A Study of Atezolizumab (Anti-PD-L1 Antibody) in Combination With Enzalutamide in Participants With Metastatic Castration-Resistant Prostrate Cancer (mCRPC) After Failure of an Androgen Synthesis Inhibitor And Failure of, Ineligibility For, or Refusal of a Taxane Regimen
- Conditions
- Prostatic Neoplasms, Castration-Resistant
- Interventions
- Registration Number
- NCT03016312
- Lead Sponsor
- Hoffmann-La Roche
- Brief Summary
This Phase III, multicenter, randomized, open-label study will evaluate the safety and efficacy of atezolizumab (anti-programmed death-ligand 1 \[anti-PD-L1\] antibody) in combination with enzalutamide compared with enzalutamide alone in participants with mCRPC after failure of an androgen synthesis inhibitor (e.g., abiraterone) and failure of, ineligibility for, or refusal of a taxane regimen. Participants will be randomized to one of the two treatment arms (atezolizumab in combination with enzalutamide, and enzalutamide alone) in a 1:1 ratio (experimental to control arm) in global randomized phase. Participants will receive treatment until investigator-assessed confirmed radiographic disease progression per Prostate Cancer Working Group 3 (PCWG3) criteria or unacceptable toxicity.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- Male
- Target Recruitment
- 759
- Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
- Life expectancy greater than or equal to (>/=) 3 months
- Histologically confirmed adenocarcinoma of the prostate
- Known castrate-resistant disease with serum testosterone level less than or equal to (</=) 50 nanograms per deciliter (ng/dL) with prior surgical castration or ongoing androgen deprivation for the duration of the study
- Progressive disease prior to screening by PSA or imaging per PCWG3 criteria during or following the direct prior line of therapy in the setting of medical or surgical castration
- One prior regimen/line of a taxane-containing regimen for mCRPC or refusal or ineligibility of a taxane-containing regimen
- Progression on a prior regimen/line of an androgen synthesis inhibitor for prostate cancer
- Availability of a representative tumor specimen from a site not previously irradiated that is suitable for determination of programmed death-ligand 1 (PD-L1) status via central testing
- Adequate hematologic and end organ function
- Prior treatment with enzalutamide or any other newer hormonal androgen receptor inhibitor (e.g., apalutamide, ODM-201)
- Treatment with any approved anti-cancer therapy, including chemotherapy, immunotherapy, radiopharmaceutical or hormonal therapy (with the exception of abiraterone), within 4 weeks prior to initiation of study treatment
- Treatment with abiraterone within 2 weeks prior to study treatment
- Structurally unstable bone lesions suggesting impending fracture
- Known or suspected brain metastasis or active leptomeningeal disease
- Major surgical procedure other than for diagnosis within 4 weeks prior to initiation of study treatment or anticipation of need for a major surgical procedure during the course of the study
- Active or history of autoimmune disease or immune deficiency
- Prior allogeneic stem cell or solid organ transplantation
- History of idiopathic pulmonary fibrosis, organizing pneumonia (e.g., bronchiolitis obliterans), drug-induced pneumonitis, or idiopathic pneumonitis, or evidence of active pneumonitis on screening chest computed tomography (CT) scan
- Positive human immunodeficiency virus (HIV) test, active tuberculosis, active hepatitis B virus (HBV) or hepatitis C virus (HCV) infection
- Prior treatment with cluster of differentiation (CD)137 agonists or immune checkpoint blockade therapies, including anti Cytotoxic T Lymphocyte-Associated 4 (CTLA4), anti-programmed death 1 (PD-1), and anti-PD-L1 therapeutic antibodies
- Treatment with systemic immunostimulatory agents within 4 weeks or five half-lives of the drug, whichever is shorter, prior to initiation of study treatment
- Treatment with systemic immunosuppressive medication within 2 weeks prior to initiation of study
- History of seizure or any condition that may predispose to seizure within 12 months prior to study treatment, including history of unexplained loss of consciousness or transient ischemic attack
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Atezolizumab + Enzalutamide Enzalutamide Participants will receive atezolizumab along with enzalutamide until investigator-assessed confirmed radiographic disease progression per PCWG3 criteria or unacceptable toxicity (up to approximately 42 months). Atezolizumab + Enzalutamide Atezolizumab Participants will receive atezolizumab along with enzalutamide until investigator-assessed confirmed radiographic disease progression per PCWG3 criteria or unacceptable toxicity (up to approximately 42 months). Enzalutamide Enzalutamide Participants will receive enzalutamide alone until investigator-assessed confirmed radiographic disease progression per PCWG3 criteria or unacceptable toxicity (up to approximately 42 months).
- Primary Outcome Measures
Name Time Method Overall Survival (OS) Baseline until death from any cause (up to approximately 42 months) Overall Survival is defined as the time from randomization to death from any cause.
- Secondary Outcome Measures
Name Time Method Time to PSA Progression, Assessed as Per PCWG3 Criteria Baseline until disease progression (up to approximately 42 months) In participants with no PSA decline from baseline, PSA progression is defined as a ≥25% increase and an absolute increase of ≥2 ng/mL above the baseline value, ≥12 weeks after baseline. In participants with an initial PSA decline from baseline, PSA progression is defined as a ≥25% increase and an absolute increase of ≥2 ng/mL above the nadir value, which is confirmed by a consecutive second value obtained ≥3 weeks later.
Percentage of Participant With Objective Response, as Determined by the Investigator Through Use of PCWG3 Criteria Baseline until disease progression or death from any cause (up to approximately 42 months) Objective response rate in soft tissue lesions, defined as the percentage of participants with either a CR or PR on two consecutive occasions ≥ 6 weeks apart, as determined by the investigator through use of PCWG3 criteria
Percentage of Participants With Adverse Events Baseline up to end of study (up to approximately 42 month) Verbatim description of adverse events will be coded to MedDRA preferred terms and graded according to NCI CTCAE v4.0.
Plasma Concentration of Enzalutamide Predose (0 hr) and 1 hr postdose on Day 1 Cycle 1 and 3 (Cycle length: 21 days); pre-dose (within 1 hr) on Day 1 Cycle 8 Safety visit-Discontinued participants had these visits within approximately 120 days after the last dosing; Study Completion Pre-dose visit-Participants had these visits at the last treatment dosing, samples were taken before the last dosing; Early Discontinuation Pre-dose visit-Participants who discontinued the study had these visits within the 30 days after their last dosing but samples were takes before their last dosing; Study Completion visit-Participants had these visits at their last treatment dosing but samples were taken after their last dosing; Early Discontinuation visit-Participants who discontinued the study had the visits within the 30 days after their last dosing but samples were taken after their last dosing; Unscheduled and Unscheduled Pre-dose Visits- At these visits, participants' samples were collected without dosing event and before dosing dosing at a visit unscheduled per protocol respectively. Enzalutamide Arm had no Atezolizumab dosing.
Radiographic Progression-Free Survival (rPFS), as Assessed by the Investigator and Adapted From the PCWG3 Criteria Baseline until disease progression or death from any cause (up to approximately 42 months) rPFS is defined as the time from randomization to the earliest occurrence of one of the following:
* A participant is considered to have progressed by bone scan if: The first bone scan with ≥2 new lesions compared to baseline is observed \< 12 weeks from randomization and is confirmed by a second bone scan taken ≥6 weeks later showing ≥2 additional new lesions (a total of ≥4 new lesions compared to baseline); the date of progression is the date of the first post-treatment scan, OR After the first post-treatment scan, ≥2 new lesions are observed relative to the first post-treatment scan, which is confirmed on a subsequent scan ≥6 weeks later; the date of progression is the date of the post-treatment scan when ≥2 new lesions were first documented.
* Progression of soft tissue lesions, as defined per PCWG3 modified RECIST v1.1
* Death from any causePercentage of Participants Who Are Radiographic Progression-Free, as Assessed by the Investigator and Adapted From the PCWG3 Criteria Months 6, 12 rPFS is defined as the time from randomization to the earliest occurrence of one of the following:
* A participant is considered to have progressed by bone scan if: The first bone scan with ≥2 new lesions compared to baseline is observed \< 12 weeks from randomization and is confirmed by a second bone scan taken ≥6 weeks later showing ≥2 additional new lesions (a total of ≥4 new lesions compared to baseline); the date of progression is the date of the first post-treatment scan, OR After the first post-treatment scan, ≥2 new lesions are observed relative to the first post-treatment scan, which is confirmed on a subsequent scan ≥6 weeks later; the date of progression is the date of the post-treatment scan when ≥2 new lesions were first documented.
* Progression of soft tissue lesions, as defined per PCWG3 modified RECIST v1.1
* Death from any causeMinimum Observed Serum Concentration (Cmin) of Atezolizumab Pre-infusion (0 hour[hr]) on Day 1 Cycles 1, 2, 3, 4, 8, 12, 16 (Cycle length: 21 days); treatment discontinuation visit, 120 days after last dose (up to approximately 42 months) Safety visit-Discontinued participants had these visits within approximately 120 days after the last dosing; Study Completion Pre-dose visit-Participants had these visits at the last treatment dosing, samples were taken before the last dosing; Early Discontinuation Pre-dose visit-Participants who discontinued the study had these visits within the 30 days after their last dosing but samples were takes before their last dosing; Study Completion visit-Participants had these visits at their last treatment dosing but samples were taken after their last dosing; Early Discontinuation visit-Participants who discontinued the study had the visits within the 30 days after their last dosing but samples were taken after their last dosing; Unscheduled and Unscheduled Pre-dose Visits- At these visits, participants' samples were collected without dosing event and before dosing dosing at a visit unscheduled per protocol respectively. Enzalutamide Arm had no Atezolizumab dosing.
Plasma Concentration of N-Desmethyl Enzalutamide Predose (0 hr) and 1 hr postdose on Day 1 Cycle 1 and 3 (Cycle length: 21 days); pre-dose (within 1 hr) on Day 1 Cycle 8 Safety visit-Discontinued participants had these visits within approximately 120 days after the last dosing; Study Completion Pre-dose visit-Participants had these visits at the last treatment dosing, samples were taken before the last dosing; Early Discontinuation Pre-dose visit-Participants who discontinued the study had these visits within the 30 days after their last dosing but samples were takes before their last dosing; Study Completion visit-Participants had these visits at their last treatment dosing but samples were taken after their last dosing; Early Discontinuation visit-Participants who discontinued the study had the visits within the 30 days after their last dosing but samples were taken after their last dosing; Unscheduled and Unscheduled Pre-dose Visits- At these visits, participants' samples were collected without dosing event and before dosing dosing at a visit unscheduled per protocol respectively. Enzalutamide Arm had no Atezolizumab dosing.
Percentage of Participants Who Survived at Month 6 and 12 Months 6, 12 OS (Overall Survival is defined as the time from randomization to death from any cause) probability at 6 and 12 months
Time to First Symptomatic Skeletal Event (SSE) Baseline up to end of study (up to approximately 42 months) An SSE is defined as external beam radiation therapy to relieve skeletal symptoms (including initiation of radium-223 dichloride or other types of radionuclide therapy to treat symptoms of bone metastases), new symptomatic pathologic bone fracture, clinically apparent occurrence of spinal cord compression, or tumor related orthopedic surgical intervention.
Percentage of Participants With Greater Than (>) 50 Percent (%) Decrease in Prostate-Specific Antigen (PSA) From Baseline Baseline until disease progression (up to approximately 42 months) PSA response rate, defined as a \> 50% decrease in PSA from baseline that is confirmed after ≥ 3 weeks by a consecutive confirmatory PSA measurement
Maximum Observed Serum Concentration (Cmax) of Atezolizumab Day Cycle 1 Day 1 0.5 hr post-infusion (infusion duration: 60 minutes [min]) Safety visit-Discontinued participants had these visits within approximately 120 days after the last dosing; Study Completion Pre-dose visit-Participants had these visits at the last treatment dosing, samples were taken before the last dosing; Early Discontinuation Pre-dose visit-Participants who discontinued the study had these visits within the 30 days after their last dosing but samples were takes before their last dosing; Study Completion visit-Participants had these visits at their last treatment dosing but samples were taken after their last dosing; Early Discontinuation visit-Participants who discontinued the study had the visits within the 30 days after their last dosing but samples were taken after their last dosing; Unscheduled and Unscheduled Pre-dose Visits- At these visits, participants' samples were collected without dosing event and before dosing dosing at a visit unscheduled per protocol respectively. Enzalutamide Arm had no Atezolizumab dosing.
Number of Participants With Anti-Drug Antibodies (ADAs) to Atezolizumab Predose (0 hr) on Day 1 Cycles 1, 2, 3, 4, 8, 12, 16 (Cycle length: 21 days); at atezolizumab discontinuation visit (30 days after last dose); 120 days after last dose of atezolizumab; up to 42 months The numbers and proportions of ADA-positive participants and ADA-negative participants at baseline (baseline prevalence) and after baseline (post-baseline incidence) will be summarized by treatment group.
Enzalutamide Arm has no Atezolizumab dosing therefore no participants to include here for Atezolizumab ADA.
Trial Locations
- Locations (158)
Comprehensive Cancer Centers of Nevada
🇺🇸Las Vegas, Nevada, United States
City of Hope Medical Grp Inc.
🇺🇸Duarte, California, United States
University of California San Diego
🇺🇸La Jolla, California, United States
Kaiser Permanente San Diego - Los Angeles
🇺🇸Los Angeles, California, United States
University of Colorado; Division of Medical Oncology
🇺🇸Aurora, Colorado, United States
Lynn Cancer Institute/Boca Raton Regional Hospital
🇺🇸Boca Raton, Florida, United States
Stamford Hospital; BCC, MOHR
🇺🇸Stamford, Connecticut, United States
Florida Cancer Specialist, North Region
🇺🇸Saint Petersburg, Florida, United States
Investigative Clin Rsch of IN
🇺🇸Indianapolis, Indiana, United States
MSKCC at Basking Ridge
🇺🇸Basking Ridge, New Jersey, United States
New York Oncology Hematology, P.C.
🇺🇸Albany, New York, United States
Penn State Milton S. Hershey Medical Center
🇺🇸Hershey, Pennsylvania, United States
James Cancer Hospital;Solove Research Institute
🇺🇸Columbus, Ohio, United States
University of Pittsburgh Cancer Institute; Division of Medical Oncology
🇺🇸Pittsburgh, Pennsylvania, United States
Carolina Urologic Research Center
🇺🇸Myrtle Beach, South Carolina, United States
Texas Oncology - Memorial City
🇺🇸Houston, Texas, United States
Texas Oncology-Tyler
🇺🇸Irving, Texas, United States
Virginia Oncology Associates
🇺🇸Norfolk, Virginia, United States
Virginia Cancer Specialists - Alexandria
🇺🇸Alexandria, Virginia, United States
Eastern Health; Cancer Services
🇦🇺Box Hill, New South Wales, Australia
Macquarie University Hospital
🇦🇺Macquarie Park, New South Wales, Australia
LKH-UNIV. KLINIKUM GRAZ; Klinische Abteilung für Onkologie
🇦🇹Graz, Austria
Ordensklinikum Linz Elisabethinen; Abteilung für Urologie und Andrologie
🇦🇹Linz, Austria
Onze Lieve Vrouwziekenhuis Aalst
🇧🇪Aalst, Belgium
CHU Sart-Tilman
🇧🇪Liège, Belgium
Lakeridge Health Oshawa; Oncology
🇨🇦Oshawa, Ontario, Canada
Tom Baker Cancer Centre-Calgary
🇨🇦Calgary, Alberta, Canada
Kingston General Hospital
🇨🇦Kingston, Ontario, Canada
Princess Margaret Cancer Center
🇨🇦Toronto, Ontario, Canada
Hopital Charles Lemoyne; Centre Integre de Lutte Contre Le Cancer de La Monteregie
🇨🇦Greenfield Park, Quebec, Canada
Jewish General Hospital
🇨🇦Montreal, Quebec, Canada
Centre Hospitalier Universitaire de Sherbrooke - Hopital Fleurimont
🇨🇦Sherbrooke, Quebec, Canada
Fudan University Shanghai Cancer Center
🇨🇳Shanghai City, China
Jiangsu Cancer Hospital
🇨🇳Nanjing City, China
Friendship Hospital, Capital Medical University
🇨🇳Beijing, China
Zhongshan Hospital Fudan University
🇨🇳Shanghai, China
Masarykuv onkologicky ustav
🇨🇿Brno, Czechia
Fakultni nemocnice u sv. Anny v Brne
🇨🇿Brno, Czechia
Thomayerova nemocnice
🇨🇿Praha 4 - Krc, Czechia
Centre Francois Baclesse; Oncologie
🇫🇷Caen, France
Hopital Louis Pasteur; Medecine B
🇫🇷Colmar, France
Centre Oscar Lambret; Chir Cancerologie General
🇫🇷Lille, France
Hopital Saint Louis, Service D Oncologie Medicale
🇫🇷Paris, France
Hopital d'Instruction des Armees de Begin
🇫🇷Saint-Mande, France
Institut Claudius Regaud; Departement Oncologie Medicale
🇫🇷Toulouse, France
Medizinische Hochschule Hannover; Klinik für Urologie und Onkologische Urologie
🇩🇪Hannover, Germany
Universitätsklinikum Münster, Klinik für Urologie und Kinderurologie
🇩🇪Münster, Germany
Universitätsklinikum Tübingen; Klinik für Urologie
🇩🇪Tübingen, Germany
Anticancer Hospital Ag Savas; 1St Dept of Internal Medicine
🇬🇷Athens, Greece
Urologisches Zentrum Euregio; Würselen, Urologische Praxis am Wasserturm
🇩🇪Würselen, Germany
Alexandras Hospital; Dept. of Clin. Therapeutics, Athens Uni School of Medicine
🇬🇷Athens, Greece
Athens Medical Center; Dept. of Oncology
🇬🇷Athens, Greece
IASO General Hospital of Athens
🇬🇷Athens, Greece
Agioi Anargyroi Cancer Hospital; 2Nd Oncology Dept.
🇬🇷Kifisia, Greece
Papageorgiou General Hospital; Medical Oncology
🇬🇷Thessaloniki, Greece
University Hospital of Patras Medical Oncology
🇬🇷Patras, Greece
Debreceni Egyetem Klinikai Kozpont ; Department of Oncology
🇭🇺Debrecen, Hungary
Semmelwies University of Medicine; Urology Dept.
🇭🇺Budapest, Hungary
Orszagos Onkologiai Intezet; "C" Belgyógyászati-Onkológiai és Klinikai Farmakológiai Osztály
🇭🇺Budapest, Hungary
A.O. Universitaria Policlinico Di Modena; Oncologia
🇮🇹Modena, Emilia-Romagna, Italy
Azienda Ospedaliera San Camillo Forlanini; Oncologia Medica
🇮🇹Roma, Lazio, Italy
ISTITUTO NAZIONALE TUMORI IRCCS FONDAZIONE G. PASCALE; Dipartimento Uro-Ginecologico
🇮🇹Napoli, Campania, Italy
A.O. Istituti Ospitalieri - Cremona; S.C. Oncologia
🇮🇹Cremona, Lombardia, Italy
Irccs Istituto Europeo Di Oncologia (IEO); Cure Mediche
🇮🇹Milano, Lombardia, Italy
IRCCS AOU San Martino - IST; Oncologia Medica 1
🇮🇹Genova, Liguria, Italy
Irccs Istituto Nazionale Dei Tumori (Int);S.C. Medicina Oncologica 2
🇮🇹Milano, Lombardia, Italy
Irccs Ist. Tumori Giovanni Paolo Ii; Dipartimento Oncologia Medica
🇮🇹Bari, Puglia, Italy
IRCCS Ospedale Casa Sollievo Della Sofferenza; Oncologia
🇮🇹San Giovanni Rotondo, Puglia, Italy
Ospedale Area Aretina Nord; U.O.C. Oncologia
🇮🇹Arezzo, Toscana, Italy
IRCCS Istituto Oncologico Veneto (IOV); Oncologia Medica Prima
🇮🇹Padova, Veneto, Italy
Nagoya City University Hospital
🇯🇵Aichi, Japan
Toho University Sakura Medical Center
🇯🇵Chiba, Japan
Kyushu University Hospital
🇯🇵Fukuoka, Japan
National Hospital Organization Hokkaido Cancer Center
🇯🇵Hokkaido, Japan
Kitasato University Hospital
🇯🇵Kanagawa, Japan
Niigata University Medical & Dental Hospital
🇯🇵Niigata, Japan
Nara Medical University Hospital
🇯🇵Nara, Japan
Kansai Medical University Hospital
🇯🇵Osaka, Japan
Toranomon Hospital
🇯🇵Tokyo, Japan
Nippon Medical School Hospital
🇯🇵Tokyo, Japan
The Jikei University Hospital
🇯🇵Tokyo, Japan
Woj. Wielospec. Centrum Onkologii i Traumatologii
🇵🇱?ód?, Poland
National Cancer Center
🇰🇷Goyang-si, Korea, Republic of
Seoul National University Hospital
🇰🇷Seoul, Korea, Republic of
Asan Medical Center
🇰🇷Seoul, Korea, Republic of
Samsung Medical Center
🇰🇷Seoul, Korea, Republic of
Medical University of Bialystok; Oncology clinic
🇵🇱Bialystok, Poland
Przychodnia Lekarska KOMED, Roman Karaszewski
🇵🇱Konin, Poland
SPZOZ Opolskie Centrum Onkologii im. Prof. Tadeusza Koszarawskiego
🇵🇱Opole, Poland
Szpital Uniwersytecki w Krakowie, Oddzia? Kliniczny Kliniki Onkologii
🇵🇱Kraków, Poland
Europejskie Centrum Zdrowia Otwock Szpital im. Fryderyka Chopina, Klinika Onkologii
🇵🇱Otwock, Poland
Szpital Sw. Elzbiety - Mokotowskie Centrum Medyczne Sp. z o.o.
🇵🇱Warszawa, Poland
Wojewodzki Szpital; Specjalistyczny ul.
🇵🇱Wroclaw, Poland
Russian Scientific Center of Roentgenoradiology
🇷🇺Moscow, Moskovskaja Oblast, Russian Federation
SBEI HPE "The First St.Petersburg State Medical University n.a. acad. I.P.Pavlova"of MoH of RF
🇷🇺Sankt-peterburg, Sankt Petersburg, Russian Federation
Institut Catala d?Oncologia Hospital Germans Trias i Pujol
🇪🇸Badalona, Barcelona, Spain
Corporacio Sanitaria Parc Tauli; Servicio de Oncologia
🇪🇸Sabadell, Barcelona, Spain
Insititut Catala D'Oncologia
🇪🇸Hospitalet de Llobregat, Barcelona, Spain
Hospital Universitario Reina Sofia; Servicio de Oncologia
🇪🇸Córdoba, Cordoba, Spain
Clinica Universitaria de Navarra; Servicio de Oncologia
🇪🇸Pamplona, Navarra, Spain
Hospital Clinico San Carlos; Servicio de Oncologia
🇪🇸Madrid, Spain
Hospital de la Santa Creu i Sant Pau; Servicio de Oncologia
🇪🇸Barcelona, Spain
Hospital Universitario 12 de Octubre; Servicio de Oncologia
🇪🇸Madrid, Spain
Inselspital Bern; Universitätsklinik für Medizinische Onkologie, Klinische Forschungseinheit
🇨🇭Bern, Switzerland
Hospital Universitario Virgen del Rocio; Servicio de Oncologia
🇪🇸Sevilla, Spain
TAIPEI VETERANS GENERAL HOSPITAL, Urology
🇨🇳Taipei, Taiwan
National Taiwan University Hospital, Department of Urology
🇨🇳Taipei, Taiwan
Taichung Veterans General Hospital; Division of Urology
🇨🇳Taichung, Taiwan
Kantonsspital St. Gallen; Onkologie/Hämatologie
🇨🇭St. Gallen, Switzerland
Chang Gung Memorial Hospital-LinKou; Urology
🇨🇳Taoyuan, Taiwan
Leicester Royal Infirmary
🇬🇧Leicester, United Kingdom
Royal Blackburn Hospital
🇬🇧Blackburn, United Kingdom
Barts and the London NHS Trust.
🇬🇧London, United Kingdom
The Christie NHS Foundation Trust
🇬🇧Manchester, United Kingdom
Sarah Cannon Research Institute
🇬🇧London, United Kingdom
Royal Marsden Hospital; Institute of Cancer Research
🇬🇧Sutton, United Kingdom
Columbia University Medical Center
🇺🇸New York, New York, United States
UC Irvine Medical Center
🇺🇸Orange, California, United States
Allegheny Cancer Center
🇺🇸Pittsburgh, Pennsylvania, United States
Oncology Hematology Care, Inc.
🇺🇸Cincinnati, Ohio, United States
Texas Oncology Cancer Center
🇺🇸Austin, Texas, United States
Miriam Hospital
🇺🇸Providence, Rhode Island, United States
Memorial Sloan-Kettering Cancer Center
🇺🇸New York, New York, United States
Texas Oncology - Methodist Dallas Cancer Center
🇺🇸Dallas, Texas, United States
Texas Oncology, P.A. - Fort Worth
🇺🇸Fort Worth, Texas, United States
Pacific Hematology Oncology Associates
🇺🇸San Francisco, California, United States
Karmanos Cancer Institute..
🇺🇸Detroit, Michigan, United States
Yale School of Medicine
🇺🇸New Haven, Connecticut, United States
Associates in Oncology/Hematology P.C.
🇺🇸Rockville, Maryland, United States
UZ Gent
🇧🇪Gent, Belgium
Dana-Farber Cancer Institute
🇺🇸Boston, Massachusetts, United States
Miami Cancer Institute of Baptist Health, Inc.
🇺🇸Miami, Florida, United States
Urology Cancer Center & GU Research Network
🇺🇸Omaha, Nebraska, United States
Sarah Cannon Research Institute / Tennessee Oncology
🇺🇸Chattanooga, Tennessee, United States
Medizinische Universität Wien; Universitätsklinik für Urologie
🇦🇹Wien, Austria
CHU de Québec - Université Laval - Hôtel-Dieu de Québec
🇨🇦Quebec, Canada
Institut Gustave Roussy
🇫🇷Villejuif, France
SCRI Florida Cancer Specialists South
🇺🇸Fort Myers, Florida, United States
Charleston Oncology, P .A
🇺🇸Charleston, South Carolina, United States
Clinique Chenieux; Oncology
🇫🇷Limoges, France
Universitätsklinikum Freiburg; Chirurgische Klinik; Abteilung Urologie
🇩🇪Freiburg, Germany
National Cancer Center East
🇯🇵Chiba, Japan
Nebraska Cancer Specialists; Oncology Hematology West, PC
🇺🇸Omaha, Nebraska, United States
University Hospital Kyoto Prefectural University of Medicine
🇯🇵Kyoto, Japan
P.A. Herzen Oncological Inst. ; Oncology
🇷🇺Moscow, Moskovskaja Oblast, Russian Federation
Royal Brisbane & Women's Hosp; Cancer Care Serv
🇦🇺Herston, Queensland, Australia
Adelaide Cancer Centre
🇦🇺Kurralta Park, South Australia, Australia
Monash Medical Centre; Oncology
🇦🇺Clayton, Victoria, Australia
Institut Sainte-Catherine; Oncologie
🇫🇷Avignon, France
Yokohama City University Medical Center
🇯🇵Kanagawa, Japan
Aalborg Universitetshospital; Onkologisk Afdeling
🇩🇰Aalborg, Denmark
Odense Universitetshospital, Onkologisk Afdeling R
🇩🇰Odense C, Denmark
Herlev Hospital; Afdeling for Kræftbehandling
🇩🇰Herlev, Denmark
Hospital Universitari Vall d'Hebron; Oncology
🇪🇸Barcelona, Spain
Hospital Clínic i Provincial; Servicio de Oncología
🇪🇸Barcelona, Spain
Hospital Ramon y Cajal; Servicio de Oncologia
🇪🇸Madrid, Spain
Hospital Clinico Universitario Virgen de la Victoria; Servicio de Oncologia
🇪🇸Malaga, Spain
Concord Repatriation General Hospital; Concord Cancer Centre
🇦🇺Concord, New South Wales, Australia