MedPath

Platinum-Based Chemotherapy With/Without INCMGA00012, an Anti-PD-1 Antibody, in Non-Small Cell Lung Cancer

Phase 3
Active, not recruiting
Conditions
Metastatic Squamous Non-Small Cell Lung Cancer
Metastatic Nonsquamous Non-Small Cell Lung Cancer
Interventions
Registration Number
NCT04205812
Lead Sponsor
Incyte Corporation
Brief Summary

The purpose of this study is to assess the efficacy and safety of platinum-based chemotherapy with or without INCMGA00012 in participants with metastatic squamous and nonsquamous non-small cell lung cancer (NSCLC).

Detailed Description

Not available

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
583
Inclusion Criteria
  • Histologically or cytologically confirmed NSCLC (either nonsquamous or squamous) that is Stage IV (AJCC v8).
  • No prior systemic treatment for the advanced/metastatic NSCLC
  • Able to provide a formalin-fixed archival tumor tissue sample during screening, or a fresh tumor biopsy
  • Measurable disease per RECIST v1.1.
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
  • Life expectancy of at least 3 months.
  • Willingness to avoid pregnancy or fathering children.
  • Adequate organ function as indicated by protocol-specified laboratory values. - Has been fully vaccinated against SARS-CoV-2 or is willing and able to be fully vaccinated against SARS-CoV-2 during the study by starting the vaccination process during screening.
Exclusion Criteria
  • Clinically significant cardiac disease within 6 months of start of study treatment.
  • Any major surgery within 3 weeks of the first dose of study treatment.
  • Thoracic radiation therapy of > 30 Gy within 6 months of the first dose of study treatment.
  • History of peripheral neuropathy ≥ Grade 2 CTCAE v5 for participants who may receive cisplatin, paclitaxel, or nab-paclitaxel.
  • Untreated central nervous system metastases and/or carcinomatous meningitis.
  • Evidence or history of interstitial lung disease or noninfectious pneumonitis that required systemic steroids.
  • Active infection requiring systemic therapy or active tuberculosis. Note: If required by country or local regulations to be tested for COVID-19 during screening, a participant should be excluded if they have a positive test result for SARS CoV-2 infection until both the retesting result is negative and clinical recovery is obtained.
  • Superficial bladder cancer, squamous cell carcinoma of the skin, in situ cervical cancer, or other in situ cancers.
  • Has contraindications to chemotherapy agents used in the study.
  • Has an active autoimmune disease that has required systemic treatment in past 2 years.
  • Is receiving systemic antibiotics or steroid therapy ≤ 7 days prior to the first dose of study treatment.
  • Has received a live vaccine within 30 days before the first dose of study treatment (and until 90 days after last dose of study drug).

Note: While based on approved SARS-CoV-2 vaccines available worldwide, many vaccines are not live (mRNA and adenovirus vaccines do not contain live virus), if a live vaccine against SARS-CoV-2 is the only available option, prior consultation with the medical monitor should be obtained.

• Has known active HBV or HCV (testing must be performed to determine eligibility)

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
INCMGA00012 + chemotherapy (nonsquamous NSCLC)RetifanlimabINCMGA00012 with pemetrexed + cisplatin OR carboplatin followed by INCMGA00012 plus pemetrexed until progression.
INCMGA00012 + chemotherapy (nonsquamous NSCLC)PemetrexedINCMGA00012 with pemetrexed + cisplatin OR carboplatin followed by INCMGA00012 plus pemetrexed until progression.
INCMGA00012 + chemotherapy (nonsquamous NSCLC)CisplatinINCMGA00012 with pemetrexed + cisplatin OR carboplatin followed by INCMGA00012 plus pemetrexed until progression.
INCMGA00012 + chemotherapy (nonsquamous NSCLC)CarboplatinINCMGA00012 with pemetrexed + cisplatin OR carboplatin followed by INCMGA00012 plus pemetrexed until progression.
Placebo + chemotherapy (nonsquamous NSCLC)PlaceboPlacebo with pemetrexed + cisplatin OR carboplatin followed by placebo plus pemetrexed until progression. Participants assigned to placebo + chemotherapy will have the option of receiving open-label monotherapy INCMGA00012 in a crossover period after documentation of progressive disease.
Placebo + chemotherapy (nonsquamous NSCLC)PemetrexedPlacebo with pemetrexed + cisplatin OR carboplatin followed by placebo plus pemetrexed until progression. Participants assigned to placebo + chemotherapy will have the option of receiving open-label monotherapy INCMGA00012 in a crossover period after documentation of progressive disease.
Placebo + chemotherapy (nonsquamous NSCLC)CisplatinPlacebo with pemetrexed + cisplatin OR carboplatin followed by placebo plus pemetrexed until progression. Participants assigned to placebo + chemotherapy will have the option of receiving open-label monotherapy INCMGA00012 in a crossover period after documentation of progressive disease.
INCMGA00012 + chemotherapy (squamous NSCLC)PaclitaxelINCMGA00012 with carboplatin + paclitaxel OR nab-paclitaxel followed by INCMGA00012 until progression.
INCMGA00012 + chemotherapy (squamous NSCLC)nab-PaclitaxelINCMGA00012 with carboplatin + paclitaxel OR nab-paclitaxel followed by INCMGA00012 until progression.
Placebo + chemotherapy (squamous NSCLC)PlaceboPlacebo with carboplatin + paclitaxel OR nab-paclitaxel followed by placebo until progression. Participants assigned to placebo + chemotherapy will have the option of receiving open-label monotherapy INCMGA00012 in a crossover period after documentation of progressive disease.
Placebo + chemotherapy (squamous NSCLC)nab-PaclitaxelPlacebo with carboplatin + paclitaxel OR nab-paclitaxel followed by placebo until progression. Participants assigned to placebo + chemotherapy will have the option of receiving open-label monotherapy INCMGA00012 in a crossover period after documentation of progressive disease.
Placebo + chemotherapy (nonsquamous NSCLC)CarboplatinPlacebo with pemetrexed + cisplatin OR carboplatin followed by placebo plus pemetrexed until progression. Participants assigned to placebo + chemotherapy will have the option of receiving open-label monotherapy INCMGA00012 in a crossover period after documentation of progressive disease.
INCMGA00012 + chemotherapy (squamous NSCLC)RetifanlimabINCMGA00012 with carboplatin + paclitaxel OR nab-paclitaxel followed by INCMGA00012 until progression.
INCMGA00012 + chemotherapy (squamous NSCLC)CarboplatinINCMGA00012 with carboplatin + paclitaxel OR nab-paclitaxel followed by INCMGA00012 until progression.
Placebo + chemotherapy (squamous NSCLC)CarboplatinPlacebo with carboplatin + paclitaxel OR nab-paclitaxel followed by placebo until progression. Participants assigned to placebo + chemotherapy will have the option of receiving open-label monotherapy INCMGA00012 in a crossover period after documentation of progressive disease.
Placebo + chemotherapy (squamous NSCLC)PaclitaxelPlacebo with carboplatin + paclitaxel OR nab-paclitaxel followed by placebo until progression. Participants assigned to placebo + chemotherapy will have the option of receiving open-label monotherapy INCMGA00012 in a crossover period after documentation of progressive disease.
Primary Outcome Measures
NameTimeMethod
Overall Survivalup to 39.1 months

Overall survival was defined as the time between the date of randomization and the date of death due to any cause.

Secondary Outcome Measures
NameTimeMethod
Progression-free Survival (PFS)up to 35.8 months

PFS was defined as the length of time from the date of randomization until the earliest date of disease progression by Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST v1.1), as determined by blinded independent central review (BICR), or death due to any cause, if occurring sooner than progression.

Objective Response Rateup to 35.78 months

Objective response rate was defined as the percentage of participants who had a confirmed complete response (CR) or partial response (PR) per RECIST v1.1 based on BICR at any post-Baseline visit until the first progressive disease or new anticancer therapy. CR: disappearance of all target and non-target lesions and no appearance of any new lesions. Any pathological lymph nodes (whether target or non-target) must have a reduction in the short axis to \<10 millimeters (mm). PR: complete disappearance or at least a 30% decrease in the sum of the diameters of target lesions, taking as a reference the baseline sum diameters, no new lesions, and no progression of non-target lesions.

Duration of Responseup to 34.3 months

Duration of response was defined as the time from the earliest date of documented response until the earliest date of disease progression or death from any cause, whichever comes first, per RECIST v1.1 based on BICR. CR: disappearance of all target and non-target lesions and no appearance of any new lesions. Any pathological lymph nodes (whether target or non-target) must have a reduction in the short axis to \<10 mm. PR: complete disappearance or at least a 30% decrease in the sum of the diameters of target lesions, taking as a reference the baseline sum diameters, no new lesions, and no progression of non-target lesions. PD: progression of a target or non-target lesion or presence of a new lesion.

Number of Participants With Any Treatment-emergent Adverse Event (TEAE) in the Randomized Treatment Periodup to approximately 39 months

An adverse event (AE) was defined as any untoward medical occurrence associated with the use of a drug in humans, whether or not considered drug related. An AE could therefore have been any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of study treatment. TEAEs were defined as any AEs either reported for the first time or the worsening of pre-existing events after the first dose of retifanlimab/placebo and within 90 days of the last administration of the randomized period. AEs that occurred after new anticancer therapy (including monotherapy treatment) were to be excluded.

Number of Participants Who Discontinued Study Drug Due to TEAEs in the Randomized Treatment Periodup to approximately 39 months

An AE was defined as any untoward medical occurrence associated with the use of a drug in humans, whether or not considered drug related. An AE could therefore have been any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of study treatment. TEAEs were defined as any AEs either reported for the first time or the worsening of pre-existing events after the first dose of retifanlimab/placebo and within 90 days of the last administration of the randomized period. AEs that occurred after new anticancer therapy (including monotherapy treatment) were to be excluded.

Number of Participants With Any TEAE in the Monotherapy Treatment Periodup to approximately 27 months

An AE was defined as any untoward medical occurrence associated with the use of a drug in humans, whether or not considered drug related. An AE could therefore have been any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of study treatment. TEAEs were defined as any AEs either reported for the first time or the worsening of pre-existing events after the first dose of retifanlimab/placebo and within 90 days of the last administration of the randomized period. AEs that occurred after new anticancer therapy (including monotherapy treatment) were to be excluded.

Number of Participants Who Discontinued Study Drug Due to TEAEs in the Monotherapy Treatment Periodup to approximately 27 months

An AE was defined as any untoward medical occurrence associated with the use of a drug in humans, whether or not considered drug related. An AE could therefore have been any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of study treatment. TEAEs were defined as any AEs either reported for the first time or the worsening of pre-existing events after the first dose of retifanlimab/placebo and within 90 days of the last administration of the randomized period. AEs that occurred after new anticancer therapy (including monotherapy treatment) were to be excluded.

Cmax of RetifanlimabCycle 1 Day 1: predose and end of infusion (EOI). Cycle 2 Day 1: predose. Cycle 4 Day 1: predose and EOI. Cycles 6, 8, and beyond Day 1: predose (every 4 cycles thereafter) and end of treatment visit or 30-day safety follow-up visit

Cmax was defined as the maximum observed plasma concentration of retifanlimab

AUC of RetifanlimabCycle 1 Day 1: predose and end of infusion (EOI). Cycle 2 Day 1: predose. Cycle 4 Day 1: predose and EOI. Cycles 6, 8, and beyond Day 1: predose (every 4 cycles thereafter) and end of treatment visit or 30-day safety follow-up visit

AUC was defined as the area under the curve.

Trial Locations

Locations (138)

Trakya Universitesi Tip Fakultesi

🇹🇷

Edirne, Turkey

Wits Clinical Research

🇿🇦

Johannesburg, South Africa

Kherson Regional Oncologic Dispensary

🇺🇦

Kherson, Ukraine

University of Pretoria Oncology Department

🇿🇦

Pretoria, South Africa

Cne Ccch of Uzh Cc Oncological Center

🇺🇦

Uzhgorod, Ukraine

Yildirim Beyazit University Ankara Ataturk Training and Research Hospital

🇹🇷

Ankara, Turkey

Necmettin Erbakan Universitesi Meram Tip Fakultesi Hastanesi

🇹🇷

Konya, Turkey

Mary Potter Oncology Centre

🇿🇦

Pretoria, South Africa

Acibadem Adana Hospital

🇹🇷

Adana, Turkey

Clinical Center of Serbia

🇷🇸

Belgrade, Serbia

Communal Non-Profit Enterprise Regional Center of Oncology

🇺🇦

Kharkiv, Ukraine

Hacettepe Universitesi Tip Fakultesi Hastanesi

🇹🇷

Ankara, Turkey

Medical Center Asklepion Llc

🇺🇦

Kyiv, Ukraine

Rmi Sumy Regional Clinical Oncology Dispensary

🇺🇦

Sumy, Ukraine

Dr. Abdurrahman Yurtaslan Onkology Teaching and Research Hospital

🇹🇷

Ankara, Turkey

N.N. Petrov Research Institute of Oncology

🇷🇺

St Petersburg, Russian Federation

Clinical Center Bezanijska Kosa

🇷🇸

Belgrade, Serbia

Sbhi Volgograd Regional Onclogy Dispensary

🇷🇺

Volgograd, Russian Federation

Adana Sehir Hastanesi

🇹🇷

Adana, Turkey

Memorial Ankara Hospital

🇹🇷

Ankara, Turkey

Cape Town Oncology Trials (Pty) Ltd

🇿🇦

Cape Town, South Africa

Ci Carpathian Clinical Oncological Center

🇺🇦

Ivano-frankivsk, Ukraine

St. Lukes Medical Center

🇵🇭

Quezon City, Philippines

V.T.Zaycev Institute of General and Urgent Surgery of National Academy Medical Sciences of Ukraine

🇺🇦

Kharkiv, Ukraine

Sandton Oncology Centre

🇿🇦

Johannesburg, South Africa

Gaziantep University Gaziantep Oncology Hospital

🇹🇷

Gaziantep, Turkey

Medipol University Medical Faculty

🇹🇷

Istanbul, Turkey

Cancercare Rondebosch Oncology Centre

🇿🇦

Cape Town, South Africa

Medical Center Oncolife Llc

🇺🇦

Zaporizhzhia, Ukraine

National Cancer Hospital

🇻🇳

Hanoi, Vietnam

Multifield Clinical Hospital No 4

🇺🇦

Dnipro, Ukraine

Can Tho Oncology Hospital

🇻🇳

Can Tho, Vietnam

Hcmc Oncology Hospital

🇻🇳

Ho Chi Minh City, Vietnam

Pp Ppc Acinus Medical and Diagnostic Centre

🇺🇦

Kropyvnytskyi, Ukraine

Kyiv City Clinical Oncological Center

🇺🇦

Kyiv, Ukraine

Ci of Krc Kyiv Regional Oncologic Dispensary

🇺🇦

Kyiv, Ukraine

Bach Mai Hospital

🇻🇳

Hanoi, Vietnam

National Lung Hospital

🇻🇳

Hanoi, Vietnam

Volyn Regional Oncological Dispensary

🇺🇦

Lutsk, Ukraine

Hunan Cancer Hospital

🇨🇳

Changsha, China

The First Affiliated Hospital Sun Yat-Sen University

🇨🇳

Guangzhou, China

Sir Run Run Shaw Hospital Zhejiang University School of Medicine

🇨🇳

Hangzhou, China

Hangzhou Cancer Hospital

🇨🇳

Hangzhou, China

The First Affiliated Hospital of Zhejiang University

🇨🇳

Hangzhou, China

Zhejiang Cancer Hospital

🇨🇳

Hangzhou, China

University of Science and Technology of China-First Affiliated Hospital (Anhui Provincial Hospital)

🇨🇳

Hefei, China

Jinan Central Hospital

🇨🇳

Jinan, China

Henan Cancer Hostipal

🇨🇳

Zhengzhou, China

Henan Provincial Peoples Hospital

🇨🇳

Zhengzhou, China

Memorial Antalya Hastanesi

🇹🇷

Antalya, Turkey

Istanbul University Cerrahpasa - Cerrahpasa Medical Faculty

🇹🇷

Istanbul, Turkey

Bakirkoy Dr Sadi Konuk Teaching and Research Hospital

🇹🇷

Istanbul, Turkey

Inonu Universitesi Turgut Ozal Tip Merkezi

🇹🇷

Malatya, Turkey

Fundacao Faculdade Regional de Medicina de Sao Jose Do Rio Preto

🇧🇷

Sao Jose, Brazil

The Medical City

🇵🇭

Pasig City, Philippines

Spitalul Clinic Judetean de Urgenta Constanta

🇷🇴

Constanta, Romania

Oncomed-System

🇷🇸

Belgrad, Serbia

Clinical Center Kragujevac

🇷🇸

Kragujevac, Serbia

Pacific Cancer Medical Center

🇺🇸

Anaheim, California, United States

Innovative Clinical Research Institute

🇺🇸

Whittier, California, United States

Centro Regional Integrado de Oncologia

🇧🇷

Fortaleza, Brazil

Incan - Instituto Do Cancer - Hospital Pompeia

🇧🇷

Caxias Do Sul, Brazil

Oncosite - Centro de Pesquisa Clinica E Oncologia

🇧🇷

Ijui, Brazil

Fundacao Pio Xii Hospital de Cancer de Barretos

🇧🇷

Barretos, Brazil

Inca - Instituto Nacional de Cancer

🇧🇷

Rio de Janeiro, Brazil

Instituto Mederi de Pesquisa E Saude

🇧🇷

Passo Fundo, Brazil

Cepho - Centro de Estudos E Pesquisas de Hematologia E Oncologia

🇧🇷

Santo Andre, Brazil

Hospital Do Cancer de Londrina

🇧🇷

Londrina, Brazil

Sao Camilo Oncologia

🇧🇷

S?O Paulo, Brazil

Hgb - Hospital Giovanni Battista - Mae de Deus Center

🇧🇷

Porto Alegre, Brazil

Mc Women'S Health-Nadezhda Eood

🇧🇬

Sofia, Bulgaria

Acibadem Cityclinica Mhat Tokuda

🇧🇬

Sofia, Bulgaria

Umhat Sv. Ivan Rilski Ead

🇧🇬

Sofia, Bulgaria

Multiprofile Hospital For Active Treatment Central Onco Hospital Ood

🇧🇬

Sofia, Bulgaria

Mhat Serdika Eood

🇧🇬

Sofia, Bulgaria

Shatod Dr Marko Marko - Varna Ltd

🇧🇬

Varna, Bulgaria

Harbin Medical University Cancer Hospital

🇨🇳

Harbin, China

The Second Hospital of Anhui Medical University

🇨🇳

Hefei, China

The Second Affiliated Hospital of Nanchang University

🇨🇳

Nanchang, China

Linyi Cancer Hospital

🇨🇳

Linyi, China

The First Affiliated Hospital of Guangxi Medical University

🇨🇳

Nanning, China

Shanghai Chest Hospital

🇨🇳

Shanghai, China

General Hospital of Tianjin

🇨🇳

Tianjing, China

The Affiliated Cancer Hospital of Xinjiang Medical University

🇨🇳

Urumqi, China

University Hospital Hradec Kralove

🇨🇿

Hradec Kralove, Czechia

The First Affiliated Hospital of Zhengzhou University

🇨🇳

Zhengzhou, China

Fakultni Nemocnice V Motole

🇨🇿

Praha 5, Czechia

Fakultni Nemocnice Olomouc

🇨🇿

Olomouc, Czechia

Nemocnice Agel Ostrava - Vitkovice A.S

🇨🇿

Ostrava - Vitkovice, Czechia

High Technology Hospital Medcenter

🇬🇪

Batumi, Georgia

Israel-Georgian Medical Research Clinic Helsicore

🇬🇪

Tbilisi, Georgia

Jsc Evex Hospitals

🇬🇪

Kutaisi, Georgia

Archangel St. Michael Multi Profile Clinical Hospital

🇬🇪

Tbilisi, Georgia

New Hospitals

🇬🇪

Tbilisi, Georgia

Tbilisi State Medical University First University Clinic

🇬🇪

Tbilisi, Georgia

Medulla Chemotherapy and Immunotherapy Clinic

🇬🇪

Tbilisi, Georgia

High Technology Medical Center, University Clinic

🇬🇪

Tbilisi, Georgia

Cancer Research Center Ltd

🇬🇪

Tbilisi, Georgia

Advanced Medical and Dental Institute Husm

🇲🇾

Kepala Batas, Malaysia

Bacs Kiskun Megyei Oktatokorhaz

🇭🇺

Kecskemet, Hungary

Orszagos Koranyi Tbc Es Pulmonological Intezet

🇭🇺

Budapest, Hungary

University Malaya Medical Centre

🇲🇾

Kuala Lumpur, Malaysia

Sarawak General Hospital

🇲🇾

Kuching, Malaysia

Hospital Tengku Ampuan Afzan

🇲🇾

Kuantan, Malaysia

Hospital Pulau Pinang

🇲🇾

Pulau Pinang, Malaysia

Institut Kanser Negara - National Cancer Institute

🇲🇾

Putrajaya, Malaysia

Cebu Doctors University Hospital

🇵🇭

Cebu City, Philippines

West Visayas State University Medical Center

🇵🇭

Iloilo City, Philippines

Davao Doctors Hospital

🇵🇭

Davao City, Philippines

Makati Medical Center

🇵🇭

Makati, Philippines

Ko-Med Centra Kliniczne Biala Podlaska

🇵🇱

Biala Podlaska, Poland

Przychodnia Lekarska Komed

🇵🇱

Konin, Poland

Asian Hospital and Medical Center

🇵🇭

Muntinlupa, Philippines

Centrum Medyczne Plejady

🇵🇱

Krakow, Poland

Centrum Terapii Wspolczesnej J.M. Jasnorzewska Sp. Komandytowo-Akcyjna

🇵🇱

Lodz, Poland

Institutul Oncologic Prof. Dr. Ion Chiricuta Cluj-Napoca

🇷🇴

Cluj Napoca, Romania

S.C Oncopremium Team S.R.L

🇷🇴

Baia Mare, Romania

Przychodnia Med-Polonia Sp. Z O.O.

🇵🇱

Poznan, Poland

S C Oncocenter Oncologie Medicala S R L

🇷🇴

Timisoara, Romania

Sbih of Arkhangelsk Region Arkhangelsk Clinical Oncological Dispensary

🇷🇺

Arkhangelsk, Russian Federation

Rbih Kursk Regional Clinical Oncology Dispensary of Kursk Region Healthcare Committee

🇷🇺

Kursk, Russian Federation

Federal State Institution "Russian Cancer Research Center Named After N.N. Blokhin" Rams

🇷🇺

Moscow, Russian Federation

Llc Tonus

🇷🇺

Nizniy Novgorod, Russian Federation

Sbhi of Novosibirsk Region Novosibirsk Regional Oncological Dispensary

🇷🇺

Novosibirsk, Russian Federation

Bhi of Omsk Region Clinical Oncology Dispensary

🇷🇺

Omsk, Russian Federation

Pavlov First Saint Petersburg State Medical University

🇷🇺

Saint-petersburg, Russian Federation

Izmir Medicalpark Hospital

🇹🇷

Izmir, Turkey

Mi Kryviy Rih Center of Dnipropetrovsk Regional Council

🇺🇦

Kryvyi Rih, Ukraine

Reading Hospital and Medical Center

🇺🇸

Reading, Pennsylvania, United States

Clinica de Neoplasias Litoral Ltda

🇧🇷

Itajai, Brazil

Beacon Hospital Sdn Bhd

🇲🇾

Petaling Jaya, Malaysia

Spitalul Clinic Militar de Urgenta Dr. Constantin Papilian Cluj-Napoca

🇷🇴

Cluj-napoca, Romania

Philippine General Hospital

🇵🇭

Manila, Philippines

Institute For Pulmonary Diseases of Vojvodina

🇷🇸

Sremska Kamenica, Serbia

103 Military Hospital

🇻🇳

Hanoi, Vietnam

Hanoi Oncology Hospital

🇻🇳

Hanoi, Vietnam

Institute of Clinical Oncology Ltd

🇬🇪

Tbilisi, Georgia

Oncomed Srl

🇷🇴

Timisoara, Romania

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