined as survival at 2 years
Plasma Concentration of Cobimetinib Dose: 60 mg Pre-dose (0 hour) and 3 to 6 hours post dose on Day 15 of Cy 1 and 4 (1 Cy = 28 days) Percentage of Participants Positive for Anti-Drug Antibodies (ADA) to Atezolizumab Pre-infusion Day 1 of Cycles 1-4; at Atezolizumab discontinuation (up to approximately 90 months)(1 Cycle=28 days) (approximately up to 33 months) Presence of ADAs against atezolizumab during the study relative to the presence of ADAs at baseline
Percentage of Participants With Objective Response, as Determined by Investigator Using RECIST v1.1 Baseline up to disease progression or death due to any cause, whichever occurs first (up to approximately 33 months) Objective response is defined as a CR or PR on two consecutive occasions ≥ 4 weeks apart, as determined by the investigator according to RECIST v1.1
Time to Deterioration in Global Health Status Using The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) Global Health Status Scale Score Baseline up to disease progression or death due to any cause, whichever occurs first (up to approximately 33 months) Time to deterioration in global health status/healthrelated quality of life (GHS/HRQoL), defined as the time from randomization to first observed ≥ 10-point decrease in EORTC QLQ-C30 linearly transformed GHS/HRQoL scale score that is sustained for two consecutive assessments or followed by death while the participant is on treatment.
The score range for each EORTC QLQ-C30 scale is from 0 to 100, with higher scores indicating better functioning and better GHS/HRQoL.Percentage of Participants With Adverse Events and Serious Adverse Events Baseline up to 6 months after the last dose of study treatment (approximately 33 months) Serum Concentration of Atezolizumab Pre-infusion Day 1 of Cycles 1-4; 30 minutes post-infusion Day 1 of Cycles 1 and 4; at Atezolizumab discontinuation (up to approximately 33 months)(1 Cycle = 28 days) Time to Deterioration in Physical Functioning Using EORTC QLQ-C30 Physical Functioning Scale Score Baseline up to disease progression or death due to any cause, whichever occurs first (up to approximately 33 months) Time to deterioration in physical functioning, defined as the time from randomization to first observed ≥ 10-point decrease in EORTC QLQ-C30 linearly transformed physical functioning scale score that is sustained for two consecutive assessments or followed by death while the participant is on treatment.
The score range for each EORTC QLQ-C30 scale is from 0 to 100, with higher scores indicating better functioning and better GHS/HRQoL.Plasma Concentration of Cobimetinib Dose: 20/40 mg Pre-dose (0 hour) and 3 to 6 hours post dose on Day 15 of Cy 1 and 4 (1 Cy = 28 days) Plasma Concentration of Vemurafenib Pre-dose (0 hour) and 3 to 6 hours post dose on Day 15 of Cy 1 and 4 (1 Cy = 28 days)
Trial Locations
- Locations (116)
St. Luke's University Health network
🇺🇸Bethlehem, Pennsylvania, United States
Institut Gustave Roussy; Dermatologie
🇫🇷Villejuif, France
Universitätsklinikum Regensburg; Klinik und Poliklinik für Dermatologie
🇩🇪Regensburg, Germany
Highlands Oncology Group
🇺🇸Springdale, Arkansas, United States
UC Irvine Medical Center
🇺🇸Orange, California, United States
CHU Sart-Tilman
🇧🇪Liège, Belgium
Beneficencia Portuguesa de Sao Paulo
🇧🇷São Paulo, SP, Brazil
Medical University of Graz, Department of Dermatology
🇦🇹Graz, Austria
Groupe Hospitalier Saint André - Hôpital Saint André
🇫🇷Bordeaux, France
UZ Leuven Gasthuisberg
🇧🇪Leuven, Belgium
Sint Augustinus Wilrijk
🇧🇪Wilrijk, Belgium
Peter Maccallum Cancer Centre
🇦🇺Melbourne, Victoria, Australia
Tom Baker Cancer Centre-Calgary
🇨🇦Calgary, Alberta, Canada
The Ottawa Hospital Cancer Centre; Oncology
🇨🇦Ottawa, Ontario, Canada
Princess Alexandra Hospital
🇦🇺Woolloongabba, Queensland, Australia
Laiko General Hospital Athen
🇬🇷Athens, Greece
Hopital du Bocage; Dermatologie
🇫🇷Dijon, France
Juravinski Cancer Clinic; Department of Oncology
🇨🇦Hamilton, Ontario, Canada
LHSC - Victoria Hospital; London Regional Cancer Program
🇨🇦London, Ontario, Canada
Hopital Saint Eloi; CHU de Montpellier; Svc de Dermatologie
🇫🇷Montpellier, France
Universitätsmedizin Göttingen; Klinik für Gastroenterologie, gastrointestinale
🇩🇪Göttingen, Germany
HELIOS Klinikum Erfurt; Klinik für Dermatologie & Allergologie
🇩🇪Erfurt, Germany
Medizinische Hochschule Hannover; Klinik für Dermatologie, Allergologie und Venerologie
🇩🇪Hannover, Germany
Orszagos Onkologiai Intezet; Borgyogyaszati Osztaly
🇭🇺Budapest, Hungary
University of Szeged Szent-Györgyi Albert Clinical Center; Department of Dermatology and Allergology
🇭🇺Szeged, Hungary
Clinica Universitaria de Navarra; Servicio de Oncologia
🇪🇸Pamplona, Navarra, Spain
Hospital Universitario La Paz; Servicio de Oncologia
🇪🇸Madrid, Spain
Mid Central DHB
🇳🇿Palmerston North, New Zealand
COZL Oddzial Onkologii Klinicznej z pododdzialem Chemioterapii Dziennej
🇵🇱Lublin, Poland
Erasmus Mc - Daniel Den Hoed Kliniek; Interne Oncologie
🇳🇱Rotterdam, Netherlands
University of Alabama at Birmingham
🇺🇸Birmingham, Alabama, United States
Arizona Oncology Associates, PC - HAL
🇺🇸Tempe, Arizona, United States
Oncology Specialists, S.C.
🇺🇸Park Ridge, Illinois, United States
Lakeridge Health Oshawa; Oncology
🇨🇦Oshawa, Ontario, Canada
Royal Adelaide Hospital
🇦🇺Adelaide, South Australia, Australia
Fiona Stanley Hospital
🇦🇺Murdoch, Western Australia, Australia
IRCCS Istituto Nazionale Tumori Fondazione Pascale; Oncologia Medica B
🇮🇹Napoli, Campania, Italy
Hopital Claude Huriez - CHU Lille
🇫🇷Lille, France
Centro de Pesquisa e Ensino em Oncologia de Santa Catarina - CEPEN
🇧🇷Florianopolis, SC, Brazil
Instituto do Cancer do Estado de Sao Paulo - ICESP
🇧🇷Sao Paulo, SP, Brazil
Fundacion Instituto Valenciano de Oncologia (IVO)
🇪🇸Valencia, Spain
UF Health Cancer Center at Orlando Health
🇺🇸Orlando, Florida, United States
Cliniques Universitaires St-Luc
🇧🇪Bruxelles, Belgium
Medizinische Universität Wien; Univ.Klinik für Dermatologie
🇦🇹Wien, Austria
LKH Innsbruck; Universitätsklinik für Dermatologie
🇦🇹Innsbruck, Austria
Hospital das Clinicas - UFRGS
🇧🇷Porto Alegre, RS, Brazil
Clinicas Oncologicas Integradas - COI
🇧🇷Rio De Janeiro, RJ, Brazil
Princess Margaret Hospital
🇨🇦Toronto, Ontario, Canada
Centre Hospitalier Universitaire de Grenoble - Albert Michallon
🇫🇷La Tronche, France
CHU de Quebec - Hopital de l'Enfant-Jesus; Unite de Recherche en Hematologie et Oncologie
🇨🇦Quebec, Canada
CHU de Nantes; Cancéro-dermatologie
🇫🇷Nantes, France
Hopital Robert Debre; DERMATOLOGIE
🇫🇷Reims, France
Centre Eugene Marquis; Service d'oncologie
🇫🇷Rennes, France
CHU de Rouen - Hôpital Charles Nicolle
🇫🇷Rouen, France
Elbekliniken Buxtehude; Klinik für Dermatologie
🇩🇪Buxtehude, Germany
Universitätsklinikum Erlangen; Hautklinik
🇩🇪Erlangen, Germany
Charite - Universitätsmedizin Berlin
🇩🇪Berlin, Germany
Universitatsklinikum Essen; Klinik für Dermatologie
🇩🇪Essen, Germany
UKSH Kiel; Klinik für Dermatologie, Venerologie und Allergologie
🇩🇪Kiel, Germany
Klinikum d.Universität zu Köln Klinik u.Poliklinik f.Dermatologie
🇩🇪Köln, Germany
Universitatsklinik Heidelberg; Universitätshautklinik und Nationales Centrum für Tumorerkrankungen
🇩🇪Heidelberg, Germany
Universitätsklinikum Leipzig; Klinik für Dermatologie, Venerologie und Allergologie
🇩🇪Leipzig, Germany
UKSH Universitatsklinikum Schleswig-Holstein; Studienzentrum Dermatologie 10d
🇩🇪Lübeck, Germany
Universitatsklinikum Mainz; Klinik und Poliklinik fur Dermatologie
🇩🇪Mainz, Germany
Klinikum der Ludwigs-Maximilians-Universität München; Dermatologie
🇩🇪München, Germany
Fachklinik Hornheide; Dermatologie
🇩🇪Münster, Germany
Harzklinikum Dorothea Christiane Erxleben GmbH, Standort Quedlinburg; Hautkrebszentrum Harz
🇩🇪Quedlinburg, Germany
Metropolitan Hospital; Dept. of Oncology
🇬🇷Pireaus, Greece
Zentrum für Dermatoonkologie, Universitäts-Hautklinik Tübingen
🇩🇪Tübingen, Germany
Universitätsklinikum Würzburg; Med. Klinik 1, Pneumologie
🇩🇪Würzburg, Germany
Sharett Institute - Hadassah Hebrew University Medical Center
🇮🇱Jerusalem, Israel
Rabin MC; Davidof Center - Oncology Institute
🇮🇱Petach Tikva, Israel
Ella Institute - Sheba Medical Center
🇮🇱Ramat-Gan, Israel
Rambam Health Care Campus; Oncology
🇮🇱Haifa, Israel
A.O. Universitaria S. Maria Della Misericordia Di Udine; Oncologia
🇮🇹Udine, Friuli-Venezia Giulia, Italy
IFO - Istituto Regina Elena; Oncologia Medica
🇮🇹Roma, Lazio, Italy
IRST Istituto Scientifico Romagnolo Per Lo Studio E Cura Dei Tumori, Sede Meldola; Oncologia Medica
🇮🇹Meldola, Emilia-Romagna, Italy
IRCCS Istituto Nazionale Per La Ricerca Sul Cancro (IST); Oncologia Medica A
🇮🇹Genova, Liguria, Italy
Irccs Istituto Nazionale Dei Tumori (Int);S.C. Medicina Oncologica 2
🇮🇹Milano, Lombardia, Italy
Fondazione Del Piemonte Per L'oncologia Ircc Di Candiolo; Dipartimento Oncologico
🇮🇹Candiolo, Piemonte, Italy
A.O.U. Senese Policlinico Santa Maria Alle Scotte
🇮🇹Siena, Toscana, Italy
Irccs Istituto Europeo Di Oncologia (IEO); Oncologia Medica
🇮🇹Milano, Lombardia, Italy
Istituto Tumori ?Giovanni Paolo II?, Oncologia
🇮🇹Bari, Puglia, Italy
Seoul National University Hospital
🇰🇷Seoul, Korea, Republic of
Wellington Hospital; Wellington Blood and Cancer Centre
🇳🇿Newtown, New Zealand
Auckland city hospital; Auckland Regional Cancer Centre and Blood Service
🇳🇿Auckland, New Zealand
Tauranga Hospital, Clinical Trials Unit; BOP Clinical School
🇳🇿Tauranga, New Zealand
Uniwersyteckie Centrum Kliniczne; Klinika Onkologii i Radioterapii
🇵🇱Gdansk, Poland
Narodowy Inst.Onkol.im.Sk?odowskiej-Curie Pa?stw.Inst.Badawczy Kraków; Klinika Onkologii Klinicznej
🇵🇱Kraków, Poland
Uniwersytecki Szpital Kliniczny w Poznaniu
🇵🇱Pozna?, Poland
Dolno?l?skie Centrum Onkologii, Pulmonologii i Hematologii
🇵🇱Wroc?aw, Poland
Narodowy Instytut Onkologii im. Marii Sk?odowskiej-Curie - Pa?stwowy Instytut Badawczy
🇵🇱Warszawa, Poland
IPO de Lisboa; Servico de Oncologia Medica
🇵🇹Lisboa, Portugal
IPO do Porto; Servico de Oncologia Medica
🇵🇹Porto, Portugal
Moscow City Oncology Hospital #62
🇷🇺Moscovskaya Oblast, Moskovskaja Oblast, Russian Federation
Hospital Clínic i Provincial; Servicio de Oncología
🇪🇸Barcelona, Spain
FBI "Scientific Research Institute of Oncology n. a. N. N. Petrov"
🇷🇺Saint-Petersburg, Sankt Petersburg, Russian Federation
Hospital Universitari Vall d'Hebron; Oncology
🇪🇸Barcelona, Spain
Hospital Ramon y Cajal; Servicio de Oncologia
🇪🇸Madrid, Spain
Hospital Universitario Virgen de la Macarena;
🇪🇸Sevilla, Spain
Bristol Haematology and Oncology centre
🇬🇧Bristol, United Kingdom
Hospital General Universitario de Valencia; Servicio de oncologia
🇪🇸Valencia, Spain
Hospital Universitario Miguel Servet; Servicio Oncologia
🇪🇸Zaragoza, Spain
Beatson West of Scotland Cancer Centre
🇬🇧Glasgow, United Kingdom
Guys and St Thomas NHS Foundation Trust, Guys Hospital
🇬🇧London, United Kingdom
Ipswich Hospital; Oncology Pharmacy
🇬🇧Ipswich, United Kingdom
St James Uni Hospital; Icrf Cancer Medicine Research Unit
🇬🇧Leeds, United Kingdom
Royal Cornwall Hospital
🇬🇧Truro, United Kingdom
Freeman Hospital; Northern Centre For Cancer Care
🇬🇧New Castle Upon Tyne, United Kingdom
Singleton Hospital; Pharmacy Department
🇬🇧Swansea, United Kingdom
Asan Medical Center
🇰🇷Seoul, Korea, Republic of
Severance Hospital, Yonsei University Health System
🇰🇷Seoul, Korea, Republic of
Samsung Medical Center
🇰🇷Seoul, Korea, Republic of
FSBSI "Russian Oncological Scientific Center n.a. N.N. Blokhin"
🇷🇺Moscow, Moskovskaja Oblast, Russian Federation
St. Petersburg Oncology Hospital
🇷🇺Sankt-peterburg, Sankt Petersburg, Russian Federation
Mount Sinai Medical Center
🇺🇸Miami Beach, Florida, United States