A Study of Atezolizumab (MPDL3280A) Compared With a Platinum Agent (Cisplatin or Carboplatin) + (Pemetrexed or Gemcitabine) in Participants With Stage IV Non-Squamous or Squamous Non-Small Cell Lung Cancer (NSCLC) [IMpower110]
- Conditions
- Non-Squamous Non-Small Cell Lung Cancer, Squamous Non-Small Cell Lung Cancer
- Interventions
- Registration Number
- NCT02409342
- Lead Sponsor
- Hoffmann-La Roche
- Brief Summary
This randomized, open-label study will evaluate the efficacy and safety of atezolizumab compared with chemotherapy consisting of a platinum agent (cisplatin or carboplatin per investigator discretion) combined with either pemetrexed (non-squamous disease) or gemcitabine (squamous disease) in programmed death-ligand 1 (PD-L1)-selected, chemotherapy-naive participants with Stage IV Non-Squamous or Squamous NSCLC.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 572
- Histologically or cytologically confirmed, Stage IV non-squamous or squamous NSCLC
- No prior treatment for Stage IV non-squamous or squamous NSCLC. Participant known to have a sensitizing mutation in the epidermal growth factor receptor (EGFR) gene or an anaplastic lymphoma kinase (ALK) fusion oncogene are excluded from the study
- Tumor PD-L1 expression as determined by immunohistochemistry (IHC) assay of archival tumor tissue or tissue obtained at screening
- Eastern Cooperative Oncology Group (ECOG) performance status 0 to 1
- Measurable disease as defined by Response Evaluation Criteria in Solid Tumors (RECIST v1.1)
- Adequate hematologic and end-organ function
- Known sensitizing mutation in the EGFR gene or ALK fusion oncogene
- Active or untreated central nervous system (CNS) metastases as determined by Computed Tomography (CT) or magnetic resonance imaging (MRI) evaluation
- Malignancies other than NSCLC within 5 years prior to randomization, with the exception of those with a negligible risk of metastasis or death treated with expected curative outcome
- Pregnant or lactating women
- History of autoimmune disease
- History of idiopathic pulmonary fibrosis, organizing pneumonia, drug induced pneumonitis, idiopathic pneumonitis, or evidence of active pneumonitis on screening chest CT scan. History of radiation pneumonitis in the radiation field (fibrosis) is permitted
- Positive test for Human Immunodeficiency Virus (HIV)
- Active hepatitis B or hepatitis C
- Prior treatment with cluster of differentiation (CD) 137 agonists or immune checkpoint blockade therapies, anti PD1, and anti-PD-L1 therapeutic antibody
- Severe infection within 4 weeks prior to randomization
- Significant history of cardiovascular disease
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Atezolizumab Atezolizumab (MPDL3280A) [TECENTRIQ], an engineered anti-PDL1 antibody Participants with squamous or non-squamous NSCLC will receive atezolizumab on Day 1 of each 21-day cycle until loss of clinical benefit (as assessed by the investigator), unacceptable toxicity, or death (maximum up to approximately 58 months). (Carboplatin/ Cisplatin) + (Pemetrexed/ Gemcitabine) Carboplatin Participants with non-squamous NSCLC will receive chemotherapy with pemetrexed in combination with either cisplatin or carboplatin (per investigator discretion) on Day 1 of each 21-day cycle for 4 or 6 cycles as per local standard of care, followed by maintenance therapy with pemetrexed alone as per local standard of care until disease progression (per RECIST v1.1), unacceptable toxicity, or death (maximum up to approximately 58 months). Participants with squamous NSCLC will receive chemotherapy with gemcitabine on Days 1 and 8 of each 21-day cycle in combination with either cisplatin or carboplatin on Day 1 of each 21-day cycle for 4 or 6 cycles as per local standard of care, followed by best supportive care as per local standard of care until disease progression, unacceptable toxicity, or death (maximum up to approximately 58 months). (Carboplatin/ Cisplatin) + (Pemetrexed/ Gemcitabine) Cisplatin Participants with non-squamous NSCLC will receive chemotherapy with pemetrexed in combination with either cisplatin or carboplatin (per investigator discretion) on Day 1 of each 21-day cycle for 4 or 6 cycles as per local standard of care, followed by maintenance therapy with pemetrexed alone as per local standard of care until disease progression (per RECIST v1.1), unacceptable toxicity, or death (maximum up to approximately 58 months). Participants with squamous NSCLC will receive chemotherapy with gemcitabine on Days 1 and 8 of each 21-day cycle in combination with either cisplatin or carboplatin on Day 1 of each 21-day cycle for 4 or 6 cycles as per local standard of care, followed by best supportive care as per local standard of care until disease progression, unacceptable toxicity, or death (maximum up to approximately 58 months). (Carboplatin/ Cisplatin) + (Pemetrexed/ Gemcitabine) Gemcitabine Participants with non-squamous NSCLC will receive chemotherapy with pemetrexed in combination with either cisplatin or carboplatin (per investigator discretion) on Day 1 of each 21-day cycle for 4 or 6 cycles as per local standard of care, followed by maintenance therapy with pemetrexed alone as per local standard of care until disease progression (per RECIST v1.1), unacceptable toxicity, or death (maximum up to approximately 58 months). Participants with squamous NSCLC will receive chemotherapy with gemcitabine on Days 1 and 8 of each 21-day cycle in combination with either cisplatin or carboplatin on Day 1 of each 21-day cycle for 4 or 6 cycles as per local standard of care, followed by best supportive care as per local standard of care until disease progression, unacceptable toxicity, or death (maximum up to approximately 58 months). (Carboplatin/ Cisplatin) + (Pemetrexed/ Gemcitabine) Pemetrexed Participants with non-squamous NSCLC will receive chemotherapy with pemetrexed in combination with either cisplatin or carboplatin (per investigator discretion) on Day 1 of each 21-day cycle for 4 or 6 cycles as per local standard of care, followed by maintenance therapy with pemetrexed alone as per local standard of care until disease progression (per RECIST v1.1), unacceptable toxicity, or death (maximum up to approximately 58 months). Participants with squamous NSCLC will receive chemotherapy with gemcitabine on Days 1 and 8 of each 21-day cycle in combination with either cisplatin or carboplatin on Day 1 of each 21-day cycle for 4 or 6 cycles as per local standard of care, followed by best supportive care as per local standard of care until disease progression, unacceptable toxicity, or death (maximum up to approximately 58 months).
- Primary Outcome Measures
Name Time Method Overall Survival (OS) in the TC3 or IC3-WT Populations From randomization to death from any cause until data cut-off on 10 September 2018 (up to approximately 38 months) OS is defined as the time from randomization to death from any cause.
Overall Survival (OS) in the TC2/3 or IC2/3-WT and TC1/2/3 or IC1/2/3-WT Populations From randomization to death from any cause until data cut-off on 4 February 2020 (up to approximately 54.5 months) OS is defined as the time from randomization to death from any cause.
- Secondary Outcome Measures
Name Time Method OS in Participants With PD-L1 Expression From randomization to death from any cause until data cut-off on 10 September 2018 (up to approximately 38 months) OS is defined as the time from randomization to death from any cause.
OS in Participants With Blood Tumor Mutational Burden (bTMB) From randomization to death from any cause until data cut-off on 10 September 2018 (up to approximately 38 months) OS is defined as the time from randomization to death from any cause.
Progression-free Survival (PFS) in the TC3 or IC3-WT Populations From randomization to the first occurrence of disease progression or death from any cause, whichever occurs first until data cut-off on 10 September 2018 (up to approximately 38 months) PFS is defined as the time from randomization to the first occurrence of disease progression, as determined by the investigator with use of RECIST v1.1, or death from any cause, whichever occurs first. PFS could not be formally tested.
Change From Baseline in Patient-reported Lung Cancer Symptoms Score as Assessed by the SILC Scale Symptom Score in the TC3 or IC3-WT Populations Baseline until data cut-off on 10 September 2018 (up to approximately 38 months) Change from baseline in each of the patient-reported lung cancer symptoms with use of the SILC scale. The SILC scale is a nine-item content valid self-report measure of lung cancer symptoms. It measures severity of cough, dyspnea, and chest pain with a total symptom severity score. Each SILC symptom scale (dyspnea, cough, chest pain) score was calculated as the average of the component items (range 0 to 4). An increase in score suggested worsening in symptomatology. A symptom score change of 0.3 points for the dyspnea and cough scores was considered to be clinically significant; whereas a symptom score change of 0.5 points for the chest pain score was considered to be clinically significant.
Percentage of Participants Who Are Alive at 1 Year in the TC3 or IC3-WT Populations Baseline to 1 year or death, whichever occurs first until data cut-off on 10 September 2018 (up to approximately 38 months) Percentage of Participants With at Least One Adverse Event Baseline up to until data cut-off on 8 March 2022 (up to approximately 79.5 months) Percentage of participants with at least one adverse event.
Progression-free Survival (PFS) in the TC2/3 or IC2/3-WT and TC1/2/3 or IC1/2/3-WT Populations From randomization to the first occurrence of disease progression or death from any cause, whichever occurs first until data cut-off on 4 February 2020 (up to approximately 54.5 months) PFS is defined as the time from randomization to the first occurrence of disease progression, as determined by the investigator with use of RECIST v1.1, or death from any cause, whichever occurs first. PFS could not be formally tested.
Percentage of Participants With Objective Response (ORR) in the TC2/3 or IC2/3-WT and TC1/2/3 or IC1/2/3-WT Populations Every 6 weeks for 48 weeks following Day 1, thereafter every 9 weeks after completion of Week 48 tumor assessment, regardless of treatment delays, until radiographic disease progression until data cut-off on 4 Feb 2020 (up to approximately 54.5 months) Objective response (partial response plus complete response) as determined by the investigator according to RECIST v1.1.
Duration of Response (DOR) in the TC3 or IC3-WT Populations From first occurrence of a complete response or partial response, whichever occurs first, until first date that progressive disease or death is documented, whichever occurs first until data cut-off on 10 September 2018 (up to approximately 38 months) DOR is defined as the time from the first occurrence of a documented objective response to the time of disease progression, as determined by the investigator with use of RECIST v1.1, or death from any cause, whichever occurs first.
Duration of Response (DOR) in the TC2/3 or IC2/3-WT and TC1/2/3 or IC1/2/3-WT Populations From first occurrence of a complete response or partial response, whichever occurs first, until first date that progressive disease or death is documented, whichever occurs first until data cut-off on 4 February 2020 (up to approximately 54.5 months) DOR is defined as the time from the first occurrence of a documented objective response to the time of disease progression, as determined by the investigator with use of RECIST v1.1, or death from any cause, whichever occurs first.
Time to Deterioration (TTD) in Patient-reported Lung Cancer Symptoms Score as Assessed by the Symptoms in Lung Cancer (SILC) Scale Symptom Score in the TC3 or IC3-WT Populations Baseline until data cut-off on 10 September 2018 (up to approximately 38 months) TTD in each of the patient-reported lung cancer symptoms with use of the SILC scale. The SILC scale is a nine-item content valid self-report measure of lung cancer symptoms. It measures severity of cough, dyspnea, and chest pain with a total symptom severity score. Each SILC symptom scale (dyspnea, cough, chest pain) score was calculated as the average of the component items (range 0 to 4). An increase in score suggested worsening in symptomatology. A symptom score change of 0.3 points for the dyspnea and cough scores was considered to be clinically significant; whereas a symptom score change of 0.5 points for the chest pain score was considered to be clinically significant.
Minimum Observed Serum Concentration (Cmin) of Atezolizumab Prior to infusion (0 hour) on Day 1 of Cycles 2, 3, 4, 8, 16, and every eighth cycle thereafter, and at treatment discontinuation until data cut-off on 10 September 2018 (up to approximately 38 months) (cycle duration = 21 days) Percentage of Participants With Objective Response (ORR) in the TC3 or IC3-WT Populations Every 6 weeks for 48 weeks following Day 1, thereafter every 9 weeks after completion of Week 48 tumor assessment, regardless of treatment delays, until radiographic disease progression until data cut-off on 10 Sep 2018 (up to approximately 38 months) Objective response (partial response plus complete response) as determined by the investigator according to RECIST v1.1.
Percentage of Participants Who Are Alive at 2 Years in the TC3 or IC3-WT Populations Baseline to 2 years or death, whichever occurs first until data cut-off on 10 September 2018 (up to approximately 38 months) Percentage of Participants Who Are Alive at 1 Year in the TC2/3 or IC2/3-WT and TC1/2/3 or IC1/2/3-WT Populations Baseline to 1 year or death, whichever occurs first until clinical cut-off date on 4 February 2020 (up to approximately 54.5 months) Percentage of Participants Who Are Alive at 2 Years in the TC2/3 or IC2/3-WT and TC1/2/3 or IC1/2/3-WT Populations Baseline to 2 years or death, whichever occurs first until clinical cut-off date on 4 February 2020 (up to approximately 54.5 months) TTD as Assessed Using EORTC QLQ Supplementary Lung Cancer Module (EORTC QLQ-LC13) in the TC3 or IC3-WT Populations Baseline until data cut-off on 10 September 2018 (up to approximately 38 months) TTD in patient-reported lung cancer symptoms, defined as time from randomization to deterioration (10-point change) in any of the following symptom subscales (cough, dyspnea \[multi-item scale\], and chest pain), whichever occurs first, as measured by the EORTC QLQ-LC13. EORTC QLQ-LC13 module incorporates one multi-item scale to assess dyspnea and a series of single items assessing pain, coughing, sore mouth, dysphagia, peripheral neuropathy, alopecia, and hemoptysis.
Investigator-Assessed PFS in Participants With bTMB According to RECIST v1.1 From randomization to the first occurrence of disease progression or death from any cause, whichever occurs first until data cut-off on 10 September 2018 (up to approximately 38 months) PFS according to RECIST v1.1 in the bTMB subpopulations.
Maximum Observed Serum Concentration (Cmax) of Atezolizumab 0 hour (predose) and 30 minutes after atezolizumab infusion on Day 1 (infusion duration = up to 1 hour) Investigator-Assessed PFS in Participants With PD-L1 Expression According to RECIST v1.1 From randomization to the first occurrence of disease progression or death from any cause, whichever occurs first until data cut-off on 10 September 2018 (up to approximately 38 months) Investigator-assessed PFS according to RECIST v1.1 in the PD-L1 (defined with SP263 IHC assay)
Percentage of Participants With Anti-therapeutic Antibodies (ATAs) Baseline until data cut-off on 10 September 2018 (up to approximately 38 months)
Trial Locations
- Locations (142)
Centre D'oncologie de Gentilly
🇫🇷Nancy, France
Centre Hospitalier Regional Sud Reunion
🇫🇷Saint-pierre, France
Centro de Pesquisas Clinicas em Oncologia - CPCO
🇧🇷Cachoeiro de Itapemirim, ES, Brazil
Pius-Hospital Oldenburg
🇩🇪Oldenburg, Germany
Santa Casa de Misericordia de Porto Alegre
🇧🇷Porto Alegre, RS, Brazil
Instituto Joinvilense de Hematologia E Oncologia
🇧🇷Joinville, SC, Brazil
Hospital Sao Lucas - PUCRS
🇧🇷Porto Alegre, RS, Brazil
Harbin Medical University Tumor Hospital
🇨🇳Harbin City, China
Hôpital Universitaire Dupuytren
🇫🇷Limoges, France
Clinique Clémentville
🇫🇷Montpellier, France
Hopital d'Instruction des Armees de Begin
🇫🇷Saint-Mande, France
Associacao Hospital de Caridade Ijui*X; Departamento De Oncologia
🇧🇷Ijui, RS, Brazil
Instituto Nacional de Cancer - INCa; Oncologia
🇧🇷Rio de Janeiro, RJ, Brazil
CHU Angers
🇫🇷Angers, France
Hospital d Instructions des Armees Percy
🇫🇷Clamart, France
Centre Paul Strauss
🇫🇷Strasbourg, France
Hopital Tenon
🇫🇷Paris, France
Asklepios-Fachklinik Muenchen-Gauting; Klinik Für Pneumologie
🇩🇪Gauting, Germany
Centro Di Riferimento Oncologico; Struttura Operativa Complessa Di Oncologia Medica B
🇮🇹Aviano, Friuli-Venezia Giulia, Italy
Asst Papa Giovanni XXIII
🇮🇹Bergamo, Lombardia, Italy
Azienda Socio Sanitaria Territoriale ? ASST di Monza
🇮🇹Monza, Lombardia, Italy
Centre Hospitalier Regional La Reunion Site Felix Guyon
🇫🇷Saint Denis Cedex, France
Georgios Papanikolaou General Hosp. of Thessaloniki
🇬🇷Thessaloniki, Greece
Hospital Universitario Vall d'Hebron - PPDS
🇪🇸Barcelona, Spain
Hacettepe Universitesi Tip Fakultesi Hastanesi
🇹🇷Ankara, Turkey
IRST Istituto Scientifico Romagnolo Per Lo Studio E Cura Dei Tumori, Sede Meldola; Oncologia Medica
🇮🇹Meldola, Emilia-Romagna, Italy
Hospital Universitari i Politecnic La Fe de Valencia
🇪🇸Valencia, Spain
Azienda Ospedaliera Istituti Ospitalieri
🇮🇹Cremona, Lombardia, Italy
Ospedale San Raffaele S.r.l.
🇮🇹Milano, Lombardia, Italy
Chonnam National University Hwasun Hospital
🇰🇷Jeollanam-do, Korea, Republic of
Azienda Ospedaliera Universitaria Integrata Verona; UOC Oncologia
🇮🇹Verona, Veneto, Italy
Aichi Cancer Center Hospital; Respiratory Medicine
🇯🇵Aichi, Japan
Ibaraki Prefectural Central Hospital; Division of respiratory
🇯🇵Ibaraki, Japan
Istituto Nazionale dei Tumori
🇮🇹Monza, Lombardia, Italy
Cukurova University Medical Faculty Balcali Hospital
🇹🇷Adana, Turkey
Seoul National University Bundang Hospital
🇰🇷Seongnam-si, Korea, Republic of
Ege Universitesi Tip Fakultesi Hastanesi
🇹🇷Izmir, Turkey
Hospital del Mar
🇪🇸Barcelona, Spain
Hospital Universitario Virgen Macarena
🇪🇸Sevilla, Spain
Hosp Clinico Univ Lozano Blesa; División De Oncología Médica
🇪🇸Zaragoza, Spain
Hospital Universitario Miguel Servet
🇪🇸Zaragoza, Spain
Saitama Cancer Center; Thoracic Oncology
🇯🇵Satima, Japan
Hospital Universitario A Coruña
🇪🇸Coruna, LA Coruña, Spain
Khon Kaen University
🇹🇭Khon Kaen, Thailand
Inonu University Faculty of Medicine Turgut Ozal Medical Center
🇹🇷Malatya, Turkey
Consorcio Hospitalario Provincial de Castellon
🇪🇸Castellon DE LA Plana/castello DE LA Plana, Castellon, Spain
Complejo Hospitalario de Jaen
🇪🇸Jaen, Spain
Colchester General Hospital
🇬🇧Colchester, Essex, United Kingdom
Kansai Medical university Hospital; Thoracic Oncology
🇯🇵Osaka, Japan
Sotiria Chest Hospital of Athens
🇬🇷Athens, Greece
University General Hospital of Patras
🇬🇷Patras, Greece
Hokkaido University Hospital
🇯🇵Hokkaido, Japan
Oregon Health & Science Uni
🇺🇸Portland, Oregon, United States
Hematology Oncology Associates of Fredericksburg, Inc.
🇺🇸Fredericksburg, Virginia, United States
Lynn Cancer Institute - West
🇺🇸Boca Raton, Florida, United States
University of Maryland Greenebaum Cancer Center
🇺🇸Baltimore, Maryland, United States
Sarah Cannon Cancer Center
🇺🇸Germantown, Tennessee, United States
VA Puget Sound Health Care Sys
🇺🇸Seattle, Washington, United States
Oncovida*X
🇧🇷Salvador, BA, Brazil
Hospital da Cidade de Passo Fundo; Centro de Pesquisa em Oncologia
🇧🇷Passo Fundo, RS, Brazil
*X*Fundacao PIO XII
🇧🇷Barretos, SP, Brazil
Instituto Do Câncer Do Estado de São Paulo Octávio Frias de Oliveira
🇧🇷São Paulo, SP, Brazil
Hospital Santa Marcelina
🇧🇷Sao Paulo, SP, Brazil
Azienda Ospedaliera Città della Salute e della Scienza di Torino
🇮🇹Torino, Piemonte, Italy
Istituto Clinico Humanitas
🇮🇹Rozzano (MI), Lombardia, Italy
Leningrad Regional Clinical Hospital
🇷🇺St Petersburg, Russian Federation
St. Petersburg Med Univ; n.a. I.P. Pavlov; Pulmonology Research
🇷🇺St Petersburg, Russian Federation
Principal Military Clinical Hospital n.a. N.N. Burdenko
🇷🇺Moscow, Moskovskaja Oblast, Russian Federation
Uniwersyteckie Centrum Kliniczne
🇵🇱Gdansk, Poland
Saint Petersburg Clinical Hospital of the Russian Academy of Sciences
🇷🇺St. Petersburg, Sankt Petersburg, Russian Federation
Institute of Lung Diseases Vojvodina
🇷🇸Sremska Kamenica, Serbia
Hospital Universitari Germans Trias i Pujol; Servicio de Oncologia
🇪🇸Badalona, Barcelona, Spain
Hospital Universitario Cruces
🇪🇸Barakaldo, Vizcaya, Spain
Hospital Clinico San Carlos; Servicio de Oncologia
🇪🇸Madrid, Spain
Chiang Rai Prachanukroh Hospital
🇹🇭Muang, Thailand
Istanbul University Cerrahpasa Medical Faculty
🇹🇷Istanbul, Turkey
Buddhachinnaraj Hospital
🇹🇭Phitsanulok, Thailand
Izmir Dr. Suat Seren Gogus Hastaliklari ve Cerrahisi Egitim ve Arastirma Hastanesi
🇹🇷Izmir, Turkey
Communal Non-profit Enterprise City Clinical Hospital #4 of Dnipro City Council - PPDS; Chemotherapy
🇺🇦Dnipro, KIEV Governorate, Ukraine
Municipal Noncomercial Enterprise Odessa Regional Oncology Center ofthe Odessa StateAdministration
🇺🇦Odesa, Kherson Governorate, Ukraine
Municipal non profit enterprise of Sumy Regional Council Sumy Regional Clinical Oncology Disp
🇺🇦Sumy, Kholm Governorate, Ukraine
Kyiv Railway Clinical Hospital #3 of Branch Health Center of the PJSC Ukrainian Railway
🇺🇦Kyiv, KIEV Governorate, Ukraine
Communal Nonprofit Enterprise Podilsky Regional Center Of Oncology OfTheVinnytsia Regional Council
🇺🇦Vinnytsia, KIEV Governorate, Ukraine
The Municipal Enterprise Volyn Regional Medical Oncology Centre of the Volyn Regional Council
🇺🇦Lutsk, Volhynian Governorate, Ukraine
Birmingham Heartlands Hospital
🇬🇧Birmingham, United Kingdom
Private Enterprise Private Manufacturing Company Acinus
🇺🇦Kirovograd, Ukraine
Christie Hospital
🇬🇧Manchester, United Kingdom
Istituto Europeo Di Oncologia
🇮🇹Milano, Lombardia, Italy
Azienda Ospedaliero-Universitaria ?PoliclinicoVittorio Emanuele?- P.O. G. Rodolico; Oncologia Medica
🇮🇹Catania, Sicilia, Italy
Hospital Clinico Universitario de Valencia
🇪🇸Valencia, Spain
Kangbuk Samsung Hospital
🇰🇷Seoul, Korea, Republic of
Clinical Center Kragujevac
🇷🇸Kragujevac, Serbia
Uzsoki Utcai Korhaz
🇭🇺Budapest, Hungary
Attikon University General Hospital
🇬🇷Chaidari, Greece
Thermi Clinic
🇬🇷Thermi, Thessaloniki, Greece
EUROMEDICA General Clinic of Thessaloniki; Gastroenterology Department
🇬🇷Thessaloniki, Greece
Papageorgiou General Hospital of Thessaloniki
🇬🇷Thessaloniki, Greece
Pecsi Tudomanyegyetem
🇭🇺Pecs, Hungary
Nagoya University Hospital; Respiratory Medicine
🇯🇵Aichi, Japan
Kyushu University Hospital; Respiratory
🇯🇵Fukuoka, Japan
Kobe City Medical Center General Hospital; Respiratory Medicine
🇯🇵Hyogo, Japan
Hyogo Cancer Center; Thoracic Oncology
🇯🇵Hyogo, Japan
Osaka International Cancer Institute; Thoracic Oncology
🇯🇵Osaka, Japan
Osaka Habikino Medical Center
🇯🇵Osaka, Japan
National Cancer Center Hospital; Thoracic Medical Oncology
🇯🇵Tokyo, Japan
Warminsko-Mazurskie Centrum Chorób P?uc w Olsztynie; Oddzial onkologii z pododdzialem chemioterapii
🇵🇱Olsztyn, Poland
Wielkopolskie Centrum Pulmonologii i Torakochirurgii w Poznaniu
🇵🇱Poznan, Poland
Med-Polonia Sp. z o.o.
🇵🇱Poznan, Poland
Teo Health SA - Saint Constantin Hospital
🇷🇴Brasov, Romania
Prof. Dr. I. Chiricuta Institute of Oncology
🇷🇴Cluj Napoca, Romania
Sibiu Emergency Clinical County Hospital
🇷🇴Sibiu, Romania
Oncomed SRL
🇷🇴Timisoara, Romania
Federal State Institution Medical Radiology Research Center
🇷🇺Obninsk, Kaluga, Russian Federation
Moscow City Oncology Hospital #62
🇷🇺Moscovskaya Oblast, Moskovskaja Oblast, Russian Federation
Clinical Center of Serbia
🇷🇸Belgrade, Serbia
Vanderbilt University Medical Center; Multiple Sclerosis Center
🇺🇸Nashville, Tennessee, United States
IASO General Hospital of Athens
🇬🇷Athens, Greece
Metropolitan Hospital
🇬🇷Athens, Greece
University General Hospital of Larissa
🇬🇷Larissa, Greece
Bioclinic Thessaloniki
🇬🇷Thessaloniki, Greece
Szabolcs-Szatmar-Bereg Megyei; Korhazak es Egyetemi Oktatokorhaz
🇭🇺Nyiregyhaza, Hungary
Jasz-Nagykun-Szolnok Megyei Hetenyi Geza Korhaz-Rendelointezet; Megyei Onkologiai Kozpont
🇭🇺Szolnok, Hungary
Sendai Kousei Hospital; Pulmonary Medicine
🇯🇵Miyagi, Japan
Okayama University Hospital; Respiratory and Allergy Medicine
🇯🇵Okayama, Japan
Mazowieckie Centrum Leczenia Chorob Pluc i Gruzlicy
🇵🇱Otwock, Poland
Oncology Center Sf. Nectarie
🇷🇴Craiova, Romania
Institutul Regional de Oncologie Iasi; Clinica de Hematologie
🇷🇴Iasi, Romania
Oncocenter Clinical Oncology
🇷🇴Timi?oara, Romania
Arkhangelsk Regional Clinical Oncology Dispensary
🇷🇺Arkhangelsk, Arhangelsk, Russian Federation
Mordovia State University
🇷🇺Saransk, Russian Federation
University of California San Diego
🇺🇸La Jolla, California, United States
Yale Cancer Center
🇺🇸New Haven, Connecticut, United States
National Hospital Organization Kinki-Chuo Chest Medical Center
🇯🇵Sakai-shi, Japan
Tokyo Medical University Hospital; Dept of Surgery
🇯🇵Tokyo, Japan
Regional Clinical Oncology Center
🇷🇺Ryazan, Russian Federation
Hospital Universitario Son Espases
🇪🇸Palma de Mallorca, Islas Baleares, Spain
Prince of Songkla University; Department Of Internal Medicine, Faculty Of Medicine
🇹🇭Hat Yai, Thailand
Republican Clinical Oncology Dispensary of Ministry of Healthcare of Tatarstan Republic
🇷🇺Kazan, Tatarstan, Russian Federation
Volgograd Regional Clinical Oncology Dispensary
🇷🇺Volgograd, Russian Federation
Institute for Oncology and Radiology of Serbia; Medical Oncology
🇷🇸Belgrade, Serbia
Municipal Noncommercial Institution Regional Center of Oncology
🇺🇦Kharkiv, Kharkiv Governorate, Ukraine
Hospital Son Llatzer
🇪🇸Palma de Mallorca, Islas Baleares, Spain