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Study To Evaluate the Efficacy and Safety Of Bevacizumab, and Associated Biomarkers, In Combination With Paclitaxel Compared With Paclitaxel Plus Placebo as First-line Treatment Of Patients With Her2-Negative Metastatic Breast Cancer

Phase 3
Completed
Conditions
Metastatic Breast Cancer
Interventions
Registration Number
NCT01663727
Lead Sponsor
Hoffmann-La Roche
Brief Summary

This is a Phase III, randomized, double-blind, placebo-controlled multicenter study to evaluate the efficacy and safety of bevacizumab administered in combination with paclitaxel in patients with previously untreated, locally recurrent, or metastatic HER2-negative breast cancer. Patients will be randomized to one of two treatment arms: bevacizumab or placebo. All patients will be given an intravenous (IV) infusion of of paclitaxel (90 mg/m2) for 3 weeks during each 28-day cycle. bevacizumab or placebo (10 mg/kg) will be administered by IV infusion on Days 1 and 15 of each 28-day cycle. Patients will be treated until disease progression, unacceptable toxicity or death from any cause occurs.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
481
Inclusion Criteria
  • Histologically or cytologically confirmed, HER2-negative adenocarcinoma of the breast, with measurable or non-measurable locally recurrent or metastatic disease. Locally recurrent disease must not be amenable to resection with curative intent.
  • ECOG performance status of 0 or 1
  • For women of childbearing potential, use of an acceptable and effective method of non-hormonal contraception
  • For patients who have received recent radiotherapy, recovery prior to randomization from any significant acute toxicity, and radiation treatments have to be completed more than 3 weeks from randomization
Exclusion Criteria

Disease-Specific Exclusions:

  • HER2-positive status
  • Prior chemotherapy for locally recurrent or metastatic disease
  • Prior hormonal therapy < 2 weeks prior to randomization
  • Prior adjuvant or neo-adjuvant chemotherapy is allowed, provided its conclusion has been for at least 12 months prior to randomization
  • Investigational therapy within 28 days of randomization

General Medical Exclusions:

  • Life expectancy of < 12 weeks
  • Inadequate organ function
  • Uncontrolled serious medical or psychiatric illness
  • Active infection requiring intravenous (IV) antibiotics at screening
  • Pregnancy or lactation
  • History of other malignancies within 5 years prior to screening, except for tumors with a negligible risk for metastasis or death

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
ABevacizumab [Avastin]Paclitaxel + Bevacizumab \[Avastin\]
BPaclitaxelPaclitaxel + Placebo
BPlaceboPaclitaxel + Placebo
APaclitaxelPaclitaxel + Bevacizumab \[Avastin\]
Primary Outcome Measures
NameTimeMethod
Percentage of Participants With Progression or Death in Intent-to-Treat (ITT) PopulationBaseline, every 8 weeks until documented disease progression, death or clinical cut-off (up to 117.7 weeks)

Tumor assessment was performed as per Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST v1.1) by investigator. Disease progression was defined as at least 20 percent (%) increase in the sum of diameters of target lesions compared to smallest sum of diameters on-study and absolute increase of at least 5 millimeter (mm), unequivocal progression of existing non-target lesions, or presence of new lesions.

Progression Free Survival (PFS) in ITT PopulationBaseline, every 8 weeks until documented disease progression, death or clinical cut-off (up to 117.7 weeks)

PFS was defined as the interval between the date of randomization and the first documentation of progressive disease or death from any cause. Tumor assessment was performed as per RECIST v1.1 by investigator. Disease progression was defined as at least 20% increase in the sum of diameters of target lesions compared to smallest sum of diameters on-study and absolute increase of at least 5 mm, unequivocal progression of existing non-target lesions, or presence of new lesions. PFS was estimated using Kaplan Meier method.

PFS in High Baseline Plasma VEGF-A ITT PopulationBaseline, every 8 weeks until documented disease progression, death or clinical cut-off (up to 111.3 weeks)

PFS was defined as the interval between the date of randomization and the first documentation of progressive disease or death from any cause. Tumor assessment was performed as per RECIST v1.1 by investigator. Disease progression was defined as at least 20% increase in the sum of diameters of target lesions compared to smallest sum of diameters on-study and absolute increase of at least 5 mm, unequivocal progression of existing non-target lesions, or presence of new lesions. PFS was estimated using Kaplan Meier method.

Percentage of Participants With Progression or Death in High Baseline Plasma Vascular Endothelial Growth Factor-A (VEGF-A) ITT PopulationBaseline, every 8 weeks until documented disease progression, death or clinical cut-off (up to 111.3 weeks)

Tumor assessment was performed as per RECIST v1.1 by investigator. Disease progression was defined as at least 20% increase in the sum of diameters of target lesions compared to smallest sum of diameters on-study and absolute increase of at least 5 mm, unequivocal progression of existing non-target lesions, or presence of new lesions.

Secondary Outcome Measures
NameTimeMethod
Percentage of Participants Who Died - ITT PopulationFrom randomization till death or clinical cut-off (up to 244 weeks)
Percentage of Participants With an Objective Response - ITT PopulationBaseline, every 8 weeks until documented disease progression, death or clinical cut-off (up to 117.7 weeks)

Objective response was defined as having a Complete Response (CR) or Partial Response (PR) according to a RECIST criteria v 1.1. CR was defined as disappearance of all target and non-target lesions and no new lesions, all pathological lymph nodes must have decreased to \<10 mm in short axis and normalization of tumor marker level. PR was defined as at least a 30% decrease in the sum of diameters of target lesions (taking as reference the baseline sum diameters), no progression in non-target lesions, and no new lesions. Measurable disease was defined by the presence of at least one measurable lesion by clinical measurement, chest x-ray, computed tomography (CT), or magnetic resonance imaging (MRI).

Percentage of Participants With an Objective Response - High Baseline Plasma VEGF-A ITT PopulationBaseline, every 8 weeks until documented disease progression, death or clinical cut-off (up to 111.3 weeks)

Objective response was defined as having a CR or PR according to a RECIST criteria v 1.1. CR was defined as disappearance of all target and non-target lesions and no new lesions, all pathological lymph nodes must have decreased to \<10 mm in short axis and normalization of tumor marker level. PR was defined as at least a 30% decrease in the sum of diameters of target lesions (taking as reference the baseline sum diameters), no progression in non-target lesions, and no new lesions. Measurable disease was defined by the presence of at least one measurable lesion by clinical measurement, chest x-ray, CT, or MRI.

Overall Survival (OS) - ITT PopulationFrom randomization till death or clinical cut-off (up to 244 weeks)

OS was defined as the interval between the date of randomization and death from any cause. OS was estimated using Kaplan Meier method.

Secondary: Percentage of Participants Who Were Alive at 1 Year - High Baseline Plasma VEGF-A ITT Population1 year
Percentage of Participants Who Died - High Baseline Plasma VEGF-A ITT PopulationFrom randomization till death or clinical cut-off (up to 244 weeks)
OS - High Baseline Plasma VEGF-A ITT PopulationFrom randomization till death or clinical cut-off (up to 244 weeks)

OS was defined as the interval between the date of randomization and death from any cause. OS was estimated using Kaplan Meier method.

Duration of Response - ITT PopulationBaseline, every 8 weeks until documented disease progression or clinical cut-off (up to 117.7 weeks)

Duration of response was defined as the time from the initial date of the objective response to documented disease progression or death (whichever occurred first). Objective response was defined as having a CR or PR according to a RECIST criteria v 1.1. CR was defined as disappearance of all target and non-target lesions and no new lesions, all pathological lymph nodes must have decreased to \<10 mm in short axis and normalization of tumor marker level. PR was defined as at least a 30% decrease in the sum of diameters of target lesions (taking as reference the baseline sum diameters), no progression in non-target lesions, and no new lesions. Disease progression was defined as at least 20% increase in the sum of diameters of target lesions compared to smallest sum of diameters on-study and absolute increase of at least 5 mm, unequivocal progression of existing non-target lesions, or presence of new lesions. Analysis was performed using Kaplan Meier method.

Percentage of Participants Who Were Alive at 1 Year - ITT Population1 year
Duration of Response - High Baseline Plasma VEGF-A ITT PopulationBaseline, every 8 weeks until documented disease progression or clinical cut-off (up to 111.3 weeks)

Duration of response was defined as the time from the initial date of the objective response to documented disease progression or death (whichever occurred first). Objective response was defined as having a CR or PR according to a RECIST criteria v 1.1. CR was defined as disappearance of all target and non-target lesions and no new lesions, all pathological lymph nodes must have decreased to \<10 mm in short axis and normalization of tumor marker level. PR was defined as at least a 30% decrease in the sum of diameters of target lesions (taking as reference the baseline sum diameters), no progression in non-target lesions, and no new lesions. Disease progression was defined at least 20% increase in the sum of diameters of target lesions compared to smallest sum of diameters on-study and absolute increase of at least 5 mm, unequivocal progression of existing non-target lesions, or presence of new lesions. Analysis was performed using Kaplan Meier method.

Trial Locations

Locations (173)

Univ of Texas Medical Branch

🇺🇸

Galveston, Texas, United States

Texas Oncology, P.A.

🇺🇸

The Woodlands, Texas, United States

Wellmonth Physician Services

🇺🇸

Bristol, Virginia, United States

West Virginia University; Endocrinology

🇺🇸

Morgantown, West Virginia, United States

Kumamoto City Hospital

🇯🇵

Kumamoto, Japan

Iwate Medical University Hospital

🇯🇵

Iwate, Japan

Fondazione Salvatore Maugeri IRCCS

🇮🇹

Pavia, Lombardia, Italy

Gifu University Hospital

🇯🇵

Gifu, Japan

NHO Kyushu Cancer Center

🇯🇵

Fukuoka, Japan

Lviv State Oncological Regional Treatment and Diagnostic Center

🇺🇦

Lviv, Ukraine

CCCH City Oncological Center SHEI Uzhgorod NU

🇺🇦

Uzhgorod, Ukraine

Velindre Cancer Centre

🇬🇧

Cardiff, United Kingdom

Peterborough City Hospital

🇬🇧

Peterborough, United Kingdom

Hopelands Cancer Centre Durban

🇿🇦

Durban, South Africa

Medical Research Centre

🇵🇦

Panama, Panama

SHI Republican Clinical Oncological Dispensary of HM RT

🇷🇺

Kazan, Russian Federation

NHO Osaka National Hospital

🇯🇵

Osaka, Japan

NHO Shikoku Cancer Center; Dept of Respiratory Medicine

🇯🇵

Ehime, Japan

Samsung Medical Center

🇰🇷

Seoul, Korea, Republic of

Hyogo College of Medicine Hospital

🇯🇵

Hyogo, Japan

Kindai University Hospital

🇯🇵

Osaka, Japan

Seoul National University Hospital

🇰🇷

Seoul, Korea, Republic of

University of Pretoria; Department of Medical Oncology

🇿🇦

Pretoria, South Africa

Kyiv Сity Clinical Oncological Center

🇺🇦

Kyiv, Ukraine

RCI Sumy Regional Clinical Oncological Dispensary

🇺🇦

Sumy, Ukraine

Medical and Prophylactic Institution Volyn Regional Oncological Dispensary

🇺🇦

Lutsk, Ukraine

Western General Hospital

🇬🇧

Edinburgh, United Kingdom

Mary Potter Oncology Centre

🇿🇦

Groenkloof, South Africa

Mount Vernon Hospital

🇬🇧

Middlesex, United Kingdom

CI Dnipropetrovsk CMCH 4 of Dnipropetrovsk RC Dept of Chemotherapy SI Dnipropetrovsk MA of MOHU

🇺🇦

Dnipropetrovsk, Ukraine

Royal Devon and Exeter Hospital (Wonford)

🇬🇧

Exeter, United Kingdom

Hiroshima University Hospital

🇯🇵

Hiroshima, Japan

Asan Medical Center.

🇰🇷

Seoul, Korea, Republic of

City Clinical Oncology Dispensary

🇷🇺

Saint-Petersburg, Russian Federation

Cape Town Oncology Trials

🇿🇦

Cape Town, South Africa

Non-state Healthcare Institution "Road Clinical Hospital of JSC Russian Railways"

🇷🇺

St. Petersburg, Russian Federation

Seoul National University Bundang Hospital

🇰🇷

Gyeonggi-do, Korea, Republic of

Severance Hospital, Yonsei University Health System; Pharmacy

🇰🇷

Seoul, Korea, Republic of

NHO Hokkaido Cancer Center

🇯🇵

Sapporo-shi, Japan

Peachtree Hematology & Oncology Consultants, Pc

🇺🇸

Atlanta, Georgia, United States

Arizona Cancer Center

🇺🇸

Tucson, Arizona, United States

Northeast Georgia Cancer Care LLC

🇺🇸

Athens, Georgia, United States

Washington University; Center for Adv Medicine

🇺🇸

Saint Louis, Missouri, United States

Long Beach Memorial Medical Center; Oncology

🇺🇸

Long Beach, California, United States

CTPI Chernihiv Regional Oncological Dispensary

🇷🇺

Chernihiv, Russian Federation

Ospedale Mater Salutis

🇮🇹

Legnago (VR), Lombardia, Italy

Missouri Cancer Associates

🇺🇸

Columbia, Missouri, United States

Pennsylvania Oncology Hematology Associates, Inc.; PA Oncology & Hematology

🇺🇸

Philadelphia, Pennsylvania, United States

Hospital Provincial del Centenario

🇦🇷

Rosario, Argentina

Texas Oncology, P.A. - Fort Worth

🇺🇸

Fort Worth, Texas, United States

Virginia Oncology Associates - Hampton

🇺🇸

Hampton, Virginia, United States

Texas Oncology, P.A. - Dallas Presbyterian

🇺🇸

Dallas, Texas, United States

Centro Oncologico Riojano Integral (CORI)

🇦🇷

La Rioja, Argentina

CHU Ambroise Paré; Hematology and Oncology Department

🇧🇪

Mons, Belgium

Northwest Medical Specialties, PLLC; Research Department

🇺🇸

Tacoma, Washington, United States

Washington Hospital

🇺🇸

Washington, District of Columbia, United States

The Jones Clinic, PC

🇺🇸

New Albany, Mississippi, United States

Hematology Oncology Associates of the Treasure Coast

🇺🇸

Port Saint Lucie, Florida, United States

Texas Oncology-Medical City Dallas

🇺🇸

Dallas, Texas, United States

Oncology and Hematology Assoc. of SW VA, Inc. - Low Moor

🇺🇸

Low Moor, Virginia, United States

UZ Brussel

🇧🇪

Brussel, Belgium

UZ Antwerpen

🇧🇪

Edegem, Belgium

Lahey Clinic Inc. - PARENT ACCOUNT

🇺🇸

Burlington, Massachusetts, United States

Virginia Cancer Specialists, PC

🇺🇸

Fairfax, Virginia, United States

Virginia Oncology Associates - Virginia Beach

🇺🇸

Virginia Beach, Virginia, United States

Centro de Investigacion Pergamino SA

🇦🇷

Pergamino, Argentina

Texas Oncology- Southwest Fort Worth

🇺🇸

Fort Worth, Texas, United States

Instituto de Oncología de Rosario

🇦🇷

Rosario, Argentina

ISIS Clinica Especializada

🇦🇷

Santa Fe, Argentina

FBI "Scientific Research Institute of Oncology n. a. N. N. Petrov"

🇷🇺

Saint-Petersburg, Russian Federation

Universitaetsklinikum Ulm

🇩🇪

Ulm, Germany

Hospital das Clinicas - FMUSP Ribeirao Preto

🇧🇷

Ribeirao Preto, SP, Brazil

Texas Oncology, P.A. - Garland

🇺🇸

Garland, Texas, United States

Sanatorio Parque S.A.

🇦🇷

Rosario, Santa FE, Argentina

Texas Oncology Plano West

🇺🇸

Plano, Texas, United States

Azienda Ospedaliera A. Cardarelli

🇮🇹

Napoli, Campania, Italy

Virginia Oncology Associates

🇺🇸

Norfolk, Virginia, United States

GHdC Site Saint-Joseph

🇧🇪

Gilly (Charleroi), Belgium

Oncology and Hematology Assoc. of SW VA, Inc.

🇺🇸

Salem, Virginia, United States

Oncology and Hematology Assoc. of SW VA, Inc. - Wytheville

🇺🇸

Wytheville, Virginia, United States

Hospital Britanico de Buenos Aires

🇦🇷

Ciudad Autonoma Buenos Aires, Argentina

Instituto CAICI

🇦🇷

Rosario, Argentina

Instituto de Investigaciones Clínicas Quilmes

🇦🇷

Quilmes, Argentina

Hospital da Cidade de Passo Fundo; Centro de Pesquisa em Oncologia

🇧🇷

Passo Fundo, RS, Brazil

National Hospital; Oncotherapy Dept

🇿🇦

Bloemfontein, South Africa

UMHAT Tsaritsa Yoanna - ISUL, EAD

🇧🇬

Sofia, Bulgaria

St. Johannes Hospital; Klinik fuer innere Medizin II, Onkologie, Haematologie

🇩🇪

Dortmund, Germany

Universidade Federal de Sao Paulo - UNIFESP

🇧🇷

Sao Paulo, SP, Brazil

Universitätsklinikum Heidelberg

🇩🇪

Heidelberg, Germany

St. Elisabeth-Krankenhaus

🇩🇪

Köln, Germany

University of Alabama at Birmingham

🇺🇸

Birmingham, Alabama, United States

IU Cancer Pavilion

🇺🇸

Indianapolis, Indiana, United States

CancerCare Centers of South Texas

🇺🇸

San Antonio, Texas, United States

SCRI-Tennessee Oncology

🇺🇸

Nashville, Tennessee, United States

Cancer Care Centers of South Texas

🇺🇸

San Antonio, Texas, United States

Oncology & Hematology Associates of SW Va Inc. - Market Street

🇺🇸

Christiansburg, Virginia, United States

SHATOD - Sofia City, EOOD

🇧🇬

Sofia, Bulgaria

Complex Oncological Center - Plovdiv, EOOD

🇧🇬

Plovdiv, Bulgaria

SHATOD - Sofia District, EOOD

🇧🇬

Sofia, Bulgaria

COC - Veliko Tarnovo

🇧🇬

Veliko Tarnovo, Bulgaria

Fundacion Arturo Lopez Perez

🇨🇱

Santiago, Chile

MHAT Dr. Tota Venkova AD

🇧🇬

Gabrovo, Bulgaria

SHATOD Haskovo EOOD

🇧🇬

Haskovo, Bulgaria

MHAT Serdika, EOOD

🇧🇬

Sofia, Bulgaria

Instituto Nacional del Cancer

🇨🇱

Santiago, Chile

Complex Oncological Center - Shumen, EOOD; Department of Chemotherapy

🇧🇬

Shumen, Bulgaria

Instituto Oncologico Ltda.

🇨🇱

Viña del Mar, Chile

Institutul Oncologic Prof. Dr. Ion Chiricuta Cluj-Napoca; Radioterapie I - Oncologie

🇷🇴

Cluj-Napoca, Romania

SHATOD Dr. Marko Antonov Markov-Varna, EOOD

🇧🇬

Varna, Bulgaria

Centro de Estudios Oncologicos de Santiago (CEOS) Oncologia

🇨🇱

Santiago, Chile

Institutul Oncologic "Prof. Dr. Al. Trestioreanu"

🇷🇴

Bucuresti, Romania

Centro Hemato Oncologico Panama

🇵🇦

Panama, Panama

Centro de Pesquisas Oncologicas - CEPON

🇧🇷

Florianopolis, SC, Brazil

Tokai University Hospital

🇯🇵

Kanagawa, Japan

Tohoku University Hospital

🇯🇵

Miyagi, Japan

Toranomon Hospital

🇯🇵

Tokyo, Japan

Osaka International Cancer Institute

🇯🇵

Osaka, Japan

Shizuoka General Hospital

🇯🇵

Shizuoka-shi, Japan

Tokyo Metropolitan Cancer and Infectious diseases Center Komagome Hospital

🇯🇵

Tokyo, Japan

Cancer Care Centers of S Texas

🇺🇸

Kerrville, Texas, United States

Texas Oncology- Longview Cancer Center

🇺🇸

Longview, Texas, United States

Wilshire Oncology Medical Group

🇺🇸

West Covina, California, United States

Sylvester Comprehensive Cancer Center - Deerfield Beach; Sylvester Cancer Center

🇺🇸

Deerfield Beach, Florida, United States

Tenet Health System Desert Inc

🇺🇸

Palm Springs, California, United States

Wilshire Oncology Medical Group; Oncology

🇺🇸

Pomona, California, United States

Florida Cancer Specialists - Broadway

🇺🇸

Fort Myers, Florida, United States

Maryland Oncology Hematology, P.A.

🇺🇸

Columbia, Maryland, United States

BRCR Medical Center, Inc.

🇺🇸

Plantation, Florida, United States

Greater Baltimore Medical Center

🇺🇸

Baltimore, Maryland, United States

Hackensack University Medical Center

🇺🇸

Hackensack, New Jersey, United States

ProMedica Hickman Cancer Center at Flower Hospital; Hickman Cancer Center

🇺🇸

Sylvania, Ohio, United States

Virginia Cancer Specialists - Leesburg

🇺🇸

Leesburg, Pennsylvania, United States

Signal Point Clinical; Research Center, LLC

🇺🇸

Middletown, Ohio, United States

Texas Oncology, P.A. - Tyler

🇺🇸

The Woodlands, Texas, United States

Virginia Cancer Specialists - Alexandria

🇺🇸

Alexandria, Virginia, United States

Virginia Oncology Associates - Chesapeake

🇺🇸

Chesapeake, Virginia, United States

Fairfax Northern Virginia Hematology-Oncology PC

🇺🇸

Arlington, Virginia, United States

Virginia Oncology Associates - New Port News

🇺🇸

Newport News, Virginia, United States

Oncology & Hematolgy Associates of SW Va Inc. - Roanoke

🇺🇸

Roanoke, Virginia, United States

Virginia Cancer Specialists - Gainsville

🇺🇸

Gainesville, Virginia, United States

AZ KLINA

🇧🇪

Brasschaat, Belgium

Clinica de Tratamento e Pesquisa Oncologica - Oncotek

🇧🇷

Brasilia, DF, Brazil

Hospital Sao Lucas - PUCRS; Pesquisa Clinica

🇧🇷

Porto Alegre, RS, Brazil

Clinica de Oncologia de Porto Alegre - CliniOnco

🇧🇷

Porto Alegre, RS, Brazil

Clinica de Neoplasias Litoral

🇧🇷

Itajai, SC, Brazil

Hakuaikai Sagara Hospital

🇯🇵

Kagoshima, Japan

Studienzentrum Aschaffenburg

🇩🇪

Aschaffenburg, Germany

Wilhelm-Anton-Hospital gGmbH

🇩🇪

Goch, Germany

Ospedale degli Infermi

🇮🇹

Rimini, Emilia-Romagna, Italy

Ospedale San Raffaele

🇮🇹

Milano, Lombardia, Italy

Ospedale Casa Sollievo Della Sofferenza IRCCS

🇮🇹

San Giovanni Rotondo, Puglia, Italy

Ospedale Versilia

🇮🇹

Lido Di Camaiore, Toscana, Italy

Niigata Cancer Center Hospital

🇯🇵

Niigata, Japan

Kumamoto University Hospital

🇯🇵

Kumamoto, Japan

Juntendo University Hospital

🇯🇵

Tokyo, Japan

National Cancer Centre

🇰🇷

Gyeonggi-do, Korea, Republic of

Oncomed SRL

🇷🇴

Timisoara, Romania

Medisprof SRL

🇷🇴

Cluj-Napoca, Romania

Regional Clinical Oncology Dispensary

🇷🇺

Krasnodar, Russian Federation

SBEIHPE SSMU n.a. I.P.Pavlov of MOH and SD of RF

🇷🇺

Saint-Petersburg, Russian Federation

Samara Regional Oncology Dispensary

🇷🇺

Samara, Russian Federation

CCTPI Donetsk Regional Antitumor Center

🇺🇦

Donetsk, Ukraine

Hopelands Cancer Centre

🇿🇦

Hilton, South Africa

Cancercare

🇿🇦

Port Elizabeth, South Africa

Derriford Hospital; Clinical Neurology Research Group

🇬🇧

Plymouth, United Kingdom

Texas Oncology, P.A. - McAllen; South Texas Cancer Center-McAllen

🇺🇸

McAllen, Texas, United States

University of Toledo; Dept. of Medicine

🇺🇸

Toledo, Ohio, United States

Hematology Oncology Associates of Fredericksburg, Inc.

🇺🇸

Fredericksburg, Virginia, United States

Hospital Nossa Senhora da Conceicao

🇧🇷

Porto Alegre, RS, Brazil

CI Cherkasy Regional Oncological Dispensary of Cherkasy RC RC of Clinical Oncology

🇺🇦

Cherkassy, Ukraine

Medical University of South Carolina; Division of Hematology-Oncology

🇺🇸

Charleston, South Carolina, United States

Kaiser Foundation Hospital; Dr. Eron's Office

🇺🇸

Honolulu, Hawaii, United States

FSBSI "Russian Oncological Scientific Center n.a. N.N. Blokhin"

🇷🇺

Moscow, Russian Federation

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