MedPath

A Study of a Combination of Trastuzumab and Capecitabine With or Without Pertuzumab in Patients With HER2-positive Metastatic Breast Cancer (PHEREXA)

Phase 3
Completed
Conditions
Breast Cancer
Interventions
Registration Number
NCT01026142
Lead Sponsor
Hoffmann-La Roche
Brief Summary

This randomized, two-arm study evaluated the efficacy and safety of a combination of trastuzumab and capecitabine with or without pertuzumab in patients with human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer. The study population consisted of female patients, whose disease had progressed during or following previous trastuzumab therapy for metastatic disease. All patients in Arm A and Arm B received trastuzumab (8 mg/kg iv as loading dose and then 6 mg/kg iv every 3 weeks thereafter) and capecitabine oral twice daily for 14 days every 3 weeks (1250 mg/m2 twice daily in Arm A and 1000 mg/m2 twice daily in Arm B). In addition, patients in Arm B received pertuzumab (840 mg iv as loading dose and then 420 mg iv thereafter) every 3 weeks. Study treatment continued until disease progression or unacceptable toxicity.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
452
Inclusion Criteria
  • Adult female patients >/=18 years of age
  • Metastatic HER2 positive breast cancer
  • Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1
  • Disease progression during or following trastuzumab-based therapy for 1st line metastatic breast cancer (trastuzumab must have been part of the last prior treatment regimen)
  • Prior treatment with taxane-containing regimen
  • Left ventricular ejection fraction (LVEF) >/=50 percent
  • For women of childbearing potential agreement to use highly effective non-hormonal form of contraception or two effective forms of non-hormonal contraception by patient and/or partner. Contraception must continue for duration of study treatment and for at least 6 months after last dose of study drug treatment
Exclusion Criteria
  • Prior treatment with pertuzumab or capecitabine
  • Concurrent treatment with other experimental drug
  • Concurrent immunotherapy or anticancer hormonal therapy
  • Serious concurrent disease (e.g. active infection, uncontrolled hypertension, cardiovascular disease)
  • Central nervous system (CNS) metastases, which are not well controlled
  • History of exposure to anthracycline cumulative dose equivalent to 360mg/m2
  • History of congestive heart failure of any New York Heart Association criteria, or serious cardiac arrhythmia requiring treatment
  • History of myocardial infarction within 6 months prior to randomization
  • History of LVEF decline to below 50% during or after prior trastuzumab therapy or other cardiac toxicity during previous trastuzumab treatment that necessitated discontinuation of trastuzumab
  • History of another cancer which could affect compliance or result interpretation
  • Inadequate organ function
  • Pregnant or breastfeeding women
  • life expectancy < 12 weeks

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
B: Capecitabine + Trastuzumab + PertuzumabCapecitabine-
B: Capecitabine + Trastuzumab + PertuzumabPertuzumab-
A: Capecitabine + TrastuzumabCapecitabine-
A: Capecitabine + TrastuzumabTrastuzumab-
B: Capecitabine + Trastuzumab + PertuzumabTrastuzumab-
Primary Outcome Measures
NameTimeMethod
Progression Free Survival (Independent Assessment)Tumor assessments every 9 weeks from randomization until Week 27, then every 12 weeks thereafter, until IRF-determined PD, initiation of alternative anticancer medication, or death (up to 5.5 years).

Progression Free Survival (PFS) was defined as the time from randomization to first documented disease progression (PD), as determined by an Independent Review Facility (IRF) using Response Evaluation Criteria in Solid Tumors (RECIST) version 1.0, or death from any cause, whichever occurred first. PD was defined as at least a 20% increase in the sum of the longest diameter (LD) of target lesions taking as reference the smallest sum LD recorded since the treatment started or the appearance of one or more new lesions; or the appearance of one or more new lesions and/or unequivocal progression of existing non-target lesions. IRF review of tumor assessment ceased after the primary PFS analysis. The primary endpoint was analyzed after approximately 337 IRF-assessed PFS events were observed.

Secondary Outcome Measures
NameTimeMethod
Overall Survival (OS)From randomization until death from any cause (up to 7.5 years).

Overall Survival (OS) was defined as the time from the date of randomization to the date of death from any cause. The results of the final OS analysis are presented here. Participants who were alive or lost to follow-up at the time of the analysis were censored at the last known alive date. Participants with no postbaseline information were censored at the time of randomization plus 1 day. Prior to the final data analysis cut-off, it was ensured that all participants who were in survival follow-up had been contacted as recently as possible within the last 3 months to confirm current survival status.

Overall Survival (OS) Rate Based on a 2-year Truncated AnalysisFrom randomization until death from any cause (up to 2 years)

The Overall Survival (OS) 2-year truncated analysis is the Kaplan-Meier estimate of the percentage of participants who were surviving at 2 years. OS is defined as the time from the date of randomization to the date of death from any cause, with censoring of all events and follow-up beyond the end of the second year.

Investigator Assessment Progression-Free Survival (PFS)Tumor assessments every 9 weeks from randomization until Week 27, then every 12 weeks thereafter, until IRF-determined PD, initiation of alternative anticancer medication, or death (up to 7.5 years).

Investigator Assessment Progression-Free Survival (PFS) was defined as the time from randomization to the first documented progressive disease, as determined by the investigator using Response Evaluation Criteria in Solid Tumors (RECIST) v1.0, or death from any cause, whichever occurred first. PD is defined as at least a 20% increase in the sum of the longest diameter (LD) of target lesions taking as reference the smallest sum LD recorded since the treatment started or the appearance of one or more new lesions; or the appearance of one or more new lesions and/or unequivocal progression of existing non-target lesions.

Time to Progression (TTP) Based Upon Independent Review Facility (IRF) AssessmentTumor assessments every 9 weeks from randomization until Week 27, then every 12 weeks thereafter, until IRF-determined PD, initiation of alternative anticancer medication, or death (up to 5.5 years).

Time to Progression (TTP) was defined as time between randomization and the first occurrence of progressive disease (PD), based on IRF assessment.

Time to Treatment Failure (TTF) Based Upon Independent Review Facility (IRF) AssessmentTumor assessments every 9 weeks from randomization until Week 27, then every 12 weeks thereafter, until IRF-determined PD, initiation of alternative anticancer medication, or death (up to 5.5 years).

Time to Treatment Failure (TTF) was defined as time between randomization and date of disease progression based on independent review, death, or withdrawal of treatment due to adverse events, withdrawn informed consent, refusal of treatment/failure to cooperate, or failure to return, whichever occurred first.

Overall Objective Response Rate (ORR)Tumor assessments every 9 weeks from randomization until Week 27, then every 12 weeks thereafter, until IRF-determined PD, initiation of alternative anticancer medication, or death (up to 5.5 years).

Overall Objective Response Rate is based upon investigator and IRF assessments. Objective Response Rate (ORR) was defined as the percentage of participants with a confirmed complete response (CR) or partial response (PR) among those who had measurable disease at baseline. CR was defined as the disappearance of all target lesions. PR was defined as at least a 30% decrease in the sum of the longest diameter (LD) of target lesions, taking as reference the baseline sum LD.

Clinical Benefit Rate (CBR)Tumor assessments every 9 weeks from randomization until Week 27, then every 12 weeks thereafter, until IRF-determined PD, initiation of alternative anticancer medication, or death (up to 5.5 years).

Clinical Benefit Rate is based upon Independent Review Facility (IRF) assessments; defined as the percentage of participants a complete response (CR), partial response (PR), or stable disease for at least 8 cycles or 6 months.

Duration of Objective ResponseTumor assessments every 9 weeks from randomization until Week 27, then every 12 weeks thereafter, until IRF-determined PD, initiation of alternative anticancer medication, or death (up to 5.5 years).

Duration of Objective Response was defined for the subpopulation of responders as time from first Independent Review Facility (IRF)-assessed complete response (CR) or partial response (PR) to subsequent first documented, IRF-confirmed evidence of disease progression. Only participants with an objective response were included in the analysis of duration of objective response.

Trial Locations

Locations (190)

UZ Brussel

🇧🇪

Brussel, Belgium

Queen Mary Hospital; Surgery

🇭🇰

Hong Kong, Hong Kong

Semashko Central Clinical Hospital; Dept of Chemotherapy

🇷🇺

Moscow, Russian Federation

Unidad de Investigacion Oncologia Clinica - Piura; Unidad de Oncología Clínica

🇵🇪

Piura, Peru

Szpital Specjalistyczny Podkarpacki Ośrodek Onkologiczny

🇵🇱

Brzozów, Poland

SBI of Healthcare of Stavropol region Stavropol Regional Clinical Oncology Dispensary

🇷🇺

Stavropol, Russian Federation

Blokhin Cancer Research Center; Combined Treatment

🇷🇺

Moscow, Russian Federation

Saint-Petersburg City Clinical Oncology Dispensary

🇷🇺

St Petersburg, Russian Federation

Phramongkutklao Hospital;Dept Surgery/Surgical Oncology Unit

🇹🇭

Bangkok, Thailand

Wojewodzki Sziptal Specjalistyczny Im. Janusza Korczaka; Oddzial Onkologiczny, Oddzial Chemioterapii

🇵🇱

Slupsk, Poland

Cluj Clinical County Hospital; Oncology Dept

🇷🇴

Cluj-Napoca, Romania

Broomfield Hospital

🇬🇧

Chelmsford, United Kingdom

Hospital Universitario de Canarias;servicio de Oncologia

🇪🇸

La Laguna, Tenerife, Spain

Institut of Oncology Al. Trestioreanu Bucharest; Oncology Department

🇷🇴

Bucuresti, Romania

Regional Oncology Hospital of Krasnodar; Oncology

🇷🇺

Krasnodar, Russian Federation

Consorci Hospitalari de Terrassa

🇪🇸

Terrassa, Barcelona, Spain

Hospital Provincial de Castellón

🇪🇸

Castellon, Spain

Hospital Ruber Internacional;Servicio de Oncologia

🇪🇸

Madrid, Spain

Hospital Clinic i Provincial; Servicio de Farmacia

🇪🇸

Barcelona, Spain

Euroclinic Center of Oncology SRL

🇷🇴

Iasi, Romania

Fundacion Hospital de Alcorcon; Servicio de Oncologia

🇪🇸

Alcorcon, Madrid, Spain

Hospital de Basurto; Servicio de Oncologia

🇪🇸

Bilbao, Vizcaya, Spain

Hospital La Paz

🇪🇸

Madrid, Spain

Royal Cornwall Hospital; Dept of Clinical Oncology

🇬🇧

Truro, United Kingdom

Beatson West of Scotland Cancer Centre

🇬🇧

Glasgow, United Kingdom

Hospital de Sagunto; Servicio de Oncologia

🇪🇸

Sagunto, Valencia, Spain

Complejo Hospitalario Nuestra Señora de la Candelaria; Servicio de Oncologia

🇪🇸

Santa Cruz de Tenerife, Tenerife, Spain

Institut Catala d Oncologia Hospital Duran i Reynals

🇪🇸

Barcelona, Spain

Complejo Asistencial Universitario de Leon; Servicio de Oncologia

🇪🇸

Leon, Spain

Hospital General Universitario Gregorio Marañon; Servicio de Oncologia

🇪🇸

Madrid, Spain

Complejo Hospitalario de Pontevedra; Servicio de Oncologia

🇪🇸

Pontevedra, Spain

Instituto Valenciano Oncologia; Oncologia Medica

🇪🇸

Valencia, Spain

Hospital Univ. Nuestra Señora de Valme;

🇪🇸

Sevilla, Spain

Hospital Sant Pau i Santa Tecla

🇪🇸

Tarragona, Spain

Hospital Clinico Universitario de Valencia; Servicio de Onco-hematologia

🇪🇸

Valencia, Spain

Tuen Mun Hospital; Clinical Oncology

🇭🇰

Hong Kong, Hong Kong

Hospital of Aladar Petz; Dept of Oncoradiology

🇭🇺

Gyor, Hungary

Centre Antoine Lacassagne; Hopital De Jour A2

🇫🇷

Nice, France

Fundación Investigar

🇦🇷

Buenos Aires, Argentina

Instituto FIDES

🇦🇷

La Plata, Argentina

Hospital Britanico; Oncologia

🇦🇷

Buenos Aires, Argentina

Instituto de Investigaciones Clínicas Quilmes

🇦🇷

Quilmes, Argentina

Lkh Salzburg - Univ. Klinikum Salzburg; Iii. Medizinische Abt.

🇦🇹

Salzburg, Austria

A.Ö. Landesschwerpunktkrankenhaus Krems; Abtl. F. Innere Med.

🇦🇹

Krems, Austria

ISIS Clinica Especializada

🇦🇷

Santa Fe, Argentina

Landeskrankenhaus Rankweil; Interne E

🇦🇹

Rankweil, Austria

Medizinische Universität Wien; Univ.Klinik für Innere Medizin I - Abt. für Onkologie

🇦🇹

Wien, Austria

Imeldaziekenhuis

🇧🇪

Bonheiden, Belgium

AZ KLINA

🇧🇪

Brasschaat, Belgium

GHdC Site Notre Dame

🇧🇪

Charleroi, Belgium

CH Jolimont - Lobbes (Jolimont)

🇧🇪

Haine-Saint-Paul, Belgium

Hospital Sao Lucas - PUCRS

🇧🇷

Porto Alegre, RS, Brazil

CHU Sart-Tilman

🇧🇪

Liège, Belgium

Clinique Ste-Elisabeth

🇧🇪

Namur, Belgium

Oncologia Sul Capixaba Servicos Medicos - Oncosul

🇧🇷

Cachoeiro Do Itapemirim, ES, Brazil

Hospital Perola Byington

🇧🇷

Sao Paulo, SP, Brazil

AZ Nikolaas (Lodewijk)

🇧🇪

Sint-Niklaas, Belgium

Hospital A. C. Camargo; Oncologia

🇧🇷

Sao Paulo, SP, Brazil

Humber River Hospital

🇨🇦

Toronto, Ontario, Canada

Centro Oncológico de Mogi das Cruzes

🇧🇷

São Paulo- SP, SP, Brazil

Durham Regional Cancer Centre

🇨🇦

Oshawa, Ontario, Canada

Masarykuv onkologicky ustav; Oncology II

🇨🇿

Brno, Czechia

Uni Hospital For Tumours; Dept of Medical Oncology

🇭🇷

Zagreb, Croatia

University Health Network; Princess Margaret Hospital; Medical Oncology Dept

🇨🇦

Toronto, Ontario, Canada

University Hospital; Oncology and Radiotherapy

🇨🇿

Hradec Kralove, Czechia

Fakultni Poliklinika Vseobecne Fakultni Niemocnice; Onkologicka Klinika

🇨🇿

Praha 2, Czechia

Lekarske Fakulty Univerzity Karlovy Fakultni Nemocnice Na Bulovce; Ustav Radiacni Onkologie

🇨🇿

Praha, Czechia

Tartu University Hospital; Clinic of Hematology and Oncology

🇪🇪

Tartu, Estonia

C.H. Du Pays D'aix En Provence Service du Dr Blanc

🇫🇷

Aix En Provence, France

North Estonia Medical Centre Foundation; Oncology Centre

🇪🇪

Tallinn, Estonia

Centre Oncologie Du Pays Basque

🇫🇷

Bayonne, France

Centre Hospitalier Fleyriat; Oncologie/Hematologie

🇫🇷

Bourg En Bresse, France

Centre Georges Francois Leclerc; Oncologie 3

🇫🇷

Dijon, France

Centre Leon Berard; Oncologie Genetique

🇫🇷

Lyon, France

CHU Henri Mondor; Service d'Oncologie Medicale

🇫🇷

Creteil, France

Institut Curie; Oncologie Medicale

🇫🇷

Paris, France

Hopital Saint Antoine; Sce Oncologie

🇫🇷

Paris, France

Institut Jean Godinot; Oncologie Medicale

🇫🇷

Reims CEDEX, France

Centre Henri Becquerel; Oncologie Medicale

🇫🇷

Rouen, France

Centre Rene Huguenin; CONSULT SPECIALISEES

🇫🇷

St Cloud, France

Hopital Hautepierre; Hematologie Oncologie

🇫🇷

Strasbourg, France

Institut Claudius Regaud; Departement Oncologie Medicale

🇫🇷

Toulouse, France

CAMPUS CHARITÉ MITTE; Tagesklinik für Onkologie u.Hämatologie

🇩🇪

Berlin, Germany

Klinikum Bremen-Mitte gGmbH; Frauenklinik

🇩🇪

Bremen, Germany

Clinique Pasteur; Oncologie Medicale

🇫🇷

Toulouse, France

Klinikum Darmstadt GmbH; Med. Klinik V; Onkologie & Hämatologie

🇩🇪

Darmstadt, Germany

Universitätsklinikum Essen; Zentrum Für Frauenheilkunde

🇩🇪

Essen, Germany

Klinikum Dortmund gGmbH Klinikzentrum Mitte

🇩🇪

Dortmund, Germany

Klinikum Frankfurt Höchst GmbH; Klinik für Gynäkologie und Geburtshilfe

🇩🇪

Frankfurt, Germany

Universitätsklinikum Hamburg-Eppendorf; Zentrum für operative Medizin Klinik für Gynäkologie

🇩🇪

Hamburg, Germany

Klinik Fulda, Medizinisches Versorgungszentrum Osthessen GmbH

🇩🇪

Fulda, Germany

Diakovere Henriettenstift, Frauenklinik

🇩🇪

Hannover, Germany

HOPA MVZ GmbH

🇩🇪

Hamburg, Germany

Medizinische Hochschule Zentrum Frauenheilkunde Abt.Gynäkologische Onkologie

🇩🇪

Hannover, Germany

ViDia Christliche Kliniken Karlsruhe, Vincentius-Diakonissen-Kliniken gAG; Frauenklinik

🇩🇪

Karlsruhe, Germany

St. Elisabeth Krankenhaus Köln GmbH; Gynäkologie und Geburtshilfe

🇩🇪

Koeln, Germany

Systemedic Frauenarzte Pruener Gang

🇩🇪

Kiel, Germany

Institut für Versorgungsforschung in der Onkologie GbR Koblenz

🇩🇪

Koblenz, Germany

Universitätsklinikum Schleswig-Holstein / Campus Lübeck; Klinik für Frauenheilkunde und Geburtshilfe

🇩🇪

Lübeck, Germany

St. Vincenz-Elisabeth-Hospital; Katholisches Klinikum Mainz

🇩🇪

Mainz, Germany

Klinikum rechts der Isar der TU München; Frauenklinik & Poliklinik

🇩🇪

München, Germany

Universitätsklinikum Münster; Klinik für Frauenheilkunde und Geburtshilfe

🇩🇪

Münster, Germany

St. Josefs Klinik; Medizinische Klinik

🇩🇪

Offenburg, Germany

Johanniter Klinik

🇩🇪

Stendal, Germany

GRN Klinik Weinheim

🇩🇪

Weinheim, Germany

Fövárosi Önkormányzat Bajcsy-Zsilinszky Kórház; Onkológiai Osztály

🇭🇺

Budapest, Hungary

Orszagos Onkologiai Intezet; B Belgyogyaszati Osztaly

🇭🇺

Budapest, Hungary

Semmelweis Egyetem Onkologiai Központ

🇭🇺

Budapest, Hungary

Ogyi, Orszagos Gyogyszereszeti Intezet

🇭🇺

Budapest, Hungary

Semmelweis Egyetem Aok; Iii.Sz. Belgyogyaszati Klinika

🇭🇺

Budapest, Hungary

Békés Megyei Pándy Kálmán Kórház; Onkologiai tanszek

🇭🇺

Gyula, Hungary

Municipal Hospital of Uzsoki Utca; Centre of Oncoradiology

🇭🇺

Budapest, Hungary

Kaposi Mor County Hospital; Dept. of Oncology

🇭🇺

Kaposvar, Hungary

Borsod-Abauj-Zemplen Megyei Korhaz Es Egyetemi Oktato Korhaz; Onkologiai Osztaly

🇭🇺

Miskolc, Hungary

Josa Andras Korhaz; Dept of Oncoradiology

🇭🇺

Nyíregyháza, Hungary

Szegedi Tudomanyegyetem, AOK, Szent-Gyorgyi Albert Klinikai Kozpont, Onkoterapias Klinika

🇭🇺

Szeged, Hungary

Pécsi Tudományegyetem Áok; Onkoterapias Intezet

🇭🇺

Pecs, Hungary

Fejér Megyei Szent György Kórház; Onkológiai Osztály

🇭🇺

Szekesfehervar, Hungary

Istituto Tumori Fondazione Pascale; Endocrinologia Oncologica

🇮🇹

Napoli, Campania, Italy

Ospedale Cervesi di Cattolica ; Unità Operativa di Oncologia ed Oncoematologia

🇮🇹

Cattalica, Emilia-Romagna, Italy

Az. Osp. S. Orsola Malpighi; Istituto Di Oncologia Seragnoli

🇮🇹

Bologna, Emilia-Romagna, Italy

AUSL Cesena; Servizio di Oncologia

🇮🇹

Cesena, Emilia-Romagna, Italy

Ausl Ravenna-Osp.Infermi; Day Hospital Oncologia Medica

🇮🇹

Faenza, Emilia-Romagna, Italy

Ospedale Umberto I ASL di Ravenna Presidio Ospedaliero di Lugo

🇮🇹

Lugo, Emilia-Romagna, Italy

Azienda USL di Ravenna; Unità Operativa di Oncologia Medica

🇮🇹

Ravenna, Emilia-Romagna, Italy

Ospedale Infermi Di Rimini; Unità Operativa di Oncologia e Oncoematologia

🇮🇹

Rimini, Emilia-Romagna, Italy

ASST DI CREMONA; Dipartimento Aziendale Oncologico

🇮🇹

Cremona, Lombardia, Italy

Istituto Regina Elena; Oncologia Medica A

🇮🇹

Roma, Lazio, Italy

Uni Cattolica Policlinico Gemelli; Oncologia Medica Ist. Medicina Interna

🇮🇹

Roma, Lazio, Italy

Ospedale Mater Salutis; Dept of Oncology

🇮🇹

Legnago, Lombardia, Italy

ASST LARIANA; Oncologia

🇮🇹

S. Fermo Della Battaglia (CO), Lombardia, Italy

Asst Papa Giovanni XXIII; Oncologia Medica

🇮🇹

Bergamo, Lombardia, Italy

ASST DI MONZA; Oncologia Medica

🇮🇹

Monza, Lombardia, Italy

Instituto de Oncología de Rosario

🇦🇷

Rosario, Argentina

IRCCS Fondazione Maugeri; Oncologia Medica II

🇮🇹

Pavia, Lombardia, Italy

Ospedale Civile; Oncologia Medica

🇮🇹

Sassari, Sardegna, Italy

A.O. Città della Salute e della Scienza - Presidio Molinette; divisione oncologia medica

🇮🇹

Torino, Piemonte, Italy

Severance Hospital

🇰🇷

Seoul, Korea, Republic of

Azienda ospedaliero-universitaria careggi, Sezione di radioterapia del dipartimento di fisiopatolo

🇮🇹

Firenze, Toscana, Italy

ARNAS-Ospedale Civico Maurizio Ascoli; Unità Operativa di Oncologia Medica

🇮🇹

Palermo, Sicilia, Italy

A.O. Universitaria Pisana; Oncologia

🇮🇹

Pisa, Toscana, Italy

Seoul National University Hosp; Dept Internal Med Hem Onc

🇰🇷

Seoul, Korea, Republic of

Klinikum Sindelfinden Boblingen

🇩🇪

Böblingen, Germany

Asan Medical Center, Uni Ulsan Collegemedicine; Dept.Internal Medicine / Divisionhematology/Oncology

🇰🇷

Seoul, Korea, Republic of

Oaxaca Site Management Organization

🇲🇽

Oaxaca, Mexico

Korea University Guro Hospital; Oncology

🇰🇷

Seoul, Korea, Republic of

Praxis für Onkologie und Hämatologie

🇩🇪

Recklinghausen, Germany

Hospital Juan Ramon Jimenez;Servicio de Oncologia

🇪🇸

Huelva, Spain

Vu Medisch Centrum; Afdeling Maag-, Darm- En Leverziekte

🇳🇱

Amsterdam, Netherlands

Hospital Nacional Carlos Alberto Seguin Escobedo-Essalud; Oncology & Haemathology

🇵🇪

Arequipa, Peru

Klinikum Mutterhaus der Borromaeerinnen gGmbH; Haematologie/Onkologie

🇩🇪

Trier, Germany

S.-Peterburg Pavlov State Medical University ; Haematology

🇷🇺

St Petersburg, Russian Federation

Hospital Universitario Puerta de Hierro

🇪🇸

Majadahonda, Madrid, Spain

Fundacion Jimenez Diaz; Servicio de Oncologia

🇪🇸

Madrid, Spain

Hospital Universitario Virgen Macarena; Servicio de Oncologia

🇪🇸

Sevilla, Spain

Hospital Clinico Universitario de Salamanca; Servicio de Oncologia

🇪🇸

Salamanca, Spain

Hospital Universitario Virgen del Rocio

🇪🇸

Sevilla, Spain

Complejo Hospitalario de Toledo- H. Virgen de la Salud; Servicio de Oncologia

🇪🇸

Toledo, Spain

Hospital Universitario Miguel Servet

🇪🇸

Zaragoza, Spain

Hospital Universitario la Fe; Servicio de Oncologia

🇪🇸

Valencia, Spain

Ramathibodi Hospital; Department of Surgery/Breast and Endocrine Unit

🇹🇭

Bangkok, Thailand

Maharaj Nakorn Chiang Mai Hospital; Department of Surgery/Head Neck and Breast Unit; Clinical Trial

🇹🇭

Chiang Mai, Thailand

Srinagarind Hospital; Department of Surgery

🇹🇭

Khon Kaen, Thailand

Songklanagarind Hospital; Department of Surgery

🇹🇭

Songkla, Thailand

Royal Bournemouth General Hospital; Oncology

🇬🇧

Bournemouth, United Kingdom

Velindre Cancer Centre; Oncology Dept

🇬🇧

Cardiff, United Kingdom

University Hospital of North Durham; Oncology

🇬🇧

Durham, United Kingdom

Christie Hospital; Breast Cancer Research Office

🇬🇧

Manchester, United Kingdom

Nottingham City Hospital

🇬🇧

Nottingham, United Kingdom

Peterborough City Hospital, Edith Cavell Campus; Oncology Department

🇬🇧

Peterborough, United Kingdom

Great Western Hospital; Clinical Oncology

🇬🇧

Swindon, United Kingdom

Hospital Nacional Edgardo Rebagliati Martins

🇵🇪

Jesus Maria, Peru

Clinica Anglo Americana - Centro de Investigacion Oncologia CAA

🇵🇪

Lima, Peru

Wojewodzki Szpital Zespolony; Oddzial Chemioterapii

🇵🇱

Elblag, Poland

Wojewodzkie Centrum Onkologii

🇵🇱

Gdansk, Poland

Spitalul Clinic Sf. Maria; Departmental De Oncologie

🇷🇴

Bucharest, Romania

Institute Of Oncology Bucharest; Medical Oncology

🇷🇴

Bucharest, Romania

Prof. Dr. I. Chiricuta Institute of Oncology

🇷🇴

Cluj Napoca, Romania

GUZ Perm Region Oncology Dispensary

🇷🇺

Perm, Russian Federation

Hospital Clinica Benidorm

🇪🇸

Benidorm, Alicante, Spain

Medisprof SRL

🇷🇴

Cluj-Napoca, Romania

Jessa Zkh (Campus Virga Jesse)

🇧🇪

Hasselt, Belgium

Jász-Nagykun-Szolnok Megyei Hetényi Géza Kórház; Onkológiai Osztály

🇭🇺

Szolnok, Hungary

AZ Groeninge

🇧🇪

Kortrijk, Belgium

Clinique Saint-Joseph

🇧🇪

Liège, Belgium

COZL Oddzial Onkologii Klinicznej z pododdzialem Chemioterapii Dziennej

🇵🇱

Lublin, Poland

Municipal Clinical Hospital Filantropia; Oncology

🇷🇴

Craiova, Romania

Centro Oncológico Estatal; ISSSEMYM Oncología

🇲🇽

Toluca, Mexico

Complejo Hospitalario Torrecardenas; Servicio de Oncologia

🇪🇸

Almería, Almeria, Spain

Queen Elizabeth Hospital; Clinical Oncology

🇭🇰

Hong Kong, Hong Kong

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