A Study of Trastuzumab Emtansine Versus Trastuzumab as Adjuvant Therapy in Patients With HER2-Positive Breast Cancer Who Have Residual Tumor in the Breast or Axillary Lymph Nodes Following Preoperative Therapy (KATHERINE)
- Registration Number
- NCT01772472
- Lead Sponsor
- Hoffmann-La Roche
- Brief Summary
This 2-arm, randomized, open-label study will evaluate the efficacy and safety of trastuzumab emtansine versus trastuzumab as adjuvant therapy in patients with HER2-positive breast cancer who have residual tumor present in the breast or axillary lymph nodes following preoperative therapy. Eligible patients will be randomized to receive either trastuzumab emtansine 3.6 mg/kg or trastuzumab 6 mg/kg intravenously every 3 weeks for 14 cycles. Radiotherapy and/or hormone therapy will be given in addition if indicated.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 1487
- Adult patient, >/= 18 years of age
- HER2-positive breast cancer
- Histologically confirmed invasive breast carcinoma
- Clinical stage T1-4/N0-3/M0 at presentation (patients with T1a/bN0 tumors will not be eligible)
- Completion of preoperative systemic chemotherapy and HER2-directed treatment consisting of at least 6 cycles of chemotherapy with a total duration of at least 16 weeks, including at least 9 weeks of trastuzumab and at least 9 weeks of taxane-based therapy
- Adequate excision: surgical removal of all clinically evident disease in the breast and lymph nodes as specified in protocol
- Pathological evidence of residual invasive carcinoma in the breast or axillary lymph nodes following completion of preoperative therapy
- An interval of no more than 12 weeks between the date of surgery and the date of randomization
- Known hormone-receptor status
- Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1
- Adequate hematologic, renal and liver function
- Screening Left ventricular ejection fraction (LVEF) >/= 50% on echocardiogram (ECHO) or multiple-gated acquisition (MUGA) after receiving neoadjuvant chemotherapy and no decrease in LVEF by more than 15% absolute points from the pre-chemotherapy LVEF. Or, if pre-chemotherapy LVEF was not assessed, the screening LVEF must be >/= 55% after completion of neoadjuvant chemotherapy.
- For women who are not postmenopausal or surgically sterile: agreement to remain abstinent or use single or combined contraceptive methods that result in a failure rate of < 1% per year during the treatment period and for at least 7 months after the last dose of study drug
- Documentation of hepatitis B virus and hepatitis C virus serology is required
- Stage IV (metastatic) breast cancer
- History of any prior (ipsi- or contralateral breast cancer except lobular carcinoma in situ
- Evidence of clinically evident gross residual or recurrent disease following preoperative therapy and surgery
- Progressive disease during preoperative systemic therapy
- Treatment with any anti-cancer investigational drug within 28 days prior to commencing study treatment
- History of other malignancy within the last 5 years except for appropriately treated carcinoma in situ of the cervix, non-melanoma skin carcinoma, Stage I uterine cancer, or other non-breast malignancies with a similar outcome to those mentioned above
- Patients for whom radiotherapy would be recommended for breast cancer treatment but for whom it is contraindicated because of medical reasons
- Current NCI CTCAE (Version 4.0) Grade >/= 2 peripheral neuropathy
- History of exposure to the following cumulative doses of anthracyclines: Doxorubicin > 240 mg/m2; Epirubicin or Liposomal Doxorubicin-Hydrochloride (Myocet®) > 480 mg/m2; For other anthracyclines, exposure equivalent to doxorubicin > 240 mg/m2
- Cardiopulmonary dysfunction as defined by protocol
- Prior treatment with trastuzumab emtansine
- Current severe, uncontrolled systemic disease
- Pregnant or lactating women
- Any known active liver disease, e.g. due to HBV, HCV, autoimmune hepatic disorders, or sclerosing cholangitis
- Concurrent serious uncontrolled infections requiring treatment or known infection with HIV
- History of intolerance, including Grade 3 to 4 infusion reaction or hypersensitivity to trastuzumab or murine proteins or any components of the product
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Trastuzumab trastuzumab - Trastuzumab emtansine trastuzumab emtansine -
- Primary Outcome Measures
Name Time Method Invasive Disease-free Survival (IDFS) From randomization to data cut-off date of 25 July 2018 (approximately up to 64 months) IDFS event was defined as the first occurrence of one of the following events: Ipsilateral invasive breast tumor recurrence (i.e., an invasive breast cancer involving the same breast parenchyma as the original primary lesion); ipsilateral local-regional invasive breast cancer recurrence (i.e., an invasive breast cancer in the axilla, regional lymph nodes, chest wall, and/or skin of the ipsilateral breast); distant recurrence (i.e., evidence of breast cancer in any anatomic site - other than the two above mentioned sites); death attributable to any cause; contralateral invasive breast cancer. 3-year IDFS event-free rate per randomized treatment arms in the ITT population were estimated using the Kaplan-Meier method and estimated the probability of a patient being event-free after 3 years after randomization.
- Secondary Outcome Measures
Name Time Method Invasive Disease-free Survival Including Second Primary Non-breast Cancer From baseline up to 12 years IDFS including second primary non-breast cancer was defined the same way as IDFS for the primary endpoint but including second primary non breast invasive cancer as an event (with the exception of non-melanoma skin cancers and carcinoma in situ (CIS) of any site). 3-year IDFS including second primary non-breast cancer event-free rates per treatment arm in the ITT population were estimated using the Kaplan-Meier method and estimated the probability of a patient being event-free after 3 years after randomization.
Disease-free Survival From baseline up to 12 years Disease-free survival was defined as the time between randomization and the date of the first occurrence of an invasive disease-free survival event including second primary non-breast cancer event or contralateral or ipsilateral DCIS. 3-year DFS event-free rates per randomized treatment arms in the ITT population were estimated using the Kaplan-Meier method and estimated the probability of a patient being event-free after 3 years after randomization.
Overall Survival (OS) Baseline up to 12 years Overall survival in the overall study population was defined as the time from the date of randomization to the date of death from any cause. 5 years OS event-free rate per randomized treatment arms in the ITT population were estimated using the Kaplan-Meier method and estimated the probability of a patient being event-free after 5 years after treatment.
Distant Recurrence-Free Interval (DRFI) Baseline up to 12 years DRFI was defined as the time between randomization and the date of distant breast cancer recurrence. 3 years DRFI event-free rate per randomized treatment arms in the ITT population were estimated using the Kaplan-Meier method and estimated the probability of a patient being event-free after 3 years after treatment.
Percentage of Participants With Adverse Events From Day 1 to 30 days after last dose of study drug, up to the clinical cutoff date (approximately 64 months) An adverse event is any untoward medical occurrence in a participant administered a pharmaceutical product and which does not necessarily have to have a causal relationship with the treatment. An adverse event can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding, for example), symptom, or disease temporally associated with the use of a pharmaceutical product, whether or not considered related to the pharmaceutical product. Preexisting conditions which worsen during a study are also considered as adverse events. AEs, including AEs of Special Interest and AEs of Particular Interest, were reported based on the national cancer institute common terminology criteria for AEs, Version 4.0 (NCI-CTCAE, v4.0). Reported are the number of subjects with AEs, Grade 3-5 AEs, and Serious Adverse Events (SAEs).
Percentage of Participants With Cardiac Dysfunction From baseline up to 12 years Cardiac events were reported based on the NCI-CTCAE, v4.0.
Change From Baseline of Functional Scales, Symptom Scales and Single Items in European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire - Core 30 (QLQ-C30) Baseline, Cycle 5, 11, Follow-up (FU) Month 6, Follow-up Month 12 The EORTC QLQ-C30 included global health status, functional scales (physical, role, emotional, cognitive, and social), symptom scales (fatigue, nausea/vomiting, and pain) and single items (dyspnoea, insomnia, appetite loss, constipation, diarrhea, and financial difficulties). Most questions used a 4-point scale (1 'Not at all' to 4 'Very much'; 2 questions used 7-point scale \[1 'very poor' to 7 'Excellent'\]). Scores were averaged and transformed to 0 - 100 scale, whereby higher scores indicate greater functioning, greater quality of life, or a greater degree of symptoms, with changes of 5 - 10 points considered to be a minimally important difference to participants. A positive value means an increase, while a negative value means a decrease, in score at the indicated time-point relative to the score at baseline (Cycle 1, Day 1).
Change From Baseline of Four Functioning Scales and Four Symptom Scales in European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire - Breast Cancer (QLQ-BR23) Baseline, Cycle 5, 11, Follow-up Month 6, Follow-up Month 12 EORTC-QLQ-BR23 is a 23-item breast cancer-specific companion module to the EORTC-QLQ-C30 and consists of four functional scales (body image, sexual enjoyment, sexual functioning, future perspective \[FP\]) and four symptom scales (systemic side effects \[SE\], upset by hair loss, arm symptoms, breast symptoms). Questions used 4-point scale (1=not at all, 2=a little, 3=quite a bit, 4=very much). Scores averaged and transformed to 0-100 scale. High score for functional scale indicated high/better level of functioning/healthy functioning. Higher scores for symptom scales represent higher levels of symptoms/problems. For functional scales, positive change from baseline indicated deterioration in quality of life (QOL) and negative change from baseline indicated an improvement in QOL. For symptom scales, positive change from baseline indicated an improvement in quality of life (QOL) and negative change from baseline indicated a deterioration in QOL.
Serum Concentrations (Area Under the Concentration-time Curve [AUC]) of Trastuzumab Emtansine (Including Total Trastuzumab and DM1) Cycle (C) 1, Day (D) 1 and C4D1 of pre-infusion, C1D1 and C4D1 post-infusion, C2D1 and C5D1 pre-infusion and study treatment termination Blood and serum samples for measurement of trastuzumab emtansine, total trastuzumab, and DM1 will be obtained from patients randomized to the trastuzumab emtansine arm.
Serum Concentrations (AUC) of Trastuzumab C1D1 and C4D1 of post-infusion and study treatment termination Serum blood samples were collected for trastuzumab measurement prior to dosing and 15-30 minutes post infusion for Cycle 1 and Cycle 4. Additional serum samples were collected at study treatment termination.
Plasma Concentrations of DM1 Day 1 on Cycles 1 and 4. Each cycle is 21 days. Trastuzumab Emtansine Exposure Day 1 on Cycles 1, 2, 4 and 5, at study treatment termination and 3-4 months after last dose of trastuzumab emtansine. Each cycle is 21 days. Anti-trastuzumab Emtansine Antibody (ATA) Day 1 on Cycles 1, and 4, at study treatment termination and 3-4 months after last dose of trastuzumab emtansine. Each cycle is 21 days. Anti-trastuzumab Antibody (ATA) Day 1 on Cycles 1, and 4, at study treatment termination and 3-4 months after last dose of trastuzumab emtansine. Each cycle is 21 days.
Trial Locations
- Locations (293)
Kaiser Permanente - Vallejo
🇺🇸Vallejo, California, United States
The Cleveland Clinic Foundation
🇺🇸Cleveland, Ohio, United States
Kaiser Permanente - San Diego
🇺🇸San Diego, California, United States
Policlinico Universitario Campus Biomedico; Uoc Oncologia Medica
🇮🇹Roma, Lazio, Italy
Taichung Veterans General Hospital; Dept of Surgery
🇨🇳Taichung, Taiwan
Rocky Mountain Cancer Centers - Colorado Springs (Circle)
🇺🇸Lone Tree, Colorado, United States
New England Cancer Specialists
🇺🇸Scarborough, Maine, United States
Sint Augustinus Wilrijk
🇧🇪Wilrijk, Belgium
Cliniques Universitaires St-Luc
🇧🇪Bruxelles, Belgium
Instituto Nacional de Cancer - INCa; Oncologia
🇧🇷Rio de Janeiro, RJ, Brazil
Hospital de Cancer de Barretos
🇧🇷Barretos, São Paulo, Brazil
Tom Baker Cancer Centre; Dept of Medicine
🇨🇦Calgary, Alberta, Canada
BC Cancer ? Surrey
🇨🇦Surrey, British Columbia, Canada
Guangdong General Hospital
🇨🇳Guangzhou, China
The Ottawa Hospital; Division of Infectious Diseases
🇨🇦Ottawa, Ontario, Canada
London Regional Cancer Centre
🇨🇦London, Ontario, Canada
CSSS champlain - Charles-Le Moyne
🇨🇦Greenfield Park, Quebec, Canada
Princess Margaret Cancer Center
🇨🇦Toronto, Ontario, Canada
Hopital du Saint Sacrement
🇨🇦Quebec City, Quebec, Canada
Harbin Medical University Cancer Hospital
🇨🇳Harbin, China
Sun Yet-sen University Cancer Center
🇨🇳Guangzhou, China
Shandong Cancer Hospital
🇨🇳Jinan, China
Clinica del Country
🇨🇴Bogota, Colombia
Fudan University Shanghai Cancer Center
🇨🇳Shanghai City, China
Fakultni Nemocnice Hradec Kralove; Dept of Radiotherapy & Oncology
🇨🇿Hradec Kralove, Czechia
Institut Sainte Catherine;Recherche Clinique
🇫🇷Avignon, France
HOPITAL JEAN MINJOZ; Oncologie
🇫🇷Besancon, France
Centre Hospitalier Fleyriat; Oncologie/Hematologie
🇫🇷Bourg En Bresse, France
Centre de Cancerologie de la Sarthe, Clinique Victor Hugo SoReCOH
🇫🇷Le Mans, France
Centre Francois Baclesse; Comite Sein
🇫🇷Caen, France
Institut Bergonie; Oncologie
🇫🇷Bordeaux, France
Centre Jean Perrin; Oncologie
🇫🇷Clermont Ferrand, France
Institut Paoli Calmettes; Oncologie Medicale
🇫🇷Marseille, France
Institut Curie; Oncologie Medicale
🇫🇷Paris, France
Hopital Saint Louis; Oncologie Medicale
🇫🇷Paris, France
HOPITAL TENON; Cancerologie Medicale
🇫🇷Paris, France
Centre Rene Huguenin; CONSULT SPECIALISEES
🇫🇷St Cloud, France
HELIOS Klinikum Berlin-Buch; Klinik für Gynäkologie und Geburtshilfe
🇩🇪Berlin, Germany
St. Johannes-Hospital
🇩🇪Dortmund, Germany
Klinikum Sindelfingen-Böblingen; Frauenklinik
🇩🇪Böblingen, Germany
Klinikum Essen-Mitte Ev. Huyssens-Stiftung / Knappschafts GmbH; Klinik für Senologie / Brustzentrum
🇩🇪Essen, Germany
Klinik Johann Wolfgang von Goethe Uni; Klinik für Frauenheilkunde und Geburtshilfe
🇩🇪Frankfurt, Germany
Universitätsklinikum Greifswald; Klinik für Frauenheilkunde und Brustzentrum
🇩🇪Greifswald, Germany
MVZ Onko Medical GmbH Hannover, Ralf Lohse (Geschäftsführer)
🇩🇪Hannover, Germany
St. Barbara-Klinik Hamm-Heessen GmbH; Frauenklinik
🇩🇪Hamm, Germany
Medizinische Hochschule Hannover, Klinik für Frauenheilkunde und Geburtshilfe
🇩🇪Hannover, Germany
St. Elisabeth Krankenhaus Köln GmbH; Gynäkologie und Geburtshilfe
🇩🇪Koeln, Germany
Klinikum der Universität München; Frauenklinik - Onkologie II
🇩🇪München, Germany
Oncologianova GmbH - Gesellschaft für Innovationen in der Onkologie
🇩🇪Recklinghausen, Germany
St. Vincenz-Krankenhaus Paderborn; Haus 3 Frauenklinik
🇩🇪Paderborn, Germany
Sana Klinikum Offenbach GmbH; Klinik für Gynäkologie & Geburtshilfe
🇩🇪Offenbach, Germany
Universitätsfrauen- und Poliklinik am Klinikum Suedstadt
🇩🇪Rostock, Germany
Gynäkologie Kompetenzzentrum; Praxis Dr. med. Carsten Hielscher
🇩🇪Stralsund, Germany
Robert-Bosch-Krankenhaus; Brustzentrum
🇩🇪Stuttgart, Germany
Gemeinschaftspraxis Dr. Kronawitter und Dr. Jung
🇩🇪Traunstein, Germany
Univ General Hosp Heraklion; Medical Oncology
🇬🇷Heraklion, Greece
Centro Oncológico Sixtino / Centro Oncológico SA
🇬🇹Guatemala, Guatemala
St Vincent'S Uni Hospital; Medical Oncology
🇮🇪Dublin, Ireland
Shaare Zedek Medical Center; Oncology Dept
🇮🇱Jerusalem, Israel
University Hospital Limerick - Oncology
🇮🇪Limerick, Ireland
Soroka Medical Center
🇮🇱Beer Sheva, Israel
Sheba Medical Center; Tel Hashomer
🇮🇱Ramat Gan, Israel
Istituto Nazionale Tumori Fondazione G. Pascale
🇮🇹Napoli, Campania, Italy
Ausl Di Bologna-Ospedale Bellaria;U.O. Oncologia Medica
🇮🇹Bologna, Emilia-Romagna, Italy
Università degli Studi Federico II; Clinica di Oncologia Medica
🇮🇹Napoli, Campania, Italy
Policlinico S.Orsola-Malpighi; Istituto Oncologia R. Addarii
🇮🇹Bologna, Emilia-Romagna, Italy
Az. Osp. Sant'Andrea; Oncologia Medica
🇮🇹Roma, Lazio, Italy
ASST DI CREMONA; Unità di Patologia Mammaria Senologia e Breast Unit
🇮🇹Cremona, Lombardia, Italy
Asst Papa Giovanni XXIII; Oncologia Medica
🇮🇹Bergamo, Lombardia, Italy
Irccs Ospedale San Raffaele;Oncologia Medica
🇮🇹Milano, Lombardia, Italy
Irccs Istituto Nazionale Dei Tumori (Int);S.C. Medicina Oncologica 1
🇮🇹Milano, Lombardia, Italy
Istituto Europeo Di Oncologia
🇮🇹Milano, Lombardia, Italy
ASST DI MONZA; Oncologia Medica
🇮🇹Monza, Lombardia, Italy
Azienda usl 5 Di Pisa-Ospedale Di Pontedera;U.O. Oncologia
🇮🇹Pontedera, Toscana, Italy
Ospedale Antonio Perrino; Oncologia Medica
🇮🇹Brindisi, Puglia, Italy
A.O.U.I. VERONA-OSPEDALE BORGO TRENTO; ONCOLODIA MEDICA-d.O.
🇮🇹Verona, Veneto, Italy
Fondazione Del Piemonte Per L'oncologia IRCC Di Candiolo
🇮🇹Candiolo, Piemonte, Italy
Hospital Angeles Metropolitano; Room 220
🇲🇽Mexico City, Mexico CITY (federal District), Mexico
Oaxaca Site Management Organization
🇲🇽Oaxaca de Juárez, Oaxaca, Mexico
The Panama Clinic
🇵🇦Panama, Panama
Hospital IV Alberto Sabogal Sologuren; Unidad de Investigacion
🇵🇪Bellavista, Peru
Centro Medico Monte Carmelo
🇵🇪Arequipa, Peru
Clinica San Borja
🇵🇪Lima, Peru
Hospital Nacional Guillermo Almenara Irigoyen; Oncology
🇵🇪Lima, Peru
Institute for Oncology and Radiology of Serbia; Clinic for Medical Oncology
🇷🇸Belgrade, Serbia
Hopelands Cancer Centre
🇿🇦Hilton, South Africa
Medical Oncology Centre of Rosebank; Oncology
🇿🇦Johannesburg, South Africa
Cancercare
🇿🇦Port Elizabeth, South Africa
Private Oncology Centre
🇿🇦Pretoria, South Africa
Hospital de Donostia; Servicio de Oncologia Medica
🇪🇸San Sebastian, Guipuzcoa, Spain
Hospital Clínic i Provincial; Servicio de Oncología
🇪🇸Barcelona, Spain
Hospital Universitari Sant Joan de Reus; Servicio de Oncologia
🇪🇸Reus, Tarragona, Spain
Hospital Universitario La Paz; Servicio de Oncologia
🇪🇸Madrid, Spain
HOSPITAL DE MADRID NORTE SANCHINARRO- CENTRO INTEGRAL ONCOLOGICO CLARA CAMPAL; Servicio de Oncologia
🇪🇸Madrid, Spain
Hospital Clinico Universitario de Salamanca; Servicio de Oncologia
🇪🇸Salamanca, Spain
Skånes University Hospital, Skånes Department of Onclology
🇸🇪Lund, Sweden
Hospital Universitario Dr. Peset; Servicio de Oncologia
🇪🇸Valencia, Spain
Instituto Valenciano Oncologia; Oncologia Medica
🇪🇸Valencia, Spain
Brust-Zentrum Zürich AG Seefeldstrasse 214 Zürich
🇨🇭Zürich, Switzerland
Karolinska Hospital; Oncology - Radiumhemmet
🇸🇪Stockholm, Sweden
VETERANS GENERAL HOSPITAL; Department of General Surgery
🇨🇳Taipei, Taiwan
Koo Foundation Sun Yat-Sen Cancer Center; Hemato-Oncology
🇨🇳Taipei City, Taiwan
Uludag Uni Hospital; Oncology
🇹🇷Bursa, Turkey
Trakya University Medical Faculty Research And Practice Hospital Medical Oncology Department
🇹🇷Edirne, Turkey
Inonu University Medical Faculty Turgut Ozal Medical Center Medical Oncology Department
🇹🇷Malatya, Turkey
Ege Uni Medical Faculty Hospital; Oncology Dept
🇹🇷Izmir, Turkey
Bristol Haematology and Oncology centre
🇬🇧Bristol, United Kingdom
Royal Cornwall Hospital; Dept of Clinical Oncology
🇬🇧Cornwall, United Kingdom
Castle Hill Hospital; The Queens Centre for Oncology and Haematology
🇬🇧Cottingham, United Kingdom
North Devon District Hospital
🇬🇧Devon, United Kingdom
Ninewells Hospital; Cancer Medicine
🇬🇧Dundee, United Kingdom
Huddersfield Royal Infirmary
🇬🇧Huddersfield, United Kingdom
St Thomas Hospital; Medicine Div.
🇬🇧London, United Kingdom
Charing Cross Hospital; Medical Oncology.
🇬🇧London, United Kingdom
Nottingham City Hospital; Oncology
🇬🇧Nottingham, United Kingdom
Christie Hospital Nhs Trust; Medical Oncology
🇬🇧Manchester, United Kingdom
Hartford Hospital
🇺🇸Hartford, Connecticut, United States
Providence Alaska Medical Center
🇺🇸Anchorage, Alaska, United States
Todd Cancer Institute at Long Beach Memorial Medical Center
🇺🇸Long Beach, California, United States
Chao Family Comprehensive Cancer Center; UC Irvine Medical Center
🇺🇸Orange, California, United States
Stanford University Medical Center
🇺🇸Palo Alto, California, United States
Breastlink Medical Group Inc
🇺🇸Santa Ana, California, United States
Washington Cancer Institute; Washington Hospital Center
🇺🇸Washington, District of Columbia, United States
Rush University Medical Center
🇺🇸Chicago, Illinois, United States
Edward Cancer Center Naperville
🇺🇸Naperville, Illinois, United States
Edward Cancer Center Plainfield
🇺🇸Plainfield, Illinois, United States
Cancer Care of Maine
🇺🇸Brewer, Maine, United States
Mercy Medical Center; Medical Oncology & Hematology
🇺🇸Baltimore, Maryland, United States
Greater Baltimore Medical Center
🇺🇸Baltimore, Maryland, United States
Karmanos Cancer Institute
🇺🇸Detroit, Michigan, United States
Med Star Franklin Square Medical Center/Weinburg Cancer Institute
🇺🇸Baltimore, Maryland, United States
Spectrum Health Hospitals
🇺🇸Grand Rapids, Michigan, United States
Breslin Cancer Center
🇺🇸Lansing, Michigan, United States
Henry Ford Health System
🇺🇸Detroit, Michigan, United States
William Beaumont Hospital
🇺🇸Royal Oak, Michigan, United States
Sparta Cancer Center
🇺🇸Sparta, New Jersey, United States
Carolinas Medical Center
🇺🇸Charlotte, North Carolina, United States
Troy Cancer Treatment Program
🇺🇸Troy, New York, United States
Batte Cancer Center - Carolinas Medical Center
🇺🇸Concord, North Carolina, United States
Aultman Hospital; Aultman Hospital Cancer Center
🇺🇸Canton, Ohio, United States
Fairview Hospital; Cleveland Clinic Cancer Center
🇺🇸Cleveland, Ohio, United States
Kimmel Cancer Center Thomas Jefferson University
🇺🇸Philadelphia, Pennsylvania, United States
Ohio State University, Arthur James Cancer Hospital
🇺🇸Columbus, Ohio, United States
Lake Health/University Hospitals - Mentor Campus
🇺🇸Mentor, Ohio, United States
Allegheny Cancer Center
🇺🇸Pittsburgh, Pennsylvania, United States
York Hospital
🇺🇸York, Pennsylvania, United States
Baylor College of Medicine
🇺🇸Houston, Texas, United States
Houston Methodist Hospital Outpatient Center
🇺🇸Houston, Texas, United States
Hematology Oncology Associates of Fredericksburg, Inc.
🇺🇸Fredericksburg, Virginia, United States
Uni of Texas - Md Anderson Cancer Center; Dept of Breast Medical Oncology
🇺🇸Houston, Texas, United States
Joe Arrington Cancer Research & Treatment Center
🇺🇸Lubbock, Texas, United States
Lynchburg Hem Onc Clinic Inc
🇺🇸Lynchburg, Virginia, United States
Swedish Cancer Institute - Issaquah
🇺🇸Issaquah, Washington, United States
PeaceHealth St. John Medical Center - Lower Columbia Cancer Center
🇺🇸Longview, Washington, United States
Marshfield Clinic
🇺🇸Marshfield, Wisconsin, United States
Centro Oncologico Riojano Integral (CORI)
🇦🇷La Rioja, Argentina
Fundación CENIT para la Investigación en Neurociencias
🇦🇷Buenos Aires, Argentina
Tiroler Landeskrankenanstalten Ges.M.B.H.; Abt. Für Gynäkologie
🇦🇹Innsbruck, Austria
Medizinische Universität Wien; Univ.Klinik für Frauenheilkunde - Klinik für Gynäkologie
🇦🇹Wien, Austria
Lkh Salzburg - Univ. Klinikum Salzburg; Iii. Medizinische Abt.
🇦🇹Salzburg, Austria
Instituto de Oncología de Rosario
🇦🇷Rosario, Argentina
Medizinische Universität Wien; Univ.Klinik für Innere Medizin I - Abt. für Onkologie
🇦🇹Wien, Austria
AZ Sint Lucas (Sint Lucas)
🇧🇪Gent, Belgium
CHU Sart-Tilman
🇧🇪Liège, Belgium
Hospital Nossa Senhora da Conceicao
🇧🇷Porto Alegre, Rio Grande Do Sul, Brazil
Hospital Perola Byington
🇧🇷Sao Paulo, São Paulo, Brazil
British Columbia Cancer Agency (Bcca) - Vancouver Cancer Centre
🇨🇦Vancouver, British Columbia, Canada
Centre Hospitalier de l?Université de Montréal (CHUM)
🇨🇦Montreal, Quebec, Canada
Jewish General Hospital
🇨🇦Montreal, Quebec, Canada
McGill University Health Centre - Glen Site
🇨🇦Montreal, Quebec, Canada
the First Hospital of Jilin University
🇨🇳Changchun, China
Shanghai Jiao Tong University School of Medicine (SJTUSM) - Ruijin Hospital (GuangCi Hospital)
🇨🇳Shanghai, China
Oncomedica S.A.
🇨🇴Monteria, Colombia
Vseobecna fakultni nemocnice v Praze
🇨🇿Praha 2, Czechia
Fakultni nemocnice Olomouc; Onkologicka klinika
🇨🇿Olomouc, Czechia
Hospital Pablo Tobon Uribe
🇨🇴Medellin, Colombia
Centre Val Aurelle Paul Lamarque; Recherche Clinique
🇫🇷Montpellier, France
Centre Henri Becquerel; Oncologie Medicale
🇫🇷Rouen, France
Centre Paul Strauss; Oncologie Medicale
🇫🇷Strasbourg, France
Hämatologie Onkologie im Zentrum MVZ GmbH
🇩🇪Augsburg, Germany
Institut Gustave Roussy; Departement Oncologie Medicale
🇫🇷Villejuif, France
Praxisklinik Krebsheilkunde für Frauen / Brustzentrum (Dres. Kittel/Klare)
🇩🇪Berlin, Germany
Onkologische Schwerpunktpraxis Kurfürstendamm
🇩🇪Berlin, Germany
Studienzentrum Berlin City
🇩🇪Berlin, Germany
Onkologische Schwerpunktpraxis Bielefeld
🇩🇪Bielefeld, Germany
Luisenkrankenhaus GmbH & Co. KG., Brustzentrum
🇩🇪Düsseldorf, Germany
Universitätsklinikum Essen; Zentrum Für Frauenheilkunde
🇩🇪Essen, Germany
Universitätsklinikum Erlangen; Frauenklinik
🇩🇪Erlangen, Germany
Klinikum Esslingen; Klinik für Frauenheilkunde und Geburtshilfe
🇩🇪Esslingen, Germany
Hämatologisch-Onkologische Gemeinschaftspraxis am Bethanien-Krankenhaus
🇩🇪Frankfurt am Main, Germany
Evangelische Kliniken Gelsenkirchen GmbH; Brustzentrum
🇩🇪Gelsenkirchen, Germany
Universitätsklinikum Freiburg; Frauenklinik
🇩🇪Freiburg, Germany
Krankenhaus St. Elisabeth und St. Barbara, Klinik für Frauenheilkunde und Geburtshilfe
🇩🇪Halle, Germany
Kooperatives Mammazentrum Hamburg Krankenhaus Jerusalem
🇩🇪Hamburg, Germany
Diakovere Henriettenstift, Frauenklinik
🇩🇪Hannover, Germany
Nationales Centrum für Tumorerkrankungen (NCT) ; Gyn. Onk. Frauenklinik; Uniklinikum Heidelberg
🇩🇪Heidelberg, Germany
Elisabeth-Krankenhaus Brustzentrum
🇩🇪Kassel, Germany
Klinikum Kassel GmbH; Klinik für Frauenheilkunde und Geburtshilfe
🇩🇪Kassel, Germany
UNI-Klinikum Campus Kiel Klinik für Gynäkologie und Geburtshilfe
🇩🇪Kiel, Germany
Kliniken der Stadt Köln gGmbH Krankenhaus Holweide; Brustzentrum
🇩🇪Köln, Germany
Gemeinschaftspraxis für Hämatologie und Onkologie, PD Dr. Bauer, Dr. Thiel
🇩🇪Lebach, Germany
Medizinisches Zentrum für Hämatologie und Onkologie
🇩🇪München, Germany
MVZ Nordhausen gGmbH, Praxis Dr. Grafe
🇩🇪Nordhausen, Germany
Klinikum am Steinenberg Frauenklinik
🇩🇪Reutlingen, Germany
HELIOS Dr. Horst Schmidt Kliniken Wiesbaden; Klinik für Gynäkologie und gynäkologische Onkologie
🇩🇪Wiesbaden, Germany
Universitätsklinik Tübingen; Frauenklinik
🇩🇪Tübingen, Germany
Universitätsklinikum Ulm Am Michelsberg; Frauenklinik
🇩🇪Ulm, Germany
Marien-Hospital Witten; Frauenklinik Brustzentrum
🇩🇪Witten, Germany
Grupo Angeles
🇬🇹Guatemala City, Guatemala
Hämatologisch-Onkologische Schwerpunktpraxis Dres. Schlag & Schöttker
🇩🇪Würzburg, Germany
Cork Uni Hospital; Oncology Dept
🇮🇪Cork, Ireland
Galway Uni Hospital; Oncology Dept
🇮🇪Galway, Ireland
Hadassah University Hospital - Ein Kerem
🇮🇱Jerusalem, Israel
Kaplan Medical Center; Oncology Inst.
🇮🇱Rehovot, Israel
Rabin MC; Davidof Center - Oncology Institute
🇮🇱Petach Tikva, Israel
Azlenda Ospendaliero-Universitaria Pisana; C.O. Oncologia 2
🇮🇹Pisa, Toscana, Italy
IOV - Istituto Oncologico Veneto - IRCCS; Oncologia Medica II
🇮🇹Padova, Veneto, Italy
Médicos Especialistas en Cáncer SC
🇲🇽Aguascalientes, Mexico
Centro Oncologico America
🇵🇦Panama, Panama
Instituto Nacional de Cancerologia; Oncology
🇲🇽Mexico City, Mexico
Oncology Institute of Vojvodina
🇷🇸Sremska Kamenica, Serbia
Cape Town Oncology Trials
🇿🇦Cape Town, South Africa
Wits Donald Gordon Clinical Trial Centre; Medical Oncology
🇿🇦Johannesburg, South Africa
Complexo Hospitalario de Vigo. Hospital Álvaro Cunqueiro; Servicio de Oncología
🇪🇸Vigo, Pontevedra, Spain
Hospital Severo Ochoa; Servicio de Oncologia
🇪🇸Leganes, Madrid, Spain
Hospital Regional Universitario Carlos Haya; Servicio de Oncologia
🇪🇸Malaga, Spain
Gävle Sjukhus; Onkologiska Kliniken
🇸🇪Gävle, Sweden
Hospital Universitario Virgen del Rocio; Servicio de Oncologia
🇪🇸Sevilla, Spain
Hospital de Navarra; Servicio de Oncologia
🇪🇸Navarra, Spain
Kantonsspital Aarau AG Medizin Onkologie; ZENTRUM FÜR ONKOLOGIE, HÄMATOLOGIE & TRANSFUSIONSMEDIZIN
🇨🇭Aarau, Switzerland
National Taiwan Uni Hospital; General Surgery
🇨🇳Taipei, Taiwan
Kartal Dr Lutfi Kirdar Sehir Hastanesi; Medical Oncology Department
🇹🇷Istanbul, Turkey
University Hospital Birmingham The Cancer Centre, Queen Elizabeth Hospital
🇬🇧Birmingham, United Kingdom
Bradford Royal Infirmary; Dept of Medical Oncology C/O Ward15
🇬🇧Bradford, United Kingdom
Weston Park Hospital
🇬🇧Sheffield, United Kingdom
Leeds Teaching Hosp NHS Trust;St James's Institute of Onc
🇬🇧Leeds, United Kingdom
US oncology research at Minnesota Oncology
🇺🇸Saint Louis Park, Minnesota, United States
Mount Sinai Medical Center
🇺🇸Miami Beach, Florida, United States
Uni of Pittsburgh; Magee-Women'S Hospital
🇺🇸Pittsburgh, Pennsylvania, United States
Avera Cancer Institute
🇺🇸Sioux Falls, South Dakota, United States
Sanford Roger Maris Cancer Center
🇺🇸Fargo, North Dakota, United States
Thompson Cancer Survival Center
🇺🇸Knoxville, Tennessee, United States
Cancer Care Northwest
🇺🇸Spokane, Washington, United States
Universitätsklinikum Halle (Saale); Universitätsklinik Und Poliklinik Für Gynäkologie
🇩🇪Halle, Germany
Mater Misericordiae Uni Hospital; Oncology
🇮🇪Dublin, Ireland
Euromedical General Clinic of Thessaloniki; Oncology Department
🇬🇷Thessaloniki, Greece
Beaumont Hospital; Cancer Clinical Trials Unit
🇮🇪Dublin, Ireland
Nstituto Nacional de Ciancias Medicas Y Nutricion, Salvador Zubir
🇲🇽Mexico City, Mexico CITY (federal District), Mexico
Hospital Nacional Carlos Alberto Seguin Escobedo-Essalud; Oncology & Haemathology
🇵🇪Arequipa, Peru
Chang Gung Medical Foundation - Linkou; Dept of Surgery
🇨🇳Taoyuan, Taiwan
IRCCS Istituto Nazionale Per La Ricerca Sul Cancro (IST); Oncologia Medica A
🇮🇹Genova, Liguria, Italy
Colorado Cancer Research Program/Admin
🇺🇸Denver, Colorado, United States
Kaiser Permanente - Franklin
🇺🇸Denver, Colorado, United States
Moffitt Cancer Center
🇺🇸Tampa, Florida, United States
UF Health Orlando
🇺🇸Orlando, Florida, United States
Columbia River Oncology Program
🇺🇸Portland, Oregon, United States
Medical University of South Carolina; Hollings Cancer Center
🇺🇸Charleston, South Carolina, United States
Norton Healthcare Inc.
🇺🇸Louisville, Kentucky, United States
Virginia Commonwealth University - Massey Cancer Center
🇺🇸Richmond, Virginia, United States
University of Florida; Davis Cancer Pavilion and Shands Medical Plaza
🇺🇸Gainesville, Florida, United States
University of Kentucky Medical Center
🇺🇸Lexington, Kentucky, United States
Cross Cancer Institute ; Dept of Medical Oncology
🇨🇦Edmonton, Alberta, Canada
Hospital Sao Jose
🇧🇷Sao Paulo, SP, Brazil
Columbia University Medical Center
🇺🇸New York, New York, United States
Rutgers Cancer Institute of New Jersey
🇺🇸New Brunswick, New Jersey, United States
Yale Cancer Center
🇺🇸New Haven, Connecticut, United States
Centra Alan B. Pearson Regional Cancer Center
🇺🇸Lynchburg, Virginia, United States
University of Iowa
🇺🇸Iowa City, Iowa, United States
Iop Instituto de Oncologia Do Parana
🇧🇷Curitiba, Paraná, Brazil
Clinicas Oncologicas Integradas - COI
🇧🇷Rio De Janeiro, Brazil
UPCO - Unidade de Pesquisas Clínicas em Oncologia
🇧🇷Pelotas, Rio Grande Do Sul, Brazil
Hospital Moinhos de Vento
🇧🇷Porto Alegre, Rio Grande Do Sul, Brazil
Instituto de Ensino e Pesquisa Sao Lucas - IEP
🇧🇷Sao Paulo, São Paulo, Brazil
Instituto do Cancer do Estado de Sao Paulo - ICESP
🇧🇷Sao Paulo, São Paulo, Brazil
Chao Family Comprehensive Cancer Center
🇺🇸Orange, California, United States
Washington Cancer Institute
🇺🇸Washington, District of Columbia, United States
University of Florida
🇺🇸Gainesville, Florida, United States
Mercy Medical Center
🇺🇸Baltimore, Maryland, United States
Aultman Hospital
🇺🇸Canton, Ohio, United States
Fairview Hospital
🇺🇸Cleveland, Ohio, United States
Uni of Pittsburgh
🇺🇸Pittsburgh, Pennsylvania, United States
Medical University of South Carolina
🇺🇸Charleston, South Carolina, United States
Uni of Texas - Md Anderson Cancer Center
🇺🇸Houston, Texas, United States
Tiroler Landeskrankenanstalten Ges.M.B.H.
🇦🇹Innsbruck, Austria
Lkh Salzburg - Univ. Klinikum Salzburg
🇦🇹Salzburg, Austria
Medizinische Universität Wien
🇦🇹Wien, Austria
Instituto Nacional de Cancer - INCa
🇧🇷Rio de Janeiro, Brazil
Arthur J.E. Child Comprehensive Cancer Center
🇨🇦Calgary, Alberta, Canada
Cross Cancer Institute
🇨🇦Edmonton, Alberta, Canada
The Ottawa Hospital
🇨🇦Ottawa, Ontario, Canada
Queen Mary Hospital; Surgery
🇭🇰Hong Kong, Hong Kong
Tuen Mun Hospital; Clinical Oncology
🇭🇰Hong Kong, Hong Kong
Pamela Youde Nethersole Eastern Hospital; Clinical Oncology
🇭🇰Hong Kong, Hong Kong