Study of Lenvatinib (MK-7902/E7080) in Combination With Pembrolizumab (MK-3475) Versus Standard of Care in Participants With Metastatic Colorectal Cancer (MK-7902-017/E7080-G000-325/LEAP-017)
- Conditions
- Colorectal Neoplasms
- Interventions
- Registration Number
- NCT04776148
- Lead Sponsor
- Merck Sharp & Dohme LLC
- Brief Summary
The purpose of this study is to assess the safety and efficacy of lenvatinib (MK-7902/E7080) in combination with pembrolizumab (MK-3475) in participants with metastatic colorectal cancer. The study will also compare lenvatinib plus pembrolizumab with the standard of care treatment of regorafenib and TAS-102 (trifluridine and tipiracil hydrochloride).
The primary study hypothesis is that lenvatinib plus pembrolizumab is superior to standard of care with respect to overall survival.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 480
-
Has histologically or cytologically confirmed diagnosis of unresectable and metastatic colorectal adenocarcinoma (Stage IV A, B and C as defined by American Joint Committee on Cancer [AJCC] 8th edition). Note: Tumor must be determined to be NOT microsatellite instability-high (MSI-H)/mismatch repair deficient (dMMR) by local testing
-
Has been previously treated for their disease and has shown disease progression as defined by RECIST 1.1 on or after or could not tolerate standard treatment, which must include ALL of the following agents if approved and locally available in the country where the participant is randomized:
- fluoropyrimidine, irinotecan and oxaliplatin
- with or without an anti-vascular endothelial growth factor (VEGF) monoclonal antibody (bevacizumab)
- with anti- epidermal growth factor receptor (EGFR) monoclonal antibodies (cetuximab or panitumumab) for RAS (KRAS/NRAS) wild-type (WT) participants
- BRAF inhibitor (in combination with cetuximab +/- binimetinib) for BRAF V600E mutated metastatic colon cancer (mCRC)
-
Has measurable disease per RECIST 1.1 assessed by the investigator
-
Has provided to a designated central laboratory an archival tumor tissue sample or newly obtained core, incisional, or excisional biopsy of a tumor lesion which has not been previously irradiated
-
Has an Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 1 within 3 days prior to randomization
-
Has a life expectancy of at least 3 months, based on the investigator assessment
-
Has the ability to swallow capsules or ingest a suspension orally or by a feeding tube
-
Has adequately controlled blood pressure (BP) with or without antihypertensive medications, defined as BP ≤150/90 millimeter of mercury (mmHg) with no change in antihypertensive medications within 1 week prior to randomization
-
Male participants must agree to the following during the treatment period and for at least 90 days after the last dose of regorafenib or TAS-102 and at least 7 days after the last dose of lenvatinib: refrain from donating sperm PLUS either be abstinent from heterosexual intercourse as their preferred and usual lifestyle or use contraception. The male contraception period should continue for at least 7 days after discontinuation of lenvatinib
-
A female participant is eligible to participate if she is not pregnant or breastfeeding, and at least one of the following conditions applies: is not a woman of childbearing potential (WOCBP) OR is a WOCBP and using a highly-effective contraceptive method during the treatment period and for at least 30 days after the last dose of lenvatinib, 120 days after the last dose of pembrolizumab, and 180 days after the last dose of regorafenib or TAS-102 (whichever is last) AND agrees not to donate eggs (ova, oocytes)
-
A WOCBP must have a negative highly sensitive pregnancy test (urine or serum) within 24 hours before the first dose of study treatment
- Has a tumor that is microsatellite instability-high (MSI-H)/mismatch repair deficient (dMMR) per local testing
- Has presence of gastrointestinal condition, eg, malabsorption, that might affect the absorption of study drug.
- Has present or progressive accumulation of pleural, ascitic, or pericardial fluid requiring drainage or diuretic drugs within 2 weeks prior to enrollment
- Has radiographic evidence of encasement or invasion of a major blood vessel invasion or of intratumoral cavitation. In the chest, major blood vessels include the main pulmonary artery, the left and right pulmonary arteries, the 4 major pulmonary veins, the superior or inferior vena cava, and the aorta
- Has clinically significant hemoptysis or tumor bleeding within 2 weeks prior to the first dose of study drug
- Has clinically significant cardiovascular disease within 12 months from first dose of study intervention, including New York Heart Association Class III or IV congestive heart failure, unstable angina, myocardial infarction, cerebral vascular accident, or cardiac arrhythmia associated with hemodynamic instability.
Participants with cardiac failure NYHA Class II, III and IV are not allowed to be assigned to the regorafenib in Arm B
- Has a history of arterial thromboembolism within 12 months of start of study drug
- Has urine protein ≥1 gram/24 hour
- Has prolongation of QT interval corrected with Fridericia's formula (QTcF interval) to >480 milliseconds
- Has left ventricular ejection fraction (LVEF) below the institutional (or local laboratory) normal range as determined by multigated acquisition (MUGA) or echocardiogram (ECHO)
- Has a known additional malignancy that is progressing or has required active treatment within the past 3 years with certain exceptions
- Has serious nonhealing wound, ulcer or bone fracture
- Has had major surgery within 3 weeks prior to first dose of study treatment
- Has received biologic response modifiers (eg, granulocyte colony-stimulating factor) within 4 weeks before study entry
- Has preexisting ≥Grade 3 gastrointestinal or nongastrointestinal fistula
- Has received prior treatment with a combination of an anti-PD-1, anti-PD-L1, or anti PD-L2 agent with anti-VEGF monoclonal antibodies or vascular endothelial growth factor receptor (VEGFR) inhibitors
- Has previously received regorafenib or TAS-102
- Has received prior systemic anti-cancer therapy including investigational agents within 28 days prior to randomization
- Has received prior radiotherapy within 2 weeks of start of study treatment
- Has received a live or live-attenuated vaccine within 30 days prior to the first dose of study treatment
- Has known intolerance to lenvatinib, regorafenib, or TAS-102 and/or any of their excipients
- Is currently participating in or has participated in a study of an investigational agent or has used an investigational device within 28 days prior to the first dose of study treatment
- Has known central nervous system (CNS) metastases and/or carcinomatous meningitis.
- Has severe hypersensitivity (≥Grade 3) to pembrolizumab and/or any of its excipients
- Has an active autoimmune disease that has required systemic treatment in past 2 years
- Has a diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy (in dosing exceeding 10 mg daily of prednisone equivalent) or any other form of immunosuppressive therapy within 7 days prior the first dose of study medication
- Has a history of (non-infectious) pneumonitis that required steroids or has current pneumonitis
- Has an active infection requiring systemic therapy
- Has a known history of Human Immunodeficiency Virus (HIV) infection
- Has a known history of Hepatitis B or known active Hepatitis C virus infection
- Has a history or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the study, interfere with the participant's participation for the full duration of the study, or is not in the best interest of the participant to participate, in the opinion of the treating investigator
- Has a known psychiatric or substance abuse disorder that would interfere with the participant's ability to cooperate with the requirements of the study
- Has had an allogenic tissue/solid organ transplant
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description standard of care treatment (regorafenib OR TAS-102) TAS-102 (trifluridine and tipiracil) Participants receive regorafenib 160 mg via oral tablet once daily on Days 1 through 21 of each 4-week cycle OR TAS-102 (trifluridine and tipiracil hydrochloride) 35 mg/m\^2 via oral tablet twice a day on Days 1 through 5 and Days 8-12 of each 4-week cycle until progressive disease. lenvatinib+pembrolizumab pembrolizumab Participants receive pembrolizumab 400 mg via intravenous (IV) infusion on Day 1 of each 6-week (Q6W) Cycle for up to 18 cycles (up to approximately 2 years) PLUS lenvatinib 20 mg via oral capsule once daily until progressive disease. standard of care treatment (regorafenib OR TAS-102) regorafenib Participants receive regorafenib 160 mg via oral tablet once daily on Days 1 through 21 of each 4-week cycle OR TAS-102 (trifluridine and tipiracil hydrochloride) 35 mg/m\^2 via oral tablet twice a day on Days 1 through 5 and Days 8-12 of each 4-week cycle until progressive disease. lenvatinib+pembrolizumab lenvatinib Participants receive pembrolizumab 400 mg via intravenous (IV) infusion on Day 1 of each 6-week (Q6W) Cycle for up to 18 cycles (up to approximately 2 years) PLUS lenvatinib 20 mg via oral capsule once daily until progressive disease.
- Primary Outcome Measures
Name Time Method Overall Survival (OS) Up to approximately 22 months OS was defined as the time from randomization to the date of death from any cause.
- Secondary Outcome Measures
Name Time Method Progression Free Survival (PFS) Per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) as Assessed by Blinded Independent Central Review (BICR) Up to approximately 22 months PFS was defined as the time from date of randomization to the date of the first documentation of progressive disease (PD) or death from any cause, whichever occurs first. Per RECIST 1.1 modified to follow a maximum of 10 target lesions and a maximum of 5 target lesions per organ, PD was defined as ≥20% increase in the sum of diameters of target lesions. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of ≥5 mm. Note: The appearance of one or more new lesions was also considered PD. PFS as assessed by BICR per modified RECIST 1.1 is presented.
Duration of Response (DOR) Per RECIST 1.1 as Assessed by BICR Up to approximately 22 months For participants who demonstrated CR (disappearance of all target lesions) or PR (at least a 30% decrease in the sum of diameters of target lesions), DOR is defined as the time from the first documented evidence of CR or PR until PD or death from any cause, whichever occurs first. Per RECIST 1.1 modified to follow a maximum of 10 target lesions and a maximum of 5 target lesions per organ, or death from any cause, PD is defined as ≥20% increase in the sum of diameters of target lesions. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of ≥5 mm. Note: The appearance of one or more new lesions is also considered PD. DOR as assessed by BICR per modified RECIST 1.1 is presented.
Number of Participants Who Discontinue Study Treatment Due to an Adverse Event (AE) Up to approximately 22 months An adverse event is defined as any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of a study intervention. The number of participants who discontinued any study treatment due to an adverse event is presented.
Objective Response Rate (ORR) Per RECIST 1.1 as Assessed by BICR Up to approximately 22 months ORR is defined as the percentage of participants in the analysis population who have a Complete Response (CR: Disappearance of all target lesions) or a Partial Response (PR: At least a 30% decrease in the sum of diameters of target lesions) per RECIST 1.1, modified to follow a maximum of 10 target lesions and a maximum of 5 target lesions per organ. ORR per modified RECIST 1.1 assessed by BICR is presented.
Change From Baseline in European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Core 30 (QLQ-C30) Global Health Status (Item 29) and Quality of Life (Item 30) Combined Score Baseline and 8 weeks The EORTC QLQ-C30 is a cancer specific health-related quality-of life (QoL) questionnaire. Participant responses to the questions regarding Global Health Status (GHS; "How would you rate your overall health during the past week?") and Quality of Life (QoL; "How would you rate your overall quality of life during the past week?") are scored on a 7-point scale (1= Very poor to 7=Excellent). Using linear transformation, raw scores are standardized, so that scores range from 0 to 100. The change from baseline in GHS (EORTC QLQ-C30 Item 29) and QoL (EORTC QLQ-C30 Item 30) combined score will be presented. A higher score indicates a better outcome.
Number of Participants Who Experience an Adverse Event (AE) Up to approximately 22 months An adverse event is defined as any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of a study intervention.
Change From Baseline in EORTC QLQ-C30 Appetite Loss (Item 13) Score Baseline and 8 weeks The EORTC QLQ-C30 is a cancer specific health-related quality-of life (QoL) questionnaire, including a single-item scale score for appetite loss (QLQ-C30 Item 13). For this item, individual responses to the question "Have you lacked appetite?" are given on a 4-point scale (1=Not at all; 4=Very much). Scores are transformed to a range from 0-100, with a lower score indicating a better outcome. The change from baseline in the EORTC QLQ-C30 appetite loss (Item 13) scale score is presented.
Change From Baseline in EORTC Quality of Life Questionnaire-Colorectal Cancer-Specific 29 Items (QLQ-CR29) Bloating (Item 37) Score Baseline and 8 weeks The EORTC QLQ-CR29 is a health-related quality-of life (QoL) questionnaire specific for colorectal cancer, including a single-item scale score for bloating (QLQ-CR29 Item 37). For this item, individual responses to the question "Did you have a bloated feeling in your abdomen?" are given on a 4-point scale (1=Not at all; 4=Very much). Scores are transformed to a range from 0-100, with a lower score indicating a better outcome. The change from baseline in the EORTC QLQ-CR29 bloating (Item 37) scale score is presented.
Time to Deterioration (TTD) in European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Core 30 (QLQ-C30) Global Health Status (Item 29) and Quality of Life (Item 30) Combined Score Up to approximately 21 months TTD is defined as the time from baseline to the first onset of a ≥10-point deterioration (decrease) from baseline in Global Health Status (GHS; EORTC QLQ-C30 Item 29) \& Quality of Life (QoL; EORTC QLQ-C30 Item 30) combined score. Using linear transformation, raw scores are standardized, so that scores range from 0 to 100. The TTD, as assessed based on a ≥10-point negative change (decrease) from baseline in GHS and QoL combined score, is presented. A longer TTD indicates a better outcome.
Change From Baseline in EORTC QLQ-C30 Physical Functioning (Items 1-5) Score Baseline and 8 weeks The EORTC QLQ-C30 is a cancer specific health-related quality-of life (QoL) questionnaire. Participant responses to 5 questions about their physical functioning (Items 1-5) are scored on a 4-point scale (1=Not at All to 4=Very Much). Using linear transformation, raw scores are standardized, so that scores range from 0 to 100. Higher scores meant a better level of function.
TTD in EORTC QLQ-C30 Physical Functioning (Items 1-5) Score Up to approximately 21 months TTD is defined as the time from baseline to the first onset of a ≥10-point deterioration (decrease) from baseline in physical functioning score (QLQ-C30 Items 1-5). Using linear transformation, raw scores are standardized, so that scores range from 0 to 100. The TTD, as assessed based on a ≥10-point negative change (decrease) from baseline in physical functioning score, is presented. A longer TTD indicates a better outcome.
TTD in EORTC QLQ-C30 Appetite Loss (Item 13) Score Up to approximately 21 months TTD is defined as the time from baseline to the first onset of a ≥10-point deterioration (increase) from baseline in appetite loss (QLQ-C30 Item 13) score. Using linear transformation, raw scores are standardized, so that scores range from 0 to 100. The TTD, as assessed based on a ≥10-point change (increase) from baseline in appetite loss score, is presented. A longer TTD indicates a better outcome.
TTD in EORTC Quality of Life Questionnaire-Colorectal Cancer-Specific 29 Items (QLQ-CR29) Bloating (Item 37) Score Up to approximately 21 months TTD is defined as the time from baseline to the first onset of a ≥10-point deterioration (increase) from baseline in bloating (QLQ-CR29 Item 37) score. Using linear transformation, raw scores are standardized, so that scores range from 0 to 100. The TTD, as assessed based on a ≥10-point change (increase) from baseline in appetite loss score, is presented. A longer TTD indicates a better outcome.
Trial Locations
- Locations (95)
NSHA-QEII Health Sciences Centre-Dickson Bldg-Dept. of Medical Oncology ( Site 0200)
🇨🇦Halifax, Nova Scotia, Canada
Shizuoka Cancer Center ( Site 1706)
🇯🇵Nagaizumi, Shizuoka, Japan
Herlev and Gentofte Hospital-Department of Oncology ( Site 0704)
🇩🇰Copenhagen, Hovedstaden, Denmark
Vejle Sygehus-Department of Oncology ( Site 0701)
🇩🇰Vejle, Syddanmark, Denmark
Northwest Medical Specialties, PLLC ( Site 0033)
🇺🇸Tacoma, Washington, United States
Pacific Cancer Care ( Site 0031)
🇺🇸Monterey, California, United States
Hospital Británico de Buenos Aires-Oncology ( Site 0308)
🇦🇷Ciudad autónoma de Buenos Aires, Buenos Aires, Argentina
Centro de Educación Médica e Investigaciones Clínicas (CEMIC)-Medical Oncology ( Site 0303)
🇦🇷Buenos Aires, Argentina
The First People's Hospital of Foshan-Gastrointestinal oncology ( Site 1604)
🇨🇳Foshan, Guangdong, China
HOSPITAL GENERAL UNIVERSITARIO GREGORIO MARAÑON ( Site 1205)
🇪🇸Madrid, Spain
Royal Brisbane and Women's Hospital-Medical Oncology Clinical Trials Unit, Cancer Care Services ( Si
🇦🇺Brisbane, Queensland, Australia
IDIM - Instituto de Diagnóstico e Investigaciones Metabólicas ( Site 0300)
🇦🇷Buenos Aires, Argentina
The Queen Elizabeth Hospital-Cancer Clinical Trials ( Site 1503)
🇦🇺Woodville, South Australia, Australia
Western Health-Sunshine & Footscray Hospitals ( Site 1501)
🇦🇺St Albans, Victoria, Australia
Hollywood Private Hospital-Medical Oncology ( Site 1507)
🇦🇺Perth, Western Australia, Australia
North York General Hospital ( Site 0206)
🇨🇦Toronto, Ontario, Canada
Gallipoli Medical Research Foundation-GMRF CTU ( Site 1500)
🇦🇺Greenslopes, Queensland, Australia
Odense Universitetshospital ( Site 0700)
🇩🇰Odense, Syddanmark, Denmark
Kobe City Medical Center General Hospital ( Site 1707)
🇯🇵Kobe, Hyogo, Japan
Kindai University Hospital- Osakasayama Campus-Medical Oncology ( Site 1704)
🇯🇵Osakasayama, Osaka, Japan
National Hospital Organization Kyushu Cancer Center ( Site 1709)
🇯🇵Fukuoka, Japan
National Cancer Center Hospital ( Site 1702)
🇯🇵Tokyo, Japan
SUN YAT-SEN UNIVERSITY CANCER CENTRE ( Site 1600)
🇨🇳Guangzhou, Guangdong, China
Sourasky Medical Center-Oncology ( Site 0801)
🇮🇱Tel Aviv, Israel
Hacettepe Universitesi-oncology hospital ( Site 1302)
🇹🇷Ankara, Turkey
Memorial Ankara Hastanesi-Medical Oncology ( Site 1304)
🇹🇷Ankara, Turkey
Aichi Cancer Center Hospital ( Site 1701)
🇯🇵Nagoya, Aichi, Japan
Trakya University-Oncology ( Site 1303)
🇹🇷Edirne, Turkey
Kanagawa cancer center ( Site 1705)
🇯🇵Yokohama, Kanagawa, Japan
İnönü Üniversitesi Turgut Özal Tıp Merkezi ( Site 1306)
🇹🇷Malatya, Turkey
ROYAL MARSDEN HOSPITAL (CHELSEA) ( Site 1403)
🇬🇧London, London, City Of, United Kingdom
Guy's & St Thomas' NHS Foundation Trust ( Site 1404)
🇬🇧London, London, City Of, United Kingdom
Sir Run Run Shaw Hospital-Medical Oncology ( Site 1606)
🇨🇳Hangzhou, Zhejiang, China
Japanese Foundation for Cancer Research-GI Oncology ( Site 1710)
🇯🇵Tokyo, Japan
Rigshospitalet ( Site 0702)
🇩🇰Copenhagen, Hovedstaden, Denmark
Acıbadem Maslak Hastanesi ( Site 1307)
🇹🇷İstanbul, Turkey
GBUZ Republican Clinical Oncological Dispensary-Antitumor drug therapy department ( Site 1109)
🇷🇺Ufa, Baskortostan, Respublika, Russian Federation
SHBI Leningrad Regional Clinical Oncology Dispensary-Clinical Trials Department ( Site 1111)
🇷🇺Sankt-Peterburg, Russian Federation
NATIONAL CHENG-KUNG UNI. HOSP. ( Site 1904)
🇨🇳Tainan, Taiwan
Korea University Anam Hospital ( Site 1806)
🇰🇷Seoul, Korea, Republic of
Charité Universitaetsmedizin Berlin - Campus Mitte ( Site 0901)
🇩🇪Berlin, Germany
Saitama Prefectural Cancer Center ( Site 1703)
🇯🇵Ina-machi, Saitama, Japan
Istanbul Universitesi Cerrahpasa-Medical Oncology ( Site 1300)
🇹🇷Istanbul, Turkey
UCLH-Cancer Clinical Trials Unit ( Site 1400)
🇬🇧London, Essex, United Kingdom
Hospital Universitario Marqués de Valdecilla ( Site 1201)
🇪🇸Santander, Cantabria, Spain
Severance Hospital, Yonsei University Health System-Medical oncology ( Site 1801)
🇰🇷Seoul, Korea, Republic of
Asan Medical Center ( Site 1803)
🇰🇷Seoul, Korea, Republic of
Northwest Georgia Oncology Centers, a Service of Wellstar Cobb Hospital ( Site 0021)
🇺🇸Marietta, Georgia, United States
Hospital Universitari Vall d'Hebron-Oncology ( Site 1204)
🇪🇸Barcelona, Spain
Hospital Universitario Virgen de Valme-Departamento de Oncologia ( Site 1207)
🇪🇸Sevilla, Spain
Samsung Medical Center-Division of Hematology/Oncology ( Site 1804)
🇰🇷Seoul, Korea, Republic of
The Catholic Univ. of Korea Seoul St. Mary's Hospital ( Site 1802)
🇰🇷Seoul, Korea, Republic of
University of Chicago Medical Center-Medicine - Section of Hematology/Oncology - Gastrointestinal P
🇺🇸Chicago, Illinois, United States
Providence Portland Medical Center ( Site 0019)
🇺🇸Portland, Oregon, United States
MedStar Good Samaritan Hospital-Oncology Research ( Site 0038)
🇺🇸Baltimore, Maryland, United States
Henry Ford Hospital ( Site 0024)
🇺🇸Detroit, Michigan, United States
Inova Schar Cancer Institute ( Site 0022)
🇺🇸Fairfax, Virginia, United States
Blue Ridge Cancer Care ( Site 0036)
🇺🇸Roanoke, Virginia, United States
Thomas Jefferson University - Clinical Trials Office ( Site 0027)
🇺🇸Philadelphia, Pennsylvania, United States
St. Vincent Frontier Cancer Center ( Site 0005)
🇺🇸Billings, Montana, United States
MFSMC-HJWCI-Oncology Research ( Site 0012)
🇺🇸Baltimore, Maryland, United States
Fundación favaloro para la Docencia e Investigación Médica-Oncología ( Site 0301)
🇦🇷Buenos Aires, Caba, Argentina
Instituto de Oncología de Rosario ( Site 0305)
🇦🇷Rosario, Santa Fe, Argentina
Cross Cancer Institute-Department of Medical Oncology ( Site 0207)
🇨🇦Edmonton, Alberta, Canada
Hamilton Health Sciences-Juravinski Cancer Centre ( Site 0205)
🇨🇦Hamilton, Ontario, Canada
Klinikum am Steinenberg-Kreiskliniken Reutlingen GmbH ( Site 0908)
🇩🇪Reutlingen, Baden-Wurttemberg, Germany
klinikum rechts der isar der technischen universität münchen-Klinik und Poliklinik für Innere Mediz
🇩🇪Munich, Bayern, Germany
Rambam Health Care Campus-Oncology ( Site 0800)
🇮🇱Haifa, Israel
Onkodok GmbH ( Site 0907)
🇩🇪Gütersloh, Nordrhein-Westfalen, Germany
Sheba Medical Center ( Site 0803)
🇮🇱Ramat Gan, Israel
Asklepios Altona-Oncology ( Site 0903)
🇩🇪Hamburg, Germany
National Cancer Center Hospital East ( Site 1700)
🇯🇵Kashiwa, Chiba, Japan
Kagawa University Hospital ( Site 1708)
🇯🇵Kita, Kagawa, Japan
Seoul National University Hospital-Internal Medicine ( Site 1800)
🇰🇷Seoul, Korea, Republic of
Saint-Petersburg City Clinical Oncology Dispensary-Department of chemotherapy ( Site 1100)
🇷🇺Saint Petersburg, Leningradskaya Oblast, Russian Federation
First Moscow State Medical University I.M. Sechenov-Interhospital Institution ""Health Management (
🇷🇺Moscow, Moskva, Russian Federation
TC Saglik Bakanligi Goztepe Prof. Dr. Suleyman Yalcin Sehir Hastanesi-oncology ( Site 1301)
🇹🇷Istanbul, Turkey
Royal Marsden Hospital (Sutton) ( Site 1409)
🇬🇧London, Surrey, United Kingdom
Ege University Medicine of Faculty-Medical Oncology ( Site 1305)
🇹🇷Izmir, Turkey
The Christie-Medical Oncology ( Site 1411)
🇬🇧Manchester, United Kingdom
China Medical University Hospital-Surgical Department ( Site 1903)
🇨🇳Taichung, Taiwan
Fed State Budgetary Inst N.N. Blokhin Med Center of Oncology MHRF ( Site 1107)
🇷🇺Moscow, Moskva, Russian Federation
SVERDLOVSK REGIONAL ONCOLOGY DISPENSARY ( Site 1108)
🇷🇺Ekaterinburg, Sverdlovskaya Oblast, Russian Federation
Addenbrooke's Hospital ( Site 1407)
🇬🇧Cambridge, Cambridgeshire, United Kingdom
Western General Hospital ( Site 1401)
🇬🇧Edinburgh, Midlothian, United Kingdom
Epworth Freemasons ( Site 1506)
🇦🇺Melbourne, Victoria, Australia
Shaare Zedek Medical Center-Oncology ( Site 0804)
🇮🇱Jerusalem, Israel
Chang Gung Medical Foundation.Linkou Branch ( Site 1902)
🇨🇳Taoyuan, Taiwan
CIUSSS de l'Est-de-l'Île-de-Montréal ( Site 0211)
🇨🇦Montreal, Quebec, Canada
CHU de Quebec - Université Laval - Hotel Dieu de Quebec-Hemato-Dermato-Gyneco-Oncology ( Site 0203)
🇨🇦Québec, Quebec, Canada
Hadassah Medical Center-Oncology ( Site 0802)
🇮🇱Jerusalem, Israel
The National Medico-Surgical Center N.I. Pirogov ( Site 1102)
🇷🇺Moscow, Moskva, Russian Federation
National Taiwan University Hospital ( Site 1900)
🇨🇳Taipei, Taiwan
Hospital Universitario Central de Asturias-Digestive ( Site 1200)
🇪🇸Oviedo, Asturias, Spain
Taipei Veterans General Hospital-Oncology ( Site 1901)
🇨🇳Taipei, Taiwan
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