Phase I-II, FIH, TROP2 ADC, Advanced Unresectable/Metastatic Solid Tumors, Refractory to Standard Therapies (KL264-01)

Phase 1

Active, not recruiting

• Conditions: Epithelial Ovarian Cancer; Gastric Adenocarcinoma; Gastroesophageal Junction Adenocarcinoma; Urothelial Carcinoma; Small-Cell Lung Cancer; Endometrial Carcinoma; Head and Neck Squamous Cell Carcinoma; Breast Cancer; Cervical Cancer; Non-Small Cell Lung Cancer
• Interventions: Drug: SKB264

• Registration Number: NCT04152499
• Lead Sponsor: Klus Pharma Inc.

Brief Summary

A Phase I-II, First-in-Human Study of SKB264 (Sac-TMT; MK-2870) in Patients with Locally Advanced Unresectable/Metastatic Solid Tumors who are refractory to Available Standard Therapies. Patient must have historically documented, incurable, locally advanced or metastatic cancer that are refractory to standard therapies of one of the following types:

1. Triple negative breast cancer

2. Epithelial ovarian cancer

3. Non-small cell lung cancer

4. Gastric adenocarcinoma/Gastroesophageal junction adenocarcinoma

5. Small cell lung cancer

6. HR+/ HER2-breast cancer

7. Head and neck squamous cell carcinoma

8. Endometrial carcinoma

9. Urothelial carcinoma

10. Cervical cancer

Detailed Description

This is an open label, Phase I-II, first in human (FIH) study for SKB264 as monotherapy in patients who have locally advanced unresectable or metastatic solid tumor that is refractory to all standard therapies. TROP2 (trophoblast antigen 2) assessments will not be performed prior to enrollment but it will be assessed retrospectively. Confirmation of TROP2 (trophoblast antigen 2) expression by immunohistology or other means is not required, but the Sponsor will request fresh tumor biopsy or tissue specimens from archived materials for determination of TROP2 (trophoblast antigen 2) expression retrospectively. The patient must be, in the judgment of the investigator, an appropriate candidate for experimental therapy whose tumor is refractory to standard therapies. Patients will receive study drug as a single IV infusion at the prescribed dose level at each administration. Cycles will continue until disease progression or unacceptable toxicity. The study is divided into 2 parts (Phase I and Phase II).

Study Timeline

• Study First Submitted: 2019-10-29
• Study First Submitted QC: 2019-11-01
• Study First Posted: 2019-11-05
• Study Start: 2020-02-28
• Status Verified: 2024-06
• Last Update Submitted: 2025-05-15
• Last Update Posted: 2025-05-20
• Primary Completion: 2025-12-31
• Study Completion: 2026-07-16

Recruitment & Eligibility

• Status: ACTIVE_NOT_RECRUITING
• Sex: All
• Target Recruitment: 1410

Inclusion Criteria

Patients must meet the following criteria for inclusion into the study:

Phase I:

1. Patients must be able to provide documented voluntary informed consent.

2. Male or female patient aged 18-75 years.

3. Histologically documented, incurable, locally advanced or metastatic epithelial origin malignant cancer, priority to include but not limited to the following tumor types:

   Breast cancer Ovarian epithelial cancer Non-small cell lung cancer Gastric adenocarcinoma Small cell lung cancer Urothelial carcinoma Note: Confirmation of TROP2 expression by immunohistology or other means is not required, but the Sponsor will request tissue specimens from fresh or archived materials for determination of TROP2 expression.

4. Measurable disease by CT/MRI during dose escalation.

5. Patients should have an unresectable locally advanced or metastatic solid tumor that is refractory to standard therapies, or have no standard therapies, or standard treatment is not applicable at this stage.

6. Granulocyte count ≥ 1.5×109/L, platelet count ≥ 100×109/L, and hemoglobin ≥ 9 g/dL.

7. International normalized ratio (INR) and activated partial thromboplastin time (aPTT) ≤ 1.5×ULN.

8. Serum bilirubin ≤ 1.5 mg/dL (Patients with known Gilbert disease who have serum bilirubin level ≤ 3 ×ULN may be enrolled)., aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase ≤ 2.5 × upper limit of normal (ULN), with the exception of patients with hepatic metastases (ALT and AST ≤ 5 × ULN) and patients with hepatic and/or bone metastases (alkaline phosphatase ≤ 5 × ULN).

9. Creatinine clearance ≥ 50 mL/min calculated by Cockcroft-Gault, Chronic Kidney Disease Epidemiology Collaboration, or Modification of Diet in Renal Disease formulas. Note that 24 hour urine collection is not required but is allowed.

10. Eastern Cooperative Oncology Group (ECOG) Performance Status 0 or 1.

11. For female patients of childbearing potential and male patients with partners of childbearing potential, agreement (by patient and/or partner) to use a highly effective form(s) of contraception during study treatment. Female and male patient treated with SKB264 should continue contraception use for 7 months after the last dose. Such methods include combined (estrogen and progestogen containing) hormonal contraception, progestogen-only hormonal contraception associated with inhibition of ovulation together with another additional barrier method always containing a spermicide, intrauterine device (IUD), intrauterine hormone-releasing system (IUS), bilateral tubal occlusion or vasectomized partner (on the understanding that this is the only one partner during the whole study duration), and sexual abstinence.

    • Oral contraception should always be combined with an additional contraceptive method because of a potential interaction with the study drug. The same rules are valid for male patients involved in this clinical trial if they have a partner of childbirth potential. Male patients must always use a condom.
    • Women are excluded from birth control if they had had tubal ligation or a hysterectomy.

12. Patients must have recovered (i.e., improvement to Grade 1 or better) from all acute toxicities from previous therapy, excluding alopecia and vitiligo.

13. Expected survival ≥ 3 months.

Phase II:

1. Patients must be able to provide documented voluntary informed consent.

2. Male or female patient aged ≥ 18 years.

3. Histologically or cytologically documented, incurable, locally advanced, recurrent or metastatic cancer, including the following tumor types:

   • Cohort 1: triple negative breast cancer (< 1% expression for estrogen receptor [ER] and progesterone receptor [PR] and HER2 negative)
   • Cohort 2: ovarian cancer, fallopian tube cancer, or primary peritoneal cancer
   • Cohort 3: non-small cell lung cancer
   • Cohort 4: gastric adenocarcinoma or gastroesophageal junction adenocarcinoma (HER2 negative)
   • Cohort 6: HR+/ HER2- breast cancer (≥1% expression for ER and/or PR and HER2 negative)
   • Cohort 7: Head and neck squamous cell carcinoma (including primary tumor location of oropharynx, oral cavity, hypopharynx, or larynx. Other primary tumor sites of HNSCC are not eligible)
   • Cohort 8: Endometrial carcinoma (including carcinosarcoma, but excluding sarcoma and neuroendocrine endometrial carcinoma)
   • Cohort 9: Urothelial carcinoma (including urothelial carcinoma of the renal pelvis, ureter, bladder, or urethra, patients with mixed histology are eligible provided urothelial component > 50% and plasmacytoid component<10%, patients whose tumors contain any neuroendocrine component are not eligible)
   • Cohort 10: Cervical cancer (including squamous cell carcinoma, adenosquamous carcinoma, or adenocarcinoma of the cervix) Note: Evaluation of TROP-2 expression is required.

4. Measurable disease by CT/MRI.

5. Patients should have an unresectable locally advanced or metastatic solid tumor that is refractory to standard therapies.

6. Neutrophil count ≥ 1.5×109/L, platelet count ≥ 100×109/L, and hemoglobin ≥ 9 g/dL.

7. International normalized ratio (INR) and activated partial thromboplastin time (aPTT) ≤ 1.5×ULN.

8. Serum bilirubin ≤ 1.5 ×ULN (Patients with known Gilbert disease who have serum bilirubin level ≤ 3 ×ULN may be enrolled), aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase ≤ 2.5 × upper limit of normal (ULN), with the exception of patients with hepatic metastases (ALT and AST ≤ 5 × ULN) and patients with hepatic and/or bone metastases (alkaline phosphatase ≤ 5 × ULN).

9. Creatinine clearance ≥ 30 mL/min calculated by Cockcroft-Gault, Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), or Modification of Diet in Renal Disease (MDRD) formulas. Note that 24 hour urine collection is not required but is allowed.

10. ECOG Performance Status 0 or 1.

11. For female patients of childbearing potential and male patients with partners of childbearing potential, agreement (by patient and/or partner) to use a highly effective form(s) of contraception during study treatment. Female and male patient treated with SKB264 should continue contraception use for 6 months after the last dose. Such methods include combined (estrogen and progestogen containing) hormonal contraception, progestogen-only hormonal contraception associated with inhibition of ovulation together with another additional barrier method always containing a spermicide, intrauterine device (IUD), intrauterine hormone-releasing system (IUS), bilateral tubal occlusion or vasectomized partner (on the understanding that this is the only one partner during the whole study duration), and sexual abstinence.

    • Oral contraception should always be combined with an additional contraceptive method because of a potential interaction with the study drug. The same rules are valid for male patients involved in this clinical trial if they have a partner of childbirth potential. Male patients must always use a condom.
    • Women are excluded from birth control if they had had tubal ligation or a hysterectomy.

12. Patients must have recovered (i.e., improvement to Grade 1 or better) from all acute toxicities from previous therapy, excluding alopecia and vitiligo. Note: Subjects with endocrine AE of any grade are permitted to enroll if they are stably maintained on appropriate replacement therapy and are asymptomatic.

13. Expected survival ≥ 3 months.

Exclusion Criteria

Patients that meet the following criteria will be excluded from entry into the study:

Phase I:

1. Severe or uncontrolled cardiac disease requiring treatment, congestive heart failure (New York Heart Association) III or IV, unstable angina pectoris even if medically controlled, history of myocardial infarction during the last 6 months, serious arrhythmias requiring medication (with exception of atrial fibrillation or paroxysmal supraventricular tachycardia).
2. Symptomatic brain metastases or any radiation or surgery for brain metastases within 1 months of first infusion of study drug.
3. Subjects with second primary cancers (except for cured in situ non-melanoma skin cancer and in situ cervical cancer with no relapse in the last 3 years).
4. Require supplemental oxygen for daily activities.
5. Documented Grade ≥ 2 peripheral neuropathy.
6. History of documented severe dry eye syndrome, severe Meibomian gland disease and/or blepharitis, corneal disease that prevents/delays corneal healing, macular degeneration.
7. Subjects previously treated with TROP 2 targeted therapies.
8. Any standard cancer therapy (e.g. chemotherapy, hormonal therapy, radiotherapy, immunotherapy, biologic therapy treatment, or therapy with traditional Chinese medicines approved for anti-tumor treatment, etc.) within 4 weeks or five half-lives, whichever is shorter, of first infusion of study drug.
9. Any experimental therapy within 4 weeks or five half-lives, whichever is shorter, of first infusion of study drug.
10. Any major surgical procedure within 4 weeks of first infusion of study drug.
11. Diagnosed active liver disease, including viral or other hepatitis, current or history of alcoholism, or cirrhosis.
12. Have known prior positive test results or medical history for human immunodeficiency virus.
13. Uncontrolled hypertension (systolic blood pressure ≥ 160 mmHg and/or diastolic blood pressure ≥ 100 mmHg) or diabetes (HbA1c ≥ 9.0%).
14. Subjects who require use of strong inhibitors or inducers of CYP3A4 at least 14 days prior to and throughout Study. Use of strong inhibitors or inducers of CYP3A4 is not allowed in this study. List of representative examples of strong inhibitors or inducers of CYP3A4 is provided in Appendix III.
15. Pregnancy or lactation.
16. Left ventricular ejection fraction < 45% determined by echocardiogram or multiple gated acquisition scan.
17. Resting QTc > 480 msec at baseline.
18. Ascites requiring paracentesis ≥1 per week.
19. Symptomatic pleural effusion (< 90% oxygen saturation).
20. Subjects with non-infectious interstitial lung diseases (ILD) or medical history of pneumonia requiring steroid treatments; severe pulmonary dysfunction caused by lung diseases.
21. New diagnosed thromboembolic events that requires therapeutic intervention over the last 6 months (patients with stable control of lower limb deep venous thrombosis are allowed).
22. The investigator considers other situations that patients are not appropriate to participate in this trial.

Phase II:

1. Any patient who was treated in the Phase I part of this study.
2. Severe or uncontrolled cardiac disease requiring treatment, congestive heart failure (New York Heart Association) III or IV, unstable angina pectoris even if medically controlled, history of myocardial infarction during the last 6 months, serious arrhythmias requiring medication (with exception of atrial fibrillation or paroxysmal supraventricular tachycardia).
3. Subjects with known meningeal metastases, brainstem metastases, spinal cord metastases and/or compression, or other active CNS metastases.
4. Patients with active second primary cancers (except for cured in situ non-melanoma skin cancer and in situ cervical cancer with no relapse in the last 3 years, or other malignant cancers that have been cured and no evidence of recurrence).
5. Require supplemental oxygen for daily activities.
6. Documented Grade ≥ 2 peripheral neuropathy.
7. History of documented severe dry eye syndrome, severe Meibomian gland disease and/or blepharitis, corneal disease that prevents/delays corneal healing, macular degeneration.
8. Patients previously treated with TROP 2 targeted therapies at any time for early stage or metastatic disease.
9. Any standard cancer therapy (e.g. chemotherapy, hormonal therapy, radiotherapy, immunotherapy, biologic therapy treatment, or therapy with traditional Chinese medicines approved for anti-tumor treatment, etc.) within 4 weeks or 5 half-lives, whichever is shorter, of first infusion of study drug.
10. Any experimental therapy within 4 weeks or 5 half-lives, whichever is shorter, of first infusion of study drug.
11. Any major surgical procedure within 4 weeks of first infusion of study drug.
12. Diagnosed active liver disease, including viral or other hepatitis, current or history of alcoholism, or cirrhosis.
13. Have known prior positive test results or medical history for human immunodeficiency virus.
14. Uncontrolled hypertension (systolic blood pressure ≥ 160 mmHg and/or diastolic blood pressure ≥ 100 mmHg) or diabetes (HbA1c ≥ 9.0%).
15. Subjects who require use of strong inhibitors or inducers of CYP3A4 at least 14 days prior to and throughout Study. Use of strong inhibitors or inducers of CYP3A4 is not allowed in this Study. List of representative examples of strong inhibitors or inducers of CYP3A4 is provided in Appendix III.
16. Pregnancy or lactation.
17. Left ventricular ejection fraction < 45% determined by echocardiogram or multiple gated acquisition scan.
18. Resting QTcF > 480 msec at baseline.
19. Ascites requiring paracentesis >1 per week.
20. Symptomatic pleural effusion (< 90% oxygen saturation).
21. History of interstitial lung diseases (ILD) or non-infectious pneumonitis requiring steroid treatments; severe pulmonary dysfunction caused by lung diseases.
22. New diagnosed thromboembolic events that requires therapeutic intervention over the last 6 months (patients with stable control of lower limb deep venous thrombosis are allowed).
23. Known allergic to any components of SKB264, including excipients (including polysorbate-20); or history of severe hypersensitivity to another biologic therapy.
24. The investigator considers other situations that patients are not appropriate to participate in this trial.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SEQUENTIAL

Arm && Interventions

Group	Intervention	Description
Phase I: Dose Escalation	SKB264	Five dose levels have been selected for evaluation in the Phase I part of the study: 2, 4, 6, 9, and 12 mg/kg of SKB264
Phase II: Triple Negative Breast Cancer	SKB264	Histologically documented or cytologically , incurable, locally advanced or metastatic cancer
Phase II: Epithelial Ovarian Cancer	SKB264	Histologically documented or cytologically, incurable, locally advanced or metastatic cancer
Phase II: Non-Small Cell Lung Cancer	SKB264	Histologically documented or cytologically, incurable, locally advanced or metastatic cancer
Phase II: Gastric Adenocarcinoma or Gastroesophageal Junction Adenocarcinoma	SKB264	Histologically or cytologically documented, incurable, locally advanced or metastatic cancer
Phase II: Extensive-stage Small Cell Lung Cancer	SKB264	Histologically documented or cytologically, incurable, locally advanced or metastatic cancer
Phase II: HR+/ HER2- Breast Cancer	SKB264	Histologically documented or cytologically, incurable, locally advanced or metastatic cancer
Phase II: Head and Neck Squamous Cell Carcinoma	SKB264	Histologically documented or cytologically, incurable, locally advanced or metastatic cancer
Phase II: Endometrial carcinoma	SKB264	Histologically documented or cytologically, incurable, locally advanced or metastatic cancer
Phase II: Urothelial carcinoma	SKB264	Histologically or cytologically documented, incurable, locally advanced or metastatic cancer
Phase II: Cervical Cancer	SKB264	Histologically or cytologically documented, incurable, locally advanced or metastatic cancer

Primary Outcome Measures

Name	Time	Method
Phase I: Maximum Tolerated Dose (MTD) and Recommended Doses for Expansion (RDEs)	Assess up to 12 months	To determine the maximum tolerated dose (MTD) and/or recommended doses for expansion (RDEs). RDEs will not exceed MTD.
Phase II: Objective Response Rate (ORR)	From date of enrollment until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 12 months	To evaluate the objective response rate (ORR) \[Complete Response (CR) + Partial Response (PR)\] of SKB264 when administered intravenously (IV) as monotherapy at the RDEs to patients with metastatic or locally advanced unresectable tumors.

Secondary Outcome Measures

Name	Time	Method
Phase I: Preliminary efficacy based on DOR(Duration of Response)	From date of enrollment until the date of first documented progression or date of death from any cause, whichever came first, approximately 12 months	To evaluate preliminary efficacy in patients treated with SKB264 as monotherapy based on DOR(Duration of Response).
Phase I: Overall safety and tolerability profile	from the date of informed consent until 30 days after last infusion of study drug or begin a new anti cancer therapy, whichever occurs first	Percentage of patients with adverse events (AEs), serious adverse events (SAEs), AEs with Grade ≥ 3 per NCI CTCAE v5.0, adverse events of Special Interest (AESI) and AEs related to study drug.
Phase II: Efficacy based on DOR (Duration of Response)	From date of enrollment until the date of first documented progression or date of death from any cause, whichever came first, approximately 12 months.	To evaluate efficacy in patients treated with SKB264 as monotherapy based on DOR(Duration of Response)
Phase I: Dose Limiting Toxicities (DLTs)	Day 28 days after first infusion of study drug	To determine the dose limiting toxicities (DLTs) of SKB264 when administered IV twice (on Days 1 and 15) every 2 weeks in 4 weeks (28 days) cycles as monotherapy to patients with metastatic or locally advanced unresectable tumors.
Phase I: Preliminary efficacy based on ORR (Objective Response Rate)	From date of enrollment until the date of first documented progression or date of death from any cause, whichever came first, approximately 12 months	ORR (Objective Response Rate) as determined by the Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1, which will be complete response (CR) + partial response (PR)
Phase I: Preliminary efficacy based on OS(Overall Survival)	From date of enrollment until the date of first documented progression or date of death from any cause, whichever came first, approximately 12 months	To evaluate preliminary efficacy in patients treated with SKB264 as monotherapy based on OS(Overall Survival)
Phase II: Levels of TROP2 expression in tumor tissue	Screening and End of Treatment(EOT), approximately 12 months	To assess levels of TROP2 expression in tumor tissue and correlation of those levels with responses and toxicity.
Phase I: Preliminary efficacy based on PFS(Progression-Free Survival)	From date of enrollment until the date of first documented progression or date of death from any cause, whichever came first, approximately 12 months	To evaluate preliminary efficacy in patients treated with SKB264 as monotherapy based on PFS(Progression-Free Survival).
Phase II: Efficacy based on OS (Overall Survival)	From date of enrollment until the date of first documented progression or date of death from any cause, whichever came first, approximately 12 months.	To evaluate efficacy in patients treated with SKB264 as monotherapy based on OS (Overall Survival)
Phase II: PK parameters for SKB264-ADC, SKB264 TAB, and free KL610023 payload	From Cycle 1 to Cycle 6 and End of Treatment(EOT), approximately 12 months	To characterize the PK of SKB264-ADC, SKB264 TAB, and free KL610023 payload, such as half life
Phase I: Percentage of patients with ADA formation to SKB264.	From Cycle 1 to Cycle 6 and End of Treatment(EOT), approximately 12 months	To assess the incidence of anti-drug antibody (ADA) formation to SKB264.
Phase II: Percentage of patients with ADA formation to SKB264.	From Cycle 1 to Cycle 6 and End of Treatment(EOT), approximately 12 months	To obtain Percentage of patients with ADA formation to SKB264.
Phase I: PK parameters for SKB264-ADC, SKB264 TAB, and free KL610023 payload.	From Cycle 1 to Cycle 6 and End of Treatment(EOT), approximately 12 months	To characterize the PK of SKB264-ADC, SKB264 TAB, and free KL610023 payload, such as Cmax
Phase II: Overall safety and tolerability profile	from the date of informed consent until 30 days after last infusion of study drug or begin a new anti cancer therapy, whichever occurs first	Percentage of patients with adverse events (AEs), serious adverse events (SAEs), AEs with Grade ≥ 3 per NCI CTCAE v5.0, adverse events of Special Interest (AESI) and AEs related to study drug.
Phase II: Efficacy based on PFS (Progression-Free Survival)	From date of enrollment until the date of first documented progression or date of death from any cause, whichever came first, approximately 12 months.	To evaluate efficacy in patients treated with SKB264 as monotherapy based on PFS (Progression-Free Survival)

Trial Locations

Locations (109)

Los Angeles Hematology Oncology Medical Group; 🇺🇸 Glendale, California, United States

University of California Los Angeles; 🇺🇸 Los Angeles, California, United States

Florida Cancer Specialists and Research Institute; 🇺🇸 Sarasota, Florida, United States

START MidWest; 🇺🇸 Grand Rapids, Michigan, United States

The University of Oklahoma Health Sciences Center; 🇺🇸 Oklahoma City, Oklahoma, United States

Oklahoma Cancer Specialists and Research Institute, LLC; 🇺🇸 Tulsa, Oklahoma, United States

Providence Cancer Institute, Franz Clinic; 🇺🇸 Portland, Oregon, United States

Mary Crowley Cancer Research; 🇺🇸 Dallas, Texas, United States

MD Anderson Cancer Center; 🇺🇸 Houston, Texas, United States

Virginia Cancer Specialists; 🇺🇸 Fairfax, Virginia, United States

Princess Margaret Cancer Centre; 🇨🇦 Toronto, Ontario, Canada

Sunnybrook Research Institute; 🇨🇦 Toronto, Ontario, Canada

MUHC,Glen - Women's Health Research Unit; 🇨🇦 Montreal, Quebec, Canada

Centro de Estudios Clínicos SAGA; 🇨🇱 Providencia, Chile

Centro de Investigacion Clinica Bradford Hill; 🇨🇱 Santiago, Chile

Pontificia Universidad Catolica de Chile - CICUC; 🇨🇱 Santiago, Chile

The First Affiliated Hospital of Bengbu Medical University; 🇨🇳 Bengbu, Anhui, China

Anhui Cancer Hospital; 🇨🇳 Hefei, Anhui, China

AnHui Provincial Cancer Hospital; 🇨🇳 Hefei, Anhui, China

The First Affiliated Hospital of Anhui Medical University; 🇨🇳 Hefei, Anhui, China

The First Affiliated Hospital of USTC Anhui Provincial Hospital; 🇨🇳 Hefei, Anhui, China

The Second Hospital of Anhui Medical University; 🇨🇳 Hefei, Anhui, China

Beijing Cancer Hospital; 🇨🇳 Beijing, Beijing, China

Beijing Chao-Yang Hospital, Capital Medical University; 🇨🇳 Beijing, Beijing, China

Beijing Obstetrics and Gynecology Hospital, Capital Medical University; 🇨🇳 Beijing, Beijing, China

Beijing Tongren Hospital, Capital Medical University; 🇨🇳 Beijing, Beijing, China

Chinese PLA General Hospital (301 Hospital); 🇨🇳 Beijing, Beijing, China

Peking University Third Hospital; 🇨🇳 Beijing, Beijing, China

Chongqing University Cancer Hospital; 🇨🇳 Chongqing, Chongqing, China

Chongqing University Cancer Hosptital; 🇨🇳 Chongqing, Chongqing, China

900TH Hospital of Joint Logistics Support Force; 🇨🇳 Fuzhou, Fujian, China

Fujian Cancer Hospital; 🇨🇳 Fuzhou, Fujian, China

Fujian Medical University Uion Hospital; 🇨🇳 Fuzhou, Fujian, China

The First Affiliated Hospital Of Xiamen University; 🇨🇳 Xiamen, Fujian, China

The First Hospital of Lanzhou University; 🇨🇳 Lanzhou, Gansu, China

Affiliated Hospital of Guangdong Medical University; 🇨🇳 Guangzhou, Guangdong, China

Guangdong Provincial People's Hospital; 🇨🇳 Guangzhou, Guangdong, China

Sun Yat-Sen Memorial Hospital , Sun Yat-sen University; 🇨🇳 Guangzhou, Guangdong, China

Sun Yat-sen Memorial Hospital, Sun Yat-sen University; 🇨🇳 Guangzhou, Guangdong, China

Sun Yat-sen University Cancer Center; 🇨🇳 Guangzhou, Guangdong, China

Sun Yat-sen University Cancer prevention Center; 🇨🇳 Guangzhou, Guangdong, China

The Second Affiliated Hospital of Guilin Medical University; 🇨🇳 Guilin, Guangxi, China

Guangxi Medical University Cancer Center; 🇨🇳 Nanning, Guangxi, China

Hainan General Hospital; 🇨🇳 Haikou, Hainan, China

The First Affiliated Hospital of Hainan Medical University; 🇨🇳 Haikou, Hainan, China

The Fourth Hospital of Hebei Medical University; 🇨🇳 Shijiazhuang, Hebei, China

Harbin Medical University Cancer Hospital; 🇨🇳 Harbin, Heilongjiang, China

Anyang City Cancer Hospital; 🇨🇳 Anyang, Henan, China

The First Affiliated Hospital of Henan University of Science and Technology; 🇨🇳 Luoyang, Henan, China

Nanyang Center Hospital; 🇨🇳 Nanyang, Henan, China

The First Affiliated Hospital of Xinxiang Medical College; 🇨🇳 Xinxiang, Henan, China

Henan Cancer Hospital; 🇨🇳 Zhengzhou, Henan, China

The First Affiliated Hospital of Zhengzhou University; 🇨🇳 Zhengzhou, Henan, China

Zhengzhou Central Hospital; 🇨🇳 Zhengzhou, Henan, China

Hubei Cancer Hospital; 🇨🇳 Wuhan, Hubei, China

Tongji Hospital Tongji Medical College Huazhong University Of Science And Technology; 🇨🇳 Wuhan, Hubei, China

Union Hospital Tongji Medical College Huazhong University Of Science And Technology; 🇨🇳 Wuhan, Hubei, China

Wuhan Union Hospital of China; 🇨🇳 Wuhan, Hubei, China

Zhongnan Hospital of Wuhan University; 🇨🇳 Wuhan, Hubei, China

Xiangyang Central Hospital; 🇨🇳 Xiangyang, Hubei, China

Hunan Cancer Hospital; 🇨🇳 Changsha, Hunan, China

The Second Xiangya Hospital of Central South University; 🇨🇳 Changsha, Hunan, China

Xiangya Hospital Central South University; 🇨🇳 Changsha, Hunan, China

Xiangya Hospital of Central South University; 🇨🇳 Changsha, Hunan, China

The first people's hospital of Lianyungang; 🇨🇳 Lianyungang, Jiangsu, China

Jiangsu Province Hospital; 🇨🇳 Nanjing, Jiangsu, China

Nanjing Drum Tower Hospital; 🇨🇳 Nanjing, Jiangsu, China

Xuzhou Central Hospital; 🇨🇳 Xuzhou, Jiangsu, China

Jiangxi Cancer Hospital; 🇨🇳 Nanchang, Jiangxi, China

The First Affiliated Hospital of Nanchang University; 🇨🇳 Nanchang, Jiangxi, China

First Hospital of Jilin University; 🇨🇳 Changchun, Jilin, China

Jilin Cancer Hospital; 🇨🇳 Changchun, Jilin, China

Liaoning Cancer Hospital; 🇨🇳 Shenyang, Liaoning, China

The Second Hospital of Dalian Medical University; 🇨🇳 Dalian, Liaoning, China

Shengjing Hospital of China Medical University; 🇨🇳 Shenyang, Liaoning, China

The First Affiliated Hospital of Xi'an Jiaotong University; 🇨🇳 Xi'an, Shaanxi, China

Shandong Cancer Hospital; 🇨🇳 Jinan, Shandong, China

Zhongshan Hospital, Fudan University; 🇨🇳 Shanghai, Shanghai, China

West China Hospital of Sichuan University; 🇨🇳 Chengdu, Sichuan, China

Neijiang Second People's Hospital; 🇨🇳 Neijiang, Sichuan, China

Yibin Second People's Hospital; 🇨🇳 Yibin, Sichuan, China

The Second Hospital of Tianjin Medical University; 🇨🇳 Tianjin, Tianjin, China

The First Hospital of China Medical University; 🇨🇳 Shenyang, Liaoning, China

Affiliated Hospital of Binzhou Medical College; 🇨🇳 Binzhou, Shandong, China

Affiliated Hospital of Jining Medical College; 🇨🇳 Jining, Shandong, China

Weifang People's Hospital; 🇨🇳 Weifang, Shandong, China

Jinan Central Hospital; 🇨🇳 Jinan, Shandong, China

Fudan University Shanghai Cancer Center; 🇨🇳 Shanghai, Shanghai, China

Obstetrics&Gynecology Hospital of Fudan University; 🇨🇳 Shanghai, Shanghai, China

Shanghai East Hospital; 🇨🇳 Shanghai, Shanghai, China

Shanghai General Hospital; 🇨🇳 Shanghai, Shanghai, China

Shanxi Cancer Hospital; 🇨🇳 Taiyuan, Shanxi, China

Shanxi Provincial Cancer Hospital; 🇨🇳 Taiyuan, Shanxi, China

Sichuan Cancer Hospital; 🇨🇳 Chengdu, Sichuan, China

Tianjin Medical University Cancer Institute and Hospital; 🇨🇳 Tianjin, Tianjin, China

Zhejiang Cancer Hospital; 🇨🇳 Hangzhou, Zhejiang, China

Zhejiang University School of Medical Sir Run Run Shaw Hospital; 🇨🇳 Hangzhou, Zhejiang, China

Taizhou Hospital of Zhejiang Province; 🇨🇳 Taizhou, Zhejiang, China

Seoul National University Bundang Hospital; 🇰🇷 Seongnam-si, Gyeonggi-do, Korea, Republic of

Inje University Haeundae Paik Hospital; 🇰🇷 Busan, Korea, Republic of

Kyungpook National University Chilgok Hospital; 🇰🇷 Daegu, Korea, Republic of

National Cancer Center; 🇰🇷 Goyang-si, Korea, Republic of

CHA Bundang Medical Center, CHA University; 🇰🇷 Gyeonggi-do, Korea, Republic of

Gachon University Gil Medical Center; 🇰🇷 Incheon, Korea, Republic of

Asan Medical Center; 🇰🇷 Seoul, Korea, Republic of

Gangnam Severance Hospital, Yonsei University Health System; 🇰🇷 Seoul, Korea, Republic of

Seoul National University Hospital; 🇰🇷 Seoul, Korea, Republic of

Severance Hospital, Yonsei University Health System; 🇰🇷 Seoul, Korea, Republic of

Gazi University Medical Faculty; 🇹🇷 Yenimahalle, Ankara, Turkey