Study of Sacituzumab Govitecan-hziy Versus Treatment of Physician's Choice in Participants With HR+/HER2- Metastatic Breast Cancer

Phase 3

Completed

Conditions: Metastatic Breast Cancer

Interventions: Drug: Eribulin
Drug: Sacituzumab Govitecan-hziy
Drug: Capecitabine
Drug: Gemcitabine
Drug: Vinorelbine

Registration Number: NCT03901339

Lead Sponsor: Gilead Sciences

Brief Summary: The primary objective of this study is to assess and compare the efficacy and safety of sacituzumab govitecan-hzi versus treatment of physician's choice (TPC) in participants with hormonal receptor-positive (HR+) human epidermal growth factor receptor 2 (HER2-) negative metastatic breast cancer (MBC).

Detailed Description: Not available

Recruitment & Eligibility

Status: COMPLETED

Sex: All

Target Recruitment: 543

Inclusion Criteria

Documented evidence of hormone receptor-positive human epidermal growth factor receptor 2 negative (HER2-negative) (hormonal receptor-positive (HR+)/HER2-) metastatic breast cancer (MBC) confirmed.
Refractory to or relapsed after at least 2, and no more than 4, prior systemic chemotherapy regimens for metastatic disease:
- At least 1 taxane in any setting.
- At least 1 prior anticancer hormonal treatment in any setting.
- At least 1 cyclin-dependent kinase inhibitor 4/6 in any setting.
Eligible for one of the chemotherapy options listed in the TPC arm.
Documented disease progression after the most recent therapy.
Adequate bone marrow function (hemoglobin ≥ 9 g/dL, absolute neutrophil count (ANC) ≥ 1,500 per mm^3, platelets ≥ 100,000 per mm^3).
Adequate renal function: calculated creatinine clearance ≥ 30 mL/minute according to the Cockcroft and Gault formula .
Adequate liver function (bilirubin ≤ 1.5 institutional upper limit of normal (IULN), or ≤ 3 IULN for individuals with documented Gilbert's syndrome, aspartate aminotransferase (AST) and Alanine aminotransferase (ALT) ≤ 2.5 x IULN (in the case of liver metastases ≤ 5.0 x IULN)).
Females must not be lactating or pregnant at Screening or Baseline (as documented by a negative beta human chorionic gonadotropin (ß-hCG)).

Key

Exclusion Criteria

Previous treatment with topoisomerase 1 Inhibitors as a free form or as other formulations.
History of significant cardiovascular disease or clinically significant electrocardiogram (ECG) abnormality.
Active serious infection requiring antibiotics.
Any medical or other condition which, in the opinion of the Investigator, causes the individual to be medically unfit to receive sacituzumab govitecan or unsuitable for any reason.
Locally advanced MBC (stage IIIc) in individuals who are candidates for curative intent therapy at the time of study enrollment.

Note: Other protocol defined Inclusion/Exclusion criteria may apply.

Study Type: INTERVENTIONAL

Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Treatment of Physician's Choice (TPC)	Eribulin	Participants will receive TPC determined prior to randomization from one of the following single-agent treatment: Dosing per National Comprehensive Cancer Network (NCCN) guidelines (with dose modifications for if toxic) * Eribulin: 1.4 mg/m\^2 for North American sites, 1.23 mg/m\^2 for European sites) via IV on Days 1 and 8 of a 21-day cycle * Capecitabine: 1000-1250 mg/m\^2 orally twice daily for 2 weeks followed by a 1-week rest period given as a 21-day cycle * Gemcitabine: 800-1200 mg/m\^2 via IV on Days 1, 8, and 15 of each 28-day cycle or per institution * Vinorelbine: 25 mg/m\^2 via IV on Day 1 weekly cycle per institution
Sacituzumab Govitecan-hziy	Sacituzumab Govitecan-hziy	Participants will receive sacituzumab govitecan-hziy 10 mg/kg via intravenous (IV) injection administered on Day 1 and Day 8 of a 21-day cycle.
Treatment of Physician's Choice (TPC)	Gemcitabine	Participants will receive TPC determined prior to randomization from one of the following single-agent treatment: Dosing per National Comprehensive Cancer Network (NCCN) guidelines (with dose modifications for if toxic) * Eribulin: 1.4 mg/m\^2 for North American sites, 1.23 mg/m\^2 for European sites) via IV on Days 1 and 8 of a 21-day cycle * Capecitabine: 1000-1250 mg/m\^2 orally twice daily for 2 weeks followed by a 1-week rest period given as a 21-day cycle * Gemcitabine: 800-1200 mg/m\^2 via IV on Days 1, 8, and 15 of each 28-day cycle or per institution * Vinorelbine: 25 mg/m\^2 via IV on Day 1 weekly cycle per institution
Treatment of Physician's Choice (TPC)	Capecitabine	Participants will receive TPC determined prior to randomization from one of the following single-agent treatment: Dosing per National Comprehensive Cancer Network (NCCN) guidelines (with dose modifications for if toxic) * Eribulin: 1.4 mg/m\^2 for North American sites, 1.23 mg/m\^2 for European sites) via IV on Days 1 and 8 of a 21-day cycle * Capecitabine: 1000-1250 mg/m\^2 orally twice daily for 2 weeks followed by a 1-week rest period given as a 21-day cycle * Gemcitabine: 800-1200 mg/m\^2 via IV on Days 1, 8, and 15 of each 28-day cycle or per institution * Vinorelbine: 25 mg/m\^2 via IV on Day 1 weekly cycle per institution
Treatment of Physician's Choice (TPC)	Vinorelbine	Participants will receive TPC determined prior to randomization from one of the following single-agent treatment: Dosing per National Comprehensive Cancer Network (NCCN) guidelines (with dose modifications for if toxic) * Eribulin: 1.4 mg/m\^2 for North American sites, 1.23 mg/m\^2 for European sites) via IV on Days 1 and 8 of a 21-day cycle * Capecitabine: 1000-1250 mg/m\^2 orally twice daily for 2 weeks followed by a 1-week rest period given as a 21-day cycle * Gemcitabine: 800-1200 mg/m\^2 via IV on Days 1, 8, and 15 of each 28-day cycle or per institution * Vinorelbine: 25 mg/m\^2 via IV on Day 1 weekly cycle per institution

Primary Outcome Measures

Name	Time	Method
Progression-Free Survival (PFS) by Blinded Independent Central Review (BICR) Assessment	Up to 42.8 months	PFS was defined as the time from the date of randomization to the date of the first documentation of disease progression or death (whichever occurred first) according to BICR using Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1). Disease progression was defined as an increase of greater than 20% in the sum of the longest diameter (LD) of target lesions and a 5 mm absolute increase, taking as a reference the smallest sum LD recorded since the baseline assessment or the appearance of new non-target lesions. PFS was estimated using Kaplan-Meier estimate.

Secondary Outcome Measures

Name	Time	Method
Overall Survival (OS)	Up to 42.8 months	OS was defined as the time from the date of randomization to the date of death from any cause. OS was estimated using Kaplan-Meier estimate. Participants without documentation of death were censored on the date they were last known to be alive.
Objective Response Rate (ORR) by BICR and Local Investigator Review (LIR) Assessment	Up to 42.8 months	ORR was defined as the percentage of participants who had the best overall response of either complete response (CR) or partial response (PR) that was confirmed at 4 weeks or later after initial response by BICR and LIR using RECIST 1.1. CR: Disappearance of all target and non-target lesions; and normalization of tumor marker levels initially above upper limits of normal; PR: ≥30% decrease in the sum of the LD of target lesions, taking as reference the baseline sum LD.
Duration of Response (DOR) by BICR and LIR Assessment	Up to 42.8 months	DOR was defined as the time from the date a response of CR or PR was first documented until the date of the first documentation of disease progression or date of death (whichever occurred first). DOR was analyzed based on both BICR and LIR assessments. CR: Disappearance of all target and non-target lesions; and normalization of tumor marker levels initially above upper limits of normal; PR: ≥30% decrease in the sum of the LD of target lesions, taking as reference the baseline sum LD. Disease progression was defined as an increase of greater than 20% in the sum of the LD of target lesions and a 5 mm absolute increase, taking as a reference the smallest sum LD recorded since the baseline assessment or the appearance of new non-target lesions. DOR was estimated using Kaplan-Meier estimate.
Clinical Benefit Rate (CBR) by BICR and LIR Assessment	Up to 42.8 months	CBR was defined as the percentage of participants with the best overall response of CR, PR, or durable stable disease (duration of SD ≥ 6 months after randomization). CBR was analyzed based on both BICR and LIR assessments. CR: Disappearance of all target and non-target lesions; and normalization of tumor marker levels initially above upper limits of normal; PR: ≥30% decrease in the sum of the LD of target lesions, taking as reference the baseline sum LD. SD: Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for progressive disease (PD), taking as reference the smallest sum LD since the treatment started. PD: Disease progression was defined as an increase of greater than 20% in the sum of the LD of target lesions and a 5 mm absolute increase, taking as a reference the smallest sum LD recorded since the baseline assessment or the appearance of new non-target lesions.
PFS by LIR Assessment	Up to 42.8 months	PFS was defined as the time from the date of randomization to the date of the first documentation of disease progression or death (whichever occurred first) according to LIR using RECIST 1.1. Disease progression was defined as an increase of greater than 20% in the sum of the LD of target lesions and a 5 mm absolute increase, taking as a reference the smallest sum LD recorded since the baseline assessment or the appearance of new non-target lesions. PFS was estimated using Kaplan-Meier estimate.
Time to Deterioration (TTD) of Global Health Status/Quality of Life (QoL) Scale as Measured by European Organization for Research and Treatment of Cancer Quality of Life for Cancer Patients, Core Questionnaire Version 3.0 (EORTC QLQ-C30)	Up to 37.8 months	TTD was defined as the time from randomization to the first date a subject achieves 10-point deterioration from baseline in the global health status/QoL scale.The EORTC QLQ-C30 is a 30-item questionnaire to assess QoL of cancer patients. It has 5 functional scales(physical,role,emotional,cognitive, social)1 global health status scale,3 symptom scales (fatigue, nausea and vomiting, pain),and 6 single items(dyspnea, insomnia, loss of appetite, constipation, diarrhea, financial difficulties). Participant responses to global health status,'How would you rate your overall health during the past week?' (Item 29)and the QoL 'How would you rate your overall quality of life during the past week?'(Item 30)questions were scored on 7-point scale (1=very poor; 7=excellent). All scales and single-item measures range in score from 0 to 100. Summed raw scores were standardized by linear transformation so that scores ranged from 0 to 100. Higher scores for GHS show a better level of functioning.
TTD of Pain Score as Measured by EORTC QLQ-C30	Up to 37.8 months	TTD was defined as the time from randomization to the first date a subject achieves 10-point deterioration from baseline in the pain score.The EORTC QLQ-C30 is a questionnaire to assess quality of life, it is composed of 30 questions(items) resulting in 5 functional scales(physical, role, emotional, cognitive, social),1 global health status scale,3 symptom scales (fatigue, nausea and vomiting, pain),and 6 single items(dyspnea, insomnia, loss of appetite, constipation, diarrhea, financial difficulties). All of the scales and single-item measures range in score from 0 to 100. Participant responses to 2 questions about pain, 'Have you had pain' and 'Did pain interfere with your daily activities' were scored on 4-point scale (1=not at all;4=very much). Summed raw scores were standardized by linear transformation so that scores ranges from 0 to 100. Higher scores on the symptom scales indicate a higher level of symptoms (i.e. a worse state of the participant).
TTD of Fatigue Score as Measured by EORTC QLQ-C30	Up to 37.8 months	TTD was defined as the time from randomization to the first date a subject achieves 10-point deterioration from baseline in the fatigue score.The EORTC QLQ-C30 is a questionnaire to assess quality of life, it is composed of 30 questions(items) resulting in 5 functional scales(physical, role, emotional, cognitive, social),1 global health status scale,3 symptom scales (fatigue, nausea and vomiting, pain),and 6 single items(dyspnea, insomnia, loss of appetite, constipation, diarrhea, financial difficulties).All of the scales and single-item measures range in score from 0 to 100.Participant responses to 3 questions about fatigue 'Did you need to rest', 'Have you felt weak' and 'Were you tired' were scored on a 4-point scale (1=not at all;4=very much).Summed raw scores were standardized by linear transformation so that scores ranged from 0 to 100. Higher scores on the symptom scales indicate a higher level of symptoms (i.e. a worse state of the participant).
Percentage of Participants Who Experienced Treatment Emergent Adverse Events (TEAEs)	Up to 43.4 months	An AE was defined as any untoward medical occurrence in a subject administered a medicinal product that does not necessarily have a causal relationship with this treatment. TEAEs were defined as any AEs that begin or worsen on or after the start of study drug through 30 days after the last dose of the study drug. The severity was graded based on the National Cancer Institute's Common Terminology Criteria for Adverse Events Version 5.0.
Percentage of Participants Who Experienced Treatment Emergent Serious Adverse Events (TESAEs)	Up to 43.4 months	Treatment-emergent adverse events (TEAEs) were defined as any adverse events (AEs) that begin or worsen on or after the start of study drug through 30 days after the last dose of study drug. The severity was graded based on the National Cancer Institute's Common Terminology Criteria for Adverse Events Version 5.0. An AE that met one or more of the following outcomes was classified as serious: * Fatal * Life-threatening * Disabling/incapacitating * Results in hospitalization or prolongs a hospital stay * A congenital abnormality * Other important medical events may also be considered serious AEs if they may require medical or surgical intervention to prevent one of the outcomes listed above
Percentage of Participants Who Experienced the Worst Laboratory Abnormalities Grade 3 or 4 Post-Baseline	Up to 43.4 months	Blood samples were collected for hematology, serum chemistry, and the laboratory abnormalities were assessed. A treatment-emergent laboratory abnormality was defined as an increase of at least 1 toxicity grade from baseline at any time postbaseline up to and including the date of last study drug dose plus 30 days.The most severe graded abnormality observed post-baseline for each graded test was counted for each participant. Safety as assessed by grading of laboratory values and AEs according to the National Cancer Institutes' Common Terminology Criteria for Adverse Events (NCI CTCAE) covering grades 0-5 (0=Normal, 1=Mild, 2=Moderate, 3=Severe, 4=Life-threatening, 5=Death). The percentage of participants with worst postbaseline grades 3 or 4 are reported.
Percentage of Participants With Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) - Shift From Baseline Value to Best Value During Treatment	Up to 43.4 months	ECOG performance status (PS) measured on-therapy assessed participant's performance status on 5 point scale: 0=Fully active/able to carry on all pre-disease performance without restriction;1=Restricted in physically strenuous activity but ambulatory and able to carry out work of a light or sedentary nature;2=Ambulatory and capable of all self-care but unable to carry out any work activities; up and about more than 50% of waking hours;3=Capable of only limited self-care;confined to bed or chair more than 50% of waking hours;4=Completely disabled; cannot carry on any self-care; totally confined to bed or chair;5=Dead. Lower score indicated good performance status. Percentage of participants with Baseline ECOG PS score and corresponding changes to the best values post-baseline have been reported.

Trial Locations

Locations (113): The University of Kansas Cancer Center
🇺🇸
Westwood, Kansas, United States
University of Chicago Medical Center
🇺🇸
Chicago, Illinois, United States
Maryland Oncology Hematology, P.A.
🇺🇸
Rockville, Maryland, United States
Nationales Centrum für Tumorerkrankungen - Heidelberg
🇩🇪
Heidelberg, Germany
The Ohio State University
🇺🇸
Columbus, Ohio, United States
Miami Cancer Institute
🇺🇸
Miami, Florida, United States
Laura and Isaac Perlmutter Cancer Center/NYU Langone Health
🇺🇸
New York, New York, United States
Yale University Cancer Center
🇺🇸
New Haven, Connecticut, United States
UCLA Department of Medicine - Hematology/Oncology
🇺🇸
Los Angeles, California, United States
University of California, Irvine Medical Center-Chao Family Comprehensive Cancer Center
🇺🇸
Orange, California, United States
New York Oncology Hematology, P.C.
🇺🇸
Albany, New York, United States
UCSF Helen Diller Family Comprehensive Cancer Center
🇺🇸
San Francisco, California, United States
Orlando Health, Inc.
🇺🇸
Orlando, Florida, United States
Washington University School of Medicine - Siteman Cancer Center
🇺🇸
Saint Louis, Missouri, United States
Magee-Womens Hospital of UPMC
🇺🇸
Pittsburgh, Pennsylvania, United States
Masonic Cancer Center, University of Minnesota
🇺🇸
Minneapolis, Minnesota, United States
Tennessee Oncology, PLLC
🇺🇸
Nashville, Tennessee, United States
Columbia University Medical Center
🇺🇸
New York, New York, United States
Rutgers Cancer Institute of New Jersey
🇺🇸
New Brunswick, New Jersey, United States
University of Texas Southwestern Harold C. Simmons Comprehensive Cancer Center
🇺🇸
Dallas, Texas, United States
Massachusetts General Hospital
🇺🇸
Boston, Massachusetts, United States
Saint Luke's Cancer Institute
🇺🇸
Kansas City, Missouri, United States
Moffitt Cancer Center
🇺🇸
Tampa, Florida, United States
St. Vincent Frontier Cancer Center
🇺🇸
Billings, Montana, United States
Summit Medical Group
🇺🇸
Florham Park, New Jersey, United States
Texas Oncology-Longview Cancer Center
🇺🇸
Longview, Texas, United States
Virginia Oncology Associates
🇺🇸
Norfolk, Virginia, United States
Institut Jules Bordet
🇧🇪
Brussels, Belgium
Northwest Medical Specialties, PLLC
🇺🇸
Tacoma, Washington, United States
Memorial Sloan Kettering Cancer Center
🇺🇸
New York, New York, United States
Institut Sainte Catherine
🇫🇷
Avignon, France
Hôpital Jean-Minjoz
🇫🇷
Besançon, France
Marienhospital Bottrop
🇩🇪
Bottrop, Germany
Texas Oncology-Baylor Charles A. Sammons Cancer Center
🇺🇸
Dallas, Texas, United States
IFO Istituto Nazionale dei Tumori Regina Elena
🇮🇹
Rome, Italy
Städtisches Klinikum Dessau
🇩🇪
Dessau, Germany
Centrum für Hämatologie und Onkologie Bethanien
🇩🇪
Frankfurt, Germany
Hospital General Universitario Gregorio Maranon
🇪🇸
Madrid, Spain
Centre Leon Berard
🇫🇷
Lyon, France
Virginia Cancer Specialists
🇺🇸
Arlington, Virginia, United States
Ospedale di Desio
🇮🇹
Desio, Italy
Ospedale San Raffaele
🇮🇹
Milano, Italy
Hopital de Mercy
🇫🇷
Ars-Laquenexy, France
Institut Claudius Regaud
🇫🇷
Toulouse, France
Centre Hospitalier de L'Universite de Montreal - Hôpital Notre-Dame
🇨🇦
Montréal, Canada
Universitätsmedizin Mannheim
🇩🇪
Mannheim, Germany
Gynakologisches Zentrum Bonn
🇩🇪
Bonn, Germany
Kliniken Essen-Mitte
🇩🇪
Essen, Germany
Nova Scotia Cancer Centre
🇨🇦
Halifax, Nova Scotia, Canada
DIAKOVERE Krankenhaus gGmbH Henriettenstift - Standort Kirchrode
🇩🇪
Hannover, Germany
Centre Hospitalier Universitaire de Sherbrooke - Fleurimont
🇨🇦
Sherbrooke, Canada
Leicester Royal Infirmary
🇬🇧
Leicester, United Kingdom
Hospital Provincial de Castellón
🇪🇸
Castillón, Spain
Institut Curie
🇫🇷
Paris, France
Ospedale Vito Fazzi di Lecce
🇮🇹
Lecce, Italy
Institut Régional du Cancer de Montpellier
🇫🇷
Montpellier, France
Gynakologisch-Onkologische Praxis Hannover
🇩🇪
Hannover, Germany
Hospital Universitario Virgen del Rocio
🇪🇸
Sevilla, Spain
Hospital Universitari Arnau de Vilanova
🇪🇸
Lleida, Spain
Universitätsklinikum Erlangen
🇩🇪
Erlangen, Germany
Maastricht UMC+
🇳🇱
Maastricht, Netherlands
The Royal Marsden NHS Foundation Trust
🇬🇧
London, United Kingdom
The Christie NHS Foundation Trust
🇬🇧
Manchester, United Kingdom
Hospital Quirónsalud Barcelona Instituto Oncologico Baselga
🇪🇸
Barcelona, Spain
Azienda Ospedaliera San Gerardo di Monza
🇮🇹
Monza, Italy
Hospital Universitari Vall d'Hebron
🇪🇸
Barcelona, Spain
Hospital Clinico Universitario de Santiago de Compostela
🇪🇸
Santiago De Compostela, Spain
Praxisklinik für Hämatologie und Onkologie Koblenz
🇩🇪
Koblenz, Germany
Hospital de la Santa Creu I Sant Pau
🇪🇸
Barcelona, Spain
Royal Surrey County Hospital
🇬🇧
Guildford, United Kingdom
Complejo Hospitalario Universitario A Coruna
🇪🇸
A Coruña, Spain
Hospital Universitario 12 de Octubre
🇪🇸
Madrid, Spain
Royal Cornwall Hospital NHS Trust
🇬🇧
Cornwell, United Kingdom
Houston Methodist Hospital/Houston Methodist Cancer Center
🇺🇸
Houston, Texas, United States
UT Health San Antonio - Mays Cancer Center
🇺🇸
San Antonio, Texas, United States
Oncology & Hematology Associates of Southwest Virginia, Inc. DBA Blue Ridge Cancer Care
🇺🇸
Salem, Virginia, United States
CHU UCL Namur/Site Sainte Elisabeth
🇧🇪
Namur, Belgium
HonorHealth Research Institute
🇺🇸
Avondale, Arizona, United States
Los Angeles Hematology Oncology Medical Group
🇺🇸
Los Angeles, California, United States
Arizona Oncology Associates, PC
🇺🇸
Tucson, Arizona, United States
University of California, San Diego Moores Cancer Center
🇺🇸
La Jolla, California, United States
Highlands Oncology Group
🇺🇸
Fayetteville, Arkansas, United States
Southern California Permanente Medical Group
🇺🇸
San Diego, California, United States
University of Miami - Sylvester Comprehensive Cancer Center
🇺🇸
Miami, Florida, United States
Emory University - Winship Cancer Institute
🇺🇸
Atlanta, Georgia, United States
Northside Hospital, Inc.
🇺🇸
Atlanta, Georgia, United States
James Graham Brown Cancer Center
🇺🇸
Louisville, Kentucky, United States
Mercy Medical Center, Medical Oncology & Hematology
🇺🇸
Baltimore, Maryland, United States
Beth Israel Deaconess Medical Center
🇺🇸
Boston, Massachusetts, United States
Allina Health, Virginia Piper Cancer Institute
🇺🇸
Minneapolis, Minnesota, United States
Vanderbilt University Medical Center
🇺🇸
Nashville, Tennessee, United States
HELIOS Klinikum Berlin-Buch
🇩🇪
Berlin, Germany
Azienda Ospedaliera Spedali Civili di Brescia
🇮🇹
Brescia, Italy
Klinikum Mutterhaus der Borromäerinnen
🇩🇪
Trier, Germany
Azienda Unità Sanitaria Locale di Piacenza-Ospedale Guglielmo da Saliceto
🇮🇹
Piacenza, Italy
Icahn School of Medicine at Mount Sinai
🇺🇸
New York, New York, United States
Barts Health NHS Trust
🇬🇧
London, United Kingdom
Chirec Cancer Institute
🇧🇪
Brussels, Belgium
Universitair Ziekenhuis Leuven
🇧🇪
Leuven, Belgium
University of Colorado
🇺🇸
Aurora, Colorado, United States
Dana Farber Cancer Institute
🇺🇸
Boston, Massachusetts, United States
Medisch Centrum Haaglanden Antoniushove
🇳🇱
Leidschendam, Netherlands
Antoni van Leeuwenhoekziekenhuis
🇳🇱
Amsterdam, Netherlands
Centre Georges-Francois Leclerc
🇫🇷
Dijon, France
Hospices Civils de Lyon
🇫🇷
Pierre-Bénite, France
Institut de Cancérologie Lucien Neuwirth
🇫🇷
Saint-Priest-en-Jarez, France
Instituto Oncologico Bureau (IOB)
🇪🇸
Madrid, Spain
Rocky Mountain Cancer Centers
🇺🇸
Aurora, Colorado, United States
Onkologische Schwerpunktpraxis Eppendorf
🇩🇪
Hamburg, Germany
Georgetown University Medical Center
🇺🇸
Washington, District of Columbia, United States
The West Clinic, PC dba West Cancer Center
🇺🇸
Germantown, Tennessee, United States
Texas Oncology-Denton South
🇺🇸
Denton, Texas, United States
Thomas Jefferson University
🇺🇸
Philadelphia, Pennsylvania, United States

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