A Study of Tucatinib vs. Placebo in Combination With Ado-trastuzumab Emtansine (T-DM1) for Patients With Advanced or Metastatic HER2+ Breast Cancer
- Conditions
- HER2-positive Breast Cancer
- Interventions
- Registration Number
- NCT03975647
- Lead Sponsor
- Seagen, a wholly owned subsidiary of Pfizer
- Brief Summary
This study is being done to see if tucatinib with ado-trastuzumab emtansine (T-DM1) works better than T-DM1 alone to help patients who have a specific type of breast cancer called HER2 positive breast carcinoma. The breast cancer in this study is either metastatic (spread into other parts of the body) or cannot be removed completely with surgery.
Patients in this study will be randomly assigned to get either tucatinib or placebo (a pill with no medicine). This is a blinded study, so neither patients nor their doctors will know whether a patient gets tucatinib or placebo. All patients in the study will get T-DM1, a drug that is often used to treat this cancer.
Each treatment cycle lasts 21 days. Patients will swallow tucatinib pills or placebo pills two times every day. Patients will get T-DM1 injections from the study site staff on the first day of every cycle.
- Detailed Description
This study is designed to evaluate the efficacy and safety of tucatinib in combination with T-DM1 in participants with unresectable locally-advanced or metastatic HER2+ breast cancer who have had prior treatment with a taxane and trastuzumab in any setting. Prior pertuzumab treatment is permitted, but not required. Participants will be randomized in a 1:1 manner to receive 21-day cycles of either tucatinib or placebo in combination with T-DM1.
While on study treatment, participants will be assessed for progression every 6 weeks for the first 24 weeks, and every 9 weeks thereafter, irrespective of dose holds or interruptions. Study treatment will continue until unacceptable toxicity, disease progression, withdrawal of consent, or study closure. After completion of study treatment and after occurrence of disease progression, participants in both arms of the study will continue to be followed for survival until study closure or withdrawal of consent.
Recruitment & Eligibility
- Status
- ACTIVE_NOT_RECRUITING
- Sex
- All
- Target Recruitment
- 466
- Histologically confirmed HER2+ breast carcinoma as determined by a sponsor-designated central laboratory
-
History of prior treatment with a taxane and trastuzumab in any setting, separately or in combination
-
Have progression of unresectable locally advanced/metastatic breast cancer after last systemic therapy, or be intolerant of last systemic therapy
-
Measurable or non-measurable disease assessable by RECIST v1.1
-
ECOG performance status score of 0 or 1
-
CNS Inclusion - Based on screening contrast brain magnetic resonance imaging (MRI), participants must have at least one of the following:
(a) No evidence of brain metastases
(b) Untreated brain metastases not needing immediate local therapy
(c) Previously treated brain metastases
-
Brain metastases previously treated with local therapy may either be stable since treatment or may have progressed since prior local CNS therapy, provided that there is no clinical indication for immediate re-treatment with local therapy
-
Participants treated with CNS local therapy for newly identified lesions or previously treated and progressing lesions may be eligible to enroll if all of the following criteria are met:
(i) Time since SRS is at least 7 days prior to first dose of study treatment, time since WBRT is at least 14 days prior to first dose, or time since surgical resection is at least 28 days.
(ii) Other sites of evaluable disease are present
-
Relevant records of any CNS treatment must be available to allow for classification of target and non-target lesions
-
-
- Prior treatment with tucatinib, afatinib, trastuzumab deruxtecan (DS-8201a), or any other investigational anti-HER2, anti-EGFR, or HER2 TKI agent. Prior treatment with lapatinib or neratinib within 12 months of starting study treatment (except in cases where they were given for ≤21 days and was discontinued for reasons other than disease progression or severe toxicity). Prior treatment with pyrotinib for recurrent of mBC (except in cases where pyrotinib was given for ≤21 days and was discontinued for reasons other than disease progression or severe toxicity).
-
CNS Exclusion - Based on screening contrast brain magnetic resonance imaging (MRI), participants must not have any of the following:
- Any untreated brain lesions >2 cm in size
- Ongoing use of corticosteroids for control of symptoms of brain metastases at a total daily dose of >2 mg of dexamethasone (or equivalent).
- Any brain lesion thought to require immediate local therapy
- Known or concurrent leptomeningeal disease as documented by the investigator
- Poorly controlled generalized or complex partial seizures
-
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Tucatinib + T-DM1 tucatinib Tucatinib + T-DM1 Tucatinib + T-DM1 T-DM1 Tucatinib + T-DM1 Placebo + T-DM1 placebo Placebo + T-DM1 Placebo + T-DM1 T-DM1 Placebo + T-DM1
- Primary Outcome Measures
Name Time Method Progression-Free Survival (PFS) as Per Response Evaluation Criteria in Solid Tumors (RECIST) Version (v)1.1 Based on Investigator Assessment From the date of randomization to the date of PD or death from any cause or censoring date, whichever occurred first (maximum up to 43 months) PFS as per investigator was defined as the time from the date of randomization to the investigator assessment of disease progression (PD) as per RECIST v1.1 or death from any cause, whichever occurred first. PD: at least a 20 percent (%) increase in the sum of diameters of target lesions, taking as reference the smallest sum on study. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 millimiter (mm). Participants without documentation of PD, or death at the time of analysis were censored at the date of the last tumor assessment.
- Secondary Outcome Measures
Name Time Method Overall Survival (OS) Up to approximately 5 years OS was defined as the time from randomization to death due to any cause. For a participant who was not known to have died by the end of study follow-up, observation of OS was censored on the date the participant was last known to be alive (i.e., the date of last contact).
Progression-Free Survival as Per RECIST v1.1 in Participants With Brain Metastases at Baseline Based on Investigator Assessment From the date of randomization to the date of PD or death from any cause or censoring date, whichever occurred first (maximum up to 45 months) PFS as per investigator was defined as the time from the date of randomization to the investigator assessment of PD as per RECIST v1.1 or death from any cause, whichever occurred first. PD: at least a 20 % increase in the sum of diameters of target lesions, taking as reference the smallest sum on study. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. Participants without documentation of PD, or death at the time of analysis were censored at the date of the last tumor assessment. PFS was analyzed in participants with presence or history of brain metastases.
Objective Response Rate (ORR) as Per RECIST v1.1 Based on Investigator Assessment From the date of first CR or PR until the date of the first documentation of PD or death, whichever occurred first (maximum up to 43 months) ORR was defined as the percentage of participants with confirmed complete response (CR) or partial response (PR) according to RECIST v1.1. CR: disappearance of all target lesions. Any pathological lymph nodes must have reduction in short axis to less than (\<)10 mm. PR: a greater than equal (\>=) 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters. For a response to be considered as confirmed, the subsequent response needs to be at least 4 weeks after the initial response. ORR by investigator assessment is based on investigator response assessments. Two-sided 95% exact confidence interval, computed using the Clopper-Pearson method.
Progression-Free Survival as Per RECIST v1.1 Determined by Blinded Independent Committee Review (BICR) From the date of randomization to the date of PD or death from any cause or censoring date, whichever occurred first (maximum up to 43 months) PFS as per BICR was defined as the time from the date of randomization to the centrally-reviewed documented PD as per RECIST v1.1 or death from any cause, whichever occurred first. PD: at least a 20 % increase in the sum of diameters of target lesions, taking as reference the smallest sum on study. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. Participants without documented progression of PD or death at the time of analysis were censored at the date of the last tumor assessment.
Progression-Free Survival in Participants With Brain Metastases at Baseline as Per RECIST v1.1 Determined by BICR From the date of randomization to the date of PD or death from any cause or censoring date, whichever occurred first (maximum up to 43 months) PFS as per BICR was defined as the time from the date of randomization to the centrally-reviewed documented PD as per RECIST v1.1 or death from any cause, whichever occurred first. PD: at least a 20 % increase in the sum of diameters of target lesions, taking as reference the smallest sum on study. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. PFS was analyzed in participants with presence or history of brain metastases.
Objective Response Rate as Per RECIST v1.1 Determined by BICR From the date of randomization to the date of PD or death from any cause or censoring date, whichever occurred first (maximum up to 43 months) ORR was defined as the percentage of participants with confirmed CR or PR according to RECIST v1.1. CR: Disappearance of all target lesions. Any pathological lymph nodes must have reduction in short axis to \<10 mm. PR: A \>= 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters. ORR per BICR is based on BICR response assessments.
Overall Survival in Participants With Brain Metastases at Baseline Up to approximately 5 years OS was defined as the time from randomization to death due to any cause. For a participant who was not known to have died by the end of study follow-up, observation of OS was censored on the date the participant was last known to be alive (i.e., the date of last contact). OS was analyzed in participants with presence or history of brain metastases.
Duration of Response (DOR) as Per RECIST v1.1 Based on Investigator Assessment Up to approximately 5 years DOR was defined as the time from first documentation of objective response (CR or PR that is subsequently confirmed) to the first documentation of PD as per RECIST v1.1 PD: at least a 20 % increase in the sum of diameters of target lesions, taking as reference the smallest sum on study. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. Participants without documentation of PD, or death at the time of analysis were censored at the date of the last tumor assessment. CR: disappearance of all target lesions. Any pathological lymph nodes must have reduction in short axis to \<10 mm. PR: A\>=30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters. DOR per investigator was based on investigator response assessments.
Duration of Response as Per RECIST v1.1 by BICR Up to approximately 5 years DOR was defined as the time from first documentation of objective response (CR or PR that is subsequently confirmed) to the first documentation of PD as per RECIST v1.1 PD: at least a 20 % increase in the sum of diameters of target lesions, taking as reference the smallest sum on study. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. Participants without documentation of PD, or death at the time of analysis were censored at the date of the last tumor assessment. CR: disappearance of all target lesions. Any pathological lymph nodes must have reduction in short axis to \<10 mm. PR: A\>=30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters. DOR per BICR was based on BICR response assessments.
Clinical Benefit Rate (CBR) Per RECIST v1.1 Based on Investigator Assessment Up to approximately 5 years CBR was defined as the percentage of participants with stable disease (SD) or non-CR or non-PD \>= 6 months or best response of CR or PR according to RECIST v1.1. SD: neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum diameters while on study. PD: at least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study). In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. CR: disappearance of all target lesions. Any pathological lymph nodes must have reduction in short axis to \<10 mm. PR: A \>= 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters. CBR was based on investigator assessment.
Clinical Benefit Rate as Per RECIST v1.1 by BICR Up to approximately 5 years CBR was defined as the percentage of participants with SD or non-CR or non-PD \>= 6 months or best response of CR or PR according to RECIST v1.1. SD: neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum diameters while on study. PD: at least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study). In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. CR: disappearance of all target lesions. Any pathological lymph nodes must have reduction in short axis to \<10 mm. PR: A \>= 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters. CBR per BICR is based on BICR response assessments.
Number of Participants With Treatment Emergent Adverse Events (AEs) From start of treatment up to 30 days after the last study treatment (approximately 43 months) An AE was any untoward medical occurrence in a participant or clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. TEAE was defined as AE that is newly occurred or worsened after the start of study treatment.
Trial Locations
- Locations (272)
Texas Oncology - Medical City Dallas
🇺🇸Dallas, Texas, United States
University of Texas Southwestern Medical Center
🇺🇸Dallas, Texas, United States
Winship Cancer Institute / Emory University School of Medicine
🇺🇸Atlanta, Georgia, United States
Mercy Medical Center -Weinberg Center
🇺🇸Baltimore, Maryland, United States
Cancer Treatment Centers of America / Eastern Regional Medical Center
🇺🇸Philadelphia, Pennsylvania, United States
Rush University Medical Center
🇺🇸Chicago, Illinois, United States
University of Chicago Medical Center
🇺🇸Chicago, Illinois, United States
Beth Israel Deaconess Medical Center
🇺🇸Boston, Massachusetts, United States
Swedish Cancer Institute
🇺🇸Seattle, Washington, United States
Texas Oncology - Houston Memorial City
🇺🇸Houston, Texas, United States
MD Anderson Cancer Center / University of Texas
🇺🇸Houston, Texas, United States
Baylor Clinic
🇺🇸Houston, Texas, United States
Oncology Consultants, PA
🇺🇸Houston, Texas, United States
Miami Cancer Institute at Baptist Health, Inc.
🇺🇸Miami, Florida, United States
Comprehensive Cancer Centers of Nevada
🇺🇸Las Vegas, Nevada, United States
Minnesota Oncology Hematology P.A.
🇺🇸Minneapolis, Minnesota, United States
Duke University Medical Center
🇺🇸Durham, North Carolina, United States
Texas Oncology - San Antonio Medical Center
🇺🇸San Antonio, Texas, United States
San Francisco General Hospital
🇺🇸San Francisco, California, United States
University of California, San Francisco | HDFCCC - Hematopoietic Malignancies
🇺🇸San Francisco, California, United States
Tennessee Oncology-Nashville/Sarah Cannon Research Institute
🇺🇸Nashville, Tennessee, United States
Huntsman Cancer Institute/University of Utah
🇺🇸Salt Lake City, Utah, United States
Henry Ford Health System
🇺🇸Detroit, Michigan, United States
Arizona Oncology Associates, PC - HAL
🇺🇸Phoenix, Arizona, United States
Cancer Centers of Colorado - Denver
🇺🇸Denver, Colorado, United States
Providence Portland Medical Center
🇺🇸Portland, Oregon, United States
Oregon Health and Science University
🇺🇸Portland, Oregon, United States
Nebraska Cancer Specialists
🇺🇸Omaha, Nebraska, United States
University of California Davis
🇺🇸Sacramento, California, United States
Rocky Mountain Cancer Centers - Aurora
🇺🇸Aurora, Colorado, United States
University of Colorado Hospital / University of Colorado
🇺🇸Aurora, Colorado, United States
H. Lee Moffitt Cancer Center and Research Institute
🇺🇸Tampa, Florida, United States
American Oncology Networks LLC
🇺🇸Bethesda, Maryland, United States
Banner MD Anderson Cancer Center
🇺🇸Gilbert, Arizona, United States
Cancer Treatment Centers of America / Western Regional Medical Center
🇺🇸Goodyear, Arizona, United States
Ironwood Cancer & Research Centers - Chandler
🇺🇸Chandler, Arizona, United States
Arizona Oncology Associates, PC - HOPE
🇺🇸Tucson, Arizona, United States
St. Bernards Medical Center
🇺🇸Jonesboro, Arkansas, United States
St. Joseph Heritage Healthcare TRIO
🇺🇸Fullerton, California, United States
California Cancer Associates for Research and Excellence Inc (cCARE)
🇺🇸Encinitas, California, United States
City of Hope National Medical Center
🇺🇸Duarte, California, United States
Chao Family Comprehensive Cancer Center University of California Irvine
🇺🇸Orange, California, United States
University of California Irvine - Newport
🇺🇸Orange, California, United States
Kaiser Permanente Medical Center Northern California
🇺🇸Vallejo, California, United States
University of Colorado Health Memorial Hospital
🇺🇸Colorado Springs, Colorado, United States
Torrance Memorial Physician Network - TRIO
🇺🇸Torrance, California, United States
SCL Health Good Samaritan Medical Center Cancer Centers of Colorado
🇺🇸Broomfield, Colorado, United States
Baptist MD Anderson Cancer Center
🇺🇸Jacksonville, Florida, United States
Florida Cancer Specialists - South Region
🇺🇸Fort Myers, Florida, United States
Poudre Valley Health System (PVHS)
🇺🇸Fort Collins, Colorado, United States
Lombardi Cancer Center / Georgetown University Medical Center
🇺🇸Washington, District of Columbia, United States
Florida Cancer Specialists - North Region
🇺🇸Saint Petersburg, Florida, United States
Florida Cancer Specialists - East West Palm Beach, FL (SCRI)
🇺🇸West Palm Beach, Florida, United States
Illinois Cancer Specialists - Arlington Heights
🇺🇸Arlington Heights, Illinois, United States
Northside Hospital
🇺🇸Canton, Georgia, United States
University of Maryland
🇺🇸Baltimore, Maryland, United States
Ft Wayne Medical Oncology and Hematology, Inc TRIO
🇺🇸Fort Wayne, Indiana, United States
Illinois Cancer Care
🇺🇸Peoria, Illinois, United States
Maryland Oncology Hematology, P.A.
🇺🇸Rockville, Maryland, United States
Dana Farber Cancer Institute
🇺🇸Boston, Massachusetts, United States
North Mississippi Medical Center Hematology Oncology - Tupelo
🇺🇸Tupelo, Mississippi, United States
St. Vincent Frontier Cancer Center
🇺🇸Billings, Montana, United States
Washington University in St Louis
🇺🇸Saint Louis, Missouri, United States
Summit Medical Group
🇺🇸Florham Park, New Jersey, United States
Rutgers Cancer Institute of New Jersey
🇺🇸New Brunswick, New Jersey, United States
Saint Barnabas Medical Center Cancer Center
🇺🇸Livingston, New Jersey, United States
Levine Cancer Institute
🇺🇸Charlotte, North Carolina, United States
New York Oncology Hematology, P.C.
🇺🇸Albany, New York, United States
Stony Brook University Cancer Center
🇺🇸Stony Brook, New York, United States
Northwest Cancer Specialists, P.C.
🇺🇸Tigard, Oregon, United States
University of Pennsylvania / Perelman Center for Advanced Medicine
🇺🇸Philadelphia, Pennsylvania, United States
Brig Center for Cancer Care and Survivorship
🇺🇸Knoxville, Tennessee, United States
Texas Oncology - Amarillo
🇺🇸Amarillo, Texas, United States
Texas Oncology - DFW
🇺🇸Dallas, Texas, United States
Mater Hospital
🇦🇺Sydney, Other, Australia
Virginia Cancer Specialists, PC
🇺🇸Fairfax, Virginia, United States
Peninsula Cancer Institute
🇺🇸Newport News, Virginia, United States
Oncology & Hematology Associates of Southwest Virginia Inc dba Blue Ridge Cancer Care
🇺🇸Salem, Virginia, United States
Saint Francis Hospital / Bon Secours - Virginia
🇺🇸Midlothian, Virginia, United States
Swedish Cancer Institute - Edmonds
🇺🇸Edmonds, Washington, United States
Swedish Cancer Institute - Issaquah
🇺🇸Issaquah, Washington, United States
Peter MacCallum Cancer Centre
🇦🇺Melbourne, Other, Australia
Austin Health
🇦🇺Melbourne, Other, Australia
Westmead Hospital
🇦🇺Westmead, Other, Australia
Breast Cancer Research Centre
🇦🇺Nedlands, Other, Australia
LKH- Universitat Klinikum Graz
🇦🇹Graz, Other, Austria
Medizinische Universitat Innsbruck
🇦🇹Innsbruck, Other, Austria
LKH Salzburg, Universitatsklinikum der PMU
🇦🇹Salzburg, Other, Austria
Medizinische Universitat Wien
🇦🇹Vienna, Other, Austria
Klinik Ottakring
🇦🇹Vienna, Other, Austria
Institut Jules Bordet
🇧🇪Anderlecht, Other, Belgium
Cliniques Universitaires Saint Luc
🇧🇪Brussels, Other, Belgium
Grand Hôpital de Charleroi - Saint-Joseph
🇧🇪Charleroi, Other, Belgium
Universitair Ziekenhuis Antwerpen
🇧🇪Edegem, Other, Belgium
Academisch Ziekenhuis Groeninge
🇧🇪Kortrijk, Other, Belgium
University of Alberta / Cross Cancer Institute
🇨🇦Edmonton, Alberta, Canada
CHU de Liege
🇧🇪Liege, Other, Belgium
CHU UCL Namur-Site de Saint Elisabeth
🇧🇪Namur, Other, Belgium
Universitair Ziekenhuis Leuven
🇧🇪Leuven, Other, Belgium
Cancer Centre of Southeastern Ontario At Kingston General Hospital
🇨🇦Kingston, Ontario, Canada
University Health Network, Princess Margaret Hospital
🇨🇦Toronto, Ontario, Canada
London Health Sciences Centre - Victoria Hospital
🇨🇦London, Ontario, Canada
University of Ottawa / Ottawa General Hospital
🇨🇦Ottawa, Ontario, Canada
Centre Hospitalier de l'Universite de Montreal
🇨🇦Montreal, Quebec, Canada
Jewish General Hospital
🇨🇦Montreal, Quebec, Canada
Saskatoon Cancer Centre
🇨🇦Saskatoon, Saskatchewan, Canada
Hopital du Saint-Sacrement, CHU de Quebec-Universite Laval
🇨🇦Quebec, Canada
Cancer Hospital Chinese Academy of Medical Sciences
🇨🇳Beijing City, Other, China
Peking University People's Hospital
🇨🇳Beijing, Other, China
Jilin Province Cancer Hospital
🇨🇳Changghun, Other, China
Hunan Cancer Hospital
🇨🇳Changsha, Other, China
Sun Yat-sen University Cancer Center
🇨🇳Guangzhou City, Other, China
Guangdong Provincial People's Hospital
🇨🇳Guangzhou, Other, China
Zhejiang Cancer Hospital
🇨🇳Hangzhou City, Other, China
First Affiliated Hospital of Zhejiang University
🇨🇳Hangzhou City, Other, China
The Second Affiliated Hospital of Zhejiang University School of Medicine
🇨🇳Hangzhou, Other, China
Shandong Cancer Hospital
🇨🇳Jinan, Other, China
Shengjing Hospital of China Medical University
🇨🇳Shenyang City, Other, China
Gulou Hospital Affiliated to Nanjing University Medical College
🇨🇳Nanjing, Other, China
Tianjin Medical University - Cancer Institute & Hospital
🇨🇳Tianjin, Other, China
Hubei Cancer Hospital
🇨🇳Wuhan, Other, China
The Affiliated Hospital of Xuzhou Medical College
🇨🇳Xuzhou, Other, China
The Affiliated Hospital of Guangdong Medical University
🇨🇳Zhan Jiang City, Other, China
Henan Cancer Hospital
🇨🇳Zhengzhou, Other, China
Zigong First People's Hospital
🇨🇳Zigong City, Other, China
Bejing Hospital
🇨🇳Bejing, China
Wuhan University
🇨🇳Wuhan, Other, China
The First Affiliated Hospital of Xi'an Jiaotong University
🇨🇳Xi'an, Other, China
Xi'An International Medical Center Hospital
🇨🇳Xi'An, Other, China
Xuzhou Central Hospital
🇨🇳Xuzhou, Other, China
Center of Women and Children Hospital of Guangdong Province
🇨🇳Guangzhou, China
Nanchang Third Hospital
🇨🇳Nanchang City, China
Guangxi Medical University Affiliated Tumor Hospital
🇨🇳Nanning, China
Rigs Hospiltalet
🇩🇰Copenhagen, Other, Denmark
Aalborg Universitetshospital
🇩🇰Aalborg, Other, Denmark
Aarhus University Hospital
🇩🇰Aarhus N, Other, Denmark
Herlev Hospital
🇩🇰Herlev, Other, Denmark
Odense University Hospital
🇩🇰Odense C, Other, Denmark
Sygehus Lillebaelt - Vejle Sygehus
🇩🇰Vejle, Other, Denmark
University Hospital of Besancon
🇫🇷Besancon cedex, Other, France
Hospital Center Regional University Morvan De Brest
🇫🇷Brest, Other, France
Centre de Lutte contre le Cancer - Francois Baclesse
🇫🇷Caen Cedex 5, Other, France
Hopital Europeen Georges Pompidou
🇫🇷Cedex 15, Other, France
Center Georges Francois Leclerc
🇫🇷Dijon, Other, France
Clinique Victor Hugo Le Mans
🇫🇷Le Mans, Other, France
Centre Leon Berard - Centre regional de lutte contre le cancer Rhone-Alpes
🇫🇷Lyon cedex 08, Other, France
Institute Curie - Centre de Lutte Contre Le Cancer CLCC de Paris
🇫🇷Paris, Other, France
Institut Paoli Calmettes
🇫🇷Marseille, Other, France
Centre Henri Becquerel / Centre Regional de Lutte Contre le Cancer
🇫🇷Rouen, Other, France
Hopital Saint-Louis / Service d'Hematologie
🇫🇷Paris Cedex 10, Other, France
Hopitaux Universitaires de Strasbourg
🇫🇷Strasbourg, Other, France
Institut Claudius Regaud IUCT-O
🇫🇷Toulouse Cedex 9, Other, France
CHU Tours - Hopital Bretonneau
🇫🇷TOURS Cedex 09, Other, France
Helios Klinikum Berlin-Buch
🇩🇪Berlin, Other, Germany
Stadtisches Klinikum Dessau
🇩🇪Dessau-Rosslau, Other, Germany
Kliniken Essen-Mitte - Evang. Huyssens-Stiftung
🇩🇪Essen, Other, Germany
CHOP GmbH
🇩🇪Frankfurt, Other, Germany
Universitatsklinikum Heidelberg
🇩🇪Heidelberg, Other, Germany
Universitatsklinikum Schleswig-Holstein
🇩🇪Kiel, Other, Germany
Universitaetsklinikum Hamburg-Eppendorf (UKE)
🇩🇪Hamburg, Other, Germany
InVO- Institut fUr Versorgungsforschung in der onkologie GbR
🇩🇪Koblenz, Other, Germany
Universitaetsmedizin der Johannes Gutenberg-Universitaet Mainz
🇩🇪Mainz, Other, Germany
Klinikum Rechts der Isar der Technischen Universitaet Muenchen
🇩🇪Muenchen, Other, Germany
Sana Klinikum Offenbach GmbH
🇩🇪Offenbach am Main, Other, Germany
University of Rostock
🇩🇪Rostock, Other, Germany
Klinikum der Universitat Munchen
🇩🇪Munchen, Other, Germany
Shaare Zedek Medical Center
🇮🇱Jerusalem, Other, Israel
Meir Medical Center
🇮🇱Kfar Saba, Other, Israel
Rabin Medical Center
🇮🇱Petach Tikva, Other, Israel
Kaplan Medical Center
🇮🇱Rehovot, Other, Israel
Azienda Ospedaliero-Universitaria di Bologna Policlinico S. Orsola-Malpighi
🇮🇹Bologna, Other, Italy
Fondazione del Piemonte per l'Oncologia - Istituto di Candiolo FPO - IRCCS
🇮🇹Candiolo, Other, Italy
Irccs Irst
🇮🇹Meldola, Other, Italy
Istituto Europeo di Oncologia
🇮🇹Milano, Other, Italy
Seconda Università degli Studi di Napoli, AOU
🇮🇹Napoli, Other, Italy
Nuovo Ospedale di Prato - Santo Stefano
🇮🇹Prato, Other, Italy
Ospedale degli Infermi
🇮🇹Rimini, Other, Italy
Policlinico Universitario Agostino Gemelli
🇮🇹Roma, Other, Italy
Azienda Ospedaliera S. Maria di Terni
🇮🇹Terni, Other, Italy
A.O.U. - Ospedali Riuniti di Ancona
🇮🇹Torrette, Other, Italy
Chiba Cancer Center
🇯🇵Chiba, Other, Japan
National Cancer Center Hospital
🇯🇵Chuo-ku, Other, Japan
National Hospital Organization Kyushu Cancer Center
🇯🇵Fukuoka-shi, Other, Japan
Hiroshima City Hiroshima Citizens Hospital
🇯🇵Hiroshima, Other, Japan
University of Tsukuba Hospital
🇯🇵Ibaraki, Other, Japan
National Cancer Center Hospital East
🇯🇵Kashiwa-shi, Other, Japan
Saitama Cancer Center
🇯🇵Kitaadachi-gun, Other, Japan
Kumamoto Shinto General Hospital
🇯🇵Kumamoto, Other, Japan
NHO Shikoku Cancer Center
🇯🇵Matsuyama, Other, Japan
Aichi Cancer Center
🇯🇵Nagoya-shi, Other, Japan
Hakuaikai Sagara Hospital/Breast Surgery
🇯🇵Kagosima, Other, Japan
Kameda General Hospital
🇯🇵Kamogawa, Other, Japan
Hyogo College of Medicine Hospital
🇯🇵Nishinomiya, Other, Japan
National Hospital Organization Osaka
🇯🇵Osaka, Other, Japan
Osaka International Cancer Institute
🇯🇵Osaka, Other, Japan
National Hospital Organization Hokkaido Cancer Center
🇯🇵Sapporo, Other, Japan
Shizuoka Cancer Center
🇯🇵Sunto-Gun, Other, Japan
The Cancer Institute Hospital of JFCR
🇯🇵Tokyo, Other, Japan
Kanagawa Cancer Center
🇯🇵Yokohama, Other, Japan
National Cancer Center
🇰🇷Goyang-si, Other, Korea, Republic of
Seoul National University Bundang Hospital
🇰🇷Seongnam-si, Other, Korea, Republic of
Seoul National University Hospital
🇰🇷Seoul, Other, Korea, Republic of
Severance Hospital, Yonsei University Health System
🇰🇷Seoul, Other, Korea, Republic of
Korea University Anam Hospital
🇰🇷Seoul, Other, Korea, Republic of
Asan Medical Center - Oncology
🇰🇷Seoul, Other, Korea, Republic of
Isala Ziekenhuis Zwolle
🇳🇱AB Zwolle, Other, Netherlands
Netherlands Cancer Institute
🇳🇱Amsterdam, Other, Netherlands
Samsung Medical Center
🇰🇷Seoul, Other, Korea, Republic of
Reinier de Graaf Hospital
🇳🇱Delft, Other, Netherlands
University Medical Center Groningen
🇳🇱Groningen, Other, Netherlands
Martini Ziekenhuis
🇳🇱Groningen, Other, Netherlands
Maastricht University Medical Center
🇳🇱Maastricht, Other, Netherlands
Erasmus Medisch Centrum Daniel Den Hoed
🇳🇱Rotterdam, Other, Netherlands
National University Cancer Institute, Singapore
🇸🇬Singapore, Other, Singapore
Amphia Ziekenhuis
🇳🇱Breda, Other, Netherlands
National Cancer Centre Singapore
🇸🇬Singapore, Other, Singapore
Hospital del Mar
🇪🇸Barcelona, Other, Spain
Hospital General Universitario Gregorio Marañon
🇪🇸Madrid, Other, Spain
Hospital Ruber Internacional
🇪🇸Madrid, Other, Spain
Hospital Clinico San Carlos
🇪🇸Madrid, Other, Spain
Hospital Universitario HM Sanchinarro
🇪🇸Madrid, Other, Spain
Hospital Universitario Virgen de la Victoria
🇪🇸Malaga, Other, Spain
Hospital Universitario Son Espases
🇪🇸Palma de Mallorca, Other, Spain
L'Institut Catala d'Oncologia
🇪🇸Saint Joan Despi, Other, Spain
Hospital Universitari Vall d'Hebron
🇪🇸Barcelona, Other, Spain
Hospital Universitario Reina Sofia
🇪🇸Cordoba, Other, Spain
Hospital Universitario de Canarias
🇪🇸San Cristóbal de la Laguna, Other, Spain
Hospital Universitario Virgen del Rocio
🇪🇸Sevilla, Other, Spain
Hospital Clinico Universitario de Valencia
🇪🇸Valencia, Other, Spain
Hospital Universitario Miguel Servet
🇪🇸Zaragoza, Other, Spain
Goteborgs Universitet - Sahlgrenska Akademin - Institutionen For Kliniska Vetenskaper (Institute Of Clinical Sciences)
🇸🇪Gothenburg, Other, Sweden
Skanes University Hospital - Universitetssjukhus
🇸🇪Lund, Other, Sweden
Orebro University Hospital
🇸🇪Orebro, Other, Sweden
Ryhov Hospital
🇸🇪Jonkoping, Other, Sweden
Onkologklinike Sodersjukhuset
🇸🇪Stockholm, Other, Sweden
University Hospital Basel - Brustzentrum
🇨🇭Basel, Other, Switzerland
Institute of Oncology of Southern Switzerland
🇨🇭Bellinzona, Other, Switzerland
University Hospital Lausanne CHUV
🇨🇭Lausanne, Other, Switzerland
Kantonsspital Winterthur (KSW)
🇨🇭Winterthur, Other, Switzerland
National Cheng-Kung University Hospital
🇨🇳Tainan, Other, Taiwan
National Taiwan University Hospital
🇨🇳Tainan, Other, Taiwan
University Hospitals Birmingham NHS Foundation Trust
🇬🇧Birmingham, Other, United Kingdom
The University of Edinburgh
🇬🇧Edinburgh, Other, United Kingdom
Addenbrooke's Hospital
🇬🇧Cambridge, Other, United Kingdom
Oxford University Hospitals
🇬🇧Headington, Other, United Kingdom
The Royal Marsden NHS Foundation Trust (RM)
🇬🇧London, Other, United Kingdom
Sarah Cannon Research Institute UK
🇬🇧London, Other, United Kingdom
Maidstone and Tunbridge Wells NHS Trust
🇬🇧Maidstone, Other, United Kingdom
The Christie NHS Foundation Trust
🇬🇧Manchester, Other, United Kingdom
The Newcastle upon Tyne Hospitals NHS Foundation Trust
🇬🇧Newcastle Upon Tyne, Other, United Kingdom
Mount Vernon Hospital, UK
🇬🇧Northwood, Other, United Kingdom
The Royal Marsden Hospital (Surrey)
🇬🇧Sutton, Other, United Kingdom
AdventHealth Cancer Institute
🇺🇸Orlando, Florida, United States
Orlando Health, Inc. TRIO
🇺🇸Orlando, Florida, United States
University of Michigan Comprehensive Cancer Center
🇺🇸Ann Arbor, Michigan, United States
University of Miami
🇺🇸Miami, Florida, United States
The Center for Cancer and Blood Disorders: Fortworth
🇺🇸Fort Worth, Texas, United States
Helen F. Graham Cancer Center / Christiana Care Health Systems
🇺🇸Newark, Delaware, United States
UCLA Department of Medicine - Hematology & Oncology
🇺🇸Santa Monica, California, United States
Augusta University
🇺🇸Augusta, Georgia, United States
University of South Alabama - Mitchell Cancer Institute
🇺🇸Mobile, Alabama, United States
Saint Luke's Cancer Institute LLC
🇺🇸Kansas City, Missouri, United States
HCA Midwest Health Kansas City
🇺🇸Kansas City, Missouri, United States
UNC Lineberger Comprehensive Cancer Center / University of North Carolina
🇺🇸Chapel Hill, North Carolina, United States
Ochsner Medical Center
🇺🇸New Orleans, Louisiana, United States
Texas Oncology - Austin Central
🇺🇸Austin, Texas, United States
Kapi'olani Medical Center for Women and Children
🇺🇸Honolulu, Hawaii, United States
Kaiser Permanente Moanalua Medical Center
🇺🇸Honolulu, Hawaii, United States
CHI Saint Joseph Medical Group Cancer Care Center
🇺🇸Lexington, Kentucky, United States
Royal Cornwall Hospitals NHS Trust
🇬🇧Truro, Other, United Kingdom
University of Kansas Medical Center
🇺🇸Kansas City, Kansas, United States
Queen Elizabeth II Health Sciences Centre
🇨🇦Halifax, Nova Scotia, Canada