Study to Evaluate Loncastuximab Tesirine With Rituximab Versus Immunochemotherapy in Participants With Relapsed or Refractory Diffuse Large B-Cell Lymphoma

Phase 3

Recruiting

• Conditions: Relapsed Diffuse Large B-Cell Lymphoma; Refractory Diffuse Large B-Cell Lymphoma
• Interventions: Drug: Loncastuximab Tesirine; Drug: Rituximab; Drug: Gemcitabine; Drug: Oxaliplatin

• Registration Number: NCT04384484
• Lead Sponsor: ADC Therapeutics S.A.

Brief Summary

The purpose of this study is to evaluate the efficacy of loncastuximab tesirine (ADCT-402) combined with rituximab compared to standard immunochemotherapy.

Detailed Description

Not available

Basic Information
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Recruitment & Eligibility
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Study & Design
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Trial Locations
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Related News

Study Timeline

• Study First Submitted: 2020-05-08
• Study First Submitted QC: 2020-05-08
• Study First Posted: 2020-05-12
• Study Start: 2020-09-16
• Status Verified: 2024-03
• Last Update Submitted: 2024-10-21
• Last Update Posted: 2024-10-23
• Primary Completion: 2025-06-30
• Study Completion: 2028-06-30

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 350

Inclusion Criteria

• Male or female participant aged 18 years or older

• Pathologic diagnosis of DLBCL, as defined by the 2016 World Health Organization classification (including participants with DLBCL transformed from indolent lymphoma), or high-grade B-cell lymphoma, with MYC and BCL2 and/or BCL6 rearrangements

• Relapsed (disease that has recurred following a response) or refractory (disease that failed to respond to prior therapy) disease following at least one multi-agent systemic treatment regimen [For China only: Adequate first line anti-DLBCL therapy is defined as having received at least 4 cycles of multiagent systemic treatment regimen containing rituximab and anthracycline, unless the participants are intolerant to the regimen, or had disease progression during the treatment. If disease progression occurred during the treatment period, then the disease is considered refractory where the number of treatment cycles will not be specified. For participants who are ineligible for anthracycline, anthracycline is not required.]

• Not considered by the investigator to be a candidate for stem cell transplantation based on performance status, advanced age, and/or significant medical comorbidities such as organ dysfunction

• Measurable disease as defined by the 2014 Lugano Classification as assessed by positron-emission tomography (PET)- computed tomography (CT) or by CT or magnetic resonance imaging (MRI) if tumor is not fluorodeoxyglucose (FDG)-avid on screening PET-CT

• Availability of formalin-fixed paraffin-embedded (FFPE) tumor tissue block (or minimum 10 freshly cut unstained slides if block is not available) Note: Any biopsy since initial diagnosis is acceptable, but if several samples are available, the most recent sample is preferred [For China only: This inclusion criterion is not applicable]

• ECOG performance status 0-2

• Adequate organ function as defined by screening laboratory values within the following parameters:

  1. Absolute neutrophil count ≥1000/μL (off growth factors for at least 72 hours)
  2. Platelet count ≥100000/μL without transfusion within the past 2 weeks
  3. ALT, AST, and GGT ≤2.5 × the upper limit of normal (ULN)
  4. Total bilirubin ≤1.5 × ULN (participants with known Gilbert's syndrome may have a total bilirubin up to ≤3 × ULN)
  5. Calculated creatinine clearance ≥30 mL/min by the Cockcroft and Gault equation

Note: A laboratory assessment may be repeated a maximum of two times during the Screening period to confirm eligibility.

• Negative beta-human chorionic gonadotropin (β-hCG) pregnancy test within 7 days prior to start of study drug (Cycle 1 Day 1) for women of childbearing potential
• Women of childbearing potential must agree to use a highly effective method of contraception from the time of giving informed consent until at least 12 months after the last dose of study treatment. Men with female partners who are of childbearing potential must agree to use a condom when sexually active or practice total abstinence from the time of giving informed consent until at least 7 months after the participant receives his last dose of study treatment.

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Exclusion Criteria

• Previous treatment with loncastuximab tesirine

• Previous treatment with R-GemOx

• Known history of hypersensitivity to a CD19 antibody, loncastumiximab tesirine (including SG3249) or any of its excipients, or history of positive serum human ADA to a CD19 antibody

• Pathologic diagnosis of Burkitt lymphoma

• Active second primary malignancy other than non-melanoma skin cancers, non-metastatic prostate cancer, in situ cervical cancer, ductal or lobular carcinoma in situ of the breast, or other malignancy that the Sponsor's medical monitor and Investigator agree and document should not be exclusionary

• Autologous transplant within 30 days prior to start of study drug (Cycle 1 Day 1)

• Allogeneic transplant within 60 days prior to start of study drug (Cycle 1 Day 1)

• Active graft-versus-host disease

• Post-transplantation lymphoproliferative disorders

• Active autoimmune disease, including motor neuropathy considered of autoimmune origin and other central nervous system (CNS) autoimmune disease

• Human immunodeficiency virus (HIV) seropositive with any of the following:

  1. CD4+ T-cell (CD4+) counts <350 cells/μL
  2. Acquired immunodeficiency syndrome-defining opportunistic infection within 12 months prior to screening
  3. Not on anti-retroviral therapy, or on anti-retroviral therapy for <4 weeks at the time of screening
  4. HIV viral load ≥400 copies/mL

• Serologic evidence of chronic hepatitis B virus (HBV) infection and unable or unwilling to receive standard prophylactic antiviral therapy or with detectable HBV viral load

• Serologic evidence of hepatitis C virus (HCV) infection without completion of curative treatment or with detectable HCV viral load

• History of Stevens-Johnson syndrome or toxic epidermal necrolysis

• Lymphoma with active CNS involvement, including leptomeningeal disease

• Clinically significant third space fluid accumulation (i.e., ascites requiring drainage or pleural effusion that is either requiring drainage or associated with shortness of breath)

• Breastfeeding or pregnant

• Uncontrolled hypertension (blood pressure ≥160/100 mm Hg repeatedly), unstable angina, congestive heart failure (greater than New York Heart Association class II), electrocardiographic evidence of acute ischemia, coronary angioplasty or myocardial infarction within 6 months prior to screening, uncontrolled atrial or ventricular cardiac arrhythmia, poorly controlled diabetes, severe chronic pulmonary disease, or other serious medical condition which is likely to significantly impair the participant's ability to tolerate the study treatment

• Major surgery within 4 weeks prior to start of study drug (Cycle 1 Day 1); radiotherapy, chemotherapy or other antineoplastic therapy within 14 days prior to start of study drug (Cycle 1 Day 1), except shorter if approved by the Sponsor

• Use of any other experimental medication within 14 days or 5 half-lives prior to start of study drug (Cycle 1 Day 1)

• Received live vaccine within 4 weeks of Cycle 1 Day 1

• Failure to recover to ≤Grade 1 (Common Terminology Criteria for Adverse Events [CTCAE] version 5.0) from acute non-hematologic toxicity (except alopecia) due to previous therapy prior to screening

• Congenital long QT syndrome or a corrected QTcF interval of ≥480 ms at screening (unless secondary to pacemaker or bundle branch block)

• Any other significant medical illness, abnormality, or condition that would, in the Investigator's judgment, make the participant inappropriate for study participation or put the participant at risk

• Known history of hypersensitivity to oxaliplatin or other platinum-based drugs, or gemcitabine, or rituximab, or any of their excipients

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Part 1: Loncastuximab Tesirine + Rituximab (Lonca-R)	Loncastuximab Tesirine	Part 1 consists of a non-randomized safety run-in period evaluating the study drug for the first 20 participants. Participants will receive Lonca-R on Day 1 of each cycle for up to 8 cycles, where 1 cycle is 3 weeks. Lonca-R will be administered via an intravenous infusion of loncastuximab tesirine 150 µg/kg + rituximab 375 mg/m\^2 Q3W for 2 cycles, then loncastuximab tesirine 75 µg/kg + rituximab 375 mg/m\^2 Q3W for up to 6 additional cycles.
Part 1: Loncastuximab Tesirine + Rituximab (Lonca-R)	Rituximab	Part 1 consists of a non-randomized safety run-in period evaluating the study drug for the first 20 participants. Participants will receive Lonca-R on Day 1 of each cycle for up to 8 cycles, where 1 cycle is 3 weeks. Lonca-R will be administered via an intravenous infusion of loncastuximab tesirine 150 µg/kg + rituximab 375 mg/m\^2 Q3W for 2 cycles, then loncastuximab tesirine 75 µg/kg + rituximab 375 mg/m\^2 Q3W for up to 6 additional cycles.
Part 2: Loncastuximab Tesirine + Rituximab (Lonca-R)	Loncastuximab Tesirine	Randomized participants will receive Lonca-R on Day 1 of each cycle for up to 8 cycles, where 1 cycle is 3 weeks. Lonca-R will be administered via an intravenous infusion of loncastuximab tesirine 150 µg/kg + rituximab 375 mg/m\^2 every Q3W for 2 cycles, then loncastuximab tesirine 75 µg/kg + rituximab 375 mg/m\^2 Q3W for up to 6 additional cycles.
Part 2: Standard Immunochemotherapy (R-GemOx)	Gemcitabine	Randomized participants will receive R-GemOx consisting of rituximab, gemcitabine and oxaliplatin as a standard immunochemotherapy treatment on Day 1 or Day 2 of each cycle for up to 8 cycles, where 1 Cycle is 2 weeks. R-GemOx will be administered via an intravenous infusion of rituximab 375 mg/m\^2 + gemcitabine 1000 mg/m\^2 + oxaliplatin 100 mg/m\^2 every 2 weeks (Q2W) for up to 8 cycles.
Part 2: Loncastuximab Tesirine + Rituximab (Lonca-R)	Rituximab	Randomized participants will receive Lonca-R on Day 1 of each cycle for up to 8 cycles, where 1 cycle is 3 weeks. Lonca-R will be administered via an intravenous infusion of loncastuximab tesirine 150 µg/kg + rituximab 375 mg/m\^2 every Q3W for 2 cycles, then loncastuximab tesirine 75 µg/kg + rituximab 375 mg/m\^2 Q3W for up to 6 additional cycles.
Part 2: Standard Immunochemotherapy (R-GemOx)	Rituximab	Randomized participants will receive R-GemOx consisting of rituximab, gemcitabine and oxaliplatin as a standard immunochemotherapy treatment on Day 1 or Day 2 of each cycle for up to 8 cycles, where 1 Cycle is 2 weeks. R-GemOx will be administered via an intravenous infusion of rituximab 375 mg/m\^2 + gemcitabine 1000 mg/m\^2 + oxaliplatin 100 mg/m\^2 every 2 weeks (Q2W) for up to 8 cycles.
Part 2: Standard Immunochemotherapy (R-GemOx)	Oxaliplatin	Randomized participants will receive R-GemOx consisting of rituximab, gemcitabine and oxaliplatin as a standard immunochemotherapy treatment on Day 1 or Day 2 of each cycle for up to 8 cycles, where 1 Cycle is 2 weeks. R-GemOx will be administered via an intravenous infusion of rituximab 375 mg/m\^2 + gemcitabine 1000 mg/m\^2 + oxaliplatin 100 mg/m\^2 every 2 weeks (Q2W) for up to 8 cycles.

Primary Outcome Measures

Name	Time	Method
Progression-free Survival (PFS)	Up to 4 years

Secondary Outcome Measures

Name	Time	Method
Overall Survival (OS)	Up to 4 years
Overall Response Rate (ORR)	Up to 4 years
Complete Response Rate (CRR)	Up to 4 years
Duration of Response (DOR)	Up to 4 years
Number of Participants Who Experience At Least One Serious Adverse Event (SAE)	Up to 4 years
Number of Participants Who Experience a Clinically Significant Change From Baseline in Electrocardiogram (ECG) Results	Day 1 up to a maximum of Week 25
Number of Participants Who Experience a Clinically Significant Change From Baseline in Physical Examinations	Day 1 up to a maximum of Week 25
Number of Participants Who Experience a Clinically Significant Change From Baseline in Eastern Cooperative Oncology Group (ECOG) Performance Status	Day 1 up to a maximum of Week 25
Number of Participants Who Experience At Least One Treatment-Emergent Adverse Event (TEAE)	Day 1 up to a maximum of Week 39
Average Concentration of Loncastuximab Tesirine Before Infusion	Day 1 of Cycles 1 through 6 (each cycle is 3 weeks)
Number of Participants Who Experience a Clinically Significant Change From Baseline in Clinical Laboratory Results	Day 1 up to a maximum of Week 25
Average Concentration of Loncastuximab Tesirine at the End of Infusion	Day 1 of Cycles 1 through 6 (each cycle is 3 weeks)
Part 2: Change from Baseline in Health-Related Quality of Life (HRQoL) as Measured by the Lymphoma Subscale of Functional Assessment of Cancer Therapy- Lymphoma (LymS of FACT-Lym)	Baseline up to a maximum of Week 25
Number of Participants Who Experience a Clinically Significant Change From Baseline in Vital Sign Measurements	Day 1 up to a maximum of Week 25
Number of Participants With Anti-Drug Antibody (ADA) Titers to Loncastuximab Tesirine	Day 1 up to a maximum of Week 25
Part 2: Change from Baseline in Health-Related Quality of Life (HRQoL) as Measured by GP5 Item of the Functional Assessment of Cancer Therapy- Lymphoma (FACT-Lym)	Baseline up to a maximum of Week 25
Part 2: Change from Baseline in Health-Related Quality of Life (HRQoL) as Measured by EuroQol-5 Dimensions-5 Levels (EQ-5D-5L)	Baseline to up to 4 years
Part 2: Change from Baseline in Health-Related Quality of Life (HRQoL) as Measured by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire -Core 30 (EORTC QLQ-C30)	Baseline up to a maximum of Week 25

Trial Locations

Locations (143)

University of California San Diego Moores Cancer Center; 🇺🇸 La Jolla, California, United States

Redlands Community Hospital; 🇺🇸 Redlands, California, United States

The Oncology Institute of Hope and Innovation; 🇺🇸 Whittier, California, United States

Baptist MD Anderson Cancer Center; 🇺🇸 Jacksonville, Florida, United States

UnityPoint Health - Iowa Oncology Research Association (IORA); 🇺🇸 Des Moines, Iowa, United States

Norton Cancer Institute; 🇺🇸 Louisville, Kentucky, United States

Comprehensive Cancer Centers of Nevada - Henderson; 🇺🇸 Las Vegas, Nevada, United States

Kaiser Permanente Interstate Medical Office Central; 🇺🇸 Portland, Oregon, United States

Hollings Cancer Center; 🇺🇸 Charleston, South Carolina, United States

Virginia Cancer Specialists; 🇺🇸 Gainesville, Virginia, United States

Medical College of Wisconsin Cancer Center Clinical Trials Office; 🇺🇸 Milwaukee, Wisconsin, United States

Clinica Adventista Belgrano; 🇦🇷 Belgrano, Buenos Aires, Argentina

Clínica de Nefrología, Urología y Enfermedades Cardiovasculares S.A.; 🇦🇷 Santa Fe, Buenos Aires, Argentina

Instituto Médico Especializado Alexander Fleming; 🇦🇷 Buenos Aires, Distrito Federal, Argentina

Grupo Gamma - Hospital Privado Rosario; 🇦🇷 Rosario, Santa Fe, Argentina

Algemeen Ziekenhuis Sint-Jan Brugge-Oostende - Campus Sint-Jan; 🇧🇪 Brugge, Belgium

Cliniques Universitaires Saint-Luc; 🇧🇪 Brussels, Belgium

Centre Hospitalier Universitaire Universite Catholique de Louvain; 🇧🇪 Namur, Belgium

Algemeen Ziekenhuis Delta - Campus Rumbeke; 🇧🇪 Roeselare, Belgium

Hospital Erasto Gaertner - Liga Paranaense de Combate ao Câncer; 🇧🇷 Curitiba, Paraná, Brazil

Hospital Moinhos de Vento; 🇧🇷 Porto Alegre, Rio Grande Do Sul, Brazil

Hospital de Clínicas de Porto Alegre; 🇧🇷 Porto Alegre, Rio Grande Do Sul, Brazil

Hospital Mãe de Deus - Centro Integrado de Oncologia; 🇧🇷 Porto Alegre, Rio Grande Do Sul, Brazil

Hospital do Câncer; 🇧🇷 Rio De Janeiro, Brazil

Hemomed Instituto de Oncologia e Hematologia; 🇧🇷 São Paulo, Brazil

A Beneficência Portuguesa de São Paulo - Unidade Mirante; 🇧🇷 São Paulo, Brazil

Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo; 🇧🇷 São Paulo, Brazil

Hospital Israelita Albert Einstein; 🇧🇷 São Paulo, Brazil

Hospital Santa Marcelina; 🇧🇷 São Paulo, Brazil

Cross Cancer Institute; 🇨🇦 Edmonton, Canada

Research Institute of the McGill University Health Centre; 🇨🇦 Montréal, Canada

Hôpital Fleurimont; 🇨🇦 Sherbrooke, Canada

Centro de Estudios Clínicos SAGA; 🇨🇱 Santiago, Región Metropolitana De Santiago, Chile

Instituto Oncológico Fundación Arturo López Pérez; 🇨🇱 Santiago, Región Metropolitana De Santiago, Chile

CeCim - Centro de Estudios Clínicos e Investigaciones Médicas; 🇨🇱 Santiago, Región Metropolitana De Santiago, Chile

Peking University Third Hospital; 🇨🇳 Beijing, Beijing, China

The First Affiliated Hospital of Xiamen University; 🇨🇳 Xiamen, Fujian, China

Sun Yat-Sen University Cancer Center; 🇨🇳 Guangzhou, Guangdong, China

Guangdong Provincial People's Hospital; 🇨🇳 Guangzhou, Guangdong, China

Zhujiang Hospital of Southern Medical University; 🇨🇳 Guangzhou, Guangdong, China

Henan Cancer Hospital - Zhengzhou University; 🇨🇳 Zhengzhou, Henan, China

Jilin Cancer Hospital; 🇨🇳 Changchun, Jilin, China

The First Hospital of Jilin University; 🇨🇳 Changchun, Jilin, China

Second Affiliated Hospital of Dalian Medical University; 🇨🇳 Dalian, Liaoning, China

Shanghai Cancer Center; 🇨🇳 Shanghai, Shanghai, China

West China School of Medicine - West China Hospital of Sichuan University; 🇨🇳 Chengdu, Sichuan, China

Tianjin Medical University Cancer Institute & Hospital; 🇨🇳 Tianjin, Tianjin, China

The First Affiliated Hospital of Zhejiang University School of Medicine; 🇨🇳 Hangzhou, Zhejiang, China

Chongqing University Cancer Hospital - Chongqing Cancer Hospital; 🇨🇳 Chongqing, China

Huizhou Municipal Central Hospital; 🇨🇳 Huizhou, China

The First Affiliated Hospital of Nanchang University; 🇨🇳 Nanchang, China

Institute of Hematology and Blood Diseases Hospital of CAMS - PUMC; 🇨🇳 Tianjin, China

Wuhan Union Hospital; 🇨🇳 Wuhan, China

Tongji Hospital; 🇨🇳 Wuhan, China

Fakultni nemocnice Ostrava; 🇨🇿 Ostrava, Czechia

Fakultni Nemocnice Kralovske Vinohrady; 🇨🇿 Prague, Czechia

Fakultni nemocnice v Motole; 🇨🇿 Prague, Czechia

Centre Hospitalier Regional Universitaire Brest; 🇫🇷 Brest, France

Hôpital Avicenne; 🇫🇷 Bobigny, France

Hôpital François Mitterrand; 🇫🇷 Dijon, France

Hôpital Privé du Confluent; 🇫🇷 Nantes, France

Hopital Universitaire Pitie Salpetriere; 🇫🇷 Paris, France

Hôpital Haut-Lévêque; 🇫🇷 Pessac, France

Centre de Lutte Contre le Cancer - Centre Henri-Becquerel; 🇫🇷 Rouen, France

Heves Varmegyei Markhot Ferenc Oktatokorhaz es Rendelointezet; 🇭🇺 Heves, Budapest, Hungary

Dél-pesti Centrumkórház - Országos Hematológiai és Infektológiai Intézet - Szent László; 🇭🇺 Budapest, Pest, Hungary

Semmelweis Egyetem; 🇭🇺 Budapest, Hungary

Orszagos Onkologiai Intezet; 🇭🇺 Budapest, Hungary

Samson Assuta Ashdod University Hospital; 🇮🇱 Ashdod, Israel

Soroka Medical Center; 🇮🇱 Be'er Sheva, Israel

Shamir Medical Center (Assaf Harofeh); 🇮🇱 Be'er Ya'aqov, Israel

Carmel Medical Center; 🇮🇱 Haifa, Israel

Rabin Medical Center - Beilinson Hospital; 🇮🇱 Petah tikva, Israel

The Chaim Sheba Medical Center; 🇮🇱 Tel Aviv, Israel

Tel Aviv Sourasky Medical Center; 🇮🇱 Tel Aviv, Israel

Presidio Ospedaliero Universitario Santa Maria della Misericordia; 🇮🇹 Udine, Friuli Venezia Giulia, Italy

Azienda Socio Sanitaria Territoriale (ASST) degli Spedali Civili di Brescia; 🇮🇹 Brescia, Italy

Azienda Ospedaliero - Universitaria Careggi; 🇮🇹 Florence, Italy

Ospedale Casa Sollievo della Sofferenza; 🇮🇹 Foggia, Italy

Istituto Romagnolo per lo Studio dei Tumori "Dino Amadori" - IRST; 🇮🇹 Meldola, Italy

Istituto Europeo di Oncologia; 🇮🇹 Milano, Italy

Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) - Istituto Clinico Humanitas; 🇮🇹 Milan, Italy

Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) - Ospedale San Raffaele; 🇮🇹 Milan, Italy

Fondazione IRCCS Policlinico San Matteo; 🇮🇹 Pavia, Italy

Sanitaria Locale della Romagna; 🇮🇹 Ravenna, Italy

National Hospital Organization - Nagoya Medical Center; 🇯🇵 Nagoya, Aichi, Japan

Toyohashi Municipal Hospital; 🇯🇵 Toyohashi, Aichi, Japan

National Cancer Center Hospital East; 🇯🇵 Kashiwa, Chiba, Japan

Matsuyama Red Cross Hospital; 🇯🇵 Matsuyama, Ehime, Japan

Gunma Prefectural Cancer Center; 🇯🇵 Ota, Gunma, Japan

Sapporo Hokuyu Hospital; 🇯🇵 Sapporo, Hokkaido, Japan

Hokkaido Cancer Center; 🇯🇵 Sapporo, Hokkaido, Japan

Kobe City Medical Center General Hospital; 🇯🇵 Kobe, Hyogo, Japan

Kanagawa Cancer Center; 🇯🇵 Yokohama, Kanagawa, Japan

Tohoku University Hospital; 🇯🇵 Sendai, Miyagi, Japan

Nagasaki University Hospital; 🇯🇵 Nagasaki-city, Nagasaki, Japan

Saitama Medical University - International Medical Center; 🇯🇵 Hidaka-Shi, Saitama, Japan

Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital; 🇯🇵 Bunkyo-ku, Tokyo, Japan

National Hospital Organization Disaster Medical Center; 🇯🇵 Tachikawa, Tokyo, Japan

Fukushima Medical University Hospital; 🇯🇵 Fukushima, Japan

Gifu Municipal Hospital; 🇯🇵 Gifu, Japan

Kagoshima University Hospital; 🇯🇵 Kagoshima, Japan

Niigata University Medical and Dental Hospital; 🇯🇵 Niigata, Japan

National Hospital Organization Okayama Medical Center; 🇯🇵 Okayama, Japan

Osaka Prefectural Hospital Organization - Osaka International Cancer Institute; 🇯🇵 Osaka, Japan

Boca Raton Clinical Research (BRCR) Global Mexico - Guadalajara; 🇲🇽 Guadalajara, Jalisco, Mexico

PanAmerican Clinical Research Mexico - Guadalajara; 🇲🇽 Guadalajara, Jalisco, Mexico

PanAmerican Clinical Research Mexico - Cuernavaca; 🇲🇽 Cuernavaca, Morelos, Mexico

Hospital Universitario Dr. José Eleuterio González; 🇲🇽 Monterrey, Nuevo Leon, Mexico

Hematológica Alta Especialidad; 🇲🇽 Huixquilucan, Mexico

Boca Raton Clinical Research (BRCR) Global Mexico - Ciudad de México; 🇲🇽 Mexico City, Mexico

Hagaziekenhuis Van Den Haag - Leyweg; 🇳🇱 Den Haag, South Holland, Netherlands

Elisabeth-TweeSteden Ziekenhuis - Elisabeth; 🇳🇱 Tilburg, Netherlands

Uniwersytecki Szpital Kliniczny im. Jana Mikulicza-Radeckiego we Wrocławiu; 🇵🇱 Wroclaw, Dolnoslaskie, Poland

Pratia MCM Kraków; 🇵🇱 Kraków, Malopolskie, Poland

Szpitale Pomorskie Spółka Z Ograniczoną Odpowiedzialnością; 🇵🇱 Gdynia, Poland

Pratia Onkologia Katowice; 🇵🇱 Katowice, Poland

Szpital Wojewódzki w Opolu; 🇵🇱 Opole, Poland

Centrum Medyczne Pratia Poznań; 🇵🇱 Skorzewo, Poland

Instytut Hematologii I Transfuzjologii; 🇵🇱 Warszawa, Poland

Wojewodzkie Wielospecjalistyczne Centrum Onkologii i Traumatologii im. M. Kopernika w Lodzi; 🇵🇱 Łódź, Poland

Hospital Español Auxilio Mutuo; 🇵🇷 San Juan, Puerto Rico

Hospital del Mar - Parc de Salut Mar; 🇪🇸 Barcelona, Spain

Institut Català d'Oncologia - Hospital Duran i Reynals (ICO L'Hospitalet); 🇪🇸 Barcelona, Spain

Hospital San Pedro de Alcantara; 🇪🇸 Cáceres, Spain

Hospital Universitario Ramón y Cajal; 🇪🇸 Madrid, Spain

Hospital Universitario Fundación Jiménez Díaz; 🇪🇸 Madrid, Spain

Hospital Universitario 12 de Octubre; 🇪🇸 Madrid, Spain

Hospital Universitario La Paz; 🇪🇸 Madrid, Spain

Hospital Universitario Marqués de Valdecilla; 🇪🇸 Santander, Spain

Hospital Universitario Virgen del Rocío; 🇪🇸 Sevilla, Spain

Hospital Arnau de Vilanova; 🇪🇸 Valencia, Spain

Istituto Oncologico della Svizzera Italiana; 🇨🇭 Bellinzona, Switzerland

Özel Koru Hastanesi; 🇹🇷 Çukurambar, Ankara, Turkey

VKV Amerikan Hastanesi; 🇹🇷 Şişli, Istanbul, Turkey

Ege Universitesi Tip Fakultesi Hastanesi; 🇹🇷 Bornova, Izmir, Turkey

Ondokuz Mayis Üniversitesi; 🇹🇷 Kurupelit, Samsun, Turkey

Karadeniz Teknik Üniversitesi Tip Fakültesi; 🇹🇷 Ortahisar, Trabzon, Turkey

Ankara Universitesi Tip Fakultesi - Cebeci Arastirma ve Uygulama Hastanesi; 🇹🇷 Ankara, Turkey

Mehmet Kemal Dedeman Hematoloji Hastanesi; 🇹🇷 Kayseri, Turkey

The Royal Marsden NHS Foundation Trust; 🇬🇧 Sutton, England, United Kingdom

NHS Greater Glasgow and Clyde; 🇬🇧 Glasgow, United Kingdom

The Christie NHS Foundation Trust; 🇬🇧 Manchester, United Kingdom