MedPath

A Study of Atezolizumab in Combination With Nab-Paclitaxel Compared With Placebo With Nab-Paclitaxel for Participants With Previously Untreated Metastatic Triple-Negative Breast Cancer (IMpassion130)

Phase 3
Completed
Conditions
Triple Negative Breast Cancer
Interventions
Registration Number
NCT02425891
Lead Sponsor
Hoffmann-La Roche
Brief Summary

This multicenter, randomized, double-blind study evaluated the efficacy, safety, and pharmacokinetics of atezolizumab (MPDL3280A) administered with nab-paclitaxel compared with placebo in combination with nab-paclitaxel in participants with locally advanced or metastatic triple-negative breast cancer (TNBC) who have not received prior systemic therapy for metastatic breast cancer (mBC). The safety of single-agent nab-paclitaxel has been determined in previous studies of participants with mBC and the safety data to date suggest that atezolizumab can be safely combined with standard chemotherapy agents.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
902
Inclusion Criteria
  • Metastatic or locally advanced, histologically documented TNBC characterized by absence of human epidermal growth factor 2 (HER2), estrogen receptor (ER), and progesterone receptor (PR) expression
  • No prior chemotherapy or targeted systemic therapy for inoperable locally advanced or metastatic TNBC
  • Eligible for taxane monotherapy (i.e., absence of rapid clinical progression, life-threatening visceral metastases, or the need for rapid symptom and/or disease control)
  • A representative formalin-fixed, paraffin-embedded tumor specimen in paraffin blocks, or at least 20 unstained slides with an associated pathology report documenting ER, PR, and HER2 negativity. Participants with fewer than 20 unstained slides available at baseline, and not fewer than 12 unstained slides will be eligible upon discussion with Medical Monitor
  • Eastern Cooperative Oncology Group performance status of 0 or 1
  • Measurable disease as defined by RECIST v1.1
  • Adequate hematologic and end-organ function
Read More
Exclusion Criteria
  • Known central nervous system (CNS) disease, except for treated asymptomatic CNS metastases
  • Leptomeningeal disease
  • Pregnancy or lactation
  • History of autoimmune disease
  • Prior allogeneic stem cell or solid organ transplantation
  • Positive test for human immunodeficiency virus
  • Active hepatitis B or hepatitis C
  • Receipt of a live, attenuated vaccine within 4 weeks prior to randomization, during treatment, or within 5 months following the last dose of atezolizumab/placebo
Read More

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Atezolizumab Plus Nab-PaclitaxelAtezolizumab (MPDL3280A), an engineered anti-PDL1 antibodyParticipants assigned to atezolizumab plus nab-paclitaxel received both agents until disease progression or unacceptable toxicity.
Atezolizumab Plus Nab-PaclitaxelNab-PaclitaxelParticipants assigned to atezolizumab plus nab-paclitaxel received both agents until disease progression or unacceptable toxicity.
Placebo Plus Nab-PaclitaxelPlaceboParticipants assigned to placebo plus nab-paclitaxel received both agents until disease progression or unacceptable toxicity.
Placebo Plus Nab-PaclitaxelNab-PaclitaxelParticipants assigned to placebo plus nab-paclitaxel received both agents until disease progression or unacceptable toxicity.
Primary Outcome Measures
NameTimeMethod
Progression Free Survival (PFS) According to Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1 (v1.1) in All Randomized ParticipantsBaseline up to approximately 34 months

PFS was defined as the time from randomization to the occurrence of disease progression, as determined by investigators from tumor assessments per RECIST v1.1, or death from any cause, whichever occurred first.

OS in Participants With Detectable PD-L1Baseline until death due to any cause (up to approximately 58 months)

OS was defined as the time from the date of randomization to the date of death from any cause.

Overall Survival (OS) in All Randomized ParticipantsBaseline until death due to any cause (up to approximately 58 months)

OS was defined as the time from the date of randomization to the date of death from any cause.

PFS According to RECIST v1.1 in Participants With Detectable Programmed Death-Ligand 1 (PD-L1)Baseline up to approximately 34 months

PFS was defined as the time from randomization to the occurrence of disease progression, as determined by investigators from tumor assessments per RECIST v1.1, or death from any cause, whichever occurred first.

Secondary Outcome Measures
NameTimeMethod
Percentage of Participants With an Objective Response of Complete Response (CR) or Partial Response (PR) According to RECIST v1.1 in All Randomized ParticipantsBaseline up to approximately 34 months

An objective response was defined for participants with measurable disease at baseline as either a partial response (PR) or a complete response (CR) using RECIST v1.1.

Percentage of Participants With an Objective Response of CR or PR According to RECIST v1.1 in Participants With Detectable PD-L1Baseline up to approximately 34 months

An objective response was defined for participants with measurable disease at baseline as either a partial response (PR) or a complete response (CR) using RECIST v1.1.

Duration of Response (DOR) According to RECIST v1.1 in All Randomized ParticipantsBaseline up to approximately 34 months

DOR was defined for participants who had an objective response as the time from the first occurrence of a documented unconfirmed response (CR or PR) to the date of disease progression per RECIST v1.1 or death from any cause, whichever occurred first.

DOR Acccording to RECIST v1.1 in Participants With Detectable PD-L1Baseline up to approximately 34 months

DOR was defined for participants who had an objective response as the time from the first occurrence of a documented unconfirmed response (CR or PR) to the date of disease progression per RECIST v1.1 or death from any cause, whichever occurred first.

Time to Deterioration (TTD) in Global Health Status/Health Related Quality of Life According to European Organisation for Research and Treatment of Cancer (EORTC) Quality-of-Life Questionnaire Core 30 (QLQ-C30) v3.0 in All Randomized ParticipantsBaseline up to approximately 58 months

Deterioration in GHS/HRQoL (Items 29, 30 of the EORTC QLQ C30) was defined by the following two criteria: 1. The time from randomization to the first time the participant's GHS/HRQoL scale score showed a \>=10-point decrease from the baseline scale score. A 10-point change was defined as the minimally important difference (MID). 2. The score decrease of \>= 10-points from baseline was held for at least two consecutive cycles, or an initial score decrease of \>= 10-points was followed by death or treatment discontinuation within 3 weeks from the last assessment.

TTD in Global Health Status/Health Related Quality of Life According to EORTC QLQ-C30 v3.0 in Participants With Detectable PD-L1Baseline up to approximately 58 months

Deterioration in GHS/HRQoL (Items 29, 30 of the EORTC QLQ C30) was defined by the following two criteria: 1. The time from randomization to the first time the participants's GHS/HRQoL scale score showed a \>=10-point decrease from the baseline scale score. A 10-point change was defined as the minimally important difference (MID). 2. The score decrease of \>= 10-points from baseline was held for at least two consecutive cycles, or an initial score decrease of \>= 10-points was followed by death or treatment discontinuation within 3 weeks from the last assessment.

Percentage of Participants With at Least One Adverse EventBaseline up to to the data cutoff date: 31 August 2021 (up to approximately 74 months)

Percentage of participants with at least one adverse event.

Percentage of Participants With Anti-Therapeutic Antibodies (ATAs) Against AtezolizumabBaseline up to approximately 53 months

Percentage of Participants with Anti-Therapeutic Antibodies (ATAs) Against Atezolizumab

Maximum Serum Concentration (Cmax) for AtezolizumabCycle 1 Day 1 (Cycle = 28 days)

Maximum serum concentration for atezolizumab.

Minimum Serum Concentration (Cmin) for AtezolizumabDay 27 of Cycle 1, 2, 3, and 7 (Cycle = 28 days)

Minimum serum concentration for atezolizumab.

Plasma Concentrations of Total PaclitaxelPre-dose (Hour 0) on Cycle 1 Day 1, pre-dose (Hour 0), 5-10 minutes before end of nab-paclitaxel infusion, 1 hour after end of nab-paclitaxel infusion (infusion duration = 30 minutes) on Cycle 3 Day 1 (Cycle = 28 days)

Plasma Concentrations of Total Paclitaxel

Trial Locations

Locations (247)

Johns Hopkins Sidney Kimmel Comprehensive Cancer Center

🇺🇸

Baltimore, Maryland, United States

Treatment and Prevention Institution Volyn Regional Oncology Dispensary

🇺🇦

Lutsk, Ukraine

The Methodist Cancer Center

🇺🇸

Houston, Texas, United States

University of Texas;M.D. Anderson Cancer Center

🇺🇸

Houston, Texas, United States

Royal Marsden Hospital; Dept of Medical Oncology

🇬🇧

Sutton, United Kingdom

Sarah Cannon Cancer Center - Tennessee Oncology, Pllc

🇺🇸

Nashville, Tennessee, United States

Vanderbilt

🇺🇸

Nashville, Tennessee, United States

University of Alabama at Birmingham

🇺🇸

Birmingham, Alabama, United States

Barbara Ann Karmanos Cancer Institute; Oncology

🇺🇸

Detroit, Michigan, United States

Kaiser Perm NW - Rheuma

🇺🇸

Portland, Oregon, United States

Providence Cancer Center

🇺🇸

Portland, Oregon, United States

Univ of Calif, San Francisco; Breast Cancer Center

🇺🇸

San Francisco, California, United States

Universitätsklinikum Erlangen; Frauenklinik

🇩🇪

Erlangen, Germany

Laura and ISAAC Perlmutter Cancer Center at NYU Langone.

🇺🇸

New York, New York, United States

Kaiser Permanente of Northern California

🇺🇸

Oakland, California, United States

Highlands Oncology Group

🇺🇸

Springdale, Arkansas, United States

Cancer Research Collaboration, Inc.

🇺🇸

Santa Ana, California, United States

Stamford Hospital; BCC, MOHR

🇺🇸

Stamford, Connecticut, United States

Florida Cancer Specialists - SCRI; Pharmacy

🇺🇸

Fort Myers, Florida, United States

MedStar Georgetown University Hospital (Lombardi Comprehensive Cancer Center)

🇺🇸

Washington, District of Columbia, United States

The Mount Siani Comprehensive Cancer Center

🇺🇸

Miami Beach, Florida, United States

Florida Cancer Research Institute

🇺🇸

Plantation, Florida, United States

Florida Cancer Specialists (St. Petersburg - St. Anthony's Professional Building)

🇺🇸

Saint Petersburg, Florida, United States

Cancer Specialists; North Florida ;Jacksonville (AC Skinner Pkwy)

🇺🇸

Jacksonville, Florida, United States

Northwest Georgia Oncology Centers PC - Marietta

🇺🇸

Marietta, Georgia, United States

Mercy Medical Center

🇺🇸

Baltimore, Maryland, United States

Rush University Medical Center - Chicago

🇺🇸

Chicago, Illinois, United States

Maryland Oncology Hematology

🇺🇸

Rochville, Maryland, United States

West Michigan Cancer Center

🇺🇸

Kalamazoo, Michigan, United States

New Hampshire Hematology Oncology

🇺🇸

Manchester, New Hampshire, United States

The Valley Hospital

🇺🇸

Ridgewood, New Jersey, United States

The Mark H. Zangmeister Ctr; Mid Ohio Onc/Hem Inc.

🇺🇸

Columbus, Ohio, United States

Onc/Hem Care Clin Trials LLC

🇺🇸

Cincinnati, Ohio, United States

St. Luke's Cancer Care Associates

🇺🇸

Bethlehem, Pennsylvania, United States

Greenville Health System (GHS) Cancer Institute

🇺🇸

Greenville, South Carolina, United States

West Clinic

🇺🇸

Germantown, Tennessee, United States

Texas Oncology- El Paso Cancer Treatment Center Gateway

🇺🇸

El Paso, Texas, United States

Inova Medical Group

🇺🇸

Fairfax, Virginia, United States

Cancer Care Northwest

🇺🇸

Spokane, Washington, United States

Centro de Oncologia e Investigacion Buenos Aires (COIBA)

🇦🇷

Buenos Aires, Argentina

Chris O'Brien Lifehouse

🇦🇺

Camperdown, New South Wales, Australia

Centro Oncologico Riojano Integral (CORI)

🇦🇷

La Rioja, Argentina

Princess Alexandra Hospital; Division of Cancer Services

🇦🇺

Woolloongabba, Queensland, Australia

Sunshine Hospital

🇦🇺

St Albans, Victoria, Australia

St John of God Hospital; Bendat Cancer Centre

🇦🇺

Subiaco, Western Australia, Australia

Ordensklinikum Linz Barmherzige Schwestern; Abt. fur Innere Medizin 1

🇦🇹

Linz, Austria

Lkh-Univ. Klinikum Graz; Klinik Für Innere Medizin I

🇦🇹

Graz, Austria

Medizinische Universität Wien; Univ.Klinik für Innere Medizin I

🇦🇹

Wien, Austria

Institut Jules Bordet

🇧🇪

Anderlecht, Belgium

A.Ö. Lhk; Ii. Medizinische Abt. Mit Schwerpunkt Gaströnter. & Onkologie

🇦🇹

Steyr, Austria

Cliniques Universitaires St-Luc

🇧🇪

Bruxelles, Belgium

GHdC Site Notre Dame

🇧🇪

Charleroi, Belgium

AZ Groeninge

🇧🇪

Kortrijk, Belgium

Sint Augustinus Wilrijk

🇧🇪

Wilrijk, Belgium

Centro de Pesquisas Oncologicas - CEPON

🇧🇷

Florianopolis, SC, Brazil

Hospital Araujo Jorge; Departamento de Ginecologia E Mama

🇧🇷

Goiania, GO, Brazil

Crio - Centro Regional Integrado de Oncologia

🇧🇷

Fortaleza, CE, Brazil

Hospital das Clinicas - UFRGS

🇧🇷

Porto Alegre, RS, Brazil

Hospital Sao Lucas - PUCRS

🇧🇷

Porto Alegre, RS, Brazil

Clinica de Neoplasias Litoral

🇧🇷

Itajai, SC, Brazil

Hospital Perola Byington

🇧🇷

Sao Paulo, SP, Brazil

Tom Baker Cancer Centre-Calgary

🇨🇦

Calgary, Alberta, Canada

Kingston General Hospital

🇨🇦

Kingston, Ontario, Canada

Lakeridge Health Oshawa; Oncology

🇨🇦

Oshawa, Ontario, Canada

Sunnybrook Odette Cancer Centre

🇨🇦

Toronto, Ontario, Canada

The Ottawa Hospital Cancer Centre

🇨🇦

Ottawa, Ontario, Canada

Hopital du Saint Sacrement

🇨🇦

Quebec City, Quebec, Canada

Jewish General Hospital

🇨🇦

Montreal, Quebec, Canada

Sociedad de Investigaciones Medicas Ltda (SIM)

🇨🇱

Temuco, Chile

Oncomedica S.A.

🇨🇴

Monteria, Colombia

Clinica del Country

🇨🇴

Bogota, Colombia

Clinica CIMCA

🇨🇷

San José, Costa Rica

ICIMED Instituto de Investigación en Ciencias Médicas

🇨🇷

San José, Costa Rica

Fakultni Poliklinika Vseobecne Fakultni Niemocnice; Onkologicka Klinika

🇨🇿

Praha 2, Czechia

Fakultni nemocnice v Motole

🇨🇿

Praha 5, Czechia

North Estonia Medical Centre Foundation; Oncology Centre

🇪🇪

Tallinn, Estonia

Tampere University Hospital; Dept of Oncology

🇫🇮

Tampere, Finland

Tartu Uni Hospital; Hematology - Oncology Clinic

🇪🇪

Tartu, Estonia

Ico - Paul Papin

🇫🇷

Angers, France

Hopital Jean Minjoz

🇫🇷

Besancon, France

Institut Sainte Catherine

🇫🇷

Avignon, France

HOPITAL MICHALLON - CENTRE HOSPITALIER UNIVERSITAIRE DE GRENOBLE, Service d'oncologie Médicale

🇫🇷

Grenoble, France

Clinique Catherine de Sienne

🇫🇷

Nantes, France

Centre Oscar Lambret

🇫🇷

Lille, France

Institut régional du Cancer Montpellier

🇫🇷

Montpellier, France

Hopital La Pitie Salpetriere

🇫🇷

Paris, France

Institut De Cancerologie De L'Ouest; Medical Oncology

🇫🇷

Saint Herblain, France

Institut Curie

🇫🇷

Paris, France

Centre Paul Strauss

🇫🇷

Strasbourg, France

St. Johannes Hospital; Abt. für Hämatologie und Onkologie

🇩🇪

Dortmund, Germany

Ambulantes Tumorzentrum Spandau; Dres. Benno Mohr und Uwe Peters

🇩🇪

Berlin, Germany

Uniklinik Essen; Gynäkologie

🇩🇪

Essen, Germany

Niels-Stensen-Kliniken Franziskus-Hospital Harderberg GmbH

🇩🇪

Georgsmarienhütte, Germany

Facharztzentrum Eppendorf, Studien GbR

🇩🇪

Hamburg, Germany

Universitätsklinikum Halle (Saale); Universitätsklinik Und Poliklinik Für Gynäkologie

🇩🇪

Halle, Germany

St. Elisabeth-Krankenhaus; Brustzentrum

🇩🇪

Köln, Germany

Universitätsklinikum Hamburg-Eppendorf; Frauenklinik

🇩🇪

Hamburg, Germany

Universitätsklinikum Schleswig-Holstein; Campus Lübeck

🇩🇪

Lübeck, Germany

Praxis Köppler, Heymann, Weide, Thomalla; Fä Für Innere Medizin

🇩🇪

Koblenz, Germany

Klinikum rechts der Isar der TU München; Klinik und Poliklinik für Frauenheilkunde

🇩🇪

München, Germany

MVZ Nordhausen gGmbH, Praxis Dr. Grafe

🇩🇪

Nordhausen, Germany

Gemeinschaftspraxis für Hämatologie und Onkologie

🇩🇪

Münster, Germany

Oncologianova GmbH - Gesellschaft für Innovationen in der Onkologie

🇩🇪

Recklinghausen, Germany

Mutterhaus der Borromäerinnen gGmbH, Abteilung Hämatologie-Onkologie

🇩🇪

Trier, Germany

IASO General Hospital of Athens

🇬🇷

Athens, Greece

Anticancer Hospital Ag Savas; 1St Dept of Internal Medicine

🇬🇷

Athens, Greece

Fövárosi Önkormányzat uzsoki utcai Kórház

🇭🇺

Budapest, Hungary

Euromedical General Clinic of Thessaloniki; Oncology Department

🇬🇷

Thessaloniki, Greece

Grupo Angeles

🇬🇹

Guatemala City, Guatemala

University Hospital of Patras Medical Oncology

🇬🇷

Patras, Greece

Szegedi Tudomanyegyetem Szent-Gyorgyi Albert Klinikai Kozpont

🇭🇺

Szeged, Hungary

Orszagos Onkologiai Intezet; B Belgyogyaszati Osztaly

🇭🇺

Budapest, Hungary

Istituto Nazionale Tumori Irccs Fondazione g. PASCALE;U.O.C. Oncologia Medica Senologica

🇮🇹

Napoli, Campania, Italy

Irccs Istituto Europeo Di Oncologia (IEO); Ricerca Di Senologia Medica

🇮🇹

Milano, Lombardia, Italy

Gunma Prefectural Cancer Center

🇯🇵

Gunma, Japan

Fukushima Medical University Hospital

🇯🇵

Fukushima, Japan

Aichi Cancer Center Hospital

🇯🇵

Aichi, Japan

Hiroshima University Hospital

🇯🇵

Hiroshima, Japan

National Hospital Organization Hokkaido Cancer Center

🇯🇵

Hokkaido, Japan

Tokai University Hospital

🇯🇵

Kanagawa, Japan

Hyogo Medical University Hospital

🇯🇵

Hyogo, Japan

Sagara Hospital

🇯🇵

Kagoshima, Japan

St. Marianna University Hospital

🇯🇵

Kanagawa, Japan

Kumamoto University Hospital

🇯🇵

Kumamoto, Japan

Kyoto University Hospital

🇯🇵

Kyoto, Japan

Niigata Cancer Center Hospital

🇯🇵

Niigata, Japan

Mie University Hospital

🇯🇵

Mie, Japan

Tohoku University Hospital

🇯🇵

Miyagi, Japan

Naha-nishi Clinic

🇯🇵

Okinawa, Japan

Okayama University Hospital

🇯🇵

Okayama, Japan

Kindai University Hospital

🇯🇵

Osaka, Japan

Osaka International Cancer Institute

🇯🇵

Osaka, Japan

Saitama Medical University International Medical Center

🇯🇵

Saitama, Japan

Shizuoka Cancer Center

🇯🇵

Shizuoka, Japan

Saitama Cancer Center

🇯🇵

Saitama, Japan

St. Luke's International Hospital

🇯🇵

Tokyo, Japan

National Cancer Center Hospital

🇯🇵

Tokyo, Japan

Komagome Hospital

🇯🇵

Tokyo, Japan

The Cancer Institute Hospital of JFCR

🇯🇵

Tokyo, Japan

National Cancer Center

🇰🇷

Goyang-si, Korea, Republic of

Seoul National University Hospital

🇰🇷

Seoul, Korea, Republic of

Asan Medical Center

🇰🇷

Seoul, Korea, Republic of

Severance Hospital, Yonsei University Health System

🇰🇷

Seoul, Korea, Republic of

Daugavpils Regional Hospital

🇱🇻

Daugavpils, Latvia

Riga East Clinical University Hospital Latvian Oncology Centre

🇱🇻

Riga, Latvia

Centro Medico Dalinde

🇲🇽

Cdmx, Mexico CITY (federal District), Mexico

Centro Médico Zambrano Hellion

🇲🇽

Monterrey, Nuevo LEON, Mexico

Helse Bergen HF Haukeland universitetssjukehus kreftavdelingen poliklinikk

🇳🇴

Bergen, Norway

Szpital Uniwersytecki w Krakowie, Oddział Kliniczny Kliniki Onkologii

🇵🇱

Kraków, Poland

Centro Oncológico de Panamá

🇵🇦

Panama, Panama

Centrum Onkologii w Bydgoszczy; Oddzial Kliniczny Onkologii

🇵🇱

Bydgoszcz, Poland

Centrum Onkologii Ziemi LUBELSKIEJ im. Sw Jana z Dukli, I oddz. Chemioterapii

🇵🇱

Lublin, Poland

Wojskowy Instytut Medyczny

🇵🇱

Warszawa, Poland

Oncomed SRL

🇷🇴

Timisoara, Romania

Moscow City Oncology Hospital #62

🇷🇺

Moscovskaya Oblast, Moskovskaja Oblast, Russian Federation

Blokhin Cancer Research Center; Combined Treatment

🇷🇺

Moskva, Moskovskaja Oblast, Russian Federation

Ivanovo Regional Oncology Dispensary

🇷🇺

Ivanovo, Russian Federation

Clinical Oncology Dispensary of Ministry of Health of Tatarstan

🇷🇺

Kazan, Russian Federation

National University Hospital

🇸🇬

Singapore, Singapore

S-Pb clinical scientific practical center of specialized kinds of medical care (oncological)

🇷🇺

Saint-Petersburg, Russian Federation

National Cancer Centre

🇸🇬

Singapore, Singapore

Hospital Universitario Reina Sofia; Servicio de Oncologia

🇪🇸

Córdoba, Cordoba, Spain

Hospital del Mar; Servicio de Oncologia

🇪🇸

Barcelona, Spain

Hospital Universitario 12 de Octubre; Servicio de Oncologia

🇪🇸

Madrid, Spain

Sodersjukhuset; Onkologkliniken

🇸🇪

Stockholm, Sweden

Hospital Duran i Reynals; Oncologia

🇪🇸

Barcelona, Spain

Hospital Universitario La Paz; Servicio de Oncologia

🇪🇸

Madrid, Spain

Instituto Valenciano Oncologia; Oncologia Medica

🇪🇸

Valencia, Spain

Akademiska sjukhuset, Onkologkliniken

🇸🇪

Uppsala, Sweden

Universitaetsspital Basel; Onkologie

🇨🇭

Basel, Switzerland

Kaohsiung Medical Uni Chung-Ho Hospital; Dept of Surgery

🇨🇳

Kaohsiung, Taiwan

National Taiwan Uni Hospital; General Surgery

🇨🇳

Taipei, Taiwan

Ramathibodi Hospital; Dept of Med.-Div. of Med. Onc

🇹🇭

Bangkok, Thailand

Faculty of Med. Siriraj Hosp.; Med.-Div. of Med. Oncology

🇹🇭

Bangkok, Thailand

Songklanagarind Hospital; Department of Oncology

🇹🇭

Songkhla, Thailand

Medipol University MF; Oncology Department

🇹🇷

Istanbul, Turkey

Cukurova Uni Faculty of Medicine; Medical Oncology

🇹🇷

Adana, Turkey

Kyiv City Clinical Oncological Center

🇺🇦

Kyiv, Ukraine

Chemotherapy SI Dnipropetrovsk MA of MOHU

🇺🇦

Dnipropetrovsk, Ukraine

Hacettepe Uni Medical Faculty Hospital; Oncology Dept

🇹🇷

Sihhiye/Ankara, Turkey

Lviv State Oncology Regional Treatment and Diagnostic Centre

🇺🇦

Lviv, Ukraine

Guys ST Thomas Hospital

🇬🇧

London, United Kingdom

Western General Hospital; Clinical Oncology

🇬🇧

Edinburgh, United Kingdom

St Bartholomew's Hospital

🇬🇧

London, United Kingdom

Royal Marsden Hospital - London

🇬🇧

London, United Kingdom

Christie Hospital Nhs Trust; Medical Oncology

🇬🇧

Manchester, United Kingdom

Royal Preston Hosptial

🇬🇧

Preston, United Kingdom

Jackson Oncology Associates, PLLC

🇺🇸

Jackson, Mississippi, United States

Centre Leon Berard

🇫🇷

Lyon, France

Kaiser Permanente - San Marcos

🇺🇸

San Marcos, California, United States

Norwalk Hospital

🇺🇸

Norwalk, Connecticut, United States

Washington University School of Medicine

🇺🇸

Saint Louis, Missouri, United States

ProHEALTH Care Associates LLP

🇺🇸

Lake Success, New York, United States

Magee Womens Hospital

🇺🇸

Pittsburgh, Pennsylvania, United States

UZ Leuven Gasthuisberg

🇧🇪

Leuven, Belgium

Peninsula and South Eastern Haematology and Oncology Group

🇦🇺

Frankston, Victoria, Australia

Peter MacCallum Cancer Centre; Medical Oncology

🇦🇺

Melbourne, Victoria, Australia

Icon Cancer Foundation

🇦🇺

South Brisbane, Queensland, Australia

Clinic of Oncology, University Clinical Center Sarajevo

🇧🇦

Sarajevo, Bosnia and Herzegovina

Santa Casa de Misericordia de Salvador

🇧🇷

Salvador, BA, Brazil

Hospital de Caridade de Ijui; Oncologia

🇧🇷

Ijui, RS, Brazil

Fakultni nemocnice Olomouc; Onkologicka klinika

🇨🇿

Olomouc, Czechia

Centro de Cancer Pontificie Universidad Catolica de Chile

🇨🇱

Santiago, Chile

Universitatsklinik Heidelberg; Universitätshautklinik und Nationales Centrum für Tumorerkrankungen

🇩🇪

Heidelberg, Germany

Universitätsklinikum "Carl Gustav Carus" der Technischen Universität Dresden

🇩🇪

Dresden, Germany

Dres. Helmut Forstbauer, Carsten Ziske und Kollegen; Onkologische Schwerpunktpraxis

🇩🇪

Troisdorf, Germany

Universitätsklinik Tübingen; Frauenklinik & Poliklinik

🇩🇪

Tübingen, Germany

Univ General Hosp Heraklion; Medical Oncology

🇬🇷

Heraklion, Greece

Hiroshima City Hiroshima Citizens Hospital

🇯🇵

Hiroshima, Japan

National Hospital Organization Osaka National Hospital

🇯🇵

Osaka, Japan

Szpitale Wojewodzkie w Gdyni Sp. z o.o.

🇵🇱

Gdynia, Poland

Arkhangelsk Regional Clinical Oncology Dispensary

🇷🇺

Arkhangelsk, Arhangelsk, Russian Federation

Main Military Clinical Hospital named after N.N. Burdenko

🇷🇺

Moscow, Moskovskaja Oblast, Russian Federation

Hospital Univ Vall d'Hebron; Servicio de Oncologia

🇪🇸

Barcelona, Spain

Hospital Clinico Universitario Virgen de la Victoria; Servicio de Oncologia

🇪🇸

Malaga, Spain

Kantonsspital St.Gallen Brustzentrum/Chirurgie; Brustzentrum

🇨🇭

St. Gallen, Switzerland

Universitätsspital Zürich

🇨🇭

Zürich, Switzerland

Ege Uni Medical Faculty Hospital; Oncology Dept

🇹🇷

Izmir, Turkey

Istanbul University Cerrahpasa Medical Faculty; Radiation Oncology Department

🇹🇷

Istanbul, Turkey

Velindre Cancer Centre

🇬🇧

Cardiff, United Kingdom

Derriford Hospital

🇬🇧

Plymouth, United Kingdom

Weston Park Hospital

🇬🇧

Sheffield, United Kingdom

Fundación CENIT para la Investigación en Neurociencias

🇦🇷

Buenos Aires, Argentina

Emad Ibrahim, Md, Inc

🇺🇸

Redlands, California, United States

Nepean Cancer Care Centre

🇦🇺

Sydney, New South Wales, Australia

Queen Elizabeth II Health Sciences Centre; Oncology

🇨🇦

Halifax, Nova Scotia, Canada

Samsung Medical Center

🇰🇷

Seoul, Korea, Republic of

BC Cancer - Kelowna (Sindi Ahluwalia Hawkins Centre)

🇨🇦

Kelowna, British Columbia, Canada

Instituto Estatal de Cancerologia Colima

🇲🇽

Colima, Mexico

Consultorio de Medicina Especializada; Dentro de Condominio San Francisco

🇲🇽

Mexico City, Mexico

Institute of Oncology Ljubljana

🇸🇮

Ljubljana, Slovenia

VETERANS GENERAL HOSPITAL; Department of General Surgery

🇨🇳

Taipei, Taiwan

Iem-Fucam

🇲🇽

D.f., Mexico

Sørlandet Sykehus Kristiansand

🇳🇴

Kristiansand, Norway

Stavanger Universitetssykehus, Helse Stavanger HF

🇳🇴

Stavanger, Norway

China Medical University Hospital; Surgery

🇨🇳

Taichung, Taiwan

British Columbia Cancer Agency (Bcca) - Vancouver Cancer Centre

🇨🇦

Vancouver, British Columbia, Canada

Narodowy Inst.Onkologii im.Sklodowskiej-Curie Panstw.Inst.Bad; Klinika Nowtw.Piersi i Chir.Rekonstr

🇵🇱

Warszawa, Poland

Kaiser Permanente Of Colorado

🇺🇸

Aurora, Colorado, United States

Yale Cancer Center; Medical Oncology

🇺🇸

New Haven, Connecticut, United States

Health Midwest Ventures Group, Inc d/b/a HCA MidAmerica Division, LLC

🇺🇸

Kansas City, Missouri, United States

Cross Cancer Institute ; Dept of Medical Oncology

🇨🇦

Edmonton, Alberta, Canada

Stanford Univ School of Med; Oncology

🇺🇸

Stanford, California, United States

Wellmont Bristol Regional Medical Center

🇺🇸

Bristol, Tennessee, United States

Montefiore Medical Center

🇺🇸

Bronx, New York, United States

Hospital Sao Jose

🇧🇷

Sao Paulo, SP, Brazil

Queen Mary Hospital; Dept of Medicine

🇭🇰

Hong Kong, Hong Kong

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