MedPath

A Study to Evaluate the Efficacy and Safety of Pemigatinib Versus Chemotherapy in Unresectable or Metastatic Cholangiocarcinoma

Phase 3
Active, not recruiting
Conditions
Unresectable Cholangiocarcinoma
Metastatic Cholangiocarcinoma
Interventions
Registration Number
NCT03656536
Lead Sponsor
Incyte Corporation
Brief Summary

The purpose of this study is to evaluate the efficacy and safety of pemigatinib versus gemcitabine plus cisplatin chemotherapy in first-line treatment of participants with unresectable or metastatic cholangiocarcinoma with FGFR2 rearrangement.

Detailed Description

Not available

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
167
Inclusion Criteria
  • Male and female participants at least 18 years of age at the time of signing the informed consent form (ICF).
  • Histologically or cytologically confirmed cholangiocarcinoma that is previously untreated and considered unresectable and/or metastatic (Stage IV per the American Joint Committee on Cancer (AJCC) Cancer Staging Manual).
  • Radiographically measurable or evaluable disease by CT or MRI per RECIST v1.1 criteria.
  • Eastern Cooperative Oncology Group performance status 0 to 1.
  • Documented FGFR2 rearrangement.
  • Willingness to avoid pregnancy or fathering children.
Exclusion Criteria
  • Received prior anticancer systemic therapy for unresectable and/or metastatic disease (not including adjuvant/neo-adjuvant treatment completed at least 6 months prior to enrollment, and participants that have received treatment for locally advanced disease with trans-arterial chemoembolization or selective internal radiation therapy, if clear evidence of radiological progression is observed before enrollment, or enrolled as of Amendment 6 (or Amendment 5-JP2) and the participant received 1 cycle of gemcitabine plus cisplatin [the start of study drug {Cycle 1 Day 1} must be at least 14 days and ≤ 4 weeks {28 days} from the last dose of gemcitabine plus cisplatin]).
  • Child-Pugh B and C.
  • Toxicities related to prior therapy(ies) must be Common Terminology Criteria for Adverse Events (CTCAE) v5.0 ≤ Grade 1 at the time of screening.
  • Concurrent anticancer therapy, other than the therapies being tested in this study.
  • Participant is a candidate for potentially curative surgery.
  • Current evidence of clinically significant corneal (including but not limited to bullous/band keratopathy, corneal abrasion, inflammation/ulceration, and keratoconjunctivitis) or retinal disorder (including but not limited to central serous retinopathy, macular/retinal degeneration, diabetic retinopathy, retinal detachment) as confirmed by ophthalmologic examination.
  • Radiation therapy administered within 4 weeks of enrollment/randomization/first dose of study treatment.
  • Known central nervous system (CNS) metastases or history of uncontrolled seizures.
  • Known additional malignancy that is progressing or requires active treatment (exceptions: basal cell carcinoma of the skin, squamous cell carcinoma of the skin, or in situ cervical cancer that has undergone potentially curative therapy).
  • Laboratory values at screening outside the protocol-defined range.
  • History of calcium and phosphate hemostasis disorder or systemic mineral imbalance with ectopic calcification of soft tissues (exception: commonly observed calcifications in soft tissues, such as the skin, kidney, tendons or vessels due to injury, disease, and aging, in the absence of systemic mineral imbalance).
  • Significant gastrointestinal disorders that could interfere with absorption, metabolism, or excretion of pemigatinib.
  • Clinically significant or uncontrolled cardiac disease.
  • History or presence of an abnormal ECG, which, in the investigator's opinion, is clinically meaningful.
  • Chronic or current active infectious disease requiring systemic antibiotics or antifungal or antiviral treatment within 2 weeks prior to enrollment (participants with asymptomatic chronic infections on prophylactic treatment are allowed). Note: HIV-positive participants are allowed if all of the following criteria are met: CD4+ count ≥ 300/µL, undetectable viral load, receiving antiretroviral therapy that does not interact with study drug, and no HIV/AIDS-associated opportunistic infection in the last 12 months.
  • Use of any potent CYP3A4 inhibitors or inducers or moderate CYP3A4 inducers within 14 days or 5 half-lives (whichever is longer) before the first dose of study treatment. Note: Moderate CYP3A4 inhibitors are not prohibited
  • Known hypersensitivity or severe reaction to pemigatinib, gemcitabine, cisplatin, or their excipients.
  • Inadequate recovery from toxicity and/or complications from a major surgery before starting therapy.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PemigatinibPemigatinib-
Gemcitabine + CisplatinCisplatinParticipants who experience disease progression while receiving gemcitabine + cisplatin or during the follow-up period and before starting a new anticancer therapy will be eligible to cross over and receive pemigatinib.
Gemcitabine + CisplatinGemcitabineParticipants who experience disease progression while receiving gemcitabine + cisplatin or during the follow-up period and before starting a new anticancer therapy will be eligible to cross over and receive pemigatinib.
Primary Outcome Measures
NameTimeMethod
Progression-free survivalUp to approximately 12 months

Defined as the time from date of randomization until date of disease progression (according to Response Evaluation Criteria in Solid Tumors \[RECIST\] v1.1 and assessed by an independent central reviewer (ICR)) or death, whichever occurs first.

Secondary Outcome Measures
NameTimeMethod
Overall survivalUp to approximately 12 months

Defined as the time from date of randomization until death due to any cause.

Disease control rateUp to approximately 12 months

Defined as the proportion of participants who achieved best overall response of CR, PR, or stable disease (SD) per RECIST v1.1 as assessed by an ICR.

Duration of responseUp to approximately 12 months

Defined as the time from the date of the first assessment of CR or PR until the date of the first disease progression by an ICR per RECIST v1.1 or death, whichever occurs first.

Quality of Life impact as assessed by the EORTC QLQ-BIL21 questionnaireUp to 12 months
Overall response rateUp to approximately 12 months

Defined as the proportion of participants with best overall response of complete response (CR) or partial response (PR) per RECIST v1.1 as assessed by an ICR.

Number of treatment-emergent adverse eventsUp to approximately 12 months

Defined as adverse events reported for the first time or worsening of a pre-existing event after first dose of study drug.

Quality of Life impact as assessed by the EQ-5D-3L questionnaireUp to 12 months
Quality of Life impact as assessed by the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-30 questionnaireUp to 12 months

Trial Locations

Locations (214)

Parkview Research Center

🇺🇸

Fort Wayne, Indiana, United States

Beth Israel Deaconess Medical Center

🇺🇸

Boston, Massachusetts, United States

University Hospitals Cleveland Medical Center

🇺🇸

Cleveland, Ohio, United States

Baylor Scott and White Research Institute

🇺🇸

Dallas, Texas, United States

Niigata Cancer Center Hospital

🇯🇵

Niigata, Japan

White Plains Hospital

🇺🇸

White Plains, New York, United States

Xinhua Hospital

🇨🇳

SHanghai, China

Centre Hospitalier Universitaire de Bordeaux - Hospital Haut-Leveque

🇫🇷

Pessac Cedex, France

Hospital de La Miletrie

🇫🇷

Poitiers Cedex, France

Centre de Lutte Contre Le Cancer - Institut de Cancerologie de L'Ouest - Rene Gauducheau

🇫🇷

Saint Herblain, France

University Medical Center Rwth Aachen

🇩🇪

Aachen, Germany

Chu Vandoeuvre-Les-Nancy Hopital Brabois

🇫🇷

Vandoeuvre Les Nancy, France

Institut Gustave Roussy

🇫🇷

Villejuif Cedex, France

Charite - Campus Virchow-Klinikum

🇩🇪

Berlin, Germany

Universitatsklinikum Hamburg Eppendorf

🇩🇪

Hamburg, Germany

Asklepios Klinik Altona

🇩🇪

Hamburg, Germany

Universitatsklinikum Koln

🇩🇪

Koln, Germany

University Hospital Grosshadern Munich

🇩🇪

Munich, Germany

Soroka University Medical Center

🇮🇱

Beer-sheva, Israel

Hadassah University Hospital

🇮🇱

Jerusalem, Israel

Chiba Cancer Center

🇯🇵

Chiba-shi, Japan

Kyushu University Hospital

🇯🇵

Fukuoka-shi, Japan

Chiba University Hospital

🇯🇵

Chiba, Japan

Kobe University Hospital

🇯🇵

Kobe-shi, Japan

Kyoto University Hospital

🇯🇵

Kyoto-shi, Japan

Nho Shikoku Cancer Center

🇯🇵

Matsuyama-shi, Japan

Osaka International Cancer Institute

🇯🇵

Osaka-shi, Japan

Saitama Cancer Center

🇯🇵

Saitama, Japan

University Hospital Coventry and Warwickshire

🇬🇧

Coventry, United Kingdom

The Royal Marsden Nhs Foundation Trust - Chelsea

🇬🇧

London, United Kingdom

The Royal Marsden Nhs Foundation Trust - Sutton

🇬🇧

Sutton, United Kingdom

Houston Methodist Research Institute

🇺🇸

Houston, Texas, United States

Comprehensive Cancer Centers of Nevada-Twain

🇺🇸

Las Vegas, Nevada, United States

Kunming 1St People'S Hospital

🇨🇳

Kunming, China

Zhongshan Hospital Fudan University

🇨🇳

Shanghai, China

Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine

🇨🇳

Shanghai, China

Mayo Clinic Arizona

🇺🇸

Phoenix, Arizona, United States

Barbara Ann Karmanos Cancer Hospital

🇺🇸

Detroit, Michigan, United States

Azienda Ospedaliera Universitaria Policlinico Sant'Orsola Malpighi

🇮🇹

Bologna, Italy

Comitato Etico Fondazione Irccs Istituto Nazionale Dei Tumori Milano

🇮🇹

Milano, Italy

Istituto Di Ricovero E Cura A Carattere Scientifico (Irccs) Ospedale San Raffaele

🇮🇹

Milan, Italy

European Institute of Oncology

🇮🇹

Milan, Italy

A.O.U. Di Modena - Policlinico

🇮🇹

Modena, Italy

Iov - Istituto Oncologico Veneto Irccs

🇮🇹

Padova, Italy

Presidio Ospedaliero Pescara

🇮🇹

Pescara, Italy

Azienda Ospedaliera Universitaria Pisana

🇮🇹

Pisa, Italy

Fondazione Policlinico Universitario Agostino Gemelli Irccs

🇮🇹

Roma, Italy

Irccs Istituto Clinico Humanitas

🇮🇹

Rozzano, Italy

Mayo Clinic

🇺🇸

Rochester, Minnesota, United States

Marin Cancer Care

🇺🇸

Greenbrae, California, United States

UC Irvine Medical Center

🇺🇸

Orange, California, United States

Mayo Clinic-Florida

🇺🇸

Jacksonville, Florida, United States

University of Chicago Medical Center

🇺🇸

Chicago, Illinois, United States

Mount Sinai Medical Center Comprehensive Cancer Center

🇺🇸

Miami Beach, Florida, United States

Winship Cancer Institute of Emory University

🇺🇸

Atlanta, Georgia, United States

University of Iowa Hospital and Clinics

🇺🇸

Iowa City, Iowa, United States

Johns Hopkins Oncology Center

🇺🇸

Baltimore, Maryland, United States

The University of Kansas Cancer Center

🇺🇸

Westwood, Kansas, United States

Boston Medical Center

🇺🇸

Boston, Massachusetts, United States

Henry Ford Hospital

🇺🇸

Detroit, Michigan, United States

Karmanos Cancer Institute

🇺🇸

Farmington Hills, Michigan, United States

Icahn School of Medicine At Mount Sinai

🇺🇸

New York, New York, United States

Cleveland Clinic Foundation

🇺🇸

Cleveland, Ohio, United States

Providence Portland Med. Ctr

🇺🇸

Portland, Oregon, United States

Oregon Health & Science University

🇺🇸

Portland, Oregon, United States

Virginia Mason Medical Center

🇺🇸

Seattle, Washington, United States

Ordensklinikum Krankenhaus Der Barmherzigen Schwestern Linz

🇦🇹

Linz, Austria

Landeskrankenhaus Universitatsklinikum Graz

🇦🇹

Graz, Austria

West Virginia University Cancer Institute

🇺🇸

Morgantown, West Virginia, United States

Innsbruck University Hospital

🇦🇹

Innsbruck, Austria

Salzburger Universitatsklinikum

🇦🇹

Salzburg, Austria

Universitair Ziekenhuis Brussel

🇧🇪

Bruxelles, Belgium

Landeskrankenhaus Steyr

🇦🇹

Steyr, Austria

Allgemeines Krankenhaus Der Stadt Wien

🇦🇹

Vienna, Austria

Ulb Hospital Erasme

🇧🇪

Bruxelles, Belgium

Universitair Ziekenhuis Gent

🇧🇪

Gent, Belgium

Hospital de Jolimont

🇧🇪

Haine-st-paul, Belgium

Chu Ucl Namur University Hospital Mont-Godinne

🇧🇪

Yvoir, Belgium

Az Groeninge Campus Kennedylaan

🇧🇪

Kortrijk, Belgium

Cancercare Manitoba

🇨🇦

Winnipeg, Manitoba, Canada

Peking Union Medical College Hospital

🇨🇳

Beijing, China

Princess Margaret Cancer Center

🇨🇦

Toronto, Ontario, Canada

West China Hospital Sichuan University

🇨🇳

Chengdu, China

Shulan Hangzhou Hospital Co Ltd

🇨🇳

Hangzhou, China

Sun Yat-Sen Memorial Hospital Sun Yat-Sen University

🇨🇳

Guangzhou, China

Heilongjiang Province Cancer Hospital

🇨🇳

Harbin, China

University of Science and Technology of China-First Affiliated Hospital (Anhui Provincial Hospital)

🇨🇳

Hefei, China

The Affiliated Hospital of Qingdao University

🇨🇳

Shandong, China

The Second Affiliated Hospital of Zhejiang University School of Medicine

🇨🇳

Hangzhou, China

Jiangsu Province Hospital

🇨🇳

Nanjing, China

Sichuan Cancer Hospital

🇨🇳

Sichuan, China

Tianjin Medical University Cancer Institute Hospital

🇨🇳

Tianjin, China

Tongji Hospital Huazhong University of Science and Technology

🇨🇳

Wuhan, China

Hubei Cancer Hospital

🇨🇳

Wuhan, China

Northern Jiangsu Peoples Hospital

🇨🇳

Yangzhou, China

Chu Besancon Hospital Jean Minjoz

🇫🇷

Besançon, France

Herlev Og Gentofte Hospital

🇩🇰

Herlev, Denmark

Docrates Cancer Center

🇫🇮

Helsinki, Finland

Helsinki University Central Hospital

🇫🇮

Helsinki, Finland

Institut Sainte Catherine

🇫🇷

Avignon Cedex 9, France

Tampere University Hospital

🇫🇮

Tampere, Finland

Institut Bergonie

🇫🇷

Bordeaux Cedex, France

Hopital Beaujon

🇫🇷

Clichy, France

Hopital Prive Jean Mermoz

🇫🇷

Lyon Cedex 08, France

Chu Hopital de La Timone

🇫🇷

Marseille Cedex 5, France

Chu de Limoges - Hospital Dupuytren

🇫🇷

Limoges Cedex, France

Centre Hospitalier Universitaire de Nantes

🇫🇷

Nantes, France

Centre Antoine Laccassagne

🇫🇷

Nice Cedex 02, France

Hospital Universitaire Pitie-Salpetriere

🇫🇷

Paris Cedex 13, France

Hopital Europeen Georges Pompidou (Hegp)

🇫🇷

Paris Cedex 15, France

Hopital Charles Nicolle Chu Rouen Hospital de Bois-Guillaume

🇫🇷

Rouen Cedex, France

University Hospital of Saint Etienne

🇫🇷

Saint Etienne, France

Chu Toulouse Hopital Rangueil

🇫🇷

Toulouse Cedex 9, France

Charite Universitaetsmedizin Berlin - Campus Charite Mitte

🇩🇪

Berlin, Germany

Universitatsklinikum Bonn Aoer

🇩🇪

Bonn, Germany

University Clinic Carl Gustav Carus Technical University Dresden

🇩🇪

Dresden, Germany

Klinikum Der Johann Wolfgang Goethe University

🇩🇪

Frankfurt Am Main, Germany

University Medical Center Freiburg

🇩🇪

Freiburg, Germany

Hannover Medical School

🇩🇪

Hannover, Germany

Universitaetsklinikum Des Saarlandes

🇩🇪

Homburg / Saar, Germany

Klinikum Ludwigsburg

🇩🇪

Ludwigsburg, Germany

Universitatsklinikum Leipzig Aor

🇩🇪

Leipzig, Germany

Universitatsmedizin Der Johannes Gutenberg-Universitat Mainz Iii

🇩🇪

Mainz, Germany

Otto-Von-Guericke-Universitat Magdeburg

🇩🇪

Magdeburg, Germany

Klinikum Nuernberg

🇩🇪

Nuernberg, Germany

Universitaetsklinikum in Tubingen

🇩🇪

Tubingen, Germany

University Hospital Tuebingen

🇩🇪

Tubingen, Germany

Universitatkinikums Ulm

🇩🇪

ULM, Germany

St. Vincent'S University Hospital

🇮🇪

Dublin 4, Ireland

Rambam Health Care Campus

🇮🇱

Haifa, Israel

Tel Aviv Sourasky Medical Center

🇮🇱

Tel Aviv, Israel

Ospedale Papa Giovanni Xxiii

🇮🇹

Bergamo, Italy

Azienda Ospedaliero Universitaria Delle Marche

🇮🇹

Ancona, Italy

Istituto Tumori Giovanni Paolo Ii Irccs Ospedale Oncologico Bari

🇮🇹

Bari, Italy

Fondazione Del Piemonte Per L'Oncologia Ircc Candiolo

🇮🇹

Candiolo, Italy

Ospedale Degli Infermi - Faenza

🇮🇹

Faenza, Italy

Presidio Ospedaliero Garibaldi Nesima

🇮🇹

Catania, Italy

Irccs Azienda Ospedaliera Universitaria San Martino

🇮🇹

Genova, Italy

Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda

🇮🇹

Milan, Italy

Istituto Nazionale Tumori Irccs Fondazione Pascale

🇮🇹

Napoli, Italy

Azienda Ospedaliera Universitaria San Luigi Gonzaga Orbassano

🇮🇹

Orbassano, Italy

Universita Degli Studi Della Campania Luigi Vanvitelli U.O.C. Oncologia Medica

🇮🇹

Napoli, Italy

Universita Campus Bio Medico Di Roma

🇮🇹

Rome, Italy

Istituto Nazionale Tumori Regina Elena Irccs

🇮🇹

Roma, Italy

Azienda Ospedaliera San Camillo Forlanini

🇮🇹

Rome, Italy

Centro Ricerche Cliniche Di Verona (Crc)

🇮🇹

Verona, Italy

Azienda Ospedaliera Universitaria Senese Policlinico Santa Maria Alle Scotte

🇮🇹

Siena, Italy

San Bartolo Hospital

🇮🇹

Vicenza, Italy

University of Tokyo Hospital

🇯🇵

Bunkyo, Japan

National Hospital Organization Kyushu Cancer Center

🇯🇵

Fukuoka, Japan

Hyogo College of Medicine Hospital

🇯🇵

Hyogo, Japan

Hiroshima University Hospital

🇯🇵

Hiroshima-shi, Japan

Kanazawa University Hospital

🇯🇵

Ishikawa, Japan

Teikyo University Hospital

🇯🇵

Itabashi-ku, Japan

Cancer Institute Hospital of Jfcr

🇯🇵

Koto-ku, Japan

Kyorin University Hospital

🇯🇵

Mitaka-shi, Japan

Kindai University Hospital

🇯🇵

Osakasayama City, Japan

Hokkaido University Hospital

🇯🇵

Sapporo-shi, Japan

Keio University Hospital

🇯🇵

Shinjuku-ku, Japan

Tohoku University Hospital

🇯🇵

Sendai-shi, Japan

Shizuoka Cancer Center

🇯🇵

Shizuoka, Japan

Osaka University Hospital

🇯🇵

Suita-shi, Japan

Toyama University Hospital

🇯🇵

Toyama-shi, Japan

Yamaguchi University Hospital

🇯🇵

UBE, Japan

Yokohama City University Medical Center

🇯🇵

Yokohama-shi, Japan

Wakayama Medical University Hospital

🇯🇵

Wakayama, Japan

Kanagawa Cancer Center

🇯🇵

Yokohama-shi, Japan

Oita University Hospital

🇯🇵

Yufu-shi, Japan

Amsterdam University Medical Centre

🇳🇱

Amsterdam, Netherlands

Maastricht Umc+

🇳🇱

Maastricht, Netherlands

Erasmus Medical Center

🇳🇱

Rotterdam, Netherlands

Umc Utrecht

🇳🇱

Utrecht, Netherlands

Oslo University Hospital

🇳🇴

Oslo, Norway

Hospital de La Santa Creu I Sant Pau

🇪🇸

Barcelona, Spain

Hospital Universitario Reina Sofia

🇪🇸

Córdoba, Spain

Hospital Clinic Barcelona Main

🇪🇸

Barcelona, Spain

Hospital Materno Teresa Herrera

🇪🇸

La Coruña, Spain

Hospital General Universitario Vall D Hebron

🇪🇸

Barcelona, Spain

Hospital General Universitario Gregorio Maranon

🇪🇸

Madrid, Spain

Hospital Universitario Ramon Y Cajal

🇪🇸

Madrid, Spain

Hospital Universitario Hm Sanchinarro

🇪🇸

Madrid, Spain

Hospital Regional Universitario de Malaga

🇪🇸

Málaga, Spain

Clinica Universidad de Navarra (Cun)

🇪🇸

Pamplona, Spain

HOSPITAL UNiVERSITARIO DONOSTIA

🇪🇸

San Sebastian, Spain

Hospital Universitari Parc Tauli

🇪🇸

Sabadell, Spain

Karolinska Institute Universitetssjukhuset Solna

🇸🇪

Solna, Sweden

Hospital General Universitario de Valencia

🇪🇸

Valencia, Spain

Hospital Universitario Marques de Valdecilla

🇪🇸

Santander, Spain

Inselspital - Universitaetsspital Bern

🇨🇭

Bern, Switzerland

Universitatsspital Zurich

🇨🇭

Zuerich, Switzerland

Aberdeen Royal Infirmary

🇬🇧

Aberdeen, United Kingdom

Addenbrookes Hospital

🇬🇧

Cambridge, United Kingdom

Velindre Cancer Centre

🇬🇧

Cardiff, United Kingdom

Imperial College Healthcare Nhs Trust - Hammersmith Hospital

🇬🇧

London, United Kingdom

University College London Hospitals (Uclh)

🇬🇧

London, United Kingdom

Kent Oncology Centre - Maidstone Hospital

🇬🇧

Maidstone, United Kingdom

The Christie Nhs Foundation Trust

🇬🇧

Manchester, United Kingdom

Riverside Regional Medical Center

🇺🇸

Newport News, Virginia, United States

Klinikum Bremen-Nord

🇩🇪

Bremen, Germany

Fox Chase Cancer Center

🇺🇸

Philadelphia, Pennsylvania, United States

McGill University Health Centre Research Institute

🇨🇦

Montreal, Quebec, Canada

Nova Scotia Health Authority/Qeii Health Sciences Centre

🇨🇦

Halifax, Nova Scotia, Canada

Aichi Cancer Center Hospital

🇯🇵

Nagoya-shi, Japan

Jichi Medical University Hospital

🇯🇵

Shimotsuke-shi, Japan

Tom Baker Cancer Centre

🇨🇦

Calgary, Alberta, Canada

Georgetown University-Lombardi Comprehensive Cancer Center

🇺🇸

Washington, District of Columbia, United States

Universitaire Ziekenhuis Leuven - Gasthuisberg

🇧🇪

Leuven, Belgium

Rabin Medical Center - Beilinson Hospital

🇮🇱

Petach Tikva, Israel

Greenville Hospital System University Medical Center Institute For Translational Oncology Research

🇺🇸

Greenville, South Carolina, United States

Summit Medical Group

🇺🇸

Florham Park, New Jersey, United States

Ochsner Clinic Foundation Ocf Ochsner Cancer Institute Oci

🇺🇸

New Orleans, Louisiana, United States

Virginia Commonwealth University

🇺🇸

Richmond, Virginia, United States

Aurora Research Institute

🇺🇸

Wauwatosa, Wisconsin, United States

Fujian Cancer Hospital

🇨🇳

Fuzhou, China

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