A Study Of Avelumab Alone Or In Combination With Pegylated Liposomal Doxorubicin Versus Pegylated Liposomal Doxorubicin Alone In Patients With Platinum Resistant/Refractory Ovarian Cancer (JAVELIN Ovarian 200)
- Conditions
- Ovarian Cancer
- Interventions
- Drug: PLDBiological: avelumab
- Registration Number
- NCT02580058
- Lead Sponsor
- Pfizer
- Brief Summary
A Phase 3 global study comparing avelumab alone to avelumab plus PLD and to PLD alone to demonstrate that avelumab given alone or in combination with PLD is superior to PLD alone in prolonging Overall Survival in patients with platinum resistant/platinum refractory ovarian cancer.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- Female
- Target Recruitment
- 566
- Histologically confirmed epithelial ovarian, fallopian tube, or peritoneal cancer, including malignant mixed Müllerian tumors with high grade serous component.
- Platinum resistant/refractory disease, defined as disease progression within 180 days following the last administered dose of platinum therapy (resistant), or lack of response or disease progression while receiving the most recent platinum based therapy (refractory), respectively.
- Received up to 3 lines of systemic anticancer therapy for platinum sensitive disease, most recently platinum containing, and no prior systemic therapy for platinum resistant disease
- Measurable disease by investigator assessment with at least 1 unidimensional measurable lesion by RECIST v.1.1 that has not previously been irradiated
- Active autoimmune disease that might deteriorate when receiving an immunostimulatory agents. Patients with diabetes type I, vitiligo, psoriasis, hypo or hyperthyroid disease not requiring immunosuppressive treatment are eligible.
Mandatory tumor biopsy must be performed prior to enrollment for all patients (unless there is a documented clinical contraindication). In addition, availability of archived FFPE tumor tissue should be confirmed. If a patient underwent tumor tissue collection within 3 months prior to enrollment with no intervening treatment, and the sample is provided, then a new de novo tumor biopsy is not required.
- Non epithelial tumor or ovarian tumors with low malignant potential (ie, borderline tumors).
- Prior therapy with an anti PD 1, anti PD L1, anti PD L2, anti CD137, or anti cytotoxic T lymphocyte associated antigen 4 (CTLA 4) antibody (including ipilimumab, tremelimumab or any other antibody or drug specifically targeting T cell co stimulation or immune checkpoint pathways).
- Known symptomatic brain metastases requiring steroids. Patients with previously diagnosed brain metastases are eligible if they have completed their treatment and have recovered from the acute effects of radiation therapy or surgery prior to study entry, have discontinued corticosteroid treatment for these metastases for at least 4 weeks prior to study entry and are neurologically stable.
- Diagnosis of any other malignancy within 5 years prior to registration, except for adequately treated basal cell or squamous cell skin cancer, or carcinoma in situ of the breast or of the cervix.
- Severe gastrointestinal conditions such as clinical or radiological evidence of bowel obstruction within 4 weeks prior to study entry, uncontrolled diarrhea in the last 4 weeks prior to enrollment, or history of inflammatory bowel disease.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description PLD PLD Arm C: PLD alone avelumab avelumab Arm A: avelumab alone avelumab plus pegylated liposomal doxorubicin (PLD) avelumab Arm B: avelumab plus PLD avelumab plus pegylated liposomal doxorubicin (PLD) PLD Arm B: avelumab plus PLD
- Primary Outcome Measures
Name Time Method Progression Free Survival (PFS) Based on Blinded Independent Central Review (BICR) According to Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1 From randomization to date of first documentation of PD or death due to any cause whichever was first (up to 30 months); based on cutoff date: 19 September 2018. PFS is defined as the time from date of randomization to the date of the first documentation of progression of disease (PD) or death due to any cause, whichever occurs first. PFS time was summarized by treatment arm using the Kaplan-Meier method. PFS based on BICR assessment was evaluated for this endpoint.
Overall Survival (OS) From randomization until the date of first documented progression or date of deaths from any cause, whichever came first, assessed up to 30 months (based on cutoff date: 19 September 2018). OS is defined as the time from the date of randomization to the date of death due to any cause. OS time was summarized by treatment arm using the Kaplan-Meier method.
- Secondary Outcome Measures
Name Time Method Objective Response Rate (ORR) Based on BICR Assessment Tumor assessments as assessed by BICR were conducted at every 8 weeks from screening until documented disease progression (approximately up to 30 months); based on cutoff date: 19 September 2018. Percentage of participants achieved objective response (OR) based on BICR assessment is presented for this endpoint. OR is defined as a complete response (CR, disappearance of all target lesions) or partial response (PR, \>=30% decrease under the baseline of the sum of diameters of all target measurable lesions) according to the RECIST (version 1.1) recorded from randomization until disease progression or death due to any cause. Both CR and PR must be confirmed by repeat assessments performed no less than 4 weeks after the criteria for response are first met and before the first documentation of disease progression. Only tumor assessments performed on or before the start date of any further anti-cancer therapies are considered in the assessment of best overall response.
PFS Based on Investigator Assessment According to RECIST Version 1.1 From randomization to date of first documentation of PD or death due to any cause whichever was first (up to 30 months); based on cutoff date: 19 September 2018. PFS is defined as the time from date of randomization to the date of the first documentation of PD or death due to any cause, whichever occurs first. PFS time was summarized by treatment arm using the Kaplan-Meier method.
ORR Based on Investigator Assessment Tumor assessments as assessed by investigator were conducted at every 8 weeks from screening until documented disease progression, up to 30 months; based on cutoff date: 19 September 2018. Percentage of participants achieved OR based on investigator assessment is presented for this endpoint. OR is defined as a CR (disappearance of all target lesions) or PR (\>=30% decrease under the baseline of the sum of diameters of all target measurable lesions) according to the RECIST (version 1.1) recorded from randomization until disease progression or death due to any cause. The ORR on each randomized treatment arm were estimated by dividing the number of participants with OR (CR or PR) by number of participants randomized to the respective treatment arm.
Disease Control (DC) Rate Based on BICR Assessment Tumor assessments as assessed by investigator were conducted at every 8 weeks from screening until documented disease progression, up to 30 months; based on cutoff date: 19 September 2018. Percentage of participants achieving DC based on BICR assessment is presented in this endpoint. DC is a best overall response of CR (disappearance of all target lesions), PR (\>=30% decrease under the baseline of the sum of diameters of all target measurable lesions), non-complete response/non-progressive disease or stable disease (SD) according to the RECIST version 1.1.
DC Rate Based on Investigator Assessment Tumor assessments as assessed by investigator were conducted at every 8 weeks from screening until documented disease progression, up to 30 months; based on cutoff date: 19 September 2018. Percentage of participants achieving DC based on investigator assessment is presented in this endpoint. DC is a best overall response of CR (disappearance of all target lesions), PR (\>=30% decrease under the baseline of the sum of diameters of all target measurable lesions), non-complete response/non-progressive disease or SD according to the RECIST version 1.1.
Time to Deterioration in Abdominal/GI Symptom Subscale of EORTC QLQ-OV28 From Day 1 of Cycle 1 to prior to end of treatment/withdrawal visit, based on cutoff date: 19 September 2018. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Ovarian Cancer 28 (EORTC QLQ-OV28) is a 28 item instrument with 7 functional domain subscales. Time to deterioration was defined as the time from randomization to the first time the participant's score showed a 15-point or higher increase in the score of the abdominal/GI symptom subscale of the EORTC QLQ-OV28.
Number of Participants With Treatment Emergent Adverse Events (TEAEs) and Serious Adverse Events (SAEs) From the time of the first dose of study treatment through a minimum of 30 days + last dose of study treatment, start day of new anti-cancer therapy -1 day (up to 70 months); based on cutoff date: 13 July 2022. An adverse event (AE) is any untoward medical occurrence in a clinical investigation patient administered a product or medical device; the event need not necessarily have a causal relationship with the treatment or usage. An SAE is an AE resulting in any of the following outcomes or deemed significant for any other reason: death; life-threatening; initial or prolonged inpatient hospitalization; persistent or significant disability/incapacity; congenital anomaly/birth defect; progression of the malignancy under study. Treatment emergent AEs are those events with onset dates occurring during the on-treatment period for the first time, or if the worsening of an event is during the on-treatment period.
Number of Participants With Laboratory Abnormalities From screening to the end of treatment/withdrawal visit, up to 2.7 years, based on cutoff date: 19 September 2018. The number of participants with following laboratory abnormalities meeting any of the Grades 1 to 4 classified according to National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) toxicity grading version 4.03 were summarized: hematology (anemia, lymphocyte count decreased, neutrophil count decreased; and platelet count decreased) and chemistry laboratory tests (creatinine increased; serum amylase increased and lipase increased).
Number of Participants With Electrocardiogram (ECG) Abnormalities From screening to the end of treatment/withdrawal visit, up to 2.7 years, based on cutoff date: 19 September 2018. Categorical summarization ECG criteria were as follows: 1) QT interval, QTcB, QTcF and QTcP: increase from baseline \>30 ms or 60 ms; absolute value \> 450 ms, \>480 ms and \> 500 ms; 2) heart rate (HR): change from baseline \>=20 bpm and absolute value \<=50 bpm or \>=120 bpm; 3) PR interval: absolute value \>=220 ms and increase from baseline \>=20 ms; 4) QRS: \>= 120 ms.
Serum Trough Concentration (Ctrough) For Avelumab Following Cycle 2 Day 1 Pegylated Liposomal Doxorubicin (PLD) Dose At predose (0 H) on Cycle 2 Day 1 Ctrough was defined as predose concentration during multiple dosing, and can be observed directly from data.
Area Under The Concentration Time Profile From Time Zero to 24 Hours (AUC24) For Doxorubicin Following Cycle 2 Day 1 PLD Dose From 0 through 24 hours postdose AUC24 was defined as area under the concentration time profile from time zero to 24 hours.
Area Under The Concentration Time Profile From Time Zero to 336 Hours (AUC336) For Doxorubicin Following Cycle 2 Day 1 PLD Dose From predose (0 H) of Cycle 2 Day 1 through 336 hours postdose AUC336 was defined as area under the concentration time profile from time zero to 336 hours.
Area Under The Concentration Time Profile From Time Zero to The Last Quantifiable Concentration (AUClast) For Doxorubicin Following Cycle 2 Day 1 PLD Dose From predose (0 H) of Cycle 2 Day 1 through 336 hours postdose AUClast was defined as area under the concentration time profile from time zero to the time of the last quantifiable concentration (Clast).
Number of Participants With Treatment-Induced Neutralizing Antibody (nAb) At predose (0 H) of select cycles starting from Cycle 1 through Cycle 24, at end of treatment and 30 days after the last dose of avelumab Treatment-induced nAb was defined as participant who was not nAb positive at baseline and had at least one positive post-baseline nAb result; or if participant did not have a baseline sample, the participant had at least one positive past-baseline ADA result.
Duration of Response (DR) Based on BICR Assessment Tumor assessments as assessed by investigator were conducted at every 8 weeks from screening until documented disease progression, up to 30 months; based on cutoff date: 19 September 2018. DR is defined, for participants with an OR per RECIST version 1.1, as the time from the first documentation of objective tumor response (CR \[disappearance of all target lesions\] or PR \[\>=30% decrease under the baseline of the sum of diameters of all target measurable lesions\]) to the first documentation of objective tumor progression or death due to any cause, whichever occurs first.
Number of Participants With % Left Ventricular Ejection Fraction (LVEF) Decrease From Baseline Screening, Cycle 3 Day 1 (repeated every 2 cycles) to the end of treatment/withdrawal visit, based on cutoff date: 19 September 2018. LVEF decrease was summarized by multiple-gated acquisition (MUGA)/ echocardiogram (ECHO) parameter. Participants with a LVEF% \>=10 points and \>= 15 points decrease from baseline during the on-treatment period were summarized.
Number of Participants With PD-L1 Expression for PFS (Based on BICR Assessment) and for OS Biomarkers are measured only at screening. PD-L1 expression was assessed by immunohistochemistry. Participants were considered positive for PD-L1 if their baseline tissue sample demonstrated PD-L1 expression on \>=1% of tumor cells or \>=5% of immune cells.
Number of Participants With CD8 Expression for PFS (Based on BICR Assessment) and for OS Biomarkers are measured only at screening. Tumor infiltrating CD8 positive (CD8+) T lymphocytes was assessed by immunohistochemistry. Participants were considered positive for CD8 T cells if their baseline tissue sample demonstrated presence of \>=1% CD8+ cells across the area of the tumor.
Change From Baseline in EQ-VAS Score at End of Treatment Baseline and end of treatment/withdrawal visit The EuroQol- 5 Dimensions- 5 Levels (EQ-5D-5L) questionnaire consists of the EQ-5D-5L descriptive system and a visual analogue scale (the EuroQol-visual analogue scale \[EQ-VAS\]). The respondent's self-rated health is assessed on a scale from 0 (worst imaginable health state) to 100 (best imaginable health state) by the EQ-VAS.
DR Based on Investigator Assessment Tumor assessments as assessed by investigator were conducted at every 8 weeks from screening until documented disease progression, up to 30 months; based on cutoff date: 19 September 2018. DR is defined, for participants with an OR per RECIST version 1.1, as the time from the first documentation of objective tumor response (CR \[disappearance of all target lesions\] or PR \[\>=30% decrease under the baseline of the sum of diameters of all target measurable lesions\]) to the first documentation of objective tumor progression or death due to any cause, whichever occurs first.
Change From Baseline in Vital Signs - Blood Pressure From screening to the end of treatment/withdrawal visit, up to 2.7 years, based on cutoff date: 19 September 2018. Vital signs included blood pressure and pulse rate. Changes from baseline in sitting diastolic blood pressure (DBP) and systolic blood pressure (SBP) were summarized.
Change From Baseline in Vital Signs - Pulse Rate From screening to the end of treatment/withdrawal visit, up to 2.7 years, based on cutoff date: 19 September 2018. Vital signs included blood pressure and pulse rate. Changes from baseline in sitting pulse rate were summarized.
Number of Participants With Improved, Stable and Deterioration Based on 10-Point Change for EORTC QLQ-C30 Global QoL Day 1 of Cycle 1, Day 1 of each subsequent cycle, end of treatment/withdrawal visit and the 30, 60 and 90 days safety follow up visits, based on cutoff date: 19 September 2018. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire - Core 30 (EORTC QLQ-C30) is a 30 question survey and includes 5 functional domain subscales, global health status/quality of life, disease/treatment related symptoms, and the perceived financial impact of disease. Higher scores are reflective of a greater presence of symptoms.
Serum Maximum Concentration (Cmax) For Avelumab Following Cycle 2 Day 1 PLD Dose At postdose (end of infusion, 1H) on Cycle 2 Day 1 Cmax was defined as maximum observed serum concentration, and can be observed directly from data.
Cmax For Doxorubicin Following Cycle 2 Day 1 PLD Dose From predose (0 H) of Cycle 2 Day 1 through 336 hours postdose Cmax was defined as maximum observed serum concentration, and can be observed directly from data.
Number of Participants With Treatment-Boosted Anti-Drug Antibody (ADA) At predose (0 H) of select cycles starting from Cycle 1 through Cycle 24, at end of treatment and 30 days after the last dose of avelumab Treatment-boosted ADA was defined as a positive ADA result at baseline and the titer ≥ 8×baseline titer at least once after treatment with avelumab.
Number of Participants With Treatment-Induced ADA At predose (0 H) of select cycles starting from Cycle 1 through Cycle 24, at end of treatment and 30 days after the last dose of avelumab Treatment-induced ADA was defined as participant who was ADA-negative at baseline and has at least one positive post-baseline ADA result; or if participant did not have a baseline sample, the participant had at least one positive past-baseline ADA result.
Trial Locations
- Locations (256)
Maryland Oncology Hematology, P.A.
🇺🇸Columbia, Maryland, United States
Texas Oncology - The Woodlands, Gynecologic Oncology
🇺🇸The Woodlands, Texas, United States
General Hospital of Athens Alexandra
🇬🇷Athens, Greece
Chang Gung Memorial Hospital - Linkou Branch
🇨🇳Taoyuan City, Taiwan
National Cancer Centre Singapore
🇸🇬Singapore, Singapore
Universitatsspital Zurich, Universitares Herzzentrum Zurich
🇨🇭Zurich, Switzerland
Carilion Clinic
🇺🇸Roanoke, Virginia, United States
Arizona Oncology Associates, PC-HAL
🇺🇸Tempe, Arizona, United States
University of California, Irvine/UC Irvine Health
🇺🇸Orange, California, United States
Arizona Oncology Associates, PC - HAL
🇺🇸Scottsdale, Arizona, United States
Hope Women's Cancer Centers
🇺🇸Asheville, North Carolina, United States
University of New Mexico Comprehensive Cancer Center
🇺🇸Albuquerque, New Mexico, United States
Rocky Mountain Cancer Centers
🇺🇸Lakewood, Colorado, United States
The University of Kansas Clinical Research Center
🇺🇸Fairway, Kansas, United States
Center of Hope at Renown Regional Medical Center
🇺🇸Reno, Nevada, United States
CHU de Liege - Sart Tilman
🇧🇪Liege, Belgium
Cross Cancer Institute
🇨🇦Edmonton, Alberta, Canada
Icon Cancer Foundation
🇦🇺South Brisbane, Queensland, Australia
Mater Cancer Care Centre
🇦🇺South Brisbane, Queensland, Australia
The Royal Women's Hospital
🇦🇺Parkville, Victoria, Australia
British Columbia Cancer Agency-Vancouver Centre
🇨🇦Vancouver, British Columbia, Canada
Medizinische Universitat Graz, LKH-Univ. Klinikum Graz
🇦🇹Graz, Austria
Icon Cancer Care Wesley
🇦🇺Auchenflower, Queensland, Australia
Institut Jules Bordet
🇧🇪Brussels, Belgium
AZ Groeninge Hospital
🇧🇪Kortrijk, Belgium
Clinique et Maternite Sainte Elisabeth
🇧🇪Namur, Belgium
Mater Pharmacy Services
🇦🇺Brisbane, Queensland, Australia
Health Sciences Centre
🇨🇦Winnipeg, Manitoba, Canada
Icon Cancer Care Chermside
🇦🇺Chermside, Queensland, Australia
Cabrini Health Limited
🇦🇺Malvern, Victoria, Australia
Peter MacCallum Cancer Centre
🇦🇺Melbourne, Victoria, Australia
Sunnybrook Research Institute
🇨🇦Toronto, Ontario, Canada
Humanitas Cliniche Gavazzeni
🇮🇹Bergamo, Italy
State Budgetary Healthcare Institution "Clinical oncology dispensary #1"
🇷🇺Krasnodar, Russian Federation
Humanitas, Unita Operativa di Cardiologia 2
🇮🇹Bergamo, Italy
Institut Catala d'Oncologia - Hospital Duran y Reynalds
🇪🇸L'Hospitalet de Llobregat, Barcelona, Spain
C D C, Sede di Torino Centro
🇮🇹Torino, Italy
Ambulatorio dott. Francesco Cavanna, Medico Chirurgo
🇮🇹Piacenza, Italy
Clinical Trial Pharmacy, National Cheng Kung University Hospital
🇨🇳Tainan city, Taiwan
Northampton General Hospital NHS Trust
🇬🇧Northampton, Northamptonshire, United Kingdom
East and North Hertfordshire NHS Trust
🇬🇧Northwood, Middlesex, United Kingdom
State Regional Budgetary Healthcare Institution "Regional clinical oncology dispensary"
🇷🇺Velikiy Novgorod, Russian Federation
Clinical Trial Pharmacy, Keimyung University Dongsan Medical Center
🇰🇷Daegu, Korea, Republic of
State Budgetary Healthcare Institution "Orenburg Regional Clinical Oncological Dispensary"
🇷🇺Orenburg, Russian Federation
State Budget Institution of Healthcare Saint Petersburg Clinical Scientific - Practice Center
🇷🇺Saint Petersburg, Russian Federation
Hospital MD Anderson
🇪🇸Madrid, Spain
Hospital Universitario Virgen de Valme
🇪🇸Sevilla, Spain
SPZOZ Wojewodzki Szpital Specjalistyczny nr 3 w Rybniku, Apteka Szpitalna
🇵🇱Rybnik, Poland
The Clatterbridge Cancer Centre
🇬🇧Bebington, Wirral, Merseyside, United Kingdom
lnstitut Catala d Oncologia de Girona. Hospital Universitario Dr. Josep Trueta
🇪🇸Girona, Spain
National University Hospital
🇸🇬Singapore, Singapore
National Cancer Centre Singapore Pharmacy
🇸🇬Singapore, Singapore
Chemotherapy Pharmacy, Chang Gung Memorial Hospital - Linkou Branch
🇨🇳Taoyuan City, Taiwan
National Taiwan University Hospital
🇨🇳Taipei, Taiwan
Imperial College Healthcare NHS Trust
🇬🇧London, United Kingdom
Szpital Kliniczny Przemienienia Panskiego Uniwersytetu Medycznego
🇵🇱Poznan, Poland
Raffles Hospital
🇸🇬Singapore, Singapore
Nottingham University Hospital NHS Trust
🇬🇧Nottingham, United Kingdom
Hospital Universitario La Paz
🇪🇸Madrid, Spain
Guy's & St. Thomas' NHS Foundation Trust
🇬🇧London, United Kingdom
Mackay Memorial Hospital
🇨🇳Taipei City, Taiwan
Universitatsspital Zurich, Institut fur diagnostische und interventionelle Radiologie
🇨🇭Zurich, Switzerland
Centro Integral Oncologico Clara Campal
🇪🇸Madrid, Spain
Hospital Universitario Reina Sofia
🇪🇸Cordoba, Spain
The Royal Marsden NHS Foundation Trust
🇬🇧London, United Kingdom
Universitatsspital Basel
🇨🇭Basel, Basel-stadt, Switzerland
National Cheng Kung University Hospital
🇨🇳Tainan City, Taiwan
Clinical Trial Pharmacy, Mackay Memorial Hospital
🇨🇳Taipei City, Taiwan
Nottingham University Hospitals NHS Trust
🇬🇧Nottingham, United Kingdom
NHS Greater Glasgow and Clyde
🇬🇧Glasgow, United Kingdom
Universitatsspital Basel, Frauenklinik
🇨🇭Basel, Basel-stadt, Switzerland
Shaare Zedek Medical Center
🇮🇱Jerusalem, Israel
Atlanta Gynecologic Oncology
🇺🇸Atlanta, Georgia, United States
Northside Hospital - Pharmacy
🇺🇸Atlanta, Georgia, United States
Cleveland Clinic Taussig Cancer Center
🇺🇸Cleveland, Ohio, United States
Utah Cancer Specialists
🇺🇸Salt Lake City, Utah, United States
University Gynecologic Oncology
🇺🇸Atlanta, Georgia, United States
Massachusetts General Hospital
🇺🇸Boston, Massachusetts, United States
Brigham Women's Hospital
🇺🇸Boston, Massachusetts, United States
Dana Farber Cancer Institute
🇺🇸Boston, Massachusetts, United States
Fairview Hospital Moll Pavilion Cancer Center
🇺🇸Cleveland, Ohio, United States
Cleveland Clinic
🇺🇸Cleveland, Ohio, United States
Texas Oncology - San Antonio Medical Center
🇺🇸San Antonio, Texas, United States
The Sarah Cannon Research Institute
🇺🇸Nashville, Tennessee, United States
Azienda USL 4 Toscana Centro
🇮🇹Prato, Italy
Centre Antoine Lacassagne
🇫🇷Nice cedex 2, France
Hôpital Européen Georges Pompidou
🇫🇷Paris, France
Institut de Cancérologie de Lorraine
🇫🇷Vandoeuvre-lès-Nancy, France
Oxford University Hospitals NHS Foundation Trust
🇬🇧Headington, Oxford, United Kingdom
Nippon Medical School Musashikosugi Hospital
🇯🇵Kawasaki, Kanagawa, Japan
National Defense Medical College Hospital
🇯🇵Tokorozawa, Saitama, Japan
Seirei Hamamatsu General Hospital
🇯🇵Hamamatsu, Shizuoka, Japan
Metro North Hospital and Health Service
🇦🇺Herston, Queensland, Australia
Arizona Oncology Associates, PC - HOPE
🇺🇸Tucson, Arizona, United States
Highlands Oncology Group
🇺🇸Rogers, Arkansas, United States
Sansum Clinic
🇺🇸Solvang, California, United States
Florida Cancer Specialists
🇺🇸West Palm Beach, Florida, United States
The University of Kansas Cancer Center and Medical Pavilion
🇺🇸Westwood, Kansas, United States
Northwest Georgia Oncology Centers, P.C.
🇺🇸Marietta, Georgia, United States
Maryland Oncology Hematology P.A.
🇺🇸Silver Spring, Maryland, United States
Southwest GYN Oncology Associates, Inc.
🇺🇸Albuquerque, New Mexico, United States
Mission Hospital, Inc.
🇺🇸Asheville, North Carolina, United States
Hillcrest Hospital Hirsch Cancer Center Pharmacy
🇺🇸Mayfield Heights, Ohio, United States
Hillcrest Hospital
🇺🇸Mayfield Heights, Ohio, United States
Investigational Drug Services, University of Pennsylvania
🇺🇸Philadelphia, Pennsylvania, United States
Willamette Valley Cancer Institute and Research Center
🇺🇸Eugene, Oregon, United States
Fairview Hospital Moll Pavilion Pharmacy
🇺🇸Cleveland, Ohio, United States
The University of Pennsylvania Health System
🇺🇸Philadelphia, Pennsylvania, United States
Tennessee Oncology, PLLC
🇺🇸Smyrna, Tennessee, United States
Texas Oncology-Austin Central
🇺🇸Austin, Texas, United States
Texas Oncology-South Austin
🇺🇸Austin, Texas, United States
Texas Oncology -Fort Worth Cancer Center
🇺🇸Fort Worth, Texas, United States
Texas Oncology - Bedford
🇺🇸Bedford, Texas, United States
US Oncology Investigational Products Center (IPC)
🇺🇸Irving, Texas, United States
US Oncology Investigational Products Center
🇺🇸Irving, Texas, United States
Carilion Clinic Gynecologic Oncology
🇺🇸Roanoke, Virginia, United States
Medizinische Universitat Innsbruck
🇦🇹Innsbruck, Austria
Rivercity Pharmacy
🇦🇺Auchenflower, Queensland, Australia
Epic Pharmacy,Newcastle Private Hospital
🇦🇺New Lambton Heights, New South Wales, Australia
Newcastle Private Hospital Pty Limited
🇦🇺Newcastle, New South Wales, Australia
Clinical Research Unit
🇦🇺Herston, Queensland, Australia
Oncology Pharmacy
🇦🇺Herston, Queensland, Australia
Icon Cancer Care Southport
🇦🇺Southport, Queensland, Australia
Icon Cancer Care
🇦🇺South Brisbane, Queensland, Australia
Royal Melbourne Hospital
🇦🇺Parkville, Victoria, Australia
St. Boniface General Hospital
🇨🇦Winnipeg, Manitoba, Canada
Tom Baker Cancer Centre
🇨🇦Calgary, Alberta, Canada
CancerCare Manitoba
🇨🇦Winnipeg, Manitoba, Canada
The Ottawa Hospital
🇨🇦Ottawa, Ontario, Canada
Princess Margaret Cancer Centre
🇨🇦Toronto, Ontario, Canada
Nova Scotia Health Authority, QEII Health Sciences Centre, Nova Scotia Cancer Centre
🇨🇦Halifax, Nova Scotia, Canada
Nova Scotia Health Authority, QEII Health Sciences Centre
🇨🇦Halifax, Nova Scotia, Canada
McGill University Health Centre - Glen Site
🇨🇦Montreal, Quebec, Canada
Oncology Pharmacy McGill University Health Centre
🇨🇦Montreal, Quebec, Canada
Jewish General Hospital
🇨🇦Montreal, Quebec, Canada
Vseobecna fakultni nemocnice v Praze, Fakultni poliklinika
🇨🇿Praha 2, Czech Republic, Czechia
Fakultni nemocnice Olomouc
🇨🇿Olomouc, Czechia
Fakultni nemocnice Ostrava
🇨🇿Ostrava-Poruba, Czechia
Vseobecna fakultni nemocnice v Praze, Nemocnicni lekarna,
🇨🇿Praha 2, Czechia
Fakultni nemocnice v Motole
🇨🇿Praha 5, Czechia
Vseobecna fakultni nemocnice v Praze, Neurologicka klinika
🇨🇿Praha 2, Czechia
Krajska zdravotni a.s., Masarykova nemocnice v Usti nad Labem, o.z
🇨🇿Usti nad Labem, Czechia
Vseobecna fakultni nemocnice v Praze
🇨🇿Praha 2, Czechia
Aalborg University Hospital
🇩🇰Aalborg, Denmark
Rigshospitalet
🇩🇰Copenhagen, Denmark
Centre Leon Berard
🇫🇷Lyon cedex 08, France
Centre Francois Baclesse
🇫🇷Caen Cedex 5, France
Service de Radiologie
🇫🇷LYON cedex 8, France
Centre Hospitalier Lyon Sud
🇫🇷Pierre Benite cedex, France
Gustave Roussy Cancer Campus
🇫🇷Villejuif cedex, France
General Oncology Hospital of Kifissia "Agioi Anargiroi", 2nd Department of Medical Oncology
🇬🇷Athens/New Kifissia, Greece
Mater Private Hospital
🇮🇪Dublin, Ireland
Princess Margaret Hospital
🇭🇰Hong Kong, Hong Kong
Orszagos Onkologiai Intezet, Nogyogyaszati Osztaly
🇭🇺Budapest, Hungary
Orszagos Onkologiai Intezet, Gyogyszertar
🇭🇺Budapest, Hungary
Debreceni Egyetem Klinikai Gyogyszertar
🇭🇺Debrecen, Hungary
Mater Misericordiae University Hospital
🇮🇪Dublin 7, Dublin, Ireland
Debreceni Egyetem Klinikai Kozpont
🇭🇺Debrecen, Hungary
Jasz-Nagykun-Szolnok Megyei Hetenyi Geza Korhaz-Rendelointezet, Onkologiai Kozpont
🇭🇺Szolnok, Hungary
St Vincent's University Hospital
🇮🇪Dublin 4, Ireland
St James's Hospital
🇮🇪Dublin, Ireland
Mater Misericoridae University Hospital
🇮🇪Dublin, Ireland
Poliambulatorio Specialistico Villa Salute
🇮🇹Manerbio, Brescia, Italy
Congregazione delle Suore Infermiere dell'Addolorata
🇮🇹Como, Italy
ASST Fatebenefratelli Sacco
🇮🇹Miano, Milano, Italy
Servizio Sanitario Regionale Emilia-Romagna
🇮🇹Rimini, Italy
Fondazione del Piemonte per l'Oncologia
🇮🇹Candiolo, Torino, Italy
Habilita, San Marco Bergamo
🇮🇹Bergamo, Italy
Fondazione Poliambulanza Istituto Ospedelario
🇮🇹Brescia, Italy
Fondazione Teresa Camplani
🇮🇹Cremona, Italy
Regione Lombardia, A O Istituti Ospitalieri di Cremona
🇮🇹Cremona, Italy
Istituto Europeo di Oncologia
🇮🇹Milano, Italy
Regione Lombardia, ASST Cremona
🇮🇹Cremona, Italy
Azienda Unita Sanitaria Locale di Piacenza
🇮🇹Piacenza, Italy
Azienda USL 4 Prato
🇮🇹Prato, Italy
Ehime University Hospital
🇯🇵Toon, Ehime, Japan
Shikoku Cancer Center
🇯🇵Matsuyama, Ehime, Japan
Hokkaido University Hospital
🇯🇵Sapporo, Hokkaido, Japan
Hyogo Cancer Center
🇯🇵Akashi, Hyogo, Japan
University of Tsukuba Hospital
🇯🇵Tsukuba, Ibaraki, Japan
Saitama Cancer Center
🇯🇵Kita-adachi-gun, Saitama, Japan
Tokai University Hospital
🇯🇵Isehara, Kanagawa, Japan
Tohoku University Hospital
🇯🇵Sendai, Miyagi, Japan
Saitama Medical University International Medical Center
🇯🇵Hidaka, Saitama, Japan
Yokohama City University Hospital
🇯🇵Yokohama, Kanagawa, Japan
The University of Tokyo Hospital
🇯🇵Bunkyo-ku, Tokyo, Japan
Jichi Medical University Hospital
🇯🇵Shimotsuke, Tochigi, Japan
National Cancer Center Hospital
🇯🇵Chuo-ku, Tokyo, Japan
Kagoshima University Hospital
🇯🇵Kagoshima, Japan
Kagoshima City Hospital
🇯🇵Kagoshima, Japan
Niigata Cancer Center Hospital
🇯🇵Niigata, Japan
Keimyung University Dongsan Medical Center
🇰🇷Daegu, Korea, Republic of
National Cancer Center
🇰🇷Goyangsi, Gyeonggi-do, Korea, Republic of
Seoul National University Hospital
🇰🇷Seoul, Korea, Republic of
Asan Medical Center
🇰🇷Seoul, Korea, Republic of
Korea University Anam Hospital
🇰🇷Seoul, Korea, Republic of
Severance Hospital, Yonsei University Health System, Clinical Trial Pharmacy
🇰🇷Seoul, Korea, Republic of
Samsung Medical Center Clinical Trial Pharmacy
🇰🇷Seoul, Korea, Republic of
Severance Hospital, Yonsei University Health System
🇰🇷Seoul, Korea, Republic of
Department of Pharamacy, The Catholic University of Korea, Seoul St. Mary's Hospital
🇰🇷Seoul, Korea, Republic of
The Catholic University of Korea
🇰🇷Seoul, Korea, Republic of
The Catholic University of Korea, Seoul St. Mary's Hospital
🇰🇷Seoul, Korea, Republic of
Universitair Medisch Centrum Groningen
🇳🇱Groningen, Netherlands
LUMC
🇳🇱Leiden, Netherlands
Department of Obstetrics and Gynecology, Haukeland University Hospital
🇳🇴Bergen, Norway
Maastricht Universitair Medisch Centrum
🇳🇱Maastricht, Netherlands
Oslo Universitetssykehus
🇳🇴Oslo, Norway
Sykehusapoteket Oslo
🇳🇴Oslo, Norway
Sykehusapoteket i Bergen
🇳🇴Bergen, Norway
Centrum Onkologii, Instytut im. M. Sklodowskiej-Curie, Oddzial w Krakowie, Apteka Szpitalna
🇵🇱Krakow, Poland
Wojewodzki Szpital Specjalistyczny w Olsztynie, Apteka Szpitalna
🇵🇱Olsztyn, Poland
Wojewodzki Szpital Specjalistyczny w Olsztynie
🇵🇱Olsztyn, Poland
SPZOZ Wojewodzki Szpital Specjalistyczny nr 3 w Rybniku
🇵🇱Rybnik, Poland
State Budgetary Healthcare Institution "Oncology Center #2" of the Ministry of Healthcare
🇷🇺Sochi, Krasnodar Region, Russian Federation
Szpital Kliniczny Przemienienia Panskiego Uniwersytetu Medycznego im. Karola Marcinkowskiego w
🇵🇱Poznan, Poland
State Budgetary Healthcare Institution Pyatigorsk Oncology Dispensary
🇷🇺Pyatigorsk, Stavropol Region, Russian Federation
Evimed Llc
🇷🇺Chelyabinsk, Russian Federation
State Budgetary Healthcare Institution
🇷🇺Chelyabinsk, Russian Federation
Federal State Budgetary Institution "Russian Cancer Research Center n.a. N.N. Blokhin"
🇷🇺Moscow, Russian Federation
State Budgetary Healthcare Institution of Nizhegorogsky region
🇷🇺Nizhniy Novgorod, Russian Federation
Universitaetsspital Zurich, Klinik fuer Gynakologie
🇨🇭Zurich, Switzerland
Oncology Institute of Southern Switzerland (IOSI)
🇨🇭Bellinzona, Ticino, Switzerland
Universitatsspital Zurich, Clinical Trials Center
🇨🇭Zurich, Switzerland
Clinical Trial Pharmacy, Koo Foundation Sun Yat-Sen Cancer Center
🇨🇳Taipei City, Taiwan
Ross Hall Hospital
🇬🇧Glasgow, CITY OF Glasgow, United Kingdom
Clinical Trial Pharmacy, Taipei Veterans General Hospital
🇨🇳Taipei, Taiwan
Taipei Veterans General Hospital
🇨🇳Taipei, Taiwan
The Clatterbridge Cancer Centre NHS Foundation Trust
🇬🇧Bebington, Wirral, Merseyside, United Kingdom
Spire Healthcare Limited (St. Anthony's Hospital)
🇬🇧Sutton, Surrey, United Kingdom
Guy's & St Thomas' NHS Foundation Trust
🇬🇧London, United Kingdom
University College London Hospital NHS Foundation Trust
🇬🇧London, United Kingdom
The Christie Hospital NHS Foundation Trust
🇬🇧Manchester, United Kingdom
Samsung Medical Center
🇰🇷Seoul, Korea, Republic of
Pharmacy Department
🇮🇪Dublin 4, Ireland
University Hospital Waterford
🇮🇪Waterford, Ireland
Cambridge University Hospitals NHS Foundation Trust
🇬🇧Cambridge, Cambridgeshire, United Kingdom
Centrum Onkologii, Instytut im. M. Sklodowskiej-Curie, Oddzial w Krakowie
🇵🇱Krakow, Poland
Koo Foundation Sun Yat-Sen Cancer Center
🇨🇳Taipei City, Taiwan
University Hospital Gent
🇧🇪Gent, EAST Flanders, Belgium
Luzerner Kantonsspital, Medizinische Onkologie, Studienzentrale Onkologie
🇨🇭Luzern 16, Luzern, Switzerland
Kantonsapotheke Zurich
🇨🇭Zurich, Switzerland
Fox Chase Cancer Center
🇺🇸Philadelphia, Pennsylvania, United States
Norton Cancer Institute, Norton Healthcare Pavilion
🇺🇸Louisville, Kentucky, United States
Norton Healthcare Pharmacy, Attn: Marlon Baranda, Pharm D
🇺🇸Louisville, Kentucky, United States
Norton Hospital
🇺🇸Louisville, Kentucky, United States
Norton Cancer Institute, St. Matthews Campus
🇺🇸Louisville, Kentucky, United States
Norton Women's and Children's Hospital
🇺🇸Louisville, Kentucky, United States
Norton Brownsboro Hospital
🇺🇸Louisville, Kentucky, United States
Norton Cancer Institute, Brownsboro Hospital Campus
🇺🇸Louisville, Kentucky, United States
The University of Kansas Cancer Center, CCP - North
🇺🇸Kansas City, Missouri, United States
Novant Health Oncology Specialists
🇺🇸Winston-Salem, North Carolina, United States
Froedtert and The Medical College of Wisconsin
🇺🇸Milwaukee, Wisconsin, United States
Froedtert Hospital
🇺🇸Milwaukee, Wisconsin, United States
Universitaire Ziekenhuizen Leuven
🇧🇪Leuven, Belgium
British Columbia Cancer Agency - Sindi Ahluwalia Hawkins Centre for the Southern Interior
🇨🇦Kelowna, British Columbia, Canada
University of Hong Kong
🇭🇰Hong Kong, Hong Kong