A Study Evaluating Safety and Efficacy of Venetoclax in Combination With Azacitidine Versus Standard of Care After Allogeneic Stem Cell Transplantation (SCT) in Participants With Acute Myeloid Leukemia (AML)
- Conditions
- Acute Myeloid Leukemia (AML)Cancer
- Interventions
- Registration Number
- NCT04161885
- Lead Sponsor
- AbbVie
- Brief Summary
The main objective of this study is to evaluate the efficacy of venetoclax in combination with azacitidine to improve Overall Survival (OS) in Acute Myeloid Leukemia (AML) participants compared to Best Supportive Care (BSC) when given as maintenance therapy following allogeneic stem cell transplantation (SCT).
This study will have 2 parts: Part 1 (Dose Confirmation), which may include participants who are greater than or equal to 18 years old; Part 2 (Randomization) which may include participants who are greater than or equal to 12 years old. During Part 1, recommended Phase 3 dose of venetoclax in combination with azacitidine will be determined and during Part 2, the efficacy and safety of venetoclax with azacitidine (Part 2 Arm A) will be compared with BSC (Part 2 Arm B).
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- ACTIVE_NOT_RECRUITING
- Sex
- All
- Target Recruitment
- 465
- Participants must be at least 18 years old for Part 1 and, at least 12 years old for Part 2.
- Participant must be diagnosed with Acute Myeloid Leukemia (AML) by World Health Organization (WHO) criteria (2017) and either be planning for allogeneic stem cell transplantation or have received allogeneic stem cell transplantation within the past 60 days.
- Blast percentage in bone marrow before transplant must be < 10%.
- Blast count in peripheral blood must be "0" and Blast percentage in bone marrow must be < 5% after transplant.
- Participant meet adequate renal, hepatic and hematologic criteria as described in the protocol.
- Participants >= 17 years old must have a Karnofsky Performance Scale (KPS) score > 50 and participants between 12 to 16 years old must have a Lansky Play Performance Scale score > 40.
- History of disease progression during prior treatment with venetoclax.
- History of any other malignancy within 2 years prior to study entry, except for: Adequately treated in situ carcinoma of the cervix uteri or carcinoma in situ of breast; basal cell carcinoma of the skin or localized squamous cell carcinoma of the skin; previous malignancy confined and surgically resected (or treated with other modalities) with curative intent; Myelodysplastic Syndrome, Myeloproliferative neoplasm (only allowed if it transformed to AML and AML should be the indication for marrow transplantation).
- Participant has known infection with HIV or history of being positive for hepatitis B virus (HBV) or hepatitis C virus (HCV) infection.
- Presence of clinical or laboratory symptoms/signs of extramedullary myeloid malignancy.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Part 1: Venetoclax + Azacitidine (AZA) + Best Supportive Care Best Supportive Care (BSC) Participants will be administered various doses and dose regiments of venetoclax and AZA. Venetoclax will be administered once daily (QD) (Days 1-28) for up to 24 cycles, AZA QD on Days 1-5 of each 28-day cycle for up to 6 cycles and best supportive care (BSC) for 24 cycles (each cycle = 28 days) Part 2: Arm B - Best Supportive Care (BSC) Best Supportive Care (BSC) Participants will receive treatment as prescribed by their physician according to the BSC for up to 24 cycles (1 cycle = 28 days) Part 2: Arm A - Venetoclax + Azacitidine (AZA) + BSC Best Supportive Care (BSC) Participants will be administered with venetoclax and AZA at a dose level determined in Part 1 in addition to best supportive care (when required). Venetoclax will be administered once daily (QD) (Days 1-28) for up to 24 cycles, AZA QD on Days 1-5 of each 28-day cycle for up to 6 cycles and best supportive care (BSC) for 24 cycles (each cycle = 28 days). Part 1: Venetoclax + Azacitidine (AZA) + Best Supportive Care Venetoclax Participants will be administered various doses and dose regiments of venetoclax and AZA. Venetoclax will be administered once daily (QD) (Days 1-28) for up to 24 cycles, AZA QD on Days 1-5 of each 28-day cycle for up to 6 cycles and best supportive care (BSC) for 24 cycles (each cycle = 28 days) Part 1: Venetoclax + Azacitidine (AZA) + Best Supportive Care Azacitidine Participants will be administered various doses and dose regiments of venetoclax and AZA. Venetoclax will be administered once daily (QD) (Days 1-28) for up to 24 cycles, AZA QD on Days 1-5 of each 28-day cycle for up to 6 cycles and best supportive care (BSC) for 24 cycles (each cycle = 28 days) Part 2: Arm A - Venetoclax + Azacitidine (AZA) + BSC Venetoclax Participants will be administered with venetoclax and AZA at a dose level determined in Part 1 in addition to best supportive care (when required). Venetoclax will be administered once daily (QD) (Days 1-28) for up to 24 cycles, AZA QD on Days 1-5 of each 28-day cycle for up to 6 cycles and best supportive care (BSC) for 24 cycles (each cycle = 28 days). Part 2: Arm A - Venetoclax + Azacitidine (AZA) + BSC Azacitidine Participants will be administered with venetoclax and AZA at a dose level determined in Part 1 in addition to best supportive care (when required). Venetoclax will be administered once daily (QD) (Days 1-28) for up to 24 cycles, AZA QD on Days 1-5 of each 28-day cycle for up to 6 cycles and best supportive care (BSC) for 24 cycles (each cycle = 28 days).
- Primary Outcome Measures
Name Time Method Number of Participants With Dose-Limiting Toxicities (DLTs) Following Administration of Venetoclax and Azacitidine (Part 1) Up to the first treatment cycle (28 days) DLTs are any of the hematologic, nonhematologic toxicities, adverse events (AEs) occurring following administration of venetoclax and AZA as described in the protocol and evaluated by the Investigator and the sponsor.
Overall Survival (OS) (Part 2) Up to 45 months after the first participant is randomized OS is defined as the number of days from the date of randomization to the date of death from any cause.
- Secondary Outcome Measures
Name Time Method Composite Relapse-Free Survival (RFS) (Part 2) Up to 39 months after the first participant is randomized Morphologic relapse from AML, non-morphologic relapse from AML, which is defined as increase in disease burden determined by standard methods with reappearance or acquisition of new findings with or without change in anti-leukemic treatment per investigator decision due to cytogenetic abnormalities or change in molecular marker or measurable residual disease by multiparameter flow with sensitivity to at least 10\^-3; or the date of death from any cause, whichever comes first as determined by IRC.
Graft-versus-Host Disease (GvHD)-free, Relapse Free Survival (GRFS) (Part 2) Up to 39 months after the first participant is randomized GRFS is defined as number of days from the date of randomization to occurrence of disease relapse OR incidence of GvHD OR death from any cause.
Graft-versus-Host Disease (GvHD) Rate (Part 2) Up to 39 months after the first participant is randomized GvHD rate is defined as grade 2 or higher for acute graft-versus-host disease (aGvHD) and moderate/severe for chronic graft-versus-host disease (cGvHD) assessed by investigator.
Change in Patient Reported Signs, Symptoms and Impact of Acute Myeloid Leukemia (AML) as Measured by the European Quality-of-Life-5 Dimensional-5-Level (EQ-5D-5L) Up to 39 months after the first participant is randomized The EQ-5D-5L is a generic preference instrument that has been validated in numerous population and has 5 dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. These dimensions are measured on a 5-point scale: with higher scores representing better functioning/quality of life and greater symptom burden.
Measurable Residual Disease (MRD) Response Rate in Participants With MRD >= 10^-3 at Randomization (Part 2) Up to 39 months after the first participant is randomized MRD conversion rate is defined as percentage of participants who convert to MRD \< 10\^-3 after initiation of treatment.
Change From Randomization in Fatigue in Adult Participants (Part 2) Up to 39 months after the first participant is randomized Fatigue is measured as Patient Reported Outcome (PRO) using Patient Reported Outcomes Measurement Information System (PROMIS) Cancer Fatigue SF 7a.
Change from Baseline in Physical Functioning as Measured by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-C30) (Part 2) Up to 39 months after the first participant is randomized The EORTC-QLQ-C30 is a 30-item patient-reported questionnaire composed of both multi-item and single scales including 5 functional scales (physical, role, emotional, social, and cognitive), 3 symptom scales (fatigue, nausea and vomiting, and pain), a global health status/QoL scale, and 6 single items (dyspnea, insomnia, appetite loss, constipation, diarrhea, and financial difficulties). Participantts rate items on a 4-point scale ranging from 1 to 4 (1 = Not at All, 2 = A Little, 3 = Quite a Bit, and 4 = Very Much).
Time to Deterioration in Global Health Status (GHS)/Quality of Life (QoL) in Adult Participants (Part 2) Up to 39 months after the first participant is randomized Time to deterioration defined as number of days from randomization to either deterioration of \>= 5 points based on the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) version 3 or death due to any cause.
Morphologic Relapse-Free Survival (RFS) (Part 2) Up to 39 months after the first participant is randomized Morphologic relapse from AML defined as bone marrow blasts of \>= 5% or reappearance of blasts in the peripheral blood not attributable to any other cause (e.g., bone marrow regeneration) in at least 2 peripheral blood samples at least one week apart or development of extramedullary disease after achieving a complete remission (CR) or complete remission with incomplete count recovery (CRi); or the date of death from any cause, whichever comes first as determined by Independent Review Committee (IRC).
Trial Locations
- Locations (165)
Hospital Clinico Universitario de Valencia /ID# 215106
🇪🇸Valencia, Spain
Hospital Universitario Virgen del Rocio /ID# 215463
🇪🇸Sevilla, Spain
Arizona Oncology - Scottsdale - Cancer Transplant Institute /ID# 239711
🇺🇸Scottsdale, Arizona, United States
University of Arizona Cancer Center - Tucson /ID# 242507
🇺🇸Tucson, Arizona, United States
University of Arkansas for Medical Sciences /ID# 239804
🇺🇸Little Rock, Arkansas, United States
City of Hope /ID# 213681
🇺🇸Duarte, California, United States
UCHSC Anschultz Cancer Pavilion /ID# 215618
🇺🇸Aurora, Colorado, United States
Colorado Blood Cancer Institute /ID# 215980
🇺🇸Denver, Colorado, United States
Mayo Clinic /ID# 239710
🇺🇸Jacksonville, Florida, United States
AdventHealth Medical Group Blood & Marrow Transplant at Orlando /ID# 213985
🇺🇸Orlando, Florida, United States
Ann & Robert H Lurie Children's Hospital of Chicago /ID# 215840
🇺🇸Chicago, Illinois, United States
The University of Chicago Medical Center /ID# 215616
🇺🇸Chicago, Illinois, United States
Loyola University Medical Ctr /ID# 215617
🇺🇸Maywood, Illinois, United States
Indiana Blood & Marrow Transpl /ID# 215842
🇺🇸Indianapolis, Indiana, United States
Duplicate_Ochsner Clinic Foundation-New Orleans /ID# 213834
🇺🇸New Orleans, Louisiana, United States
University of Maryland, Baltimore /ID# 213855
🇺🇸Baltimore, Maryland, United States
Massachusetts General Hospital /ID# 215765
🇺🇸Boston, Massachusetts, United States
Karmanos Cancer Institute - Dresner Clinic /ID# 214581
🇺🇸Detroit, Michigan, United States
Masonic Cancer Center /ID# 239492
🇺🇸Minneapolis, Minnesota, United States
Mayo Clinic - Rochester /ID# 214685
🇺🇸Rochester, Minnesota, United States
University of Mississippi Medical Center /ID# 239343
🇺🇸Jackson, Mississippi, United States
The John Theurer Cancer /ID# 215251
🇺🇸Hackensack, New Jersey, United States
Montefiore Medical Center - Moses Campus /ID# 241669
🇺🇸Bronx, New York, United States
Roswell Park Cancer Institute /ID# 217857
🇺🇸Buffalo, New York, United States
Columbia University Medical Center /ID# 240875
🇺🇸New York, New York, United States
Memorial Sloan Kettering Cancer Center-Koch Center /ID# 240680
🇺🇸New York, New York, United States
Weill Cornell Medical College /ID# 214887
🇺🇸New York, New York, United States
University of North Carolina /ID# 215814
🇺🇸Chapel Hill, North Carolina, United States
Wake Forest Univ HS /ID# 239210
🇺🇸Winston-Salem, North Carolina, United States
UC Health - Cincinnati /ID# 239263
🇺🇸Cincinnati, Ohio, United States
University Hospitals - Seidman Cancer Center /ID# 239260
🇺🇸Cleveland, Ohio, United States
University of Oklahoma, Stephenson Cancer Center /ID# 215611
🇺🇸Oklahoma City, Oklahoma, United States
Oregon Health and Science University /ID# 215874
🇺🇸Portland, Oregon, United States
Penn State Hershey Medical Ctr /ID# 217120
🇺🇸Hershey, Pennsylvania, United States
Children's Hospital of Philadelphia - Main /ID# 215410
🇺🇸Philadelphia, Pennsylvania, United States
Perelman Center for Advanced Medicine /ID# 214518
🇺🇸Philadelphia, Pennsylvania, United States
Duplicate_Allegheny General Hospital /ID# 216756
🇺🇸Pittsburgh, Pennsylvania, United States
UPMC Hillman Cancer Ctr /ID# 213715
🇺🇸Pittsburgh, Pennsylvania, United States
TriStar Centennial Medical Center /ID# 218750
🇺🇸Nashville, Tennessee, United States
Texas Oncology - Medical City Dallas /ID# 216720
🇺🇸Dallas, Texas, United States
Texas Oncology- Baylor Charles A. Sammons Cancer Center /ID# 213735
🇺🇸Dallas, Texas, United States
Texas Transplant Institute /ID# 214691
🇺🇸San Antonio, Texas, United States
Virginia Commonwealth University Medical Center Main Hospital /ID# 239203
🇺🇸Richmond, Virginia, United States
Fred Hutchinson Cancer Research Center /ID# 214436
🇺🇸Seattle, Washington, United States
Univ of Wisconsin Hosp/Clinics /ID# 216096
🇺🇸Madison, Wisconsin, United States
The Kinghorn Cancer Centre /ID# 214660
🇦🇺Darlinghurst, New South Wales, Australia
Royal Adelaide Hospital /ID# 215678
🇦🇺Adelaide, South Australia, Australia
Peter MacCallum Cancer Ctr /ID# 214653
🇦🇺Melbourne, Victoria, Australia
The Alfred Hospital /ID# 240931
🇦🇺Melbourne, Victoria, Australia
Hospital de Clinicas de Porto Alegre /ID# 215042
🇧🇷Porto Alegre, Rio Grande Do Sul, Brazil
Hospital Amaral Carvalho - Fundacao Doutor Amaral Carvalho /ID# 215145
🇧🇷Jaú, Sao Paulo, Brazil
Hospital Nove de Julho /ID# 242359
🇧🇷São Paulo, Sao Paulo, Brazil
Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao /ID# 239516
🇧🇷Sao Paulo, Brazil
Vancouver Coastal Health Research Institute (VCHRI) /ID# 215363
🇨🇦Vancouver, British Columbia, Canada
University Health Network_Princess Margaret Cancer Centre /ID# 215344
🇨🇦Toronto, Ontario, Canada
CIUSSS de l'est de l'Ile-de-Montreal - Hopital Maisonneuve-Rosemont /ID# 214591
🇨🇦Montreal, Quebec, Canada
Royal Victoria Hospital / McGill University Health Centre /ID# 215253
🇨🇦Montreal, Quebec, Canada
Saskatoon Cancer Centre /ID# 238821
🇨🇦Saskatoon, Saskatchewan, Canada
Peking University People's Hospital /ID# 215551
🇨🇳Beijing, Beijing, China
Chinese PLA General Hospital /ID# 216287
🇨🇳Beijing, Beijing, China
Aerospace Center Hospital /ID# 217018
🇨🇳Beijing, Beijing, China
Fujian Medical University Union Hospital /ID# 215555
🇨🇳Fuzhou, Fujian, China
Guangdong Provincial People's Hospital /ID# 218666
🇨🇳Guangzhou, Guangdong, China
Zhujiang Hospital of Southern Medical University /ID# 216333
🇨🇳Guangzhou, Guangdong, China
Nanfang Hospital of Southern Medical University /ID# 215553
🇨🇳Guangzhou, Guangdong, China
Shenzhen Second People's Hospital /ID# 239401
🇨🇳Shenzhen, Guangdong, China
Henan Cancer Hospital /ID# 215554
🇨🇳Zhengzhou, Henan, China
Tongji Hospital Tongji Medical College Huazhong University of Science and Techno /ID# 215552
🇨🇳Wuhan, Hubei, China
Union Hospital Tongji Medical College Huazhong University of Science and Technol /ID# 238373
🇨🇳Wuhan, Hubei, China
Xiangya Hospital Central South University /ID# 219025
🇨🇳Changsha, Hunan, China
Zhongda Hospital Southeast University /ID# 218926
🇨🇳Nanjing, Jiangsu, China
The First Affiliated Hospital of Soochow University /ID# 216605
🇨🇳Suzhou, Jiangsu, China
The Affiliated Hospital of Xuzhou Medical College /ID# 239098
🇨🇳Xuzhou, Jiangsu, China
The First Affiliated Hospital of Nanchang University /ID# 239168
🇨🇳Nanchang, Jiangxi, China
Shanghai Changhai Hospital /ID# 216334
🇨🇳Shanghai, Shanghai, China
Tangdu Hospital of The Fourth Military Medical University, PLA /ID# 216282
🇨🇳Xi'an, Shanxi, China
Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sc /ID# 215546
🇨🇳Tianjin, Tianjin, China
The First Affiliated Hospital, Zhejiang University School of Medicine /ID# 215550
🇨🇳Hangzhou, Zhejiang, China
Fakultní Nemocnice Brno - Jihlavská /ID# 214811
🇨🇿Brno, Brno-mesto, Czechia
Fakultní nemocnice Hradec Králové - Sokolská /ID# 214814
🇨🇿Hradec Králové, Hradec Kralove, Czechia
Fakultni Nemocnice Ostrava /ID# 239922
🇨🇿Ostrava, Ostrava-mesto, Czechia
Ustav hematologie a krevni transfuze /ID# 215133
🇨🇿Praha, Czechia
Duplicate_CHU de Nice - Hôpital Archet 1 /ID# 214056
🇫🇷Nice, Alpes-Maritimes, France
CHU de Besancon - Jean Minjoz /ID# 241171
🇫🇷Besancon, Doubs, France
Duplicate_CHU Bordeaux - Hopital Haut Leveque /ID# 214055
🇫🇷Pessac, Gironde, France
Hopital Pitie Salpetriere /ID# 241072
🇫🇷Paris Cedex 13, Ile-de-France, France
CHRU Lille - Hopital Claude Huriez /ID# 217916
🇫🇷Lille, Nord, France
CHU de Nantes, Hotel Dieu -HME /ID# 214060
🇫🇷Nantes, Pays-de-la-Loire, France
Hôpital Saint-Louis /ID# 214054
🇫🇷Paris, France
AP-HP - Hopital Saint-Antoine /ID# 216957
🇫🇷Paris, France
Universitaetsklinik Heidelberg /ID# 216623
🇩🇪Heidelberg, Baden-Wuerttemberg, Germany
Klinikum Augsburg /ID# 239583
🇩🇪Augsburg, Bayern, Germany
Universitaetsklinikum Wuerzburg /ID# 215212
🇩🇪Wuerzburg, Bayern, Germany
Universitaetsklinikum Muenster /ID# 215213
🇩🇪Muenster, Nordrhein-Westfalen, Germany
Universitaetsklinikum Carl Gustav Carus Dresden /ID# 214244
🇩🇪Dresden, Sachsen, Germany
Universitaetsklinikum Leipzig /ID# 245892
🇩🇪Leipzig, Sachsen, Germany
Universitaetsklinikum Halle (Saale) /ID# 239585
🇩🇪Halle (Saale), Germany
Medizinische Hochschule Hannover /ID# 214243
🇩🇪Hannover, Germany
General Hospital of Athens Evangelismos /ID# 238810
🇬🇷Athens, Attiki, Greece
University General Hospital Attikon /ID# 238812
🇬🇷Athens, Attiki, Greece
University General Hospital of Patras /ID# 238811
🇬🇷RION Patras Achaia, Greece
Debreceni Egyetem-Klinikai Kozpont /ID# 241123
🇭🇺Debrecen, Hajdu-Bihar, Hungary
Rambam Health Care Campus /ID# 214507
🇮🇱Haifa, H_efa, Israel
Schneider Children's Medical Center /ID# 224326
🇮🇱Petah Tikva, HaMerkaz, Israel
Sheba Medical Center /ID# 239571
🇮🇱Ramat Gan, Tel-Aviv, Israel
The Chaim Sheba Medical Center /ID# 214305
🇮🇱Ramat Gan, Tel-Aviv, Israel
Tel Aviv Sourasky Medical Center /ID# 214508
🇮🇱Tel Aviv, Tel-Aviv, Israel
Hadassah Medical Center-Hebrew University /ID# 218697
🇮🇱Jerusalem, Yerushalayim, Israel
Rabin Medical Center /ID# 214509
🇮🇱Petah Tikva, Israel
IRCCS Ospedale San Raffaele /ID# 214311
🇮🇹Milan, Milano, Italy
Istituto Europeo Di Oncologia /ID# 242579
🇮🇹Milan, Milano, Italy
A.O.U. CITTA' DELLA SALUTE E DELLA SCIENZA DI TORINO - Ospedale Molinette /ID# 216148
🇮🇹Torino, Piemonte, Italy
Azienda Ospedaliero-Universitaria Policlinico Umberto I /ID# 254964
🇮🇹Rome, Roma, Italy
Fondazione Policlinico Universitario Agostino Gemelli IRCCS-Università Cattolica /ID# 214910
🇮🇹Rome, Roma, Italy
ASST degli Spedali Civili di Brescia /ID# 215997
🇮🇹Brescia, Italy
Anjou Kousei Hospital /ID# 215857
🇯🇵Anjo-shi, Aichi, Japan
Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital /ID# 215679
🇯🇵Nagoya-shi, Aichi, Japan
University of Fukui Hospital /ID# 253383
🇯🇵Yoshida-gun, Fukui, Japan
Kyushu University Hospital /ID# 215285
🇯🇵Fukuoka-shi, Fukuoka, Japan
Fukushima Medical University Hospital /ID# 252293
🇯🇵Fukushima-shi, Fukushima, Japan
Hiroshima Red Cross Hospital & Atomic-bomb Survivors Hospital /ID# 217522
🇯🇵Hiroshima-shi, Hiroshima, Japan
Hokkaido University Hospital /ID# 215937
🇯🇵Sapporo-shi, Hokkaido, Japan
Kobe City Medical Center General Hospital /ID# 215388
🇯🇵Kobe-shi, Hyogo, Japan
Hyogo Medical University Hospital /ID# 215389
🇯🇵Nishinomiya-shi, Hyogo, Japan
Kanazawa University Hospital /ID# 242955
🇯🇵Kanazawa-shi, Ishikawa, Japan
Imamura General Hospital /ID# 215688
🇯🇵Kagoshima-shi, Kagoshima, Japan
Tokai University Hospital /ID# 250086
🇯🇵Isehara, Kanagawa, Japan
Kanagawa Cancer Center /ID# 215029
🇯🇵Yokohama-shi, Kanagawa, Japan
Kyoto University Hospital /ID# 243209
🇯🇵Kyoto-shi, Kyoto, Japan
Tohoku University Hospital /ID# 214670
🇯🇵Sendai-shi, Miyagi, Japan
Okayama University Hospital /ID# 214842
🇯🇵Okayama-shi, Okayama, Japan
Osaka Metropolitan University Hospital /ID# 215227
🇯🇵Osaka-shi, Osaka, Japan
Kindai University Hospital /ID# 214917
🇯🇵Osakasayama-shi, Osaka, Japan
Jichi Medical University Saitama Medical Center /ID# 216092
🇯🇵Saitama-shi, Saitama, Japan
Jichi Medical University Hospital /ID# 216091
🇯🇵Shimotsuke-shi, Tochigi, Japan
Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital /ID# 215939
🇯🇵Bunkyo-ku, Tokyo, Japan
National Cancer Center Hospital /ID# 242639
🇯🇵Chuo-ku, Tokyo, Japan
Toranomon Hospital /ID# 215311
🇯🇵Minato-ku, Tokyo, Japan
National Center for Child Health and Development /ID# 242479
🇯🇵Setagaya-ku, Tokyo, Japan
Keio University Hospital /ID# 243549
🇯🇵Shinjuku-ku, Tokyo, Japan
Yamagata University Hospital /ID# 253304
🇯🇵Yamagata-shi, Yamagata, Japan
Seoul National University Hospital /ID# 214891
🇰🇷Seoul, Seoul Teugbyeolsi, Korea, Republic of
Asan Medical Center /ID# 214893
🇰🇷Seoul, Seoul Teugbyeolsi, Korea, Republic of
Samsung Medical Center /ID# 239087
🇰🇷Seoul, Seoul Teugbyeolsi, Korea, Republic of
The Catholic University of Korea, Seoul St. Marys Hospital /ID# 214892
🇰🇷Seoul, Seoul Teugbyeolsi, Korea, Republic of
Hospital Clinic de Barcelona /ID# 215108
🇪🇸Barcelona, Spain
Hospital Santa Creu i Sant Pau /ID# 240397
🇪🇸Barcelona, Spain
Hospital General Universitario Gregorio Maranon /ID# 215107
🇪🇸Madrid, Spain
Hospital Universitario Ramon y Cajal /ID# 218102
🇪🇸Madrid, Spain
Hospital Universitario La Paz /ID# 218103
🇪🇸Madrid, Spain
Duplicate_Universitätsspital Basel /ID# 215892
🇨🇭Basel, Basel-Stadt, Switzerland
University Hospital Zurich /ID# 215891
🇨🇭Zurich, Zuerich, Switzerland
National Taiwan University Hospital /ID# 215245
🇨🇳Taipei City, Taipei, Taiwan
Kaohsiung Medical University Chung-Ho Memorial Hospital /ID# 215197
🇨🇳Kaohsiung, Taiwan
China Medical University Hospital /ID# 215198
🇨🇳Taichung, Taiwan
Taichung Veterans General Hospital /ID# 239288
🇨🇳Taichung, Taiwan
Taipei Veterans General Hosp /ID# 239289
🇨🇳Taipei, Taiwan
Linkou Chang Gung Memorial Hospital /ID# 215319
🇨🇳Taoyuan City, Taiwan
Hammersmith Hospital /ID# 215665
🇬🇧London, England, United Kingdom
Gartnavel General Hospital /ID# 215663
🇬🇧Glasgow, Glasgow City, United Kingdom
University College London Hospital /ID# 215662
🇬🇧London, Greater London, United Kingdom
University Hospitals Birmingham NHS Foundation Trust /ID# 215120
🇬🇧Birmingham, United Kingdom
The Royal Marsden NHS Foundation Trust /ID# 215124
🇬🇧London, United Kingdom
The Newcastle Upon Tyne Hospitals NHS Foundation Trust /ID# 248359
🇬🇧Newcastle upon Tyne, United Kingdom
King's College Hospital NHS Foundation Trust /ID# 215338
🇬🇧London, United Kingdom