A Study of Ipatasertib in Combination With Atezolizumab and Paclitaxel as a Treatment for Participants With Locally Advanced or Metastatic Triple-Negative Breast Cancer

Phase 3

Completed

Conditions: Triple-Negative Breast Cancer

Interventions: Drug: Paclitaxel
Drug: Atezolizumab
Drug: Ipatasertib
Drug: Placebo for Atezolizumab
Drug: Placebo for Ipatasertib

Registration Number: NCT04177108

Lead Sponsor: Hoffmann-La Roche

Brief Summary: This study evaluated the efficacy and safety of ipatasertib in combination with atezolizumab and paclitaxel in locally advanced or metastatic Triple-Negative Breast Cancer (TNBC) previously untreated in this setting.

Detailed Description: Not available

Recruitment & Eligibility

Status: COMPLETED

Sex: All

Target Recruitment: 242

Inclusion Criteria

Willingness and ability to complete all study-related assessments, including Participant-Reported Outcome (PRO) assessments, in the investigator's judgement.
Adequate hematologic and organ function within 14 days before the first study treatment on Day 1 of Cycle 1.
Life expectancy of at least 6 months.
Measurable disease according to Response Evaluation Criteria in Solid Tumors, Version 1.1 (RECIST v 1.1).
Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 or 1.
For women of childbearing potential: agreement to remain abstinent (refrain from heterosexual intercourse) or use contraception, and agreement to refrain from donating eggs.
For men: agreement to remain abstinent (refrain from heterosexual intercourse) or use contraceptive methods, and agreement to refrain from donating sperm.
Appropriate candidate for paclitaxel monotherapy if tumor programmed death-ligand 1 (PD-L1) status is unknown or non-positive; appropriate candidate for paclitaxel and atezolizumab if tumor PD-L1 status is positive.
Histologically documented triple-negative adenocarcinoma of the breast that is locally advanced or metastatic and is not amenable to resection with curative intent.

Exclusion Criteria

Inability to comply with study and follow-up procedures.
History of malabsorption syndrome or other condition that would interfere with enteral absorption or results in the inability or unwillingness to swallow pills.
Severe infection within 4 weeks prior to initiation of study treatment (including, but not limited to, hospitalization for complications of infection, bacteremia, or severe pneumonia) as well as those who have received treatment with therapeutic oral or intravenous (IV) antibiotics within 2 weeks prior to initiation of study treatment.
Known human immunodeficiency virus (HIV) infection (there must be a negative HIV test at screening).
Known clinically significant history of liver disease consistent with Child-Pugh Class B or C.
Current treatment with anti-viral therapy for hepatitis B virus (HBV).
Major surgical procedure, open biopsy, or significant traumatic injury within 28 days prior to Day 1 of Cycle 1 or anticipation of need for a major surgical procedure during the study.
Pregnancy or breastfeeding, or intention to become pregnant during the study or within 28 days after the final dose of ipatasertib or (/) placebo, 5 months after the final dose of atezolizumab/placebo, and 6 months after the final dose of paclitaxel whichever occurs later.
New York Heart Association Class II, III, or IV heart failure, left ventricular ejection fraction less than (<) 50 percent (%), or active ventricular arrhythmia requiring medication.
Current unstable angina or history of myocardial infarction within 6 months prior to Day 1 of Cycle 1.
Congenital long QT syndrome or screening QT interval corrected through use Fridericia's formula (QTcF) greater than (>) 480 milliseconds (ms).
Current treatment with medications used at doses known to cause clinically relevant prolongation of QT/QTc interval.
History or presence of an abnormal ECG that is clinically significant in the investigator's opinion (including complete left bundle branch block, second- or third-degree heart block, or evidence of prior myocardial infarction).
Requirement for chronic corticosteroid therapy of > 10 mg of prednisone per day or an equivalent dose of other anti-inflammatory corticosteroids or immunosuppressant agents for a chronic disease.
Treatment with approved or investigational cancer therapy within 14 days prior to Day 1 of Cycle 1.
Any other disease, metabolic dysfunction, physical examination finding, or clinical laboratory finding that, in the investigator's opinion, gives reasonable suspicion of a disease or condition that contraindicates the use of an investigational drug or that may affect the interpretation of the results or renders the participant at high risk from treatment complications.
History of or known presence of spinal cord metastases, as determined by computed tomography (CT) or magnetic resonance imaging (MRI) evaluation during screening or prior radiographic assessments.
Known central nervous system (CNS) disease, except for treated asymptomatic CNS metastases.
Known germline breast cancer gene (BRCA)1/2 deleterious mutation, unless the participant is not an appropriate candidate for a poly adenosine diphosphate ribose polymerase (PARP)-inhibitor.
Any previous systemic therapy for inoperable locally advanced or metastatic triple-negative adenocarcinoma of the breast.
Unresolved, clinically significant toxicity from prior therapy, except for alopecia and Grade 1 peripheral neuropathy.
Participants who have received palliative radiotherapy to peripheral sites (e.g., bone metastases) for pain control and whose last treatment was completed 14 days prior to Day 1 of Cycle 1 may be enrolled in the study if they have recovered from all acute, reversible effects (e.g., to Grade 1 or resolved by enrolment).
Uncontrolled pleural effusion, pericardial effusion or ascites.
Uncontrolled tumor-related pain.
Malignancies other than breast cancer within 5 years prior to Day 1 of Cycle 1, except for appropriately treated carcinoma in situ of the cervix, non-melanoma skin carcinoma, or Stage I uterine cancer.
Known hypersensitivity or contraindication to any component of the study treatments, including the paclitaxel excipient, macrogolglycerol ricinoleate.
Grade greater than or equal to (≥) 2 peripheral neuropathy.
History of Type I or Type II diabetes mellitus requiring insulin.
Grade ≥ 2 uncontrolled or untreated hypercholesterolemia or hypertriglyceridemia.
History of or active inflammatory bowel disease (e.g., Crohn disease and ulcerative colitis) or active bowel inflammation (e.g., diverticulitis).
Lung disease: pneumonitis, interstitial lung disease, idiopathic pulmonary fibrosis, cystic fibrosis, Aspergillosis, active tuberculosis, or history of opportunistic infections (pneumocystis pneumonia or cytomegalovirus pneumonia).
Treatment with strong Cytochrome P450 (CYP)3A inhibitors or strong CYP3A inducers within 2 weeks or 5 drug-elimination half-lives, whichever is longer, prior to initiation of study drug.
Prior treatment with an Protein kinase B (Akt) inhibitor.
Active or history of autoimmune disease or immune deficiency.
History of idiopathic pulmonary fibrosis, organizing pneumonia (e.g., bronchiolitis obliterans), drug-induced pneumonitis, idiopathic pneumonitis, or evidence of active pneumonitis on screening chest CT scan.
Prior allogeneic stem cell or solid organ transplantation.
Treatment with a live, attenuated vaccine within 4 weeks prior to initiation of study treatment, or anticipation of need for such a vaccine during treatment with atezolizumab or within 5 months after the final dose of atezolizumab.
History of severe allergic anaphylactic reactions to chimeric or humanized antibodies or fusion proteins.
Known hypersensitivity to Chinese hamster ovary cell products or recombinant human antibodies.
Treatment with systemic immunostimulatory agents (including, but not limited to, interferon and interleukin-2) within 4 weeks or 5 half-lives of the drug (whichever is longer) prior to initiation of study treatment.
Treatment with systemic immunosuppressive medication (including, but not limited to corticosteroids, cyclophosphamide, azathioprine, methotrexate, thalidomide, and anti-tumor necrosis factor-alpha agents) within 2 weeks prior to initiation of study treatment, or anticipation of need for systemic immunosuppressive medication during the study.

Study & Design

Study Type: INTERVENTIONAL

Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Cohort 1 Arm C: Placebo + Placebo + Paclitaxel	Paclitaxel	TNBC participants with PD-L1 non-positive received a combination of paclitaxel, 80 mg/m\^2, IV infusion on Days 1, 8, and 15 of each 28-day cycle and ipatasertib-matching placebo, PO, QD, from Day 1 to Day 21 of each 28-day cycle and atezolizumab-matching placebo, IV infusion on Day 1 and 15 of each 28-day cycle until loss of clinical benefit, unacceptable toxicity, or withdrawal of consent, whichever occurred first.
Cohort 1 Arm B: Ipatasertib + Placebo + Paclitaxel	Paclitaxel	TNBC participants with PD-L1 non-positive received a combination of paclitaxel, 80 mg/m\^2, IV infusion on Days 1, 8, and 15 of each 28-day cycle and ipatasertib, 400 mg, PO, QD, from Day 1 to Day 21 of each 28-day cycle and atezolizumab-matching placebo, IV infusion on Day 1 and 15 of each 28-day cycle until loss of clinical benefit, unacceptable toxicity, or withdrawal of consent, whichever occurred first.
Cohort 1 Arm B: Ipatasertib + Placebo + Paclitaxel	Placebo for Atezolizumab	TNBC participants with PD-L1 non-positive received a combination of paclitaxel, 80 mg/m\^2, IV infusion on Days 1, 8, and 15 of each 28-day cycle and ipatasertib, 400 mg, PO, QD, from Day 1 to Day 21 of each 28-day cycle and atezolizumab-matching placebo, IV infusion on Day 1 and 15 of each 28-day cycle until loss of clinical benefit, unacceptable toxicity, or withdrawal of consent, whichever occurred first.
Cohort 1 Arm C: Placebo + Placebo + Paclitaxel	Placebo for Atezolizumab	TNBC participants with PD-L1 non-positive received a combination of paclitaxel, 80 mg/m\^2, IV infusion on Days 1, 8, and 15 of each 28-day cycle and ipatasertib-matching placebo, PO, QD, from Day 1 to Day 21 of each 28-day cycle and atezolizumab-matching placebo, IV infusion on Day 1 and 15 of each 28-day cycle until loss of clinical benefit, unacceptable toxicity, or withdrawal of consent, whichever occurred first.
Cohort 1 Arm A: Ipatasertib + Atezolizumab + Paclitaxel	Atezolizumab	TNBC participants with programmed death-ligand 1 (PD-L1) non-positive received a combination of paclitaxel, 80 milligrams per meter square (mg/m\^2), intravenous (IV) infusion on Days 1, 8, and 15 of each 28-day cycle and ipatasertib, 400 mg, orally (PO), once daily (QD), from Day 1 to Day 21 of each 28-day cycle and atezolizumab, 840 mg, IV infusion on Day 1 and 15 of each 28-day cycle until loss of clinical benefit, unacceptable toxicity, or withdrawal of consent, whichever occurred first.
Cohort 1 Arm A: Ipatasertib + Atezolizumab + Paclitaxel	Ipatasertib	TNBC participants with programmed death-ligand 1 (PD-L1) non-positive received a combination of paclitaxel, 80 milligrams per meter square (mg/m\^2), intravenous (IV) infusion on Days 1, 8, and 15 of each 28-day cycle and ipatasertib, 400 mg, orally (PO), once daily (QD), from Day 1 to Day 21 of each 28-day cycle and atezolizumab, 840 mg, IV infusion on Day 1 and 15 of each 28-day cycle until loss of clinical benefit, unacceptable toxicity, or withdrawal of consent, whichever occurred first.
Cohort 1 Arm A: Ipatasertib + Atezolizumab + Paclitaxel	Paclitaxel	TNBC participants with programmed death-ligand 1 (PD-L1) non-positive received a combination of paclitaxel, 80 milligrams per meter square (mg/m\^2), intravenous (IV) infusion on Days 1, 8, and 15 of each 28-day cycle and ipatasertib, 400 mg, orally (PO), once daily (QD), from Day 1 to Day 21 of each 28-day cycle and atezolizumab, 840 mg, IV infusion on Day 1 and 15 of each 28-day cycle until loss of clinical benefit, unacceptable toxicity, or withdrawal of consent, whichever occurred first.
Cohort 2 Arm A: Ipatasertib + Atezolizumab + Paclitaxel	Ipatasertib	TNBC participants with PD-L1 positive received a combination of paclitaxel, 80 mg/m\^2, IV infusion on Days 1, 8, and 15 of each 28-day cycle and ipatasertib, 400 mg, PO, QD, from Day 1 to Day 21 of each 28-day cycle and atezolizumab, 840 mg, IV infusion on Day 1 and 15 of each 28-day cycle until loss of clinical benefit, unacceptable toxicity, or withdrawal of consent, whichever occurred first.
Cohort 2 Arm A: Ipatasertib + Atezolizumab + Paclitaxel	Paclitaxel	TNBC participants with PD-L1 positive received a combination of paclitaxel, 80 mg/m\^2, IV infusion on Days 1, 8, and 15 of each 28-day cycle and ipatasertib, 400 mg, PO, QD, from Day 1 to Day 21 of each 28-day cycle and atezolizumab, 840 mg, IV infusion on Day 1 and 15 of each 28-day cycle until loss of clinical benefit, unacceptable toxicity, or withdrawal of consent, whichever occurred first.
Cohort 2 Arm B: Placebo+ Atezolizumab + Paclitaxel	Atezolizumab	TNBC participants with PD-L1 positive received a combination of paclitaxel, 80 mg/m\^2, IV infusion on Days 1, 8, and 15 of each 28-day cycle and ipatasertib-matching placebo, PO, QD, from Day 1 to Day 21 of each 28-day cycle and atezolizumab, 840 mg, IV infusion on Day 1 and 15 of each 28-day cycle until loss of clinical benefit, unacceptable toxicity, or withdrawal of consent, whichever occurred first.
Cohort 2 Arm B: Placebo+ Atezolizumab + Paclitaxel	Paclitaxel	TNBC participants with PD-L1 positive received a combination of paclitaxel, 80 mg/m\^2, IV infusion on Days 1, 8, and 15 of each 28-day cycle and ipatasertib-matching placebo, PO, QD, from Day 1 to Day 21 of each 28-day cycle and atezolizumab, 840 mg, IV infusion on Day 1 and 15 of each 28-day cycle until loss of clinical benefit, unacceptable toxicity, or withdrawal of consent, whichever occurred first.
Cohort 1 Arm C: Placebo + Placebo + Paclitaxel	Placebo for Ipatasertib	TNBC participants with PD-L1 non-positive received a combination of paclitaxel, 80 mg/m\^2, IV infusion on Days 1, 8, and 15 of each 28-day cycle and ipatasertib-matching placebo, PO, QD, from Day 1 to Day 21 of each 28-day cycle and atezolizumab-matching placebo, IV infusion on Day 1 and 15 of each 28-day cycle until loss of clinical benefit, unacceptable toxicity, or withdrawal of consent, whichever occurred first.
Cohort 2 Arm B: Placebo+ Atezolizumab + Paclitaxel	Placebo for Ipatasertib	TNBC participants with PD-L1 positive received a combination of paclitaxel, 80 mg/m\^2, IV infusion on Days 1, 8, and 15 of each 28-day cycle and ipatasertib-matching placebo, PO, QD, from Day 1 to Day 21 of each 28-day cycle and atezolizumab, 840 mg, IV infusion on Day 1 and 15 of each 28-day cycle until loss of clinical benefit, unacceptable toxicity, or withdrawal of consent, whichever occurred first.
Cohort 2 Arm A: Ipatasertib + Atezolizumab + Paclitaxel	Atezolizumab	TNBC participants with PD-L1 positive received a combination of paclitaxel, 80 mg/m\^2, IV infusion on Days 1, 8, and 15 of each 28-day cycle and ipatasertib, 400 mg, PO, QD, from Day 1 to Day 21 of each 28-day cycle and atezolizumab, 840 mg, IV infusion on Day 1 and 15 of each 28-day cycle until loss of clinical benefit, unacceptable toxicity, or withdrawal of consent, whichever occurred first.
Cohort 1 Arm B: Ipatasertib + Placebo + Paclitaxel	Ipatasertib	TNBC participants with PD-L1 non-positive received a combination of paclitaxel, 80 mg/m\^2, IV infusion on Days 1, 8, and 15 of each 28-day cycle and ipatasertib, 400 mg, PO, QD, from Day 1 to Day 21 of each 28-day cycle and atezolizumab-matching placebo, IV infusion on Day 1 and 15 of each 28-day cycle until loss of clinical benefit, unacceptable toxicity, or withdrawal of consent, whichever occurred first.

Primary Outcome Measures

Name	Time	Method
Progression-Free Survival (PFS) According to Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1	From Randomization to disease progression, study completion, or death (up to 39 months)	PFS was defined as the time from randomization to the first occurrence of disease progression as determined locally by RECIST or death from any cause during treatment, whichever occurs first.
Overall Survival (OS)	From randomization up to study completion or death (Up to 39 months)	OS was defined as the time from randomization to the time of death from any cause on study.

Secondary Outcome Measures

Name	Time	Method
Number of Participants With Adverse Events (AEs)	Up to 39 months	An AE is any untoward medical occurrence in a participant or clinical investigation participant administered a pharmaceutical product and which does not necessarily have to have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with the use of a medicinal product, whether or not considered related to the medicinal product.

Trial Locations

Locations (181): Winship Cancer Institute
🇺🇸
Atlanta, Georgia, United States
McGill University; Glen Site; Oncology
🇨🇦
Montreal, Quebec, Canada
Royal Victoria Hospital
🇨🇦
Barrie, Ontario, Canada
The Ottawa Hospital Cancer Centre
🇨🇦
Ottawa, Ontario, Canada
IRST Istituto Scientifico Romagnolo Per Lo Studio E Cura Dei Tumori, Sede Meldola; Oncologia Medica
🇮🇹
Meldola, Emilia-Romagna, Italy
Fakultni nemocnice Olomouc; Onkologicka klinika
🇨🇿
Olomouc, Czechia
ASU FC S. M. DELLA MISERICORDIA; Oncologia
🇮🇹
Udine, Friuli-Venezia Giulia, Italy
ASST DI LECCO; Oncologia Medica
🇮🇹
Lecco, Lombardia, Italy
Cancer Care Manitoba
🇨🇦
Winnipeg, Manitoba, Canada
Jewish General Hospital; Research Unit
🇨🇦
Montréal, Quebec, Canada
MHAT Nadezhda
🇧🇬
Sofia, Bulgaria
Docrates Cance Center
🇫🇮
Helsinki, Finland
Istituto Nazionale per lo Studio e la Cura dei Tumori Fondazione G. Pascale
🇮🇹
Napoli, Campania, Italy
Cross Cancer Institute ; Dept of Medical Oncology
🇨🇦
Edmonton, Alberta, Canada
Clinica de Pesquisa e Centro de Estudos em Oncologia Ginecologica e Mamaria Ltda
🇧🇷
Sao Paulo, SP, Brazil
Wellington Regional Hospital; Clinical Trials Unit
🇳🇿
Wellington, New Zealand
Oncólogos de Occidente
🇨🇴
Pereira, Colombia
Clinica CIMCA
🇨🇷
San José, Costa Rica
Masaryk?v onkologický ústav; Klinika komplexní onkologické pé?e
🇨🇿
Brno, Czechia
Hopital du Saint Sacrement
🇨🇦
Quebec City, Quebec, Canada
Tauranga Hospital, Clinical Trials Unit; BOP Clinical School
🇳🇿
Tauranga, New Zealand
Seoul St Mary's Hospital
🇰🇷
Seoul, Korea, Republic of
Núcleo de Pesquisa São Camilo; ONCOLOGIA CLINICA / QUIMIOTERAPIA
🇧🇷
Sao Paulo, SP, Brazil
Centre Eugene Marquis; Service d'oncologie
🇫🇷
Rennes, France
Hiroshima University Hospital
🇯🇵
Hiroshima, Japan
Hospital Universitario Puerta de Hierro; Servicio de Oncologia
🇪🇸
Majadahonda, Madrid, Spain
Cancercare
🇿🇦
Port Elizabeth, South Africa
Hospital Clínico Universitario de Valencia; Servicio de Oncología
🇪🇸
Valencia, Spain
Auckland City Hospital, Cancer and Blood Research
🇳🇿
Auckland, New Zealand
Hospital Provincial de Castellon; Servicio de Oncologia
🇪🇸
Castellon de La Plana, Castellon, Spain
Health Pharma Professional Research
🇲🇽
Cdmx, Mexico CITY (federal District), Mexico
Hospital Univ Vall d'Hebron; Servicio de Oncologia
🇪🇸
Sant Andreu de La Barca, Barcelona, Spain
Severance Hospital, Yonsei University Health System
🇰🇷
Seoul, Korea, Republic of
Wits Clinical Research
🇿🇦
Johannesberg, South Africa
Christus Muguerza Clinica Vidriera
🇲🇽
Monterrey, Nuevo LEON, Mexico
Wielkopolskie Centrum Onkologii
🇵🇱
Poznan, Poland
Wilgers Oncology Centre
🇿🇦
Pretoria, South Africa
Centro Integral Oncologico Clara Campal; Servicio de Oncología
🇪🇸
Madrid, Spain
Hospital Clínic i Provincial; Servicio de Hematología y Oncología
🇪🇸
Barcelona, Spain
Memorial Ankara Hastanesi
🇹🇷
Ankara, Turkey
National Hospital; Oncotherapy Dept
🇿🇦
Bloemfontein, South Africa
Nottingham University Hospitals NHS Trust
🇬🇧
Nottingham, United Kingdom
The Royal Marsden Hospital, Fulham
🇬🇧
London, United Kingdom
UCLA
🇺🇸
Los Angeles, California, United States
Sahyadri Super Specialty Hospital Hadapsar
🇮🇳
Pune, Maharashtra, India
Memorial Healthcare System - Memorial Regional Hospital
🇺🇸
Hollywood, Florida, United States
Rush University
🇺🇸
Chicago, Illinois, United States
St John of God Hospital; Bendat Cancer Centre
🇦🇺
Subiaco, Western Australia, Australia
Shaare Zedek Medical Center
🇮🇱
Jerusalem, Israel
Ochsner Clinic Foundation
🇺🇸
Baton Rouge, Louisiana, United States
Medizinische Universität Wien; Univ.Klinik für Innere Medizin I
🇦🇹
Wien, Austria
Clinica del Country
🇨🇴
Bogota, Colombia
Instituto Nacional de Enfermedades Neoplasicas
🇵🇪
Lima, Peru
Hospital da Luz; Departamento de Oncologia Medica
🇵🇹
Lisboa, Portugal
Hospital de Santa Maria; Servico de Oncologia Medica
🇵🇹
Lisboa, Portugal
P.A. Gertsen Cancer Research Inst. ; Chemotherapy Dept
🇷🇺
Moscow, Moskovskaja Oblast, Russian Federation
Monash Health Monash Medical Centre
🇦🇺
Clayton, Victoria, Australia
Clinica Ricardo Palma
🇵🇪
San Isidro, Peru
Instyt. Centrum Zdrowia Matki Polki; Klinika Chirurgii Onk. Chorób Piersi z Podod. Onko Klinicznej
🇵🇱
?ód?, Poland
Narodowy Inst.Onkol.im.Sklodowskiej-Curie Panstw.Inst.Bad Gliwice; Centr.Diagn.i Lecz.Chor.Piersi
🇵🇱
Gliwice, Poland
Narodowy Instytut Onkologii im. M.Sklodowskiej-Curie; Klinika Nowotworow Piersi i Chirurgii Rekonstr
🇵🇱
Warszawa, Poland
Hospital Beatriz Angelo; Departamento de Oncologia
🇵🇹
Loures, Portugal
IPO do Porto; Servico de Oncologia Medica
🇵🇹
Porto, Portugal
Arkhangelsk Regional Clinical Oncology Dispensary
🇷🇺
Arkhangelsk, Arhangelsk, Russian Federation
Peter MacCallum Cancer Centre; Medical Oncology
🇦🇺
Melbourne, Victoria, Australia
KYS Sadesairaala; Syopatautien poliklinikka
🇫🇮
Kuopio, Finland
Agioi Anargyroi Cancer Hospital; 2Nd Oncology Dept.
🇬🇷
Kifisia, Greece
Euromedical General Clinic of Thessaloniki; Oncology Department
🇬🇷
Thessaloniki, Greece
Szpital Uniwersytecki w Krakowie, Oddzia? Kliniczny Kliniki Onkologii
🇵🇱
Kraków, Poland
Clinical Oncology Dispensary of Ministry of Health of Tatarstan
🇷🇺
Kazan, Tatarstan, Russian Federation
Tiroler Landeskrankenanstalten Ges.M.B.H.; Abt. Für Gynäkologie
🇦🇹
Innsbruck, Austria
AZ Maria Middelares
🇧🇪
Gent, Belgium
Instituto Regional de Enfermedades Neoplasicas
🇵🇪
Arequipa, Peru
Unidad de Investigación Oncologica; Hospital Nacional Daniel Alcides Carrion
🇵🇪
Lima, Peru
Clínica San Gabriel; Unidad de Investigación Oncológica de la Clínica San Gabriel
🇵🇪
Lima, Peru
VAASAN KESKUSSAIRAALA; Onkologian poliklinikka
🇫🇮
Vaasa, Finland
Prince of Wales Hospital; Department of Clinical Onocology
🇭🇰
Shatin, Hong Kong
Fraser Valley Centre British Columbia Cancer Agency
🇨🇦
Surrey, British Columbia, Canada
Investigacion Oncofarmaceutica
🇲🇽
La Paz, BAJA California SUR, Mexico
Centro Medico Monte Carmelo
🇵🇪
Arequipa, Peru
Oncosalud Sac; Oncología
🇵🇪
Lima, Peru
Oncology Center Sf. Nectarie
🇷🇴
Craiova, Romania
SBIH "Moscow Clinical Scientific and Practical Center named after A.S. Loginov of DHM"
🇷🇺
Moskva, Moskovskaja Oblast, Russian Federation
Fed State Budgetary Inst "N.N. Blokhin Med Center of Oncology" MHRF
🇷🇺
Moskva, Moskovskaja Oblast, Russian Federation
National Cancer Centre; Medical Oncology
🇸🇬
Singapore, Singapore
China Medical University Hospital; Surgery
🇨🇳
Taichung, Taiwan
Faculty of Med. Siriraj Hosp.; Med.-Div. of Med. Oncology
🇹🇭
Bangkok, Thailand
Maharaj Nakorn Chiang Mai Hospital; Department of Surgery/Head Neck and Breast Unit; Clinical Trial
🇹🇭
Chiang Mai, Thailand
VETERANS GENERAL HOSPITAL; Department of General Surgery
🇨🇳
Taipei, Taiwan
Khonkaen Hospital
🇹🇭
Khonkaen, Thailand
Songklanagarind Hospital; Department of Oncology
🇹🇭
Songkhla, Thailand
Chang Gung Memorial Hosipital at Linkou
🇨🇳
Taoyuan City, Taiwan
Chulalongkorn Hospital; Medical Oncology
🇹🇭
Bangkok, Thailand
Universitätsspital Basel
🇨🇭
Basel, Switzerland
Universitätsspital Zürich Gynäkologische Klinik; Klinik für Gynäkologie
🇨🇭
Zürich, Switzerland
ME Kryviy Rih Oncology Dispensary of Dnipropetrovs?k Regional Council; Chemotherapy Department
🇺🇦
Kryvyi Rih, Ukraine
RCI Sumy Regional Clinical Oncological Dispensary
🇺🇦
Sumy, Ukraine
Herlev Hospital; Afdeling for Kræftbehandling
🇩🇰
Herlev, Denmark
Odense Universitetshospital, Onkologisk Afdeling R
🇩🇰
Odense C, Denmark
Henry Ford Health System
🇺🇸
Detroit, Michigan, United States
Oregon Health and Science University
🇺🇸
Portland, Oregon, United States
Kaiser Permanente - Portland
🇺🇸
Portland, Oregon, United States
Vanderbilt Univ Medical Ctr
🇺🇸
Nashville, Tennessee, United States
IOV - Istituto Oncologico Veneto - IRCCS; Oncologia Medica II
🇮🇹
Padova, Veneto, Italy
ASST DEGLI SPEDALI CIVILI DI BRESCIA; Oncologia Medica
🇮🇹
Brescia, Lombardia, Italy
IRCCS Istituto Clinico Humanitas; Oncologia
🇮🇹
Rozzano (MI), Lombardia, Italy
Ospedale Civile; Unita Operativa Di Oncologia Medica
🇮🇹
Livorno, Toscana, Italy
Complejo Hospitalario Universitario A Coruña (CHUAC); Servicio de Oncologia
🇪🇸
A Coruña, LA Coruña, Spain
Hospital Ramon y Cajal; Servicio de Oncologia
🇪🇸
Madrid, Spain
Hospital General Universitario Gregorio Marañon; Servicio de Oncologia
🇪🇸
Madrid, Spain
Hospital Universitario Clínico San Carlos; Servicio de Oncologia
🇪🇸
Madrid, Spain
Hospital Clinico Universitario Virgen de la Victoria; Servicio de Oncologia
🇪🇸
Malaga, Spain
Fundacion Scherbovsky
🇦🇷
Mendoza, Argentina
Princess Alexandra Hospital
🇦🇺
Woolloongabba, Queensland, Australia
Kaiser Permanente-SCPMG; Oncology Research
🇺🇸
San Diego, California, United States
Hospital Arzobispo Loayza
🇵🇪
Lima, Peru
Adelaide Cancer Centre
🇦🇺
Kurralta Park, South Australia, Australia
Highlands Oncology Group
🇺🇸
Springdale, Arkansas, United States
USA Mitchell Cancer Institute
🇺🇸
Mobile, Alabama, United States
Kaiser Permanente - Franklin
🇺🇸
Denver, Colorado, United States
Stamford Hospital; BCC, MOHR
🇺🇸
Stamford, Connecticut, United States
Stanford Cancer Center
🇺🇸
Stanford, California, United States
Holy Cross Hospital
🇺🇸
Fort Lauderdale, Florida, United States
Memorial Cancer Institute at Memorial West
🇺🇸
Pembroke Pines, Florida, United States
Nancy N. and J.C. Lewis Cancer & Research Pavillion -St. Josephs / Candler Health System-CCD PRIME
🇺🇸
Savannah, Georgia, United States
University of Maryland Medical Center
🇺🇸
Baltimore, Maryland, United States
Medstar Franklin Square Medical Center
🇺🇸
Baltimore, Maryland, United States
Mercy Medical Center
🇺🇸
Baltimore, Maryland, United States
CHI Health Saint Francis; Oncology
🇺🇸
Grand Island, Nebraska, United States
Jackson Oncology Associates, PLLC
🇺🇸
Jackson, Mississippi, United States
Hackensack Univ Med Ctr
🇺🇸
Hackensack, New Jersey, United States
Inst. Angel Roffo; Haematology
🇦🇷
Buenos Aires, Argentina
Fundación CENIT para la Investigación en Neurociencias
🇦🇷
Buenos Aires, Argentina
Hospital Britanico
🇦🇷
Ciudad Autonoma Bs As, Argentina
Centro Oncologico Riojano Integral (CORI)
🇦🇷
La Rioja, Argentina
Instituto Medico Rio Cuarto
🇦🇷
Cordoba, Argentina
Mid North Coast Cancer Institute
🇦🇺
Port Macquarie, New South Wales, Australia
Royal North Shore Hospital; Department of Medical Oncology
🇦🇺
St Leonards, New South Wales, Australia
Calvary Mater Newcastle; Medical Oncology
🇦🇺
Waratah, New South Wales, Australia
Sunshine Hospital; Oncology Research
🇦🇺
St Albans, Victoria, Australia
Ordensklinikum Linz Barmherzige Schwestern; Interne 1 - Hämato-Onkologie
🇦🇹
Linz, Austria
Uniklinikum Salzburg, LKH; Univ.Klinik f. Innere Medizin III der PMU
🇦🇹
Salzburg, Austria
Jessa Zkh (Campus Virga Jesse)
🇧🇪
Hasselt, Belgium
Hospital Sao Rafael - HSR
🇧🇷
Salvador, BA, Brazil
Hospital das Clinicas - UFRGS
🇧🇷
Porto Alegre, RS, Brazil
Aichi Cancer Center Hospital
🇯🇵
Aichi, Japan
Gunma Prefectural Cancer Center
🇯🇵
Gunma, Japan
Fukushima Medical University Hospital
🇯🇵
Fukushima, Japan
Kanagawa Cancer Center
🇯🇵
Kanagawa, Japan
Okayama University Hospital
🇯🇵
Okayama, Japan
Kumamoto Shinto General Hospital
🇯🇵
Kumamoto, Japan
Osaka International Cancer Institute
🇯🇵
Osaka, Japan
Kyungpook National University Medical Center
🇰🇷
Daegu, Korea, Republic of
National Cancer Center
🇰🇷
Goyang-si, Korea, Republic of
Asan Medical Center
🇰🇷
Seoul, Korea, Republic of
Samsung Medical Center
🇰🇷
Seoul, Korea, Republic of
Centro Hospitalar do Porto ? Hospital de Santo António; Oncologia
🇵🇹
Porto, Portugal
University ?linic of headaches
🇷🇺
Moscow, Moskovskaja Oblast, Russian Federation
S-Pb clinical scientific practical center of specialized kinds of medical care (oncological)
🇷🇺
Saint-Petersburg, Sankt Petersburg, Russian Federation
FSAI Treatment and rehabilitation Centre Ministry of Health; Clinical research and chemotherapy.
🇷🇺
Moskva, Moskovskaja Oblast, Russian Federation
Limited Liability Company "RC Medical"
🇷🇺
Novosibirsk, Russian Federation
Rajavithi Hospital; Division of Medical Oncology
🇹🇭
Bangkok, Thailand
Medipol University Medical Faculty; Oncology Department
🇹🇷
Istanbul, Turkey
Hacettepe Uni Medical Faculty Hospital; Oncology Dept
🇹🇷
Sihhiye/Ankara, Turkey
SI Institute of general&urgent surgery n/a Zaytseva V.T NAMSU; Purulent Surgery department
🇺🇦
Kharkiv, Kharkiv Governorate, Ukraine
Regional Oncology Center; Department of Mammology
🇺🇦
Chernigiv, Ukraine
MI Kyiv Regional Council Kyiv Regional Oncological Dispensary; Department of Mammology
🇺🇦
Kyiv, Ukraine
Chemotherapy SI Dnipropetrovsk MA of MOHU
🇺🇦
Dnipropetrovsk, Ukraine
Municipal Institution Odesa Regional Clinical Hospital
🇺🇦
Odesa, Ukraine
BEATSON WEST OF SCOTLAND CANCER CENTRE; Clinical Research Unit ? Level 1
🇬🇧
Glasgow, United Kingdom
Dartmouth Hitchcock Medical Center
🇺🇸
Lebanon, New Hampshire, United States
Greenville Health System; Cancer Center
🇺🇸
Greenville, South Carolina, United States
The West Clinic; West Cancer Center
🇺🇸
Germantown, Tennessee, United States
Macquarie University Hospital
🇦🇺
Macquarie Park, New South Wales, Australia
St. Joseph Mercy Hospital; Cancer Care Center.
🇺🇸
Ann Arbor, Michigan, United States
Wake Forest University Baptist Medical Center
🇺🇸
Winston-Salem, North Carolina, United States
Charleston Oncology, P .A
🇺🇸
Charleston, South Carolina, United States
Ochsner Health System
🇺🇸
New Orleans, Louisiana, United States
National Taiwan Uni Hospital; General Surgery
🇨🇳
Taipei, Taiwan
Queen Mary Hospital; Dept of Medicine
🇭🇰
Hong Kong, Hong Kong
Tuen Mun Hospital; Clinical Onc
🇭🇰
Hong Kong, Hong Kong