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A Study of Tislelizumab (BGB-A317) Plus Chemoradiotherapy Followed by Tislelizumab Monotherapy in Newly Diagnosed, Stage III Subjects With Locally Advanced, Unresectable Non-small Cell Lung Cancer

Phase 3
Terminated
Conditions
Carcinoma, Non-Small-Cell Lung
Interventions
Drug: Concurrent chemoradiotherapy (cCRT)
Other: Placebo
Registration Number
NCT03745222
Lead Sponsor
Celgene
Brief Summary

This is a Phase 3, randomized, double-blind, placebo-controlled multicenter global study designed to compare the efficacy and safety of tislelizumab in combination with concurrent chemoradiotherapy (cCRT) followed by tislelizumab monotherapy versus cCRT alone, and tislelizumab given sequentially after cCRT versus cCRT alone, in newly diagnosed stage III subjects with locally advanced, unresectable non-small cell lung cancer (NSCLC). The primary endpoint is centrally-assessed progression free survival (PFS) in the intent-to-treat (ITT) population. .

Detailed Description

Not available

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
1
Inclusion Criteria
  1. Newly diagnosed, histologically confirmed, locally advanced, stage III unresectable non small cell lung cancer (NSCLC).

    Staging will be confirmed at screening by positron emission tomography-computed tomography (PET/CT) and brain imaging by magnetic resonance imaging (MRI) or computed tomography (CT) with contrast.

  2. Eastern Cooperative Oncology Group (ECOG) performance status ≤ 1.

  3. Epidermal growth factor receptor (EGFR) mutation and anaplastic lymphoma kinase (ALK) gene translocation status available prior to randomization.

  4. Provision of fresh or archival tumor tissue or discussion with Sponsor.

  5. Adequate hematologic and end-organ function.

Exclusion Criteria
  1. Prior therapies including those targeting PD-1 or PD-L1 or chemotherapy, radiation, targeted therapy, biologic therapy, immunotherapy or investigational agent used to control non-small cell lung cancer (NSCLC).
  2. History of severe hypersensitivity reactions to other monoclonal antibodies or any contraindication to the planned chemotherapy regimen.
  3. History of, or ongoing, interstitial lung disease; pneumonitis requiring steroids; or clinically significant pericardial effusion.
  4. Any active malignancy less than or equal to 2 years before randomization, with the exception of non-small cell lung cancer (NSCLC) and any locally recurring cancer that has been treated curatively.
  5. Severe chronic or active infections including those requiring systemic antibacterial, antifungal or antiviral therapy; known human immunodeficiency virus (HIV) infection; untreated chronic hepatitis B or chronic hepatitis B virus carries or active hepatitis C; or active autoimmune disease.
  6. Prior allogeneic stem cell transplantation or organ transplantation.
  7. Significant cardiovascular disease or other condition which places the patient at risk.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Arm 1:Tislelizumab + cCRT followed by tislelizumab monotherapyConcurrent chemoradiotherapy (cCRT)Tislelizumab 200 mg is administered by intravenous (IV) administration and given together upfront with concurrent platinum-based chemoradiotherapy (cCRT) for the first 6 weeks, followed by tislelizumab 200 mg by IV adminstration monotherapy. The standard platinum-based chemotherapy options include carboplatin/ paclitaxel and cisplatin/etoposide
Arm 2: Placebo + cCRT followed by tislelizumab monotherapyConcurrent chemoradiotherapy (cCRT)Placebo is given with concurrent platinum-based chemoradiotherapy (cCRT) for the first 6 weeks, followed by tislelizumab 200 mg by IV administration monotherapy. The standard platinum-based chemotherapy options include carboplatin/paclitaxel and cisplatin/etoposide.
Arm 3: Placebo + cCRT followed by placebo monotherapyConcurrent chemoradiotherapy (cCRT)Placebo is given with concurrent platinum-based chemoradiotherapy (cCRT) for the first 6 weeks, followed by placebo monotherapy. The standard platinum-based chemotherapy options include carboplatin/paclitaxel and cisplatin/etoposide.
Arm 2: Placebo + cCRT followed by tislelizumab monotherapyPlaceboPlacebo is given with concurrent platinum-based chemoradiotherapy (cCRT) for the first 6 weeks, followed by tislelizumab 200 mg by IV administration monotherapy. The standard platinum-based chemotherapy options include carboplatin/paclitaxel and cisplatin/etoposide.
Arm 3: Placebo + cCRT followed by placebo monotherapyPlaceboPlacebo is given with concurrent platinum-based chemoradiotherapy (cCRT) for the first 6 weeks, followed by placebo monotherapy. The standard platinum-based chemotherapy options include carboplatin/paclitaxel and cisplatin/etoposide.
Arm 1:Tislelizumab + cCRT followed by tislelizumab monotherapyTislelizumabTislelizumab 200 mg is administered by intravenous (IV) administration and given together upfront with concurrent platinum-based chemoradiotherapy (cCRT) for the first 6 weeks, followed by tislelizumab 200 mg by IV adminstration monotherapy. The standard platinum-based chemotherapy options include carboplatin/ paclitaxel and cisplatin/etoposide
Arm 2: Placebo + cCRT followed by tislelizumab monotherapyTislelizumabPlacebo is given with concurrent platinum-based chemoradiotherapy (cCRT) for the first 6 weeks, followed by tislelizumab 200 mg by IV administration monotherapy. The standard platinum-based chemotherapy options include carboplatin/paclitaxel and cisplatin/etoposide.
Primary Outcome Measures
NameTimeMethod
Progression-Free Survival (PFS)Up to approximately 5 years; date of randomization to the date of tumor progression or death; until study withdrawal date of 26 June 2019

Progression-free survival was defined as the time from the date of randomization to the date of the first objectively tumor progression as assessed by the blinded independent central review per Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1 criteria (documented by radiological assessment) or death (any cause) on or prior to the clinical cut-off date, which ever occurred first. Stable disease-neither sufficient shrinkage to qualify for PR nor sufficient increase of lesions to qualify for Progressive disease (PD)• Progressive Disease- At least a 20% increase in the sum of diameters of target lesions from nadir.

Secondary Outcome Measures
NameTimeMethod
Overall Survival at 24 MonthsUp to approximately 24 months

Overall survival was defined as the time between randomization of treatment and death from any cause.

Duration of ResponseUp to approximately 5 years

Duration of Response is defined as the time from the first occurrence of a documented objective response to the time of relapse, as determined by blinded independent central review per RECIST v1.1, or death from any cause, whichever comes first.

Overall Survival (OS)Up to approximately 5 years; date of randomization to date of death from any cause.

Overall survival was defined as the time between randomization of treatment and death from any cause.

Percentage of Participants Who Achieved a Best Overall Response of Complete Response or Partial ResponseUp to approximately 5 years

Overall Response was defined as percentage of participants who had a radiologic confirmed complete response (CR) or partial response (PR) according to Response Evaluation Criteria in Solid Tumors (RECIST 1.1) guidelines, between Day 1 of treatment and subsequent anti-cancer therapy, death or study discontinuation. Complete response was defined as the disappearance of all target lesions; partial response (PR) is defined as at least a 30% decrease in the sum of diameters of target lesions from baseline; stable disease-neither sufficient shrinkage to qualify for PR nor sufficient increase of lesions to qualify for progressive disease (PD).

Percentage of Participants Alive and Progression-Free at 12 Months (APF12)Up to 12 months

Progression-free survival was defined as the time from the date of randomization to the date of the first objectively tumor progression as assessed by the blinded independent central review per Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1 criteria (documented by radiological assessment) or death (any cause) on or prior to the clinical cut-off date, which ever occurred first

Percentage of Participants Who Would Have Continued on to Monotherapy PhaseUp to approximately 5 years

Included the percentage of participants who would have received at least one dose of tislelizumab or placebo in the monotherapy phase before progression.

Percentage of Participants Alive and Progression-free at 18 Months (APF18)Up to approximately 18 months

Progression-free survival was defined as the time from the date of randomization to the date of the first objectively tumor progression as assessed by the blinded independent central review per Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1 criteria (documented by radiological assessment) or death (any cause) on or prior to the clinical cut-off date, which ever occurred first

Time to Distant Metastasis (TTDM)Up to approximately 5 years

TTDM was defined as the time from the date of randomization until the first date of distant metastasis or death in the absence of distant metastasis. Distant metastasis was defined as any new lesion that is outside of the radiation field according to RECIST v1.1 or proven by biopsy.

Number of Participants With Treatment Emergent Adverse Events (TEAEs)From first dose of study drug up to study withdrawal date of 26 June 2019; 15 days.

TEAEs include any adverse events (AEs) that had an onset date or a worsening in severity from baseline on or after the first dose of study drug up to 30 days following study drug discontinuation or initiation of new anticancer therapy, whichever occurred first. TEAEs also included all immune-related AEs recorded up to 90 days after the last dose of tislelizumab or placebo, regardless of whether or not the particpant started a new anticancer therapy. In addition, any serious AE with an onset date more than 30 days after the last dose of study drug that is assessed by the investigator as related to study drug were considered a TEAE."

Number of Participants With Lung Cancer Symptoms Assessed by the Corresponding Domains of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC-QLQ-C30) and Lung-Cancer Specific QLQ-LC13Up to approximately 5 years

The EORTC QLQ-C30 is a 30-item, questionnaire assessing quality of life (QoL), psychosocial burden and physical symptoms. It is classified into 15 domains: 5 functional subscales (physical functioning, role functioning, emotional functioning, cognitive functioning, and social functioning); 3 multi-item symptom subscales (fatigue, nausea/vomiting, and pain); each item is measured on a 4 point response scale; (not at all, a little, quite a bit, very much), with the exception of the 2 items measuring global health and QoL, (measured on a 7-point response scale). Scores are linearly transformed to 0 to 100 scores. Scores vary from 0 (worst) to 100 (best) for the functional dimensions and GHS, and from 0 (best) to 100 (worst) for the symptom dimensions; higher scores = better QoL, better functioning, or more severe symptoms, respectively. The LC13 covers 13 typical symptoms of lung cancer patients, such as coughing, pain, dyspnea, sore mouth, peripheral neuropathy, and hair loss.

Trial Locations

Locations (163)

University of Chicago Medical Center

🇺🇸

Chicago, Illinois, United States

Fort Wayne Medical Oncology and Hematology

🇺🇸

Fort Wayne, Indiana, United States

Dayton Physicians, LLC

🇺🇸

Kettering, Ohio, United States

Allegheny General Hospital

🇺🇸

Pittsburgh, Pennsylvania, United States

Sichuan University - West China Hospital

🇨🇳

Chengdu, China

Fujian Medical University - Fujian Provincial Cancer Hospital

🇨🇳

Fuzhou Shi, China

Cancer Center of Guangzhou Medical University

🇨🇳

Guangzhou, China

Yunnan Cancer Hospital

🇨🇳

Kunming Shi, China

Guangxi Tumour Institute and Hospital

🇨🇳

Nanning, China

Chongqing Cancer Hospital

🇨🇳

Shapingbaqu, China

Liaoning Cancer Hospital & Institute

🇨🇳

Shenyang Shi, China

The First Hospital of Xinjiang Medical University

🇨🇳

Urumqi, China

Zhongnan Hospital of Wuhan University

🇨🇳

Wuhan, China

Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology

🇨🇳

Wuhan, China

First Hospital of Xiamen

🇨🇳

Xiamen, China

Zhengzhou University (ZZU) - Henan Cancer Hospital

🇨🇳

Zhengzhou, China

The First Affiliated Hospital of Zhengzhou University

🇨🇳

Zhengzhou, China

Agioi Anargyroi Cancer Hospital

🇬🇷

Kifissia, Greece

Sotiria Chest Hospital of Athens

🇬🇷

Athens, Greece

Kansai Medical University Hospital

🇯🇵

Hirakata-shi, Japan

Matsusaka Municipal Hospital

🇯🇵

Matsusaka-shi, Japan

Yokohama Municipal Citizen's Hospital

🇯🇵

Yokohama-shi, Japan

Med Polonia Sp. z o.o. NSZOZ

🇵🇱

Poznan, Poland

Tampereen yliopistollinen sairaala

🇫🇮

Tampere, Finland

Pulmonary Institute Torokbalint

🇭🇺

Torokbalint, Hungary

Iwate Medical University Hospital

🇯🇵

Morioka, Japan

Centrum Onkologii - Instytut im. Marii Sklodowskiej-Curie

🇵🇱

Gliwice, Poland

Centro Hospitalar do Alto Ave, Hospital da Senhora da Oliveira Guimaraes

🇵🇹

Guimaraes, Portugal

Instituto Portugues de Oncologia Do Porto Francisco Gentil Epe

🇵🇹

Porto, Portugal

Prof. Dr. I. Chiricuta Institute of Oncology

🇷🇴

Cluj-Napoca, Romania

Ryazan State Medical University n.a. I.P. Pavlov

🇷🇺

Ryazan, Russian Federation

Turku University Hospital

🇫🇮

Turku, Finland

Fejer Megyei Szent Gyorgy Egyetemi Oktato Korhaz

🇭🇺

Szekesfehervar, Hungary

Niigata Cancer Center Hospital

🇯🇵

Niigata-shi, Japan

Sendai Kousei Hospital

🇯🇵

Sendai-shi, Japan

Beacon Hospital

🇮🇪

Dublin, Ireland

MidWestern Regional Hospital

🇮🇪

Limerick, Ireland

Nagoya University Hospital

🇯🇵

Nagoya-shi, Japan

Osaka City University Hospital

🇯🇵

Osaka, Japan

Kitasato University Hospital

🇯🇵

Sagamihara, Japan

Kanagawa Cardiovascular and Respiratory Center

🇯🇵

Yokohama-shi, Japan

Vrije Universiteit Medisch Centrum (VUMC)

🇳🇱

Amsterdam, Netherlands

CUF Porto Hospital

🇵🇹

Porto, Portugal

Research Oncology Institute of Rosmed Technologies n.a. prof. N.N. Petrov

🇷🇺

St. Petersburg, Russian Federation

Kaohsiung Medical University Hospital

🇨🇳

Kaohsiung, San Ming Dist., Taiwan

National Hospital Organization - Nagoya Medical Center

🇯🇵

Nagoya-shi, Japan

Gelre Hospitals

🇳🇱

Zutphen, Netherlands

Medisprof SRL

🇷🇴

Cluj-Napoca, Romania

Sf. Apostol Andrei Constanta Emergency Clinical County Hospital

🇷🇴

Constanta, Romania

Oncology Center Sfantul Nectarie

🇷🇴

Craiova, Romania

Buddhist Dalin Tzu Chi General Hospital

🇨🇳

Dalin, Taiwan

Centrum Onkologii-Instytut im.Marii Sklodowskiej-Curie

🇵🇱

Warszawa, Poland

Oncology Institute Professor Doctor Alexandru Trestioreanu

🇷🇴

Bucharest, Romania

Mordovia State University

🇷🇺

Saransk, Russian Federation

CUF Descobertas Hospital

🇵🇹

Lisboa, Portugal

Centro Hospitalar do Porto - Hospital de Santo António

🇵🇹

Porto, Portugal

Oncocenter Clinical Oncology

🇷🇴

Timisoara, Romania

E-DA Hospital

🇨🇳

Kaohsiung, Taiwan

Chang Gung Medical Foundation, Kaohsiung Memorial Hospital

🇨🇳

Niao-Sung Hsiang Kaohsiung County, Taiwan

Istituto Scientifico Romagnolo Per Lo Studio e La Cura Dei Tumori (I.R.S.T.)

🇮🇹

Meldola, Italy

Cancer Hospital Chinese Academy of Medical Sciences

🇨🇳

Beijing, China

Bengbu Medical College - First Affiliated Hospital

🇨🇳

Bengbu Shi, China

Cliniques Universitaires Saint-Luc

🇧🇪

Brussels, Belgium

Appalachian Regional Healthcare, Inc.

🇺🇸

Hazard, Kentucky, United States

USC Norris Comprehensive Cancer Center

🇺🇸

Los Angeles, California, United States

Center For Cancer and Blood Disorders

🇺🇸

Bethesda, Maryland, United States

Universitair Ziekenhuis Brussel

🇧🇪

Brussels, Belgium

Jewish General Hospital

🇨🇦

Montreal, Quebec, Canada

Beijing Cancer Hospital - Beijing Institute for Cancer Research

🇨🇳

Beijing, China

University of Mississippi Medical Center

🇺🇸

Jackson, Mississippi, United States

Mercy Health Youngstown Hospital, LLC

🇺🇸

Youngstown, Ohio, United States

Medical Oncology Associates, P.S.

🇺🇸

Spokane, Washington, United States

Chinese PLA General Hospital / 307 Hospital

🇨🇳

Beijing, China

Jilin Province Cancer Hospital

🇨🇳

Changchun Shi, China

Central South University - Xiangya School of Medicine - Hunan Cancer Hospital

🇨🇳

Changsha, China

First Hospital of Jilin University

🇨🇳

Changchun, China

Sichuan Cancer Hospital & Institute

🇨🇳

Chengdu, China

Foshan First People's Hospital

🇨🇳

Foshan, China

The First Affiliated Hospital of Guangzhou Medical University

🇨🇳

Guangzhou, China

Shanghai Chest Hospital

🇨🇳

Shanghai Shi, China

Zhejiang University School of Medicine - The Second Affiliated Hospital

🇨🇳

Hangzhou, China

Zhejiang Medical University - Zhejiang Cancer Hospital

🇨🇳

Hangzhou, China

Fudan University Shanghai Cancer Center

🇨🇳

Shanghai, China

Union Hospital, Tongji Medical College, Huazhong University of Science and Technology

🇨🇳

Wuhan, China

The Affiliated Hospital of Xuzhou Medical University

🇨🇳

Xuzhou, China

Azienda Ospedaliero - Universitaria Policlinico - Vittorio Emanuele - Ospedale Gaspare Rodolico

🇮🇹

Catania, Italy

Centre Francois Baclesse

🇫🇷

Caen Cedex 5, France

Health Nordhessen Holding AG - Klinikum Kassel - Medical Clinic IV

🇩🇪

Kassel, Germany

Helios Klinikum Emil Von Behring

🇩🇪

Berlin, Germany

The First Affiliated Hospital of Xi'an Jiaotong University

🇨🇳

Xi'an City, China

Istituto Nazionale Tumori Regina Elena di Roma

🇮🇹

Roma, Italy

The First Affiliated Hospital of Harbin Medical University

🇨🇳

Harbin, China

Nantong Tumor Hospital

🇨🇳

Nantong, China

Institut de Cancerologie de l'Ouest (ICO) - Saint-Herblain

🇫🇷

Saint Herblain, France

Metaxa Cancer Hospital of Piraeus

🇬🇷

Piraeus, Greece

Interbalkan Medical Center of Thessaloniki

🇬🇷

Pylaia, Greece

Medical Study Company NORD-WEST GmbH Oncology Aurich

🇩🇪

Aurich, Germany

St. Antonius-Hospital

🇩🇪

Schweiler, Germany

Clinique Victor Hugo

🇫🇷

Le Mans, France

Asklepios Fachkliniken Muenchen Gauting

🇩🇪

Gauting, Germany

University General Hospital of Patras

🇬🇷

Rio Patras, Greece

Florence Nightingale KH der Kaiserwerther Diakonie

🇩🇪

Dusseldorf, Germany

Oncological practice Goslar

🇩🇪

Goslar, Germany

Kliniken der Stadt Koln gGmbH - Krankenhaus Merheim

🇩🇪

Koln, Germany

Evangelisches Krankenhaus Hamm

🇩🇪

Hamm, Germany

IASO General

🇬🇷

Athens, Greece

University General Hospital of Heraklion

🇬🇷

Heraklion, Greece

Klinik Loewenstein gGmbH

🇩🇪

Loewenstein, Germany

Medizinische Studiengesellschaft Nord-West

🇩🇪

Westerstede, Germany

Papageorgiou General Hospital of Thessaloniki

🇬🇷

Thessaloniki, Greece

St James Hospital

🇮🇪

Dublin, Ireland

Kanazawa University Hospital

🇯🇵

Kanazawa-shi, Japan

IRCCS AziendaOspedaliera Universitaria San Martino

🇮🇹

Genova, Italy

Universita Campus Bio-Medico di Roma

🇮🇹

Roma, Italy

Osaka Prefectural Medical Center for Respiratory and Allergic Diseases

🇯🇵

Habikino-shi, Japan

Waikato Hospital

🇳🇿

Hamilton, New Zealand

Hiroshima University Hospital

🇯🇵

Hiroshima, Japan

Toranomon Hospital

🇯🇵

Minato-ku, Japan

Gunma Prefectural Cancer Center

🇯🇵

Ota-ku, Japan

Asan Medical Center

🇰🇷

Seoul, Korea, Republic of

Hospital Universitario a Coruna

🇪🇸

A Coruna, Spain

Centrum Onkologii im. prof. Franciszka Lukaszczyka w Bydgoszczy

🇵🇱

Bydgoszcz, Poland

Hospital Prof. Doutor Fernando Fonseca

🇵🇹

Amadora, Portugal

Centro Hospitalar E Universitario de Coimbra EPE

🇵🇹

Coimbra, Portugal

Life Search SRL

🇷🇴

Timisoara, Romania

Omsk Regional Oncology Center

🇷🇺

Omsk, Russian Federation

GBUZ Saint Petersburg Clinical Research Center of Specialized Types of Care (Oncology)

🇷🇺

St. Petersburg, Russian Federation

Hospital Universitario Central de Asturias

🇪🇸

Oviedo, Spain

Hospital Universitario Germans Trias i Pujol

🇪🇸

Barcelona, Spain

Hospital Universitario Fundacion Jimenez Diaz

🇪🇸

Madrid, Spain

Hospital General Universitario de Alicante

🇪🇸

Alicante, Spain

Hospital Universitario Puerta de Hierro-Majadahonda

🇪🇸

Majadahonda, Madrid, Spain

Raffles Hospital

🇸🇬

Singapore, Singapore

Hospital General Carlos Haya

🇪🇸

Malaga, Spain

Hospital Universitario 12 de Octubre

🇪🇸

Madrid, Spain

Hospital Universitari i Politecnic La Fe de Valencia

🇪🇸

Valencia, Spain

Manchester University NHS Foundation Trust - Wythenshawe Hospital - North West Lung Centre

🇬🇧

Manchester, United Kingdom

Maidstone and Tunbridge Wells NHS Trust - Maidstone Hospital

🇬🇧

Maidstone, United Kingdom

University Hospitals Birmingham NHS Foundation Trust - Queen Elizabeth Hospital

🇬🇧

Birmingham, United Kingdom

East Suffolk and North Essex NHS Foundation Trust - Colchester Hospital

🇬🇧

Colchester, United Kingdom

The Hillingdon Hospitals NHS Foundation Trust - Mount Vernon Hospital

🇬🇧

Northwood, United Kingdom

University College London Hospitals NHS Foundation Trust - University College Hospital

🇬🇧

London, United Kingdom

Seoul National University Bundang Hospital

🇰🇷

Seongnam-si, Korea, Republic of

LMU Klinikum der Universität

🇩🇪

München, Germany

Norton Healthcare - Norton Cancer Institute

🇺🇸

Louisville, Kentucky, United States

Cancer Specialists of North Florida - Jacksonville

🇺🇸

Jacksonville, Florida, United States

Bond Clinic, P.A.

🇺🇸

Winter Haven, Florida, United States

Millennium Oncology

🇺🇸

Houston, Texas, United States

Klinikum Esslingen GmbH

🇩🇪

Esslingen Am Neckar, Germany

EUROMEDICA General Clinic of Thessaloniki

🇬🇷

Thessaloniki, Greece

Bioclinic Thessaloniki Galinos clinic

🇬🇷

Thessaloniki, Greece

Ajou University Hospital

🇰🇷

Suwon si, Korea, Republic of

Chungbuk National University Hospital

🇰🇷

Cheongju, Korea, Republic of

Tauranga Hospital

🇳🇿

Tauranga, New Zealand

Principal Military Clinical Hospital n.a. N.N. Burdenko

🇷🇺

Moscow, Russian Federation

Clinical Hospital of the Russian Academy of Sciences

🇷🇺

St. Petersburg, Russian Federation

National University Hospital

🇸🇬

Singapore, Singapore

Guys Hospital

🇬🇧

London, United Kingdom

National Taiwan University Hospital

🇨🇳

Taipei, Zhongzheng Dist., Taiwan

Insular-Maternal and Child University Hospital Complex

🇪🇸

Las Palmas de Gran Canaria, Spain

Royal Marsden Hospital

🇬🇧

London, United Kingdom

Royal Cornwall Hospitals Trust

🇬🇧

Truro, United Kingdom

Sheffield Teaching Hospitals NHS Foundation Trust - Weston Park Hospital

🇬🇧

Sheffield South Yorkshire, United Kingdom

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