A Study of Talazoparib in Men With DNA Repair Defects and Metastatic Castration-Resistant Prostate Cancer
- Registration Number
- NCT03148795
- Lead Sponsor
- Pfizer
- Brief Summary
The purpose of this international, phase 2, open-label, response rate study of talazoparib is to assess the efficacy and safety of talazoparib in men with DNA repair defects metastatic castration-resistant prostate cancer (CRPC) who previously received taxane-based chemotherapy and progressed on at least 1 novel hormonal agent (enzalutamide and/or abiraterone acetate/prednisone).
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- Male
- Target Recruitment
- 128
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At least 18 years of age.
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Histologically or cytologically confirmed adenocarcinoma of the prostate without signet cell, or small cell features.
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Patients must have measurable soft tissue disease per RECIST 1.1
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DNA damage repair deficiency as assessed centrally by a gene mutation biomarker panel (testing of de novo or archival tumor tissue (via central laboratory) or prior historical testing (with Sponsor approval) using the Foundation Medicine, FoundationOne CDx™ NGS gene panel test.
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Consent to a saliva sample collection for a germline comparator, unless prohibited by local regulations or ethics committee (EC) decision.
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Serum testosterone ≤ 1.73 nmol/L (50 ng/dL) at screening.
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Bilateral orchiectomy or ongoing androgen deprivation therapy with a gonadotropin-releasing hormone (GnRH) agonist/antagonist (surgical or medical castration).
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Progressive disease at study entry defined as 1 or more of the following 3 criteria:
- A minimum of 3 rising PSA values with an interval of at least 1 week between determinations. The screening central laboratory PSA value must be ≥ 2 μg/L (2 ng/mL) if qualifying solely by PSA progression.
- Soft tissue disease progression as defined by RECIST 1.1.
- Bone disease progression defined by PCWG3 with 2 or more new metastatic lesions on bone scan.
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Metastatic disease.
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Previous treatment with 1 or 2 chemotherapy regimens including at least 1 taxane-based regimen for metastatic (non castrate or castrate) prostate cancer. Patients may have received radium-223 and/or cabazitaxel, or were deemed unsuitable, declined, or did not have access to these therapies.
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Documented disease progression (either radiographic or biochemical) on at least 1 novel hormonal therapy (enzalutamide and/or abiraterone acetate/prednisone) for the treatment of metastatic CRPC, irrespective of prior NHT treatment for non castrate prostate cancer or nonmetastatic (M0) CRPC.
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Bisphosphonate or denosumab dosage must have been stable for at least 4 weeks before day 1 for patients receiving these therapies.
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Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2.
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Estimated life expectancy of ≥ 6 months as assessed by the investigator.
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Able to swallow the study drug, have no known intolerance to study drugs or excipients, and comply with study requirements.
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Must use a condom when having sex from the time of the first dose of study drug through 4 months after last dose of study drug. A highly effective form of contraception must be used from the time of the first dose of study drug through 4 months after last dose of study drug when having sex with a non pregnant female partner of childbearing potential.
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Must agree not to donate sperm from the first dose of study drug to 4 months after the last dose of study drug.
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Patients must be willing and able to comply with scheduled visits, treatment plan, laboratory tests and other study procedures.
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- Use of systemic chemotherapeutic (including but not limited to taxanes), hormonal, biologic, or radionuclide therapy for treatment of metastatic prostate cancer (other than approved bone targeting agents and GnRH agonist/antagonist) or any other investigational agent within 4 weeks before day 1.
- Prior treatment with a PARP inhibitor, cyclophosphamide, or mitoxantrone chemotherapy. Patients who discontinued prior platinum based chemotherapy <=6 months prior to screening or whose disease previously progressed on platinum based therapy at any time in the past are also excluded.
- Treatment with any concurrent cytotoxic chemotherapy or investigational drug(s) within 4 weeks or 5 half lives of the drug (whichever is longer) before Day 1 and/or during study participation
- Radiation therapy within 3 weeks (within 2 weeks, if single fraction of radiotherapy) before day 1.
- Major surgery within 2 weeks before day 1.
- Clinically significant cardiovascular disease.
- Significant renal, hepatic, or bone marrow organ dysfunction.
- Known or suspected brain metastasis or active leptomeningeal disease.
- Symptomatic or impending spinal cord compression or cauda equina syndrome.
- Prior diagnosis of myelodysplastic syndrome or acute myeloid leukemia
- History of another cancer within 3 years before enrollment with the exception of nonmelanoma skin cancers, or American Joint Committee on Cancer stage 0 or stage 1 cancer that has a remote probability of recurrence in the opinion of the investigator and the sponsor.
- Gastrointestinal disorder affecting absorption.
- Current or anticipated use within 7 days prior to first dose of study drug or anticipated use during the study of the following P gp inhibitors (amiodarone, carvedilol, clarithromycin, cobicistat, darunavir, dronedarone, erythromycin, indinavir, itraconazole, ketoconazole, lapatinib, lopinavir, propafenone, quinidine, ranolazine, ritonavir, saquinavir, telaprevir, tipranavir, verapamil, and valspodar).
- Any other acute or chronic medical or psychiatric condition (concurrent disease, infection, or comorbidity) that interferes with ability to participate in the study, causes undue risk, or complicates the interpretation of data, in the opinion of the investigator or sponsor, including recent (within the past year) or active suicidal ideation or behavior or laboratory abnormality that may increase the risk associated with study participation or investigational product administration or may interfere with the interpretation of study results and, in the judgment of the investigator, would make the patient inappropriate for entry into this study.
- Investigator site staff members directly involved in the conduct of the study and their family members, site staff members otherwise supervised by the investigator, or patients who are Pfizer employees, including their family members, directly involved in the conduct of the study.
- Fertile male subjects who are unwilling or unable to use a highly effective method of contraception as outlined in this protocol for the duration of the study and for at least 4 months after the last dose of investigational product.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description Talazoparib Talazoparib Talazoparib 1 mg daily
- Primary Outcome Measures
Name Time Method Best Objective Response Rate (ORR) From first dose of study drug to best overall soft tissue response CR or PR (maximum duration of 25 months) Best ORR was defined as the percentage of participants with best overall soft tissue response of complete response (CR) or partial response (PR) as per RECIST1.1 by an independent central review. RECIST 1.1 criteria, CR: disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to less than 10 millimeter (mm). Disappearance of all non-target lesions and normalization of tumor marker level. All lymph nodes must be non-pathological in size (less than 10 mm short axis); PR: at least 30 percent (%) decrease in sum of diameters of target lesions taking as reference baseline sum diameters.
- Secondary Outcome Measures
Name Time Method Time to Objective Response From first dose of study drug to first objective response (maximum duration of 25 months) Time to objective response was defined as the time from first dose of talazoparib to the first objective evidence of soft tissue response with no evidence of confirmed bone disease progression on bone scan per prostate cancer working Group 3 (PCWG3). Soft tissue response is defined as a best overall response of CR or PR per RECIST 1.1 by independent central review. RECIST 1.1 criteria, CR: disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to less than 10 mm. Disappearance of all non-target lesions and normalization of tumor marker level. All lymph nodes must be non-pathological in size (less than 10 mm short axis); PR: at least 30 % decrease in sum of diameters of target lesions taking as reference baseline sum diameters.
Percentage of Participants With a Null CTC Count Baseline to anytime on study during final analysis of the outcome measure, up to maximum duration of 25 months Percentage of participants with a null CTC count was defined as percentage of participants with CTC count \>=1 CTC per 7.5 mL of blood at baseline that decreased to CTC = 0 per 7.5 mL of blood any time on study.
Percentage of Participants With Baseline CTC Count <5 CTC Showed Increased CTC Counts at Any Time on Study Baseline to anytime on study during final analysis of the outcome measure, up to maximum duration of 25 months Percentage of participants with CTC count \<5 CTC per 7.5 mL of blood at baseline those who showed an increased CTC count, compared to baseline, any time on study was reported in this study.
Percentage of Participants With Conversion of Circulating Tumor Cell (CTC) Count Baseline to anytime on study during final analysis of the outcome measure, up to maximum duration of 25 months Percentage of participants with conversion of CTC count was defined as percentage of participants with a CTC count \>= 5 CTC per 7.5 milliliter (mL) of blood at baseline that decreased to \< 5 CTC per 7.5 mL of blood any time on study.
Number of Participants With Clinically Significant Abnormalities in Vital Signs During study treatment (approximately up to 36 months) Vital sign abnormalities criteria included: 1) Systolic blood pressure (SBP) in millimeters of mercury (mmHg): absolute result greater than (\>) 180 mmHg and increase from baseline greater than or equal to (\>=) 40 mmHg or absolute result \< 90 mmHg and decrease from baseline \> 30 mmHg; 2) Diastolic blood pressure (DBP) (mmHg): absolute result \> 110 mmHg and increase from baseline \>= 30 mmHg or absolute result \< 50 mmHg and decrease from baseline \> 20 mmHg or \>= 20 mmHg increase from baseline; 3) Heart rate in beats per minutes (bpm): absolute result \< 50 bpm and decrease from baseline \> 20 bpm or absolute result \> 120 bpm and increase from baseline \> 30 bpm; Weight in kilogram: \> 10% decrease from baseline.
Number of Participants With Dose Modification During study treatment (approximately up to 36 months) Number of participants with dose modification due to adverse events was reported.
Duration of Response (DOR) From the first objective evidence of soft tissue response (CR or PR, whichever is earlier) to radiographic progression or death due to any cause without evidence of radiographic progression, whichever occurs first (maximum duration of 25 months) DOR was defined as the time from the first objective evidence of soft tissue response (CR or PR, whichever is earlier) per RECIST 1.1 and no evidence of confirmed bone disease progression per PCWG3 to the date of first objective evidence of radiographic progression or death due to any cause without evidence of radiographic progression, whichever occurs first. RECIST 1.1 criteria, CR: disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to less than 10 mm. Disappearance of all non-target lesions and normalization of tumor marker level. All lymph nodes must be non-pathological in size (less than 10 mm short axis); PR: at least 30 % decrease in sum of diameters of target lesions taking as reference baseline sum diameters.
Percentage of Participants With Prostate-Specific Antigen (PSA) Response of Greater Than or Equal to (>=) 50 Percentage (%) From the date of first dose of study treatment until confirmed PSA progression or start of new anticancer treatment given after the first dose of study treatment (maximum duration of 25 months) Percentage of participants with PSA response of \>= 50% was reported in this outcome measure. PSA response was calculated as a decline from baseline PSA (ng/mL) by at least 50% measured by central laboratory.
Time to Prostate-Specific Antigen (PSA) Progression From the date of first dose of study treatment until confirmed PSA progression or start of new anticancer treatment given after the first dose of study treatment (maximum duration of 25 months) Time to PSA progression was defined as the time from first dose of study treatment to the date of PSA progression, which was subsequently confirmed. The time from first dose of talazoparib to the date that a \>=25% increase in PSA with an absolute increase of \>=2micogram per liter (2 nanogram per mL) above the nadir (or baseline for participants with no PSA decline) was documented, confirmed by a second consecutive PSA value obtained \>=3 weeks (21 days) later. Kaplan-Meier method was used for analysis.
Radiographic Progression-Free Survival (PFS) From date of first dose of study drug to first objective evidence of radiographic progression or death without documented radiographic progression, whichever occurs first (maximum duration of 25 months) Radiographic PFS was defined as the time from date of first dose of talazoparib to first objective evidence of radiographic progression as assessed in soft tissue per modified RECIST 1.1 or confirmed progression in bone per PCWG3 guidelines by independent central review or death without documented radiographic progression, whichever occurs first.
Number of Participants With Treatment Emergent Adverse Events (TEAEs) First dose of study drug up to 28 days after last dose of study drug (study treatment was approximately for 36 months, safety follow up to approximately 37 months) An adverse event (AE) was any untoward medical occurrence in a participant who received study drug without regard to possibility of causal relationship. AEs included both serious AEs and all non-serious AEs. Treatment-emergent are events between first dose of study drug and up to 28 days after last dose that were absent before treatment or that worsened relative to pretreatment state.
Number of Participants With Permanent Treatment Discontinuation Due to Adverse Events During study treatment (approximately up to 36 months) Treatment discontinuation was defined as permanent cessation of study drug treatment administration.
Number of Participants With Shift in Laboratory Parameter Values (Chemistry) From Grade <=2 at Baseline to Grade 3 or 4 Post-baseline During study treatment (approximately up to 36 months) Chemistry parameters:alanine aminotransferase increased(inc), alkaline phosphatase inc, aspartate aminotransferase inc, blood bilirubin inc, chronic kidney disease, creatinine inc, gamma-glutamyl transferase (GGT) inc, hypercalcemia, Hyperglycemia, hyperkalemia, hypermagnesemia, hypocalcemia, Hyponatremia, hypoglycemia, hypokalemia, hypomagnesemia, hypernatremia, Hypoalbuminemia and hypophosphatemia. Severity was graded as Grade(G)1: asymptomatic or mild symptoms, clinical or diagnostic observations only, intervention not indicated; G2:moderate, minimal, local or noninvasive intervention indicated, limiting age-appropriate instrumental ADL; G3:severe or medically significant but not immediately life-threatening, hospitalization or prolongation of existing hospitalization indicated, disabling, limiting self-care ADL; G4:life-threatening consequence, urgent intervention indicated; G5: death related to AEs.
Time to Deterioration in Pain Symptom Scores Baseline till final analysis of the outcome measure, up to maximum duration of 25 months Time deterioration is based on BPI-SF question 3: "Please rate your pain by marking the box beside the number that best describes your pain at its worst in the last 24 hours." Pain intensity was to be answered on a range of 0 to 10, where 0 corresponded to no pain and 10 worst pain. Time to this event is defined as the time from the date of first dose of study treatment to onset of pain progression, where pain progression is defined as a 2-point or more increase from baseline in the question 3 score. Kaplan-Meier method was used for analysis. Average of all assessments visits is reported in this outcome measure.
Number of Participants With 5 Response Levels for EQ-5D-5L Pain and Discomfort Domain Baseline, Week 1, 3, 5,7, 9, 13, 17, 21, 25, 37, 49, 61, 73, 85, 97, Follow-up Visit (28 days after last dose) [maximum duration of 25 months] EQ-5D-5L: participant rated assessed level of current health using 5 domains: mobility, self-care, usual activities, pain and discomfort, anxiety, and depression. EQ-5D pain and discomfort domain had 5 responses: no problem, slight problem, moderate problem, severe problem and extreme problem.
Change From Baseline in European Quality of Life 5-Domain 5-Level Scale (EQ-5D-5L) Visual Analogue Scores (VAS) Baseline, Week 1, 3, 5,7, 9, 13, 17, 21, 25, 37, 49, 61, 73, 85, 97, Follow-up Visit (28 days after last dose) [maximum duration of 25 months] The EQ-5D VAS score was a participant rated questionnaire where participants rated how they felt at assessment visit on a vertical VAS that ranged from 0 (worst imaginable health state) to 100 (best imaginable health state), with higher scores indicating a better health condition.
Number of Participants With 5 Response Levels for EQ-5D-5L Self-Care Domain Baseline, Week 1, 3, 5,7, 9, 13, 17, 21, 25, 37, 49, 61, 73, 85, 97, Follow-up Visit (28 days after last dose) [maximum duration of 25 months] EQ-5D-5L: participant rated assessed level of current health using 5 domains: mobility, self-care, usual activities, pain and discomfort, anxiety, and depression. EQ-5D self-care domain had 5 responses: no problem, slight problem, moderate problem, severe problem and extreme problem.
Number of Participants With 5 Response Levels for EQ-5D-5L Usual Activity Domain Baseline, Week 1, 3, 5,7, 9, 13, 17, 21, 25, 37, 49, 61, 73, 85, 97, Follow-up Visit (28 days after last dose) [maximum duration of 25 months] EQ-5D-5L: participant rated assessed level of current health using 5 domains: mobility, self-care, usual activities, pain and discomfort, anxiety, and depression. EQ-5D usual activities domain had 5 responses: no problem, slight problem, moderate problem, severe problem and extreme problem.
Overall Survival (OS) From first dose of study treatment up to death due to any cause during study or date of last contact (approximately 36 months) OS was defined as the time from start date (the date of first dose of treatment) to the date of death due to any cause. Participants who had not died were censored at the date of last contact. Kaplan-Meier method was used for analysis.
Number of Participants With Shift in Laboratory Parameter Values (Hematology) From Grade Less Than Equal to (<=) 2 at Baseline to Grade 3 or 4 Post-baseline During study treatment (approximately up to 36 months) Hematology parameters included anemia, hemoglobin increased, lymphocyte count decreased, lymphocyte count increased, neutrophil count decreased, platelet count decreased, Leukocytosis and white blood cell decreased. Severity was graded as Grade 1: asymptomatic or mild symptoms, clinical or diagnostic observations only, intervention not indicated; Grade 2: moderate, minimal, local or non-invasive intervention indicated, limiting age-appropriate instrumental activities of daily life (ADL); Grade 3: severe or medically significant but not immediately life-threatening, hospitalization or prolongation of existing hospitalization indicated, disabling, limiting self-care ADL; Grade 4: life-threatening consequence, urgent intervention indicated; Grade 5: death related to AE.
Pre-dose Plasma Concentration (Ctrough) of Talazoparib Pre-dose at Week 1, 5, 9 and 13 Ctrough was defined as pre-dose plasma concentration during dosing and observed directly from data.
Change From Baseline in Participant Reported Pain Scores Per BPI-SF Question 3 Baseline, Week 1, 3, 5, 7, 9, 13, 17, 21, 25, 37, 49, 61, 73, 85, Follow-up Visit (28 days after last dose) [maximum duration of 25 months] BPI-SF is an 11-item self-report questionnaire that is designed to assess the severity and impact of pain on daily functions. BPI-SF have 4 questions that assess pain intensity (worst, least, average, right now) and 7 questions that assess impact of pain on daily functions (general activity, mood, walking ability, normal work, relations with other people, sleep, enjoyment of life). Each question is answered on a scale ranging from 0 to 10; '0=No pain and 10=Pain as bad as you can imagine'. Measure can be scored by item, with lower scores being indicative of less pain or pain interference. BPI-SF question 3 was related to participant experiencing pain at its worst in last 24 hours, score range 0 to 10, where large values corresponded to worse outcomes.
Number of Participants With 5 Response Levels for EQ-5D-5L Mobility Domain Baseline, Week 1, 3, 5,7, 9, 13, 17, 21, 25, 37, 49, 61, 73, 85, 97, Follow-up Visit (28 days after last dose) [maximum duration of 25 months] EQ-5D-5L: participant rated assessed level of current health using 5 domains: mobility, self-care, usual activities, pain and discomfort, anxiety, and depression. EQ-5D mobility domain had 5 responses: no problem, slight problem, moderate problem, severe problem and extreme problem.
Number of Participants With 5 Response Levels for EQ-5D-5L Anxiety and Depression Domain Baseline, Week 1, 3, 5,7, 9, 13, 17, 21, 25, 37, 49, 61, 73, 85, 97, Follow-up Visit (28 days after last dose) [maximum duration of 25 months] EQ-5D-5L: participant rated assessed level of current health using 5 domains: mobility, self-care, usual activities, pain and discomfort, anxiety, and depression. EQ-5D anxiety and depression domain had 5 responses: no problem, slight problem, moderate problem, severe problem and extreme problem.
Post-dose Plasma Concentration (Ctrough) of Talazoparib 2 hours post-dose at Week 1 and 5 Plasma concentration was measured 2 hours after dosing and observed directly from data.
Trial Locations
- Locations (118)
Institut de Cancerologie Strasbourg Europe
🇫🇷Strasbourg, France
Levine Cancer Institute-Lincolnton
🇺🇸Lincolnton, North Carolina, United States
Intergrated Clinical Oncology Network (ICON)
🇦🇺South Brisbane, Queensland, Australia
Icon Cancer Care Southport
🇦🇺Southport, Queensland, Australia
Hospital de Clinicas de Porto Alegre-HCPA
🇧🇷Porto Alegre, RS, Brazil
ICO-Site Paul Papin
🇫🇷Angers Cedex 02, France
UC Irvine Health Investigational Drug Pharmacy
🇺🇸Orange, California, United States
Siteman Cancer Center - West County
🇺🇸Creve Coeur, Missouri, United States
Swedish Cancer Institute Edmonds Campus
🇺🇸Edmonds, Washington, United States
Icon Cancer Care
🇦🇺South Brisbane, Queensland, Australia
Siteman Cancer Center - South County
🇺🇸Saint Louis, Missouri, United States
Siteman Cancer Center - St. Peters
🇺🇸Saint Peters, Missouri, United States
Eastern Health Pathology Service
🇦🇺Box Hill, Victoria, Australia
Levine Cancer Institute-Southpark
🇺🇸Charlotte, North Carolina, United States
City of Hope-Antelope Valley
🇺🇸Lancaster, California, United States
The Emory Clinic
🇺🇸Atlanta, Georgia, United States
Barnes-Jewish Hospital
🇺🇸Saint Louis, Missouri, United States
Weill Cornell Medical Center-New York Presbyterian Hospital
🇺🇸New York, New York, United States
City of Hope (City of Hope National Medical Center, City of Hope Medical Center)
🇺🇸Duarte, California, United States
Levine Cancer Institute-University
🇺🇸Charlotte, North Carolina, United States
Levine Cancer Institute-Ballantyne
🇺🇸Charlotte, North Carolina, United States
St Vincent's Hospital Sydney, The Kinghorn Cancer Centre
🇦🇺Darlinghurst, New South Wales, Australia
University of California, Irvine Medical Center
🇺🇸Orange, California, United States
Universitatsklinikum Tubingen
🇩🇪Tubingen, Germany
Levine Cancer Institute-Albermarle
🇺🇸Albemarle, North Carolina, United States
Universitaetsklinikum Essen
🇩🇪Essen, Germany
Virginia Oncology Associates
🇺🇸Norfolk, Virginia, United States
Swedish Cancer Institute Issaquah Campus
🇺🇸Issaquah, Washington, United States
PRP Diagnostic Imaging
🇦🇺Westmead, New South Wales, Australia
Westmead Hospital
🇦🇺Westmead, New South Wales, Australia
Icon Cancer Care South Brisbane
🇦🇺South Brisbane, Queensland, Australia
Hopital Foch Service Oncologie
🇫🇷Suresnes Cedex, France
Levine Cancer Institute-Monroe
🇺🇸Monroe, North Carolina, United States
CHRUBesangon-H6pital Jean Minjoz
🇫🇷Besancon, France
Swedish Cancer Institute
🇺🇸Seattle, Washington, United States
Sharp Outpatient Infusion Therapy Center
🇺🇸San Diego, California, United States
Fundacao Doutor Amaral Carvalho
🇧🇷Jau, SAO Paulo, Brazil
Winship Cancer Institute, Emory University
🇺🇸Atlanta, Georgia, United States
Levine Cancer Institute-Pineville
🇺🇸Charlotte, North Carolina, United States
Froedtert Hospital/Medical College of Wisconsin
🇺🇸Milwaukee, Wisconsin, United States
Weill Cornell Medical Center - New York Presbyterian Hospital
🇺🇸New York, New York, United States
Liz Plummer Cancer Care Center
🇦🇺Cairns, Queensland, Australia
Medizinische Fakultat Mannheim der Universitat Heidelberg
🇩🇪Mannheim, Germany
Universitatsklinikum Munster
🇩🇪Munster, Germany
Hospital Virgen de la Victoria
🇪🇸Malaga, Malga, Spain
Hospital General Vall D'Hebron-Oncology Service
🇪🇸Barcelona, Spain
Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori
🇮🇹Meldola, Forli - Cesena, Italy
Institut Bergonie, Service d'Oncologie
🇫🇷Bordeaux cedex, France
Clinique Victor Hugo-Centre Jean Bernard
🇫🇷Le Mans Cedex 02, France
Mount Vernon Hospital
🇬🇧Northwood, Middlesex, United Kingdom
Studienpraxis Urologie
🇩🇪Nuertingen, Germany
Eastern Clinical Research Unit
🇦🇺Box Hill, Victoria, Australia
Universitaetsklinikum Wuerzburg
🇩🇪Wuerzburg, Germany
Severance Hospital, Yonsei University Health System
🇰🇷Seoul, Korea, Republic of
Szabolcs- Szatmar-Bereg Megyei Korhazak es Egyetemi Oktato Korhaz
🇭🇺Nyiregyhaza, Hungary
AULSS3 Serenissima - Ospedale dell'Angelo - Oncologia Medica
🇮🇹Mestre, Venezia, Italy
Medizinische Hochschule Hannover
🇩🇪Hannover, Germany
Azienda Ospedaliera San Camillo Forlanini
🇮🇹Roma, Rome, Italy
Instituto Valenciano de Oncologia (IVO-FINCIVO)
🇪🇸Valencia, Spain
Hospital Clinic de Barcelona
🇪🇸Barcelona, Spain
Azienda Ospedaliero Universitari di Parma - U.O. Oncologia Medica
🇮🇹Parma, Italy
Azienda Ospedaliero Universitaria Citta della Salute e della Scienza di Torino
🇮🇹Torino, Italy
Kyungpook National University Chilgok Hospital
🇰🇷Daegu, Korea, Republic of
Szpital Specjalistyczny W Brzozowie, Podkarpacki Osrodek Onkologiczny Im.Ks.B.Markiewicza
🇵🇱Brzozow, Poland
IOV - Istituto Oncologico Veneto IRCCS - U.O. Oncologia Medica 1
🇮🇹Padova, Italy
Hospital Universitario Quironsalud Madrid-Oncology Service
🇪🇸Madrid, Spain
Pusan National University Hospital
🇰🇷Busan, Korea, Republic of
Clinica Universidad de Navarra-Oncology Service
🇪🇸Pamplona, Navarra, Spain
Azienda Ospedaliero-Universitaria S. Luigi Gonzaga-SCDU Oncologia Medica
🇮🇹Orbassano, Torino/piemonte, Italy
Azienda Socio Sanitaria Territoriale di Cremona (Istituti Ospitalieri di Cremona)
🇮🇹Cremona, Italy
Seoul National University Bundang Hospital
🇰🇷Seongnam-si, Gyeonggi-do, Korea, Republic of
Medical Oncology Associates-SD
🇺🇸San Diego, California, United States
Sharp Rees-Stealy
🇺🇸San Diego, California, United States
Piedmont Cancer Institute, PC
🇺🇸Newnan, Georgia, United States
Christian Hospital North East
🇺🇸Saint Louis, Missouri, United States
Levine Cancer Institute
🇺🇸Charlotte, North Carolina, United States
Carolinas Medical Center
🇺🇸Charlotte, North Carolina, United States
Carolina Urologic Research Center
🇺🇸Myrtle Beach, South Carolina, United States
Levine Cancer Institute-Rock Hill
🇺🇸Rock Hill, South Carolina, United States
The University of Texas Health Science Center at Tyler dba UT Health East Texas HOPE Cancer Center
🇺🇸Tyler, Texas, United States
Medical Imaging St Vincent's Hospital Sydney
🇦🇺Darlinghurst, New South Wales, Australia
Icon Cancer Care Wesley
🇦🇺Auchenflower, Queensland, Australia
Icon Cancer Care Chermside
🇦🇺Chermside, Queensland, Australia
Monash Medical Centre
🇦🇺Clayton, Victoria, Australia
Olivia Newton John Cancer Wellness & Research Centre Austin Health
🇦🇺Heidelberg, Victoria, Australia
Ordensklinikum Linz GmbH, Elisabethinen
🇦🇹Linz, Upper Austria, Austria
Medizinische Universitat Wien
🇦🇹Vienna, Austria
Algemeen Ziekenhuis Sint-Lucas
🇧🇪Gent, Belgium
Centre Hospitalier Departemental Les Oudairies
🇫🇷La Roche sur Yon, France
Institut Gustave Roussy
🇫🇷VILLEJUIF cedex, France
Radboud UMC
🇳🇱Nijmegen, THE Netherlands, Netherlands
The Institute of Cancer Research, The Royal Marsden NHS Foundation Trust , Sycamore House
🇬🇧Sutton, Surrey, United Kingdom
Hospital de Caridade de Ijui
🇧🇷Ijui, RIO Grande DO SUL, Brazil
SD Oncologia Clinica Sperimentale di Uro-Ginecologia
🇮🇹Napoli, Italy
Azienda Ospedaliero Universitaria di Parma - U.O. Oncologia Medica
🇮🇹Parma, Italy
Addenbrookes Hospital
🇬🇧Cambridge, United Kingdom
Fundacao Pio XII-Hospital de Cancer de Barretos
🇧🇷Barretos, SAO Paulo, Brazil
Hospital Universitari i Politecnic La Fe
🇪🇸Valencia, Spain
Asan Medical Center
🇰🇷Seoul, Korea, Republic of
Debreceni Egyetem
🇭🇺Debrecen, Hungary
Paracelsus Medical University, SALK
🇦🇹Salzburg, Austria
Diagnosezentrum Meidling
🇦🇹Vienna, Austria
Parkway Surgery Center
🇺🇸Myrtle Beach, South Carolina, United States
Swedish Medical Center
🇺🇸Seattle, Washington, United States
Peninsula Health
🇦🇺Frankston, Victoria, Australia
Vinzenz Pathologieverbund
🇦🇹Linz, Upper Austria, Austria
Cliniques Universitaires Saint-Luc
🇧🇪Bruxelles, Belgium
Swietokrzyskie Centrum Onkologii Samodzielny Publiczny Zaklad Opieki Zdrowotnej
🇵🇱Kielce, Poland
Emory University Hospital
🇺🇸Atlanta, Georgia, United States
Semmelweis Egyetem
🇭🇺Budapest, Hungary
Arizona Oncology Associates
🇺🇸Tempe, Arizona, United States
Isotopix-Ambulatorium fur Nuklearmedizin
🇦🇹Vienna, Austria
Medical University of Vienna
🇦🇹Vienna, Austria
UZ Leuven, Campus Gasthuisberg
🇧🇪Leuven, Belgium
Ordensklinikum Linz, Barmherzige Schwestern
🇦🇹Linz, Upper Austria, Austria
Orszagos Onkologiai Intezet, "C" Belgyogyaszati-Onkologiai es Klinikai Farmakogogiai Osztaly
🇭🇺Budapest, Hungary
Washington University School of Medicine
🇺🇸Saint Louis, Missouri, United States
Levine Cancer Institute- Gaston
🇺🇸Gastonia, North Carolina, United States