A Study Of Inotuzumab Ozogamicin Versus Investigator's Choice Of Chemotherapy In Patients With Relapsed Or Refractory Acute Lymphoblastic Leukemia
- Conditions
- Acute Lymphoblastic Leukemia
- Interventions
- Drug: FLAG (fludarabine, cytarabine and G-CSF)Drug: inotuzumab ozogamicinDrug: 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
- CD22 expression
- Adequate liver and renal functions
- Isolated extramedullary disease
- Active Central Nervous System [CNS] disease
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Arm B HIDAC (high dose cytarabine) - Arm B FLAG (fludarabine, cytarabine and G-CSF) - Arm B cytarabine and mitoxantrone - Arm A inotuzumab ozogamicin -
- Primary Outcome Measures
Name Time Method 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
Name Time Method 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) Score Day 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 Dosing Days 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 Score Day 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 VAS Day 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 HSCT Up 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