MedPath

A Study Of Inotuzumab Ozogamicin Versus Investigator's Choice Of Chemotherapy In Patients With Relapsed Or Refractory Acute Lymphoblastic Leukemia

Phase 3
Completed
Conditions
Acute Lymphoblastic Leukemia
Interventions
Drug: FLAG (fludarabine, cytarabine and G-CSF)
Drug: inotuzumab ozogamicin
Drug: HIDAC (high dose cytarabine)
Drug: cytarabine and mitoxantrone
Registration Number
NCT01564784
Lead Sponsor
Pfizer
Brief Summary

This study will compare the efficacy, in terms of complete responses and overall survival, of inotuzumab ozogamicin versus investigator's choice of chemotherapy.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
326
Inclusion Criteria
  • CD22 expression
  • Adequate liver and renal functions
Read More
Exclusion Criteria
  • Isolated extramedullary disease
  • Active Central Nervous System [CNS] disease
Read More

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Arm BHIDAC (high dose cytarabine)-
Arm BFLAG (fludarabine, cytarabine and G-CSF)-
Arm Bcytarabine and mitoxantrone-
Arm Ainotuzumab ozogamicin-
Primary Outcome Measures
NameTimeMethod
Overall Survival (OS)Up to 5 years after randomization or 2 years from randomization of the last participant, whichever occurs first.

OS was defined as the time from randomization to date of death due to any cause. Participants last known to be alive were censored at date of last contact.

Percentage of Participants With Hematologic Remission (Complete Remission [CR]/Complete Remission With Incomplete Hematologic Recovery [CRi]) as Assessed by the Endpoint Adjudication Committee (EAC)Screening, Day 16 to 28 of Cycles 1, 2 and 3, then every 1 to 2 cycles (or as clinically indicated) up to approximately 4 weeks (end of treatment [EoT]) from the last dose

CR was the disappearance of leukemia indicated by less than (\<) 5 percent (%) marrow blasts \& absence of peripheral blood leukemic blasts, with recovery of hematopoiesis defined by absolute neutrophil count (ANC) greater than or equal to (≥)1000 per microliter (/μL) \& platelets ≥100,000/μL. C1 extramedullary disease status (i.e. complete disappearance of measurable \& non-measurable extramedullary disease with the following exceptions: for participants with at least 1 measurable lesion, all nodal masses greater than (\>) 1.5 centimeters (cm) in greatest transverse diameter (GTD) at baseline must have regressed to less than or equal to (≤) 1.5 cm in GTD; all nodal masses ≥1 cm \& ≤1.5 cm in GTD at baseline must have regressed to \<1 cm GTD or reduced by 75% in sum of products of greatest diameters, no new lesions, spleen \& other previously enlarged organs must have regressed in size \& must not be palpable) was required. CRi was defined as CR except ANC \<1000/μL \&/or platelets \<100,000/μL.

Secondary Outcome Measures
NameTimeMethod
Percentage of Participants Achieving MRD Negativity (Based on Central Laboratory Analysis) in Participants Achieving a CR/CRi (Per EAC Assessment)Up to approximately 4 weeks (EoT) from last dose of study drug

MRD analysis was performed at least once in participants with prior assessment of CR or CRi. Bone marrow aspirates, collected at screening and during the study, were sent to the central laboratory and analyzed using multiparametric flow cytometry. The antibody combinations were designed to maximize discrimination between normal and abnormal cells of B-cell lineage and similar maturational stage and included antibodies detecting cluster of differentiation (CD) 9, CD10, CD13, CD19, CD20, CD33, CD34, CD38, CD45, CD58, CD66c, and CD123. A peripheral blood sample was provided if a participant had an inadequate bone marrow aspirate at screening. MRD negativity was considered to have been achieved if the lowest value of MRD from the first date of CR/CRi to EoT was \<1 × 10\^-4 blasts/nucleated cells.

Duration of Remission (DoR) for Participants Who Achieved CR/CRi (Per Investigator Assessment)Up to 2 years from randomization

DoR was defined as time from date of first response in responders (CR/CRi per Investigator assessment) to date of PFS event (i.e. death, progressive disease \[objective progression, relapse from CR/CRi or treatment discontinuation due to global deterioration of health status\] or starting new induction therapy or post-therapy stem cell transplant \[SCT\] without achieving CR/CRi). Responders without PFS events were censored at the last valid disease assessment including follow-up.

Percentage of Participants Who Had a Hematopoietic Stem-Cell Transplant (HSCT)Up to 19 weeks from last dose

HSCT rate was defined as the percentage of participants who underwent SCT following treatment with inotuzumab ozogamicin or Investigator's choice of chemotherapy.

Change From Baseline in European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, Core 30 (EORTC QLQ-C30) ScoreDay 1 of each cycle prior to dosing and EoT

This questionnaire comprised 30 questions within which are 9 multi-item scales \& 6 single-item measures. There are 5 functional scales; physical, role, cognitive, emotional \& social, 3 symptom scales; fatigue, pain, \& nausea \& vomiting, \& a global health status/quality of life (QoL) scale. There are 5 single item measures assessing additional symptoms commonly reported by cancer patients (loss of appetite, insomnia, constipation, diarrhea, \& dyspnea) \& a single item concerning perceived financial impact of the disease. Most questions used a 4 point scale (1='not at all' to 4='very much'); 2 questions used a 7-point scale (1='very poor' to 7='excellent'). Scores were averaged \& transformed to a scale ranging from 0 to 100; a higher score indicates a better level of functioning or greater degree of symptoms.

Maximum Observed Inotuzumab Ozogamicin Serum Concentration (Cmax) and Pre-Dose Inotuzumab Ozogamicin Serum Concentration (Ctrough) Following Single and Multiple DosingDays 1, 4, 8, and 15 of Cycle 1, Days 1 and 8 of Cycle 2 and Day 1 of Cycle 4

Blood samples were collected and analyzed for inotuzumab ozogamicin serum concentrations using a validated high performance liquid chromatography with tandem mass spectrometry (HPLC/MS/MS) method with a lower limit of quantification of 1.0 nanograms per milliliter (ng/mL). Cmax was the maximum observed concentration occurring between 0-8 hours post-dose. Ctrough was the concentration prior to subsequent dose (pre-dose) occurring after 8 hours. n = number of observations (non-missing concentrations).

Change From Baseline in EuroQol 5 Dimension Health Questionnaire (EQ-5D) Index ScoreDay 1 of each cycle prior to dosing and EoT

The EQ-5D self-report questionnaire is a standardized measure of health status developed by the EuroQoL Group. It consists of the EQ-5D descriptive system and a visual analogue scale (VAS), EQ-VAS. The EQ-5D descriptive system measures a participants' health state on 5 dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Each dimension has 3 levels, reflecting "no problems", "some problems", and "extreme problems". The EQ-VAS records the respondent's self-rated health on a scale from 0 (worst imaginable health state) to 100 (best imaginable health state); higher scores indicate a better health state. EQ-5D summary index is obtained with a formula that weights each level of the dimensions. The index-based score is interpreted along a continuum of 0 (death) to 1 (perfect health).

Progression-Free Survival (PFS)Up to 2 years from randomization

PFS was defined as time from date of randomization to earliest date of the following events: death, progressive disease (objective progression, relapse from CR/CRi or treatment discontinuation due to global deterioration of health status) and starting new induction therapy or post-therapy SCT without achieving CR/CRi. Participants without a PFS event at time of analysis were censored at the last valid disease assessment. In addition, participants with documentation of an event after an unacceptably long interval (\>28 weeks if there was post-baseline disease assessment, or \>12 weeks if there was no post-baseline assessment) since the previous disease assessment were censored at the time of the previous assessment (date of randomization if no post-baseline assessment). Post-study treatment follow-up disease assessments was included. Kaplan-Meier method used and 2-sided 95% confidence interval (CI) calculated based on the Brookmeyer and Crowley method.

Cytogenetic Status (Based on Local Laboratory Analysis) of Participants With CR/CRi (Per EAC Assessment)Up to approximately 4 weeks (EoT) from last dose of study drug

Karyotyping was required locally, at screening and at least once during the study in participants who had abnormal cytogenetics at baseline and who achieved CR/CRi. Data presented below are for participants who achieved CR/CRi per EAC and had abnormal karyotype at screening.

Change From Baseline in EQ-5D VASDay 1 of each cycle prior to dosing and EoT

The EQ-5D self-report questionnaire is a standardized measure of health status developed by the EuroQoL Group. It consists of the EQ-5D descriptive system and a visual analogue scale (VAS), EQ-VAS. The EQ-5D descriptive system measures a participants' health state on 5 dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Each dimension has 3 levels, reflecting "no problems", "some problems", and "extreme problems". The EQ-VAS records the respondent's self-rated health on a scale from 0 (worst imaginable health state) to 100 (best imaginable health state); higher scores indicate a better health state.

Percentage of Participants With Veno-Occlusive Liver Disease (VOD)/Sinusoidal Obstruction Syndrome (SOS) Following Post Study HSCTUp to 2 years from randomization

VOD/SOS was defined as the occurrence of 2 out of the following 3 clinical criteria: 1) total serum bilirubin level \>34 micromoles per liter (μmol/L) (\>2.0 milligrams per deciliter \[mg/dL\]), 2) an increase in liver size from baseline or development of right upper quadrant pain of liver origin and 3) sudden weight gain \>2.5% (eg, within a 72 hour period) because of fluid accumulation in the weeks following infusion of study drug or chemotherapy, or HSCT conditioning/preparative therapy, or development of ascites not present at baseline following such exposures AND the absence of other explanations for these signs and symptoms, OR development of bilirubin elevation, weight gain, or hepatomegaly plus histologic abnormalities on liver biopsy demonstrating hepatocyte necrosis in zone 3 of the liver acinus, sinusoidal fibrosis, and centrilobular hemorrhage, with or without fibrosis of the terminal hepatic venules.

Trial Locations

Locations (192)

University of Kansas Cancer Center

🇺🇸

Westwood, Kansas, United States

Investigational Drug Services - UC San Diego Moores Cancer Center

🇺🇸

La Jolla, California, United States

UC San Diego Medical Center - La Jolla

🇺🇸

La Jolla, California, United States

UC San Diego Moores Cancer Center

🇺🇸

La Jolla, California, United States

Children's Center for Cancer and Blood Diseases, Childrens Hospital Los Angeles

🇺🇸

Los Angeles, California, United States

USC/Norris Comprehensive Cancer Center / Investigational Drug Services

🇺🇸

Los Angeles, California, United States

Keck Hospital of USC

🇺🇸

Los Angeles, California, United States

LAC+USC Medical Center

🇺🇸

Los Angeles, California, United States

USC/Norris Comprehensive Cancer Center

🇺🇸

Los Angeles, California, United States

UCLA Drug Information/Investigation Drug

🇺🇸

Los Angeles, California, United States

UCLA Ronald Reagan Medical Center

🇺🇸

Los Angeles, California, United States

UCLA Hematology/Oncology Clinic

🇺🇸

Los Angeles, California, United States

UCLA Rrmc

🇺🇸

Los Angeles, California, United States

UC Irvine Medical Center

🇺🇸

Orange, California, United States

Freidenrich Center for Translational Research (CTRU), Stanford University

🇺🇸

Palo Alto, California, United States

Children's Hospital of Orange County

🇺🇸

Orange, California, United States

Martha Hamilton, Investigational Drug Services, Dept of Pharmacy

🇺🇸

Stanford, California, United States

Stanford Cancer Institute

🇺🇸

Stanford, California, United States

Stanford University Hospital and Clinics

🇺🇸

Stanford, California, United States

Investigational Drug Service, Emory University Clinic

🇺🇸

Atlanta, Georgia, United States

Emory University Hospital

🇺🇸

Atlanta, Georgia, United States

The Emory Clinic

🇺🇸

Atlanta, Georgia, United States

Georgia Regents Medical Center Pharmacy, Georgia Regents University Cancer Center

🇺🇸

Augusta, Georgia, United States

Blood and Marrow Transplant Group of Georgia

🇺🇸

Atlanta, Georgia, United States

Northside Hospital

🇺🇸

Atlanta, Georgia, United States

Winship Cancer Institute, Emory University

🇺🇸

Atlanta, Georgia, United States

Georgia Regents University

🇺🇸

Augusta, Georgia, United States

Northwestern Medical Faculty Foundation

🇺🇸

Chicago, Illinois, United States

Northwestern Medicine Developmental Therapeutics Institute

🇺🇸

Chicago, Illinois, United States

Northwestern Memorial Hospital

🇺🇸

Chicago, Illinois, United States

The University of Chicago

🇺🇸

Chicago, Illinois, United States

University of Chicago Medical Center, Dept. of Pharmacy

🇺🇸

Chicago, Illinois, United States

University of Iowa Hospitals and Clinics

🇺🇸

Iowa City, Iowa, United States

Oncology Investigational Drug Service

🇺🇸

Baltimore, Maryland, United States

The Sidney Kimmel Comprehensive Cancer Center

🇺🇸

Baltimore, Maryland, United States

Hackensack University Medical Center

🇺🇸

Hackensack, New Jersey, United States

Karmanos Cancer Institute Weisberg Cancer Treatment Center

🇺🇸

Farmington Hills, Michigan, United States

John Theurer Cancer Center at Hackensack University Medical Center

🇺🇸

Hackensack, New Jersey, United States

Rutgers Cancer Institute of New Jersey

🇺🇸

New Brunswick, New Jersey, United States

UNM Cancer Center

🇺🇸

Albuquerque, New Mexico, United States

Monter Cancer Center

🇺🇸

Lake Success, New York, United States

New York Presbyterian Hospital-Weill Cornell Medical College

🇺🇸

New York, New York, United States

North Shore University Hospital

🇺🇸

Manhasset, New York, United States

NewYork-Presbyterian Hospital

🇺🇸

New York, New York, United States

Stony Brook University Medical Center, The Cancer Center

🇺🇸

Stony Brook, New York, United States

Weill Cornell Medical College - New York-Presbyterian Hospital

🇺🇸

New York, New York, United States

Stony Brook University Medical Center

🇺🇸

Stony Brook, New York, United States

Division of Hematology/Oncology, Stony Brook University Hospital

🇺🇸

Stony Brook, New York, United States

IDS-investigational drug pharmacy Penn State Milton S. Hershey Medical Center

🇺🇸

Hershey, Pennsylvania, United States

Penn State Milton S. Hershey Medical Center,

🇺🇸

Hershey, Pennsylvania, United States

Baylor Charles A. Sammons Cancer Center

🇺🇸

Dallas, Texas, United States

Parkland Health and Hospital System

🇺🇸

Dallas, Texas, United States

University of Texas Southwestern Universtiy Hospital - William P Clements Jr.

🇺🇸

Dallas, Texas, United States

Baylor University Medical Center

🇺🇸

Dallas, Texas, United States

UT Southwestern University Hospital- Zale Lipshy

🇺🇸

Dallas, Texas, United States

UT Southwestern Medical Center at Dallas

🇺🇸

Dallas, Texas, United States

West Virginia University Hospitals Pharmaceutical Services

🇺🇸

Morgantown, West Virginia, United States

West Virginia University Hospitals

🇺🇸

Morgantown, West Virginia, United States

Sanatorio Allende

🇦🇷

Cordoba, Argentina

Eastern Clinical Research Unit, Box Hill Hospital

🇦🇺

Box Hill, Victoria, Australia

Royal Adelaide Hospital

🇦🇺

Adelaide, South Australia, Australia

Princess Margaret Cancer Centre

🇨🇦

Toronto, Ontario, Canada

Guangdong General Hospital

🇨🇳

Guangzhou, Guangdong, China

Beijing Chao-yang Hospital

🇨🇳

Beijing, China

Henan Cancer Hostipal

🇨🇳

Zhengzhou, Henan, China

Interni Hematologicka a Onkologicka Klinika

🇨🇿

Brno, Czechia

The 307th Hospital of PLA

🇨🇳

Beijing, China

Fakultni Nemocnice Hradec Kralove

🇨🇿

Hradec Kralove, Czechia

Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences,

🇨🇳

Tianjin, China

HUS-Kuvantaminen

🇫🇮

Helsinki, Finland

HYKS/Hematologian klinikka

🇫🇮

Helsinki, Finland

Fakultni nemocnice Kralovske Vinohrady

🇨🇿

Praha 10, Czechia

Hopital Universitaire Andre Mignot

🇫🇷

Le Chesnay Cedex, France

CHU de Dijon-Hopital d'Enfants-Service d'hematologie Clinique

🇫🇷

Dijon, France

C.H.U. de Grenoble, Hopital Albert Michallon

🇫🇷

Grenoble Cedex 09, France

Institut Paoli-Calmettes

🇫🇷

Marseille, France

CHU Dupuytren

🇫🇷

Limoges Cedex, France

Centre Hospitalier Lyon Sud

🇫🇷

Pierre Benite Cedex, France

Hôpital Saint-Louis

🇫🇷

Paris Cedex 10, France

Institut de Cancérologie Lucien Neuwirth

🇫🇷

Saint Priest en Jarez Cedex, France

Zentralapotheke des Universitaetsklinikums Muenster

🇩🇪

Muenster, Nordrhein-westfalen, Germany

CHU Brabois- Service d'hematologie

🇫🇷

Vandoeuvre-les-Nancy, France

Klinikum der Goethe Universitaet

🇩🇪

Frankfurt, Germany

Universitaetsklinikum Heidelberg

🇩🇪

Heidelberg, Germany

Universitätsklinikum Köln, Klinik I für Innere Medizin

🇩🇪

Köln, Germany

Institut fuer klinische Radiologie

🇩🇪

Muenster, Germany

Klinikum Rechts der Isar der TU München

🇩🇪

Muenchen, Germany

Universitaetsklinikum Muenster

🇩🇪

Muenster, Germany

Debreceni Egyetem Orvos-es Egeszsegtudomanyi Centrum II. Belgyogyaszati Klinika

🇭🇺

Debrecen, Hungary

Egyesitett Szent Istvan és Szent Laszlo Korhaz-Rendelointezet;

🇭🇺

Budapest, Hungary

Farmacia

🇮🇹

Cagliari, CA, Italy

U.O. Radiodiagnostica

🇮🇹

Cagliari, CA, Italy

Istituto di Ematologia Seragnoli

🇮🇹

Bologna, Italy

IRST-Ematologia

🇮🇹

Meldola (FC), FC, Italy

Radiology (Radiology Only)

🇮🇹

Udine, Italy

A.O.U. Vittorio Emanuele di Catania-Ospedale Ferrarotto

🇮🇹

Catania, Italy

Pharmacy

🇮🇹

Genova, Italy

Radiology Department (Radiology ONLY)

🇮🇹

Genova, Italy

Radiology Department

🇮🇹

Genova, Italy

A.O. San Gerardo di Monza

🇮🇹

Monza, Italy

S.C. Radiology

🇮🇹

Milano, Italy

AORN "A. Cardarelli"

🇮🇹

Napoli, Italy

Nagoya Daini Red Cross Hospital

🇯🇵

Nagoya, Aichi, Japan

U.O. Ematologia, Ospedale S. Maria delle Croci

🇮🇹

Ravenna, Italy

Servizio di Farmacia

🇮🇹

Ravenna, Italy

Radiologist Department

🇮🇹

Ravenna, Italy

Tohoku University Hospital

🇯🇵

Sendai, Miyagi, Japan

The Hospital of Hyogo College of Medicine

🇯🇵

Nishinomiya-shi, Hyogo, Japan

Osaka City University Hospital

🇯🇵

Osaka-city, Osaka, Japan

Akita University Hospital

🇯🇵

Akita, Japan

National Cancer Center Hospital

🇯🇵

Chuo-ku, Tokyo, Japan

Erasmus Medical Center

🇳🇱

Rotterdam, South Holland, Netherlands

Chonnam National University, Hwasun Hospital

🇰🇷

Hwasun-Gun, Jeonnam, Korea, Republic of

Asan Medical Center

🇰🇷

Seoul, Korea, Republic of

Samsung Medical Center

🇰🇷

Seoul, Korea, Republic of

Klinika Hematologii i Transplantologii

🇵🇱

Gdansk, Poland

Oddzial Hematologii, Klinika Hematologii, Regionalny Osrodek Onkologiczny Wojewodzki Szpital

🇵🇱

Lodz, Poland

Dolnoslaskie Centrum Transplantacji Komorkowych z Krajowym Bankiem Dawcow Szpiku

🇵🇱

Wroclaw, Poland

Instytut Hematologii i Transfuzjologii, Klinika Hematologii

🇵🇱

Warsaw, Poland

Singapore General Hospital

🇸🇬

Singapore, Singapore

Hospital Universitari Germans Trias i Pujol

🇪🇸

Badalona, Barcelona, Spain

Hospital Universitario de Salamanca

🇪🇸

Salamanca, Castille AND LION, Spain

Hospital Vall d'Hebron

🇪🇸

Barcelona, Catalonia, Spain

Hospital General Universitario Gregorio Maranon

🇪🇸

Madrid, Spain

Hospital de la Santa Creu i Sant Pau(Nuevo Hospital)

🇪🇸

Barcelona, Spain

Hospital Son Llatzer

🇪🇸

Palma de Mallorca, Mallorca, Spain

Hospital General Universitario Jose Maria Morales Meseguer

🇪🇸

Murcia, Spain

Hospital Ramon y Cajal

🇪🇸

Madrid, Spain

Hospital Universitario 12 de Octubre

🇪🇸

Madrid, Spain

Hospital Universitario Virgen del Rocio

🇪🇸

Sevilla, Spain

Hospital Clinico Universitario de Valencia

🇪🇸

Valencia, Spain

Universitetssjukhus Lund, Hematologkliniken

🇸🇪

Lund, Sweden

National Taiwan University Hospital

🇨🇳

Taipei, Taiwan

Hematology Center

🇸🇪

Stockholm, Sweden

Chang Gung Medical Foundation, Kaohsiung Branch

🇨🇳

Kaohsiung, Taiwan

Southampton General Hospital

🇬🇧

Southampton, Hampshire, United Kingdom

Bristol Haematology and Oncology Centre

🇬🇧

Bristol, United Kingdom

The Christie NHS Foundation Trust

🇬🇧

Manchester, United Kingdom

Department of Academic Oncology

🇬🇧

London, United Kingdom

Nottingham University Hospitals NHS Trust

🇬🇧

Nottingham, United Kingdom

Churchill Hospital

🇬🇧

Oxford, United Kingdom

The first hospital of jilin university

🇨🇳

Changchun, Jilin, China

Peking University People's Hospital

🇨🇳

Beijing, China

UC San Diego Medical Center - Hillcrest

🇺🇸

San Diego, California, United States

Miami Children's Hospital

🇺🇸

Miami, Florida, United States

Massachusetts General Hospital (MGH)

🇺🇸

Boston, Massachusetts, United States

Brigham and Women's Hospital

🇺🇸

Boston, Massachusetts, United States

Dana-Farber Cancer Institute

🇺🇸

Boston, Massachusetts, United States

University of Cincinnati Medical Center

🇺🇸

Cincinnati, Ohio, United States

University Hospitals of Cleveland

🇺🇸

Cleveland, Ohio, United States

Cleveland Clinic Foundation

🇺🇸

Cleveland, Ohio, United States

The University of Texas MD Anderson Cancer Center

🇺🇸

Houston, Texas, United States

Seattle Cancer Care Alliance

🇺🇸

Seattle, Washington, United States

University of Washington

🇺🇸

Seattle, Washington, United States

University of Rochester Medical Center

🇺🇸

Rochester, New York, United States

University of Kansas Hospital

🇺🇸

Kansas City, Kansas, United States

S.C. Pharmacy

🇮🇹

Milano, Italy

SC Ematologia

🇮🇹

Milano, Italy

A.O. San Gerardo - Farmacia

🇮🇹

Monza, Italy

Azienda Ospedaliera Brotzu CTMO P.O. Businco

🇮🇹

Cagliari, CA, Italy

U.O. di Ematologia Dip. Medicine Specialistiche A.O.U. Arcispedale Sant'Anna

🇮🇹

Cona, Ferrara, Italy

Clinica Ematologica

🇮🇹

Udine, Italy

U.O. Ematologia 1

🇮🇹

Genova, Italy

RAdiology Department (RAdiology only)

🇮🇹

Napoli, Italy

Karmanos Cancer Institute

🇺🇸

Detroit, Michigan, United States

OU Medical Center Presbyterian Tower

🇺🇸

Oklahoma City, Oklahoma, United States

Stephenson Cancer Center

🇺🇸

Oklahoma City, Oklahoma, United States

LDS Hospital

🇺🇸

Salt Lake City, Utah, United States

Iuct - Oncopole

🇫🇷

Toulouse Cedex 9, France

USC Norris Comprehensive Cancer Center

🇺🇸

Los Angeles, California, United States

University of Colorado Cancer Center

🇺🇸

Aurora, Colorado, United States

University of Colorado Hospital, Cancer Center Infusion Center

🇺🇸

Aurora, Colorado, United States

University of Colorado Hospital

🇺🇸

Aurora, Colorado, United States

MD Anderson Cancer Center Orlando - 5th Floor Investigational Pharmacy

🇺🇸

Orlando, Florida, United States

MD Anderson Cancer Center Orlando

🇺🇸

Orlando, Florida, United States

Orlando Heart Health Institute

🇺🇸

Orlando, Florida, United States

Orlando Regional Medical Center

🇺🇸

Orlando, Florida, United States

Norton Cancer Institute

🇺🇸

Louisville, Kentucky, United States

Norton Cancer Institute, Suburban

🇺🇸

Louisville, Kentucky, United States

University of Michigan Health System-

🇺🇸

Ann Arbor, Michigan, United States

Wake Forest Baptist Health

🇺🇸

Winston-Salem, North Carolina, United States

University of Maryland

🇺🇸

Baltimore, Maryland, United States

National Hospital Organization Kyushu Cancer Center

🇯🇵

Fukuoka, Japan

Tokai University Hospital

🇯🇵

Kanagawa, Japan

National University Hospital/National University Cancer Institute Singapore (NCIS)

🇸🇬

Singapore, Singapore

Yale-New Haven Hospital & Smilow Cancer Center

🇺🇸

New Haven, Connecticut, United States

UNC Cancer Hospital Infusion Pharmacy

🇺🇸

Chapel Hill, North Carolina, United States

UNC Hospitals - The University of North Carolina at Chapel Hill

🇺🇸

Chapel Hill, North Carolina, United States

Hollings Cancer Center

🇺🇸

Charleston, South Carolina, United States

MUSC Hospital

🇺🇸

Charleston, South Carolina, United States

University of New Mexico Comprehensive Cancer Center

🇺🇸

Albuquerque, New Mexico, United States

Castle Hill Hospital

🇬🇧

Hull, United Kingdom

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