MedPath

A Study of Atezolizumab (Tecentriq) to Investigate Long-term Safety and Efficacy in Previously-treated Participants With Locally Advanced or Metastatic Non-small Cell Lung Cancer (NSCLC)

Phase 4
Completed
Conditions
Carcinoma, Non-Small-Cell Lung
Interventions
Registration Number
NCT03285763
Lead Sponsor
Hoffmann-La Roche
Brief Summary

This is a Phase III/IV, single-arm, multicenter study of the long-term safety and efficacy of atezolizumab treatment in participants with Stage IIIb or Stage IV NSCLC who have progressed after standard systemic chemotherapy (including if given in combination with anti-programmed cell death protein 1 \[anti-PD-1\] therapy, after anti-PD-1 as monotherapy, or after tyrosine kinase inhibitor \[TKI\] therapy). The study will consist of a Screening Period, a Treatment Period, a Treatment Discontinuation Visit, and a Follow-Up Period.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
619
Inclusion Criteria
  • Histologically or cytologically documented Stage IIIb or Stage IV NSCLC that has progressed following standard systemic chemotherapy (including if given in combination with anti-PD-1 therapy, after anti-PD-1 as monotherapy, or after TKI therapy). Participants with a previously detected sensitizing epidermal growth factor receptor (EGFR) mutation or echinoderm microtubule-associated protein-like 4-anaplastic lymphoma kinase (ALK) fusion oncogene must have received targeted therapy (TKI) followed by at least one line of standard systemic chemotherapy prior to receiving atezolizumab. Overall, participants should not have received more than two lines of standard systemic chemotherapy. Participants who have discontinued first-line or second-line therapy due to intolerance are also eligible
  • The last dose of prior systemic anticancer therapy or targeted therapy must have been administered more than or equal to (≥) 21 days prior to randomization.
  • The last dose of prior anti-PD-1 therapy must have been administered. Nivolumab must have been discontinued >= 14 days and pembrolizumab >= 21 days prior to study treatment initiation, providing that these treatments were not administered in a clinical trial setting.
  • Measurable disease, as defined by Response Evaluation Criteria for Solid Tumors, Version 1.1 (RECIST v1.1)
  • Participants with asymptomatic central nervous system (CNS) metastases (treated or untreated), as determined by computed tomography (CT) or magnetic resonance imaging evaluation during screening and prior radiographic evaluation, are eligible
  • Eastern Cooperative Oncology Group (ECOG) performance status 0, 1, or 2
  • Life expectancy ≥ 12 weeks
  • Adequate hematologic and end-organ function
  • For women of childbearing potential: agreement to remain abstinent (refrain from heterosexual intercourse) or use contraceptive methods that result in a failure rate of less than (<) 1 percent (%) per year during the treatment period and for at least 5 months after the last dose of atezolizumab
  • Participants must have recovered (i.e., improvement to Grade 1 or better) from all acute toxicities from previous therapy, excluding alopecia and toxicities related to prior anti-PD-1-therapy
Exclusion Criteria
  • Symptomatic CNS metastases
  • Spinal cord compression not definitively treated with surgery and/or radiation or previously diagnosed and treated spinal cord compression without evidence that disease has been clinically stable for ≥ 2 weeks prior to study treatment initiation
  • Leptomeningeal disease
  • Uncontrolled pericardial effusion or ascites requiring recurrent drainage procedures
  • Pregnant or lactating, or intending to become pregnant during the study
  • Evidence of significant uncontrolled concomitant disease that could affect compliance with the protocol, including significant liver disease (such as cirrhosis, uncontrolled major seizure disorder, or superior vena cava syndrome)
  • Significant cardiovascular disease, such as New York Heart Association cardiac disease ≥ Class III, myocardial infarction within 3 months, unstable arrhythmias, or unstable angina
  • Significant renal disorder requiring dialysis or indication for renal transplant
  • Treatment with any other investigational agent or participation in another clinical trial with therapeutic intent within 28 days prior to study treatment initiation
  • Major surgical procedure within 4 weeks prior to study treatment initiation or anticipation of need for a major surgical procedure during the course of the study other than for diagnosis
  • Inability to understand the local language(s) for which the EORTC QLQ-LC13 and EQ-5D-5L questionnaires are available
  • History of severe allergic, anaphylactic, or other hypersensitivity reactions to chimeric or humanized antibodies or fusion proteins
  • Known hypersensitivity or allergy to biopharmaceuticals produced in Chinese hamster ovary cells or any component of the atezolizumab formulation
  • History of autoimmune disease are allowed if controlled and on stable treatment (i.e., same treatment, same dose) for the last 12 weeks
  • Prior allogeneic stem cell or solid organ transplantation
  • History of idiopathic pulmonary fibrosis, including pneumonitis, drug-induced pneumonitis, organizing pneumonia (i.e., bronchiolitis obliterans, cryptogenic organizing pneumonia), or evidence of active pneumonitis on screening chest CT scan
  • Active tuberculosis
  • Administration of a live, attenuated vaccine within 4 weeks prior to study treatment initiation
  • Prior treatment with cluster of differentiation 137 (CD137) agonists or immune checkpoint blockade therapies other than anti-PD-1 therapy, including anti-programmed death-ligand 1 therapeutic antibodies
  • Treatment with systemic immunostimulatory agents (including, but not limited to, interferons or interleukin-2) within 4 weeks or five half-lives of the drug, whichever is longer, prior to initiation of study treatment
  • Specifically for participants without autoimmune disease: treatment with systemic corticosteroids or other systemic immunosuppressive medications (including but not limited to prednisone, dexamethasone, cyclophosphamide, azathioprine, methotrexate, thalidomide, and anti-tumor necrosis factor agents) within 2 weeks prior to study treatment initiation, or anticipated requirement for systemic immunosuppressive medications during the trial. For participants with CNS metastases, use of prednisone at a stable dose (or dose equivalent) of <= 20 mg/day is acceptable.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
AtezolizumabAtezolizumabParticipants with Stage IIIb or State IV NSCLC who have progressed after standard systemic chemotherapy will receive atezolizumab until Investigator-assessed loss of clinical benefit, unacceptable toxicity, investigator or participant's decision to withdraw from therapy, or death (whichever occurs first).
Primary Outcome Measures
NameTimeMethod
Percentage of Participants With Adverse EventsBaseline up to 4 years

An adverse event (AE) was defined as any untoward medical occurrence in a participant administered a pharmaceutical product, regardless of causal attribution. An AE can therefore be any unfavorable and unitended sign (including an abnormal laboratory finding), symptom or disease temporally associated with the use of a pharmaceutical product whether or not considered related to the pharmaceutical product. Preexisting conditions which worsen during a study are also considered as a AEs.

Secondary Outcome Measures
NameTimeMethod
Percentage of Participants Alive 2 Years After Initiation of TreatmentBaseline up to Year 2

The overall survival (OS) rate at 2 years, was defined as the percentage of participants remaining alive 2 years after initiation of study treatment.

Overall Survival (OS)Baseline up to death (up to 4 years)

OS was defined as the time (in months) from initiation of study treatment to death from any cause.

Progression-Free Survival (PFS) as Evaluated By the Investigator in Accordance With Response Evaluation Criteria in Solid Tumors (RECIST), Version 1.1 (v.1.1)Baseline up to disease progression or death whichever occurs first (up to 4 years)

PFS was defined as the time (in months) from initiation of study treatment to the first documented disease progression or death from any cause, whichever occurred first. PFS was evaluated by the investigator according to RECIST v1.1.

EuroQol 5-Dimension 5-Level (EQ-5D-5L) Questionnaire - Mobility ItemDay 1 of first 2 cycles (21-day cycle), then every 6 weeks for 54 weeks; thereafter every 3 weeks or 6 weeks until disease progression or until treatment discontinuation (up to 4 years)

The EQ-5D-5L was a self-reported health status questionnaire that consisted of six questions used to calculate a health utility score for use in health economic analysis. The EQ-5D-5L has two components: a five-item health state profile that assesses mobility, self-care, usual activities, pain/discomfort, and anxiety/depression, as well as a Visual Analogue Scale (VAS) that measures health state. Each item was rated from 1 (no problems) to 5 (extreme problems). Categories with non-zero values are reported here. Number of participants who rated the mobility item ranging from 1-5 are reported. Participants who had a invalid response were presented under the category 'Invalid Response'.

EQ-5D-5L Questionnaire - Self-Care ItemDay 1 of first 2 cycles (21-day cycle), then every 6 weeks for 54 weeks; thereafter every 3 weeks or 6 weeks until disease progression or until treatment discontinuation (up to 4 years)

The EQ-5D-5L was a self-reported health status questionnaire that consisted of six questions used to calculate a health utility score for use in health economic analysis. The EQ-5D-5L has two components: a five-item health state profile that assesses mobility, self-care, usual activities, pain/discomfort, and anxiety/depression, as well as a VAS that measures health state. Each item was rated from 1 (no problems) to 5 (extreme problems). Categories with non-zero values are reported here. Number of participants who rated the self-care item ranging from 1-5 are reported. Participants who had a invalid response were presented under the category 'Invalid Response'.

EQ-5D-5L Questionnaire - Usual Activities ItemDay 1 of first 2 cycles (21-day cycle), then every 6 weeks for 54 weeks; thereafter every 3 weeks or 6 weeks until disease progression or until treatment discontinuation (up to 4 years)

The EQ-5D-5L was a self-reported health status questionnaire that consisted of six questions used to calculate a health utility score for use in health economic analysis. The EQ-5D-5L has two components: a five-item health state profile that assesses mobility, self-care, usual activities, pain/discomfort, and anxiety/depression, as well as a VAS that measures health state. Each item was rated from 1 (no problems) to 5 (extreme problems). Categories with non-zero values are reported here. Number of participants who rated the usual activities item ranging from 1-5 are reported. Participants who had a invalid response were presented under the category 'Invalid Response'.

EQ-5D-5L Questionnaire - Pain/Discomfort ItemDay 1 of first 2 cycles (21-day cycle), then every 6 weeks for 54 weeks; thereafter every 3 weeks or 6 weeks until disease progression or until treatment discontinuation (up to 4 years)

The EQ-5D-5L was a self-reported health status questionnaire that consisted of six questions used to calculate a health utility score for use in health economic analysis. The EQ-5D-5L has two components: a five-item health state profile that assesses mobility, self-care, usual activities, pain/discomfort, and anxiety/depression, as well as a VAS that measures health state. Each item was rated from 1 (no problems) to 5 (extreme problems). Categories with non-zero values are reported here. Number of participants who rated the pain/discomfort item ranging from 1-5 are reported. Participants who had a invalid response were presented under the category 'Invalid Response'.

EQ-5D-5L Questionnaire - Anxiety/Depression ItemDay 1 of first 2 cycles (21-day cycle), then every 6 weeks for 54 weeks; thereafter every 3 weeks or 6 weeks until disease progression or until treatment discontinuation (up to 4 years)

The EQ-5D-5L was a self-reported health status questionnaire that consisted of six questions used to calculate a health utility score for use in health economic analysis. The EQ-5D-5L has two components: a five-item health state profile that assesses mobility, self-care, usual activities, pain/discomfort, and anxiety/depression, as well as a VAS that measures health state. Each item was rated from 1 (no problems) to 5 (extreme problems). Categories with non-zero values are reported here. Number of participants who rated the anxiety/depression item ranging from 1-5 are reported. Participants who had a invalid response were presented under the category 'Invalid Response'.

EQ-5D-5L Questionnaire - VAS ScoresDay 1 of first 2 cycles (21-day cycle), then every 6 weeks for 54 weeks; thereafter every 3 weeks or 6 weeks until disease progression or until treatment discontinuation (up to 4 years)

The EQ-5D-5L was a self-reported health status questionnaire that consisted of six questions used to calculate a health utility score for use in health economic analysis. The EQ-5D-5L has two components: a five-item health state profile that assesses mobility, self-care, usual activities, pain/discomfort, and anxiety/depression, as well as a VAS that measures health state. The VAS is designed to rate the participant's current health state on a scale from 0 to 100, where 0 represents the worst imaginable health state and 100 represents the best imaginable health state. Values presented after baseline represent the change from baseline.

European Organisation for Research and Treatment of Cancer Quality-of-Life Questionnaire Supplemental Lung Cancer Module (EORTC QLQ-LC13)Day 1 of first 3 cycles (21-day cycle), then every 6 weeks for 48 weeks; thereafter every 9 weeks until disease progression or until treatment discontinuation (up to 4 years)

The EORTC QLQ-LC13 consisted of 13 items that address key lung cancer symptoms (cough, hemoptysis, dyspnea, and site-specific pain), treatment-related adverse effects (sore mouth, dysphagia, peripheral neuropathy and alopecia) and pain medication. The dysphagia scale is multi-item, while the rest are single-item scales. The scales are linearly transformed so that each score has a range from 0 to 100. A high scale score represents a higher response level (e.g. a high score for global health status represents a high QoL). A high score for the symptom scale represents a high level of symptoms. A \>=10-point change in the EORTC scale score was perceived by participants as clinically significant. Values presented after baseline represent the change from baseline.

Progression-Free Survival as Evaluated By the Investigator in Accordance With Modified RECISTBaseline up to disease progression or death whichever occurs first (up to 4 years)

PFS was defined as the time (in months) from initiation of study treatment to the first documented disease progression or death from any cause, whichever occurred first. PFS was evaluated by the investigator according to modified RECIST.

Percentage of Participants Alive 3 Years After Initiation of TreatmentBaseline up to Year 3

The OS rate at 3 years, was defined as the percentage of participants remaining alive 3 years after initiation of study treatment.

Percentage of Participants With Objective Reponse as Assessed by the Investigator According to RECIST v1.1Baseline up to disease progression or death whichever occurs first (up to 4 years)

Objective response rate (ORR), according to RECIST v1.1, was defined as the percentage of participants with a confirmed best overall response (BOR), either complete response (CR) or partial response (PR), as determined by the investigator using RECIST v1.1.

Percentage of Participants With Objective Reponse as Assessed by the Investigator According to Modified RECISTBaseline up to disease progression or death whichever occurs first (up to 4 years)

The investigator-assessed ORR was defined as the proportion of participants whose confirmed BOR is either a PR or CR per modified RECIST.

Duration of Response as Assessed by the Investigator According to RECIST v.1.1From date of first objective response up to disease progression or death whichever occurs first (up to 4 years)

DOR was defined as the time from the first tumor assessment that supported the participant's objective response (CR or PR, whichever was first reported) to documented disease progression as determined by the investigator according to RECIST v1.1 or death from any cause, whichever occurred first, among participants who had a best overall response as CR or PR.

Duration of Response as Assessed by the Investigator According to Modified RECISTFrom date of first objective response up to disease progression or death whichever occurs first (up to 4 years)

DOR was defined as the duration from the first tumor assessment that supports the participant's objective response (CR or PR, whichever is first recorded) to disease progression or death due to any cause, whichever occurred first.

Trial Locations

Locations (111)

Hospital Aleman

🇦🇷

Caba, Argentina

Centro Oncologico Riojano Integral (CORI)

🇦🇷

La Rioja, Argentina

CETUS Hospital Dia Oncologia

🇧🇷

Uberaba, MG, Brazil

Hospital das Clinicas - UFRGS

🇧🇷

Porto Alegre, RS, Brazil

Azienda Ospedaliero-Universitaria Careggi; SOD Radioterapia

🇮🇹

Firenze, Toscana, Italy

Azienda Ospedaliera Universitaria Pisana - Ospedale Cisanello; Dipartimento Cardio Toraco Vascolare

🇮🇹

Pisa, Toscana, Italy

Ospedale Regionale Umberto Parini; S.C. Oncologia

🇮🇹

Aosta, Valle D?Aosta, Italy

ULSS2 Marca Trevigiana; UOC Oncologia Medica - Distretto di Treviso

🇮🇹

Treviso, Veneto, Italy

Pauls Stradins Clinical University Hospital

🇱🇻

R?ga, Latvia

Riga East Clinical University Hospital Latvian Oncology Centre

🇱🇻

Riga, Latvia

Hotel Dieu de France; Oncology

🇱🇧

Beirut, Lebanon

Bellevue Medical Center

🇱🇧

El-Metn, Lebanon

University Malaya Medical Centre; Clinical Oncology Unit,

🇲🇾

Kuala Lumpur, FED. Territory OF Kuala Lumpur, Malaysia

Institute Kanser Negara (IKN)

🇲🇾

Putrajaya, FED. Territory OF Kuala Lumpur, Malaysia

Hospital Pulau Pinang; Jabatan Respiratori

🇲🇾

Georgetown, Penang, Malaysia

Mount Miriam Cancer Hospital

🇲🇾

Pulau Pinang, Penang, Malaysia

Hospital Umum Sarawak; Oncology and Radiotherapy

🇲🇾

Kuching, Sarawak, Malaysia

Health Pharma Professional Research

🇲🇽

Cdmx, Mexico CITY (federal District), Mexico

Centro Oncologico Internacional

🇲🇽

Mexico D.F., Mexico CITY (federal District), Mexico

Oaxaca Site Management Organization

🇲🇽

Oaxaca de Juárez, Oaxaca, Mexico

Oncologico Potosino

🇲🇽

San Luis Potosí, SAN LUIS Potosi, Mexico

Investigacion Clinica Merida

🇲🇽

Mérida, Yucatan, Mexico

Clinique le Littoral

🇲🇦

Casablanca, Morocco

Centre Hospitalier Universitaire Hassan II

🇲🇦

FES, Morocco

Institut National D'oncologie Sidi Med Benabdellah

🇲🇦

Rabat, Morocco

Meander Medisch Centrum

🇳🇱

Amersfoort, Netherlands

Ziekenhuis Rijnstate

🇳🇱

Arnhem, Netherlands

Amphia Ziekenhuis; Afdeling Longziekten

🇳🇱

Breda, Netherlands

Tergooiziekenhuizen, loc. Hilversum

🇳🇱

Hilversum, Netherlands

UMC Radboud Nijmegen

🇳🇱

Nijmegen, Netherlands

Isala

🇳🇱

Zwolle, Netherlands

The Panama Clinic

🇵🇦

Panama, Panama

Instituto Regional de Enfermedades Neoplásicas del Sur; Centro de Inv. de Medicina Oncológica

🇵🇪

Arequipa, Peru

Clinica Internacional, Sede San Borja; Unidad de Investigacion de Clínica Internacional

🇵🇪

Lima, Peru

University of Perpetual Help System DALTA Medical Center

🇵🇭

Las Pinas, Philippines

The Medical City Hospital; Cancer Research Room

🇵🇭

Pasig, Philippines

East Avenue Medical Center

🇵🇭

Quezon City, Philippines

Narodowy Instytut Onkologii Oddzial Gliwice; II Klinika Radioterapii i Chemioterapii

🇵🇱

Gliwice, Poland

Samodzielny Publiczny Zespol Gruzlicy i Chorob Pluc w Olsztynie

🇵🇱

Olsztyn, Poland

Mazowieckie Centrum Leczenia Chorob Pluc I Gruzlicy; Oddzial Iii

🇵🇱

Otwock, Poland

Szpital Kliniczny; Przemienienia Panskiego;Uniwersytetu Medyczny im.; Karola Marcinkowskiego w Pozna

🇵🇱

Poznan, Poland

Narod.Inst.Onkol. im. M.Sklodowskiej - Curie-Panst.Inst.Bad; Klinika Nowot.Pluca i Klatki Piers

🇵🇱

Warszawa, Poland

University Clinic Golnik

🇸🇮

Golnik, Slovenia

Hospital Univ. Central de Asturias; Servicio de Oncologia

🇪🇸

Oviedo, Asturias, Spain

Hospital Universitario Marques de Valdecilla; Servicio de Oncologia

🇪🇸

Santander, Cantabria, Spain

Hospital Provincial de Castellon; Servicio de Oncologia

🇪🇸

Castellon de La Plana, Castellon, Spain

Hospital Universitario Reina Sofia; Servicio de Oncologia

🇪🇸

Córdoba, Cordoba, Spain

Hospital de Donostia; Servicio de Oncologia Medica

🇪🇸

San Sebastian, Guipuzcoa, Spain

Hospital Universitario Son Espases; Servicio de Oncologia

🇪🇸

Palma De Mallorca, Islas Baleares, Spain

Complejo Hospitalario Universitario Insular?Materno Infantil; Servicio de Oncologia

🇪🇸

Las Palmas de Gran Canaria, LAS Palmas, Spain

Hospital Universitario Puerta de Hierro; Servicio de Oncologia

🇪🇸

Majadahonda, Madrid, Spain

Hospital Quiron de Madrid; Servicio de Oncologia

🇪🇸

Pozuelo de Alarcon, Madrid, Spain

Hospital Infanta Sofia; Servico de Oncologia

🇪🇸

San Sebastian de Los Reyes, Madrid, Spain

Complejo Hospitalario de Navarra; Servicio de Oncologia

🇪🇸

Pamplona, Navarra, Spain

Hospital Universitario de Canarias;servicio de Oncologia

🇪🇸

La Laguna, Tenerife, Spain

Hospital General Univ. de Alicante; Servicio de Oncologia

🇪🇸

Alicante, Spain

Hospital del Mar; Servicio de Oncologia

🇪🇸

Barcelona, Spain

Hospital Clínic i Provincial; Servicio de Hematología y Oncología

🇪🇸

Barcelona, Spain

Hospital de la Santa Creu i Sant Pau; Servicio de Oncologia

🇪🇸

Barcelona, Spain

Hospital Universitari de Girona Dr Josep Trueta; Departamento de Oncologia Medica

🇪🇸

Girona, Spain

Hospital Universitario Virgen de las Nieves; Servicio de Oncologia

🇪🇸

Granada, Spain

Complejo Hospitalario de Jaen-Hospital Universitario Medico Quirurgico; Servicio de Oncologia

🇪🇸

Jaen, Spain

Hospital Lucus Augusti; Servicio de Oncologia

🇪🇸

Lugo, Spain

Hospital Ramon y Cajal; Servicio de Oncologia

🇪🇸

Madrid, Spain

Hospital Universitario 12 de Octubre; Servicio de Oncologia

🇪🇸

Madrid, Spain

Hospital Universitario La Paz; Servicio de Oncologia

🇪🇸

Madrid, Spain

Hospital Universitario Virgen del Rocio; Servicio de Oncologia

🇪🇸

Sevilla, Spain

Hospital General Universitario de Valencia; Servicio de oncologia

🇪🇸

Valencia, Spain

Hospital Universitario la Fe; Servicio de Oncologia

🇪🇸

Valencia, Spain

Hospital Clinico Universitario Lozano Blesa; Servicio de Oncologia

🇪🇸

Zaragoza, Spain

Sahlgrenska Universitetssjukhuset, Lungmedicinkliniken

🇸🇪

Goeteborg, Sweden

Karolinska Universitetssjukhuset, Solna; Kliniska prövningsenheten Z:4:01

🇸🇪

Stockholm, Sweden

Uppsala University Hospital; Department of Oncology

🇸🇪

Uppsala, Sweden

Tawam Hospital

🇦🇪

Al Ain, United Arab Emirates

Royal United Hospital

🇬🇧

Bath, United Kingdom

Birmingham Heartlands Hospital ; Department of Respiratory Medicine (Rm 30)

🇬🇧

Birmingham, United Kingdom

Castle Hill Hospital; The Queen's Centre for Oncology & Haematology

🇬🇧

Hull, United Kingdom

Forth Valley Royal Hospital ; Oncology Department

🇬🇧

Larbert, United Kingdom

Chelsea & Westminster Hospital

🇬🇧

London, United Kingdom

Mount Vernon Cancer Centre

🇬🇧

Northwood, United Kingdom

New Cross Hospital

🇬🇧

Wolverhampton, United Kingdom

Ospedale Cannizzaro, Oncologia

🇮🇹

Catania, Sicilia, Italy

Hospital Alemao Oswaldo Cruz

🇧🇷

Sao Paulo, SP, Brazil

Beijing Hospital

🇨🇳

Beijing City, China

Chinese PLA General Hospital

🇨🇳

Beijing, China

Shandong Cancer Hospital

🇨🇳

Jinan, China

First Affiliated Hospital of Soochow University

🇨🇳

Suzhou, China

Henan Cancer Hospital

🇨🇳

Zhengzhou, China

Organizacion Sanitas Internacional

🇨🇴

Bogota, D.C., Colombia

Clinica CIMCA

🇨🇷

San José, Costa Rica

Sjællands Universitetshospital, Næstved; Onkologisk Afdeling

🇩🇰

Naestved, Denmark

Odense Universitetshospital, Onkologisk Afdeling R

🇩🇰

Odense C, Denmark

Vejle Sygehus; Onkologisk Afdeling

🇩🇰

Vejle, Denmark

Anticancer Hospital Ag Savas; 1St Dept of Internal Medicine

🇬🇷

Athens, Greece

Uoa Sotiria Hospital; Oncology

🇬🇷

Athens, Greece

Agioi Anargyroi; 3Rd Dept. of Medical Oncology

🇬🇷

Athens, Greece

Univ General Hosp Heraklion; Medical Oncology

🇬🇷

Heraklion, Greece

University Hospital of Patras Medical Oncology

🇬🇷

Patras, Greece

Diavalkaniko Hospital

🇬🇷

Thessaloniki, Greece

Oncomedica

🇬🇹

Guatemala, Guatemala

Ist. Ricovero e Cura a Carattere Scientifico-Centro Rif. Oncologico della Basilica

🇮🇹

Rionero In Vulture (PZ), Basilicata, Italy

Campus Universitario S.Venuta; Centro Oncologico T.Campanella

🇮🇹

Catanzaro, Calabria, Italy

Azienda Ospedaliero-Universitaria S.Orsola-Malpighi; Unità Operativa Oncologia Medica

🇮🇹

Bologna, Emilia-Romagna, Italy

Arcispedale Santa Maria Nuova; Medicina Nucleare

🇮🇹

Reggio Emilia, Emilia-Romagna, Italy

Policlinico Umberto i di Roma; dip. Scienze Radiologiche, Oncologiche, Anatomopatologiche

🇮🇹

Roma, Lazio, Italy

AZ. Ospedaliera San Giovanni - Addolorata

🇮🇹

Roma, Lazio, Italy

Cliniche Gavazzeni S.p.A.; Dip. di Oncologia Pneumologica ed Urologica

🇮🇹

Bergamo, Lombardia, Italy

ASST DEGLI SPEDALI CIVILI DI BRESCIA; Oncologia Medica

🇮🇹

Brescia, Lombardia, Italy

Asst Grande Ospedale Metropolitano Niguarda; Dipartimento Di Ematologia Ed Oncologia

🇮🇹

Milano, Lombardia, Italy

Ospedali Riuniti Di Ancona; Oncology

🇮🇹

Ancona, Marche, Italy

Ospedale Oncologico A.Businco; Div. Oncologia Medica II

🇮🇹

Cagliari, Sardegna, Italy

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