Trastuzumab Deruxtecan (DS-8201a) Versus Investigator's Choice for HER2-low Breast Cancer That Has Spread or Cannot be Surgically Removed [DESTINY-Breast04]
- Conditions
- Breast Cancer
- Interventions
- Registration Number
- NCT03734029
- Lead Sponsor
- Daiichi Sankyo
- Brief Summary
This study will compare DS-8201a to physician choice standard treatment.
Participants must have HER2-low breast cancer that has been treated before.
Participants' cancer:
* Cannot be removed by an operation
* Has spread to other parts of the body
- Detailed Description
This is a randomized, 2-arm, Phase 3, open-label, multicenter study to compare the safety and efficacy of trastuzumab deruxtecan versus the physician's choice (2:1) in HER2-low, unresectable and/or metastatic breast cancer participants.
The Sponsor proposes to define a new HER2-low population in this trial including tumors with IHC 1+ and IHC 2+/ISH- HER2 expression.
Recruitment & Eligibility
- Status
- ACTIVE_NOT_RECRUITING
- Sex
- All
- Target Recruitment
- 557
-
Is the age of majority in their country
-
Has pathologically documented breast cancer that:
- Is unresectable or metastatic
- Has low-HER2 expression defined as IHC 2+/ISH- or IHC 1+ (ISH- or untested)
- Is HR-positive or HR-negative
- Has progressed on, and would no longer benefit from, endocrine therapy
- Has been treated with 1 to 2 prior lines of chemotherapy/adjuvant in the recurrent or metastatic setting
- Was never previously HER2-positive (ICH 3+ or ISH+) on prior pathology testing (per American Society of Clinical Oncology-College of American Pathologists [ASCO-CAP] guidelines)
-
Has documented radiologic progression (during or after most recent treatment)
-
Has adequate archival tumor samples available or is wiling to provide fresh biopsies prior to randomization for:
- assessment of HER2 status
- assessment of post-treatment status
-
Has at least 1 measurable lesion per Response Evaluation Criteria In Solid Tumors 1.1
-
Has protocol-defined adequate cardiac, bone marrow, renal, hepatic and blood clotting functions
-
Male and female participants of reproductive/childbearing potential, agrees to follow instructions for method(s) of contraception and agrees to avoid preserving ova or sperm for at least 4.5 months after treatment (or longer, per locally approved labels)
- Is ineligible for all options in the physician's choice arm
- Has breast cancer ever assessed with high-HER2 expression
- Has previously been treated with any anti-HER2 therapy, including an antibody drug conjugate
- Has uncontrolled or significant cardiovascular disease
- Has spinal cord compression or clinically active central nervous system metastases
- Has history of (noninfectious) interstitial lung disease (ILD)/pneumonitis that required steroids, has current ILD/pneumonitis, or suspected ILD/pneumonitis that cannot be ruled out by imaging at screening
- Has any medical history or condition that per protocol or in the opinion of the investigator is inappropriate for the study
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Physician's Choice Nab-paclitaxel HER2-low, unresectable, and/or metastatic breast cancer participants previously treated with chemotherapy randomized to Physician's choice from the following options: * Capecitabine * Eribulin * Gemcitabine * Paclitaxel * Nab-paclitaxel Trastuzumab deruxtecan Trastuzumab deruxtecan (DS-8201a) HER2-low, unresectable, and/or metastatic breast cancer participants previously treated with chemotherapy randomized to DS8201a Physician's Choice Capecitabine HER2-low, unresectable, and/or metastatic breast cancer participants previously treated with chemotherapy randomized to Physician's choice from the following options: * Capecitabine * Eribulin * Gemcitabine * Paclitaxel * Nab-paclitaxel Physician's Choice Gemcitabine HER2-low, unresectable, and/or metastatic breast cancer participants previously treated with chemotherapy randomized to Physician's choice from the following options: * Capecitabine * Eribulin * Gemcitabine * Paclitaxel * Nab-paclitaxel Physician's Choice Paclitaxel HER2-low, unresectable, and/or metastatic breast cancer participants previously treated with chemotherapy randomized to Physician's choice from the following options: * Capecitabine * Eribulin * Gemcitabine * Paclitaxel * Nab-paclitaxel Physician's Choice Eribulin HER2-low, unresectable, and/or metastatic breast cancer participants previously treated with chemotherapy randomized to Physician's choice from the following options: * Capecitabine * Eribulin * Gemcitabine * Paclitaxel * Nab-paclitaxel
- Primary Outcome Measures
Name Time Method Progression-free Survival (PFS) Based on Blinded Independent Central Review (BICR) in the Hormone Receptor-Positive Cohort in Participants With HER2-low Breast Cancer From the date of randomization to the earliest date of the first objective documentation of radiographic disease progression or death due to any cause, up to approximately 3 years Progression-free survival (PFS), defined as at least a 20% increase in the sum of diameters of target lesions, was assessed from the date of randomization to the date of the first radiographic disease progression or death due to any cause, whichever came first. PFS was based on blinded independent central review (BICR) in the hormone receptor-positive cohort according to modified Response Evaluation Criteria in Solid Tumors (mRECIST) version 1.1. Median PFS was from Kaplan-Meier analysis. Confidence interval for median was computed using the Brookmeyer-Crowley method.
- Secondary Outcome Measures
Name Time Method Best Overall Response and Confirmed Objective Response Rate (ORR) in the Hormone Receptor-Positive Cohort in Participants With HER2-low Breast Cancer From screening and every 6 weeks up to withdrawal of subject consent, progressive disease (PD), or unacceptable toxicity, up to approximately 3 years Best overall response rate and confirmed objective response rate (ORR) were assessed by blinded independent central review (BICR) and investigator assessment. Complete response (CR) was defined as a disappearance of all target lesions, partial response (PR) was defined as at least a 30% decrease in the sum of diameters of target lesions, and stable disease (SD) was defined as neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for progressive disease (PD; at least a 20% increase in the sum of diameters of target lesions. Confirmed ORR was defined as the number of participants with complete and partial responses and confirmed by a second assessment.
Best Overall Response and Confirmed Objective Response Rate (ORR) in Participants With HER2-low Breast Cancer (All Patients) From screening and every 6 weeks up to withdrawal of subject consent, progressive disease (PD), or unacceptable toxicity, up to approximately 3 years Best overall response rate and confirmed objective response rate (ORR) were assessed by blinded independent central review (BICR) and investigator assessment. Complete response (CR) was defined as a disappearance of all target lesions, partial response (PR) was defined as at least a 30% decrease in the sum of diameters of target lesions, and stable disease (SD) was defined as neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for progressive disease (PD; at least a 20% increase in the sum of diameters of target lesions. Confirmed ORR was defined as the number of participants with complete and partial responses and confirmed by a second assessment.
Duration of Response in the Hormone Receptor-Positive Cohort in Participants With HER2-low Breast Cancer From the date of the first documented objective response (CR or PR) to the first documented disease progression or death, whichever occurs first, up to approximately 3 years Duration of Response (DoR) is defined as the date of the first documented objective response (complete response \[CR\] or partial response \[PR\]) to the first documented disease progression or death, whichever occurs first. DoR was based on blinded independent central review (BICR) and investigator assessment. Median was from Kaplan-Meier estimate. Confidence interval for median was computed using the Brookmeyer-Crowley method.
Duration of Response in Participants With HER2-low Breast Cancer (All Patients) From the date of the first documented objective response (CR or PR) to the first documented disease progression or death, whichever occurs first, up to approximately 3 years Duration of Response (DoR) is defined as the date of the first documented objective response (complete response \[CR\] or partial response \[PR\]) to the first documented disease progression or death, whichever occurs first. DoR was based on blinded independent central review (BICR) and investigator assessment. Median was from Kaplan-Meier estimate. Confidence interval for median was computed using the Brookmeyer-Crowley method.
Overall Survival (OS) in the Hormone Receptor-Positive Cohort in Participants With HER2-low Breast Cancer From the date of randomization up to the date of death due to any cause, up to approximately 3 years Overall survival (OS) was defined as the time from the date of randomization to the date of death due to any cause. If there was no death reported for a participant before the data cutoff for OS analysis, OS was censored at the last contact date at which the participant was known to be alive.
Overall Survival (OS) in All Patients From the date of randomization up to the date of death due to any cause, up to approximately 3 years Overall survival (OS) was defined as the time from the date of randomization to the date of death due to any cause. If there was no death reported for a participant before the data cutoff for OS analysis, OS was censored at the last contact date at which the participant was known to be alive.
Progression-free Survival (PFS) Based on Blinded Independent Central Review (BICR) in Participants With HER2-low Breast Cancer (All Patients) Regardless of Hormone Receptor Status From the date of randomization to the earliest date of the first objective documentation of radiographic disease progression or death due to any cause, up to approximately 3 years Progression-free survival (PFS), defined as at least a 20% increase in the sum of diameters of target lesions, was assessed from the date of randomization to the date of the first radiographic disease progression or death due to any cause, whichever came first. PFS was based on blinded independent central review (BICR) according to modified Response Evaluation Criteria in Solid Tumors (mRECIST) version 1.1. Median PFS was from Kaplan-Meier analysis. Confidence interval for median was computed using the Brookmeyer-Crowley method.
Progression-free Survival Based on Investigator Assessment in the Hormone Receptor-Positive Cohort in Participants With HER2-low Breast Cancer From the date of randomization to the earliest date of the first objective documentation of radiographic disease progression or death due to any cause, up to approximately 3 years Progression-free survival (PFS), defined as at least a 20% increase in the sum of diameters of target lesions, was assessed from the date of randomization to the date of the first radiographic disease progression or death due to any cause, whichever came first. PFS was based on investigator assessment in the hormone receptor-positive cohort according to modified Response Evaluation Criteria in Solid Tumors (mRECIST) version 1.1. Median PFS was from Kaplan-Meier analysis. Confidence interval for median was computed using the Brookmeyer-Crowley method.
Progression-free Survival Based on Investigator Assessment in Participants With HER2-low Breast Cancer (All Patients) From the date of randomization to the earliest date of the first objective documentation of radiographic disease progression or death due to any cause, up to approximately 3 years Progression-free survival (PFS), defined as at least a 20% increase in the sum of diameters of target lesions, was assessed from the date of randomization to the date of the first radiographic disease progression or death due to any cause, whichever came first. PFS was based on investigator assessment according to modified Response Evaluation Criteria in Solid Tumors (mRECIST) version 1.1. Median PFS was from Kaplan-Meier analysis. Confidence interval for median was computed using the Brookmeyer-Crowley method.
Number of Overall Survival Events (Deaths) From the date of randomization up to the date of death due to any cause, up to approximately 3 years
Trial Locations
- Locations (208)
Anhui Provincial Hospital
🇨🇳Hefei, Anhui, China
Harbin Medical University Cancer Hospital
🇨🇳Harbin, Heilongjiang, China
Jilin Cancer Hospital
🇨🇳Chang chun, Jilin, China
Liaoning Cancer Hospital & Institute
🇨🇳Shenyang, Liaoning, China
Sun Yat-sen Memorial hospital, Sun Yat-sen University
🇨🇳Guangzhou, Guangdong, China
Linyi Cancer Hospital
🇨🇳Linyi, Shandong, China
Shanghai General Hospital
🇨🇳Shanghai, Shanghai, China
Severance Hospital, Yonsei University Health System
🇰🇷Seoul, Korea, Republic of
Ironwood Cancer & Research Centers - Chandler II
🇺🇸Chandler, Arizona, United States
Banner MD Anderson Cancer Center
🇺🇸Gilbert, Arizona, United States
Cancer Treatment Centers of America at Western Regional Medical Center
🇺🇸Goodyear, Arizona, United States
Cancer Care Associates Medical Group, Inc. TORI
🇺🇸Redondo Beach, California, United States
UCLA School of Medicine
🇺🇸Los Angeles, California, United States
Stanford Cancer Institute
🇺🇸Palo Alto, California, United States
Eastern Connecticut Hematology/Oncology Assoc.
🇺🇸Norwich, Connecticut, United States
Sylvester Comprehensive Cancer Center - Deerfield Beach
🇺🇸Boca Raton, Florida, United States
Florida Cancer Specialists (South Region)
🇺🇸Fort Myers, Florida, United States
Memorial Healthcare System MRH Cancer Center
🇺🇸Hollywood, Florida, United States
Cancer Treatment Centers of America-Georgia
🇺🇸Newnan, Georgia, United States
Touro Infirmary
🇺🇸New Orleans, Louisiana, United States
University of Chicago Medical Center
🇺🇸Chicago, Illinois, United States
Dana-Farber Cancer Institute
🇺🇸Boston, Massachusetts, United States
New York University Medical Center
🇺🇸New York, New York, United States
Memorial Sloan Kettering Hospital
🇺🇸New York, New York, United States
Weill Cornell Medicine Breast Center
🇺🇸New York, New York, United States
The Cleveland Clinic Foundation
🇺🇸Cleveland, Ohio, United States
Allegheny General Hospital
🇺🇸Pittsburgh, Pennsylvania, United States
University of Pittsburgh Medical Center Health System
🇺🇸Pittsburgh, Pennsylvania, United States
Brig Center for Cancer Care and Survivorship
🇺🇸Knoxville, Tennessee, United States
St Francis Hospital
🇺🇸Greenville, South Carolina, United States
Baptist Cancer Center
🇺🇸Memphis, Tennessee, United States
BloomTrials Clinical Research, LLC
🇺🇸Dallas, Texas, United States
Virginia Cancer Specialists
🇺🇸Fairfax, Virginia, United States
Institut Jules Bordet
🇧🇪Bruxelles, Belgium
UZ Leuven
🇧🇪Leuven, Belgium
Tom Baker Cancer Center
🇨🇦Calgary, Alberta, Canada
Toronto Sunnybrook Hospital
🇨🇦Toronto, Ontario, Canada
McGill University - Dept. Oncology Clinical Research Program
🇨🇦Montréal, Quebec, Canada
Cancer Hospital Chinese Academy of Medical Sciences
🇨🇳Beijing, Beijing, China
Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA
🇨🇳Fuzhou, Fujian, China
Hubei Cancer Hospital
🇨🇳Wuhan, Hubei, China
The First Hospital of Jilin University
🇨🇳Chang chun, Jilin, China
The Affiliated Drum Tower Hospital of Nanjing University
🇨🇳Nanjing, Jiangsu, China
General Hospital of Ningxia Medical University
🇨🇳Yinchuan, Ningxia, China
West China Hospital, Sichuan University
🇨🇳Chengdu, Sichuan, China
Zhejiang Cancer Hospital
🇨🇳Hangzhou, Zhejiang, China
Fudan University Shanghai Cancer Center
🇨🇳Shanghai, Shanghai, China
Sir Run Run Shaw Hospital, Zhejiang University, School of Medicine
🇨🇳Hangzhou, Zhejiang, China
Clinique Clementville
🇫🇷Montpellier, Herault, France
Institut Bergonié
🇫🇷Bordeaux cedex, Gironde, France
CARIO - Centre Armoricain de Radiothérapie, Imagerie médicale et Oncologie
🇫🇷Plérin, Cotes d'Armor, France
CHU Brest - Hôpital Morvan
🇫🇷Brest Cedex, Finistere, France
Institut Régional du Cancer de Montpellier
🇫🇷Montpellier, Herault, France
ICO - Site Paul Papin
🇫🇷Angers Cedex 2, Maine Et Loire, France
CRLCC Eugene Marquis
🇫🇷Rennes-cedex, Ille Et Vilaine, France
Institut Curie - site de Paris
🇫🇷Paris, France
Hôpital d'Instruction des Armees Begin*
🇫🇷Saint Mande, Val De Marne, France
Hopital Tenon
🇫🇷Paris, France
Universitaetsklinikum Heidelberg
🇩🇪Heidelberg, Baden Wuerttemberg, Germany
Institut Gustave Roussy
🇫🇷Villejuif cedex, Val De Marne, France
General Hospital of Athens "Alexandra"
🇬🇷Athens, Greece
Klinikum der Universitaet Muenchen - Campus Grosshardern
🇩🇪Munich, Bayern, Germany
General Hospital Papageorgiou
🇬🇷Thessaloníki, Greece
Interbalkan Hospital of Thessaloniki
🇬🇷Thessaloníki, Greece
Debreceni Egyetem
🇭🇺Debrecen, Hungary
Bekes Megyei Kozponti Korhaz Pandy Kalman Tagkorhaza
🇭🇺Gyula, Hungary
Shaare Zedek Medical Center
🇮🇱Jerusalem, Israel
Rabin Medical Center-Beilinson Campus
🇮🇱Petah tikva, Israel
Azienda Socio Sanitaria Territoriale di Monza (Presidio San Gerardo)
🇮🇹Monza, Milano, Italy
Istituto Clinico Humanitas
🇮🇹Rozzano, Milano, Italy
Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia (Presidio Spedali Civili)
🇮🇹Brescia, Italy
Azienda Ospedaliera Universitaria Policlinico Sant'Orsola Malpighi
🇮🇹Bologna, Italy
IEO Istituto Europeo di Oncologia
🇮🇹Milano, Italy
Istituto Nazionale Tumori Fondazione G. Pascale
🇮🇹Napoli, Italy
Azienda Ospedaliera Universitaria Policlinico Tor Vergata
🇮🇹Roma, Italy
Fondazione Policlinico Universitario Agostino Gemelli IRCCS
🇮🇹Roma, Italy
NHO Kyushu Cancer Center
🇯🇵Fukuoka-shi, Fukuoka-Ken, Japan
NHO Shikoku Cancer Center
🇯🇵Matsuyama-shi, Ehime-Ken, Japan
NHO Hokkaido Cancer Center
🇯🇵Sapporo-shi, Hokkaido, Japan
Hiroshima City Hiroshima Citizens Hospital
🇯🇵Hiroshima-shi, Hiroshima-Ken, Japan
Fukushima Medical University Hospital
🇯🇵Fukushima, Fukushima-Ken, Japan
Hyogo College of Medicine Hospital
🇯🇵Nishinomiya-shi, Hyogo-Ken, Japan
Hakuaikai Sagara Hospital
🇯🇵Kagoshima, Kagoshima-Ken, Japan
NHO Osaka National Hospital
🇯🇵Osaka-shi, Osaka-Fu, Japan
Kindai University Hospital
🇯🇵Onohigashi, Osakasayama-shi, Japan
Cancer Institute Hospital of JFCR
🇯🇵Koto-Ku, Tokyo-To, Japan
Showa University Hospital
🇯🇵Shinagawa-Ku, Tokyo-To, Japan
Chungbuk National University Hospital
🇰🇷Cheongju-si, Chungcheongbuk-do, Korea, Republic of
Inha University Hospital
🇰🇷Incheon, Gyeonggi-do, Korea, Republic of
Ajou University Hospital
🇰🇷Suwon, Gyeonggi-do, Korea, Republic of
Kyungpook National University Chilgok Hospital
🇰🇷Daegu, Korea, Republic of
Asan Medical Center
🇰🇷Seoul, Korea, Republic of
Seoul National University Hospital
🇰🇷Seoul, Korea, Republic of
Samsung Medical Center
🇰🇷Seoul, Korea, Republic of
The Catholic University of Korea, Seoul St. Mary's Hospital
🇰🇷Seoul, Korea, Republic of
Cancer Center of Kansas
🇺🇸Wichita, Kansas, United States
Institut Paoli Calmettes
🇫🇷Marseille cedex 9, Bouches-du-Rhône, France
Ospedale Sacro Cuore Don Calabria
🇮🇹Negrar, Verona, Italy
AKH - Medizinische Universität Wien (4305)
🇦🇹Vienna, Austria
Saint Barnabas Medical Center
🇺🇸Livingston, New Jersey, United States
LKH - Universitätsklinikum der PMU Salzburg
🇦🇹Salzburg, Austria
Universitair Ziekenhuis Brussel
🇧🇪Bruxelles, Belgium
Cliniques Universitaires Saint-Luc
🇧🇪Bruxelles, Belgium
Grand Hôpital de Charleroi
🇧🇪Loverval, Belgium
CHU UCL Namur
🇧🇪Namur, Belgium
Cancer Treatment Centers of America
🇺🇸Zion, Illinois, United States
Kepler Universitätsklinikum
🇦🇹Linz, Austria
Klinikum Wels-Grieskirchen GmbH
🇦🇹Wels, Austria
Centre Hospitalier Wallonie picarde - Site IMC
🇧🇪Tournai, Belgium
Euromedica General Clinic Thessaloniki
🇬🇷Thessaloníki, Greece
Bioclinic Thessaloniki
🇬🇷Thessaloníki, Greece
Kaplan Medical Center
🇮🇱Rechovot, Israel
Tel Aviv Sourasky Medical Center
🇮🇱Tel Aviv, Israel
Christiana Care Health Services, Inc.
🇺🇸Newark, Delaware, United States
Centre François Baclesse
🇫🇷Caen, Calvados, France
Centre Hospitalier Valenciennes
🇫🇷Valenciennes, Nord, France
University General Hospital of Heraklion
🇬🇷Heraklion, Greece
SzSzB Megyei Korhazak es Egyetemi Oktatokorhaz
🇭🇺Nyiregyhaza, Hungary
Ziv Medical Center
🇮🇱Safed, Israel
Aichi Cancer Center Hospital
🇯🇵Nagoya, Aichi-Ken, Japan
Shizuoka Cancer Center
🇯🇵Sunto-gun, Shizuoka-Ken, Japan
Centro Hospitalar do Porto, E.P.E. - Hospital de Santo António
🇵🇹Porto, Portugal
Centre Hospitalier Emile Roux
🇫🇷Le Puy-en-Velay, Loiret, France
Hôpital Saint-Louis - Paris
🇫🇷Paris Cedex 10, Paris, France
Clinique Victor Hugo - Centre Jean Bernard
🇫🇷Le Mans Cedex 02, Sarthe, France
General Oncology Hospital of Kifissia " Agioi Anargyroi"
🇬🇷Athens, Greece
Jasz-Nagykun-Szolnok Megyei Hetenyi Geza Korhaz-Rendelointezet
🇭🇺Szolnok, Hungary
Hadassah University Hospital - Ein Kerem
🇮🇱Jerusalem, Israel
Kanagawa Cancer Center
🇯🇵Yokohama, Kanagawa, Japan
Saitama Cancer Center
🇯🇵Kitaadachi-gun, Saitama-Ken, Japan
Del-pesti Centrumkorhaz - Orszagos Hematologiai es Infektologiai Intezet
🇭🇺Budapest, Hungary
University General Hospital of Larissa
🇬🇷Larissa, Greece
Chaim Sheba Medical Center
🇮🇱Ramat Gan, Israel
Orszagos Onkologiai Intezet
🇭🇺Budapest, Hungary
Athens Medical Center
🇬🇷Athens, Greece
Rambam Health Care Center
🇮🇱Haifa, Israel
Azienda Ospedaliera Card. G. Panico
🇮🇹Tricase, Lecce, Italy
National Cancer Center Hospital East
🇯🇵Kashiwa-shi, Chiba-Ken, Japan
Tokai University Hospital
🇯🇵Isehara, Kanagawa-Ken, Japan
Centro Hospitalar de Entre o Douro e Vouga, E.P.E - Hospital de São Sebastião
🇵🇹Santa Maria Da Feira, Portugal
Toranomon Hospital
🇯🇵Minato-Ku, Tokyo-To, Japan
Queen Mary University of London
🇬🇧London, Greater London, United Kingdom
National Taiwan University Hospital
🇨🇳Taipei, Taiwan
National Cancer Center
🇰🇷Goyang-si, Gyeonggi-do, Korea, Republic of
Royal Surrey County Hospital
🇬🇧Guildford, Surrey, United Kingdom
Kaohsiung Medical University Chung-Ho Memorial Hospital
🇨🇳Kaohsiung, Taiwan
Chinese PLA General Hospital
🇨🇳Beijing, Beijing, China
Ospedale degli Infermi
🇮🇹Rimini, Italy
ICO - Site René Gauducheau
🇫🇷Saint-Herblain, Loire Atlantique, France
Institut Sainte Catherine
🇫🇷Avignon Cedex 9, Vaculuse, France
Azienda Ospedaliera Univ. Policlinico Gaspare Rodolico
🇮🇹Catania, Italy
Azienda Ospedaliero Universitaria Mater Domini-Campus Universitario
🇮🇹Catanzaro, Italy
University College London Hospitals
🇬🇧London, Greater London, United Kingdom
Hospital de Braga
🇵🇹Braga, Portugal
Centro Hospitalar do Alto do Ave, EPE
🇵🇹Guimarães, Portugal
Fundação Champalimaud
🇵🇹Lisboa, Portugal
Centro Hospitalar de Lisboa Norte, E.P.E. - Hospital de Santa Maria
🇵🇹Lisboa, Portugal
Unidade Local de Saúde de Matosinhos, EPE (Hospital Pedro Hispano)
🇵🇹Matosinhos, Portugal
Instituto Português de Oncologia do Porto Francisco Gentil, EPE
🇵🇹Porto, Portugal
Centro Hospitalar Vila Nova de Gaia/Espinho, E.P.E
🇵🇹Vila Nova De Gaia, Portugal
FSBSI "Russian Oncological Scientific Center n.a. N.N. Blokhin"
🇷🇺Moscow, Russian Federation
Centro Hospitalar de Trás-os-Montes e Alto Douro, EPE
🇵🇹Vila Real, Portugal
SBIH of Moscow City "Moscow City Oncology Hospital №62" of Moscow Healthcare Departement
🇷🇺Moscow, Russian Federation
SBIH of Yaroslavl Region "Regional Clinical Oncological Hospital"
🇷🇺Yaroslavl, Russian Federation
ICO l'Hospitalet - Hospital Duran i Reynals
🇪🇸L'Hospitalet De Llobregat, Barcelona, Spain
Hospital Universitario Donostia
🇪🇸San Sebastián, Guipuzcoa, Spain
Complejo Hospitalario Universitario A Coruña
🇪🇸A Coruña, La Coruña, Spain
Hospital Universitario de Canarias
🇪🇸San Cristobal de la Laguna, Tenerife, Spain
Hospital del Mar
🇪🇸Barcelona, Spain
Hospital de Basurto
🇪🇸Bilbao, Vizcaya, Spain
Hospital Quironsalud Barcelona
🇪🇸Barcelona, Spain
Hospital Universitari Vall d'Hebron
🇪🇸Barcelona, Spain
Hospital Clinic de Barcelona
🇪🇸Barcelona, Spain
MD Anderson Cancer Centre
🇪🇸Madrid, Spain
Hospital Ruber Internacional
🇪🇸Madrid, Spain
Hospital Universitario Ramon y Cajal
🇪🇸Madrid, Spain
Hospital Universitario Clinico San Carlos
🇪🇸Madrid, Spain
Hospital Clinico Universitario Virgen de la Victoria
🇪🇸Málaga, Spain
Hospital Universitario Virgen Macarena
🇪🇸Sevilla, Spain
Hospital Universitario Virgen del Rocio
🇪🇸Sevilla, Spain
Instituto Valenciano de Oncologia IVO
🇪🇸Valencia, Spain
Hospital General Universitario de Valencia
🇪🇸Valencia, Spain
Karolinska universitetssjukhuset - Solna
🇸🇪Solna, Sweden
Länssjukhuset Sundsvall-Härnösand
🇸🇪Sundsvall, Sweden
Akademiska Sjukhuset
🇸🇪Uppsala, Sweden
Universitaetsspital Basel
🇨🇭Basel, Switzerland
Hirslanden Medical Center
🇨🇭Aarau, Switzerland
Kantonsspital Graubuenden
🇨🇭Chur, Switzerland
Kantonsspital St. Gallen
🇨🇭Saint Gallen, Switzerland
Centre Hospitalier Universitaire Vaudois
🇨🇭Lausanne, Switzerland
Universitaetsspital Zuerich
🇨🇭Zürich, Switzerland
Kantonsspital Winterthur
🇨🇭Winterthur, Switzerland
National Cheng Kung University Hospital
🇨🇳Tainan, Taiwan
Royal Cornwall Hospital
🇬🇧Truro, Cornwall, United Kingdom
Royal Free Hospital
🇬🇧London, Greater London, United Kingdom
Western General Hospital
🇬🇧Edinburgh, Lothian Region, United Kingdom
Nottingham University Hospitals City Campus
🇬🇧Nottingham, Nottinghamshire, United Kingdom
Moffitt Cancer Center -Tampa
🇺🇸Tampa, Florida, United States
Henry Ford Hospital
🇺🇸Detroit, Michigan, United States
University of California at San Francisco (PARENT)
🇺🇸San Francisco, California, United States
Oregon Health & Science University
🇺🇸Portland, Oregon, United States
Tennessee Oncology - Skyline Satellite
🇺🇸Nashville, Tennessee, United States
The Methodist Hospital Research Institute
🇺🇸Houston, Texas, United States
University of Texas M. D. Anderson Cancer Center - Investigational Cancer Therapeutics
🇺🇸Houston, Texas, United States
Seoul National University Bundang Hospital
🇰🇷Seongnam-si, Gyeonggi-do, Korea, Republic of
Orlando Health, Inc.
🇺🇸Orlando, Florida, United States
Saint Luke's Hospital of Kansas City
🇺🇸Kansas City, Missouri, United States
Medizinische Universität Innsbruck
🇦🇹Innsbruck, Austria