A Study to Evaluate the Efficacy and Safety of Lenalidomide as Maintenance Therapy for Patients With B-Cell Chronic Lymphocytic Leukemia (CLL) Following Second Line Therapy

Phase 3

Completed

Conditions: B-cell Chronic Lymphocytic Leukemia

Interventions: Drug: Placebo
Drug: Lenalidomide

Registration Number: NCT00774345

Lead Sponsor: Celgene

Brief Summary: The purpose of this study is to determine if lenalidomide (Revlimid®) is safe and effective as a maintenance therapy at improving further the quality of the response you achieved with your last therapy and at prolonging the duration of your response. This study will compare the effects (good and bad) of lenalidomide with the dummy drug.

Detailed Description: This is a phase 3, randomized (computer assigned by chance to treatment arm), study being completed an multiple sites to compare the safety and efficacy (how well a drug works) of lenalidomide maintenance therapy to placebo (dummy capsule that contains no lenalidomide or active substances) maintenance therapy.

Patients are assigned by a computer with a 50/50 chance to receive placebo or lenalidomide study treatment. Study drug will be taken once each day until the patient discontinues the study. Patients will remain on study drug until progression of disease.

Patients will visit their study doctor every 28 days until disease progression to complete safety and efficacy assessments. Quality of life assessments will be completed every other month. If a patient who discontinue study drug prior to disease progression (i.e. due to an adverse reaction to the study drug), they will continue to visit the study doctor each month to complete the efficacy assessments up to progression of disease. Safety assessments may include laboratory blood tests, ECG tests and questions about any medical conditions or side effects experienced during the study. Efficacy assessments may include laboratory blood tests and focused physical exams.

Computed tomography (CT) scans along with blood tests and bone marrow samples will be collected to confirm if a patient has improvement of response while on study.

After disease progression, patients will be contacted every 12 weeks for survival information, next CLL treatments and quality of life questions.

Subjects currently on lenalidomide treatment will discontinue lenalidomide treatment immediately and complete the Treatment Discontinuation assessment. The subjects will then transition to the survival follow-up period.

Recruitment & Eligibility

Status: COMPLETED

Sex: All

Target Recruitment: 317

Inclusion Criteria

Must understand and voluntarily sign an informed consent form.
Must be greater than or equal to 18 years at the time of signing the informed consent form.
Must be able to adhere to the study visit schedule and other protocol requirements.
Must have a documented diagnosis of B-cell CLL (IWCLL guidelines for the diagnosis and treatment of chronic lymphocytic leukemia [Hallek, 2008]).
Must have been treated with one of the following in first and/or second line:
- a purine analog-containing regimen
- a bendamustine-containing regimen
- an anti-CD20 antibody-containing regimen
- a chlorambucil-containing regimen
- an alemtuzumab-containing regimen (for those subjects with a 17p deletion)
Must have achieved a minimum response of partial response (PR, nPR, CRi, CR, and MRD-negative CR) (IWCLL guidelines for the diagnosis and treatment of chronic lymphocytic leukemia [Hallek, 2008]) following completion of second-line induction therapy prior to randomization (documentation of response status must be available). Second-line induction therapy must be documented to have been of sufficient duration.
Must have completed last cycle of second-line induction no less than 8 weeks (56 days) and no greater than 20 weeks (140 days) prior to randomization.
Must have an ECOG performance status score of less than or equal to 2.
Females of childbearing potential (FCBP)† must:
- Have two negative medically supervised pregnancy tests prior to starting of study therapy. She must agree to ongoing pregnancy testing during the course of the study, and after end of study therapy. This applies even if the subject practices complete and continued sexual abstinence.
- Either commit to continued abstinence from heterosexual contact (which must be reviewed on a monthly basis) or agree to use, and be able to comply with, effective contraception without interruption, 28 days prior to starting study drug, during the study therapy (including dose interruptions), and for 28 days after discontinuation of study therapy.
Male subjects must:
- Commit to continued abstinence from heterosexual contact or agree to use a condom during sexual contact with a FCBP, even if they have had a vasectomy, throughout study drug therapy, during any dose interruption and after cessation of study therapy.
- Agree to not donate semen during study drug therapy and for a period after end of study drug therapy.
All subjects must:
- Have an understanding that the study drug could have a potential teratogenic risk.
- Agree to abstain from donating blood while taking study drug therapy and following discontinuation of study drug therapy. • Agree not to share study medication with another person.
- All subjects must be counseled about pregnancy precautions and risks of fetal exposure.

Exclusion Criteria

Any serious medical condition, laboratory abnormality, or psychiatric illness that would prevent the subject from participating in the study.
Active infections requiring systemic antibiotics.
Systemic infection that has not resolved > 2 months prior to initiating lenalidomide treatment in spite of adequate anti-infective therapy
Autologous or allogeneic bone marrow transplant as second-line therapy.
Pregnant or lactating females.
Systemic treatment for B-cell CLL in the interval between completing the last cycle of second-line induction therapy and randomization.
Participation in any clinical study or having taken any investigational therapy for a disease other than CLL within 28 days prior to initiating maintenance therapy.
Known presence of alcohol and/or drug abuse.
Central nervous system involvement as documented by spinal fluid cytology or imaging. Subjects who have signs or symptoms suggestive of leukemic meningitis or a history of leukemic meningitis must have a lumbar puncture procedure performed within two weeks prior to randomization.
Prior history of malignancies, other than CLL, unless the subject has been free of the disease for ≥5 years. Exceptions include the following:
- Basal cell carcinoma of the skin
- Squamous cell carcinoma of the skin
- Carcinoma in situ of the cervix
- Carcinoma in situ of the breast
- Incidental histologic finding of prostate cancer (TNM stage of T1a or T1b)
History of renal failure requiring dialysis.
Known Human Immunodeficiency Virus (HIV), active Hepatitis B Virus (HBV), and/or active Hepatitis C Virus (HCV) infection.
Prior therapy with lenalidomide.
Evidence of TLS per the Cairo-Bishop definition of laboratory TLS (subjects may be enrolled upon correction of electrolyte abnormalities).
Any of the following laboratory abnormalities:
- Calculated (method of Cockroft-Gault) creatinine clearance <60 mL/min.
- Absolute neutrophil count (ANC) <1,000/μL (1.0 X 109/L)
- Platelet count <50,000/μL (50 X 109/L)
- Serum aspartate aminotransferase (AST)/serum glutamic-oxaloacetic transaminase (SGOT) or alanine transaminase (ALT)/serum glutamate pyruvate transaminase (SGPT) > 3.0 x upper limit of normal (ULN)
- Serum total bilirubin >2.0 mg/dL (with the exception of Gilbert's Syndrome)
Grade 4 rash due to prior thalidomide treatment
Uncontrolled hyperthyroidism or hypothyroidism
Venous thromboembolism within one year
Greater than or equal to Grade-2 neuropathy
Uncontrolled autoimmune hemolytic anemia or thrombocytopenia
Disease transformation (active) (ie, Richter's Syndrome, prolymphocytic leukemia)
Known allergy to allopurinol for subjects assessed with PR following their second-line induction therapy.
Prisoners.
More than 2 prior lines of CLL therapy.

Study & Design

Study Type: INTERVENTIONAL

Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Placebo Comparator: 2	Placebo	Placebo capsules given orally on days 1-28 of a 28 day cycle
Experimental: 1	Lenalidomide	Lenalidomide po qd on days 1-28 of a 28 day cycle

Primary Outcome Measures

Name	Time	Method
Overall Survival (OS)	Up to approximately 11 years	Overall Survival (OS) is defined as the time from randomization to death from any cause. OS will be censored at the last date that the participant was known to be alive for participants who were alive at the time of analysis and for participants who were lost to follow-up before death was documented.

Secondary Outcome Measures

Name	Time	Method
Progression Free Survival 2 (PFS2)	Up to 6 years	Progression Free Survival (PFS2) assessed by investigator is defined as the time from randomization to the second objective disease progression, or death from any cause, whichever occurs first.
Number of Participants With Adverse Events (AEs)	From first dose to 30 days post last dose (up to 9 years)	Number of participants with adverse events (AEs) that measure type, frequency and severity of AEs graded by National Cancer Institute Common Terminology Criteria (NCI CTCAE V 3.0) including any grade adverse events (AEs), Grade 3-4 AEs, AEs related to study drug, grade 3-4 AEs related to study drug.

Trial Locations

Locations (240): Pacific Coast Hematology Oncology
🇺🇸
Fountain Valley, California, United States
Memorial Hospital
🇺🇸
Hollywood, Florida, United States
The Cancer Center, Hackensack University Medical Center
🇺🇸
Hackensack, New Jersey, United States
Northwestern University, Division of Hematology Oncology, Dept. of Medicine
🇺🇸
Chicago, Illinois, United States
Bnei Zion Medical Center
🇮🇱
Haifa, Israel
Royal Prince Alfred Hospital
🇦🇺
Camperdown, Australia
Peter MacCallum Cancer Centre
🇦🇺
East Melbourne, Australia
Boca Raton Community Hospital
🇺🇸
Boca Raton, Florida, United States
St. Vincent Hospital
🇦🇺
Fitzroy, Australia
Nepean Hospital
🇦🇺
Kingswood, NSW, Australia
Clinical Trials Unit The St George Hospital
🇦🇺
Kogarah, Australia
Frankston Hospital
🇦🇺
Farkston, Australia
Florida Hospital Cancer Institute Waterman
🇺🇸
Tavares, Florida, United States
Royal North Shore HospitalDepartment of HematologyLevel 4
🇦🇺
St. Leonards, Australia
The Queen Elizabeth Hospital
🇦🇺
Woodville, Australia
Flinders Medical Centre
🇦🇺
Bedford Park, Australia
Winthrop University Hospital
🇺🇸
Mineola, New York, United States
Cancer Center of Central Connecticut
🇺🇸
Plainville, Connecticut, United States
Concord Hospital
🇦🇺
Concord, New South Wales, Australia
Poliklinika Agel Novy Jicin
🇨🇿
Novy Jicin, Czechia
Faculty Hospital Kralovske Vinohrady
🇨🇿
Prague, Czechia
Fakultni nemocnice Hradec Kralove
🇨🇿
Hradec Kralove, Czechia
Rigshospitalet University Hospital
🇩🇰
Copenhagen, Denmark
Interni hematoonkologicka klinika
🇨🇿
Brno, Czechia
Faculty Hospital Plzen
🇨🇿
Plzen, Czechia
Pretoria Academic Hospital
🇿🇦
Pretoria, South Africa
John Radcliffe Hospital
🇬🇧
Headington, United Kingdom
Groote Schuur Hospital
🇿🇦
Cape Town, South Africa
University Witwatersrand Oncology
🇿🇦
Parktown, South Africa
Hospital del Mar
🇪🇸
Barcelona, Spain
Hospital Universitario de la Princesa
🇪🇸
Madrid, Spain
Karolinska University
🇸🇪
Stockholm, Sweden
St. Bartholomew's and The Royal London Hospital
🇬🇧
London, United Kingdom
Guy's and St. Thomas' Hospital
🇬🇧
London, United Kingdom
Hospital Germans Trias I Pujol
🇪🇸
Badalona, Spain
Skane University Hospital
🇸🇪
Lund, Sweden
Stockholm South Hospital
🇸🇪
Stockholm, Sweden
Gartnavel General Hospital
🇬🇧
Glasgow, United Kingdom
St George's Healthcare NHS Trust
🇬🇧
London, United Kingdom
Mary Potter Oncology Centre
🇿🇦
Pretoria, South Africa
Hospital General Universitario Morales Messeguer
🇪🇸
Murcia, Spain
Hospital Ramon y Cajal
🇪🇸
Madrid, Spain
Hospital 12 de Octubre
🇪🇸
Madrid, Spain
King's College Hospital
🇬🇧
London, United Kingdom
Hospital Universitario Vall D hebron
🇪🇸
Barcelona, Spain
Hospital Universitario Marques de Valdecilla
🇪🇸
Santander, Spain
Wilgers Oncology CentreWilgrers Hospital
🇿🇦
Pretoria, South Africa
Stanford University Stanford
🇺🇸
Stanford, California, United States
Augusta Oncology Associates, P.C.
🇺🇸
Augusta, Georgia, United States
Ingalls Memorial Hospital
🇺🇸
Harvey, Illinois, United States
Rush University Medical Center
🇺🇸
Chicago, Illinois, United States
Floyd Memorial Cancer Center of Indiana, a division of Floyd Memorial Hospital and Health Services
🇺🇸
New Albany, Indiana, United States
SUNY Upstate Medical University Medicine Oncology
🇺🇸
Syracuse, New York, United States
Roswell Park Cancer Institute
🇺🇸
Buffalo, New York, United States
Biomedical Research Alliance of New York, LLC
🇺🇸
New Hyde Park, New York, United States
Westchester County Medical Center
🇺🇸
Valhalla, New York, United States
Hematology Oncology Consultants, Inc.
🇺🇸
Columbus, Ohio, United States
Gabrail Cancer Center Research
🇺🇸
Dover, Ohio, United States
Trilogy Cancer Care
🇺🇸
Wooster, Ohio, United States
Drexel University, College of Medicine, Clinical Research Group
🇺🇸
Philadelphia, Pennsylvania, United States
Abington Memorial Hospital
🇺🇸
Abington, Pennsylvania, United States
Western Pennsylvania Hospital
🇺🇸
Pittsburgh, Pennsylvania, United States
Gettysburg Cancer Center
🇺🇸
Gettysburg, Pennsylvania, United States
Abington Hematology Oncology Associates Inc
🇺🇸
Willow Grove, Pennsylvania, United States
UT Southwestern Medical Center
🇺🇸
Dallas, Texas, United States
Wenatchee Valley Hospital and Clinics
🇺🇸
Wenatchee, Washington, United States
Northwest Georgia Oncology Centers, PCWilliam S. Gibbons Center Research Institute
🇺🇸
Marietta, Georgia, United States
North Chicago VA Medical Center
🇺🇸
North Chicago, Illinois, United States
Edward Hines Jr VA Hospital
🇺🇸
Hines, Illinois, United States
Hematology Oncology Assoc. of IL Orchard Research LLC
🇺🇸
Skokie, Illinois, United States
McFarland Clinic
🇺🇸
Ames, Iowa, United States
Ochsner Medical Institutions
🇺🇸
New Orleans, Louisiana, United States
Siouxland Hematology-Oncology Associates, LLP
🇺🇸
Sioux City, Iowa, United States
IMVS
🇦🇺
Adelaide, South Australia, Australia
Sir Charles Gairdner Hospital
🇦🇺
Nedlands, Australia
AZ Groeninge
🇧🇪
Kortrijk, Belgium
General Hospital, Eastern Health
🇨🇦
St John's, Newfoundland and Labrador, Canada
Shaare Zedek Medical Center
🇮🇱
Jerusalem, Israel
Facharzte fur Innere Medizin Hämatologie und Onkologie Gemeinschaftspraxis
🇩🇪
Münster, Germany
Specjalistyczny Szpital miejski im. Kopernika
🇵🇱
Torun, Poland
Spitalul Clinic Judetean de Urgenta Sibiu
🇷🇴
Sibiu, Romania
State Healthcare Institution Sverdlovsk regional clinical hospital 1
🇷🇺
Ekaterinburg, Russian Federation
Addenbrookes Hospital
🇬🇧
Cambridge, United Kingdom
Royal Hallamshire Hospital Sheffield Teaching Hospitals NHS Trust
🇬🇧
Sheffield, United Kingdom
Odense University Hospital
🇩🇰
Odense, Denmark
Vejle Hospital
🇩🇰
Vejle, Denmark
Sharp Memorial Hospital
🇺🇸
San Diego, California, United States
Mayo Clinic - Arizona
🇺🇸
Phoenix, Arizona, United States
Kaiser Permanente Medical Group
🇺🇸
San Diego, California, United States
Swedish Cancer Institute
🇺🇸
Seattle, Washington, United States
Rocky Mountain Cancer Center
🇺🇸
Denver, Colorado, United States
Cleveland Clinic
🇺🇸
Cleveland, Ohio, United States
The Christ Hospital
🇺🇸
Cincinnati, Ohio, United States
Oncology Hematology Care
🇺🇸
Cincinnati, Ohio, United States
Sarah Cannon Cancer Center
🇺🇸
Nashville, Tennessee, United States
Clinical Unit for Research Trials in Skin CURTIS Massachusetts General Hospital
🇺🇸
Boston, Massachusetts, United States
Nevada Cancer Research Foundation
🇺🇸
Las Vegas, Nevada, United States
Mayo Clinic - Jacksonville
🇺🇸
Jacksonville, Florida, United States
Hospital Bamherzige Schwestern
🇦🇹
Linz, Austria
Institut Jules Bordet
🇧🇪
Brussels, Belgium
Cliniques Universitaires St Luc
🇧🇪
Bruxelles, Belgium
Hopital du Sacre-Coeur de Montreal
🇨🇦
Montreal, Quebec, Canada
CMRU-Hotel Dieu Service Hematologie Clinique et Therapie Cellulaire
🇫🇷
Clermont Ferrand, France
Hopital Bretonneau
🇫🇷
Tours Cedex, France
Universitaetsklinikum FreiburgInnere Med.1, Haematologie
🇩🇪
Freiburg, Germany
Klinikum der Universitat zu Koln
🇩🇪
Köln, Germany
Szegedi TudomanyegyetemII Belgyogyaszati Klinika
🇭🇺
Szeged, Hungary
Barzilai Medical Center
🇮🇱
Ashkelon, Israel
Soroka University Medical Center
🇮🇱
Beer Sheva, Israel
Rambam Health Care Campus
🇮🇱
Haifa, Israel
Tel Aviv Sourasky Medical Center Department of Hematology
🇮🇱
Tel Aviv, Israel
Sheba Medical Center
🇮🇱
Tel Hashomer, Israel
CDHA Centre for Clinical Research
🇨🇦
Halifax, Nova Scotia, Canada
Kaiser Permanente Northwest Oncology Hematology
🇺🇸
Portland, Oregon, United States
Oncomedica S.A.
🇨🇴
Monteria, Colombia
CHU La Miletrie
🇫🇷
Poitiers, France
CHU de Reims
🇫🇷
Reims cedex, France
Universitaetsklinikum EssenZentrum fuer Innere Medizin
🇩🇪
Essen, Germany
Innere Medizin Klinikum Frankfurt Oder GmBH
🇩🇪
Frankfurt (Oder), Germany
University Hospital of Ulm
🇩🇪
Ulm, Germany
Debreceni Egyetem Orvos- es Egeszsegtudomanyi Centrum
🇭🇺
Debrecen, Hungary
Ha'Emek Medical Center
🇮🇱
Afula, Israel
Centre Hospitalier Lyon Sud
🇫🇷
Lyon, France
Florida Cancer Specialist
🇺🇸
Tavares, Florida, United States
Pasco Hernando Oncology Associates, PA
🇺🇸
Brooksville, Florida, United States
Haematology and Oncology Clinics of Australasia
🇦🇺
South Brisbane, Queensland, Australia
M. Francisco Gonzalez, MD, PA
🇺🇸
Sumter, South Carolina, United States
Hopital de Jolimont
🇧🇪
Haine-Saint Paul, Belgium
CIUSSS de l'Est-de-l'Ile-de-Montreal
🇨🇦
Montreal/Quebec, Quebec, Canada
Hopital De L'Enfant-Jesus
🇨🇦
Quebec, Canada
Hopital Aviecenne
🇫🇷
Bobigny Cedex, France
CHU Hopital Michallon
🇫🇷
Grenoble Cedex 09, France
Hopital de l'Archet 1
🇫🇷
Nice, France
CLCC H BecquerelHematology
🇫🇷
Rouen, France
Hopital Petie- SalpetriereDepartment d'Hematologie
🇫🇷
Paris, France
Princess Margaret Hospital
🇨🇦
Toronto, Ontario, Canada
University Hospitals Cleveland Medical Center
🇺🇸
Cleveland, Ohio, United States
Regional Health Authority B-Saint John Regional Hospital
🇨🇦
Saint John, New Brunswick, Canada
Universitaetsklinik Innsbruck
🇦🇹
Innsbruck, Austria
UZ Leuven
🇧🇪
Leuven, Belgium
CHU Mont -Godinne
🇧🇪
Yvoir, Belgium
Charleston Hematology Oncology P.A.
🇺🇸
Charleston, South Carolina, United States
Medical University of Vienna Internalmedicine 1, Hematology
🇦🇹
Vienna, Austria
AZ Sint-Jan AV Brugge
🇧🇪
Brugge, Belgium
UZ Gent Hematology
🇧🇪
Gent, Belgium
McGill University
🇨🇦
Montreal, Quebec, Canada
Medizinische Hochschule Hannover
🇩🇪
Hannover, Germany
Universitatsklinikum Leipzig
🇩🇪
Leipzig, Germany
Mannheimer Onkologie Praxis
🇩🇪
Mannheim, Germany
Petz Aladar Country Hospital
🇭🇺
Gyor, Hungary
Kaposi Mor Oktato Korhaz
🇭🇺
Kaposvar, Hungary
Komarom-Esztergom Megye Onkormanyzat Szent Borbala Korhaza
🇭🇺
Tatabanya, Hungary
Midwestern Regional Hospital
🇮🇪
Limerick, Ireland
Bergonie Institut
🇫🇷
Bordeaux, France
Praxis fuer Haematologie und Onkologie Koblenz
🇩🇪
Koblenz, Germany
Stadtisches Klinikum Munchen GmbH
🇩🇪
München, Germany
TU München - Klinikum rechts der Isar
🇩🇪
München, Germany
Pecsi Tudomanyegytem Altalanos Orvostudomanyi Kar
🇭🇺
Pecs, Hungary
Kaplan Medical Center
🇮🇱
Rehovot, Israel
Azienda Ospedaliera Universitaria Careggi
🇮🇹
Florence, Italy
Universita del Piemonte Orientale
🇮🇹
Novara, Italy
Azienda Ospedaliera Universitaria Senese Policlinico Le Scotte
🇮🇹
Siena, Italy
Osp. S.Giovanni Battista Le Molinette
🇮🇹
Torino, Italy
Instituto Biomedico de Investigacion AC
🇲🇽
Aguascalientes, Mexico
Cetre Hospitalier Hotel-Dieu
🇫🇷
Nantes cedex 01, France
Semmelweis Egyetem
🇭🇺
Budapest, Hungary
St James's Hospital
🇮🇪
Dublin, Ireland
Western Galilee Hospital
🇮🇱
Naharia, Israel
Rabin Medical Center
🇮🇱
Petach Tikva, Israel
Charite, Campus Benjamin Franklin, Medizinische Klinik III
🇩🇪
Berlin, Germany
A.O. Pugliese Ciaccio
🇮🇹
Catanzaro, Italy
Azienda Ospedaliera San Martino
🇮🇹
Genova, Italy
Istituto Oncologico Europeo
🇮🇹
Milano, Italy
IRCSS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena
🇮🇹
Milan, Italy
Meir Medical Center
🇮🇱
Kfar-Saba, Israel
Azienda Ospedaliera Poloclinico di Bari
🇮🇹
Bari, Italy
Azienda Ospedaliero Universitaria OORR Foggia
🇮🇹
Foggia, Italy
Istituto dei Tumori Giovanni Paolo II di Bari
🇮🇹
Bari, Italy
AO Spedali Civili di Brescia
🇮🇹
Brescia, Italy
Azienda Ospedaliera Vittorio Emanuele-Ferrarotto
🇮🇹
Catania, Italy
Azienda Ospedaliera Annunziala
🇮🇹
Cosenza, Italy
Azienda Ospedaliero-Universitaria di Bologna - Policlinico S.Orsola-Malpighi
🇮🇹
Ferrara, Italy
Azienda Ospedaliero Universitaria di Modena
🇮🇹
Modena, Italy
Fondazione Centro San Raffaele del Monte Tabor
🇮🇹
Milano, Italy
Ospedale Cardarelli
🇮🇹
Naples, Italy
Policlinico Universitario Federico II
🇮🇹
Naples, Italy
Azienda Policlinico Umberto I, Universita La Sapienzadi Roma
🇮🇹
Rome, Italy
Universita degli Studi di Padova
🇮🇹
Padova, Italy
Ospedale Sant'Eugenio
🇮🇹
Rome, Italy
Wojewodzki Szpital Specjalistyczny im. M. Kopernika w Lodzi
🇵🇱
Lodz, Poland
Ospedale Umberto I
🇮🇹
Torrette Di Ancona, Italy
Ospedale San Bortolo di Vicenza
🇮🇹
Vicenza, Italy
Azienda Ospedaliera Ospedale San Carlo
🇮🇹
Potenza, Italy
Christchurch Hospital
🇳🇿
Christchurch, New Zealand
North Shore Hospital
🇳🇿
Takapuna, New Zealand
Uniwersyteckie Centrum Kliniczne
🇵🇱
Gdansk, Poland
VU University Medical Center
🇳🇱
Amsterdam, Netherlands
Hospital de Dia de Hematologia
🇵🇹
Lisbon, Portugal
GMU Republic clinical hospital
🇷🇺
Kazan, Russian Federation
Nizhegorodskaya Regional Clinical Hospital n.a. N.A. Semashko
🇷🇺
Nizhniy Novgorod, Russian Federation
Middlemore Clinical Trials
🇳🇿
Manukau, New Zealand
Malopolskie Centrum Medyczne S.C.
🇵🇱
Kraków, Poland
Centralny Szpital Kliniczny MON
🇵🇱
Warszawa, Poland
Samodzielny Publiczny Szpital Kliniczny Nr 1 we Wroclawiu
🇵🇱
Wroclaw, Poland
Hospitais da Universidade de Coimbra
🇵🇹
Coimbra, Portugal
Spitalul Clinic Coltea
🇷🇴
Bucharest, Romania
Instituto Portugues Oncologia do Porto Francisco Gentil EPE
🇵🇹
Porto, Portugal
Institutul Clinic Fundeni
🇷🇴
Bucharest, Romania
Spitalul Clinic Municipal de Urgenta Timisoara
🇷🇴
Timisoara, Romania
Spitalul Clinic Judetean de Urgenta Sf Spiridon Iasi
🇷🇴
Iasi, Romania
Archangelsk Regional Clinical Hospital
🇷🇺
Arkhangelsk, Russian Federation
Krasnoyarsk Regional Clinical Hospital
🇷🇺
Krasnoyarsk, Russian Federation
City Hospital 8
🇷🇺
Barnaul, Russian Federation
MUZ City Clinical Hospital 2
🇷🇺
Novosibirsk, Russian Federation
State Budgetary Institution of the City of Moscow
🇷🇺
Moscow, Russian Federation
GUZ Volgograd Regional Clinical Oncology
🇷🇺
Volgograd, Russian Federation
Institution of Russian Academy of Medical Sciences Russian Oncological Research Centre n.a. N. N. Bl
🇷🇺
Moscow, Russian Federation
NUZ Central Clinical Hospital
🇷🇺
Moscow, Russian Federation
Federal State Budgetary Establishment Medical Radiological Research Center Ministry of Health and so
🇷🇺
Obninsk, Russian Federation
Saratov State Medical University
🇷🇺
Saratov, Russian Federation
Federal State Institution Federal Centre of Heart, Blood and Endocrinology of Rosmedtechnologies
🇷🇺
St. Petersburg, Russian Federation
St. Petersburg Pavlov State Medical Univ
🇷🇺
St.Petersburg, Russian Federation
FGU Russian Scientific Research Institute of Haematology and Transfusiology of Federal Agency
🇷🇺
St. Petersburg, Russian Federation
GUS Leningrad Regional Clinical Hospital
🇷🇺
St. Petersburg, Russian Federation
Royal Bournemouth General Hospital
🇬🇧
Bournemouth, United Kingdom
Christie Hospital NHS Foundation Trust
🇬🇧
Manchester, United Kingdom
Saint James University Hospital
🇬🇧
Leeds, United Kingdom
Singleton Hospital, Southwest Wales Cancer Inst
🇬🇧
Swansea, United Kingdom
Sandwell Hospital
🇬🇧
West Bromwich, United Kingdom
University of Colorado Hospital
🇺🇸
Aurora, Colorado, United States
Hospital La Paz
🇪🇸
Madrid, Spain
Virgen de la Victoria Hospital Malaga
🇪🇸
Malaga, Spain
Hospital Universitario Puerta de Hierro-Majadahonda
🇪🇸
Majadahonda, Spain
Hospital Donostia
🇪🇸
San Sebastian, Spain
Hospital Clinico Universitario
🇪🇸
Valencia, Spain
Hospital Universitario de Salamanca
🇪🇸
Salamanca, Spain
General Faculty Hosital1.Internal Clinic
🇨🇿
Prague, Czechia
Wake Forest Univ. Health Sciences Outpatient Comprehensive Cancer Center
🇺🇸
Winston-Salem, North Carolina, United States
Gundersen Clinic Lutheran Hospital
🇺🇸
La Crosse, Wisconsin, United States
Royal Liverpool University Hospital
🇬🇧
Liverpool, United Kingdom