Study of Atezolizumab as Monotherapy and in Combination With Platinum-Based Chemotherapy in Participants With Untreated Locally Advanced or Metastatic Urothelial Carcinoma
- Conditions
- Urothelial Carcinoma
- Interventions
- Registration Number
- NCT02807636
- Lead Sponsor
- Hoffmann-La Roche
- Brief Summary
A Phase III, randomised study of atezolizumab alone and in combination with chemotherapy versus chemotherapy alone in participants with untreated advanced urothelial cancer.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 1213
Not provided
- Any approved anti-cancer therapy, including chemotherapy or hormonal therapy, within 3 weeks prior to initiation of study treatment
- Treatment with any other investigational agent or participation in another clinical study with therapeutic intent within 28 days prior to enrolment
- Active or untreated CNS metastases as determined by computed tomography (CT) or magnetic resonance imaging evaluation during screening and prior radiographic assessments
- Participants with treated asymptomatic central nervous system (CNS) metastases are eligible, provided they meet all of the following criteria: * Evaluable or measurable disease outside the CNS * No metastases to midbrain, pons, medulla, or within 10 mm of the optic apparatus (optic nerves and chiasm) * No history of intracranial or spinal cord hemorrhage * No ongoing requirement for corticosteroid as therapy for CNS disease; anti-convulsants at a stable dose are allowed * No evidence of significant vasogenic edema * No stereotactic radiation, whole-brain radiation or neurosurgical resection within 4 weeks prior to Cycle 1, Day 1 * Radiographic demonstration of interim stability (i.e., no progression) between the completion of CNS-directed therapy and the screening radiographic study * Screening CNS radiographic study >/=4 weeks since completion of radiotherapy or surgical resection and >/=2 weeks since discontinuation of corticosteroids
- Prior treatment with CD137 agonists, anti-CTLA-4, anti-programmed death-1 (PD-1), or anti-PD-L1 therapeutic antibody or pathway-targeting agents
- Treatment with systemic corticosteroids or other systemic immunosuppressive medications (including but not limited to prednisone, dexamethasone, cyclophosphamide, azathioprine, methotrexate, thalidomide, and anti-tumor necrosis factor [TNF] agents) within 2 weeks prior to Cycle 1, Day 1 or anticipated requirement for systemic immunosuppressive medications during the study
- Leptomeningeal disease
- Uncontrolled pleural effusion, pericardial effusion, or ascites requiring recurrent drainage procedures (once monthly or more frequently)
- Uncontrolled tumour-related pain or hypercalcemia
- Significant cardiovascular disease including known left ventricular ejection fraction (LVEF) <40%
- Severe infections within 4 weeks before randomization or therapeutic oral or IV antibiotics within 2 weeks before randomization
- Major surgical procedure within 4 weeks prior to randomization or anticipation of need for a major surgical procedure during the course of the study other than for diagnosis
- Malignancies other than urothelial carcinoma within 5 years prior to Cycle 1, Day 1
- Life expectancy of <12 weeks
- Pregnant or lactating, or intending to become pregnant during the study
- Serum albumin <25 gram per liter (g/L)
- History of severe allergic, anaphylactic, or other hypersensitivity reactions to chimeric or humanized antibodies or fusion proteins
- Known hypersensitivity or allergy to biopharmaceuticals produced in Chinese hamster ovary cells or any component of the atezolizumab formulation
- History of autoimmune disease
- Participants with prior allogeneic stem cell or solid organ transplantation
- History of idiopathic pulmonary fibrosis (including pneumonitis), drug-induced pneumonitis, organizing pneumonia (i.e., bronchiolitis obliterans, cryptogenic organizing pneumonia), or evidence of active pneumonitis on screening chest CT scan
- Positive test for human immunodeficiency virus (HIV)
- Active hepatitis B or hepatitis C
- Active tuberculosis
- Administration of a live, attenuated vaccine within 4 weeks before Cycle 1, Day 1
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Atezolizumab+Gemcitabine+Carboplatin/Cisplatin Gemcitabine Participants will receive blinded atezolizumab in combination with open-label platinum-based chemotherapy (gemcitabine with either cisplatin or carboplatin). Atezolizumab+Gemcitabine+Carboplatin/Cisplatin Cisplatin Participants will receive blinded atezolizumab in combination with open-label platinum-based chemotherapy (gemcitabine with either cisplatin or carboplatin). Placebo+Gemcitabine+Carboplatin/Cisplatin Carboplatin Participants will receive blinded placebo matched to atezolizumab in combination with open-label platinum-based chemotherapy (gemcitabine with either cisplatin or carboplatin). Placebo+Gemcitabine+Carboplatin/Cisplatin Placebo Participants will receive blinded placebo matched to atezolizumab in combination with open-label platinum-based chemotherapy (gemcitabine with either cisplatin or carboplatin). Atezolizumab Monotherapy Atezolizumab Eligible participants will receive open-label atezolizumab as monotherapy. Atezolizumab+Gemcitabine+Carboplatin/Cisplatin Atezolizumab Participants will receive blinded atezolizumab in combination with open-label platinum-based chemotherapy (gemcitabine with either cisplatin or carboplatin). Atezolizumab+Gemcitabine+Carboplatin/Cisplatin Carboplatin Participants will receive blinded atezolizumab in combination with open-label platinum-based chemotherapy (gemcitabine with either cisplatin or carboplatin). Placebo+Gemcitabine+Carboplatin/Cisplatin Gemcitabine Participants will receive blinded placebo matched to atezolizumab in combination with open-label platinum-based chemotherapy (gemcitabine with either cisplatin or carboplatin). Placebo+Gemcitabine+Carboplatin/Cisplatin Cisplatin Participants will receive blinded placebo matched to atezolizumab in combination with open-label platinum-based chemotherapy (gemcitabine with either cisplatin or carboplatin).
- Primary Outcome Measures
Name Time Method Investigator Assessed Progression-Free Survival (PFS) in the Placebo+Gemcitabine+Carboplatin/Cisplatin Arm Versus Atezolizumab +Gemcitabine+Carboplatin/Cisplatin Arm Baseline up to first documented disease progression or death, whichever occurs first (up to approximately 35 months) PFS is defined as the time from randomization to the first documented disease progression as determined by the investigator with the use of RECIST v1.1, or death from any cause, whichever occurs first.
Overall Survival (OS) in Atezolizumab+Gemcitabine+Carboplatin/Cisplatin Arm Versus Placebo+Gemcitabine+Carboplatin/Cisplatin Arm Baseline until death due to any cause (up to approximately 73 months) OS is defined as the time from randomization to death due to any cause.
Overall Survival (OS) in Atezolizumab Monotherapy Arm Versus Placebo+Gemcitabine+Carboplatin/Cisplatin Arm Baseline until death due to any cause (up to approximately 73 months) OS is defined as the time from randomization to death due to any cause.
- Secondary Outcome Measures
Name Time Method Objective Response Rate (ORR) in Atezolizumab+Gemcitabine+Carboplatin/Cisplatin Arm Versus Placebo+Gemcitabine+Carboplatin/Cisplatin Arm Baseline up to disease progression, death, or loss of follow-up, whichever occurs first (up to approximately 73 months) Objective response rate (ORR) is defined as the proportion of participants with a confirmed objective response, either complete response (CR) or partial response (PR), observed on two assessments \>= 28 days apart per RECIST v1.1, based on investigator assessment. The analysis population for ORR will be all randomized participants with measurable disease at baseline.
Objective Response Rate (ORR) in Atezolizumab Monotherapy Arm Versus Placebo+Gemcitabine+Carboplatin/Cisplatin Arm Baseline up to disease progression, death, or loss of follow-up, whichever occurs first (up to approximately 73 months) Objective response rate (ORR) is defined as the proportion of participants with a confirmed objective response, either complete response (CR) or partial response (PR), observed on two assessments \>= 28 days apart per RECIST v1.1, based on investigator assessment. The analysis population for ORR will be all randomized participants with measurable disease at baseline.
Duration of Response (DOR) in Atezolizumab+Gemcitabine+Carboplatin/Cisplatin Arm Versus Placebo+Gemcitabine+Carboplatin/Cisplatin Arm From first documented objective response (CR or PR) to disease progression, death, or loss of follow-up, whichever occurs first (up to approximately 73 months) Duration of response (DOR) is defined for participants with an objective response as the time from the first documented objective response to documented disease progression per RECIST v1.1, based on investigator assessment, or death due to any cause, whichever occurs first.
Duration of Response (DOR) in Atezolizumab Monotherapy Arm Versus Placebo+Gemcitabine+Carboplatin/Cisplatin Arm From first documented objective response (CR or PR) to disease progression, death, or loss of follow-up, whichever occurs first (up to approximately 73 months) Duration of response (DOR) is defined for participants with an objective response as the time from the first documented objective response to documented disease progression per RECIST v1.1, based on investigator assessment, or death due to any cause, whichever occurs first.
IRF-PFS Randomization to first documented disease progression or death from any cause (up to 35 months) Independent review facility PFS (IRF-PFS) is defined as the time from randomization to the first documented disease progression as determined by blinded independent central review with use of RECIST v1.1, or death due to any cause, whichever occurs first.
OS Event Free Rate Atezolizumab+Gemcitabine+Carboplatin/Cisplatin Arm Versus Placebo+Gemcitabine+Carboplatin/Cisplatin Arm Year 1 Overall Survival (OS) Event Free Rate at 1 Year.
OS Event Free Rate in Atezolizumab Monotherapy Arm Versus Placebo+Gemcitabine+Carboplatin/Cisplatin Arm Year 1 Overall Survival (OS) Event Free Rate at 1 Year.
PFS Event Free Rate Year 1 Progression Free Survival (PFS) Event Free Rate at Year 1
Time to Deterioration in Global Health Status as Measured by the EORTC QLQ-C30 Score in the Placebo+Gemcitabine+Carboplatin/Cisplatin Arm Versus Atezolizumab +Gemcitabine+Carboplatin/Cisplatin Arm Up to approximately 73 months Time to deterioration in global health status as measured by the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 in the Placebo+Gemcitabine+Carboplatin/Cisplatin Arm versus Atezolizumab +Gemcitabine+Carboplatin/Cisplatin Arm.
Time to Deterioration in Global Health Status as Measured by the EORTC QLQ-C30 Score in the Placebo+Gemcitabine+Carboplatin/Cisplatin Arm Versus Atezolizumab Monotherapy Arm Up to approximately 73 months Time to deterioration in global health status as measured by the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 in the Placebo+Chemo Arm versus Atezolizumab Monotherapy Arm.
Time to Deterioration in Physical Function as Measured by the EORTC QLQ-C30 Score in the Placebo+Gemcitabine+Carboplatin/Cisplatin Arm Versus Atezolizumab +Gemcitabine+Carboplatin/Cisplatin Arm Up to approximately 73 months Median time to deterioration in physical function as measured by the QLQ-C30 in the Placebo+Gemcitabine+Carboplatin/Cisplatin Arm versus Atezolizumab +Gemcitabine+Carboplatin/Cisplatin Arm.
Time to Deterioration in Physical Function as Measured by the EORTC QLQ-C30 Score in the Placebo+Gemcitabine+Carboplatin/Cisplatin Arm Versus Atezolizumab Monotherapy Arm Up to approximately 73 months Median time to deterioration in physical function as measured by the QLQ-C30 in the Placebo+Gemcitabine+Carboplatin/Cisplatin Arm versus Atezolizumab Monotherapy Arm.
Maximum Atezolizumab Serum Concentration Cycle 1 Day 1 Maximum atezolizumab serum concentration.
Minimum Atezolizumab Serum Concentration Cycle 2 Day 1, Cycle 3 Day 1, Cycle 4 Day 1, Cycle 8 Day 1, Cycle 16 Day 1, Cycle 24 Day 1, Cycle 32 Day 1, Day 120 post dose of last blinded atezolizumab treatment, and study drug early discontinuation Minimum atezolizumab serum concentration.
Percentage of Participants With Anti-Therapeutic (Anti-Atezolizumab) Antibodies (ATAs) Up to approximately 35 months Percentage of participants with Anti-Therapeutic (Anti-Atezolizumab) Antibodies (ATAs).
Investigator-Assessed Progression-Free Survival (INV-PFS) in Participants Treated With Atezolizumab Monotherapy Arm Compared With Placebo+Gemcitabine+Carboplatin/Cisplatin Arm Baseline up to disease progression, death, or loss of follow-up, whichever occurs first (assessed at baseline, every 9 weeks for 54 weeks and every 12 weeks thereafter up to 35 months) PFS is defined as the time from randomization to the first documented disease progression as determined by the investigator with the use of RECIST v1.1, or death from any cause, whichever occurs first.
Percentage of Participants With Grade 3-4 Adverse Events (AEs) Baseline up to 93 months Percentage of participants with Grade 3-4 Adverse Events (AEs) assessed using National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) v4.0.
Percentage of Participants With Grade 5 Adverse Events (AEs) Baseline up to 93 months Percentage of participants with Grade 5 Adverse Events (AEs) assessed using National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) v4.0.
Percentage of Participants With Serious Adverse Events (SAEs) Baseline up to 93 months Percentage of participants with Serious Adverse Events (SAEs) assessed using National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) v4.0.
Percentage of Participants With Adverse Events (AEs) Leading to Withdrawal of Any Study Treatment Baseline up to 93 months Percentage of participants with Adverse Events (AEs) leading to withdrawal of any study treatment assessed Using National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) v4.0.
Percentage of Participants With Atezolizumab-Specific Adverse Events of Special Interest (AESIs) Baseline up to 93 months Percentage of participants with atezolizumab-specific Adverse Events of Special Interest (AESIs) Using National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) v4.0.
Trial Locations
- Locations (204)
UZ Leuven Gasthuisberg
🇧🇪Leuven, Belgium
CHC MontLégia
🇧🇪Liege, Belgium
Clinical center University of Sarajevo
🇧🇦Sarajevo, Bosnia and Herzegovina
CETUS Hospital Dia Oncologia
🇧🇷Belo Horizonte, Minas Gerais, Brazil
Fundacion Arturo Lopez Perez
🇨🇱Santiago, Chile
Clinica Alemana
🇨🇱Vitacura, Chile
Beijing Friendship Hospital
🇨🇳Beijing, China
Peking Union Medical College Hospital
🇨🇳Beijing, China
Chongqing Cancer Hospital
🇨🇳Chongqing, China
Sun Yat-sen Memorial Hospital
🇨🇳Guangzhou, China
North Estonia Medical Centre Foundation
🇪🇪Tallinn, Estonia
Policlinico Umberto i di Roma
🇮🇹Roma, Lazio, Italy
Cancerología
🇲🇽Queretaro, Mexico
Martini Ziekenhuis
🇳🇱Groningen, Netherlands
Hagaziekenhuis, locatie Leyweg
🇳🇱Nl -den Haag, Netherlands
Zuyderland Medisch Centrum
🇳🇱Sittard-Geleen, Netherlands
Isala Klinieken, Sophia
🇳🇱Zwolle, Netherlands
Bialostockie Centrum Onkologii
🇵🇱Bialystok, Poland
Przychodnia Lekarska KOMED, Roman Karaszewski
🇵🇱Konin, Poland
Szpital Uniwersytecki w Krakowie
🇵🇱Kraków, Poland
Woj.Wielospecjalistyczne Centrum Onkologii i Traumatologii
🇵🇱Lodz, Poland
Wilgers Oncology Centre
🇿🇦Pretoria, South Africa
Sandton Oncology Medical Group
🇿🇦Sandton, South Africa
Hospital Universitario Miguel Servet
🇪🇸Zaragoza, Spain
Chang Gung Medical Foundation - Kaohsiung
🇨🇳Kaohisung, Taiwan
Highlands Oncology Group
🇺🇸Rogers, Arkansas, United States
Coastal Integrative Cancer Care
🇺🇸San Luis Obispo, California, United States
Yale School of Medicine
🇺🇸New Haven, Connecticut, United States
Norwalk Hospital
🇺🇸Norwalk, Connecticut, United States
Christina Care Institutional Review Board
🇺🇸Newark, Delaware, United States
Florida Cancer Specialists
🇺🇸Fort Myers, Florida, United States
UF Health Cancer Center at Orlando Health
🇺🇸Orlando, Florida, United States
Florida Cancer Specialists (St. Petersburg ? St. Anthony?s Professional Building)
🇺🇸Saint Petersburg, Florida, United States
Moffitt Cancer Center
🇺🇸Tampa, Florida, United States
Parkview Research Center
🇺🇸Fort Wayne, Indiana, United States
Norton Cancer Institute
🇺🇸Louisville, Kentucky, United States
East Jefferson Hematology Oncology
🇺🇸Metairie, Louisiana, United States
Park Nicollet Clin-Cancer Ctr
🇺🇸Saint Louis Park, Minnesota, United States
Comprehensive Cancer Centers of Nevada
🇺🇸Las Vegas, Nevada, United States
Mount Sinai School of Medicine - Tisch Cancer Institute
🇺🇸New York, New York, United States
Consultorio Médico
🇲🇽Zapopan, Jalisco, Mexico
University of North Carolina, Lineberger Cancer Ctr
🇺🇸Chapel Hill, North Carolina, United States
Bon Secours - St. Francis Hospital
🇺🇸Greenville, South Carolina, United States
Sarah Cannon Research Institute / Tennessee Oncology
🇺🇸Nashville, Tennessee, United States
Macquarie University Hospital
🇦🇺Macquarie University, New South Wales, Australia
Royal Brisbane and Women's Hospital
🇦🇺Herston, Queensland, Australia
Lyell McEwin Hospital
🇦🇺Adelaide, South Australia, Australia
Box Hill Hospital
🇦🇺Box Hill, Victoria, Australia
Cabrini Medical Centre
🇦🇺Malvern, Victoria, Australia
Sunshine Hospital
🇦🇺St Albans, Victoria, Australia
GHdC Site Notre Dame
🇧🇪Charleroi, Belgium
AZ Sint Lucas (Sint Lucas)
🇧🇪Gent, Belgium
Hospital Luxemburgo
🇧🇷Belo Horizonte, Minas Gerais, Brazil
Oncosite - Centro de Pesquisa Clinica Em Oncologia Ltda
🇧🇷Ijui, Rio Grande Do Sul, Brazil
Hospital das Clinicas - UFRGS
🇧🇷Porto Alegre, Rio Grande Do Sul, Brazil
Hospital Nossa Senhora da Conceicao
🇧🇷Porto Alegre, Rio Grande Do Sul, Brazil
Clinica Viver
🇧🇷Santa Maria, Rio Grande Do Sul, Brazil
Clinica de Neoplasias Litoral
🇧🇷Itajai, Santa Catarina, Brazil
Hospital de Base de Sao Jose do Rio Preto
🇧🇷Sao Jose do Rio Preto, São Paulo, Brazil
Instituto do Cancer do Estado de Sao Paulo - ICESP
🇧🇷Sao Paulo, São Paulo, Brazil
Beneficencia Portuguesa de Sao Paulo
🇧🇷Sao Paulo, São Paulo, Brazil
Clinicas Oncologicas Integradas - COI
🇧🇷Rio de Janeiro, Brazil
Arthur J.E. Child Comprehensive Cancer Center-Calgary
🇨🇦Calgary, Alberta, Canada
Cross Cancer Institute
🇨🇦Edmonton, Alberta, Canada
BC Cancer Agency, CSI
🇨🇦Kelowna, British Columbia, Canada
Dr. Georges L. Dumont University Hospital Centre
🇨🇦Moncton, New Brunswick, Canada
Juravinski Cancer Clinic
🇨🇦Hamilton, Ontario, Canada
Lakeridge Health Center
🇨🇦Oshawa, Ontario, Canada
North York General Hospital
🇨🇦Toronto, Ontario, Canada
Bradford Hill Centro de Investigaciones Clinicas
🇨🇱Recoleta, Chile
OrlandiOncología
🇨🇱Santiago, Chile
Jiangsu Cancer Hospital
🇨🇳Nanjing, China
Fudan University Shanghai Cancer Center
🇨🇳Shanghai, China
Zhongshan Hospital Fudan University
🇨🇳Shanghai, China
Huadong Hospital Affiliated to Fudan University
🇨🇳Shanghai, China
The 2nd Hospital of Tianjin Medical University
🇨🇳Tianjin, China
Masarykuv onkologicky ustav
🇨🇿Brno, Czechia
Fakultni nemocnice Olomouc
🇨🇿Olomouc, Czechia
Vseobecna fakultni nemocnice v Praze
🇨🇿Praha 2, Czechia
University Hospital Motol
🇨🇿Praha 5, Czechia
East Tallinn Central Hospital
🇪🇪Tallinn, Estonia
Oulu University Hospital
🇫🇮Oulu, Finland
Turku Uni Central Hospital
🇫🇮Turku, Finland
Research institute for Clinical Medicine
🇬🇪Tbilisi, Georgia
National Center of Urology
🇬🇪Tbilisi, Georgia
Alexandras General Hospital of Athens
🇬🇷Athens, Greece
University Hospital of Patras Medical Oncology
🇬🇷Patras, Greece
Princess Margaret Hospital
🇭🇰Hong Kong, Hong Kong
Queen Elizabeth Hospital
🇭🇰Hong Kong, Hong Kong
Queen Mary Hospital
🇭🇰Hong Kong, Hong Kong
The Chinese University of Hong Kong
🇭🇰Hong Kong, Hong Kong
Rambam Health Care Campus
🇮🇱Haifa, Israel
Azienda Ospedaliera A. Cardarelli
🇮🇹Napoli, Campania, Italy
IRST Istituto Scientifico Romagnolo Per Lo Studio E Cura Dei Tumori, Sede Meldola
🇮🇹Meldola, Emilia-Romagna, Italy
A.O. Universitaria Policlinico Di Modena
🇮🇹Modena, Emilia-Romagna, Italy
Irccs Istituto Nazionale Dei Tumori (Int)
🇮🇹Milano, Lombardia, Italy
Az. Osp. Uni Ria San Martino
🇮🇹Genova, Liguria, Italy
Istituto Clinico Humanitas
🇮🇹Rozzano, Lombardia, Italy
A.O CITTA' DELLA SALUTE E DELLA SCIENZA D. - Presidio San Lazzaro
🇮🇹Torino, Piemonte, Italy
IRCCS Ospedale Casa Sollievo Della Sofferenza
🇮🇹San Giovanni Rotondo, Puglia, Italy
Azienda USL8 Arezzo-Presidio Ospedaliero 1 San Donato
🇮🇹Arezzo, Toscana, Italy
Azienda Ospedaliera S. Maria - Terni
🇮🇹Terni, Umbria, Italy
IRCCS Istituto Oncologico Veneto (IOV)
🇮🇹Padova, Veneto, Italy
Nagoya University Hospital
🇯🇵Aichi, Japan
Hirosaki University Hospital
🇯🇵Aomori, Japan
National Hospital Organization Shikoku Cancer Center
🇯🇵Ehime, Japan
Gunma University Hospital
🇯🇵Gunma, Japan
National Hospital Organization Hokkaido Cancer Center
🇯🇵Hokkaido, Japan
University of Tsukuba Hospital
🇯🇵Ibaraki, Japan
Kanazawa University Hospital
🇯🇵Ishikawa, Japan
Kumamoto University Hospital
🇯🇵Kumamoto, Japan
Niigata University Medical & Dental Hospital
🇯🇵Niigata, Japan
Osaka Metropolitan University Hospital
🇯🇵Osaka, Japan
Kindai University Hospital
🇯🇵Osaka, Japan
Toranomon Hospital
🇯🇵Tokyo, Japan
The Cancer Institute Hospital, JFCR
🇯🇵Tokyo, Japan
Keio University Hospital
🇯🇵Tokyo, Japan
Kyungpook National University Medical Center
🇰🇷Daegu, Korea, Republic of
Gachon University Gil Medical Center
🇰🇷Incheon, Korea, Republic of
Seoul National University Hospital
🇰🇷Seoul, Korea, Republic of
Severance Hospital, Yonsei University Health System
🇰🇷Seoul, Korea, Republic of
Hospital Kuala Lumpur
🇲🇾Kuala Lumpur, FED. Territory OF Kuala Lumpur, Malaysia
University Malaya Medical Centre
🇲🇾Kuala Lumpur, FED. Territory OF Kuala Lumpur, Malaysia
Health Pharma Professional Research
🇲🇽CD Mexico, Mexico CITY (federal District), Mexico
IMSS Hospital General de Zona No. 48 S. Pedro Xalpa
🇲🇽Mexico CITY (federal District), Mexico
Oddzial Chemioterapii Szpitala Klinicznego Nr 1 w Poznaniu
🇵🇱Poznan, Poland
NU-MED Centrum Diagnostyki i Terapii Onkologicznej
🇵🇱Tomaszów Mazowiecki, Poland
Szpital Grochowski im. dr med. Rafa?a Masztaka Sp. z o.o.
🇵🇱Warszawa, Poland
Hospital de Santa Maria
🇵🇹Lisboa, Portugal
IPO do Porto
🇵🇹Porto, Portugal
Spitalul Judetean de Urgenta Dr Constantin Opris
🇷🇴Baia Mare, Romania
Institute Of Oncology Bucharest
🇷🇴Bucharest, Romania
Oncology Center Sf. Nectarie
🇷🇴Craiova, Romania
SBEI of HPE ?Bashkir State Medical University? of MoH RF
🇷🇺UFA, Baskortostan, Russian Federation
Krasnoyarsk Regional Oncology Dispensary n.a. Krizhanovsky
🇷🇺Krasnoyarsk, Krasnodar, Russian Federation
Blokhin Cancer Research Center
🇷🇺Moscow, Moskovskaja Oblast, Russian Federation
Russian Scientific Center of Roentgenoradiology
🇷🇺Moscow, Moskovskaja Oblast, Russian Federation
P.A. Herzen Oncological Inst.
🇷🇺Moscow, Moskovskaja Oblast, Russian Federation
Privolzhsk Regional Medical Center
🇷🇺Nizhny Novgorod, Niznij Novgorod, Russian Federation
SBEI HPE "The First St.Petersburg State Medical University n.a. acad. I.P.Pavlova"of MoH of RF
🇷🇺St Petersburg, Sankt Petersburg, Russian Federation
Sverdlovsk Regional Clinical Hospital 1
🇷🇺Yekaterinburg, Sverdlovsk, Russian Federation
Ivanovo Regional Oncology Dispensary
🇷🇺Ivanovo, Russian Federation
Clinical Center of Serbia
🇷🇸Belgrade, Serbia
Clinical Centre Nis, Clinic for Oncology
🇷🇸NIs, Serbia
Oncology Institute of Vojvodina
🇷🇸Sremska Kamenica, Serbia
National University Hospital
🇸🇬Singapore, Singapore
National Cancer Centre
🇸🇬Singapore, Singapore
Oncocare Cancer Centre
🇸🇬Singapore, Singapore
Institute of Oncology Ljubljana
🇸🇮Ljubljana, Slovenia
Cancercare
🇿🇦Port Elizabeth, South Africa
Hospital General Universitario de Elche
🇪🇸Elche, Alicante, Spain
Complejo Hospitalario de Althaia
🇪🇸Manresa, Barcelona, Spain
Corporacio Sanitaria Parc Tauli
🇪🇸Sabadell, Barcelona, Spain
Hospital Universitario Marques de Valdecilla
🇪🇸Santander, Cantabria, Spain
Hospital Universitario Son Espases
🇪🇸Palma De Mallorca, Islas Baleares, Spain
Clinica Universitaria de Navarra
🇪🇸Pamplona, Navarra, Spain
Hospital Alvaro Cunqueiro
🇪🇸Vigo, Pontevedra, Spain
Hospital de Basurto
🇪🇸Bilbao, Vizcaya, Spain
Complejo Hospitalario Universitario de Albacete
🇪🇸Albacete, Spain
Vall d'Hebron Institute of Oncology (VHIO), Barcelona
🇪🇸Barcelona, Spain
Hospital Clinic de Barcelona. Unidad de Nuevas Terapias
🇪🇸Barcelona, Spain
Hospital de la Santa Creu i Sant Pau
🇪🇸Barcelona, Spain
Institutio Catalan De Oncologia
🇪🇸Barcelona, Spain
Hospital Universitari Germans Trias i Pujol
🇪🇸Barcelona, Spain
Complejo Asistencial Universitario De Burgos
🇪🇸Burgos, Spain
Hospital San Pedro De Alcantara
🇪🇸Caceres, Spain
Hospital Provincial de Castellon
🇪🇸Castellon, Spain
Hospital Universitario Reina Sofia
🇪🇸Cordoba, Spain
Hospital Universitario Virgen de las Nieves
🇪🇸Granada, Spain
Complejo Hospitalario de Jaen-Hospital Universitario Medico Quirurgico
🇪🇸Jaen, Spain
Complejo Asistencial Universitario de Leon
🇪🇸Leon, Spain
Hospital Universitario Lucus Augusti
🇪🇸Lugo, Spain
Hospital General Universitario Gregorio Marañon
🇪🇸Madrid, Spain
Hospital Ramon y Cajal
🇪🇸Madrid, Spain
Hospital Universitario Clínico San Carlos
🇪🇸Madrid, Spain
Hospital Universitario 12 de Octubre
🇪🇸Madrid, Spain
Hospital Universitario La Paz
🇪🇸Madrid, Spain
Hospital Universitario Virgen del Rocio
🇪🇸Sevilla, Spain
Hospital Universitario de Toledo
🇪🇸Toledo, Spain
Hospital Universitario la Fe
🇪🇸Valencia, Spain
Hospital Clinico Universitario Lozano Blesa
🇪🇸Zaragoza, Spain
China Medical University Hospital
🇨🇳Taichung, Taiwan
Taichung Veterans General Hospital
🇨🇳Taichung, Taiwan
National Cheng Kung Uni Hospital
🇨🇳Tainan, Taiwan
National Taiwan Uni Hospital
🇨🇳Taipei City, Taiwan
Chang Gung Medical Foundation-Linkou, Urinary Oncology
🇨🇳Taoyuan, Taiwan
Vajira Hospital
🇹🇭Bangkok, Thailand
Chulalongkorn Hospital
🇹🇭Bangkok, Thailand
Faculty of Med. Siriraj Hosp.
🇹🇭Bangkok, Thailand
Maharaj Nakorn Chiang Mai Hospital
🇹🇭ChiangMai, Thailand
Baskent University Adana Dr. Turgut Noyan Practice and Research Hospital
🇹🇷Adana, Turkey
Ankara Bilkent City Hospital
🇹🇷Ankara, Turkey
Trakya Universitesi Tip Fakultesi, Medikal Onkoloji Bilim Dali, Balkan Yerleskesi
🇹🇷Edirne, Turkey
Bezmi Alem Vakif University Medical School
🇹🇷Istanbul, Turkey
Istanbul University Cerrahpa?a-Cerrahpa?a Medical Faculty
🇹🇷Istanbul, Turkey
Hacettepe Uni Medical Faculty Hospital
🇹🇷S?hhiye, Ankara, Turkey
19 Mayis University Medical Faculty
🇹🇷Samsun, Turkey
Regional Clinical Center of Urology and Nephrology n.a. V.I. Shapoval Department of Urology #4
🇺🇦Kharkiv, Kharkiv Governorate, Ukraine
CI Dnipropetrovsk CMCH #4 MA of MOHU Ch of Oncology and MR
🇺🇦Dnipropetrovsk, Ukraine
Zaporizhzhia Regional Clinic
🇺🇦Zaporizhzhia, Ukraine
Beatson West of Scotland Cancer Centre
🇬🇧Glasgow, United Kingdom
University College London Hospitals NHS Foundation Trust - University College Hospital
🇬🇧London, United Kingdom
The Christie NHS Foundation Trust
🇬🇧Manchester, United Kingdom
The York Hospital
🇬🇧York, United Kingdom