Study to Evaluate Safety and Effectiveness of Lenalidomide in Combination With Docetaxel and Prednisone for Patients With Castrate-Resistant Prostate Cancer
- Conditions
- Prostate Cancer
- Interventions
- Registration Number
- NCT00988208
- Lead Sponsor
- Celgene
- Brief Summary
The purpose of the study is to determine whether lenalidomide is safe and effective for use in combination with docetaxel and prednisone for the treatment of subjects with metastatic Castrate-Resistant Prostate Cancer.
The addition of lenalidomide to docetaxel and prednisone is proposed to increase the life expectancy of these subjects.
- Detailed Description
In November 2011, the Data Monitoring Committee concluded it was unlikely that the study would meet its primary endpoint of overall survival (OS) and recommended that the study be stopped. The study was terminated in accordance with this recommendation. All sites were instructed to immediately discontinue all patients from experimental lenalidomide/placebo treatment administered either in combination with chemotherapy or as a single agent following chemotherapy discontinuation. Subsequently, Protocol Amendment 3 was issued to provide for the following:
To continue to collect information on Second Primary Malignancies (SPMs) and additional treatments for Prostate Cancer in all randomized subjects during survival follow-up.
To continue to provide docetaxel and prednisone for up to 10 cycles to subjects randomized at non-US sites who were ongoing in the CC-5013-PC-002 protocol when the decision was made to discontinue lenalidomide/placebo and who were experiencing benefit as per investigator discretion. For subjects who had exceeded 10 cycles of docetaxel and prednisone at the time of Protocol Amendment 3 approval, an additional two cycles were provided.
All references to dosing and study procedures pertaining to the safety, efficacy, and exploratory endpoints of lenalidomide/placebo were discontinued as part of Protocol Amendment 3.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- Male
- Target Recruitment
- 1059
- Must sign an Informed Consent Form (ICF)
- Males ≥ 18 years of age
- Able to adhere to the study visit schedule and requirements of the protocol
- Eastern Cooperative Oncology Group (ECOG) performance status of ≤ 2
- Life expectancy of ≥ 12 weeks
- Willingness to participate in Patient-Reported Outcomes assessments
- Serum testosterone levels < 50 ng/dL
- Confirmed metastatic adenocarcinoma of the prostate that is unresponsive or refractory to hormonal therapy
- Have documented disease progression while receiving or following hormonal therapy as determined by increasing Serum Prostate Specific Antigen (PSA) level, Radiological Progression, or ≥2 new bone lesions
- Subjects must agree to receive counseling related to pregnancy precautions, teratogenic and other risks of lenalidomide
- Refrain from donating blood or semen as defined by protocol
- A history of clinically significant disease that places subject at an unacceptable risk for study entry
- Prior Therapy with thalidomide, lenalidomide or pomalidomide
- Prior chemotherapy for prostate cancer
- Use of any other experimental drug or therapy within 28 days prior to randomization
- Prior radiation to ≥ 30% of bone marrow or any radiation therapy within 28 days prior to randomization
- Prior use of Strontium-89 at any time or Samarium-153 within 56 days prior to randomization
- Surgery within 28 days prior to randomization
- Concurrent anti-androgen therapy
- Abnormal serum chemistry or hematology laboratory values
- Significant active cardiac disease within the previous 6 months:
- Thrombotic or thromboembolic events within the past 6 months:
- History of peripheral neuropathy of ≥grade 2
- History of severe hypersensitivity reaction to drugs formulated with polysorbate 80
- Paraplegia
- History of Central nervous system (CNS) or brain metastases
- History of malignancies other than prostate cancer within the past 5 years, with the exception of treated basal cell/squamous cell carcinoma of the skin
- Concurrent use of alternative cancer therapies
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Docetaxel and Prednisone (DP) Placebo Oral placebo once each day on Days 1-14 of the treatment cycle; 75 mg/m2 docetaxel intravenously on Day 1; 5 mg prednisone orally twice each day on each day of the treatment cycle Docetaxel, Prednisone, Lenalidomide (DPL) Prednisone 25 mg lenalidomide orally once each day on Days 1-14; 75 mg/m2 docetaxel intravenously on Day 1; 5 mg prednisone orally twice daily on each day of the treatment cycle Docetaxel, Prednisone, Lenalidomide (DPL) Lenalidomide 25 mg lenalidomide orally once each day on Days 1-14; 75 mg/m2 docetaxel intravenously on Day 1; 5 mg prednisone orally twice daily on each day of the treatment cycle Docetaxel, Prednisone, Lenalidomide (DPL) Docetaxel 25 mg lenalidomide orally once each day on Days 1-14; 75 mg/m2 docetaxel intravenously on Day 1; 5 mg prednisone orally twice daily on each day of the treatment cycle Docetaxel and Prednisone (DP) Docetaxel Oral placebo once each day on Days 1-14 of the treatment cycle; 75 mg/m2 docetaxel intravenously on Day 1; 5 mg prednisone orally twice each day on each day of the treatment cycle Docetaxel and Prednisone (DP) Prednisone Oral placebo once each day on Days 1-14 of the treatment cycle; 75 mg/m2 docetaxel intravenously on Day 1; 5 mg prednisone orally twice each day on each day of the treatment cycle
- Primary Outcome Measures
Name Time Method Overall Survival (OS) From randomization until death from any cause up to the cut-off date of 13 January 2012; up to approximately 26 months Overall survival (OS) was the time from the date of randomization to the date of death from any cause. If no death was reported for a participant before the cut-off date for OS analysis, OS was censored at the last date at which the participant was alive. The median OS was calculated based on Kaplan-Meier estimates and corresponding 95% confidence interval (CI) was calculated using the method provided by Brookmeyer and Crowley.
- Secondary Outcome Measures
Name Time Method Progression-Free Survival (PFS) From randomization until disease progression or death from any cause; up to the cut-off date of 13 Jan 2012; maximum time on study was approximately 26 months PFS was the time from randomization to disease progression, or death, whatever occurred first. Progression criteria was met by analysis of target and non-target lesions as defined by Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1 criteria. Progressive Disease (PD) is defined as at least a 20% increase in the sum of the diameters of target lesions, taking as reference the smallest sum of the diameters while on study or the appearance of one or more new lesions; an increase of at least 5mm as a total sum. Lymph nodes identified as target lesions (≥ 15 mm diameter in short axis) will be followed and reported by changes in diameter of short axis; or the unequivocal progression of a non-target lesion defined as an increase in the overall disease burden based on the change in non-measurable disease that is comparable in scope to the increase required to declare PD for measurable disease; Two or more new bone lesions as detected by bone scan
Percentage of Participants With an Objective Response According to Response Evaluation Criteria in Solid Tumors - RECIST Version 1.1 Criteria From day 1 to data cut-off 13 January 2012; maximum time on study was approximately 26 months Objective response (OR) is defined as having complete response (CR) or partial response (PR) as best overall response based on RECIST Criteria 1.1 and defines a CR = Disappearance of all target lesions except lymph nodes (LN); LN must have a decrease in the short axis to \<10mm; PR = 30% decrease in sum of diameters of target lesions taking as reference the baseline sum diameters; Progressed Disease (PD) = 20% increase in sum of diameters of target lesions taking as a reference the smallest sum of diameters and an absolute increase of ≥5 mm; the appearance of ≥1 new lesions; Stable Disease (SD)= Neither shrinkage to qualify for PR nor increase to qualify for PD taking the smallest sum diameters on study as reference. For non-target lesions a CR = Disappearance of all non-target lesions and all LN must be non-pathological in size \<10 mm; Non-CR/Non PD: persistence of one or more non-target lesions; PD = unequivocal progression of existing non-target lesions or appearance of new ones
Number of Participants With Treatment Emergent Adverse Events (AEs) From the time from of first dose of study drug administration to 28 days after the last dose of study drug and up to the data cut off date of 13 January 2012; the maximum duration of study drug was 93 weeks for DP and 90.6 weeks for DPL A TEAE is defined as any AE occurring or worsening on or after the first dose of study drug and within 28 days after the last dose of study drug. A TESAE is defined as any serious adverse event (SAE) occurring or worsening on or after the first dose of study drug and within 28 days after the last dose of study drug. Safety and severity was assessed according to the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) version 4.0; Severity of AEs were graded (including second primary malignancies) as Grade 1- Mild; Grade 2- Moderate; Grade 3- Severe; Grade 4- Life-threatening; Grade 5-Fatal;
Percentage of Participants Who Received Post-Study Therapies The date when the first consent form was signed to the last date of AE data collection;up to 5 years; up to the date of the final data analysis date of 20 April 2017 Percentage of Participants Who Received Post-Study Therapies for advanced Prostate Cancer.
Percentage of Participants With Secondary Primary Malignancies During the Course of the Trial The date when the first consent form was signed to the last date of AE data collection; up to the date of the final data analysis date of 30 November 2016; 7 years and 19 days Second primary malignancies were monitored as events of interest and reported as serious adverse events throughout the course of the trial.
Time to Onset of Secondary Primary Malignancies The date when the first consent form was signed to the last date of AE data collection; up to the date of the final data analysis date of 30 November 2016; 7 years and 19 days Time of Onset of Secondary Primary Malignancies was considered an event of interest
Trial Locations
- Locations (209)
Cookeville Regional Medical Center
🇺🇸Cookeville, Tennessee, United States
Veterans Education and Research Association of Northern New England, Inc.
🇺🇸White River Junction, Vermont, United States
Medizinische Universitat Wien
🇦🇹Vienna, Austria
Medical University of Graz
🇦🇹Graz, Austria
Landeskrankenhaus Salzburg
🇦🇹Salzburg, Austria
ZNA Middelheim
🇧🇪Antwerpen, Belgium
UZ Leuven
🇧🇪Leuven, Belgium
Hopital Erasme
🇧🇪Brussels, Belgium
AZ Groeninge
🇧🇪Kortrijk, Belgium
AZ Nikolaas
🇧🇪Sint-Niklaas, Belgium
Rambam Health Care Campus
🇮🇱Haifa, Israel
Assaf Harofeh Medical Center
🇮🇱Zerifin, Israel
Medisch Centrum Leeuwarden
🇳🇱Leeuwarden, Netherlands
Hospital Angeles Lindavista
🇲🇽D.f, Df, Mexico
Consultorio Privado- Dr Jose Arturo Rodriguez Rivera
🇲🇽Zapopan, JAL, Mexico
VU University Medical Center VU Medisch Centrum
🇳🇱Amsterdam, Netherlands
HagaZiekenhuis
🇳🇱Den Haag, Netherlands
Gemini Ziekenhuis
🇳🇱Den Helder, Netherlands
Albert Schweitzer Ziekenhuis Amstelwijck
🇳🇱Dordrecht, Netherlands
Catharina Ziekenhuis
🇳🇱Eindhoven, Netherlands
Erasmus Medical Center
🇳🇱Rotterdam, Netherlands
Erasmus Medisch Centrum
🇳🇱Rotterdam, Netherlands
VieCuri Medisch Centrum Venlo
🇳🇱Venlo, Netherlands
Leids Universitair Medisch Centrum
🇳🇱Leiden, Netherlands
Isala Klinieken
🇳🇱Zwolle, Netherlands
4 Wojskowy Szpital Kliniczny z Poliklinika SP ZOZ
🇵🇱Wroclaw, Poland
ZOZ MSWiA z Warminsko- Mazurskim Centrum Onkologii
🇵🇱Olsztyn, Poland
Oncology Dispensary 2 of Krasnodar Region
🇷🇺Sochi, Russian Federation
Yaroslavl Regional Clinical Oncology Hospital
🇷🇺Yaroslavl, Russian Federation
Centrum Onkologii-Instytut im.Marii Sklodowskiej-Curie
🇵🇱Warszawa, Poland
Medical Radiology Research Centre RAMS
🇷🇺Obninsk, Russian Federation
State Institution of Heath Omsk Regional Oncology Dispensary
🇷🇺Omsk, Russian Federation
NSHI Dorozhnaya Clinical Hospital of OAO Russian Railways
🇷🇺Rostov-on-Don, Russian Federation
The Angeles Clinc and Research Institute
🇺🇸Los Angeles, California, United States
Rocky Mountain Cancer Centers-Colorado Springs Circle
🇺🇸Colorado Springs, Colorado, United States
University of Southern California
🇺🇸Los Angeles, California, United States
Prostate Oncology Specialists
🇺🇸Marina Del Rey, California, United States
Stanford University Medical Center
🇺🇸Stanford, California, United States
Melbourne Internal Medicine Associates
🇺🇸Melbourne, Florida, United States
Ocala Oncology Center
🇺🇸Ocala, Florida, United States
Lutheran General Hospital
🇺🇸Park Ridge, Illinois, United States
Maryland Oncology Hematology PA
🇺🇸Columbia, Maryland, United States
Hematology and Oncology Specialist, LLC
🇺🇸Metairie, Louisiana, United States
Mid Dakota Clinic, PC
🇺🇸Bismarck, North Dakota, United States
Cancer Center of the Carolinas
🇺🇸Greer, South Carolina, United States
Cancer Centers of North Carolina
🇺🇸Raleigh, North Carolina, United States
Texas Oncology, P.A.-Amarillo
🇺🇸Amarillo, Texas, United States
Sarah Cannon Research Institute UK
🇺🇸Nashville, Tennessee, United States
Texas Oncology, PA
🇺🇸Austin, Texas, United States
Allison Cancer Center
🇺🇸Midland, Texas, United States
Texas Oncology, P.A.-Fort Worth
🇺🇸Fort Worth, Texas, United States
Longview Cancer Center
🇺🇸Longview, Texas, United States
Texas Oncology Deke Slayton Cancer Center
🇺🇸Webster, Texas, United States
Southlake Oncology
🇺🇸Southlake, Texas, United States
Royal Adelaide Hospital
🇦🇺Adelaide, South Australia, Australia
Les Urologues Specialises
🇨🇦Montreal, Quebec, Canada
Institut Bergonie Centre Regional de Lutte Contre Le Cancer de Bordeaux Et Sud Ouest
🇫🇷Bordeaux, France
Centre Oscar Lambret
🇫🇷Lille 59, France
CHU de Poitiers
🇫🇷Poitiers Cedex, France
Diakonissenkrankenhaus Dessau gGmbH
🇩🇪Dessau-Rosslau, Germany
Universitatsklinikum Hamburg-Eppendorf / IVDP
🇩🇪Hamburg, Germany
IORC- Innovation Onkologie Research and Consulting GmbH
🇩🇪Hamburg, Germany
Praxis fuer Haematologie und Onkologie Koblenz
🇩🇪Koblenz, Germany
Fovarosi Onkirmanyzat Peterfy S.Utcai Korhaz-Rend.Int es Baleseti Kozp.
🇭🇺Budapest, Hungary
The Soroka University Medical Center
🇮🇱Beer Sheva, Israel
Rabin Medical Center
🇮🇱Petach Tikva, Israel
Uniwersyteckie Centrum Kliniczne
🇵🇱Gdansk, Poland
Regionalny Osrodek Onkologiczny WSS im. M. Kopernika
🇵🇱Lodz, Poland
Indiana University Health
🇺🇸Indianapolis, Indiana, United States
Minnesota Oncology Hematology, PA
🇺🇸Minneapolis, Minnesota, United States
Hematology Oncology Associates
🇺🇸Phoenix, Arizona, United States
Comprehensive Cancer Centers of Nevada
🇺🇸Las Vegas, Nevada, United States
Oncology Hematology Care, Inc.
🇺🇸Cincinnati, Ohio, United States
Westmead Hospital
🇦🇺Westmead, Australia
Border Medical Oncology
🇦🇺Wodonga, Australia
The Queen Elizabeth Hospital
🇦🇺Woodville South, Australia
Weill Cornell Medical College Dr. Feldman's Office
🇺🇸New York, New York, United States
VA Long Beach Healthcare System
🇺🇸Long Beach, California, United States
Arizona Oncology
🇺🇸Tucson, Arizona, United States
Southwest Cancer Center - Escondido
🇺🇸Escondido, California, United States
City of Hope Cancer Center
🇺🇸Duarte, California, United States
Northern AZ Hematology and Oncology Assoc
🇺🇸Sedona, Arizona, United States
Scripps Cancer Center - Clinical Research
🇺🇸La Jolla, California, United States
Washington Cancer Institute
🇺🇸Washington, District of Columbia, United States
Advanced Medical Specialties
🇺🇸Miami, Florida, United States
Missouri Cancer Associates
🇺🇸Columbia, Missouri, United States
Cancer Care and Hematology Specialists of Chicagoland
🇺🇸Niles, Illinois, United States
Columbia Basin Hematology and Oncology
🇺🇸Kennewick, Washington, United States
Texas Oncology-Arlington South
🇺🇸Arlington, Texas, United States
Fairfax Northern Virginia Hematology Oncology
🇺🇸Fairfax, Virginia, United States
Columbia Univ Medical Center
🇺🇸New York, New York, United States
Hematology Oncology Associates of South Jersey
🇺🇸Mount Holly, New Jersey, United States
New Bern Cancer Care
🇺🇸New Bern, North Carolina, United States
Chris O'Brien Lifehouse
🇦🇺Camperdown, Australia
Hematology-Oncology Associates of NNJ, P
🇺🇸Morristown, New Jersey, United States
Northwest Cancer Specialists-Tualatin
🇺🇸Tualatin, Oregon, United States
New York Oncology Hematology P.C.
🇺🇸Albany, New York, United States
Summit Medical Group Overlook Oncology Center
🇺🇸Berkeley Heights, New Jersey, United States
South Carolina Oncology Associates, PA
🇺🇸Columbia, South Carolina, United States
Chattanooga Oncology Hematology Associates
🇺🇸Chattanooga, Tennessee, United States
Texas Oncology, P.A. - Paris
🇺🇸Paris, Texas, United States
Virginia Cancer Institute
🇺🇸Richmond, Virginia, United States
Centre Georges Francois Leclerc
🇫🇷Dijon Cedex, France
Hopital Civil de Strasbourg
🇫🇷Strasbourg, France
CHRU Hopital Bretonneau
🇫🇷Tours Cedex, France
VA Puget Sound HCS Seattle Division
🇺🇸Seattle, Washington, United States
Texas Oncology, P.A. - Tyler
🇺🇸Tyler, Texas, United States
Krajska zdravotni, a.s. - Masarykova nemocnice v Usti nad La
🇨🇿Usti Nad Labem, Czechia
Flinders Medical Centre
🇦🇺Bedford Park, Australia
Royal Melbourne Hospital
🇦🇺Parkville, Victoria, Australia
Evergreen Hematology and Oncology
🇺🇸Spokane, Washington, United States
Texas Oncology-Texoma Cancer Center
🇺🇸Wichita Falls, Texas, United States
Cancer Outreach Associates
🇺🇸Abingdon, Virginia, United States
Sir Charles Gairdner Hospital
🇦🇺Nedlands, Australia
The Health Institute for Men CMX Research Inc
🇨🇦Toronto, Ontario, Canada
Krankenhaus der Barmherzigen Brueder
🇦🇹Vienna, Austria
Clinique Victor Hugo
🇫🇷Le Mans, France
Herlev Hospital
🇩🇰Herlev, Denmark
Rigshospitalet University Hospital
🇩🇰Kobenhavn, Denmark
CRLCC Paul Papin
🇫🇷Angers 49, France
Arhus Universitets hospital
🇩🇰Aarhus C, Denmark
Odense Universitetshospital
🇩🇰Odense C, Denmark
CRLCC Centre Rene Gauducheau
🇫🇷Saint Herblain 44, France
Institut de Cancerologie de la Loire
🇫🇷Saint Priest En Jaroz, France
Centre Leon Berard
🇫🇷Lyon, France
Fakultni nemocnice Motol
🇨🇿Prague 5, Czechia
Vivantes Klinikum am Urban
🇩🇪Berlin, Germany
Krajska zdravotni, a.s. Nemocnice Chomutov, o.z.
🇨🇿Chomutov, Czechia
Edith Cavell Clinic
🇧🇪Bruxelles, Belgium
Clinique de Valdegour
🇫🇷Nimes, France
Centre Eugene Marquis
🇫🇷Rennes Cedex, France
University-Hospital Tübingen
🇩🇪Tuebingen, Germany
Medizinisches Zentrum Bonn-Friedensplatz
🇩🇪Bonn, Germany
Institut Gustave Roussy
🇫🇷Villejuif, France
Universitaetsklinikum Duesseldorf
🇩🇪Duesseldorf, Germany
Krankenhaus Nordwest
🇩🇪Frankfurt a.M., Germany
Onkologische Praxis Freiburg
🇩🇪Freiburg, Germany
Agioi Anargyroi Hospital
🇬🇷Athens, Greece
University Hospital of Larissa
🇬🇷Larissa, Greece
Azienda Ospedaliero Universitaria Consorziale Policlinico di Bari
🇮🇹Bari, Italy
Ospedale Vito Fazzi
🇮🇹Lecce, Italy
Universitatsklinikum Ulm
🇩🇪Ulm, Germany
Alexandra General Hospital of Athens
🇬🇷Athens, Greece
Ospedale di Mirano
🇮🇹Mirano (VE), Italy
Azienda Ospedaliero Universitaria Pisana
🇮🇹Pisa, Italy
Azienda Ospedaliero-Universitaria Santa Maria della Miserico
🇮🇹Udine, Italy
Vituro GmbH & Co KG
🇩🇪Leipzig, Germany
TU München - Klinikum rechts der Isar
🇩🇪München, Germany
Universitaetsklinikum Muenster
🇩🇪Münster, Germany
Papageorgiou General Hospital of Thessaloniki
🇬🇷Thessaloniki, Greece
Borsod-Abauj-Zemplen Megyei Korhaz es Egyetemi Oktato Korhaz
🇭🇺Miskolc, Hungary
Pecsi Tudomanyegytem Altalanos Orvostudomanyi Kar
🇭🇺Pecs, Hungary
Ordine Mauriziano
🇮🇹Candiolo, Italy
Azienda Ospedaliera Istituti Ospitalieri di Cremona
🇮🇹Cremona, Italy
Istituto Scientifico Romagnolo Per Lo Studio e La Cura Dei Tumori (I.R.S.T.)
🇮🇹Meldola, Italy
Ospedale degli Infermi di Rimini
🇮🇹Rimini, Italy
Fovarosi Onkormanyzat Bajcsy-Zsilinszky Korhaz es Rendelointezet
🇭🇺Budapest, Hungary
Ziekenhuis Rijnstate
🇳🇱Arhem, Netherlands
Azienda Ospedaliera San Camillo Forlanini
🇮🇹Roma, Italy
HCU Virgen de la Victoria
🇪🇸Malaga, Spain
Groote Schuur Hospital
🇿🇦Cape Town, W Cape, South Africa
The Oncology Centre Durban
🇿🇦Durban, KZ-Natal, South Africa
Clinica Universitaria de Navarra
🇪🇸Pamplona, Spain
Pretoria Urology Hospital
🇿🇦Pretoria, South Africa
Hospital Mutua de Terrassa
🇪🇸Terrassa (Barcelona), Spain
Consultorio de Especialidad en Urologia Privado
🇲🇽Durango, DGO, Mexico
Hospital Fatima
🇲🇽Sinaloa, SIN, Mexico
Twee Steden Ziekenhuis Tilburg
🇳🇱Tilburg, Netherlands
SPZOZ Wojewodzki Szpital Specjalistyczny nr 3 w Rybniku
🇵🇱Rybnik, Poland
Amphia Ziekenhuis Molengracht
🇳🇱Breda, Netherlands
Hospital del Mar
🇪🇸Barcelona, Spain
Hospital Clinico Universitario de Valencia
🇪🇸Valencia, Spain
St George's Hospital
🇬🇧London, United Kingdom
Hospital Universitario Miguel Servet
🇪🇸Zaragoza, Spain
Academisch Ziekenhuis Maastricht
🇳🇱Maastricht, Netherlands
St. Antonius Ziekenhuis Nieuwegein
🇳🇱Nieuwegein, Netherlands
Dr. H. Malan
🇿🇦Polokwane, South Africa
NZOZ Olsztynski Osr. Onkologiczny Kopernik Sp.z o.o
🇵🇱Olsztyn, Poland
Russian Scientific Center for Radiology and Surgical Technol, St. Petersburg
🇷🇺Pesochny Vlg Saint Petersburg, Russian Federation
Westridge Medical Centre
🇿🇦Durban, KZ-Natal, South Africa
Netcare Oncology and Interventional Centre
🇿🇦Goodwood, W Cape, South Africa
Moscow Oncology Clinical Dispensary 1
🇷🇺Moscow, Russian Federation
Centrallasarettet Vasteras
🇸🇪Västerås, Sweden
Hospital 12 de Octobre
🇪🇸Madrid, Spain
Norrlands Universitetssjukhus
🇸🇪Umeå, Sweden
Addenbrookes Hospital
🇬🇧Cambridge, United Kingdom
Royal Surrey County Hospital
🇬🇧Guildford, United Kingdom
Northern Lincolnshire and Goole Hospitals NHS Foundation Trust
🇬🇧Scunthorpe, United Kingdom
Hospital Durán i Reynals - Instituto Catalàn de Oncologìa ICO
🇪🇸Hospitalet de Llobregat, Barcelona, Spain
Hospital Arnau de Vilanova
🇪🇸Lérida, Spain
Lanssjukhuset Ryhov
🇸🇪Jönköping, Sweden
Clatterbridge Centre for Oncology NHS Trust
🇬🇧Bebington, Wirral, United Kingdom
Christie NHS Trust Hospital
🇬🇧Manchester, United Kingdom
Nottingham City Hospital
🇬🇧Nottingham, United Kingdom
Guy's and St Thomas' Hospital - London
🇬🇧London, United Kingdom
Royal Marsden Hospital
🇬🇧Sutton, United Kingdom
Virginia Oncology Associates
🇺🇸Norfolk, Virginia, United States
Oncology and Hematology Associates of Southwest Virginia, Inc.
🇺🇸Roanoke, Virginia, United States
Baylor Sammons Cancer Center
🇺🇸Dallas, Texas, United States
South Florida Oncology - Hematology
🇺🇸Tamarac, Florida, United States
Florida Cancer Institute - New Hope
🇺🇸New Port Richey, Florida, United States
Port Macquarie Base Hospital
🇦🇺Port Macquarie, Australia
Palm Beach Cancer Institute, LLC
🇺🇸West Palm Beach, Florida, United States
Redcliffe Hospital
🇦🇺Redcliffe, Australia
Newcastle Calvary Mater Hospital
🇦🇺Waratah, Australia
Royal North Shore Hospital
🇦🇺St Leonards, Australia
Princess Alexandra Hospital
🇦🇺Woolloongabba, Australia
Cancer Centers of Florida, P.A.- West Gore Street
🇺🇸Orlando, Florida, United States
Ralph H. Johnson VA Medical Center
🇺🇸Charleston, South Carolina, United States