A Trial to Learn if Odronextamab is Safe and Well-Tolerated and How Well it Works Compared to Rituximab Combined With Different Types of Chemotherapy for Participants With Follicular Lymphoma
- Conditions
- Follicular Lymphoma (FL)
- Interventions
- Drug: Prednisone/prednisolone
- Registration Number
- NCT06091254
- Lead Sponsor
- Regeneron Pharmaceuticals
- Brief Summary
This study is researching an experimental drug called odronextamab, referred to as study drug. The study is focused on participants with previously untreated follicular lymphoma (a type of non-Hodgkin lymphoma or NHL).
This study will be made up of two parts: Part 1 (non-randomized) and Part 2 (randomized - controlled).
The aim of Part 1 of the study is to see how safe and tolerable the study drug is when given alone.
The aim of Part 2 of the study is to see how the study drug works compared to rituximab (called the "comparator drug") and chemotherapy (the current standard of care for NHL). Standard of care means the usual medication expected and used when receiving treatment for a condition.
The study is looking at several other research questions, including:
* What side effects may happen from taking the study drug
* How much study drug is in the blood at different times
* Whether the body makes antibodies against the study drug (which could make the study drug less effective or could lead to side effects)
* How the study drug affects quality of life and ability to complete routine daily activities.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 478
- Diagnosis of Cluster of Differentiation 20^+ (CD20^+) FL Grade 1-3a, stage II bulky or stage III / IV
- Need for treatment as described in the protocol
- Have measurable disease on cross-sectional imaging documented by diagnostic imaging Computed Tomography (CT) or Magnetic Resonance Imaging (MRI)
- Eastern Cooperative Oncology Group (ECOG) performance status of 0-2
- Adequate bone marrow function and hepatic function
Key
- Central Nervous System (CNS) lymphoma or leptomeningeal lymphoma
- Histological evidence of transformation to a high-grade or diffuse large B-cell lymphoma
- Waldenström Macroglobulinemia (WM, lymphoplasmacytic lymphoma), Grade 3b follicular lymphoma, chronic lymphocytic leukemia, or small lymphocytic lymphoma
- Treatment with any systemic anti-lymphoma therapy
- Infections and allergy/hypersensitivity to study drug or excipient
NOTE: Other protocol defined inclusion/exclusion criteria apply
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Odronextamab Odronextamab Part 1 is a safety run-in. All participants will receive odronextamab. In part 2 participants will be randomly assigned in a 1:1 ratio to receive odronextamab followed by odronextamab maintenance. Rituximab + Investigator's Choice Chemotherapy Rituximab Part 2 only, participants will be randomized 1:1 to receive rituximab in combination with chemotherapy followed by rituximab maintenance. Rituximab + Investigator's Choice Chemotherapy Doxorubicin Part 2 only, participants will be randomized 1:1 to receive rituximab in combination with chemotherapy followed by rituximab maintenance. Rituximab + Investigator's Choice Chemotherapy Prednisone/prednisolone Part 2 only, participants will be randomized 1:1 to receive rituximab in combination with chemotherapy followed by rituximab maintenance. Rituximab + Investigator's Choice Chemotherapy Bendamustine Part 2 only, participants will be randomized 1:1 to receive rituximab in combination with chemotherapy followed by rituximab maintenance. Rituximab + Investigator's Choice Chemotherapy Cyclophosphamide Part 2 only, participants will be randomized 1:1 to receive rituximab in combination with chemotherapy followed by rituximab maintenance. Rituximab + Investigator's Choice Chemotherapy Vincristine Part 2 only, participants will be randomized 1:1 to receive rituximab in combination with chemotherapy followed by rituximab maintenance.
- Primary Outcome Measures
Name Time Method Incidence of treatment-emergent adverse events (TEAEs) of odronextamab Up to 2 years Part 1
Incidence of dose-limiting toxicities (DLTs) for odronextamab Up to 35 days Part 1
Complete Response at 30 months (CR30) as assessed by independent central review Up to 30 months Part 2
Severity of TEAEs of odronextamab Up to 2 years Part 1
- Secondary Outcome Measures
Name Time Method Objective response as assessed by the investigator Up to 30 months Part 1
Concentrations of odronextamab in serum Up to 30 months Part 1
Titer of ADAs to odronextamab over the study duration Up to 30 months Part 2
Incidence of NAbs to odronextamab over the study duration Up to 30 months Part 2
Overall mean changes in scores of PROs, as measured by the validated instruments Patient Global Impression of Change (PGIC) Up to 5 years Part 2 The PGIC item includes a single-item to assess how a patient perceives their overall change in health status since the start of study treatment. Patients will choose from response options on a 7-point scale ranging from 1 (Much Better) to 7 (Much worse); 1- Much Better, 2-Moderately Better, 3-A Little Better, 4-About the Same, 5-A Little Worse, 6-Moderately Worse, 7-Much Worse.
Progression-free survival (PFS) as assessed by independent central review Up to 5 years Part 2
CR30 as assessed by local investigator Up to 30 months Part 2
Overall survival (OS) Up to 5 years Part 2
Duration of response (DOR) assessed by independent central review Up to 5 years Part 2
Incidence of TEAEs Up to 2 years Part 2
Incidence of anti-drug antibodies (ADAs) to odronextamab over the study duration Up to 30 months Part 1
Event-free survival (EFS) as assessed by independent central review Up to 5 years Part 2
PFS as assessed by the local investigator Up to 5 years Part 2
Odronextamab concentrations in serum during the induction period Up to 30 months Part 2
Incidence of ADAs to odronextamab over the study duration Up to 30 months Part 2
Change in score of the GP5 item in the participant population Up to 5 years Part 2 A single item Global Population item 5 (GP5) of the validated FACT-G questionnaire will be used to assess from the participant perspective the overall impact of treatment side-effect. The question item is on a 5-point scale ranging from "not at all" (0) to "very much" (4).
Incidence of neutralizing antibodies (NAbs) to odronextamab over the study duration Up to 30 months Part 1
Overall mean change in physical function [European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire 30 (EORTC-QLQ-C30)] Up to 5 years Part 2 The EORTC QLQ-C30 includes 5 functional scales (physical, role, cognitive, emotional and social functioning), 3 symptom scales (fatigue, pain and nausea/vomiting), a global health status (GHS)/QoL scale, and six single items (constipation, diarrhea, insomnia, shortness of breath, appetite loss and financial difficulties). For the functioning scales and global health status / QoL, scores range from 1 = "very poor" to 7 = "excellent" with higher scores indicate better functioning; for the symptom scales, scores range from 1 = "not at all" to 4 = "very much" higher scores indicate higher symptom burden.
Objective response assessed by independent central review Up to 30 months Part 2
DOR assessed by local investigator Up to 5 years Part 2
Time to next anti-lymphoma treatment (TTNT) Up to 5 years Part 2
Severity of TEAEs Up to 2 years Part 2
Odronextamab concentrations in serum during the maintenance period Up to 30 months Part 2
Overall mean changes in scores of patient reported outcomes (PROs), as measured by the validated instruments EORTCQLQ- C30 Up to 5 years Part 2 The EORTC QLQ-C30 includes 5 functional scales (physical, role, cognitive, emotional and social functioning), 3 symptom scales (fatigue, pain and nausea/vomiting), a global health status (GHS)/QoL scale, and six single items (constipation, diarrhea, insomnia, shortness of breath, appetite loss and financial difficulties). For the functioning scales and global health status / QoL, scores range from 1 = "very poor" to 7 = "excellent" with higher scores indicate better functioning; for the symptom scales, scores range from 1 = "not at all" to 4 = "very much" higher scores indicate higher symptom burden.
Overall mean changes in scores of PROs, as measured by the validated instruments EuroQol-5 Dimension-5 Level Scale (EQ-5D- 5L) Up to 5 years Part 2 The EQ-5D-5L consists of the EQ-5D descriptive system and the EQ visual analogue scale (EQ VAS). The EQ-5D-5L descriptive system comprises the following 5 dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension has 5 levels: "no problems", "slight problems", "moderate problems", "severe problems" and "extreme problems". The EQ VAS records the participant's self-rated health on a vertical visual analogue scale where the endpoints are labeled "Best imaginable health state" and "Worst imaginable health state".
EFS as assessed by the local investigator Up to 5 years Part 2
Objective response assessed by local investigator Up to 30 months Part 2
Overall mean changes in scores of PROs, as measured by the validated instruments Functional Assessment of Cancer Therapy-Lymphoma (FACT-LymS) Up to 5 years Part 2 The FACT-Lym lymphoma subscale (LymS) includes 15 items to assess NHL-related symptoms and concerns. All questions are answered on a 5-point scale ranging from "not at all" (0) to "very much" (4). Higher scores are associated with a worse quality of life.
Overall mean changes in scores of PROs, as measured by the validated instruments Patient Global Impression of Severity (PGIS) Up to 5 years Part 2 The PGIS includes a single-item to assess how a patient perceives the overall severity of cancer symptoms over the past 7 days. Patients will choose the response that best describes the severity of their overall cancer symptoms with options on a 5-point scale ranging from 1 (No symptoms) to 4 (Very Severe).
Overall mean changes in scores PROs, as measured by the validated Functional Assessment of Cancer - General (FACT-G) global population 5 (GP5) question Up to 5 years Part 2 A single item GP5 of the validated FACT-G questionnaire will be used to assess from the participant perspective the overall impact of treatment side-effect. The question item is on a 5-point scale ranging from "not at all" (0) to "very much" (4).
Trial Locations
- Locations (171)
University of Arizona Cancer Center
🇺🇸Tucson, Arizona, United States
HOPE Cancer Center of East Texas
🇺🇸Tyler, Texas, United States
David Geffen School of Medicine at UCLA
🇺🇸Los Angeles, California, United States
UC Irvine Health
🇺🇸Orange, California, United States
Investigative Clinical Research of Indiana
🇺🇸Noblesville, Indiana, United States
Beth Israel Deaconess Medical Center
🇺🇸Boston, Massachusetts, United States
Karmanos Cancer Institute
🇺🇸Detroit, Michigan, United States
Icahn School of Medicine at Mt Sinai
🇺🇸New York, New York, United States
Stony Brook University Hospital
🇺🇸Stony Brook, New York, United States
Clinical Research Alliance Inc
🇺🇸Westbury, New York, United States
Institut Jules Bordet
🇧🇪Brussels, Belgium
University of North Carolina
🇺🇸Chapel Hill, North Carolina, United States
Levine Cancer Institute
🇺🇸Charlotte, North Carolina, United States
University of Virginia
🇺🇸Charlottesville, Virginia, United States
Prohealth Care Inc
🇺🇸Waukesha, Wisconsin, United States
Ingham Institute
🇦🇺Liverpool, New South Wales, Australia
University Hospitals Cleveland Medical Center
🇺🇸Cleveland, Ohio, United States
Center for Oncology and Blood Disorders
🇺🇸Houston, Texas, United States
Icon Cancer Centre - Wesley
🇦🇺Auchenflower, Queensland, Australia
Flinders Medical Centre
🇦🇺Bedford Park, South Australia, Australia
Monash Health
🇦🇺Clayton, Victoria, Australia
Instituto DOr de Pesquisa e Ensino Df Star
🇧🇷Brasilia, Brazil
Epworth Freemasons
🇦🇺East Melbourne, Victoria, Australia
St Vincent's Hospital - Melbourne
🇦🇺Fitzroy, Victoria, Australia
Alfred Hospital and Monash University
🇦🇺Melbourne, Victoria, Australia
Ordensklinikum Linz
🇦🇹Linz, Osterreich, Austria
Ordensklinikum Linz Gmbh, Elisabethinen
🇦🇹Linz, Austria
Uniklinikum Salzburg (LKH) Universitatsklinik fur Innere Medizin III
🇦🇹Salzburg, Austria
Medical University of Vienna
🇦🇹Vienna, Austria
Hanusch Krankenhaus
🇦🇹Vienna, Austria
AZ St.-Elisabeth Herentals vzw
🇧🇪Herentals, Antwerp, Belgium
Instituto Mario Pena de Ensino Pesquisa e Inovacao
🇧🇷Belo Horizonte, Minas Gerais, Brazil
Liga Norte Riograndense Contra o Cancer
🇧🇷Natal, Rio Grande Do Norte, Brazil
Instituto do Cancer em Hospital Sao Vicente de Paulo
🇧🇷Passo Fundo, Rio Grande Do Sul, Brazil
Centro de Hematologia e Oncologia
🇧🇷Joinville, Santa Catarina, Brazil
Amaral Carvalho Hospital
🇧🇷Jau, Sao Paulo, Brazil
Hospital das Clinicas da Faculdade de Medicina de Ribeirao Preto da Universidade de Sao Paulo
🇧🇷Ribeirao Preto, Sao Paulo, Brazil
Animi Unidade de Tratamento Oncologico Ltda
🇧🇷Lages, Brazil
Hospital de Clinicas de Porto Alegre
🇧🇷Porto Alegre, Brazil
Instituto Americas
🇧🇷Rio de Janeiro, Brazil
Hospital Alemao Oswaldo Cruz
🇧🇷Sao Paulo, Brazil
AC Camargo Cancer Center
🇧🇷Sao Paulo, Brazil
Casa de Saude Santa Marcelina
🇧🇷Sao Paulo, Brazil
Tom Baker Cancer Center
🇨🇦Calgary, Alberta, Canada
Saint John Regional Hospital
🇨🇦Saint John, New Brunswick, Canada
Cisss de la Monteregie-Centre
🇨🇦Greenfield Park, Quebec, Canada
CHU de Quebec - Universite Laval
🇨🇦Quebec City, Quebec, Canada
Ciusss de Lestrie - Centre Hospitalier Universitaire de Sherbrooke (CHUS)
🇨🇦Sherbrooke, Quebec, Canada
Fundacion Arturo Lopez Perez
🇨🇱Santiago, Region Metropolitana, Chile
Inmunocel
🇨🇱Santiago, Region Metropolitana, Chile
Clinica Alemana de Santiago
🇨🇱Santiago, Region Metropolitana, Chile
Centro Oncologia de Precision Universidad Mayor
🇨🇱Santiago, Chile
University Hospital Hradec Kralove
🇨🇿Hradec Kralove, Czechia
University Hospital Kralovske Vinohrady
🇨🇿Prague, Czechia
Vseobecna Fakultni Nemocnice
🇨🇿Praha, Czechia
Centre Hospitalier Universitaire (CHU) Rennes
🇫🇷Rennes, Bretagne, France
Centre Hospitalier Regional Universitaire de Tours
🇫🇷Tours, Centre Val De Loire, France
Hopital Victor Dupouy Argenteuil
🇫🇷Argenteuil, Ile De France, France
Gustave Roussy
🇫🇷Villejuif, Ile De France, France
Nantes University Hospital
🇫🇷Nantes, Pays De La Loire, France
Hopital de la Conception
🇫🇷Marseille, Provence-Alpes-Cote d'Azur, France
Centre Hospitalier Universitaire Angers
🇫🇷Angers, France
Institut Paoli Calmettes
🇫🇷Marseille, France
Hopital Saint Louis
🇫🇷Paris, France
Hopital Saint Antoine
🇫🇷Paris, France
Centre Hospitalier Universitaire (CHU) de Poitiers
🇫🇷Poitiers, France
Institut de Cancerologie Strasbourg Europe (ICANS)
🇫🇷Strasbourg, France
University Hospital Wurzburg
🇩🇪Würzburg, Bavaria, Germany
Kliniken Ostalb Stauferklinikum Schwab Gmund
🇩🇪Mutlangen, Gmund, Germany
Clinic Frankfurt (Oder)
🇩🇪Frankfurt, Hesse, Germany
Universitatsmedizin der Johannes-Gutenberg Universitat Mainz
🇩🇪Mainz, Rheinland-Pfalz, Germany
Hematological Praxis Dresden
🇩🇪Dresden, Sachsen, Germany
Charite Universitatsmedizin Berlin Campus Benjamin Franklin
🇩🇪Berlin, Germany
University Hospital Carl Gustav Carus
🇩🇪Dresden, Germany
Stadtisches Krankenhaus Kiel
🇩🇪Kiel, Germany
Samson Assuta Ashdod University Hospital
🇮🇱Ashdod, Israel
Bnai Zion Medical Center
🇮🇱Haifa, Israel
Hadassah Medical Center
🇮🇱Jerusalem, Israel
Galilee Medical Center
🇮🇱Nahariya, Israel
Rabin Medical Center
🇮🇱Petah-Tikva, Israel
Chaim Sheba Medical Center
🇮🇱Ramat-Gan, Israel
Tel Aviv Sourasky Medical Center
🇮🇱Tel Aviv, Israel
Istituto Romagnolo Per Lo Studio Dei Tumori
🇮🇹Meldola, Forli Cesena, Italy
Irccs Aou Di Bologna- Policlinico Di Sant'Orsola Malpighi
🇮🇹Bologna, Italia, Italy
IRCCS Ospedale Policlinico San Martino
🇮🇹Genoa, Liguria, Italy
Candiolo Cancer Institute, FPO, IRCCS
🇮🇹Candiolo, Torino, Italy
UOC Ematologia e Terapia Cellulare - PO Mazzoni AST Ascoli Piceno
🇮🇹Ascoli Piceno, Italy
Azienda Ospedaliera Spedali Civili di Brescia
🇮🇹Brescia, Italy
Istituto Europeo di Oncologia
🇮🇹Milano, Italy
Federico II University
🇮🇹Napoli, Italy
AOU Maggiore della Carita-SCDU Ematologia
🇮🇹Novara, Italy
UO Ematologia Ravenna
🇮🇹Ravenna, Italy
Santa Maria della Misericordia
🇮🇹Udine, Italy
Ospedale dell'Angelo - Varese
🇮🇹Varese, Italy
Center for Hematologic Malignancy
🇰🇷Goyang, Gyeonggi-do, Korea, Republic of
St. Vincents Hospital - The Catholic University of Korea
🇰🇷Suwon-si, Gyeonggi-do, Korea, Republic of
Ajou University Hospital
🇰🇷Suwon-si, Gyeonggi-do, Korea, Republic of
Dong-A University Hospital
🇰🇷Busan, Korea, Republic of
Pusan National University Hospital
🇰🇷Busan, Korea, Republic of
Jeonbuk National University Hospital
🇰🇷Jeonju, Korea, Republic of
Seoul St. Mary's Hospital
🇰🇷Seoul, Korea, Republic of
Uniwersytecki Szpital Kliniczny
🇵🇱Wroclaw, Dolnoslaskie, Poland
Uniwersyteckie Centrum Kliniczne
🇵🇱Gdansk, Pomorskie, Poland
Specjalistyczny Szpital im A. Sokolowskiego w Walbrzychu
🇵🇱Walbrzych, Lower Silesian, Poland
Pratia MCM Krakow
🇵🇱Krakow, Malopolska, Poland
Cm Pratia Poznan
🇵🇱Poznan, Wielkopolska, Poland
Aidport
🇵🇱Skorzewo, Wielkopolska, Poland
Pratia Onkologia Katowice
🇵🇱Katowice, Poland
Copernicus Memorial Hospital
🇵🇱Lodz, Poland
Centrum Innowacyjnych Terapii Samodzielny Publiczny Szpital Kliniczny Nr 4 w Lublinie
🇵🇱Lublin, Poland
Narodowy Instytut Onkologii im Marii Sklodowskiej Curie Panstwowy Instytut Badawczy Warszawa
🇵🇱Warszawa, Poland
Hospital Universitario Virgen Macarena
🇪🇸Sevilla, Andalucia, Spain
Hospital Universitario Central De Asturias
🇪🇸Oviedo, Asturias, Spain
Son Espases University Hospital
🇪🇸Palma, Balearic Islands, Spain
Cruces University Hospital (Hospital Universitario Cruces)
🇪🇸Barakaldo, Bizkaia, Spain
Hospital Universitario Marques de Valdecilla
🇪🇸Santander, Cantabria, Spain
Complejo Hospitalario Universitario de a Coruna
🇪🇸A Coruna, Galicia, Spain
Hospital Universitario Quironsalud Madrid
🇪🇸Pozuelo de Alarcon, Madrid, Spain
Hospital Universitario de Navarra
🇪🇸Pamplona, Navarra, Spain
University Hospital Vall d'Hebron
🇪🇸Barcelona, Spain
University Hospital of Santiago de Compostela
🇪🇸Santiago de Compostela, A Coruna, Spain
Hospital Universitario Virgen De La Victoria Malaga
🇪🇸Malaga, Andalucia, Spain
Hospital Virgen De Las Nieves De Granada
🇪🇸Granada, Spain
Chang Gung Medical Foundation Chia Yi Branch
🇨🇳Chiayi City, Taiwan
Gregorio Maranon
🇪🇸Madrid, Spain
Clinica Universidad de Navarra
🇪🇸Madrid, Spain
Fundacion Jimenez Diaz University Hospital
🇪🇸Madrid, Spain
University Hospital & Research Institute
🇪🇸Madrid, Spain
Chung-Ho Memorial Hospital
🇨🇳Kaohsiung, Taiwan
Hospital Universitario HM Sanchinarro, Servicio de Hematologia
🇪🇸Madrid, Spain
Morales Meseguer Hospital
🇪🇸Murcia, Spain
Complexo Hospitalario Universitario de Ourense
🇪🇸Ourense, Spain
Hospital Universitario de Salamanca
🇪🇸Salamanca, Spain
Hospital Universitario Virgen de Valme
🇪🇸Sevilla, Spain
University Hospital Virgen del Rocio
🇪🇸Seville, Spain
Hospital General Universitario de Toledo
🇪🇸Toledo, Spain
Hospital Clinico Universitario Valencia
🇪🇸Valencia, Spain
Hospital Universitari and Politecnic La Fe
🇪🇸Valencia, Spain
Hospital Clinico Lozano Blesa
🇪🇸Zaragoza, Spain
Kantonsspital Baden
🇨🇭Baden, Aargau, Switzerland
Cantonal Hospital St Gallen
🇨🇭St Gallen, Saint Gallen, Switzerland
Kantonsspital Winterthur Medical Oncology
🇨🇭Winterthur, Schweiz, Switzerland
University Hospital Basel
🇨🇭Basel, Switzerland
Inselspital Bern University Hospital
🇨🇭Bern, Switzerland
Chang Gung Memorial Hospital Linkou
🇨🇳Taoyuan City, Guishan District, Taiwan
Changhua Christian Hospital
🇨🇳Changhua City, Taiwan
Kaohsiung Chang Gung Memorial Hospital
🇨🇳Kaohsiung, Taiwan
Taipei Medical University-Shuang Ho Hospital
🇨🇳New Taipei City, Taiwan
Taichung General Veterans Hospital
🇨🇳Taichung, Taiwan
National Cheng Kung University Hospital
🇨🇳Tainan, Taiwan
Tri-Service General Hospital
🇨🇳Taipei City, Taiwan
National Taiwan University Hospital
🇨🇳Taipei, Taiwan
Taipei Municipal Wan Fang Hospital
🇨🇳Taipei, Taiwan
Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital
🇹🇷Yenimahalle, Ankara, Turkey
Gazi University
🇹🇷Ankara, Central Anatolia, Turkey
VM Medical Park Mersin Hospital
🇹🇷Mezitli, Mersin, Turkey
Tekirdag Namik Kemal University Hospital
🇹🇷Tekirdag, Suleymanpasa, Turkey
Liv Hospital Ankara
🇹🇷Ankara, Turkey
VKV American Hopital
🇹🇷Istanbul, Turkey
Istanbul University Istanbul Faculty of Medicine
🇹🇷Istanbul, Turkey
Ege University
🇹🇷Izmir, Turkey
Erci̇yes Uni̇versi̇ty
🇹🇷Kayseri, Turkey
Sakarya Universty Medical Faculty
🇹🇷Sakarya, Turkey
Ondokuz Mayis Universitesi Tip Fakultesi Hastanesi
🇹🇷Samsun, Turkey
Zonguldak Bulent Ecevit University
🇹🇷Zonguldak, Turkey
Royal Cornwall Hospital NHS Trust
🇬🇧Truro, Cornwall, United Kingdom
Derriford Hospital and the Royal Eye Infirmary
🇬🇧Plymouth, Devon, United Kingdom
University Hospitals Dorset
🇬🇧Bournemouth, Dorset, United Kingdom
Beatson West of Scotland Cancer Centre
🇬🇧Glasgow, Lanarkshire, United Kingdom
Norfolk and Norwich University Hospital
🇬🇧Norwich, Norfolk, United Kingdom
Barking, Havering and Redbridge University Hospitals NHS Trust
🇬🇧Romford, United Kingdom