MedPath

Avelumab in First-line NSCLC (JAVELIN Lung 100)

Registration Number
NCT02576574
Lead Sponsor
EMD Serono Research & Development Institute, Inc.
Brief Summary

The purpose of this study was to demonstrate superiority with regard to Overall Survival (OS) or Progression Free Survival (PFS) of avelumab versus platinum-based doublet, based on an Independent Review Committee assessment, in Non-small cell lung cancer (NSCLC) participants with Programmed death ligand 1+ (PD-L1+) tumors.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
1214
Inclusion Criteria
  • Male or female subjects aged greater than or equal to (>=) 18 years
  • With Eastern Cooperative Oncology Group Performance Status (ECOG PS) of 0 to 1 at trial entry
  • At least 1 measurable tumor lesion
  • With histologically confirmed metastatic or recurrent (Stage IV) non-small cell lung cancer (NSCLC)
  • With availability of a recently-obtained, formalin-fixed, paraffin-embedded (FFPE) tissue sample containing tumor (biopsy from a non-irradiated area preferably within 6 months) or a minimum number of 10 (preferably 25) unstained tumor slides cut within 1 week, and suitable for PD-L1 expression assessment
  • Subjects must not have received any treatment for systemic lung cancer, and have an estimated life expectancy of more than 12 weeks
  • Other protocol defined criteria could apply
Exclusion Criteria
  • Subjects whose disease harbors a EGFR mutation, or anaplastic lymphoma kinase (ALK) rearrangement are not eligible.
  • Other exclusion criteria include prior therapy with any antibody or drug targeting T cell coregulatory proteins, concurrent anticancer treatment, or immunosuppressive agents
  • Known severe hypersensitivity reactions to monoclonal antibodies (Grade >= 3 NCI CTCAE v 4.03), history of anaphylaxis, or uncontrolled asthma (that is, 3 or more features of partially controlled asthma), and persisting toxicity related to prior therapy of Grade > 1 NCI-CTCAE v 4.03.
  • Subjects with brain metastases are excluded, except those meeting the following criteria: brain metastases that have been treated locally and are clinically stable for at least 2 weeks prior to randomization, subjects must be either off steroids or on a stable or decreasing dose of <= 10 mg daily prednisone (or equivalent), and do not have ongoing neurological symptoms that are related to the brain localization of the disease.
  • Other protocol defined criteria could apply

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
ChemotherapyPaclitaxel-
ChemotherapyGemcitabine-
Avelumab WeeklyAvelumab Weekly-
Avelumab BiweeklyAvelumab-
Avelumab WeeklyCisplatin-
ChemotherapyPemetrexed-
ChemotherapyCarboplatin-
Primary Outcome Measures
NameTimeMethod
Progression Free Survival (PFS) According to Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1) Assessed by Independent Review Committee (IRC) in High Programmed Death Ligand 1 (PD-L1) + Full Analysis Set (FAS)Time from date of randomization up to data cutoff (assessed up to approximately 71.5 months)

PFS is defined as the time from date of randomization until date of the first documentation of progressive disease (PD) or death due to any cause in the absence of documented PD, whichever occurs first. PD is defined as at least a 20 percent (%) increase in the sum of the longest diameter (SLD), taking as reference the smallest SLD recorded from baseline or the appearance of 1 or more new lesions. PFS was measured using Kaplan-Meier (KM) estimates.

Overall Survival (OS) in High Programmed Death Ligand 1 (PD-L1) + Full Analysis Set (FAS)Time from date of randomization up to data cutoff (assessed up to approximately 71.5 months)

OS is defined as the time from randomization to the date of death, regardless of the actual cause of the participant's death. The participants who were still alive at the time of data analysis or who were lost to follow-up OS time was censored at the last recorded date that the participant was known to be alive before the data cutoff date. OS was measured using Kaplan-Meier (KM) estimates.

Overall Survival (OS) in High Programmed Death Ligand 1 (PD-L1)+ Modified Full Analysis Set (mFAS)Time from date of randomization up to data cutoff (assessed up to approximately 71.5 months)

OS is defined as the time from randomization to the date of death, regardless of the actual cause of the participant's death. The participants who were still alive at the time of data analysis or who were lost to follow-up OS time was censored at the last recorded date that the participant was known to be alive before the data cutoff date. OS was measured using Kaplan-Meier (KM) estimates.

Progression Free Survival (PFS) According to Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1) Assessed by Independent Review Committee (IRC) in High Programmed Death Ligand 1 (PD-L1) + Modified Full Analysis Set (mFAS)Time from date of randomization up to data cutoff (assessed up to approximately 71.5 months)

PFS is defined as the time from date of randomization until date of the first documentation of progressive disease (PD) or death due to any cause in the absence of documented PD, whichever occurs first. PD is defined as at least a 20 percent (%) increase in the sum of the longest diameter (SLD), taking as reference the smallest SLD recorded from baseline or the appearance of 1 or more new lesions. PFS was measured using Kaplan-Meier (KM) estimates.

Secondary Outcome Measures
NameTimeMethod
Progression Free Survival (PFS) According to Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1) Assessed by Independent Review Committee (IRC) in Moderate and High Programmed Death Ligand 1 (PD-L1)+ Full Analysis Set (FAS)Time from date of randomization up to data cutoff (assessed up to approximately 71.5 months)

PFS is defined as the time from date of randomization until date of the first documentation of progressive disease (PD) or death due to any cause in the absence of documented PD, whichever occurs first. PD is defined as at least a 20 percent (%) increase in the sum of the longest diameter (SLD), taking as reference the smallest SLD recorded from baseline or the appearance of 1 or more new lesions. PFS was measured using Kaplan-Meier (KM) estimates.

Progression Free Survival (PFS) According to Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1) Assessed by Independent Review Committee (IRC) in Moderate and High Programmed Death Ligand 1 (PD-L1)+ Modified Full Analysis Set (mFAS)Time from date of randomization up to data cutoff (assessed up to approximately 71.5 months)

PFS is defined as the time from date of randomization until date of the first documentation of progressive disease (PD) or death due to any cause in the absence of documented PD, whichever occurs first. PD is defined as at least a 20 percent (%) increase in the sum of the longest diameter (SLD), taking as reference the smallest SLD recorded from baseline or the appearance of 1 or more new lesions. PFS was measured using Kaplan-Meier (KM) estimates.

Overall Survival (OS) in Moderate and High Programmed Death Ligand 1 (PD-L1)+ Full Analysis Set (FAS)Time from date of randomization up to data cutoff (assessed up to approximately 71.5 months)

OS is defined as the time from randomization to the date of death, regardless of the actual cause of the participant's death. The participants who were still alive at the time of data analysis or who were lost to follow-up OS time was censored at the last recorded date that the participant was known to be alive before the data cutoff date. OS was measured using Kaplan-Meier (KM) estimates.

Overall Survival (OS) in Moderate and High Programmed Death Ligand 1 (PD-L1)+ Modified Full Analysis Set (mFAS)Time from date of randomization up to data cutoff (assessed up to approximately 71.5 months)

OS is defined as the time from randomization to the date of death, regardless of the actual cause of the participant's death. The participants who were still alive at the time of data analysis or who were lost to follow-up OS time was censored at the last recorded date that the participant was known to be alive before the data cutoff date. OS was measured using Kaplan-Meier (KM) estimates.

Overall Survival (OS) in Full Analysis Set (FAS)Time from date of randomization up to data cutoff (assessed up to approximately 71.5 months)

OS is defined as the time from randomization to the date of death, regardless of the actual cause of the participant's death. The participants who were still alive at the time of data analysis or who were lost to follow-up OS time was censored at the last recorded date that the participant was known to be alive before the data cutoff date. OS was measured using Kaplan-Meier (KM) estimates.

Percentage of Participants With Confirmed Objective Response According to Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1) as Assessed by Independent Review Committee (IRC) in Moderate and High PD-L1+ Modified Full Analysis SetTime from date of randomization up to data cutoff (assessed up to approximately 71.5 months)

Confirmed objective response was defined as the percentage of participants with a confirmed objective response of complete response (CR) or partial response (PR). CR: Disappearance of all evidence of target and non-target lesions. PR: At least 30% reduction from baseline in the sum of the longest diameter (SLD) of all lesions.

Overall Survival (OS) in Modified Full Analysis Set (mFAS)Time from date of randomization up to data cutoff (assessed up to approximately 71.5 months)

OS is defined as the time from randomization to the date of death, regardless of the actual cause of the participant's death. The participants who were still alive at the time of data analysis or who were lost to follow-up OS time was censored at the last recorded date that the participant was known to be alive before the data cutoff date. OS was measured using Kaplan-Meier (KM) estimates.

Percentage of Participants With Confirmed Objective Response According to Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1) as Assessed by Independent Review Committee (IRC) in High PD-L1+ Modified Full Analysis SetTime from date of randomization up to data cutoff (assessed up to approximately 71.5 months)

Confirmed objective response was defined as the percentage of participants with a confirmed objective response of complete response (CR) or partial response (PR). CR: Disappearance of all evidence of target and non-target lesions. PR: At least 30% reduction from baseline in the sum of the longest diameter (SLD) of all lesions.

Percentage of Participants With Confirmed Objective Response According to Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1) as Assessed by Independent Review Committee (IRC) in Moderate and High PD-L1+ Full Analysis SetTime from date of randomization up to data cutoff (assessed up to approximately 71.5 months)

Confirmed objective response was defined as the percentage of participants with a confirmed objective response of complete response (CR) or partial response (PR). CR: Disappearance of all evidence of target and non-target lesions. PR: At least 30% reduction from baseline in the sum of the longest diameter (SLD) of all lesions.

Number of Participants With Maximal On-Treatment Changes From Baseline in Vital Signs - Maximal Body Temperature IncreaseTime from date of randomization up to data cutoff (assessed up to approximately 71.5 months)

The number of participants with changes from baseline in increased Body Temperature (degree Celsius \[°C\]) were reported by using criteria: Baseline temperature (temp.) less than (\<) 37°C, on treatment change \<1°C, 1 - \<2°C, 2 - \<3°C, greater than or equal to (\>=)3°C and missing; Baseline temp. 37 - \<38°C, on treatment change \<1°C, 1 - \<2°C, 2 - \<3°C, \>=3°C and missing; Baseline temp. 38 - \<39°C, on treatment change \<1°C, 1 - \<2°C, 2 - \<3°C, \>=3°C and missing; Baseline temp. 39-\<40°C, on treatment change \<1°C, 1 - \<2°C, 2 - \<3°C, \>=3°C and missing; Baseline temp. \>=40°C, on treatment change \<1°C, 1 - \<2°C, 2 - \<3°C, \>=3°C and missing; Baseline temp. missing, on treatment change missing.

Number of Participants With Maximal On-Treatment Changes From Baseline in Vital Signs - Maximal Weight Increase/DecreaseTime from date of randomization up to data cutoff (assessed up to approximately 71.5 months)

The number of participants with maximal on-treatment changes from baseline in Increase (Ic.)/Decrease (Dc.) in maximal weight were reported by using criteria: Ic./Dc. From baseline, on treatment (TR) change \<10 percentage (%), \>=10% and missing.

Number of Participants With Maximal On-Treatment Changes From Baseline in Vital Signs - Maximal Heart Rate Increase/DecreaseTime from date of randomization up to data cutoff (assessed up to approximately 71.5 months)

The number of participants with maximal on-treatment (TR) changes from baseline (BS) in Increase (Ic.)/Decrease (Dc.) heart rate (HR) (beats per minute \[bpm\]) were reported by using criteria: Ic./Dc. BS HR \<100/\>=100 bpm, on treatment change =\<20 bpm, \>20 - =\<40 bpm, \>40 bpm and missing; Ic./Dc. BS HR missing, on treatment change missing.

Percentage of Participants With Confirmed Objective Response According to Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1) as Assessed by Independent Review Committee (IRC) in High PD-L1+ Full Analysis SetTime from date of randomization up to data cutoff (assessed up to approximately 71.5 months)

Confirmed objective response was defined as the percentage of participants with a confirmed objective response of complete response (CR) or partial response (PR). CR: Disappearance of all evidence of target and non-target lesions. PR: At least 30% reduction from baseline in the sum of the longest diameter (SLD) of all lesions.

Duration of Response (DOR) According to Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1) as Assessed by Independent Review Committee (IRC) in High Programmed Death Ligand 1 (PD-L1)+ Full Analysis Set (FAS)Time from date of randomization up to data cutoff (assessed up to approximately 71.5 months)

DOR was defined for participants with confirmed response, as the time from first documentation of objective response (Complete Response \[CR\] or Partial Response \[PR\]) to the date of first documentation of progression disease (PD) or death due to any cause, whichever occurred first. CR: Disappearance of all evidence of target and non-target lesions. PR: At least 30% reduction from baseline in the SLD of all lesions. PD: At least a 20 percent (%) increase in the sum of the longest diameter (SLD), taking as reference the smallest SLD recorded from baseline or the appearance of 1 or more new lesions.

Change From Baseline in European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire Lung Cancer 13 (EORTC QLQ-LC13) at End of Treatment (EOT) in High Programmed Death Ligand 1 (PD-L1)+ Modified HRQoL Analysis SetBaseline, End of treatment (up to Week 283.9)

EORTC QLQ-LC13 consisted of 13 questions relating to disease symptoms specific to lung cancer and treatment side effects typical of treatment with chemotherapy and radiotherapy. The EORTC QLQ-LC13 module generated one multiple-item score assessing dyspnea and a series of single item scores assessing coughing, hemoptysis, sore mouth, dysphagia, peripheral neuropathy, alopecia, pain in chest, pain in arms or shoulder and pain in other parts. Score range: 0 (no burden of symptom domain or single symptom item) to 100 (highest burden of symptoms for symptom domains and single items).

Number of Participants With Treatment-Emergent Adverse Events (TEAEs) and AEs of Special Interest (AESIs)Time from date of randomization up to data cutoff (assessed up to approximately 71.5 months)

Adverse event (AE) was defined as any untoward medical occurrence in a participant, which does not necessarily have causal relationship with treatment. A serious AE was defined as an AE that resulted in any of the following outcomes: death; life threatening; persistent/significant disability/incapacity; initial or prolonged in participant hospitalization; congenital anomaly/birth defect or was otherwise considered medically important. The term TEAEs were those events with onset dates occurring during the on-treatment period or if the worsening of an event is during the on-treatment period TEAEs included both serious TEAEs and non-serious TEAEs. Any AE that was suspicious to be a potential Immune-related adverse event (irAE) including infusion related reactions were considered AESIs. Number of participants with TEAEs and AESIs were reported.

Number of Participants With Shift From Baseline to Greater Than or Equal to (>=) Grade 3 in Laboratory Parameter Values Based on National Cancer Institute-Common Terminology Criteria for Adverse Events (NCI-CTCAE), Version 4.03Time from date of randomization up to data cutoff (assessed up to approximately 71.5 months)

Number of participants with shifts from Baseline values (Grade 0/1/2/3) to abnormal post-baseline values (shift to \>= Grade 4) were reported as per NCI-CTCAE, v4.03 graded from Grade 1 to 5. Grade 1: Mild; Grade 2: Moderate; Grade 3: Severe; Grade 4: Life-threatening; Grade 5: Death. Shifts in laboratory parameter (anemia, lymphocyte count decreased, neutrophil count decreased, platelet count decreased, white blood cell count decreased, alanine aminotransferase increased, alkaline phosphatase increased, aspartate aminotransferase increased, blood bilirubin increased, creatine phosphokinase increased, creatinine increased and Hyperglycemia) were reported.

Duration of Response (DOR) According to Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1) as Assessed by Independent Review Committee (IRC) in High Programmed Death Ligand 1 (PD-L1)+ Modified Full Analysis Set (mFAS)Time from date of randomization up to data cutoff (assessed up to approximately 71.5 months)

DOR was defined for participants with confirmed response, as the time from first documentation of objective response (Complete Response \[CR\] or Partial Response \[PR\]) to the date of first documentation of progression disease (PD) or death due to any cause, whichever occurred first. CR: Disappearance of all evidence of target and non-target lesions. PR: At least 30% reduction from baseline in the SLD of all lesions. PD: At least a 20 percent (%) increase in the sum of the longest diameter (SLD), taking as reference the smallest SLD recorded from baseline or the appearance of 1 or more new lesions.

Change From Baseline in European Quality Of Life 5-dimensions (EQ-5D-5L) Visual Analog Scale (VAS) in High PD-L1+ Health-related Quality of Life (HRQoL) Analysis Set at End of TreatmentBaseline, End of treatment (up to Week 283.9)

EQ-5D-5L is comprised of the following 5 participant-reported dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Each dimension has 5 levels: no problems, slight problems, moderate problems, severe problems, and extreme problems. The responses are used to derive overall score using a visual analog scale (VAS) that ranged from 0 to 100 millimeter (mm), where 0 is the worst health you can imagine and 100 is the best health you can imagine.

Change From Baseline in European Quality Of Life 5-dimensions (EQ-5D-5L) Visual Analog Scale (VAS) in High Programmed Death Ligand 1 (PD-L1)+ Modified HRQoL Analysis SetBaseline, End of treatment (Week 283.9)

EQ-5D-5L is comprised of the following 5 participant-reported dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Each dimension has 5 levels: no problems, slight problems, moderate problems, severe problems, and extreme problems. The responses are used to derive overall score using a visual analog scale (VAS) that ranged from 0 to 100 millimeter (mm), where 0 is the worst health you can imagine and 100 is the best health you can imagine.

Change From Baseline in European Organization for the Research and Treatment of Cancer Quality of Life (EORTC QLQ-C30) Global Health Status at End of Treatment (EOT) in High Programmed Death Ligand 1 (PD-L1)+ HRQoL Analysis SetBaseline, End of treatment (up to Week 283.9)

EORTC QLQ-C30 was a 30-question tool used to assess the overall quality of life (QoL) in cancer participants. It consisted of 15 domains: 1 global health status (GHS) scale, 5 functional scales (Physical, role, cognitive, emotional, social), and 9 symptom scales/items (Fatigue, nausea and vomiting, pain, dyspnea, sleep disturbance, appetite loss, constipation, diarrhea, financial impact). The EORTC QLQ-C30 GHS/QoL score ranged from 0 to 100; High score indicated better GHS/QoL. Score 0 represents: very poor physical condition and QoL. Score 100 represents: excellent overall physical condition and QoL.

Change From Baseline in European Organization for the Research and Treatment of Cancer Quality of Life (EORTC QLQ-C30) Global Health Status at End of Treatment (EOT) in High Programmed Death Ligand 1 (PD-L1)+ Modified HRQoL Analysis SetBaseline, End of treatment (Week 283.9)

EORTC QLQ-C30 was a 30-question tool used to assess the overall quality of life (QoL) in cancer participants. It consisted of 15 domains: 1 global health status (GHS) scale, 5 functional scales (Physical, role, cognitive, emotional, social), and 9 symptom scales/items (Fatigue, nausea and vomiting, pain, dyspnea, sleep disturbance, appetite loss, constipation, diarrhea, financial impact). The EORTC QLQ-C30 GHS/QoL score ranged from 0 to 100; High score indicated better GHS/QoL. Score 0 represents: very poor physical condition and QoL. Score 100 represents: excellent overall physical condition and QoL.

Change From Baseline in European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire Lung Cancer 13 (EORTC QLQ-LC13) at End of Treatment (EOT) in High Programmed Death Ligand 1 (PD-L1)+ HRQoL Analysis SetBaseline, End of treatment (up to Week 283.9)

EORTC QLQ-LC13 consisted of 13 questions relating to disease symptoms specific to lung cancer and treatment side effects typical of treatment with chemotherapy and radiotherapy. The EORTC QLQ-LC13 module generated one multiple-item score assessing dyspnea and a series of single item scores assessing coughing, hemoptysis, sore mouth, dysphagia, peripheral neuropathy, alopecia, pain in chest, pain in arms or shoulder and pain in other parts. Score range: 0 (no burden of symptom domain or single symptom item) to 100 (highest burden of symptoms for symptom domains and single items).

Number of Participants With Maximal On-Treatment Changes From Baseline in Vital Signs - Maximal Respiration Rate Increase/DecreaseTime from date of randomization up to data cutoff (assessed up to 71.5 months)

The number of participants with maximal on-treatment (TR) changes from baseline (BS) in Increase (Ic.)/Decrease (Dc.) maximal Respiration Rate (RR) were reported by using criteria: Ic./Dc. BS RR \<20 breaths per minute (breaths/min), on TR change =\<5 breaths/min, \>5 - =\<10 breaths/min, \>10 breaths/min and missing. Ic./Dc. BS RR missing, on TR change missing. Ic./Dc. BS RR \>=20 breaths/min, on TR change =\<5 breaths/min, \>5 - =\<10 breaths/min, \>10 breaths/min and missing.

Number of Participants With Potentially Clinically Significant Abnormalities (PCSA) in Electrocardiogram (ECG) ParametersTime from date of randomization up to data cutoff (assessed up to approximately 71.5 months)

ECG parameters included heart rate, PR interval, QRS interval, corrected QT interval using Bazett's formula (QTcB) and corrected QT interval using Fridericia's formula (QTcF). PCSA criteria for abnormal value of ECG parameters: any heart rate \<= 50 bpm and decrease from baseline \>=20 bpm , any hear rate \>= 120 bpm and increase from baseline \>= 20 bpm; PR interval: \>= 220 milliseconds (ms) and increase from baseline \>= 20 ms; QRS interval \>= 120 ms; QTcF \> 450 ms, \> 480 ms, \> 500 ms, QTcF increase from baseline \> 30 ms and QTcF increase from baseline \> 60 ms; QTcB \> 450 ms, \> 480 ms, \> 500 ms, QTcB increase from baseline \> 30 ms and QTcB increase from baseline \> 60 ms.

Number of Participants With Maximal On-Treatment Changes From Baseline in Vital Signs - Maximal Systolic Blood Pressure Increase/Decrease and Maximal Diastolic Blood Pressure Increase/DecreaseTime from date of randomization up to data cutoff (assessed up to approximately 71.5 months)

The number of participants with maximal on-treatment changes from baseline (BS) in Increase (Ic.)/Decrease (Dc.) Systolic Blood Pressure (SBP) and diastolic blood pressure (DBP) (millimeter of mercury \[mmHg\]) were reported by using criteria: Ic./Dc. BS SBP \<140 mmHg and \>=140 mmHg, on maximal treatment (TR) change =\<20 mmHg, \>20 - =\<40 mmHg, \>40 mmHg and missing; Ic./Dc. BS SBP missing, on maximal treatment (TR) change missing; Ic./Dc. BS DBP \<90 mmHg and \>= 90 mmHg, on maximal TR change =\<20 mmHg, \>20 - =\<40 mmHg, \>40 mmHg and missing; Ic./Dc. BS DBP missing on maximal TR change missing.

Number of Participants With Eastern Cooperative Oncology Group (ECOG) Performance: Baseline Score Versus (Vs) Worst Post-baseline ScoreTime from date of randomization up to data cutoff (assessed up to approximately 71.5 months)

ECOG performance status measured to assess participant's performance status on a scale of 0 to 5, where 0 = Fully active, able to carry on all pre-disease activities without restriction; 1 = Restricted in physically strenuous activity, ambulatory and able to carry out light or sedentary work; 2 = Ambulatory and capable of all selfcare but unable to carry out any work activities; 3 = Capable of only limited self-care, confined to bed/chair for more than 50 percent of waking hours; 4 = Completely disabled, cannot carry on any self-care, totally confined to bed/chair; 5 = dead. ECOG performance status was reported in terms of number of participants with baseline value vs worst post-baseline value (that is \[i.e.\] highest score).

Number of Participants With At Least One Positive Anti-Drug Antibodies (ADAs) and Neutralizing Antibodies (NAbs) for AvelumabTime from date of randomization up to data cutoff (assessed up to approximately 71.5 months)

Serum samples were analyzed by a validated electrochemiluminesce immunoassay to detect the presence of antidrug antibodies (ADA). Samples that screened positive were subsequently tested in a confirmatory assay were tested for neutralizing antibodies (nAb). Number of participants with ADA or nAb positive results for Avelumab were reported.

Trial Locations

Locations (347)

A.Z. Klina

🇧🇪

Brasschaat, Belgium

Fiona Stanley Hospital

🇦🇺

Murdoch, Western Australia, Australia

Arizona Center for Cancer Care

🇺🇸

Surprise, Arizona, United States

St. Vincent Frontier Cancer Center

🇺🇸

Billings, Montana, United States

Hospital Bruno Born

🇧🇷

Lajeado, Rio Grande Do Sul, Brazil

CHU Ambroise Paré

🇧🇪

Mons, Belgium

University Cancer Institute

🇺🇸

Boynton Beach, Florida, United States

ZNA Middelheim

🇧🇪

Antwerpen, Belgium

Novant Health Oncology Specialists

🇺🇸

Kernersville, North Carolina, United States

San Juan Oncology Associates

🇺🇸

Farmington, New Mexico, United States

Calvary Mater Newcastle

🇦🇺

Waratah, New South Wales, Australia

Hospital Erasto Gaertner - Liga Paranaense de Combate ao Câncer

🇧🇷

Curitiba, Paraná, Brazil

Hospital de Câncer de Barretos - Fundação Pio XII

🇧🇷

Barretos, Sao Paulo, Brazil

University Hospital Centre "Sestre Milosrdnice"

🇭🇷

Zagreb, Croatia

Vitkovicka nemocnice a.s

🇨🇿

Ostrava - Vitkovice, Czechia

Krajska nemocnice Liberec, a.s.

🇨🇿

Liberec, Czechia

Fakultni nemocnice Olomouc

🇨🇿

Olomouc, Czechia

Hospital de Clínicas de Porto Alegre

🇧🇷

Porto Alegre, Rio Grande Do Sul, Brazil

Hospital Clínico Universidad de Chile

🇨🇱

Santiago, Chile

Nemocnice Na Plesi s.r.o.

🇨🇿

Nova Ves pod Plesi, Czechia

Thomayerova nemocnice

🇨🇿

Praha 4 - Krc, Czechia

General Oncology Hospital of Kifissia " Agioi Anargyroi"

🇬🇷

Athens, Greece

Centre Hospitalier Intercommunal de Créteil

🇫🇷

Creteil cedex, Val De Marne, France

MHAT for women's health - Nadezhda, OOD

🇧🇬

Sofia, Bulgaria

Centre Antoine Lacassagne

🇫🇷

Nice cedex 02, Alpes Maritimes, France

Hôpital Saint-Louis - Paris

🇫🇷

Paris Cedex 10, France

University Clinic for Pulmonary Diseases

🇭🇷

Zagreb, Croatia

CHU Angers - Hôpital Hôtel Dieu#

🇫🇷

Angers Cedex 9, Maine Et Loire, France

Assaf Harofeh

🇮🇱

Rishon Lezion, Israel

LungenClinic Grosshansdorf GmbH

🇩🇪

Grosshansdorf, Schleswig Holstein, Germany

Petz Aladar Megyei Oktato Korhaz

🇭🇺

Györ, Hungary

Zala Megyei Szent Rafael Korhaz

🇭🇺

Zalaegerszeg, Hungary

CHU de Strasbourg - Nouvel Hôpital Civil

🇫🇷

Strasbourg, Bas Rhin, France

Administradora Country S.A.

🇨🇴

Bogotá, Colombia

Cork University Hospital

🇮🇪

Cork, Ireland

General Hospital of Athens of Chest Diseases "SOTIRIA"

🇬🇷

Athens, Greece

University General Hospital "Attikon"

🇬🇷

Athens, Greece

Hôpital Cochin

🇫🇷

Paris cedex 14, Paris, France

Metropolitan General Hospital

🇬🇷

Athens, Greece

251 General Air Force Hospital

🇬🇷

Athens, Greece

Soroka University Medical Center

🇮🇱

Beer Sheva, Israel

Tolna Megyei Balassa Janos Korhaz

🇭🇺

Szekszard, Hungary

Krajska zdravotni, a.s. - Masarykova nemocnice v Usti nad Labem, o.z.

🇨🇿

Usti nad Labem, Czechia

Centre Hospitalier de la Croix Rousse

🇫🇷

Lyon cedex 04, Rhone, France

Universitaetsklinikum Heidelberg

🇩🇪

Heidelberg, Baden Wuerttemberg, Germany

Sapir Medical Center, Meir Hospital

🇮🇱

Kfar-Saba, Israel

Orszagos Koranyi Pulmonologiai Intezet

🇭🇺

Budapest, Hungary

Orszagos Onkologiai Intezet

🇭🇺

Budapest, Hungary

Institut Sainte Catherine

🇫🇷

Avignon Cedex 9, Vaculuse, France

Hadassah University Hospital - Ein Kerem

🇮🇱

Jerusalem, Israel

CHU Brest - Hôpital Morvan

🇫🇷

Brest Cedex, Finistere, France

Borsod-Abauj-Zemplen Megyei Kozponti Korhaz es Egyetemi Oktatokorhaz

🇭🇺

Miskolc, Hungary

Azienda Ospedaliero Universitaria San Martino

🇮🇹

Genova, Italy

Ajou University Hospital

🇰🇷

Suwon-si, Gyeonggi-do, Korea, Republic of

Severance Hospital, Yonsei University

🇰🇷

Seoul, Korea, Republic of

Kyungpook National University Chilgok Hospital

🇰🇷

Daegu, Korea, Republic of

Tudogyogyintezet Torokbalint

🇭🇺

Torokbalint, Hungary

Oncosalud

🇵🇪

Lima, Peru

Azienda Ospedaliero Universitaria Pisana

🇮🇹

Pisa, Italy

Osaka Medical College Hospital

🇯🇵

Takatsuki-shi, Osaka-Fu, Japan

Presidio Ospedaliero Garibaldi Nesima

🇮🇹

Catania, Italy

Yokohama Municipal Citizen's Hospital

🇯🇵

Yokohama-shi, Kanagawa-Ken, Japan

Ulsan University Hospital

🇰🇷

Ulsan, Korea, Republic of

Seoul National University Bundang Hospital

🇰🇷

Seongnam-si, Gyeonggi-do, Korea, Republic of

The Catholic University of Korea, Yeouido St. Mary's Hospital

🇰🇷

Seoul, Korea, Republic of

National Cancer Center Hospital East

🇯🇵

Kashiwa-shi, Chiba-Ken, Japan

Kobe City Hospital Organization Kobe City Medical Center General Hospital

🇯🇵

Kobe-shi, Japan

Mount Lebanon Hospital

🇱🇧

Beirut, Lebanon

Spitalul Clinic Municipal "Dr. Gavril Curteanu" Oradea

🇷🇴

Oradea, Romania

Inje University Haeundae Paik Hospital

🇰🇷

Busan, Gyeonggi-do, Korea, Republic of

Samsung Medical Center

🇰🇷

Seoul, Korea, Republic of

Specialist

🇪🇸

Barcelona, Spain

Hospital Garcia de Orta, EPE

🇵🇹

Almada, Portugal

Hospital General Universitario Gregorio Marañon

🇪🇸

Madrid, Spain

BHI of Omsk region "Clinical Oncology Dispensary"

🇷🇺

Tomsk, Russian Federation

SBIH of Arkhangelsk region "Arkhangelsk Clinical Oncological Dispensary"

🇷🇺

Arkhangelsk, Russian Federation

Irkutsk Regional Oncology Dispensary

🇷🇺

Irkutsk, Russian Federation

Hospital Universitario Donostia

🇪🇸

San Sebastian, Guipuzcoa, Spain

SBHI "Krasnoyarsk Regional Oncology Dispensary n.a. A.I. Kryzhanovsky"

🇷🇺

Krasnoyarsk, Russian Federation

Johese Clinical Research

🇿🇦

Pretoria, Gauteng, South Africa

Srinagarind Hospital

🇹🇭

Muang, Khon Kaen, Thailand

Spitalul Militar de Urgenta "Dr.Constantin Papilian"Cluj -Napoca

🇷🇴

Cluj-Napoca, Romania

Baskent University Adana Application and Research Center

🇹🇷

Adana, Turkey

Emery Clinical Services

🇿🇦

Alberton, Gauteng, South Africa

Chelyabinsk Regional Oncology Dispensary

🇷🇺

Chelyabinsk, Russian Federation

Hospital Quiron Sagrado Corazon

🇪🇸

Sevilla, Spain

CI Dnipropetrovsk CMCH #4 of Dnipropetrovsk RC Dept of Chemotherapy SI Dnipropetrovsk MA of MOHU

🇺🇦

Dnipro, Ukraine

National University Cancer Institute

🇸🇬

Singapore, Singapore

RCI Sumy Regional Clinical Oncological Dispensary

🇺🇦

Sumy, Ukraine

Hospital Universitario La Paz

🇪🇸

Madrid, Spain

Hospital de Mataro

🇪🇸

Mataro, Barcelona, Spain

SBHI of Kaluga Region "Kaluga regional clinical oncology dispensary"

🇷🇺

Kaluga, Russian Federation

RBIH "Kursk regional clinical oncology dispensary" of Kursk Region Healthcare Committee

🇷🇺

Kursk, Russian Federation

Hospital Universitario Mutua de Terrassa

🇪🇸

Terrassa, Barcelona, Spain

Spitalul Judetean de Urgenta "Sf. Ioan cel Nou" Suceava

🇷🇴

Suceava, Romania

RBIH "Ivanovo Regional Oncological Dispensary"

🇷🇺

Ivanovo, Russian Federation

FSBHI Clinical research institute of phthisiopulmonology

🇷🇺

St. Petersburg, Russian Federation

Complejo Hospitalario Universitario de Santiago

🇪🇸

Santiago de Compostela, La Coruña, Spain

LLC Evimed

🇷🇺

Chelyabinsk, Russian Federation

Hospital Regional Universitario de Malaga

🇪🇸

Málaga, Spain

Medipol University Medical Faculty

🇹🇷

Istanbul, Turkey

Hospital de la Santa Creu i Sant Pau

🇪🇸

Barcelona, Spain

CI Chernivtsi RC Oncological Dispensary Bukovinian SMU Ch of Oncology and Radiology

🇺🇦

Chernivtsi, Ukraine

SI S.P.Grygoriev Institute of Medical Radiology of NAMSU

🇺🇦

Kharkiv, Ukraine

Lviv State Oncological Regional Treatment and Diagnostic Center

🇺🇦

Lviv, Ukraine

Podilskyi Regional Oncological Center

🇺🇦

Vinnytsia, Ukraine

Adana Numune Training and Research Hospital

🇹🇷

Adana, Turkey

Cukurova University Medical Faculty

🇹🇷

Adana, Turkey

ICO Girona - Hospital Universitari de Girona Dr. Josep Trueta

🇪🇸

Girona, Spain

MD Anderson Cancer Centre

🇪🇸

Madrid, Spain

Kartal Lutfi Kirdar Research and Training Hospital

🇹🇷

Istanbul, Turkey

Inonu Uni. Med. Fac.

🇹🇷

Malatya, Turkey

Siriraj Hospital

🇹🇭

Bangkok, Thailand

Communal Non-profit Enterprise Regional Center of Oncology

🇺🇦

Kharkiv, Ukraine

Kherson Regional Oncologic Dispensary

🇺🇦

Kherson, Ukraine

Bakirkoy Dr. Sadi Konuk Teaching and Research Hospital

🇹🇷

Istanbul, Turkey

Sakarya Traning and Research Hospital

🇹🇷

Sakarya, Turkey

Namik Kemal University

🇹🇷

Tekirdag, Turkey

Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital

🇹🇷

Ankara, Turkey

Hacettepe University Medical Faculty

🇹🇷

Ankara, Turkey

Okmeydani Research and Training Hospital

🇹🇷

Istanbul, Turkey

Chelsea and Westminster Hospital

🇬🇧

London, Greater London, United Kingdom

CI Transcarpathian Cl Onc Center Dep of Surgery#1 SHEI Ivano-Frankivsk NMU

🇺🇦

Ivano-Frankivsk, Ukraine

Treatment-Prevention Institution Volyn Regional Oncological Dispensary

🇺🇦

Lutsk, Ukraine

Odesa Regional Oncologic Dispensary

🇺🇦

Odesa, Ukraine

Acibadem Adana Hospital

🇹🇷

Adana, Turkey

Ankara University Medical Faculty

🇹🇷

Ankara, Turkey

The Clatterbridge Cancer Centre

🇬🇧

Wirral, Merseyside, United Kingdom

CI Kryvyi Rih Oncological Dispensary of DRC

🇺🇦

Kryvyi Rih, Dnipropetrovsk Region, Ukraine

Kyiv City Clinical Oncological Center

🇺🇦

Kyiv, Ukraine

Mersin University Medical Faculty

🇹🇷

Mersin, Turkey

Istanbul University Cerrahpasa Medical Faculty

🇹🇷

Istanbul, Turkey

Wojewódzkie Wielospecjalistyczne Centrum Onkologii i Traumatologii im. M. Kopernika w Łodzi

🇵🇱

Lodz, Poland

Centrum Onkologii-Instytut im. M. Sklodowskiej Curie

🇵🇱

Warszawa, Poland

Nevada Cancer Research Foundation

🇺🇸

Las Vegas, Nevada, United States

University General Hospital of Heraklion

🇬🇷

Heraklion, Greece

Euromedica General Clinic Thessaloniki

🇬🇷

Thessaloniki, Greece

IMV-Pesquisa Cardiologica Sociedade Simples - HMD - COR

🇧🇷

Porto Alegre, Rio Grande Do Sul, Brazil

Hôpital privé Clairval

🇫🇷

Marseille, Bouches-du-Rhône, France

NOB - Núcleo de Oncologia da Bahia

🇧🇷

Salvador, Bahia, Brazil

Hospital São Vicente de Paulo

🇧🇷

Passo Fundo, Rio Grande Do Sul, Brazil

Southend University Hospital

🇬🇧

Westcliff on Sea, Essex, United Kingdom

Songklanagarind Hospital

🇹🇭

Hat Yai, Songkhla, Thailand

Ospedale Mater Salutis

🇮🇹

Legnago, Verona, Italy

Hôpital Nord - AP-HM Marseille#

🇫🇷

Marseille cedex 20, Bouches-du-Rhône, France

King Chulalongkorn Memorial Hospital

🇹🇭

Patumwan, Bangkok, Thailand

Rajavithi Hospital

🇹🇭

Rajathevee, Bangkok, Thailand

Hospital São Lucas da PUCRS

🇧🇷

Porto Alegre, Rio Grande Do Sul, Brazil

Hospital Nossa Senhora da Conceição

🇧🇷

Porto Alegre, Rio Grande Do Sul, Brazil

Beijing Cancer Hospital

🇨🇳

Beijing, Beijing, China

Guangdong General Hospital

🇨🇳

Guangzhou, Guangdong, China

Harbin Medical University Cancer Hospital

🇨🇳

Harbin, Heilongjiang, China

Liaoning Cancer Hospital & Institute

🇨🇳

Shenyang, Liaoning, China

Linyi Cancer Hospital

🇨🇳

Linyi, Shandong, China

Fundación Oftalmológica de Santander - FOSCAL

🇨🇴

Floridablanca, Colombia

Clinique Victor Hugo - Centre Jean Bernard

🇫🇷

Le Mans Cedex 02, Sarthe, France

National Cancer Center

🇰🇷

Goyang-si, Gyeonggi-do, Korea, Republic of

Hospital Professor Doutor Fernando Fonseca, E.P.E.

🇵🇹

Amadora-Lisbon, Portugal

Centro Hospitalar De Coimbra-CHUC

🇵🇹

Coimbra, Portugal

Centro Hospitalar do Porto, E.P.E. - Hospital de Santo António

🇵🇹

Porto, Portugal

S.C Gral Medical S.R.L

🇷🇴

Bucuresti, Romania

Hospital Clinico Viña del Mar

🇨🇱

Viña del Mar, Chile

Hospital Pablo Tobón Uribe

🇨🇴

Medellín, Colombia

FALP - Fundación Arturo López Pérez

🇨🇱

Santiago, Chile

IPS IMAT- Instituto Medico de Alta Tecnologia - Oncomedica S.A.

🇨🇴

Monteria, Colombia

CEBROM - Centro Brasileiro de Radioterapia, Oncologia e Mastologia

🇧🇷

Goiânia, Goiás, Brazil

The Moncton Hospital

🇨🇦

Moncton, New Brunswick, Canada

North Estonia Medical Centre Foundation

🇪🇪

Tallinn, Estonia

Spitalul Judetean de Urgenta "Dr. Constantin Opris" Baia Mare

🇷🇴

Baia Mare, Romania

S.C Centrul de Oncologie Sf. Nectarie S.R.L

🇷🇴

Craiova, Romania

Institutul Regional de Oncologie Iasi

🇷🇴

Iasi, Romania

S.C Pelican Impex S.R.L

🇷🇴

Oradea, Romania

Clinical Center Bezanijska Kosa

🇷🇸

Belgrade, Serbia

Cheltenham General Hospital

🇬🇧

Cheltenham, Gloucestershire, United Kingdom

Tri-Service General Hospital

🇨🇳

Taipei, Taiwan

Clinica Santa Maria

🇨🇱

Santiago, Chile

Centro de Investigaciones Clinicas Viña del Mar

🇨🇱

Viña del Mar, Chile

Bank of Cyprus Oncology Center

🇨🇾

Nicosia, Cyprus

S.C Policlinica de Diagnostic Rapid S.A

🇷🇴

Brasov, Romania

Military Medical Academy

🇷🇸

Belgrade, Serbia

National Cancer Centre

🇸🇬

Singapore, Singapore

Taichung Veterans General Hospital

🇨🇳

Taichung, Taiwan

Chang Gung Memorial Hospital, Linkou

🇨🇳

Taoyuan County, Taiwan

Maharaj Nakorn Chiang Mai Hospital

🇹🇭

Muang, Chiang Mai, Thailand

Centro Hospitalar de Lisboa Central, E.P.E. - Hospital de Santo António dos Capuchos

🇵🇹

Lisboa, Portugal

Spitalul Clinic Coltea

🇷🇴

Bucuresti, Romania

Institute of Oncology and Radiology of Serbia

🇷🇸

Belgrade, Serbia

Clinical Center Nis, Pulmonary Diseases Clinic

🇷🇸

Gornji Matejevac, Serbia

Clinical Center Kragujevac

🇷🇸

Kragujevac, Serbia

Institutul Oncologic "Prof. Dr. Al. Trestioreanu"

🇷🇴

Bucuresti, Romania

Spitalul Clinic Judetean de Urgenta "Sf. Apostol Andrei" Constanta

🇷🇴

Constanta, Romania

S.C Radiotherapy Center Cluj S.R.L

🇷🇴

Comuna Floresti, Romania

S.C Oncocenter Oncologie Clinica S.R.L

🇷🇴

Timisoara, Romania

Clinical Center of Serbia

🇷🇸

Belgrade, Serbia

Nemocnica s poliklinikou Sv. Jakuba, n.o. Bardejov

🇸🇰

Bardejov, Slovakia

Univerzitna nemocnica Bratislava, Nemocnica Ruzinov

🇸🇰

Bratislava, Slovakia

Taipei Veterans General Hospital

🇨🇳

Taipei, Taiwan

Institute for Pulmonary Diseases of Vojvodina

🇷🇸

Sremska Kamenica, Serbia

Tan Tock Seng Hospital

🇸🇬

Singapore, Singapore

Kaohsiung Chang Gung Memorial Hospital

🇨🇳

Kaohsiung, Taiwan

China Medical University Hospital

🇨🇳

Taichung, Taiwan

Naresuan University Hospital

🇹🇭

Muang, Phitsanulok, Thailand

Cape Town Oncology Trials Pty Ltd

🇿🇦

Cape Town, Western Cape, South Africa

Complejo Hospitalario Universitario de Vigo

🇪🇸

Vigo, Pontevedra, Spain

National Taiwan University Hospital

🇨🇳

Taipei, Taiwan

Herning Sygehus

🇩🇰

Herning, Denmark

Roskilde Sygehus

🇩🇰

Roskilde, Denmark

Adana City Hospital

🇹🇷

Adana, Turkey

Toyama University Hospital

🇯🇵

Toyama-shi, Toyama-Ken, Japan

Fundacion Jimenez Diaz

🇪🇸

Madrid, Spain

Hospital Txagorritxu

🇪🇸

Vitoria, Spain

SBIH of Stavropol territory "Pyatigorsk Oncological Dispensary"

🇷🇺

Pyatigorsk, Russian Federation

Kemerovo SPI Regional Clinical Oncology Dispensary

🇷🇺

Kemerovo, Russian Federation

FSBSI "Russian Oncological Scientific Center n.a. N.N. Blokhin"

🇷🇺

Moscow, Russian Federation

Murmansk Regional Clinical Hospital named after Bayandin

🇷🇺

Murmansk, Russian Federation

SBHI of Novosibirsk region "Novosibirsk Regional Oncological Dispensary"

🇷🇺

Novosibirsk, Russian Federation

SAIH "Republican Clinical Oncological Dispensary of the Ministry of Healthcare of Republic Tatarstan

🇷🇺

Kazan, Russian Federation

SBIH "Oncological Dispensary # 2" of the MoH of Krasnodar territory

🇷🇺

Sochi, Russian Federation

SBIH "Leningrad Regional Oncological Dispensary"

🇷🇺

Saint-Petersburg, Russian Federation

"Bio Eq" LLC

🇷🇺

Saint-Petersburg, Russian Federation

SBIH of Yaroslavl region "Regional Clinical Oncological Hospital"

🇷🇺

Yaroslavl, Russian Federation

The Queen Elizabeth Hospital

🇦🇺

Woodville South, South Australia, Australia

Hospital Universitari Vall d'Hebron

🇪🇸

Barcelona, Spain

University of Vermont Medical Center

🇺🇸

Burlington, Vermont, United States

SBIH "Samara Regional Clinical Oncological Dispensary"

🇷🇺

Samara, Russian Federation

FBI "Scientific Research Institute of Oncology n. a. N. N. Petrov"

🇷🇺

Saint-Petersburg, Russian Federation

Shato, Ead

🇧🇬

Sofia, Bulgaria

Hospital Clínico San Borja Arriaran

🇨🇱

Santiago, Chile

Clearview Cancer Institute

🇺🇸

Huntsville, Alabama, United States

Christus Cancer Treatment Center

🇺🇸

Shreveport, Louisiana, United States

South Georgia Medical Center

🇺🇸

Valdosta, Georgia, United States

Sharp Memorial Hospital

🇺🇸

San Diego, California, United States

Cookeville Regional Medical Center

🇺🇸

Cookeville, Tennessee, United States

Lancaster Cancer Center

🇺🇸

Lancaster, Pennsylvania, United States

Thompson Cancer Survival Center

🇺🇸

Knoxville, Tennessee, United States

Coastal Bend Cancer Center

🇺🇸

Corpus Christi, Texas, United States

Oncology Consultants, P.A.

🇺🇸

Houston, Texas, United States

Northwest Medical Specialties, PLLC

🇺🇸

Tacoma, Washington, United States

Albury Wodonga Regional Cancer Centre

🇦🇺

Albury, New South Wales, Australia

St George Private Hospital

🇦🇺

Kogarah, New South Wales, Australia

Coffs Harbour Health Campus

🇦🇺

Coffs Harbour, New South Wales, Australia

Royal North Shore Hospital

🇦🇺

St Leonards, New South Wales, Australia

Lismore Base Hospital

🇦🇺

Lismore, New South Wales, Australia

Orange Health Service

🇦🇺

Orange, New South Wales, Australia

Gold Coast University Hospital

🇦🇺

Southport, Queensland, Australia

Gallipoli Medical Research Foundation Ltd

🇦🇺

Greenslopes, Queensland, Australia

Ballarat Base Hospital

🇦🇺

Ballarat, Victoria, Australia

South West Healthcare

🇦🇺

Warrnambool, Victoria, Australia

Bendigo Hospital

🇦🇺

Bendigo, Victoria, Australia

CRIO - Centro Regional Integrado de Oncologia

🇧🇷

Fortaleza, Ceará, Brazil

Hospital de Caridade de Ijuí

🇧🇷

Ijuí, Rio Grande Do Sul, Brazil

INCA - Instituto Nacional de Câncer

🇧🇷

Rio de Janeiro, Brazil

Clínica de Neoplasias Litoral Ltda.

🇧🇷

Itajaí, Santa Catarina, Brazil

Fundação Doutor Amaral Carvalho

🇧🇷

Jaú, Sao Paulo, Brazil

Fundação Faculdade Regional de Medicina de São José do Rio Preto

🇧🇷

São José do Rio Preto, Sao Paulo, Brazil

IBCC - Instituto Brasileiro de Controle do Câncer

🇧🇷

São Paulo, Sao Paulo, Brazil

CEPHO - Centro de Estudos e Pesquisas em Hematologia e Oncologia

🇧🇷

Santo Andre, Sao Paulo, Brazil

ICESP - Instituto do Câncer do Estado de São Paulo Octavio Frias de Oliveira

🇧🇷

São Paulo, Sao Paulo, Brazil

UMHAT "Sv. Ivan Rilski", EAD

🇧🇬

Sofia, Bulgaria

Complex Oncological Center - Ruse, EODD

🇧🇬

Ruse, Bulgaria

Mount Sinai Hospital

🇨🇦

Toronto, Ontario, Canada

IRAM - Instituto de Radio Medicina

🇨🇱

Santiago, Chile

Hospital Militar de Santiago

🇨🇱

Santiago, Chile

Groupe Hospitalier Sud - Hôpital Haut-Lévêque

🇫🇷

Pessac, Gironde, France

Centre Hospitalier de la Côte Basque

🇫🇷

Bayonne, Pyrenees Atlantiques, France

CHU Besançon - Hôpital Jean Minjoz

🇫🇷

Besancon Cedex, Doubs, France

University General Hospital of Patra

🇬🇷

Patras, Greece

Semmelweis Egyetem

🇭🇺

Budapest, Hungary

Csongrad Megyei Mellkasi Betegsegek Szakkorhaza

🇭🇺

Deszk, Hungary

Rabin Medical Center-Beilinson Campus

🇮🇱

Petach Tikva, Israel

SzSzB Megyei Korhazak es Egyetemi Oktatokorhaz

🇭🇺

Nyiregyhaza, Hungary

Fondazione Poliambulanza Istituto Ospedaliero

🇮🇹

Brescia, Italy

Chaim Sheba Medical Center

🇮🇱

Ramat Gan, Israel

Kaplan Medical Center

🇮🇱

Rechovot, Israel

Rambam Health Care Center

🇮🇱

Haifa, Israel

Tel Aviv Sourasky Medical Center

🇮🇱

Tel Aviv, Israel

Seconda Università degli Studi di Napoli

🇮🇹

Napoli, Italy

Azienda Ospedaliero Universitaria di Parma

🇮🇹

Parma, Italy

Institute of Biomedical Research and Innovation Hospital

🇯🇵

Kobe-shi, Hyogo-Ken, Japan

NHO Hokkaido Cancer Center

🇯🇵

Sapporo-shi, Hokkaido, Japan

Kurume University Hospital

🇯🇵

Kurume-shi, Fukuoka-Ken, Japan

Kanagawa Cancer Center

🇯🇵

Yokohama-shi, Kanagawa-Ken, Japan

Kansai Medical University Hospital

🇯🇵

Hirakata-shi, Osaka-Fu, Japan

Tokyo Medical University Hospital

🇯🇵

Shinjuku-ku, Tokyo-To, Japan

National Cancer Center Hospital

🇯🇵

Chuo-ku, Tokyo-To, Japan

Chungbuk National University Hospital

🇰🇷

Cheongju-si, Chungcheongbuk-do, Korea, Republic of

Yonsei University Wonju Severance Christian Hospital

🇰🇷

Wonju-si, Gangwon-do, Korea, Republic of

The Catholic University of Korea, St. Vincent's Hospital

🇰🇷

Suwon-si, Gyeonggi-do, Korea, Republic of

CHA Bundang Medical Center, CHA University

🇰🇷

Seongnam-si, Gyeonggi-do, Korea, Republic of

Gachon University Gil Medical Center

🇰🇷

Incheon, Korea, Republic of

Korea University Anam Hospital

🇰🇷

Seoul, Korea, Republic of

Asan Medical Center

🇰🇷

Seoul, Korea, Republic of

Seoul National University Hospital

🇰🇷

Seoul, Korea, Republic of

The Catholic University of Korea, Seoul St. Mary's Hospital

🇰🇷

Seoul, Korea, Republic of

Korea University Guro Hospital

🇰🇷

Seoul, Korea, Republic of

Rafik Hariri University Hospital

🇱🇧

Beirut, Lebanon

Hotel Dieu de France Hospital

🇱🇧

Beirut, Lebanon

American University of Beirut Medical Center

🇱🇧

Beirut, Lebanon

Hammoud Hospital University Medical Center

🇱🇧

Saida, Lebanon

ETZ Elisabeth

🇳🇱

Tilburg, Netherlands

Hospital of Lithuanian University of Health Sciences Kaunas Clinics

🇱🇹

Kaunas, Lithuania

Martini Ziekenhuis

🇳🇱

Groningen, Netherlands

Westfriesgasthuis - PARENT

🇳🇱

Hoorn, Netherlands

Auckland City Hospital

🇳🇿

Auckland, New Zealand

Dunedin Public Hospital

🇳🇿

Dunedin, New Zealand

Palmerston North Hospital

🇳🇿

Palmerston North, New Zealand

Waikato Hospital

🇳🇿

Hamilton, New Zealand

Instituto Nacional de Enfermedades Neoplásicas

🇵🇪

Lima, Peru

Tauranga Hospital

🇳🇿

Tauranga, New Zealand

Wellington Hospital

🇳🇿

Wellington, New Zealand

Clinica Internacional Sede San Borja

🇵🇪

Lima, Peru

Instytut MSF Sp. o.o

🇵🇱

Lodz, Poland

KO-MED Centra Kliniczne Lublin II

🇵🇱

Lublin, Poland

Centrum Terapii Wspolczesnej J.M. Jasnorzewska sp. komandytowo-akcyjna

🇵🇱

Lodz, Poland

SP Zespol Gruzlicy i Chorob Pluc w Olsztynie

🇵🇱

Olsztyn, Poland

Mazowieckie Centrum Leczenia Chorob Pluc i Gruzlicy

🇵🇱

Otwock, Poland

Centro Hospitalar e Universitário de Coimbra, E.P.E (CHC)

🇵🇹

Coimbra, Portugal

Mazowiecki Szpital Onkologiczny

🇵🇱

Wieliszew, Poland

Centro Hospitalar de Lisboa Norte, E.P.E. - Hospital Pulido Valente

🇵🇹

Lisboa, Portugal

Hospital CUF Porto

🇵🇹

Porto, Portugal

Instituto Português de Oncologia do Porto Francisco Gentil, EPE

🇵🇹

Porto, Portugal

Centro Hospitalar de São João, E.P.E.

🇵🇹

Porto, Portugal

Centro Hospitalar Vila Nova de Gaia/Espinho, E.P.E

🇵🇹

Vila Nova de Gaia, Portugal

Centro Hospitalar de Entre o Douro e Vouga, E.P.E - Hospital de São Sebastião

🇵🇹

Santa Maria da Feira, Portugal

Institutul Oncologic "Prof. Dr. Ion Chiricuta" Cluj Napoca

🇷🇴

Cluj Napoca, Romania

S.C Medisprof S.R.L

🇷🇴

Cluj-Napoca, Romania

S.C Oncomed S.R.L

🇷🇴

Timisoara, Romania

Medicinskiy gorod

🇷🇺

Tyumen, Russian Federation

Tomsk Research Instutite of Oncology

🇷🇺

Tomsk, Russian Federation

University of Pretoria Oncology Department

🇿🇦

Pretoria, Gauteng, South Africa

Hospital Universitari Quiron Dexeus

🇪🇸

Barcelona, Spain

Hospital Universitario Virgen del Rocio

🇪🇸

Sevilla, Spain

Memorial Antalya Hastanesi

🇹🇷

Antalya, Turkey

Ege University Medical Faculty

🇹🇷

Izmir, Turkey

Mount Vernon Hospital

🇬🇧

Stevenage, Hertfordshire, United Kingdom

CCCH City Oncological Center SHEI Uzhgorod NU

🇺🇦

Uzhgorod, Ukraine

Vinnytsia Regional Clinical Oncological Dispensary

🇺🇦

Vinnytsia, Ukraine

Royal Stoke University Hospital

🇬🇧

Stoke on Trent, Staffordshire, United Kingdom

SSZZOZ im. Dr Teodora Dunina w Rudce

🇵🇱

Mrozy, Poland

Szpital Kliniczny Przemienienia Panskiego Uniwersytetu Medycznego im. Karola Marcinkowskiego

🇵🇱

Poznan, Poland

Izerskie Centrum Pulmonologii i Chemioterapii "IZER-MED" Spolka z o.o.

🇵🇱

Szklarska Poręba, Poland

Treatment-Diagnostic Center of Private Enterprise of PPC Atsynus

🇺🇦

Kropyvnytskyi, Ukraine

Henry Ford Hospital

🇺🇸

Detroit, Michigan, United States

Mercy Research

🇺🇸

Oklahoma City, Oklahoma, United States

Kaiser Permanente Northwest

🇺🇸

Portland, Oregon, United States

CEPON - Centro de Pesquisas Oncológicas de Santa Catarina

🇧🇷

Florianópolis, Santa Catarina, Brazil

Cheyenne Regional Medical Center

🇺🇸

Cheyenne, Wyoming, United States

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