A Study of MEK162 vs. Physician's Choice Chemotherapy in Patients With Low-grade Serous Ovarian, Fallopian Tube or Peritoneal Cancer
- Conditions
- Low-grade Serous Ovarian CancerLow-grade Serous Fallopian Tube CancerLow-grade Serous Peritoneal Cancer
- Interventions
- Drug: MEK162, MEK inhibitor; oralDrug: Physician's choice chemotherapy
- Registration Number
- NCT01849874
- Lead Sponsor
- Pfizer
- Brief Summary
The MILO Study (MEK Inhibitor in Low-grade Serous Ovarian Cancer) is a Phase 3 study during which patients with recurrent or persistent low-grade serous (LGS) carcinomas of the ovary, fallopian tube or primary peritoneum will receive either investigational study drug MEK162 or a chemotherapy chosen by the physician (liposomal doxorubicin, paclitaxel or topotecan). Patients will be followed to compare the effectiveness of the study drug to that of the selected chemotherapies. Patients may be eligible to crossover from physician's choice chemotherapy to MEK162 if they meet certain inclusion criteria including centrally confirmed disease progression. Approximately 360 patients from North America, Europe and Australia will be enrolled in this study.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- TERMINATED
- Sex
- Female
- Target Recruitment
- 341
- Diagnosis of LGS carcinoma of the ovary, fallopian tube or primary peritoneum (invasive micropapillary serous carcinoma or invasive grade 1 serous carcinoma), confirmed histologically and verified by central pathology review.
- Recurrent or persistent measurable disease that has progressed (defined as radiological and/or clinical progression; an increase in cancer antigen [CA]-125 alone is not sufficient) on or after last therapy (i.e., chemotherapy, hormonal therapy, surgery) and is not amenable to potentially curative intent surgery, as determined by the patient's treating physician.
- Must have received at least 1 prior platinum-based chemotherapy regimen but have received no more than 3 lines of prior chemotherapy regimens, with no limit to the number of lines of prior hormonal therapy. Front-line therapy may include neoadjuvant and adjuvant therapy and will be counted as 1 prior systemic regimen. Biological therapy (e.g. bevacizumab) administered as a single agent is considered a prior systemic regimen and not a prior chemotherapy regimen. Maintenance therapy is not considered its own regimen but should be included with the regimen that it follows.
- Available archival tumor sample (excisional or core biopsy) for confirmation of LGS carcinoma diagnosis. If adequate archival tumor sample is not available, willingness to consent to tissue biopsy.
- Suitable for treatment with at least one of the physician's choice chemotherapy options (liposomal doxorubicin, paclitaxel or topotecan) as determined by the Investigator.
- Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0 or 1.
- Additional criteria exist.
Key
- History or current evidence of retinal vein occlusion (RVO) or current risk factors for RVO (e.g., uncontrolled glaucoma or ocular hypertension, history of hyperviscosity or hypercoagulability syndromes).
- Prior therapy with a MEK or BRAF inhibitor.
- History of Gilbert's syndrome.
- Impaired cardiovascular function or clinically significant cardiovascular diseases.
- Uncontrolled or symptomatic brain metastases that are not stable or require steroids, are potentially life-threatening or have required radiation within 28 days prior to first dose of study treatment.
- Concomitant malignancies or previous malignancies with less than a 5-year disease-free interval at the time of first dose of study treatment; patients with adequately resected basal or squamous cell carcinoma of the skin, carcinoma in situ of the cervix or ductal carcinoma in situ may be enrolled irrespective of the time of diagnosis.
- Known positive serology for the human immunodeficiency virus (HIV), active hepatitis B and/or active hepatitis C.
- Prior randomization into this clinical study.
- Additional criteria exist.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description MEK162 MEK162, MEK inhibitor; oral - Physician's choice chemotherapy Physician's choice chemotherapy -
- Primary Outcome Measures
Name Time Method Progression-free Survival (PFS) as Assessed by Blinded Independent Central Review (BICR) From randomization until documented progressive disease (PD) or death, whichever occurred first, for censored participants at the date of last adequate tumor assessment (up to 24 months) PFS was defined as the time from randomization to the earliest documented disease progression date or death due to any cause whichever occurred first. Disease progression was defined as at least a 20% increase in the sum of diameters of measured lesions taking as references the smallest sum of diameters recorded on study (including Baseline) and an absolute increase of greater than or equal to (\>=) 5 millimeter (mm). Appearance of new lesions \>=10 mm in diameter also constituted PD. If a participant did not have an event at the time of the analysis cutoff or at the start of any new therapy, PFS was censored at the date of last adequate tumor assessment.
- Secondary Outcome Measures
Name Time Method Number of Participants With Treatment Emergent Adverse Events (AEs) and Serious Adverse Events (SAEs) From the first dose of study intervention until 30 days after the last dose (up to 9 years) An AE was any untoward medical occurrence in a participant who received study intervention without regard to possibility of causal relationship. SAE: an AE resulting in any of the following outcomes or deemed significant for any other reason: death; initial/prolonged inpatient hospitalization; life-threatening experience (immediate risk of dying); persistent or significant disability/incapacity; congenital anomaly.
Maximum Observed Plasma Concentration (Cmax) of MEK162 2 hours ± 10 minutes postdose on Study Days 1, 57, and 113. Cmax is maximum observed plasma concentration. Cmax of MEK162 was observed directly from data.
Overall Survival (OS) From randomization date to the date of death, for censored participants at their last contact date (up to 24 months) OS was defined as the time from randomization to death due to any cause. Participants who were alive at the data cutoff date were censored for overall survival at their last contact date.
Objective Response Rate Per Response Evaluation Criteria in Solid Tumors (RECIST), Version 1.1 (RECIST V1.1) From randomization until disease progression or death (up to 24 months) ORR was defined as the percentage of participants achieving an overall best response of complete response (CR) or partial response (PR) (responders). CR was defined as disappearance of target and non-target lesions and normalization of tumor markers. Pathological lymph nodes must have short axis measures less than (\<) 10 mm, PR was defined as at least a 30% decrease in the sum of measures (longest diameter for tumor lesions and short axis measure for nodes) of target lesions, taking as reference the Baseline sum of diameters. Non-target lesions must be non-progressive disease.
Duration of Response (DOR) From the first radiographic evidence of response to the first documentation of PD or death, for censored participants at their last radiological assessment (up to 24 months) DOR was defined as the time from first radiographic evidence of response to the earliest documented progression date or death due to any cause, and was calculated on responders only. Responders with no PD or death date or subsequent anticancer therapy by the data cutoff date, were censored for DOR at their last radiological assessment. Responders who received subsequent anticancer therapy prior to PD or death were censored at their last radiological assessment prior to initiation of subsequent anticancer therapy.
Disease Control Rate (DCR) Week 24 Disease control rate was defined as percentage of participants with disease control. Disease control was defined as a best response of CR or PR, or stable disease (SD) documented at Week 24 or later. CR was defined as disappearance of target and non-target lesions and normalization of tumor markers. Pathological lymph nodes must have short axis measures \<10 mm, and PR is defined as at least a 30% decrease in the sum of measures (longest diameter for tumor lesions and short axis measure for nodes) of target lesions, taking as reference the Baseline sum of diameters. Non-target lesions must be non-progressive disease. SD was defined as neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD taking as reference the smallest sum of diameters on study.
Number of Participants With Shift Greater Than or Equal to Grade 3 From Baseline in Laboratory Parameter Values Based on National Cancer Institute-Common Terminology Criteria for Adverse Events (NCI-CTCAE), Version 4.03 From the first dose of study intervention until 30 days after the last dose (up to 9 years) Number of participants with shifts from normal Baseline values (Grade 0) to abnormal post-baseline values on-study (shift to greater than or equal to Grade 3) were reported as per NCI-CTCAE, v4.03 graded from Grade 1 to 5. Grade 1: Mild; asymptomatic/ mild symptoms; clinical/diagnostic observations only; intervention not indicated. Grade 2: Moderate; minimal, local/noninvasive intervention indicated. Grade 3: Severe/medically significant but not immediately life-threatening; hospitalization/prolongation of hospitalization indicated. Grade 4: Life-threatening consequences; urgent intervention indicated. Grade 5: Death. Shifts in lab parameter from Grade 0 to 3, Grade 0 to 4 and Grade 0 to Low 3 and 4 and Grade 0 to High 3 and 4 (for parameters total hemoglobin, lymphocytes, white blood cells, calcium, magnesium, potassium, and sodium) were reported.
Quality of Life Per European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire - Ovarian Cancer Module (QLQ-OV28) Screening, every 8 weeks from randomization for the first 72 weeks (while on treatment), treatment discontinuation visit, 30-day safety follow-up visit EORTC QLQ-OV28 contains 28 items which assess a comprehensive range of relevant issues: abdominal/gastrointestinal (GI) symptoms, peripheral neuropathy, other chemotherapy side-effects, hormonal/menopausal symptoms, body image, attitude to disease/treatment and sexual functioning. The score for each domain and component score were scaled from 0 (minimum) to 100 (maximum). Higher scores indicate lower quality of life except for sexual functioning where higher scores indicate better quality of life.
Quality of Life Per European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire - Core 30 (QLQ-C30) Screening, every 8 weeks from randomization for the first 72 weeks (while on treatment), treatment discontinuation visit, 30-day safety follow-up visit EORTC QLQ-C30 is a 30-item cancer-specific instrument that assesses participant reported outcomes, consisting of 5 functional scales, 3 symptoms scales, a global health status/quality of life (QOL) scale, and 6 single-item scales. The global health status/QOL scale has 7 possible scores of responses (1=very poor to 7=excellent). All other items have 4 possible scores (1=not at all, 2=a little, 3=quite a bit, 4=very much). A linear transformation was applied to the raw scores so that all transformed scores lie between 0 to 100, with 0 being the worst and 100 being the best for global health status/QOL and functional scales, and 0 being the best and 100 being the worst for symptoms scales. In this study, global health status/QOL scale score was identified as the primary patient-reported outcome variable of interest. Physical functioning, emotional functioning, and social functioning scale scores were considered as secondary. Higher scores indicate better quality of life.
Quality of Life Per Functional Assessment of Cancer Therapy/Gynecologic Oncology Group - Neurotoxicity (FACT/GOG-NTX) Screening, every 8 weeks from randomization for the first 72 weeks (while on treatment), treatment discontinuation visit, 30-day safety follow-up visit FACT/GOG-NTX questionnaire consists of questions for dimensions related to physical, social, emotional, and functional well-being which contains 11 items, with responses scored on a Likert scale from 0 (not at all) to 4 (very much) designed to capture the symptoms of chemotherapy-induced peripheral neuropathy (CIPN). The summed scores of each item were reverted into standardized scores ranging from 0 to 44, with a higher score indicating a lower level of neurological toxicity and less effect on quality of life (ie, higher scores indicate better quality of life). The trial outcome index consists of two subscales from the FACT-G: Physical Well Being (7 items) and Functional Well Being (7 items), plus the Cervix Cancer-specific subscale (15 items). Each item in the trial outcome index scored using a 5-point scale (0=not at all to 4=very much). The summed scores of each item were reverted into standardized scores ranging from 0 to 116. Higher scores indicate better quality of life.
Predose Plasma Concentration (Ctrough) of MEK162 Predose on Study Days 1, 57, and 113. Ctrough of MEK162 is defined as the predose plasma concentration of MEK162. Ctrough of MEK162 was observed directly from data.
Trial Locations
- Locations (221)
Karmanos Cancer Institute
🇺🇸Farmington Hills, Michigan, United States
Doris Stein Research Center Building
🇺🇸Los Angeles, California, United States
James Cancer Hospital & Solove Research Institute
🇺🇸Columbus, Ohio, United States
LAC & USC Medical Center
🇺🇸Los Angeles, California, United States
USC Healthcare Consultation Center 1
🇺🇸Los Angeles, California, United States
UCLA Hematology/Oncology Clinic - Santa Monica
🇺🇸Santa Monica, California, United States
Georgia Regents University Cancer Center
🇺🇸Augusta, Georgia, United States
University of Iowa Hospitals and Clinics
🇺🇸Iowa City, Iowa, United States
Florida Cancer Specialists
🇺🇸West Palm Beach, Florida, United States
Rocky Mountain Lions Eye Institute
🇺🇸Aurora, Colorado, United States
UCLA Hematology Oncology Clinic Santa Clarita
🇺🇸Valencia, California, United States
University of Chicago Medical Center
🇺🇸Chicago, Illinois, United States
UT Southwestern Medical Center-Zale Lipshy University Hospital
🇺🇸Dallas, Texas, United States
UCLA Hematology - Oncology Clinic - Westlake Village
🇺🇸Westlake Village, California, United States
Center for Advanced Medicine
🇺🇸Saint Louis, Missouri, United States
Fairview Hospital Moll Pavilion Cancer Center
🇺🇸Cleveland, Ohio, United States
Cleveland Clinic Taussig Cancer Center
🇺🇸Cleveland, Ohio, United States
Adelaide Eye and Retina Centre
🇦🇺Adelaide, South Australia, Australia
Sunshine Hospital
🇦🇺St Albans, Victoria, Australia
Fakultni nemocnice Olomouc
🇨🇿Olomouc, Czechia
UT Southwestern Medical Center-Clements University Hospital
🇺🇸Dallas, Texas, United States
University of New Mexico Cancer Center
🇺🇸Albuquerque, New Mexico, United States
Montefiore Medical Center - Centennial Women's Health
🇺🇸Bronx, New York, United States
Royal Adelaide Hospital
🇦🇺Adelaide, South Australia, Australia
Washington University
🇺🇸Saint Louis, Missouri, United States
Parkland Health and Hospital System
🇺🇸Dallas, Texas, United States
University of Pittsburgh Medical Center
🇺🇸Pittsburgh, Pennsylvania, United States
OSU Gynecologic Oncology at Mill Run
🇺🇸Hilliard, Ohio, United States
Innsbruck Medical University
🇦🇹Innsbruck, Tirol, Austria
Mater Misericordiae Health Services Brisbane Limited
🇦🇺South Brisbane, Queensland, Australia
Jeanes Hospital
🇺🇸Philadelphia, Pennsylvania, United States
OSU Wexner Medical Center
🇺🇸Columbus, Ohio, United States
Ghent University Hospital
🇧🇪Gent, Belgium
Thomas and Delaney Optometrists
🇦🇺Norwood, South Australia, Australia
Memorial Sloan Kettering Cancer Center
🇺🇸New York, New York, United States
University of Cincinnati Physicians Company
🇺🇸West Chester, Ohio, United States
Sint-Augustinus
🇧🇪Wilrijk, Belgium
Centre Paradis Monticelli
🇫🇷Marseille, France
Dr Anil Arora
🇦🇺Wahroonga, New South Wales, Australia
Burnside War Memorial Hospital
🇦🇺Toorak Gardens, South Australia, Australia
Fakultni nemocnice Ostrava
🇨🇿Ostrava-Poruba, Czechia
Centre Leon Berard
🇫🇷LYON Cedex 08, France
Institut Gustave Roussy
🇫🇷Villejuif Cedex, France
SSD Oncologia Medica Addarii-Zamagni - Policlinico S. Orsola-Malpighi
🇮🇹Bologna, Italy
Petz Aladar Korhaz Kardiologiai Osztaly
🇭🇺Gyor, Gyor-moson-sopron, Hungary
Kliniken Essen-Mitte
🇩🇪Essen, North Rhine-westphalia, Germany
Azienda Ospedaliera Cannizzaro
🇮🇹Catania, Italy
Azienda Ospedaliera Vincenzo Monaldi di Napoli - U.O.C. di Oculistica
🇮🇹Napoli, Italy
Universita degli Studi Federico II di Napoli Dipartimento di Neuroscienze Scienze
🇮🇹Napoli, Italy
Hospital Duran i Reynals
🇪🇸L'Hospitalet de Llobregat, Barcelona, Spain
Clinique Sourdille
🇫🇷Nantes, France
L'Hopital Prive du Confluent SAS
🇫🇷NANTES Cedex 2, France
Hopital Europeen Georges Pompidou
🇫🇷Paris Cedex 15, France
Policlinico Agostino Gemelli
🇮🇹Roma, Italy
Fondazione IRCCS Istituto Nazionale dei Tumori - SC Oncologia Ginecologica
🇮🇹Milano, Italy
Petz Aladar Korhaz Szemeszeti Osztaly
🇭🇺Gyor, Gyor-moson-sopron, Hungary
Uni Carl Gustav Carus
🇩🇪Dresden, Saxony, Germany
Spedali Civili di Brescia - Struttura Complessa Clinicizzata - U.O.di Oculistica
🇮🇹Brescia, Italy
Frauenheilkunde und Geburtshilfe
🇩🇪Greifswald, Germany
Hopital Prive La Louviere
🇫🇷Lille, France
Cabinet Liberal du Dr Xavier Zanlonghi
🇫🇷Nantes, France
Institut Paoli Calmettes - Departement d'Oncologie Medicale
🇫🇷Marseille Cedex 09, France
Institut Regional du Cancer Montpellier
🇫🇷Montpellier CEDEX 5, France
Universitaets-Brustzentrum
🇩🇪Tuebingen, Baden-wuerttemberg, Germany
Universitaetsklinik Freiburg
🇩🇪Freiburg, Germany
Ophthalmology at Instituto Oftalmologico Integral
🇪🇸Barcelona, Spain
Academic Medical Center (AMC)
🇳🇱Amsterdam, Noord-holland, Netherlands
Onkologkliniken Akademiska Sjukhuset
🇸🇪Uppsala, Sweden
Policlinico Umberto I - Università Sapienza
🇮🇹Roma, Rome, Italy
Ospedale San Raffaele - Unita Operativa di Oculistica
🇮🇹Milano, Italy
NCT Nationales Centrum für Tumorerkrankungen Heidelberg
🇩🇪Heidelberg, Germany
Instituto de Oftalmologia y Hospital La Arruzafa
🇪🇸Cordoba, Spain
Semmelweis Egyetem AOK Szemeszeti Klinika
🇭🇺Budapest, Hungary
Azienda Opsedaliera S. Maria Degli Angeli Pordenone-Dipartimento di Chirurgia Specialistica -
🇮🇹Pordenone, Italy
CHU Jean Minjoz
🇫🇷Besancon, France
Centre Investigateur CARIO - HPCA
🇫🇷Plerin, France
Klinik fur Frauenheilkunde und Geburtshilfe
🇩🇪Kassel, Hessen, Germany
Centre d'Investigations Cliniques 1423
🇫🇷Paris, France
Istituto Clinico Humanitas
🇮🇹Rozzano, Milano, Italy
Istituto Nazionale Tumori Regina Elena - Oncologia Medica A
🇮🇹Roma, RM, Italy
Spedali Civili Di Brescia
🇮🇹Brescia, Italy
Charité Universitaetsmedizin Berlin
🇩🇪Berlin, Germany
Hospital Ramón Y Cajal
🇪🇸Madrid, Spain
Istituto Europeo Oncologico
🇮🇹Milano, Italy
Orszagos Onkologiai Intezet
🇭🇺Budapest, Hungary
St. Anthony's Hospital
🇬🇧North Cheam, Sutton, United Kingdom
Centre d'Ophtalmologie du LEZ Centre Medical Les Roques
🇫🇷Montferrier S/lez, France
Radiology at Centro Medico Sanitas Ressalta
🇪🇸Cordoba, Spain
Centro de Salud Anoeta
🇪🇸Anoeta, Guipuzcoa, Spain
Avd. for gynekologisk kreft, Radiumhospitalet
🇳🇴Oslo, Norway
Oslo Universitetssykehus HF
🇳🇴Oslo, Norway
Ashtead Hospital
🇬🇧Ashtead, Surrey, United Kingdom
London Eye Diagnostic Centre
🇬🇧London, United Kingdom
Azienda Ospedaliera Sant' Andrea - Unita Operativa Semplice di Patologia Vitreo-Retinica
🇮🇹Roma, Rome, Italy
Struttura Complessa di Oftalmologia Policlinico S. Orsola-Malpighi
🇮🇹Bologna, Italy
Hospital Universitario Virgen Macarena
🇪🇸Sevilla, Spain
City Hospital
🇬🇧Birmingham, WEST Midlands, United Kingdom
Hospital Universitario Donostia
🇪🇸San Sebastian, Guipuzcoa, Spain
Centro Medico Sanitas Ressalta
🇪🇸Cordoba, Spain
Hospital Universitario Reina Sofía/ Provincial
🇪🇸Córdoba, Castilla LA Mancha, Spain
Royal Marsden NHS Foundation Trust
🇬🇧London, United Kingdom
Hospital Virgen de la Salud
🇪🇸Toledo, Spain
Sarah Cannon Research Institute UK
🇬🇧London, England, United Kingdom
The Clock House Medical Practice
🇬🇧Epsom, Surrey, United Kingdom
Karolinska Universitetssjukhuset
🇸🇪Stockholm, Sweden
Hospital Son Llatzer
🇪🇸Palma de Mallorca, Spain
University of Maryland Greenebaum Cancer Center
🇺🇸Baltimore, Maryland, United States
Ophthalmic Consultants of Boston (OCB)
🇺🇸Boston, Massachusetts, United States
University Medical Center Groningen, Medical Oncology
🇳🇱Groningen, Netherlands
Maastricht University Medical Centre
🇳🇱Maastricht, Netherlands
Sir Charles Gairdner Hospital
🇦🇺Nedlands, Western Australia, Australia
University of Arizona Cancer Center
🇺🇸Phoenix, Arizona, United States
Associated Retina Consultants, Ltd.
🇺🇸Phoenix, Arizona, United States
St. Vincent Cancer Care
🇺🇸Indianapolis, Indiana, United States
St. Vincent Gynecologic Oncology
🇺🇸Indianapolis, Indiana, United States
St. Vincent Hospital and Health Care Center, Inc.
🇺🇸Indianapolis, Indiana, United States
Associated Vitreoretinal and Uveitis Consultants
🇺🇸Indianapolis, Indiana, United States
Kresge Eye Institute
🇺🇸Detroit, Michigan, United States
University of Cincinnati Medical Center
🇺🇸Cincinnati, Ohio, United States
Dean McGee Eye Institute
🇺🇸Oklahoma City, Oklahoma, United States
Stephenson Cancer Center(clinic location)
🇺🇸Oklahoma City, Oklahoma, United States
Stephenson Cancer Center
🇺🇸Oklahoma City, Oklahoma, United States
University of Texas MD Anderson Cancer Center
🇺🇸Houston, Texas, United States
Aalborg Sygehus Apotek
🇩🇰Aalborg, North Jutland, Denmark
Aalborg University Hospital
🇩🇰Aalborg, North Jutland, Denmark
Region Hovedstadens Apotek
🇩🇰Kobenhavn o, Denmark
Herlev Hospital Onkologisk AFD
🇩🇰Herlev, Denmark
Ospedale Santa Maria delle Croci - Oculistica
🇮🇹Ravenna, Italy
Dipartimento Organi di Senso
🇮🇹Roma, Italy
Jewish General Hospital
🇨🇦Montreal, Quebec, Canada
The Christie NHS Foundation Trust
🇬🇧Manchester, United Kingdom
University of Virginia
🇺🇸Charlottesville, Virginia, United States
Keck Hospital of USC
🇺🇸Los Angeles, California, United States
Oncology Research Associates, PLLC d/b/a Pinnacle Oncology Hematology
🇺🇸Scottsdale, Arizona, United States
USC Healthcare Consultation Center 2
🇺🇸Los Angeles, California, United States
USC/Norris Comprehensive Cancer Center
🇺🇸Los Angeles, California, United States
Admin.Office/Study Supplies Mailing Address: UCLA Medicine Hematology-Oncology
🇺🇸Los Angeles, California, United States
University of California, Irvine/UC Irvine Health
🇺🇸Orange, California, United States
University of California Los Angeles, Hematology-Oncology Clinic
🇺🇸Los Angeles, California, United States
Eye Physicians of Central Florida
🇺🇸Maitland, Florida, United States
St. Vincent Gynecology Oncology
🇺🇸Indianapolis, Indiana, United States
Massachusetts General Hospital
🇺🇸Boston, Massachusetts, United States
Center For Clinical Studies
🇺🇸Saint Louis, Missouri, United States
Eye Associates of New Mexico
🇺🇸Albuquerque, New Mexico, United States
Montefiore Medical Center - Einstein Center for Cancer Care
🇺🇸Bronx, New York, United States
Montefiore Medical Center, Green Medical Arts Pavilion
🇺🇸Bronx, New York, United States
Cleveland Clinic-Main Campus
🇺🇸Cleveland, Ohio, United States
Stefanie Spielman Comprehensive Breast Cancer
🇺🇸Columbus, Ohio, United States
Hillcrest Hospital
🇺🇸Mayfield Heights, Ohio, United States
Fox Chase Cancer Center
🇺🇸Philadelphia, Pennsylvania, United States
Magee-Womens Hospital of UPMC
🇺🇸Pittsburgh, Pennsylvania, United States
UT Southwestern Medical Center
🇺🇸Dallas, Texas, United States
Adelaide Cardiology
🇦🇺Adelaide, South Australia, Australia
Sydney Adventist Hospital
🇦🇺Wahroonga, New South Wales, Australia
Westmead Hospital
🇦🇺Westmead, New South Wales, Australia
Centre Hospitalier de l'ardenne
🇧🇪Libramont, Luxembourg, Belgium
Private practice Ophthalmology
🇧🇪Libramont, Luxembourg, Belgium
University Hospital Leuven
🇧🇪Leuven, Vlaams-brabant, Belgium
Cliniques Universitaires Saint-Luc
🇧🇪Brussels, Belgium
University Hospital Gent
🇧🇪Gent, Belgium
Tom Baker Cancer Centre
🇨🇦Calgary, Alberta, Canada
CHR de la Citadelle
🇧🇪Liege, Belgium
Clinique et Maternite Sainte-Elisabeth Namur
🇧🇪Namur, Belgium
British Columbia Cancer Agency - Vancouver Centre
🇨🇦Vancouver, British Columbia, Canada
CancerCare Manitoba
🇨🇦Winnipeg, Manitoba, Canada
Princess Margaret Cancer Centre
🇨🇦Toronto, Ontario, Canada
Juravinski Cancer Center, Department of Oncology
🇨🇦Hamilton, Ontario, Canada
Centre Hospitalier de l'Universite de Montreal (Chum) - Hopital Notre-Dame
🇨🇦Montreal, Quebec, Canada
Teaching Hospital Hradec Kralove
🇨🇿Hradec Kralove, Czechia
Fakultni Nemocnice Ostrava
🇨🇿Ostrava - Poruba, Czechia
General University Hospital in Prague
🇨🇿Prague, Czechia
Rigshospitalet
🇩🇰Kobenhavn o, Denmark
Ojenklinikken 2061
🇩🇰København Ø, Denmark
Radiologisk Afdeling 2023
🇩🇰København Ø, Denmark
Centre Oscar Lambret
🇫🇷Lille, France
Hopital Edouard Herriot
🇫🇷Lyon, France
Institut de Cancerologie de I'Ouest - Rene Gauducheau
🇫🇷Saint-Herblain Cedex, France
Universitätsklinikum Bonn
🇩🇪Bonn, North-rhine Westphalia, Germany
Euromedic Diagnostics Magyarorszag Kft.
🇭🇺Gyor, Gyor-moson-sopron, Hungary
Magyar Honvedseg Egeszsegugyi Kozpont, Onkologiai Osztaly
🇭🇺Budapest, Hungary
Hospital Clinic Barcelona
🇪🇸Barcelona, Spain
Istituto Nazionale Tumori di Napoli, "G.Pascale" , Oncologia Medica, Dipartimento Uro-Ginecologico
🇮🇹Napoli, Italy
Universita degli Studi Federico II di Napoli Oncologia Medica
🇮🇹Napoli, Italy
Ospedale Santa Maria delle Croci - Unita Operativa di Oncologia
🇮🇹Ravenna, Italy
Dipartimento di Scienze Chirurgiche per le Patologie della Testa e del Collo - UOC di Oculistica
🇮🇹Roma, Italy
Hospital de Sant Joan Despi Moises Broggi
🇪🇸Barcelona, Spain
Cardiology at Consulta de Cardiologia
🇪🇸Cordoba, Spain
Radiology at Hospital Univeristari de Bellvitge
🇪🇸L'Hospitalet de Llobregat, Spain
Hospital Universitario 12 de Octubre
🇪🇸Madrid, Spain
Fundacion IVO-Instituto Valenciano de Oncologia
🇪🇸Valencia, Spain
Nottingham University Hospitals NHS Trust
🇬🇧Nottingham, Nottinghamshire, United Kingdom
The Royal Marsden NHS Foundation Trust
🇬🇧Sutton, Surrey, United Kingdom
Barnes-Jewish Hospital
🇺🇸Saint Louis, Missouri, United States
Ophthalmology at Hospital Universitari i Politecnic La Fe de Valencia
🇪🇸Valencia, Spain
USC Norris Comprehensive Cancer Center
🇺🇸Los Angeles, California, United States
Gynecologic Oncology Associates
🇺🇸Newport Beach, California, United States
Universitätsfrauenklinik Ulm
🇩🇪Ulm, Baden-wurttemberg, Germany
University of Colorado Cancer Center
🇺🇸Aurora, Colorado, United States
University of Colorado Denver, University of Colorado Cancer Center
🇺🇸Aurora, Colorado, United States
Smilow Cancer Hospital at Yale-New Haven
🇺🇸New Haven, Connecticut, United States
Florida Hospital
🇺🇸Orlando, Florida, United States
Florida Hospital Cancer Institute
🇺🇸Orlando, Florida, United States
Eye Physicians of Central
🇺🇸Orlando, Florida, United States
H. Lee Moffitt Cancer Center and Research Institute
🇺🇸Tampa, Florida, United States
Billings Clinic
🇺🇸Billings, Montana, United States
Klinikum rechts der Isar
🇩🇪Munich, Bavaria, Germany
Tampere University Hospital
🇫🇮Tampere, Finland
Centro di Riferimento Oncologico - Struttura Operativa Complessa (SOC)- Oncologia Medica C
🇮🇹Aviano, Pordenone, Italy
Orszagos Onkologiai Intezet, Nogyogyaszati Osztaly
🇭🇺Budapest, Hungary
Ospedale Civile degli Infermi - Unita Operativa di Oncologia Medica
🇮🇹Faenza, Ravenna, Italy
Universitätsklinikum Schleswig-Holstein
🇩🇪Kiel, Schleswig-holstein, Germany
Orszagos Onkologiai Intezet Kozponti Aneszteziologiai es Intenzivterapias Osztaly
🇭🇺Budapest, Hungary
St James's Hospital
🇮🇪Dublin, Dublin 8, Ireland
Centralny Szpital Kliniczny MON
🇵🇱Warsaw, Poland
Magyar Honvedseg Egeszsegugyi Kozpont
🇭🇺Budapest, Hungary
Aleris
🇳🇴Oslo, Norway
Ospedale Civile degli Infermi - Servizio di Oculistica
🇮🇹Faenza, Ravenna, Italy
Ospedale Umberto I - Unita Operativa di Oncologia
🇮🇹Lugo, Ravenna, Italy
The Harley Street Clinic
🇬🇧London, United Kingdom
Montefiore Medical Center
🇺🇸Bronx, New York, United States
University of Nottingham
🇬🇧Nottingham, Nottinghamshire, United Kingdom