Study of Nivolumab in Combination With Ipilimumab Versus Nivolumab in Combination With Ipilimumab Placebo in Patients With Recurrent or Metastatic Squamous Cell Carcinoma of the Head and Neck
- Conditions
- Head and Neck Cancer
- Interventions
- Biological: NivolumabBiological: IpilimumabOther: Placebo
- Registration Number
- NCT02823574
- Lead Sponsor
- Bristol-Myers Squibb
- Brief Summary
A study in patients with metastatic or recurrent squamous cell cancer of the head and neck to evaluate the effectiveness of Nivolumab plus Ipilumumab vs. Nivolumab alone (CheckMate 714)
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 425
- Confirmed squamous cell head and neck cancer
- Widespread (metastatic) disease, or returned after previous treatment (recurrent)
- Tumor sample must be available for analysis of PDL1 (Programmed death-ligand 1) and HPV [Human Papilloma Virus (oropharynx only)]
- Performance status ECOG 0-1 (Eastern Cooperative Oncology Group)
- Previous treatment for metastatic or recurrent disease
- Cancer arising from one of the following primary sites: paranasal sinus, nasopharynx, salivary gland, skin
- Any non-squamous subtype
- Active autoimmune disease
- Positive test for hepatitis B, C or HIV (Human Immunodeficiency Virus) virus
- Previous treatment with checkpoint inhibitor drugs
- Active CNS metastases or carcinomatous meningitis
Other protocol-defined inclusion/exclusion criteria apply
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Nivolumab and Ipilimumab Nivolumab Specified dose on specified days Nivolumab and Ipilimumab-placebo Nivolumab Specified dose on specified days Nivolumab and Ipilimumab Ipilimumab Specified dose on specified days Nivolumab and Ipilimumab-placebo Placebo Specified dose on specified days
- Primary Outcome Measures
Name Time Method Objective Response Rate (ORR) as Determined by Blinded Independent Central Review (BIRC) - Platinum Refractory Subgroup Approximately up to 30 months (from FPFV to Data base lock) ORR is defined as best overall response (BOR) of a complete response (CR) or partial response (PR) divided by the number of randomized participants for each treatment group.
Complete Response (CR): Disappearance of all target lesions. Any pathological lymph nodes(whether target or non-target) must have reduction in short axis to \< 10 mm.
Partial Response (PR): At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters.Duration of Response (DOR) as Determined by Blinded Independent Central Review (BIRC) - Platinum Refractory Subgroup Approximately up to 30 months (from FPFV to Data base lock) The time between the date of first confirmed response to the date of the first documented tumor progression, or death due to any cause, whichever occurs first.
Time to Response (TTR) as Determined by Blinded Independent Central Review (BIRC) - Platinum Refractory Subgroup Approximately up to 30 months (from FPFV to Data base lock) Time to Response (TTR) for participants demonstrating a response (either CR or PR) was defined as the time from the date of randomization to the date of the first confirmed response.
Complete Response (CR): Disappearance of all target lesions. Any pathological lymph nodes(whether target or non-target) must have reduction in short axis to \< 10 mm.
Partial Response (PR): At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters.
- Secondary Outcome Measures
Name Time Method Progression Free Survival (PFS) as Determined by Blinded Independent Central Review (BIRC) - Platinum Eligible Subgroup From randomization to disease progression or death. Approximately 63 Months the time from randomization to the date of first documented disease progression, or death due to any cause, whichever occurs first.
Progressive Disease (PD): At least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study). In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. (Note: the appearance of one or more new lesions is also considered progression).Overall Survival (OS) - Platinum Refractory Subgroup From randomization to death. Approximately 63 Months Overall survival was defined as the time from randomization to the date of death from any cause. Participants were censored at the date they were last known to be alive and at the date of randomization if they were randomized but had no follow-up.
Overall Survival (OS) From randomization to death. Approximately 63 Months Overall survival was defined as the time from randomization to the date of death from any cause. Participants were censored at the date they were last known to be alive and at the date of randomization if they were randomized but had no follow-up.
Progression Free Survival (PFS) as Determined by Blinded Independent Central Review (BIRC) - Platinum Refractory Subgroup From randomization to disease progression or death. Approximately 63 Months The time from randomization to the date of first documented disease progression, or death due to any cause, whichever occurs first.
Progressive Disease (PD): At least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study). In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. (Note: the appearance of one or more new lesions is also considered progression).ORR - Platinum Eligible Subgroup Based on HPV p-16 Status From randomization to end of study. Approximately 63 Months ORR is defined as the best overall response (BOR) of a complete response (CR) or partial response (PR) divided by the number of randomized participants for each treatment group.
Complete Response (CR): Disappearance of all target lesions. Any pathological lymph nodes(whether target or non-target) must have reduction in short axis to \< 10 mm.
Partial Response (PR): At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters.ORR - Platinum Eligible Subgroup Based on Tumor Mutation Burden (TMB) Biomarker From randomization to end of study. Approximately 63 Months ORR is defined as the best overall response (BOR) of a complete response (CR) or partial response (PR) divided by the number of randomized participants for each treatment group.
Tumor Mutational Burden (TMB) refers to the number of nonsynonymous somatic mutations that exist within a tumor's genome as measured by the Foundation One CDx panel at Foundation Medicine. The analysis was done on subjects with baseline tumor mutation burden by a cutoff of 7 mutations/megabase (mut/Mb) and 10 mut/Mb
Complete Response (CR): Disappearance of all target lesions. Any pathological lymph nodes(whether target or non-target) must have reduction in short axis to \< 10 mm.
Partial Response (PR): At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters.Objective Response Rate (ORR) as Determined by Blinded Independent Central Review (BIRC) - Platinum Eligible Subgroup From randomization to end of study. Approximately 63 Months ORR is defined as percentage of participants with a complete response (CR) or partial response (PR).
Complete Response (CR): Disappearance of all target lesions. Any pathological lymph nodes(whether target or non-target) must have reduction in short axis to \< 10 mm.
Partial Response (PR): At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters.Duration of Response (DOR) as Determined by Blinded Independent Central Review (BIRC) - Platinum Eligible Subgroup From randomization to disease progression or death. Approximately 63 Months The time between the date of first confirmed response to the date of the first documented tumor progression, or death due to any cause, whichever occurs first.
ORR - Platinum Refractory Subgroup Based on HPV p-16 Status From randomization to end of study. Approximately 63 Months ORR is defined as the best overall response (BOR) of a complete response (CR) or partial response (PR) divided by the number of randomized participants for each treatment group.
Complete Response (CR): Disappearance of all target lesions. Any pathological lymph nodes(whether target or non-target) must have reduction in short axis to \< 10 mm.
Partial Response (PR): At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters.ORR - Platinum Refractory Subgroup Based on Tumor Mutation Burden (TMB) Biomarker From randomization to end of study. Approximately 63 Months ORR is defined as the best overall response (BOR) of a complete response (CR) or partial response (PR) divided by the number of randomized participants for each treatment group.
Tumor Mutational Burden (TMB) refers to the number of nonsynonymous somatic mutations that exist within a tumor's genome as measured by the Foundation One CDx panel at Foundation Medicine. The analysis was done on subjects with baseline tumor mutation burden by a cutoff of 7 mutations/megabase (mut/Mb) and 10 mut/Mb
Complete Response (CR): Disappearance of all target lesions. Any pathological lymph nodes(whether target or non-target) must have reduction in short axis to \< 10 mm.
Partial Response (PR): At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters.Duration of Response (DOR) - Platinum Refractory Subgroup Based on HPV p-16 Status From randomization to disease progression or death. Approximately 63 Months The time between the date of first confirmed response to the date of the first documented tumor progression, or death due to any cause, whichever occurs first.
Overall Survival (OS) - Platinum Eligible Subgroup From randomization to death. Approximately 63 Months Overall survival was defined as the time from randomization to the date of death from any cause. Participants were censored at the date they were last known to be alive and at the date of randomization if they were randomized but had no follow-up.
Duration of Response (DOR) - Platinum Refractory Subgroup Based on Tumor Mutation Burden (TMB) Status From randomization to disease progression or death. Approximately 63 Months The time between the date of first confirmed response to the date of the first documented tumor progression, or death due to any cause, whichever occurs first.
Tumor Mutational Burden (TMB) refers to the number of nonsynonymous somatic mutations that exist within a tumor's genome as measured by the Foundation One CDx panel at Foundation Medicine. The analysis was done on subjects with baseline tumor mutation burden by a cutoff of 7 mutations/megabase (mut/Mb) and 10 mut/MbProgression Free Survival (PFS) - Platinum Refractory Subgroup Based on HPV p-16 Status From randomization to disease progression or death. Approximately 63 Months the time from randomization to the date of first documented disease progression, or death due to any cause, whichever occurs first.
Progressive Disease (PD): At least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study). In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. (Note: the appearance of one or more new lesions is also considered progression).Progression Free Survival (PFS) - Platinum Refractory Subgroup Based on Tumor Mutation Burden (TMB) Status From randomization to disease progression or death. Approximately 63 Months the time from randomization to the date of first documented disease progression, or death due to any cause, whichever occurs first.
Tumor Mutational Burden (TMB) refers to the number of nonsynonymous somatic mutations that exist within a tumor's genome as measured by the Foundation One CDx panel at Foundation Medicine. The analysis was done on subjects with baseline tumor mutation burden by a cutoff of 7 mutations/megabase (mut/Mb) and 10 mut/Mb
Progressive Disease (PD): At least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study). In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. (Note: the appearance of one or more new lesions is also considered progression).Overall Survival (OS) - Platinum Refractory Subgroup Based on HPV p-16 Status From randomization to death. Approximately 63 Months Overall survival was defined as the time from randomization to the date of death from any cause. Participants were censored at the date they were last known to be alive and at the date of randomization if they were randomized but had no follow-up.
Overall Survival (OS) - Platinum Refractory Subgroup Based on Tumor Mutation Burden (TMB) Status From randomization to death. Approximately 63 Months Overall survival was defined as the time from randomization to the date of death from any cause. Participants were censored at the date they were last known to be alive and at the date of randomization if they were randomized but had no follow-up.
Tumor Mutational Burden (TMB) refers to the number of nonsynonymous somatic mutations that exist within a tumor's genome as measured by the Foundation One CDx panel at Foundation Medicine. The analysis was done on subjects with baseline tumor mutation burden by a cutoff of 7 mutations/megabase (mut/Mb) and 10 mut/MbOverall Survival (OS) - Platinum Eligible Subgroup Based on HPV p-16 Status From randomization to death. Approximately 63 Months Overall survival was defined as the time from randomization to the date of death from any cause. Participants were censored at the date they were last known to be alive and at the date of randomization if they were randomized but had no follow-up.
Progression Free Survival (PFS) - Platinum Eligible Subgroup Based on HPV p-16 Status From randomization to disease progression or death. Approximately 63 Months the time from randomization to the date of first documented disease progression, or death due to any cause, whichever occurs first.
Progressive Disease (PD): At least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study). In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. (Note: the appearance of one or more new lesions is also considered progression).Progression Free Survival (PFS) - Platinum Refractory Subgroup Based on PD-L1 Status From randomization to disease progression or death. Approximately 63 Months The time from randomization to the date of first documented disease progression, or death due to any cause, whichever occurs first.
Tumor PD-L1 expression was defined as the percent of tumor cell membrane staining in a minimum of 100 evaluable tumor cells per validated Dako PD-L1 IHC assay.
Progressive Disease (PD): At least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study). In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. (Note: the appearance of one or more new lesions is also considered progression).Progression Free Survival (PFS) - Platinum Eligible Subgroup Based on PD-L1 Status From randomization to disease progression or death. Approximately 63 Months The time from randomization to the date of first documented disease progression, or death due to any cause, whichever occurs first.
Tumor PD-L1 expression was defined as the percent of tumor cell membrane staining in a minimum of 100 evaluable tumor cells per validated Dako PD-L1 IHC assay
Progressive Disease (PD): At least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study). In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. (Note: the appearance of one or more new lesions is also considered progression).Overall Survival (OS) - Platinum Eligible Subgroup Based on Tumor Mutation Burden (TMB) Status From randomization to death. Approximately 63 Months Overall survival was defined as the time from randomization to the date of death from any cause. Participants were censored at the date they were last known to be alive and at the date of randomization if they were randomized but had no follow-up.
Tumor Mutational Burden (TMB) refers to the number of nonsynonymous somatic mutations that exist within a tumor's genome as measured by the Foundation One CDx panel at Foundation Medicine. The analysis was done on subjects with baseline tumor mutation burden by a cutoff of 7 mutations/megabase (mut/Mb) and 10 mut/MbOverall Survival (OS) - Platinum Refractory Subgroup Based on PD-L1 Status From randomization to death. Approximately 63 Months Overall survival was defined as the time from randomization to the date of death from any cause. Participants were censored at the date they were last known to be alive and at the date of randomization if they were randomized but had no follow-up.
Tumor PD-L1 expression was defined as the percent of tumor cell membrane staining in a minimum of 100 evaluable tumor cells per validated Dako PD-L1 IHC assayProgression Free Survival (PFS) - Platinum Eligible Subgroup Based on Tumor Mutation Burden (TMB) Status From randomization to disease progression or death. Approximately 63 Months the time from randomization to the date of first documented disease progression, or death due to any cause, whichever occurs first.
Tumor Mutational Burden (TMB) refers to the number of nonsynonymous somatic mutations that exist within a tumor's genome as measured by the Foundation One CDx panel at Foundation Medicine. The analysis was done on subjects with baseline tumor mutation burden by a cutoff of 7 mutations/megabase (mut/Mb) and 10 mut/Mb
Progressive Disease (PD): At least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study). In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. (Note: the appearance of one or more new lesions is also considered progression).Duration of Response (DOR) - Platinum Eligible Subgroup Based on HPV p-16 Status From randomization to disease progression or death. Approximately 63 Months The time between the date of first confirmed response to the date of the first documented tumor progression, or death due to any cause, whichever occurs first.
Progressive Disease (PD): At least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study). In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. (Note: the appearance of one or more new lesions is also considered progression).Duration of Response (DOR) - Platinum Eligible Subgroup Based on Tumor Mutation Burden (TMB) Status From randomization to disease progression or death. Approximately 63 Months The time between the date of first confirmed response to the date of the first documented tumor progression, or death due to any cause, whichever occurs first.
Tumor Mutational Burden (TMB) refers to the number of nonsynonymous somatic mutations that exist within a tumor's genome as measured by the Foundation One CDx panel at Foundation Medicine. The analysis was done on subjects with baseline tumor mutation burden by a cutoff of 7 mutations/megabase (mut/Mb) and 10 mut/Mb.
Progressive Disease (PD): At least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study). In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. (Note: the appearance of one or more new lesions is also considered progression).Duration of Response (DOR) - Platinum Eligible Subgroup Based on PD-L1 Status From randomization to disease progression or death. Approximately 63 Months The time between the date of first confirmed response to the date of the first documented tumor progression, or death due to any cause, whichever occurs first.
Tumor PD-L1 expression was defined as the percent of tumor cell membrane staining in a minimum of 100 evaluable tumor cells per validated Dako PD-L1 IHC assay
Progressive Disease (PD): At least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study). In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. (Note: the appearance of one or more new lesions is also considered progression).Duration of Response (DOR) - Platinum Refractory Subgroup Based on PD-L1 Status From randomization to disease progression or death. Approximately 63 Months The time between the date of first confirmed response to the date of the first documented tumor progression, or death due to any cause, whichever occurs first.
Tumor PD-L1 expression was defined as the percent of tumor cell membrane staining in a minimum of 100 evaluable tumor cells per validated Dako PD-L1 IHC assay.
Progressive Disease (PD): At least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study). In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. (Note: the appearance of one or more new lesions is also considered progression).ORR - Platinum Refractory Subgroup Based on PD-L1 Expression From randomization to end of study. Approximately 63 Months ORR is defined as the best overall response (BOR) of a complete response (CR) or partial response (PR) divided by the number of randomized participants for each treatment group.
Tumor PD-L1 expression was defined as the percent of tumor cell membrane staining in a minimum of 100 evaluable tumor cells per validated Dako PD-L1 IHC assay
Complete Response (CR): Disappearance of all target lesions. Any pathological lymph nodes(whether target or non-target) must have reduction in short axis to \< 10 mm.
Partial Response (PR): At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters.Overall Survival (OS) - Platinum Eligible Subgroup Based on PD-L1 Status From randomization to death. Approximately 63 Months Overall survival was defined as the time from randomization to the date of death from any cause. Participants were censored at the date they were last known to be alive and at the date of randomization if they were randomized but had no follow-up.
Tumor PD-L1 expression was defined as the percent of tumor cell membrane staining in a minimum of 100 evaluable tumor cells per validated Dako PD-L1 IHC assayORR - Platinum Eligible Subgroup Based on PD-L1 Expression From randomization to end of study. Approximately 63 Months ORR is defined as the best overall response (BOR) of a complete response (CR) or partial response (PR) divided by the number of randomized participants for each treatment group.
Tumor PD-L1 expression was defined as the percent of tumor cell membrane staining in a minimum of 100 evaluable tumor cells per validated Dako PD-L1 IHC assay Complete Response (CR): Disappearance of all target lesions. Any pathological lymph nodes(whether target or non-target) must have reduction in short axis to \< 10 mm.
Partial Response (PR): At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters.
Trial Locations
- Locations (101)
Local Institution - 0087
🇺🇸Chicago, Illinois, United States
Local Institution - 0014
🇨🇦Quebec, Canada
Local Institution - 0023
🇧🇪Gent, Belgium
Local Institution - 0012
🇨🇦Toronto, Ontario, Canada
Local Institution - 0001
🇺🇸Boston, Massachusetts, United States
Local Institution - 0071
🇺🇸Boston, Massachusetts, United States
Local Institution - 0070
🇺🇸Cleveland, Ohio, United States
Mission Hospital, Inc
🇺🇸Asheville, North Carolina, United States
Local Institution - 0103
🇺🇸Cincinnati, Ohio, United States
Local Institution - 0038
🇺🇸Seattle, Washington, United States
University of Arizona Cancer Center
🇺🇸Tucson, Arizona, United States
Local Institution - 0034
🇺🇸Duarte, California, United States
Los Angeles Cancer Network
🇺🇸Los Angeles, California, United States
Ucla Department Of Medicine
🇺🇸Los Angeles, California, United States
Local Institution - 0098
🇺🇸Redondo Beach, California, United States
Central Coast Med Oncology
🇺🇸Santa Maria, California, United States
Local Institution - 0097
🇺🇸San Luis Obispo, California, United States
Local Institution - 0010
🇺🇸Atlanta, Georgia, United States
Local Institution - 0015
🇺🇸Decatur, Georgia, United States
Ft. Wayne Med Onco-Hema Inc
🇺🇸Fort Wayne, Indiana, United States
Oncology Associated Of Western Kentucky
🇺🇸Paducah, Kentucky, United States
Local Institution - 0006
🇺🇸Pittsburgh, Pennsylvania, United States
Donald Guthrie Foundation
🇺🇸Sayre, Pennsylvania, United States
Local Institution - 0102
🇺🇸Dallas, Texas, United States
Local Institution - 0121
🇦🇷Pergamino, Buenos Aires, Argentina
Local Institution - 0111
🇦🇷Buenos Aires, Argentina
Local Institution - 0074
🇧🇪Sint-Niklaas, Belgium
Local Institution - 0053
🇧🇪Yvoir, Belgium
Local Institution - 0125
🇧🇷Caxias do Sul, RIO Grande DO SUL, Brazil
Local Institution - 0047
🇧🇷Curitiba, Parana, Brazil
Local Institution - 0045
🇧🇷Barretos, Sao Paulo, Brazil
Local Institution - 0123
🇧🇷Santo Andre, Sao Paulo, Brazil
Local Institution - 0013
🇨🇦Edmonton, Alberta, Canada
Local Institution - 0048
🇧🇷Sao Jose do Rio Preto, SAO Paulo, Brazil
Local Institution
🇿🇦Cape Town, Western CAPE, South Africa
Local Institution - 0049
🇧🇷Sao Paulo, Brazil
Local Institution - 0050
🇧🇷Sao Paulo, Brazil
Local Institution - 0056
🇨🇦Ottawa, Ontario, Canada
Local Institution - 0016
🇨🇦Montreal, Quebec, Canada
Local Institution - 0115
🇨🇱Santiago, Metropolitana, Chile
Local Institution - 0022
🇨🇿Brno, Czechia
Local Institution - 0020
🇨🇿Hradec Kralove, Czechia
Local Institution - 0021
🇨🇿Olomouc, Czechia
Local Institution - 0069
🇫🇮Helsinki, Finland
Local Institution - 0032
🇫🇷Amiens Cedex 1, France
Local Institution - 0120
🇫🇷Bordeaux, France
Local Institution - 0073
🇫🇷Clermont Ferrand cedex 01, France
Local Institution - 0029
🇫🇷Lyon Cedex 08, France
Local Institution - 0075
🇫🇷Marseille Cedex 5, France
Local Institution - 0030
🇫🇷Rennes Cedex, France
Local Institution - 0079
🇫🇷Nice, France
Local Institution - 0088
🇫🇷Villejuif, France
Local Institution - 0119
🇮🇹Napoli, Italy
Local Institution - 0090
🇲🇽Merida, Yucatan, Mexico
Local Institution - 0107
🇲🇽Merida, Yucatan, Mexico
Local Institution - 0108
🇲🇽Oaxaca, Mexico
Local Institution - 0068
🇳🇱Amsterdam, Netherlands
Local Institution - 0028
🇳🇱Amsterdam, Netherlands
Local Institution - 0065
🇳🇴Bergen, Norway
Local Institution - 0027
🇳🇱Groningen, Netherlands
Local Institution - 0064
🇳🇴Oslo, Norway
Local Institution - 0054
🇷🇴Cluj-Napoca, Romania
Local Institution - 0055
🇷🇴Bucharest, Romania
Local Institution - 0060
🇷🇴Iasi, Romania
Local Institution - 0033
🇷🇴Craiova, Romania
Local Institution - 0031
🇷🇺Moscow, Russian Federation
Local Institution - 0059
🇷🇴Suceava, Romania
Local Institution - 0017
🇿🇦Sandton, Gauteng, South Africa
Local Institution - 0092
🇷🇺Ryazan, Russian Federation
Local Institution - 0116
🇪🇸Barcelona, Spain
Local Institution - 0040
🇪🇸A Coruna, Spain
Local Institution - 0077
🇪🇸Madrid, Spain
Local Institution - 0039
🇪🇸Barcelona, Spain
Local Institution - 0076
🇪🇸Marbella, Spain
Local Institution - 0041
🇪🇸San Sabastian Gipuzkoa, Spain
Local Institution - 0067
🇸🇪Goteborg, Sweden
Local Institution - 0037
🇸🇪Lund, Sweden
Local Institution - 0035
🇸🇪Stockholm, Sweden
Local Institution - 0062
🇹🇷Izmir, Turkey
Local Institution - 0063
🇹🇷Adana, Turkey
Local Institution - 0066
🇹🇷Antalya, Turkey
Local Institution - 0086
🇬🇧London, Greater London, United Kingdom
Local Institution - 0083
🇬🇧Wirral, Merseyside, United Kingdom
Local Institution - 0114
🇬🇧Cardiff, United Kingdom
Local Institution - 0082
🇬🇧Newcastle Upon Tyne, United Kingdom
Local Institution - 0084
🇬🇧Glasgow, United Kingdom
Local Institution - 0026
🇮🇪Dublin 8, Dublin, Ireland
Local Institution - 0124
🇧🇷Ipatinga, Minas Gerais, Brazil
Local Institution - 0051
🇧🇷Ijui, RIO Grande DO SUL, Brazil
Local Institution - 0046
🇧🇷Belo Horizonte, Minas Gerais, Brazil
Local Institution - 0052
🇧🇷Porto Alegre, RIO Grande DO SUL, Brazil
Local Institution - 0110
🇬🇧Aberdeen, Aberdeenshire, United Kingdom
Local Institution - 0081
🇬🇧Sutton, Surrey, United Kingdom
Local Institution - 0089
🇫🇷Clichy, France
Local Institution - 0072
🇺🇸San Francisco, California, United States
Local Institution - 0042
🇺🇸Rochester, Minnesota, United States
Local Institution - 0008
🇺🇸Portland, Oregon, United States
Local Institution - 0007
🇺🇸Tampa, Florida, United States
Local Institution - 0004
🇺🇸Sacramento, California, United States
Local Institution - 0005
🇺🇸Louisville, Kentucky, United States
Local Institution - 0101
🇺🇸New Haven, Connecticut, United States