A Study of Teclistamab in Combination With Daratumumab and Lenalidomide (Tec-DR) and Talquetamab in Combination With Daratumumab and Lenalidomide (Tal-DR) in Participants With Newly Diagnosed Multiple Myeloma
- Conditions
- Multiple Myeloma
- Interventions
- Registration Number
- NCT05552222
- Lead Sponsor
- Janssen Research & Development, LLC
- Brief Summary
The purpose of this study is to compare the efficacy of teclistamab in combination with daratumumab and lenalidomide (Tec-DR) and talquetamab in combination with daratumumab and lenalidomide (Tal-DR) versus daratumumab, lenalidomide, dexamethasone (DRd).
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 1590
- Have a diagnosis of multiple myeloma according to the International Myeloma Working Group (IMWG) diagnostic criteria
- Be newly diagnosed and not considered a candidate for high-dose chemotherapy with autologous stem cell transplant (ASCT) due to: ineligible due to advanced age OR; ineligible due to the presence of comorbid condition(s) likely to have a negative impact on tolerability of high-dose chemotherapy with ASCT OR; deferral of high-dose chemotherapy with ASCT as initial treatment
- Have an Eastern Cooperative Oncology Group (ECOG) performance status score of 0 to 2
- A participant must agree not to be pregnant, breastfeeding, or planning to become pregnant while enrolled in this study or within 6 months after the last dose of study treatment
- A participant must agree not to plan to father a child while enrolled in this study or within 100 days after the last dose of study treatment
- Received any prior therapy for multiple myeloma or smoldering myeloma other than a short course of corticosteroids (not to exceed total of 160 milligrams [mg] dexamethasone or equivalent). In addition, received a cumulative dose of systemic corticosteroids equivalent to greater than or equals to (>=) 20 mg of dexamethasone within 14 days before randomization
- Had plasmapheresis within 28 days of randomization
- Had a stroke, transient ischemic attack, or seizure within 6 months prior to randomization
- Known allergies, hypersensitivity, or intolerance to teclistamab or talquetamab excipients
- Known contraindications to the use of daratumumab or lenalidomide per local prescribing information
- Myeloma Frailty Index of >=2 with the exception of participants who have a score of 2 based on age alone
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Teclistamab, Daratumumab SC, and Lenalidomide (Tec-DR) Teclistamab Participants will receive teclistamab as subcutaneous (SC) injection in combination with daratumumab and lenalidomide. Teclistamab, Daratumumab SC, and Lenalidomide (Tec-DR) Daratumumab Participants will receive teclistamab as subcutaneous (SC) injection in combination with daratumumab and lenalidomide. Teclistamab, Daratumumab SC, and Lenalidomide (Tec-DR) Lenalidomide Participants will receive teclistamab as subcutaneous (SC) injection in combination with daratumumab and lenalidomide. Talquetamab, Daratumumab SC, and Lenalidomide (Tal-DR) Daratumumab Participants will receive talquetamab as SC injection in combination with daratumumab and lenalidomide. Talquetamab, Daratumumab SC, and Lenalidomide (Tal-DR) Lenalidomide Participants will receive talquetamab as SC injection in combination with daratumumab and lenalidomide. Talquetamab, Daratumumab SC, and Lenalidomide (Tal-DR) Talquetamab Participants will receive talquetamab as SC injection in combination with daratumumab and lenalidomide. Daratumumab SC, Lenalidomide, and Dexamethasone (DRd) Daratumumab Participants will receive daratumumab as SC injection with lenalidomide and dexamethasone. Daratumumab SC, Lenalidomide, and Dexamethasone (DRd) Lenalidomide Participants will receive daratumumab as SC injection with lenalidomide and dexamethasone. Daratumumab SC, Lenalidomide, and Dexamethasone (DRd) Dexamethasone Participants will receive daratumumab as SC injection with lenalidomide and dexamethasone.
- Primary Outcome Measures
Name Time Method Progression Free Survival (PFS) From randomization to the date of disease progression or death (Up to 09 years) PFS is defined as the duration from the date of randomization to either progressive disease or death, whichever comes first. Disease progression will be determined according to the International Myeloma Working Group (IMWG) response criteria.
12-Month Minimal Residual Disease (MRD)-Negative Complete Response (CR) At Month 12 12-month MRD-negative CR is defined as participants who achieve MRD-negative status at 12 months, as determined by next-generation sequencing (NGS) with sensitivity of 10\^-5, prior to progressive disease or subsequent anti-myeloma therapy and who also achieve CR or better, according to IMWG criteria.
- Secondary Outcome Measures
Name Time Method Very Good Partial Response (VGPR) or Better From randomization up to 09 years VGPR or better is defined as the percentage of participants achieving VGPR and CR (including stringent complete response \[sCR\]) prior to subsequent antimyeloma therapy in accordance with the IMWG criteria during or after the study treatment.
Complete Response (CR) or Better From randomization up to 09 years CR or better is defined as the percentage of participants achieving CR or sCR prior to subsequent antimyeloma therapy in accordance with the IMWG criteria during or after the study treatment.
Sustained Minimal Residual disease (MRD)-negative Complete Response (CR) From randomization up to 09 years Sustained MRD-negative CR is defined as participants with CR or better who sustain MRD-negative status, as determined by NGS with sensitivity of 10\^-5, for at least 12 months without any examination showing MRD positive status or progressive disease in between.
MRD-negative CR From randomization up to 09 years MRD-negative CR is defined as the percentage of participants who achieve MRD-negative status, as determined by NGS with sensitivity of 10\^-5, at any time after randomization and prior to progressive disease or subsequent antimyeloma therapy and who achieve CR or better.
Progression Free Survival on Next-line Therapy (PFS2) From randomization up to 09 years PFS2 is defined as the time interval between the date of randomization and date of event, which is defined as progressive disease as assessed by investigator that starts after the next line of subsequent therapy, or death from any cause, whichever occurs first.
Overall Survival (OS) From randomization to the date of death (up to 09 years) OS is defined as the time from the date of randomization to the date of death due to any cause.
Number of Participants with Adverse Events (AEs) by Severity From randomization up to 09 years An adverse event is any untoward medical occurrence in a clinical study participant administered a pharmaceutical (investigational or non-investigational) product. An adverse event does not necessarily have a causal relationship with the treatment. Severity will be graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) version 5.0. Severity scale ranges from Grade 1: mild, Grade 2: moderate, Grade 3: severe, Grade 4: life-threatening, and Grade 5: death related to adverse event.
Number of Participants with Abnormalities in Laboratory Parameters From randomization up to 09 years Number of participants with abnormalities in laboratory parameters (serum chemistry and hematology) will be reported.
Number of Participants with Abnormalities in Vital Signs From randomization up to 09 years Number of participants with abnormalities in vital signs (temperature, pulse/heart rate, respiratory rate, blood pressure) will be reported.
Number of Participants with Abnormalities in Physical Examination From randomization up to 09 years Number of participants with abnormalities in physical examination will be reported.
Number of Participants with Abnormalities in Electrocardiogram (ECG) From randomization up to 09 years Number of participants with abnormalities in ECG will be reported.
Serum Concentrations of Teclistamab and Talquetamab From randomization up to 09 years Serum samples will be analyzed to determine concentrations of teclistamab and talquetamab using validated, specific, and sensitive methods.
Number of Participants with Anti-drug Antibodies (ADAs) to Teclistamab and Talquetamab From randomization up to 09 years Number of participants with ADAs to teclistamab and talquetamab will be reported.
Change from Baseline in Symptoms, Functioning, and Health-related Quality of Life (HRQoL) as Assessed by European Organization for Research and Treatment of Cancer Quality-of-life Questionnaire Core 30 (EORTC-QLQ-C30) From baseline up to 9 years The EORTC-QLQ-C30 Version 3 includes 30 items that make up 5 functional scales (physical, role, emotional, cognitive, and social), 1 global health status scale, 3 symptom scales (pain, fatigue, and nausea/vomiting), and 5 single symptom items (dyspnea, insomnia, appetite loss, constipation, and diarrhea) and a single impact item (financial difficulties). The recall period is 7 days ("past week"), and responses are reported using a verbal and numeric rating scales. The item and scale scores are transformed to a 0 to 100 scale. A high scale score represents a higher response level. Thus, a high score for a functional scale represents a high/healthy level of functioning and a high score for the global health status represents high HRQoL, but a high score for a symptom scale/item represents a high level of symptomatology/problems.
Change from Baseline in Treatment-related Symptoms as Assessed by Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) Baseline through Cycle 6 (each cycle of 28 days) (up to 196 days) The National Cancer Institute's (NCI's) PRO-CTCAE is an item library of common AEs experienced by people with cancer that are appropriate for self-reporting of treatment tolerability. Each symptom selected for inclusion can be rated by up to 3 attributes characterizing the presence/frequency, severity, and/or interference of the AEs. It ranges from 0 to 4 with higher scores indicating higher frequency or greater severity/impact.
Change from Baseline in Symptoms, Functioning, and Overall HRQoL as Assessed by EuroQol Five Dimension Questionnaire 5-Level (EQ-5D-5L) From baseline up to 9 years The EQ-5D-5L is a 5-item questionnaire that assesses 5 domains including mobility, self-care, usual activities, pain/discomfort, and anxiety/depression plus a visual analog scale rating "health today" with anchors ranging from 0 (worst imaginable health state) to 100 (best imaginable health state).
Time to Sustained Worsening in Symptoms, Functioning, and HRQoL From randomization up to 09 years Time to sustained worsening in symptoms, functioning and HRQoL is defined as the interval from the date of randomization to the start date of meaningful change.
Trial Locations
- Locations (203)
Kantonsspital St Gallen
🇨🇭St. Gallen, Switzerland
Liga Norte Riograndense Contra O Cancer
🇧🇷Natal, Brazil
Complexo Hospitalar de Niteroi
🇧🇷Niteroi, Brazil
CHU Poitiers - Hopital la Miletrie
🇫🇷Poitiers, France
CHU de Rennes - Hopital Pontchaillou
🇫🇷Rennes, France
City of Hope Cancer Center
🇺🇸Duarte, California, United States
City of Hope Orange County Lennar Foundation Cancer Center
🇺🇸Irvine, California, United States
University of Iowa Health Care
🇺🇸Waukee, Iowa, United States
Norton Cancer Institute
🇺🇸Louisville, Kentucky, United States
Cancer And Hematology Centers of Western Michigan PC
🇺🇸Grand Rapids, Michigan, United States
University of Nebraska Medical Center
🇺🇸Omaha, Nebraska, United States
Christus St. Vincent Regional Cancer Center
🇺🇸Santa Fe, New Mexico, United States
Durham VAMC
🇺🇸Durham, North Carolina, United States
Royal Prince Alfred Hospital
🇦🇺Camperdown, Australia
Barwon Health - University Hospital Geelong
🇦🇺Geelong, Australia
Liverpool Hospital
🇦🇺Liverpool, Australia
Sir Charles Gairdner Hospital
🇦🇺Nedlands, Australia
Calvary Mater Newcastle Hospital
🇦🇺New South Wales, Australia
Wollongong Hospital
🇦🇺Wollongong, Australia
Princess Alexandra Hospital
🇦🇺Woolloongabba, Australia
Ordensklinikum Linz GmbH Elisabethinen
🇦🇹Linz, Austria
SCRI CCCIT gem GmbH
🇦🇹Salzburg, Austria
Medical University Vienna
🇦🇹Vienna, Austria
Hanusch Krankenhaus
🇦🇹Wien, Austria
Institut Jules Bordet
🇧🇪Anderlecht, Belgium
Ghent University Hospital
🇧🇪Gent, Belgium
Jolimont
🇧🇪Haine Saint Paul La Louviere, Belgium
Az Groeninge
🇧🇪Kortrijk, Belgium
Universitair Ziekenhuis Leuven
🇧🇪Leuven, Belgium
GZA Ziekenhuizen- Campus St Augustinus
🇧🇪Wilrijk, Belgium
Fundacao Pio XII
🇧🇷Barretos, Brazil
Santa Casa de Misericordia de Belo Horizonte
🇧🇷Belo Horizonte, Brazil
Liga Paranaense de Combate ao Cancer
🇧🇷Curitiba, Brazil
Instituto Do Cancer Do Ceara
🇧🇷Fortaleza, Brazil
Hospital De Clinicas De Porto Alegre
🇧🇷Porto Alegre, Brazil
Hospital Das Clinicas Da Faculdade De Medicina De RPUSP HCRP
🇧🇷Ribeirao Preto, Brazil
Hospital Sao Rafael
🇧🇷Salvador, Brazil
Hospital Nove de Julho
🇧🇷Sao Paulo, Brazil
Clinica Medica Sao Germano S/S LTDA
🇧🇷Sao Paulo, Brazil
Hospital Das Clinicas Da Faculdade De Medicina Da USP
🇧🇷Sao Paulo, Brazil
Arthur J E Child Comprehensive Cancer Centre
🇨🇦Calgary, Alberta, Canada
Cross Cancer Institute
🇨🇦Edmonton, Alberta, Canada
British Columbia Cancer Agency
🇨🇦Vancouver, British Columbia, Canada
CHU de Quebec L Hotel Dieu de Quebec
🇨🇦Quebec, Canada
Peking Union Medical College Hospital
🇨🇳Beijing, China
Peking University First Hospital
🇨🇳Beijing, China
Beijing Tongren Hospital CMU
🇨🇳Beijing, China
Changzhou No 2 Peoples Hospital
🇨🇳Chang Zhou, China
The First Hospital of Jilin University
🇨🇳Changchun, China
The Second Xiangya Hospital of Central South Hospital
🇨🇳Changsha, China
Beijing Chaoyang Hospital
🇨🇳Chaoyang District, China
Sichuan Provincial Peoples Hospital
🇨🇳Chengdu, China
Chongqing University Cancer Hospital
🇨🇳Chongqing, China
Fujian Meidical University Union Hospital
🇨🇳Fu Zhou, China
Nanfang Hospital
🇨🇳Guangzhou, China
Sun Yat -Sen University Cancer Center
🇨🇳Guangzhou, China
The Second Affiliated Hospital of Zhejiang University
🇨🇳Hang Zhou, China
No.1 Affiliated Hospital, Medical College of Zhejiang University
🇨🇳Hangzhou, China
Harbin medical university cancer hospital
🇨🇳Harbin, China
Qilu Hospital of Shandong University
🇨🇳Jinan, China
Zhongda Hospital Southeast University
🇨🇳Nan Jing, China
The First Affiliated Hospital of Guangxi Medical University
🇨🇳Nan Ning Shi, China
The First Affliated Hospital Of Nanchang University
🇨🇳Nanchang, China
Nanjing Drum Tower Hospital
🇨🇳Nanjing, China
Ruijin Hospital Shanghai Jiao Tong University
🇨🇳Shanghai, China
Renji Hospital, Shanghai Jiaotong University School of Medicine
🇨🇳Shanghai, China
Shanghai Fourth People s Hospital
🇨🇳Shanghai, China
Peking University Shenzhen Hospital
🇨🇳Shen Zhen Shi, China
Shengjing Hospital Of China Medical University
🇨🇳Shenyang, China
Institute of Hematology and Blood Diseases Hospital
🇨🇳Tian Jin, China
Tianjin Medical University Cancer Institute and Hospital
🇨🇳Tianjin, China
The First Affiliated Hospital of Wenzhou Medical University
🇨🇳Wenzhou, China
Wuhan Tongji Hospital Tongji Medical College
🇨🇳WuHan, China
The Second Affiliated Hospital of Xi'an Jiaotong University
🇨🇳Xi' An, China
The first affiliated hospital of xiamen university
🇨🇳Xiamen, China
Institut de Cancerologie Strasbourg Europe ICANS
🇫🇷Strasbourg, France
Henan Cancer Hospital
🇨🇳Zhengzhou, China
Fakultni nemocnice Brno
🇨🇿Brno - Bohunice, Czechia
Fakultni nemocnice Hradec Kralove
🇨🇿Hradec Kralove, Czechia
Fakultni nemocnice Olomouc
🇨🇿Olomouc, Czechia
Fakultni Nemocnice Ostrava
🇨🇿Ostrava, Czechia
Fakultni nemocnice Plzen
🇨🇿Plzen, Czechia
VFN v Praze
🇨🇿Praha, Czechia
Aalborg University Hospital
🇩🇰Aalborg, Denmark
Regionshospitalet Godstrup
🇩🇰Herning, Denmark
Zealand University Hospital
🇩🇰Roskilde, Denmark
Vejle Sygehus
🇩🇰Vejle, Denmark
APHP - Hopital Henri Mondor
🇫🇷Creteil, France
Hopital Claude Huriez
🇫🇷Lille, France
CHU Nantes
🇫🇷Nantes, France
CHU Hopital Saint Antoine
🇫🇷PARIS cedex 12, France
CHU de Bordeaux - Hospital Haut-Leveque
🇫🇷Pessac cedex, France
CHU Lyon Sud
🇫🇷Pierre-Benite, France
Institut Universitaire du Cancer Toulouse Oncopole
🇫🇷Toulouse, France
Helios Kliniken Berlin Buch Gmbh
🇩🇪Berlin, Germany
Universitaetsklinikum Halle Saale
🇩🇪Halle (Saale), Germany
Universitaetsklinik Hamburg-Eppendorf
🇩🇪Hamburg, Germany
Klinikum Nuernberg Nord
🇩🇪Nuernberg, Germany
Universitaetsklinikum Tuebingen der Eberhard-Karls-Universitaet, Abteilung fuer Innere Medizin II,
🇩🇪Tübingen, Germany
Anticancer Hospital of Thessaloniki Theageneio
🇬🇷Thessaloniki, Greece
Universitaetsklinikum Wuerzburg
🇩🇪Wurzburg, Germany
Alexandra General Hospital of Athens
🇬🇷Athens Attica, Greece
G Papanikolaou Hospital of Thessaloniki
🇬🇷Thessalonikis, Greece
Rambam Medical Center
🇮🇱Haifa, Israel
Shaare Zedek Medical Center
🇮🇱Jerusalem, Israel
Rabin
🇮🇱Petah Tikva, Israel
Sheba Medical Center
🇮🇱Ramat Gan, Israel
Tel Aviv Sourasky Medical Center
🇮🇱Tel Aviv Yafo, Israel
ASST Papa Giovanni XXIII Bergamo
🇮🇹Bergamo, Italy
A O U Sant Orsola Malpighi
🇮🇹Bologna, Italy
Careggi University Hospital
🇮🇹Firenze, Italy
Ospedale San Raffaele
🇮🇹Milan, Italy
Azienda Ospedaliera di Rilievo Nazionale A Cardarelli
🇮🇹Naples, Italy
IRCCS Policlinico San Matteo, Università degli studi di Pavi
🇮🇹Pavia, Italy
Universita Degli Studi di Roma Tor Vergata
🇮🇹Roma, Italy
Istituto Clinico Humanitas
🇮🇹Rozzano, Italy
Azienda Ospedaliera Universitaria Citta della Salute e della Scienza di Torino
🇮🇹Torino, Italy
Juntendo University Hospital
🇯🇵Bunkyo Ku, Japan
Chiba Cancer Center
🇯🇵Chiba, Japan
Kameda Medical Center
🇯🇵Chiba, Japan
National Hospital Organization Mito Medical Center
🇯🇵Higashiibaraki-gun, Japan
Kansai Medical University Hospital
🇯🇵Hirakata, Japan
Hyogo Medical University Hospital
🇯🇵Hyôgo, Japan
Saitama Medical University Hospital
🇯🇵Iruma-gun, Japan
Tokai University Hospital
🇯🇵Kanagawa, Japan
Kanazawa University Hospital
🇯🇵Kanazawa, Japan
Kumamoto University Hospital
🇯🇵Kumamoto-shi, Japan
Matsuyama Red Cross Hospital
🇯🇵Matsuyama-City, Japan
National Hospital Organization Nagasaki Medical Center
🇯🇵Nagasaki, Japan
National Hospital Organization Okayama Medical Center
🇯🇵Okayama, Japan
Osaka Metropolitan University Hospital
🇯🇵Osaka, Japan
National Hospital Organization Hokkaido Cancer Center
🇯🇵Sapporo, Japan
National Hospital Organization Shibukawa Medical Center
🇯🇵Shibukawa, Japan
Japanese Red Cross Medical Center
🇯🇵Shibuya-ku, Japan
Shizuoka Cancer Center
🇯🇵Sunto Gun, Japan
Fujita Health University Hospital
🇯🇵Toyoake, Japan
Yamagata University Hospital
🇯🇵Yamagata, Japan
Yamanashi Prefectural Central Hospital
🇯🇵Yamanashi, Japan
Dong-A University Hospital
🇰🇷Busan, Korea, Republic of
Pusan National University Hospital
🇰🇷Busan, Korea, Republic of
Kyungpook National University Hospital
🇰🇷Daegu, Korea, Republic of
National Cancer Center
🇰🇷Goyang si, Korea, Republic of
Chonnam National University Hwasun Hospital
🇰🇷Hwasun, 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
Asan Medical Center
🇰🇷Seoul, Korea, Republic of
Inselspital Universitatsspital Bern
🇨🇭Bern, Switzerland
Samsung Medical Center
🇰🇷Seoul, Korea, Republic of
The Catholic University of Korea Seoul St Mary s Hospital
🇰🇷Seoul, Korea, Republic of
VUMC Amsterdam
🇳🇱Amsterdam, Netherlands
Gelre Ziekenhuis
🇳🇱Apeldoorn, Netherlands
Reinier de Graaf Gasthuis
🇳🇱Delft, Netherlands
St. Antonius Ziekenhuis Nieuwegein
🇳🇱Nieuwegein, Netherlands
Zuyderland Medical Center
🇳🇱Sittard-Geleen, Netherlands
Oslo University Hospital HF Ulleval sykehus
🇳🇴Oslo, Norway
St. Olavs Hospital
🇳🇴Trondheim, Norway
Wojewodzki Szpital Kliniczny w Bialej Podlaskiej
🇵🇱Biala Podlaska, Poland
Szpital Specjalistyczny w Brzozowie Podkarpacki Osrodek Onkologiczny im Ks B Markiewicza
🇵🇱Brzozow, Poland
Szpital Uniwersytecki nr 2 im. Jana Biziela w Bydgoszczy
🇵🇱Bydgoszcz, Poland
Pratia Onkologia Katowice
🇵🇱Katowice, Poland
Swietokrzyskie Centrum Onkologii SPZOZ w Kielcach
🇵🇱Kielce, Poland
Wojewodzkie Wielospecjalistyczne Centrum Onkologii i Traumatologii im M Kopernika w Lodzi
🇵🇱Lodz, Poland
Centrum Onkologii Ziemi Lubelskiej im sw Jana z Dukli
🇵🇱Lublin, Poland
Uniwersytecki Szpital Kliniczny w Poznaniu
🇵🇱Poznan, Poland
Szpital Uniwersytecki im Karola Marcinkowskiego w Zielonej Gorze
🇵🇱Zielona Gora, Poland
Uls Braga - Hosp. Braga
🇵🇹Braga, Portugal
Champalimaud Foundation Champalimaud Centre
🇵🇹Lisbon, Portugal
Instituto Portugues de Oncologia
🇵🇹Porto, Portugal
Uls Hosp Sao Joao
🇵🇹Porto, Portugal
Hosp. Univ. Germans Trias I Pujol
🇪🇸Badalona, Spain
Hosp. de La Santa Creu I Sant Pau
🇪🇸Barcelona, Spain
Hosp Univ Vall D Hebron
🇪🇸Barcelona, Spain
Hosp. Univ. Virgen de Las Nieves
🇪🇸Granada, Spain
Hosp. de Jerez de La Frontera
🇪🇸Jerez de la Frontera, Spain
Hosp. Univ. 12 de Octubre
🇪🇸Madrid, Spain
Hosp. Univ. La Paz
🇪🇸Madrid, Spain
Hosp Univ Hm Sanchinarro
🇪🇸Madrid, Spain
Hosp. Univ. Son Espases
🇪🇸Palma de Mallorca, Spain
Hosp. Quiron Madrid Pozuelo
🇪🇸Pozuelo de Alarcon, Spain
Hosp Clinico Univ de Salamanca
🇪🇸Salamanca, Spain
Hosp. Mutua Terrassa
🇪🇸Terrassa, Spain
Hosp. Clinico Univ. de Valencia
🇪🇸Valencia, Spain
Falu Lasarett
🇸🇪Falun, Sweden
Skanes universitetssjukhus
🇸🇪Lund, Sweden
Karolinska University Hospital Huddinge
🇸🇪Stockholm, Sweden
Universitetssjukhuset Orebro
🇸🇪Örebro, Sweden
Dr Abdurrahman Yurtaslan Oncology Training and Research Hospital
🇹🇷Ankara, Turkey
Ankara University Medical Faculty
🇹🇷Ankara, Turkey
Liv Hospital Ankara
🇹🇷Ankara, Turkey
Memorial Antalya Hospital
🇹🇷Antalya, Turkey
Pamukkale University Medical Faculty
🇹🇷Denizli, Turkey
Medipol University Hospital
🇹🇷Istanbul, Turkey
Dokuz Eylul University Medical Faculty
🇹🇷Izmir, Turkey
Ondokuz Mayis University
🇹🇷Samsun, Turkey
Blackpool Victoria Hospital
🇬🇧Blackpool, United Kingdom
University Hospitals Bristol and Weston
🇬🇧Bristol, United Kingdom
Addenbrooke's Hospital
🇬🇧Cambridge, United Kingdom
Kent and Canterbury Hospital
🇬🇧Canterbury, United Kingdom
Western General Hospital
🇬🇧Edinburgh, United Kingdom
University College London Hospitals
🇬🇧London, United Kingdom
Imperial College Healthcare
🇬🇧London, United Kingdom
New Cross Hospital
🇬🇧Wolverhampton, United Kingdom