MedPath

Study Comparing Rovalpituzumab Tesirine Versus Topotecan in Subjects With Advanced or Metastatic Small Cell Lung Cancer With High Levels of Delta-like Protein 3 (DLL3) and Who Have First Disease Progression During or Following Front-line Platinum-based Chemotherapy (TAHOE)

Phase 3
Completed
Conditions
Small Cell Lung Cancer
Interventions
Registration Number
NCT03061812
Lead Sponsor
AbbVie
Brief Summary

The purpose of this randomized, open-label, 2-arm, phase 3 study is to assess the efficacy, safety and tolerability of rovalpituzumab tesirine versus topotecan in participants with advanced or metastatic SCLC with high levels of DLL3, who have first disease progression during or following front-line platinum-based chemotherapy.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
444
Inclusion Criteria
  • Participant must have histologically or cytologically confirmed advanced or metastatic Small Cell Lung Cancer (SCLC) with documented first disease progression during or following front-line platinum-based systemic regimen
  • Tumor must have high Delta-like protein 3 (DLL3) expression defined as having ≥ 75% tumor cells staining positive according to the VENTANA DLL3 (SP347) IHC Assay.
  • Participant must have measurable disease, as defined per Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1.
  • Participant must have an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
  • Participant must have recovery to Grade 0 or 1 of any clinically significant toxicity (excluding alopecia) prior to initiation of study drug administration.
Exclusion Criteria
  • Participant has a documented history of a cerebral vascular event (stroke or transient ischemic attack), unstable angina, myocardial infarction, or cardiac symptoms consistent with New York Heart Association Class (NYHA) III - IV within 6 months prior to their first dose of study drug.
  • Participant has known leptomeningeal metastases.
  • Participant has received more than one prior systemic therapy regimen for SCLC.
  • Participant had a serious infection within 2 weeks prior to randomization, including any Grade 3 or higher viral, bacterial, or fungal infection.
  • Participant has a history of active malignancies other than SCLC within the past 2 years prior to study entry, with the exception of in situ cancer which was curatively treated.
  • Participant had prior exposure to topotecan, irinotecan or any other topoisomerase I inhibitors.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Rovalpituzumab tesirineDexamethasoneRovalpituzumab tesirine IV administration (dosing based on actual body weight) on Day 1 of a 42-day cycle for 2 cycles, with up to 2 additional cycles permitted. Dexamethasone coadministered orally (PO) twice daily at a dose of 8 mg on Day -1, Day 1, and Day 2 of each 42-day cycle in which rovalpituzumab tesirine is administered.
TopotecanTopotecanTopotecan given as an intravenous (IV) infusion over 30 minutes at a dose of 1.5 mg/m\^2 on Days 1 to 5 of each 21-day cycle.
Rovalpituzumab tesirineRovalpituzumab tesirineRovalpituzumab tesirine IV administration (dosing based on actual body weight) on Day 1 of a 42-day cycle for 2 cycles, with up to 2 additional cycles permitted. Dexamethasone coadministered orally (PO) twice daily at a dose of 8 mg on Day -1, Day 1, and Day 2 of each 42-day cycle in which rovalpituzumab tesirine is administered.
Primary Outcome Measures
NameTimeMethod
Overall Survival (OS)From randomization until the end of study; median time on follow-up was 20 and 20.6 months for the topotecan and rovalpituzumab tesirine arms, respectively.

OS is defined as the time from the date of randomization to the date of death from any cause. Participants were censored at the last date they were documented alive. After the End of treatment, survival information was collected at approximately 6-week intervals (or as requested by sponsor to support data analysis) continuing until the endpoint of death, the participant became lost to follow-up, AbbVie terminated the study, or until 12 February 2020. Calculated using the Kaplan-Meier product-limit method.

Secondary Outcome Measures
NameTimeMethod
Progression Free Survival (PFS)From randomization until the end of study; median time on follow-up was 20 and 20.6 months for the topotecan and rovalpituzumab tesirine arms, respectively.

PFS is defined as the number of months from the date of randomization until the date of first progression or the date of a participant's death, whichever occurs first. If a participant neither experienced disease progression nor died, then the participant's data were censored at the last date of radiographic assessment that they were documented to be progression free. Calculated using the Kaplan-Meier product-limit method.

Radiographic tumor assessments for response were conducted by CT scanning according to Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1. Progressive Disease (PD) was defined as at least a 20% increase in the size of target lesions and an absolute increase of at least 5 mm taking as reference the smallest lesion size recorded since the treatment started (baseline or after), or the appearance of one or more new lesions.

Objective Response Rate (ORR)Radiographic tumor assessments were conducted at baseline, every 6 weeks for 30 weeks, then every 9 weeks until progression or death; median time on follow-up was 20 and 20.6 months for the topotecan and rovalpituzumab tesirine arms, respectively.

ORR is defined as the percentage of participants whose best overall response is either complete response (CR) or partial response (PR) according to RECIST version 1.1. Radiographic tumor assessments for response were conducted by CT scanning, and assessed from the date of randomization until disease progression or death, whichever came first. Any participant who did not meet CR or PR, including those who did not have post-baseline radiological assessments were considered non-responders.

CR: Disappearance of all target and non-target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to \< 10 mm. PR: At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters.

Clinical Benefit Rate (CBR)Radiographic tumor assessments were conducted at baseline, every 6 weeks for 30 weeks, then every 9 weeks until progression or death; median time on follow-up was 20 and 20.6 months for the topotecan and rovalpituzumab tesirine arms, respectively.

CBR is defined as percentage of participants whose best overall response is CR, PR, or stable disease (SD) according to RECIST version 1.1. Radiographic tumor assessments for response were conducted by CT scanning, and assessed from the date of randomization until disease progression or death, whichever came first. Any participant who did not meet CR, PR, or SD, including those who did not have post-baseline radiological assessments were considered as experiencing no clinical benefit.

CR: disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to \<10 mm. PR: at least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters. SD: neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum diameters while on study.

Change From Baseline of the Physical Functioning Scale Score in European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 15-Palliative Care (EORTC QLQ-C15-PAL) at Week 7Baseline, Week 7

The EORTC QLQ-C15-PAL is an abbreviated 15-item version of the EORTC core quality of life questionnaire (EORTC QLQ-C30) developed for use in palliative care. The score of 'physical functioning scale' score ranges from 0 (very poor) to 100 (excellent).

Duration of Objective Response (DOR)Radiographic tumor assessments were conducted at baseline, every 6 weeks for 30 weeks, then every 9 weeks until progression or death; median time on follow-up was 20 and 20.6 months for the topotecan and rovalpituzumab tesirine arms, respectively.

DOR is defined as the time between the date of first response (CR or PR, whichever is recorded first) to the date of the first documented tumor progression (per RECIST version 1.1) or death due to any cause, whichever comes first. Radiographic tumor assessments for response were conducted by CT scanning, and assessed from the date of randomization until disease progression or death, whichever came first. Any participant who did not meet CR or PR, including those who did not have post-baseline radiological assessments were considered non-responders.

CR: Disappearance of all target and non-target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to \< 10 mm. PR: At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters.

Trial Locations

Locations (195)

Georgia Cancer Center /ID# 160206

🇺🇸

Atlanta, Georgia, United States

Cedars-Sinai Medical Center /ID# 157102

🇺🇸

Beverly Hills, California, United States

Mitchell Cancer Institute /ID# 158151

🇺🇸

Mobile, Alabama, United States

Moore UC San Diego Cancer Center /ID# 156965

🇺🇸

La Jolla, California, United States

Highlands Oncology Group /ID# 155902

🇺🇸

Springdale, Arkansas, United States

UT Southwestern Medical Center /ID# 158150

🇺🇸

Dallas, Texas, United States

Carti /Id# 156982

🇺🇸

Little Rock, Arkansas, United States

Icri /Id# 157090

🇺🇸

Whittier, California, United States

St George Hospital /ID# 158855

🇦🇺

Kogarah, New South Wales, Australia

Nebraska Hematology Oncology /ID# 155900

🇺🇸

Lincoln, Nebraska, United States

Asklepios Fachkliniken M. Gaut /ID# 158791

🇩🇪

Gauting, Germany

Petz Aladar Megyei Oktato Korh /ID# 158978

🇭🇺

Gyor, Hungary

Assis.Publique-Hopital Nord /ID# 160554

🇫🇷

Marseille, Provence-Alpes-Cote-d Azur, France

Fundacao Pio XII - Hospital de Cancer de Barretos /ID# 159017

🇧🇷

Barretos, Sao Paulo, Brazil

Nemocnice Na Plesi s.r.o. /ID# 161190

🇨🇿

Nová Ves pod Pleší, Pribram, Czechia

Los Angeles Hematology Oncolog /ID# 155879

🇺🇸

Los Angeles, California, United States

Centre Leon Berard /ID# 160561

🇫🇷

Lyon CEDEX 08, Rhone, France

NorthShore University HealthSystem - Evanston Hospital /ID# 157054

🇺🇸

Evanston, Illinois, United States

University of Vermont Medical Center /ID# 162317

🇺🇸

Burlington, Vermont, United States

Grand Hôpital de Charleroi /ID# 158748

🇧🇪

Charleroi, Hainaut, Belgium

CHU de Liege Sart Tilman /ID# 158753

🇧🇪

Liege, Belgium

UMHAT Tsaritsa Joanna - ISUL /ID# 159641

🇧🇬

Sofia, Bulgaria

Istituto Europeo di Oncologia /ID# 158942

🇮🇹

Milan, Italy

Ingalls Memorial Hosp /ID# 155871

🇺🇸

Harvey, Illinois, United States

Goshen Center for Cancer Care /ID# 155946

🇺🇸

Goshen, Indiana, United States

Christiana Care Health Service /ID# 158171

🇺🇸

Newark, Delaware, United States

Nemocnice Rudolfa a Stefanie /ID# 159652

🇨🇿

Benesov, Czechia

Ochsner Clinic Foundation /ID# 160807

🇺🇸

Baton Rouge, Louisiana, United States

Klinik Loewenstein GmbH /ID# 159167

🇩🇪

Löwenstein, Germany

State Institution Republican Scientific Practical Center of Oncology and Medica /ID# 159325

🇧🇾

Lesnoy, Belarus

CHU Charleroi (Vesale) /ID# 159756

🇧🇪

Montigny-le-tilleul, Belgium

Klinika za plucne bolesti Jordanovac /ID# 159502

🇭🇷

Zagreb, Grad Zagreb, Croatia

Euromedica General Clinic /ID# 159161

🇬🇷

Thessaloniki, Greece

Yokohama City University Hospital /ID# 165748

🇯🇵

Yokohama-shi, Kanagawa, Japan

St. Luke's Mountain States Tumor Institute - Meridian /ID# 164550

🇺🇸

Meridian, Idaho, United States

A.O.U. San Luigi Gonzaga /ID# 158945

🇮🇹

Orbassano, Italy

Hospital Pontchaillou /ID# 160555

🇫🇷

Rennes, France

Blacktown Hospital /ID# 158907

🇦🇺

Blacktown, New South Wales, Australia

Sparrow Regional Cancer Center, Sparrow Health System /ID# 157021

🇺🇸

Lansing, Michigan, United States

Nemocnice Horovice a.s. /ID# 161191

🇨🇿

Horovice, Czechia

Hopital de Jolimont /ID# 159755

🇧🇪

Haine Saint Paul, Belgium

UMHAT Sv. Ivan Rilski /ID# 159642

🇧🇬

Sofia, Bulgaria

The Prince Charles Hospital /ID# 158897

🇦🇺

Chermside, Queensland, Australia

Chonnam National University Hospital /ID# 159294

🇰🇷

Gwangju, Jeonranamdo, Korea, Republic of

Ballarat Health Service /ID# 158904

🇦🇺

Ballarat, Victoria, Australia

Krajska nemocnice Liberec a.s. /ID# 159653

🇨🇿

Liberec, Czechia

University Hospital of Ioannin /ID# 159163

🇬🇷

Ioannina, Greece

Matrai Gyogyintezet /ID# 158979

🇭🇺

Matrahaza, Hungary

National Cancer Center Hospital East /ID# 165726

🇯🇵

Kashiwa-shi, Chiba, Japan

Ataturk Gogus Hastaliklari ve /ID# 160056

🇹🇷

Kecioren/ankara, Turkey

Hospital General Universitario Gregorio Maranon /ID# 159025

🇪🇸

Madrid, Spain

Orszagos Koranyi Pulmonologiai Intezet /ID# 158967

🇭🇺

Budapest, Hungary

Yonsei University Health System, Severance Hospital /ID# 159288

🇰🇷

Seodaemun-gu, Seoul Teugbyeolsi, Korea, Republic of

Torokbalinti Tudogyogyintezet /ID# 207053

🇭🇺

Budapest, Pest, Hungary

Hospital Santa Creu i Sant Pau /ID# 159028

🇪🇸

Barcelona, Spain

Kansai Medical University Hospital /ID# 165055

🇯🇵

Hirakata-shi, Osaka, Japan

Tokushima University Hospital /ID# 165812

🇯🇵

Tokushima-shi, Tokushima, Japan

Hospital da Luz, SA /ID# 158996

🇵🇹

Lisbon, Portugal

Sahlgrenska US Gbg /ID# 159534

🇸🇪

Göteborg, Vastra Gotalands Lan, Sweden

Hospital Universitario HM Sanchinarro /ID# 159024

🇪🇸

Madrid, Spain

Asan Medical Center /ID# 159290

🇰🇷

Seoul, Korea, Republic of

Health Pharma Professional Research S.A de C.V /ID# 160020

🇲🇽

Del. Benito Juárez, Mexico

Uppsala University Hospital /ID# 159050

🇸🇪

Uppsala, Sweden

Dr. Suat Seren Gogus Has /ID# 159240

🇹🇷

Izmir, Turkey

United Lincolnshire Hospitals /ID# 159579

🇬🇧

Boston, United Kingdom

Universitair Medisch Centrum Groningen /ID# 158088

🇳🇱

Groningen, Netherlands

Hospital Clinico Universitario de Valencia /ID# 159027

🇪🇸

Valencia, Spain

CHA Bundang Medical center CHA University /ID# 204416

🇰🇷

Seongnam si, Gyeonggido, Korea, Republic of

Dong-A University Hospital /ID# 159296

🇰🇷

Busan, Busan Gwang Yeogsi, Korea, Republic of

Copernicus PL Sp. z o. o., WCO /ID# 160538

🇵🇱

Gdansk, Poland

IPO Lisboa FG, EPE /ID# 158995

🇵🇹

Lisboa, Portugal

S.C. Centrul de Oncologie Sf. Nectarie S.R.L. /ID# 160847

🇷🇴

Craiova, Dolj, Romania

PMI Euromedservice /ID# 159311

🇷🇺

Pushkin, Russian Federation

National Cancer Ctr Singapore /ID# 158803

🇸🇬

Singapore, Singapore

Ege University Medical Faculty /ID# 159239

🇹🇷

Izmir, Turkey

Royal Preston Hospital /ID# 159578

🇬🇧

Preston, United Kingdom

National Cheng Kung University Hospital /ID# 158844

🇨🇳

Tainan City, Tainan, Taiwan

Municipal institution /ID# 159867

🇺🇦

Chernivtsi, Ukraine

Christie NHS Foundation Trust /ID# 159099

🇬🇧

Manchester, United Kingdom

Regional Center of Oncology /ID# 159123

🇺🇦

Kharkiv, Ukraine

Communal Nonprofit Enterprise "Central City Clinical Hospital" of Uzhhorod City /ID# 159868

🇺🇦

Uzhhorod, Ukraine

Inonu Universitesi Turgut Ozal /ID# 159241

🇹🇷

Battalgazi/malatya, Turkey

Tri-Service General Hospital /ID# 158985

🇨🇳

Taipei City, Taipei, Taiwan

Guy's and St Thomas' NHS Found /ID# 159581

🇬🇧

London, London, City Of, United Kingdom

Charing Cross Hospital /ID# 159582

🇬🇧

London, United Kingdom

Clearview Cancer Institute /ID# 155873

🇺🇸

Huntsville, Alabama, United States

Dana-Farber Cancer Institute /ID# 160210

🇺🇸

Boston, Massachusetts, United States

UPMC Hillman Cancer Ctr /ID# 164403

🇺🇸

Pittsburgh, Pennsylvania, United States

St Jude Hospital dba St Joseph /ID# 155899

🇺🇸

Santa Rosa, California, United States

Gabrail Cancer Center Research /ID# 155920

🇺🇸

Canton, Ohio, United States

University of Washington /ID# 162626

🇺🇸

Seattle, Washington, United States

Medical Oncology Associates /ID# 156856

🇺🇸

Spokane, Washington, United States

West Virginia Univ School Med /ID# 155872

🇺🇸

Morgantown, West Virginia, United States

Mogilev Reg. Oncologic dispe /ID# 159326

🇧🇾

Mogilev, Belarus

Fundacao Faculdade Regional de Medicina de Sao Jose do Rio Preto /ID# 159666

🇧🇷

Sao Jose Do Rio Preto, Sao Paulo, Brazil

Klinicki bolnicki centar Rijeka /ID# 159501

🇭🇷

Rijeka, Primorsko-goranska Zupanija, Croatia

KH Martha-Maria Halle Dolau /ID# 158796

🇩🇪

Halle (Saale), Sachsen-Anhalt, Germany

Lungen Clinic Grosshansdorf /ID# 158770

🇩🇪

Grosshansdorf, Germany

Klinikum Kassel /ID# 158788

🇩🇪

Kassel, Germany

General Hospital of Chest Diseases of Athens SOTIRIA /ID# 159165

🇬🇷

Athens, Greece

Dup_Debreceni Egyetem Klinikai Központ /ID# 161209

🇭🇺

Debrecen, Hungary

Veszprem Megyei Tuedoegyogyint /ID# 162607

🇭🇺

Farkasgyepu, Hungary

Hokkaido Cancer Center /ID# 165237

🇯🇵

Sapporo-shi, Hokkaido, Japan

Hyogo Cancer Center /ID# 165125

🇯🇵

Akashi-shi, Hyogo, Japan

Kindai University Hospital /ID# 166394

🇯🇵

Osaka-sayama-shi, Osaka, Japan

Duplicate_Showa University Hospital /ID# 165574

🇯🇵

Shinagawa-ku, Tokyo, Japan

Kyungpook National University Chilgok Hospital /ID# 159292

🇰🇷

Daegu, Seoul Teugbyeolsi, Korea, Republic of

Mrukmed. Lekarz Beata Madej Mruk i Partner /ID# 160537

🇵🇱

Rzeszów, Podkarpackie, Poland

IPO Porto FG, EPE /ID# 158686

🇵🇹

Porto, Portugal

National Medical Research Cntr /ID# 207436

🇷🇺

Moscow, Moskovskaya Oblast, Russian Federation

LLC BioEq Ltd. /ID# 159310

🇷🇺

St. Petersburg, Russian Federation

Klinicki centar Srbije /ID# 160024

🇷🇸

Belgrade, Serbia

National University Hospital /ID# 158802

🇸🇬

Singapore, Singapore

Institute For Pulmonary Diseas /ID# 158813

🇷🇸

Sremska Kamenica, Serbia

CI Zaporizhzhia Regional Clinical Oncological Dispensary /ID# 159122

🇺🇦

Zaporizhzhia, Zaporizka Oblast, Ukraine

PE PMC Acinus, Medical and Diagnostic Center /ID# 159125

🇺🇦

Kropyvnytskyi, Ukraine

Jilin Cancer Hosptial /ID# 204059

🇨🇳

Changchun, Jilin, China

Liga Norte Rio Grandense Cont. /ID# 159015

🇧🇷

Natal, Rio Grande Do Norte, Brazil

Associação Hospital Beneficente São Vicente de Paulo - Hospital São Vicente de P /ID# 159668

🇧🇷

Passo Fundo, Rio Grande Do Sul, Brazil

Herlev Hospital /ID# 158049

🇩🇰

Herlev, Hovedstaden, Denmark

Rigshospitalet, Finsen Centre /ID# 158051

🇩🇰

Copenhagen, Denmark

Odense Universitets Hospital /ID# 158050

🇩🇰

Odense C, Syddanmark, Denmark

James Cook University Hospital /ID# 159583

🇬🇧

Middlesborough, United Kingdom

Oregon Health and Science University /ID# 157055

🇺🇸

Portland, Oregon, United States

Assistance Publique- Hopitaux /ID# 160552

🇫🇷

Paris, France

AUSL 8 Arezzo Ospedale San Don /ID# 160967

🇮🇹

Arezzo, Italy

Ospedale Santa Maria delle Cro /ID# 158940

🇮🇹

Ravenna, Italy

IFO Istituto Nazionale Tumori /ID# 158941

🇮🇹

Rome, Italy

Korea University Guro Hospital /ID# 159293

🇰🇷

Seoul, Seoul Teugbyeolsi, Korea, Republic of

Himeji Medical Center /ID# 165893

🇯🇵

Himeji-shi, Hyogo, Japan

The Cancer Institute Hospital Of JFCR /ID# 166249

🇯🇵

Koto-ku, Tokyo, Japan

Matsusaka City Hospital /ID# 166126

🇯🇵

Matsusaka-shi MIE, Japan

UZ Leuven /ID# 158752

🇧🇪

Leuven, Belgium

Cross Cancer Institute /ID# 159519

🇨🇦

Edmonton, Alberta, Canada

Hopital du Sacre Coeur Montreal /ID# 159515

🇨🇦

Montreal, Quebec, Canada

Kanagawa Cardiovascular and Respiratory Center /ID# 164374

🇯🇵

Yokohama-shi, Kanagawa, Japan

Japanese Red Cross Okayama Hospital /ID# 165156

🇯🇵

Okayama-shi, Okayama, Japan

Osaka City General Hospital /ID# 165717

🇯🇵

Osaka-shi, Osaka, Japan

Riga East Clinical University /ID# 158714

🇱🇻

Riga, Latvia

Hacettepe University Medical Faculty /ID# 159238

🇹🇷

Altindağ, Ankara, Turkey

Kanagawa Cancer Center /ID# 165816

🇯🇵

Yokohama, Japan

Unidade Local Saude Matosinhos /ID# 158682

🇵🇹

Matosinhos, Portugal

Hospital CUF Porto /ID# 158685

🇵🇹

Porto, Portugal

Spitalul Judetean de Urgenta A /ID# 160846

🇷🇴

Alba, Romania

Taichung Veterans General Hosp /ID# 158866

🇨🇳

Taichung City, Taiwan

Isala /ID# 158653

🇳🇱

Zwolle, Netherlands

Szpitale Pomorskie Sp. z o.o /ID# 160536

🇵🇱

Gdynia, Poland

Centro Hospitalar Lisboa Norte, EPE /ID# 158687

🇵🇹

Lisbon, Lisboa, Portugal

Hospital Clinic /ID# 159031

🇪🇸

Barcelona, Spain

Semmelweis Egyetem /ID# 161197

🇭🇺

Budapest, Hungary

Instituto Nacional de Câncer José de Alencar Gomes da Silva (INCA) /ID# 159665

🇧🇷

Rio de Janeiro, Brazil

Thomayerova nemocnice /ID# 159061

🇨🇿

Prague, Praha 4, Czechia

Southern Medical Day Care Ctr /ID# 158853

🇦🇺

Wollongong, New South Wales, Australia

Evangelische Lungenklinik Berl /ID# 159168

🇩🇪

Berlin, Germany

Thoraxklinik Heidelberg gGmbH /ID# 159169

🇩🇪

Heidelberg, Germany

Chungbuk National University /ID# 159291

🇰🇷

Cheongju-si, Korea, Republic of

University of California, Davis Comprehensive Cancer Center /ID# 157001

🇺🇸

Sacramento, California, United States

University of Louisville /ID# 155947

🇺🇸

Louisville, Kentucky, United States

Klinicki bolnicki centar Sestre milosrdnice /ID# 158811

🇭🇷

Zagreb, Grad Zagreb, Croatia

Duplicate_Kanazawa University Hospital /ID# 165129

🇯🇵

Kanazawa-shi, Ishikawa, Japan

Sendai Kousei Hospital /ID# 166061

🇯🇵

Sendai-shi, Miyagi, Japan

Bobruysk Interdistrict Onco. /ID# 169394

🇧🇾

Bobruisk, Belarus

Cliniques universitaires Saint /ID# 158751

🇧🇪

Brussels, Belgium

Centre Hosp Intercommunal de Creteil /ID# 162684

🇫🇷

Creteil, Val-de-Marne, France

Kurume University Hospital /ID# 164586

🇯🇵

Kurume-shi, Fukuoka, Japan

CHU Saint-Pierre /ID# 159521

🇧🇪

Bruxelles, Bruxelles-Capitale, Belgium

Metropolitan Hospital /ID# 159162

🇬🇷

Athens, Greece

Wakayama Medical University /ID# 166032

🇯🇵

Wakayama-shi, Wakayama, Japan

Ziekenhuis St. Jansdal /ID# 158652

🇳🇱

Harderwijk, Netherlands

Oncocenter Oncologie Clinica S /ID# 160848

🇷🇴

Timisoara, Timis, Romania

N.N. Petrov Research Inst Onc /ID# 159312

🇷🇺

St. Petersburg, Russian Federation

National Taiwan University Hospital /ID# 158865

🇨🇳

Taipei City, Taipei, Taiwan

Pauls Stradins Clinical /ID# 158713

🇱🇻

Riga, Latvia

CHU de Quebec-Universite Laval /ID# 159093

🇨🇦

Quebec City, Quebec, Canada

Hopital Haut-Lévêque /ID# 160558

🇫🇷

Pessac CEDEX, Gironde, France

Aichi Cancer Center Hospital /ID# 164975

🇯🇵

Nagoya-shi, Aichi, Japan

Kyushu University Hospital /ID# 165723

🇯🇵

Fukuoka-shi, Fukuoka, Japan

Shizuoka Cancer Center /ID# 166466

🇯🇵

Sunto-gun, Shizuoka, Japan

National Cancer Center Hospital /ID# 166768

🇯🇵

Chuo-ku, Tokyo, Japan

Centro de Investigación Clinica Chapultepec /ID# 161000

🇲🇽

Morelia, Michoacan, Mexico

Kaluga Regional Clinical Oncol /ID# 160179

🇷🇺

Kaluga, Russian Federation

Institut za onkologiju i radio /ID# 160058

🇷🇸

Belgrade, Serbia

Municipal institution Multifie /ID# 159121

🇺🇦

Dnipro, Ukraine

ME Kryviy Rih Oncology Dispensary /ID# 159119

🇺🇦

Kryviy RIH, Ukraine

LLC Novaya Klinika /ID# 205539

🇷🇺

Pyatigorsk, Stavropol Skiy Kray, Russian Federation

Arkhangelsk clinical oncology /ID# 159309

🇷🇺

Arkhangelsk, Russian Federation

Clinical Onco Dispensary /ID# 159307

🇷🇺

Omsk, Russian Federation

Smolensk Regional Onc Clin Dis /ID# 159314

🇷🇺

Smolensk, Russian Federation

Clinical Center of Nis /ID# 160059

🇷🇸

NIS, Nisavski Okrug, Serbia

Volyn Regional Medical Oncology Centre /ID# 159124

🇺🇦

Lutsk, Ukraine

Univ Medical Ctr Brackenridge /ID# 156967

🇺🇸

Austin, Texas, United States

Cancer Specialists of North Florida - Southpoint /ID# 155828

🇺🇸

Jacksonville, Florida, United States

Austin Hospital /ID# 158898

🇦🇺

Heidelberg, Victoria, Australia

Juravinski Cancer Clinic /ID# 159514

🇨🇦

Hamilton, Ontario, Canada

Cisss Du Bas-Saint-Laurent Hopital Regional de Rimouski /Id# 208931

🇨🇦

Rimouski, Quebec, Canada

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