Phase 3 Study of Sitravatinib Plus Nivolumab vs Docetaxel in Patients With Advanced Non-Squamous Non-Small Cell Lung Cancer
- Conditions
- Metastatic Non-Squamous Non-Small Cell Lung Cancer
- Interventions
- Registration Number
- NCT03906071
- Lead Sponsor
- Mirati Therapeutics Inc.
- Brief Summary
This study will compare the efficacy of the investigational agent sitravatinib in combination with nivolumab versus docetaxel in patients with advanced non-squamous NSCLC who have previously experienced disease progression on or after platinum-based chemotherapy and checkpoint inhibitor therapy.
- Detailed Description
Sitravatinib (MGCD516) is an orally-available, small molecule inhibitor of a closely related spectrum of receptor tyrosine kinases (RTKs) including MET, TAM (Tyro3, AXL, MERTK) family, VEGFR family, PDGFR family, KIT, FLT3, TRK family, RET, DDR2, and selected EPH family members. Nivolumab is a human IgG monoclonal antibody that binds to the PD-1 receptor and selectively blocks the interaction with its ligands PD-L1 and PD-L2, thereby releasing PD-1 pathway mediated inhibition of the immune response, including anti-tumor immune response. RTKs have been implicated in mediating an immunosuppressive tumor microenvironment, which has emerged as a potential resistance mechanism to checkpoint inhibitor therapy. Inhibition of these RTKs by sitravatinib may augment anti-tumor immune response and improve outcomes by overcoming resistance to checkpoint inhibitor therapy.
Recruitment & Eligibility
- Status
- ACTIVE_NOT_RECRUITING
- Sex
- All
- Target Recruitment
- 577
- Diagnosis of Non-Squamous Non-Small Cell Lung Cancer
- Receipt of at least one but not more than two prior treatment regimens in the advanced setting
- Prior treatment with PD-1/PD-L1 checkpoint inhibitor therapy and platinum-based chemotherapy in combination or in sequence (i.e., platinum-based chemotheraphy followed by checkpoint inhibitor therapy)
- Most recent treatment regimen must have included a checkpoint inhibitor therapy with radiographic disease progression on or after treatment
- Candidate to receive docetaxel as second or third line therapy
- Uncontrolled brain metastases
- Tumors that have tested positive for EGFR, ROS1, ALK mutations, or ALK fusions
- Unacceptable toxicity with prior checkpoint inhibitor therapy
- Receipt of systemic anti-cancer therapy post checkpoint inhibitor therapy, other than maintenance chemotherapy
- Impaired heart function
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Nivolumab and Sitravatinib Sitravatinib Nivolumab will be administered by intravenous infusion over 30 minutes at 240 mg every 2 weeks or at 480 mg every 4 weeks. Sitravatinib capsules will be administered orally, once daily. Nivolumab and Sitravatinib Nivolumab Nivolumab will be administered by intravenous infusion over 30 minutes at 240 mg every 2 weeks or at 480 mg every 4 weeks. Sitravatinib capsules will be administered orally, once daily. Docetaxel Docetaxel Docetaxel will be administered by intravenous infusion at 75 mg/m2 over 1 hour every 3 weeks.
- Primary Outcome Measures
Name Time Method Overall Survival (OS) From randomization date to date of death due to any cause (Up to approximately 44 months) OS is defined as time from date of randomization to date of death due to any cause. Patients who did not die on study are censored at the date of the last on-study follow-up that the patient was known to be alive (including follow-up data). Results obtained via Kaplan-Meier estimation, Brookmeyer and Crowley (1982) method.
- Secondary Outcome Measures
Name Time Method Number of Participants With Treatment-Emergent Adverse Event (TEAEs) From first dose up to 28 days post last dose, and up to 100 days post last dose of nivolumab for immune-related AEs (Up to maximum of 38 months) An adverse event (AE) is any reaction, side effect or other undesirable medical event that occurs during participation in a clinical trial, regardless of treatment group or suspected causal relationship to study treatment. Serious adverse events (SAE) are defined as any AE which results in death; is life-threatening; requires inpatient hospitalization or prolongation of existing hospitalization; results in persistent or significant disability/incapacity; is a congenital anomaly/birth defect; constitutes an important medical event. A treatment emergent AE (TEAE) is an AE that occurs after the first dose of any study treatment or any preexisting condition that increases in severity after the first dose of study treatment. Adverse events were graded using the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0 (Grade 3 = Severe, Grade 4 = Life-threatening, Grade 5 = Death).
Number of Participants With Treatment-Emergent Adverse Events (TEAE) Leading to Study Drug Discontinuation From first dose up to 28 days post last dose, and up to 100 days post last dose of nivolumab for immune-related AEs (Up to maximum of 38 months) An adverse event (AE) is any reaction, side effect or other undesirable medical event that occurs during participation in a clinical trial, regardless of treatment group or suspected causal relationship to study treatment. A treatment emergent AE (TEAE) is an AE that occurs after the first dose of any study treatment or any preexisting condition that increases in severity after the first dose of study treatment.
Number of Participants With Maximum Post Baseline Hematology Grade Results From first dose up to 28 days post last dose (Up to an average of 7.5 months and maximum of 36 months) The severity of hematology results were graded based upon the participants symptoms according to the Common Terminology Criteria for Adverse Events (CTCAE, Version 5.0); Hematology parameters were evaluated for severity according to the following scale: Grade 1 = Mild - transient or mild discomfort; no medical intervention required; Grade 2 = Moderate - mild to moderate limitation in activity; Grade 3 = Severe; Grade 4 = Life threatening; Grade 5 = Death. Number of participants with maximum post baseline grades is presented. Grade 0 is defined as absence of an AE or within normal limits. Baseline is defined as the last pre-dose assessment.
Clinical Benefit Rate Per Central Radiographic Assessment From randomization until disease progression or start of new anti-cancer therapy (Up to approximately 44 months) CBR is defined as the percentage of patients documented to have a confirmed CR, confirmed PR, or SD, according to RECIST 1.1 as the best response. Complete response (CR) is defined as complete disappearance of all target lesions with the exception of nodal disease. Partial response (PR) is defined as \>=30% decrease under baseline of the sum of diameters of all target measurable lesions. Stable Disease (SD) is concluded when the response does not qualify for CR, PR or Progression. Progression is defined as 20% increase in the sum of diameters of target measurable lesions above the smallest sum observed (over baseline if no decrease in the sum is observed during therapy) with a minimum absolute increase of 5 mm.
1-Year Survival Rate At 12 months from first dose 1-Year Survival will be defined as the percentage of participants surviving at 1 year after the first dose. Results obtained via Kaplan-Meier estimation, Greenwood's formula (1980).
Change From Baseline in the Lung Cancer Symptom Scale (LCSS) Average Total Score Clinic visit closest to the disease evaluation on weeks 9, 17, 25, 33, 41, 49. The LCSS is a lung cancer specific measure of quality of life and includes 9 questions, including patient-reported ratings of six symptoms (appetite loss, fatigue, cough, dyspnea, hemoptysis, pain) and three summary items (symptom distress, activity level, overall quality of life) using 100-mm visual analogue scales ranging from 0 (lowest rating) to 100 (highest rating). The average total score = is a sum of items 1 to 9 divided by the total number of items (sum of items 1 to 9) / 9).
Change From Baseline in the European Quality of Life Five Dimensions Questionnaire (EQ-5D-5L) - Visual Analogue Score (VAS) Clinic visit closest to the disease evaluation on weeks 9, 17, 25, 33, 41, 49. The Visual Analogue Score (VAS) is a component of the EQ-5D-5L and assesses the patient's self-rated health using a vertical visual analogue scale where numbered 0 (the worst health you can image) to 100 (the best health you can imageine). The smallest change considered clinically meaningful, is defined as a score difference of 7 points.
Number of Participants With Maximum Post Baseline Chemistry Grade Results From first dose up to 28 days post last dose (Up to an average of 7.5 months and maximum of 36 months) The severity of chemistry results were graded based upon the participants symptoms according to the Common Terminology Criteria for Adverse Events (CTCAE, Version 5.0); Chemistry parameters were evaluated for severity according to the following scale: Grade 1 = Mild - transient or mild discomfort; no medical intervention required; Grade 2 = Moderate - mild to moderate limitation in activity; Grade 3 = Severe; Grade 4 = Life threatening; Grade 5 = Death. Number of participants with maximum post baseline grades is presented. Grade 0 is defined as absence of an AE or within normal limits. Baseline is defined as the last pre-dose assessment.
Objective Response Rate (ORR) Per Central Radiographic Assessment From randomization until disease progression or start of new anti-cancer therapy (Up to approximately 44 months) ORR is defined as percentage of participants with confirmed complete response (CR) or partial response (PR) per RECIST version 1.1 recorded from randomization until disease progression or start of new anti-cancer therapy. Patients who cannot be assessed for response are counted as non-responders. CR is defined as complete disappearance of all target lesions with the exception of nodal disease; PR is defined as \>=30% decrease under baseline of the sum of diameters of all target measurable lesions.
Duration of Response (DOR) Per Central Radiographic Assessment From randomization to the first documentation of disease progression (PD) or to death due to any cause in the absence of documented PD (Up to approximately 44 months) DOR is defined as the time from date of the first documentation of confirmed objective response (CR or PR) to the first documentation of disease progression (PD) or to death due to any cause in the absence of documented PD. Complete response (CR) is defined as complete disappearance of all target lesions with the exception of nodal disease. Partial response (PR) is defined as \>=30% decrease under baseline of the sum of diameters of all target measurable lesions. Progressive Disease (PD) is defined as a 20% increase in the sum of diameters of target measurable lesions above the smallest sum observed (over baseline if no decrease in the sum is observed during therapy) with a minimum absolute increase of 5 mm, or unequivocal progression of pre-existing non-target lesions. Results obtained via Kaplan-Meier estimation, Brookmeyer and Crowley (1982) method.
Progression-Free Survival (PFS) Per Central Radiographic Assessment From randomization to the date of the first documentation of objective disease progression or death due to any cause (Up to approximately 44 months) PFS is defined as the time from randomization to the date of the first documentation of objective disease progression or death due to any cause. Progressive Disease (PD) is defined as a 20% increase in the sum of diameters of target measurable lesions above the smallest sum observed (over baseline if no decrease in the sum is observed during therapy) with a minimum absolute increase of 5 mm, or unequivocal progression of pre-existing non-target lesions. Censoring was assigned on the date of the last tumor assessment if no assessment of tumor progression is identified and the patient does not die while on study. Patients with no evaluation of disease after first study treatment will have PFS censored on the date of randomization. Patients who start new anti-cancer therapy prior to documented PD will be censored at the date of the last tumor assessment prior to the start of the new therapy. Results obtained using Kaplan-Meier estimation, Brookmeyer and Crowley (1982) method.
Change From Baseline in the European Quality of Life Five Dimensions Questionnaire (EQ-5D-5L) - Health Utility Index (HUI) Clinic visit closest to the disease evaluation on weeks 9, 17, 25, 33, 41, 49. The European Quality of Life 5D-5L Scale (EQ-5D-5L) assesses general health-related quality of life. Health is defined in 5 dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Each dimension has 5 levels: no problems, slight problems, moderate problems, severe problems, and extreme problems. Responses are coded so that a '1' indicates no problem, and '5' indicates the most serious problem. The responses for the 5 dimensions are combined in a 5-digit number. The EQ-5D-5L health utility index (HUI) is assessed using the Crosswalk algorithm for France based on the individual responses to the 5 EQ-5D-5L domains ranging from -0.530 to 1.000. The smallest change considered clinically meaningful, is defined as a score difference of 0.08 points.
Sitravatinib Plasma Concentration by Time Point 0.5 hours post dose on cycle 1 (day 1) and 5 hours post dose on cycle 1 (day 1 and 15), and pre-dose on cycle 1 (day 15), and cycle 2, 3, and 5 (day 1)
Trial Locations
- Locations (261)
Local Institution - 005-164
🇺🇸Birmingham, Alabama, United States
Clearview Cancer Institute - Huntsville
🇺🇸Huntsville, Alabama, United States
Palo Verde Cancer Specialists - Glendale
🇺🇸Glendale, Arizona, United States
The Oncology Institute of Hope & Innovation - Tucson
🇺🇸Tucson, Arizona, United States
Yuma Regional Medical Center
🇺🇸Yuma, Arizona, United States
Local Institution - 005-174
🇺🇸Jonesboro, Arkansas, United States
NEA Baptist Fowler Family Center for Cancer Care
🇺🇸Jonesboro, Arkansas, United States
Highlands Oncology Group - Springdale
🇺🇸Springdale, Arkansas, United States
Comprehensive Blood and Cancer Center - Bakersfield
🇺🇸Bakersfield, California, United States
Local Institution - 005-118
🇺🇸Beverly Hills, California, United States
Local Institution - 005-171
🇺🇸Fresno, California, United States
Providence Medical Foundation - Virginia K. Crosson Cancer Center - Fullerton
🇺🇸Fullerton, California, United States
Local Institution - 005-096
🇺🇸Long Beach, California, United States
Cancer and Blood Specialty Clinic
🇺🇸Los Alamitos, California, United States
Los Angeles Hematology Oncology Medical Group
🇺🇸Los Angeles, California, United States
Local Institution - 005-185
🇺🇸Los Angeles, California, United States
Local Institution - 005-072
🇺🇸Newport Beach, California, United States
Local Institution - 005-109
🇺🇸Northridge, California, United States
Local Institution - 005-177
🇺🇸Redlands, California, United States
Local Institution - 005-112
🇺🇸Riverside, California, United States
University of California San Francisco
🇺🇸San Francisco, California, United States
Local Institution - 005-176
🇺🇸San Marcos, California, United States
Local Institution - 005-192
🇺🇸Torrance, California, United States
Local Institution - 005-090
🇺🇸West Covina, California, United States
Local Institution - 005-105
🇺🇸Whittier, California, United States
Local Institution - 005-097
🇺🇸Lafayette, Colorado, United States
Eastern Connecticut Hematology and Oncology Associates
🇺🇸Norwich, Connecticut, United States
Michael and Dianne Bienes Comprehensive Cancer Center
🇺🇸Fort Lauderdale, Florida, United States
Local Institution - 005-120
🇺🇸Fort Myers, Florida, United States
Memorial Regional Hospital
🇺🇸Hollywood, Florida, United States
Watson Clinic Cancer and Research Center
🇺🇸Lakeland, Florida, United States
Mount Sinai Health System
🇺🇸Miami Beach, Florida, United States
Local Institution - 005-120E
🇺🇸Naples, Florida, United States
Local Institution - 005-079
🇺🇸Ocala, Florida, United States
Local Institution - 005-104
🇺🇸Orlando, Florida, United States
SCRI - Florida Cancer Specialists - North Region Research Office
🇺🇸Saint Petersburg, Florida, United States
SCRI - Florida Cancer Specialists - Panhandle Research Office
🇺🇸Tallahassee, Florida, United States
Local Institution - 005-154
🇺🇸West Palm Beach, Florida, United States
University Cancer & Blood Center (UCBC) - Athens
🇺🇸Athens, Georgia, United States
Local Institution - 005-146
🇺🇸Atlanta, Georgia, United States
John B. Amos Cancer Center Research
🇺🇸Columbus, Georgia, United States
Local Institution - 005-119
🇺🇸Marietta, Georgia, United States
Straub Medical Center
🇺🇸Honolulu, Hawaii, United States
Local Institution - 005-191
🇺🇸Coeur d'Alene, Idaho, United States
Local Institution - 005-151
🇺🇸Chicago, Illinois, United States
Local Institution - 005-110
🇺🇸Evanston, Illinois, United States
Local Institution - 005-198
🇺🇸Niles, Illinois, United States
Orchard Healthcare Research
🇺🇸Skokie, Illinois, United States
Healthcare Research Network - Tinley Park
🇺🇸Tinley Park, Illinois, United States
Fort Wayne Medical Oncology and Hematology - Fort Wayne South Office
🇺🇸Fort Wayne, Indiana, United States
Local Institution - 005-122
🇺🇸Goshen, Indiana, United States
Franciscan Health Cancer Center Indianapolis
🇺🇸Indianapolis, Indiana, United States
Local Institution - 005-150
🇺🇸Lafayette, Indiana, United States
Local Institution - 005-169
🇺🇸Westwood, Kansas, United States
Local Institution - 005-098
🇺🇸Wichita, Kansas, United States
Commonwealth Cancer Center - Frankfort
🇺🇸Danville, Kentucky, United States
Local Institution - 005-153
🇺🇸Louisville, Kentucky, United States
New England Cancer Specialists - Scarborough
🇺🇸Scarborough, Maine, United States
Local Institution - 005-178
🇺🇸Rockville, Maryland, United States
Barbara Ann Karmanos Cancer Institute
🇺🇸Detroit, Michigan, United States
Henry Ford Hospital
🇺🇸Detroit, Michigan, United States
Local Institution - 005-127
🇺🇸Minneapolis, Minnesota, United States
Local Institution - 005-159
🇺🇸Saint Louis Park, Minnesota, United States
Jackson Oncology Associates - The Hederman Cancer Center
🇺🇸Jackson, Mississippi, United States
Central Care Cancer Center - Bolivar
🇺🇸Bolivar, Missouri, United States
Kansas City Care Health Center - Research Medical Campus
🇺🇸Kansas City, Missouri, United States
Sisters of Charity of Leavenworth Health St. Marys
🇺🇸Billings, Montana, United States
Saint Francis Cancer Treatment Center
🇺🇸Grand Island, Nebraska, United States
Methodist Hospital - Omaha
🇺🇸Omaha, Nebraska, United States
The Oncology Institute of Hope & Innovation - Henderson
🇺🇸Henderson, Nevada, United States
Local Institution - 005-152
🇺🇸Henderson, Nevada, United States
Local Institution - 005-142
🇺🇸Florham Park, New Jersey, United States
Local Institution - 005-163
🇺🇸Little Silver, New Jersey, United States
Cooperman Barnabas Medical Center
🇺🇸Livingston, New Jersey, United States
Regional Cancer Care Associates - Sparta
🇺🇸Sparta, New Jersey, United States
Local Institution - 005-123
🇺🇸Johnson City, New York, United States
Local Institution - 005-182
🇺🇸Lake Success, New York, United States
New York Cancer & Blood Specialists - Port Jefferson Medical Oncology
🇺🇸Port Jefferson Station, New York, United States
Local Institution - 005-107
🇺🇸Stony Brook, New York, United States
Local Institution - 005-196
🇺🇸Canton, Ohio, United States
USOR - Oncology Hematology Care - Blue Ash
🇺🇸Cincinnati, Ohio, United States
Local Institution - 005-181
🇺🇸Columbus, Ohio, United States
Tricounty Hematology and Oncology - Massillon
🇺🇸Massillon, Ohio, United States
Local Institution - 005-103
🇺🇸Toledo, Ohio, United States
Local Institution - 005-088
🇺🇸Oklahoma City, Oklahoma, United States
Providence Portland Medical Center
🇺🇸Portland, Oregon, United States
Local Institution - 005-073
🇺🇸Portland, Oregon, United States
USOR - Alliance Cancer Specialists - Horsham (Abington Hematology Oncology Associates)
🇺🇸Horsham, Pennsylvania, United States
Local Institution - 005-186
🇺🇸Philadelphia, Pennsylvania, United States
Local Institution - 005-137A
🇺🇸Dickson, Tennessee, United States
Local Institution - 005-137B
🇺🇸Dickson, Tennessee, United States
Local Institution - 005-137C
🇺🇸Dickson, Tennessee, United States
Local Institution - 005-137D
🇺🇸Dickson, Tennessee, United States
Local Institution - 005-137E
🇺🇸Dickson, Tennessee, United States
Local Institution - 005-137F
🇺🇸Dickson, Tennessee, United States
Local Institution - 005-137G
🇺🇸Dickson, Tennessee, United States
Local Institution - 005-137H
🇺🇸Dickson, Tennessee, United States
Local Institution - 005-137I
🇺🇸Dickson, Tennessee, United States
Local Institution - 005-137J
🇺🇸Dickson, Tennessee, United States
Local Institution - 005-137K
🇺🇸Dickson, Tennessee, United States
Local Institution - 005-137L
🇺🇸Dickson, Tennessee, United States
Local Institution - 005-137M
🇺🇸Hendersonville, Tennessee, United States
Local Institution - 005-195
🇺🇸Memphis, Tennessee, United States
Local Institution - 005-137
🇺🇸Nashville, Tennessee, United States
Local Institution - 005-134
🇺🇸Austin, Texas, United States
Local Institution - 005-075
🇺🇸Beaumont, Texas, United States
Local Institution - 005-128
🇺🇸Dallas, Texas, United States
Local Institution - 005-129
🇺🇸Dallas, Texas, United States
Local Institution - 005-126
🇺🇸Dallas, Texas, United States
USOR - Texas Oncology Northeast Texas - Denison
🇺🇸Denison, Texas, United States
Local Institution - 005-124
🇺🇸Denton, Texas, United States
The Center for Cancer & Blood Disorders - Fort Worth
🇺🇸Fort Worth, Texas, United States
Oncology Consultants - Texas Medical Center
🇺🇸Houston, Texas, United States
Local Institution - 005-076
🇺🇸Houston, Texas, United States
Millennium Research and Clinical Development
🇺🇸Houston, Texas, United States
USOR - US Oncology Investigational Products Center
🇺🇸Irving, Texas, United States
Local Institution - 005-125
🇺🇸McKinney, Texas, United States
Texas Oncology - San Antonio Medical Center
🇺🇸San Antonio, Texas, United States
USOR - Texas Oncology - Sugar Land
🇺🇸Sugar Land, Texas, United States
USOR - Texas Oncology Northeast Texas - Cancer and Research Institute - Tyler
🇺🇸Tyler, Texas, United States
Local Institution - 005-144
🇺🇸Charlottesville, Virginia, United States
Hematology Oncology Associates of Fredericksburg
🇺🇸Fredericksburg, Virginia, United States
Virginia Cancer Institute - West End
🇺🇸Richmond, Virginia, United States
Overlake Medical Center and Clinics
🇺🇸Bellevue, Washington, United States
Local Institution - 005-082
🇺🇸Everett, Washington, United States
Local Institution - 005-111
🇺🇸Seattle, Washington, United States
Local Institution - 005-187
🇺🇸Spokane, Washington, United States
Local Institution - 005-081
🇺🇸Tacoma, Washington, United States
Northwest Medical Specialties - Tacoma
🇺🇸Tacoma, Washington, United States
Local Institution - 005-136
🇺🇸Vancouver, Washington, United States
ThedaCare Regional Cancer Center
🇺🇸Appleton, Wisconsin, United States
Local Institution - 005-116
🇺🇸Madison, Wisconsin, United States
Froedtert Hospital
🇺🇸Milwaukee, Wisconsin, United States
Local Institution - 005-201
🇧🇪Brasschaat, Belgium
Local Institution - 005-200
🇧🇪Charleroi, Belgium
Local Institution - 005-206
🇧🇪Edegem, Belgium
Local Institution - 005-202
🇧🇪Gent, Belgium
Local Institution - 005-207
🇧🇪Gent, Belgium
Local Institution - 005-205
🇧🇪Roeselare, Belgium
Local Institution - 005-204
🇧🇪Ronse, Belgium
Centre Hospitalier Universitaire Universite Catholique de Louvain - Site Godinne
🇧🇪Yvoir, Belgium
Local Institution - 005-259
🇨🇦Calgary, Alberta, Canada
Local Institution - 005-250
🇨🇦Moncton, New Brunswick, Canada
Saint John Regional Hospital
🇨🇦Saint John, New Brunswick, Canada
Local Institution - 005-252
🇨🇦Hamilton, Ontario, Canada
Local Institution - 005-251
🇨🇦Toronto, Ontario, Canada
Local Institution - 005-257
🇨🇦Windsor, Ontario, Canada
Local Institution - 005-255
🇨🇦Montreal, Quebec, Canada
Saskatoon Cancer Centre
🇨🇦Saskatoon, Saskatchewan, Canada
Local Institution - 005-258
🇨🇦Quebec, Canada
Local Institution - 005-307
🇫🇷Brest, France
Local Institution - 005-310
🇫🇷Bron, France
Local Institution - 005-311
🇫🇷Creteil, France
Local Institution - 005-303
🇫🇷Dijon cedex, France
Local Institution - 005-309
🇫🇷Le Mans Cedex 9, France
Local Institution - 005-308
🇫🇷Limoges cedex, France
Local Institution - 005-317
🇫🇷Lyon, France
Local Institution - 005-301
🇫🇷Marseille, France
Local Institution - 005-312
🇫🇷Marseille, France
Local Institution - 005-313
🇫🇷Montpellier Cedex 5, France
Local Institution - 005-306
🇫🇷Mulhouse, France
Local Institution - 005-302
🇫🇷Paris, France
Local Institution - 005-314
🇫🇷Rouen cedex, France
Local Institution - 005-316
🇫🇷Saint Herblain, France
Local Institution - 005-305
🇫🇷Strasbourg, France
Local Institution - 005-304
🇫🇷Villejuif, France
Local Institution - 005-400
🇩🇪Bad Berka, Germany
Local Institution - 005-418
🇩🇪Berlin, Germany
Local Institution - 005-401
🇩🇪Bonn, Germany
Local Institution - 005-419
🇩🇪Essen, Germany
Local Institution - 005-406
🇩🇪Esslingen, Germany
Local Institution - 005-403
🇩🇪Gauting, Germany
Local Institution - 005-417
🇩🇪Grohansdorf, Germany
Local Institution - 005-408
🇩🇪Halle, Germany
Local Institution - 005-411
🇩🇪Immenstadt, Germany
Local Institution - 005-416
🇩🇪Kassel, Germany
Local Institution - 005-412
🇩🇪Koln, Germany
Local Institution - 005-410
🇩🇪Lowenstein, Germany
Local Institution - 005-405
🇩🇪Lubeck, Germany
Local Institution - 005-414
🇩🇪Mainz, Germany
Local Institution - 005-413
🇩🇪Munchen, Germany
Local Institution - 005-402
🇩🇪Munchen, Germany
Local Institution - 005-454
ðŸ‡ðŸ‡ºBudapest, Hungary
Local Institution - 005-457
ðŸ‡ðŸ‡ºBudapest, Hungary
Local Institution - 005-455
ðŸ‡ðŸ‡ºBudapest, Hungary
Local Institution - 005-453
ðŸ‡ðŸ‡ºFarkasgyepu, Hungary
Local Institution - 005-452
ðŸ‡ðŸ‡ºGyor, Hungary
Local Institution - 005-451
ðŸ‡ðŸ‡ºSzombathely, Hungary
Local Institution - 005-450
ðŸ‡ðŸ‡ºTatabanya, Hungary
Local Institution - 005-456
ðŸ‡ðŸ‡ºTorokbalint, Hungary
Local Institution - 005-500
🇮🇱Afula, Israel
Local Institution - 005-504
🇮🇱Beer Sheva, Israel
Local Institution - 005-501
🇮🇱Beer Yaakov, Israel
Local Institution - 005-502
🇮🇱Holon, Israel
Local Institution - 005-507
🇮🇱Jerusalem, Israel
Local Institution - 005-506
🇮🇱Ramat Gan, Israel
Local Institution - 005-505
🇮🇱Zsfat, Israel
Local Institution - 005-612
🇮🇹Alessandria, Italy
Local Institution - 005-602
🇮🇹Bari, Italy
Local Institution - 005-603
🇮🇹Catania, Italy
Local Institution - 005-611
🇮🇹Cremona, Italy
Local Institution - 005-608
🇮🇹Lecce, Italy
Local Institution - 005-610
🇮🇹Meldola, Italy
Local Institution - 005-606
🇮🇹Milan, Italy
Local Institution - 005-605
🇮🇹Monza, Italy
Local Institution - 005-604
🇮🇹Napoli, Italy
Local Institution - 005-600
🇮🇹Parma, Italy
Local Institution - 005-607
🇮🇹Piacenza, Italy
Local Institution - 005-609
🇮🇹Pisa, Italy
Local Institution - 005-614
🇮🇹Roma, Italy
Ospedale di Circolo e Fondazione Macchi
🇮🇹Varese, Italy
Local Institution - 005-703
🇳🇱Amsterdam, Netherlands
Local Institution - 005-711
🇳🇱Amsterdam, Netherlands
Local Institution - 005-707
🇳🇱Breda, Netherlands
Local Institution - 005-709
🇳🇱Den Haag, Netherlands
Local Institution - 005-713
🇳🇱Dordrecht, Netherlands
Local Institution - 005-702
🇳🇱Groningen, Netherlands
Local Institution - 005-712
🇳🇱Maastricht, Netherlands
Local Institution - 005-714
🇳🇱Nijmegen, Netherlands
Local Institution - 005-710
🇳🇱Rotterdam, Netherlands
Local Institution - 005-705
🇳🇱Rotterdam, Netherlands
Local Institution - 005-700
🇳🇱s-Hertogenbosch, Netherlands
Local Institution - 005-701
🇳🇱Utrecht, Netherlands
Local Institution - 005-708
🇳🇱Utrecht, Netherlands
Local Institution - 005-706
🇳🇱Zwolle, Netherlands
Local Institution - 005-807
🇪🇸A Coruna, Spain
Local Institution - 005-800
🇪🇸Badalona, Spain
Local Institution - 005-822
🇪🇸Barcelona, Spain
Local Institution - 005-811
🇪🇸Barcelona, Spain
Local Institution - 005-810
🇪🇸Barcelona, Spain
Local Institution - 005-805
🇪🇸Jaen, Spain
Local Institution - 005-816
🇪🇸Las Palmas de Gran Canaria, Spain
Local Institution - 005-817
🇪🇸Leon, Spain
Local Institution - 005-812
🇪🇸Lugo, Spain
Hospital Universitario La Princesa
🇪🇸Madrid, Spain
Local Institution - 005-808
🇪🇸Madrid, Spain
Local Institution - 005-819
🇪🇸Madrid, Spain
Local Institution - 005-821
🇪🇸Madrid, Spain
Local Institution - 005-813
🇪🇸Madrid, Spain
Local Institution - 005-815
🇪🇸Madrid, Spain
Local Institution - 005-809
🇪🇸Madrid, Spain
Hospital Universitario La Paz
🇪🇸Madrid, Spain
Local Institution - 005-806
🇪🇸Majadahonda, Spain
Local Institution - 005-801
🇪🇸Malaga, Spain
Local Institution - 005-803
🇪🇸Oviedo, Spain
Local Institution - 005-823
🇪🇸Santiago de Compostela, Spain
IVO - Fundacion Instituto Valenciano de Oncologia
🇪🇸Valencia, Spain
Local Institution - 005-804
🇪🇸Valencia, Spain
Local Institution - 005-818
🇪🇸Vigo, Spain
Inselspital Universitatsspital Bern
🇨ðŸ‡Bern, Switzerland
Hopitaux Universitaires de Geneve
🇨ðŸ‡Geneve, Switzerland
Centre Hospitalier Universitaire Vaudois Lausanne
🇨ðŸ‡Lausanne, Switzerland
Kantonsspital Winterthur
🇨ðŸ‡Winterthur, Switzerland
Velindre University NHS Trust
🇬🇧Cardiff, United Kingdom
Local Institution - 005-904
🇬🇧Cornwall, United Kingdom
University Hospitals of Leicester NHS Trust
🇬🇧Leicester, United Kingdom
Local Institution - 005-908
🇬🇧London, United Kingdom
Local Institution - 005-900
🇬🇧London, United Kingdom
The Royal Marsden NHS Foundation Trust
🇬🇧London, United Kingdom
The Christie NHS Foundation Trust
🇬🇧Manchester, United Kingdom
Local Institution - 005-903
🇬🇧Middlesex, United Kingdom