A Study to Evaluate Efficacy and Safety of Giredestrant Compared With Fulvestrant (Plus a CDK4/6 Inhibitor), in Participants With ER-Positive, HER2-Negative Advanced Breast Cancer Resistant to Adjuvant Endocrine Therapy (pionERA Breast Cancer)
- Conditions
- Estrogen Receptor-Positive, HER2-Negative Advanced Breast Cancer
- Interventions
- Drug: LHRH AgonistDiagnostic Test: FoundationOne Liquid CDx Assay (F1LCDx)
- Registration Number
- NCT06065748
- Lead Sponsor
- Hoffmann-La Roche
- Brief Summary
This is a Phase III, randomized, open-label multicenter study that will evaluate the efficacy and safety of giredestrant compared with fulvestrant, both in combination with the investigator's choice of a CDK4/6 inhibitor (palbociclib, ribociclib or abemaciclib), in participants with estrogen receptor-positive (ER+), human epidermal growth factor receptor 2-negative (HER2-) advanced breast cancer who have developed resistance to adjuvant endocrine therapy.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 1050
- Locally advanced or metastatic adenocarcinoma of the breast, not amenable to treatment with curative intent
- Documented estrogen receptor-positive (ER+), HER2-negative (HER2-) tumor assessed locally on the most recent tumor biopsy (or an archived tumor sample if a recent tumor sample is not available for testing)
- Confirmed ESR1 mutation status (ESR1m versus ESR1nmd) in baseline circulating tumor DNA (ctDNA) through central laboratory testing
- Resistance to prior adjuvant endocrine therapy (ET), which is defined as having relapsed with prior standard adjuvant ET, on-treatment after >/=12 months or off-treatment within 12 months of completion. Prior use of adjuvant CDK4/6i is allowed (if relapse occurred >/=12 months since completion).
- No prior systemic anti-cancer therapy for advanced disease
- Measurable disease as defined per RECIST v.1.1 or non-measurable (including bone-only) disease
- Eastern Cooperative Oncology Group Performance Status (ECOG PS) 0-1
- For pre/perimenopausal women and for men: willing to undergo and maintain treatment with approved LHRH agonist therapy (as per local guidelines) for the duration of study treatment
- Prior systemic therapy (e.g., prior chemotherapy, immunotherapy, or biologic therapy) for locally advanced unresectable or metastatic breast cancer
- Prior treatment with another SERD (e.g., fulvestrant, oral SERDs) or novel ER-targeting agents
- Advanced, symptomatic, visceral spread that is at risk of life-threatening complications in the short term
- Active cardiac disease or history of cardiac dysfunction
- Clinically significant history of liver disease
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Fulvestrant + Investigator's Choice of CDK4/6i Fulvestrant Participants in the control arm will receive fulvestrant plus the investigator's choice of CDK4/6 inhibitor (CDK4/6i): palbociclib, ribociclib, or abemaciclib. Fulvestrant + Investigator's Choice of CDK4/6i LHRH Agonist Participants in the control arm will receive fulvestrant plus the investigator's choice of CDK4/6 inhibitor (CDK4/6i): palbociclib, ribociclib, or abemaciclib. Giredestrant + Investigator's Choice of CDK4/6i LHRH Agonist Participants in the experimental arm will receive giredestrant plus the investigator's choice of CDK4/6 inhibitor (CDK4/6i): palbociclib, ribociclib, or abemaciclib. Giredestrant + Investigator's Choice of CDK4/6i FoundationOne Liquid CDx Assay (F1LCDx) Participants in the experimental arm will receive giredestrant plus the investigator's choice of CDK4/6 inhibitor (CDK4/6i): palbociclib, ribociclib, or abemaciclib. Giredestrant + Investigator's Choice of CDK4/6i Ribociclib Participants in the experimental arm will receive giredestrant plus the investigator's choice of CDK4/6 inhibitor (CDK4/6i): palbociclib, ribociclib, or abemaciclib. Fulvestrant + Investigator's Choice of CDK4/6i FoundationOne Liquid CDx Assay (F1LCDx) Participants in the control arm will receive fulvestrant plus the investigator's choice of CDK4/6 inhibitor (CDK4/6i): palbociclib, ribociclib, or abemaciclib. Fulvestrant + Investigator's Choice of CDK4/6i Palbociclib Participants in the control arm will receive fulvestrant plus the investigator's choice of CDK4/6 inhibitor (CDK4/6i): palbociclib, ribociclib, or abemaciclib. Giredestrant + Investigator's Choice of CDK4/6i Giredestrant Participants in the experimental arm will receive giredestrant plus the investigator's choice of CDK4/6 inhibitor (CDK4/6i): palbociclib, ribociclib, or abemaciclib. Giredestrant + Investigator's Choice of CDK4/6i Abemaciclib Participants in the experimental arm will receive giredestrant plus the investigator's choice of CDK4/6 inhibitor (CDK4/6i): palbociclib, ribociclib, or abemaciclib. Giredestrant + Investigator's Choice of CDK4/6i Palbociclib Participants in the experimental arm will receive giredestrant plus the investigator's choice of CDK4/6 inhibitor (CDK4/6i): palbociclib, ribociclib, or abemaciclib. Fulvestrant + Investigator's Choice of CDK4/6i Abemaciclib Participants in the control arm will receive fulvestrant plus the investigator's choice of CDK4/6 inhibitor (CDK4/6i): palbociclib, ribociclib, or abemaciclib. Fulvestrant + Investigator's Choice of CDK4/6i Ribociclib Participants in the control arm will receive fulvestrant plus the investigator's choice of CDK4/6 inhibitor (CDK4/6i): palbociclib, ribociclib, or abemaciclib.
- Primary Outcome Measures
Name Time Method Progression-Free Survival (PFS) in the ESR1 mutation (ESR1m) Subgroup From randomization to first occurrence of progressive disease (PD) or death (up to 5 years) PFS is defined as the time from randomization to the first occurrence of PD, as determined by the investigator according to Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1), or death from any cause during the study.
PFS in the Full Analysis Set (FAS) Population From randomization to first occurrence of PD or death (up to 5 years)
- Secondary Outcome Measures
Name Time Method Time to Confirmed Deterioration (TTCD) in Pain Severity From randomization until end of follow-up (up to 5 years) TTCD in pain severity is defined as the time from randomization to the first documentation of ≥2-point increase from baseline on the "worst pain" item score of the Brief Pain Inventory-Short Form (BPI-SF). It will be analyzed in the FAS and in the ESR1m and ESR1nmd subgroups.
Duration of Response (DOR) From the first occurrence of a documented objective response to PD or death (up to 5 years) DOR is defined as the time from the first occurrence of a documented objective response to PD, as determined by the investigator according to RECIST v1.1, or death from any cause (whichever occurs first). It will be analyzed in the FAS and in the ESR1m and ESR1nmd subgroups.
Incidence and Severity of Adverse Events From Baseline until 28 days after the final dose of study treatment (up to 5 years) Incidence will be reported as the number of participants with at least one adverse event, with severity determined according to the National Cancer Institute Common Terminology Criteria for Adverse Events, version 5 (NCI CTCAE v5.0).
Number of Participants with Clinical Laboratory Test Abnormalities for Hematology and Biochemistry Parameters Over the Course of the Study From Baseline until 28 days after the final dose of study treatment (up to 5 years) Confirmed Objective Response Rate (cORR) From randomization until treatment discontinuation (up to 5 years) The cORR is defined as the percentage of participants with a complete response (CR) or partial response (PR) on two consecutive occasions at least 4 weeks apart, as determined by the investigator according to RECIST v1.1. It will be analyzed in the FAS and in the ESR1m and ESR1nmd subgroups.
Clinical Benefit Rate (CBR) From randomization until treatment discontinuation (up to 5 years) The CBR is defined as the percentage of participants with stable disease for at least (≥)24 weeks or a CR or PR, as determined by the investigator according to RECIST v1.1. It will be analyzed in the FAS and in the ESR1m and ESR1nmd subgroups.
Time to Chemotherapy From randomization until the start of chemotherapy or death (up to 5 years) Time to chemotherapy is defined as the time from randomization until the start date of the first chemotherapy or death from any cause (whichever occurs first). It will be analyzed in the FAS and in the ESR1m and ESR1nmd subgroups.
TTCD in Pain Presence and Interference From randomization until end of follow-up (up to 5 years) TTCD in pain presence and interference is defined as the time from randomization to the first documentation of ≥10-point increase in pain score, as determined using the European Organisation for Research and Treatment of Cancer Quality of Life-Core 30 (EORTC QLQ-C30) questionnaire. It will be analyzed in the FAS and in the ESR1m and ESR1nmd subgroups.
TTCD in Role Functioning From randomization until end of follow-up (up to 5 years) TTCD in role functioning (RF) is defined as the time from randomization to the first documentation of ≥10-point decrease in RF score, as determined using the EORTC QLQ-C30 questionnaire. It will be analyzed in the FAS and in the ESR1m and ESR1nmd subgroups.
Number of Participants with Vital Sign Abnormalities Over the Course of the Study From Baseline until 28 days after the final dose of study treatment (up to 5 years) Vital signs include respiratory rate, pulse rate, systolic and diastolic blood pressure, and temperature.
PFS in the ESR1 no-mutation-detected (ESR1nmd) Subgroup From randomization to first occurrence of PD or death (up to 5 years) Overall Survival (OS) From randomization until death from any cause (up to 5 years) OS is defined as the time from randomization to death from any cause. It will be analyzed in the FAS and in the ESR1m and ESR1nmd subgroups.
TTCD in Physical Functioning From randomization until end of follow-up (up to 5 years) TTCD in physical functioning (PF) is defined as the time from randomization to the first documentation of ≥10-point decrease in PF score, as determined using the EORTC QLQ-C30 questionnaire. It will be analyzed in the FAS and in the ESR1m and ESR1nmd subgroups.
TTCD in Global Health Status/Quality of Life From randomization until end of follow-up (up to 5 years) TTCD in in Global Health Status/Quality of Life (GHS/QoL) is defined as the time from randomization to the first documentation of ≥10-point decrease in GHS/QoL score, as determined using the EORTC QLQ-C30 questionnaire. It will be analyzed in the FAS and in the ESR1m and ESR1nmd subgroups.
Trial Locations
- Locations (322)
Clínica Puerto Montt
🇨🇱Puerto Montt, Chile
Oncosalud Sac
🇵🇪Lima, Peru
St. Elisabeth Krankenhaus Köln GmbH
🇩🇪Koeln, Germany
Sheba MC
🇮🇱Ramat Gan, Israel
Sourasky Medical Center
🇮🇱Tel-Aviv, Israel
Medikal Park Samsun
🇹🇷Samsun, Turkey
Hacettepe Uni Medical Faculty Hospital
🇹🇷Sihhiye/Ankara, Turkey
Southern Cancer Center
🇺🇸Daphne, Alabama, United States
Kliniken Essen-Mitte
🇩🇪Essen, Germany
La Hematology Oncology Medical Group
🇺🇸Glendale, California, United States
Marin Cancer Care Inc
🇺🇸Greenbrae, California, United States
Kaiser Permanente - Harbor City
🇺🇸Harbor City, California, United States
USC Norris Comprehensive Cancer Center
🇺🇸Los Angeles, California, United States
USC Norris Cancer Center
🇺🇸Newport Beach, California, United States
Sutter Health Medical Center
🇺🇸Sacramento, California, United States
The Lundquist Institute for BioMedical Innovation at Harbor-UCLA Medical Cente
🇺🇸Torrance, California, United States
Rocky Mountain Cancer Centers
🇺🇸Littleton, Colorado, United States
Georgetown University Medical Center
🇺🇸Washington, District of Columbia, United States
MedStar Washington Hosp Center
🇺🇸Washington, District of Columbia, United States
AdventHealth Altamonte
🇺🇸Altamonte Springs, Florida, United States
Florida Cancer Specialists - Fort Myers (Gladiolus Dr)
🇺🇸Fort Myers, Florida, United States
Cancer Specialists of North Florida
🇺🇸Jacksonville, Florida, United States
SCRI Florida Cancer Specialists PAN
🇺🇸Tallahassee, Florida, United States
Florida Cancer Specialists - Tampa
🇺🇸Tampa, Florida, United States
Grady Health System
🇺🇸Atlanta, Georgia, United States
Winship Cancer Institute of Emory University
🇺🇸Atlanta, Georgia, United States
Advocate Lutheran General Hospital
🇺🇸Park Ridge, Illinois, United States
Springfield Clinic
🇺🇸Springfield, Illinois, United States
Mission Cancer + Blood - IMMC
🇺🇸Des Moines, Iowa, United States
Baptist Health Lexington
🇺🇸Lexington, Kentucky, United States
Baptist Health Louisville
🇺🇸Louisville, Kentucky, United States
New England Cancer Specialists
🇺🇸Scarborough, Maine, United States
Maryland Oncology Hematology
🇺🇸Annapolis, Maryland, United States
Frederick Health Hospital
🇺🇸Frederick, Maryland, United States
Dana Farber Cancer Institute
🇺🇸Boston, Massachusetts, United States
Henry Ford Hospital
🇺🇸Detroit, Michigan, United States
HCA Midwest Division
🇺🇸Kansas City, Missouri, United States
Cancer Care Center of O'Fallon
🇺🇸O'Fallon, Missouri, United States
Oncology Hematology West - Legacy
🇺🇸Omaha, Nebraska, United States
Astera Cancer Care East Brunswick
🇺🇸East Brunswick, New Jersey, United States
Capital Health Regional Medical Center
🇺🇸Pennington, New Jersey, United States
Duke Women Cancer Care
🇺🇸Raleigh, North Carolina, United States
Oncology Hematology Care
🇺🇸Cincinnati, Ohio, United States
Asante Rogue Regional Medical Center
🇺🇸Medford, Oregon, United States
Alliance Cancer Specialists
🇺🇸Bensalem, Pennsylvania, United States
Ann B. Barshinger Cancer Institute
🇺🇸Lancaster, Pennsylvania, United States
Abramson Cancer Center; Univ of Pennsylvania; Clinical Research Unit
🇺🇸Philadelphia, Pennsylvania, United States
WellSpan Oncology Research
🇺🇸York, Pennsylvania, United States
Brown University Health
🇺🇸Providence, Rhode Island, United States
Avera Cancer Institute - Aberdeen
🇺🇸Aberdeen, South Dakota, United States
Avera Cancer Institute
🇺🇸Sioux Falls, South Dakota, United States
West Cancer Center
🇺🇸Germantown, Tennessee, United States
SCRI Oncology Partners
🇺🇸Nashville, Tennessee, United States
Texas Oncology Cancer Center
🇺🇸Austin, Texas, United States
JPS Oncology & Infusion Center
🇺🇸Fort Worth, Texas, United States
Texas Oncology - DFW
🇺🇸Irving, Texas, United States
Virginia Cancer Specialists, PC
🇺🇸Fairfax, Virginia, United States
Virginia Commonwealth University - Massey Cancer Center
🇺🇸Richmond, Virginia, United States
Northwest Medical Specialties
🇺🇸Tacoma, Washington, United States
West Virginia University Hospitals Inc
🇺🇸Morgantown, West Virginia, United States
Aurora BayCare Medical Center
🇺🇸Green Bay, Wisconsin, United States
Aurora St Lukes Medical Center
🇺🇸Milwaukee, Wisconsin, United States
Inst. de Oncologia Angel H. Roffo
🇦🇷Buenos aires, Argentina
Fundación CENIT para la Investigación en Neurociencias
🇦🇷Ciudad Autonoma Buenos Aires, Argentina
Centro Oncologico Korben
🇦🇷Ciudad Autonoma Buenos Aires, Argentina
Sanatorio Allende
🇦🇷Cordoba, Argentina
Centro Oncologico Riojano Integral (CORI)
🇦🇷La Rioja, Argentina
Hospital Alemán
🇦🇷Recoleta, Argentina
Instituto de Oncología de Rosario
🇦🇷Rosario, Argentina
Sanatorio Parque S.A.
🇦🇷Rosario, Argentina
Hospital Provincial del Centenario
🇦🇷Rosario, Argentina
Centro Oncológico de Excelencia
🇦🇷San Juan, Argentina
Northern Beaches Hospital
🇦🇺Frenchs Forest, New South Wales, Australia
Nepean Hospital
🇦🇺Kingswood, New South Wales, Australia
Mater Hospital
🇦🇺North Sydney, New South Wales, Australia
University of the Sunshine Coast
🇦🇺Sippy Downs, Queensland, Australia
Mater Misericordiae Limited
🇦🇺South Brisbane, Queensland, Australia
Cancer Research SA
🇦🇺Adelaide, South Australia, Australia
Barwon Health
🇦🇺Geelong, Victoria, Australia
Sunshine Hospital
🇦🇺St Albans, Victoria, Australia
South West Healthcare
🇦🇺Warrnambool, Victoria, Australia
Lkh-Univ. Klinikum Graz
🇦🇹Graz, Austria
Medical University Innsbruck
🇦🇹Innsbruck, Austria
Ordensklinikum Linz Barmherzige Schwestern
🇦🇹Linz, Austria
Oö. Gesundheits- und Spitals-AG/LKH Steyr
🇦🇹Steyr, Austria
Medizinische Universität Wien
🇦🇹Wien, Austria
Cliniques Universitaires St-Luc
🇧🇪Bruxelles, Belgium
UZ Gent
🇧🇪Gent, Belgium
UZ Leuven Gasthuisberg
🇧🇪Leuven, Belgium
CHU Sart-Tilman
🇧🇪Liège, Belgium
Clinique Ste-Elisabeth
🇧🇪Namur, Belgium
Sint Augustinus Wilrijk
🇧🇪Wilrijk, Belgium
Obras Sociais Irma Dulce - Osid
🇧🇷Salvador, Bahia, Brazil
Crio - Centro Regional Integrado de Oncologia
🇧🇷Fortaleza, Ceará, Brazil
Hospital Sírio-Libanês
🇧🇷Sao Paulo, São Paulo, Brazil
CEDOES - Diagnóstico e Pesquisa
🇧🇷Vitoria, Espírito Santo, Brazil
Hospital Araujo Jorge
🇧🇷Goiania, Goiás, Brazil
Hospital Sao Domingos
🇧🇷Sao Luis, Maranhão, Brazil
Hospital do Cancer de Pernambuco - HCP
🇧🇷Recife, Pernambuco, Brazil
Oncosite - Centro de Pesquisa Clinica Em Oncologia Ltda
🇧🇷Ijui, Rio Grande Do Sul, Brazil
Santa Casa de Misericordia de Porto Alegre
🇧🇷Porto Alegre, Rio Grande Do Sul, Brazil
Hospital Moinhos de Vento
🇧🇷Porto Alegre, Rio Grande Do Sul, Brazil
Hospital Sao Lucas - PUCRS
🇧🇷Porto Alegre, Rio Grande Do Sul, Brazil
Hospital Nossa Senhora da Conceicao
🇧🇷Porto Alegre, Rio Grande Do Sul, Brazil
Hospital de Cancer de Barretos
🇧🇷Barretos, São Paulo, Brazil
Hospital Amaral Carvalho
🇧🇷Jau, São Paulo, Brazil
Clinica de Pesquisa e Centro de Estudos em Oncologia Ginecologica e Mamaria Ltda
🇧🇷Sao Paulo, São Paulo, Brazil
Hospital A. C. Camargo
🇧🇷Sao Paulo, São Paulo, Brazil
Instituto D'Or de Pesquisa e Ensino
🇧🇷Rio de Janeiro, Brazil
Cross Cancer Institute
🇨🇦Edmonton, Alberta, Canada
Royal Victoria Regional Health Centre
🇨🇦Barrie, Ontario, Canada
Credit Valley Hospital/Carlo Fidani Peel Regional Cancer Centre
🇨🇦Mississauga, Ontario, Canada
Lakeridge Health Oshawa
🇨🇦Oshawa, Ontario, Canada
Thunder Bay Regional Health Sciences Centre
🇨🇦Thunder Bay, Ontario, Canada
North York General Hospital
🇨🇦Toronto, Ontario, Canada
Princess Margaret Cancer Center
🇨🇦Toronto, Ontario, Canada
CIUSSS du Saguenay Lac-Saint-Jean, Chicoutimi Hospital
🇨🇦Chicoutimi, Quebec, Canada
CISSS Chaudière-Appalaches
🇨🇦Levis, Quebec, Canada
Centre Hospitalier de l'Universite de Montreal (CHUM)
🇨🇦Montreal, Quebec, Canada
McGill University Health Centre - Glen Site
🇨🇦Montreal, Quebec, Canada
CHU de Québec - Hôpital du Saint-Sacrement
🇨🇦Quebec City, Quebec, Canada
Hopital regional de saint jerome
🇨🇦Saint-jerome, Quebec, Canada
Centre hospitalier regional de Trois-Rivieres
🇨🇦Trois-Rivieres, Quebec, Canada
Allan Blair Cancer Centre
🇨🇦Regina, Saskatchewan, Canada
Saskatoon Cancer Centre
🇨🇦Saskatoon, Saskatchewan, Canada
Oncovida
🇨🇱Providencia, Chile
Centro De Cancer Universidad Catolica
🇨🇱Santiago, Chile
Instituto Nacional del Cancer
🇨🇱Santiago, Chile
Icegclinic
🇨🇱Santiago, Chile
Beijing Cancer Hospital
🇨🇳Beijing, China
the First Hospital of Jilin University
🇨🇳Changchun City, China
Hunan Cancer Hospital
🇨🇳Changsha CITY, China
West China Hospital of Sichuan University
🇨🇳Chengdu City, China
Sichuan Provincial People's Hospital
🇨🇳Chengdu, China
The First Affiliated Hospital, Chongqing Medical University
🇨🇳Chongqing, China
Fujian Medical University Union Hospital
🇨🇳Fuzhou City, China
No. 900 Hospital (Fuzhou General Hospital)
🇨🇳Fuzhou City, China
Cancer Center, Sun Yat-sen University of Medical Sciences
🇨🇳Guangzhou City, China
The Second Affiliated Hospital of Zhejiang University College
🇨🇳Hangzhou, China
Harbin Medical University Cancer Hospital
🇨🇳Harbin, China
Jinan Central Hospital
🇨🇳Jinan City, China
Shandong Cancer Hospital
🇨🇳Jinan, China
The First People's Hospital of Yunnan Province
🇨🇳Kunming City, China
The First Affiliated Hospital to Henan University of Science and Technology
🇨🇳Luoyang, China
Guangxi Cancer Hospital of Guangxi Medical University
🇨🇳Nanning, China
Fudan University Shanghai Cancer Center
🇨🇳Shanghai City, China
Zhongshan Hospital Fudan University
🇨🇳Shanghai, China
Shanxi Province Cancer Hospital
🇨🇳Taiyuan City, China
Taizhou Hospital of Zhejiang Province
🇨🇳Taizhou, China
Tianjin Cancer Hospital
🇨🇳Tianjin, China
The Tumor Hospital of Xinjiang Medical University
🇨🇳Urumqi, China
Union Hospital Tongji Medical College Huazhong University of Science and Technology
🇨🇳Wuhan City, China
Hubei Cancer Hospital
🇨🇳Wuhan, China
The Second Affiliated Hospital of Xi'an Jiao Tong University
🇨🇳Xi'an City, China
Xi'an International Medical Center Hospital
🇨🇳Xian, China
The Affiliated Hospital of Xuzhou Medical University
🇨🇳Xuzhou, China
Zhejiang Cancer Hospital
🇨🇳Zhejiang, China
The First Affiliated Hospital of Zhengzhou University
🇨🇳Zhengzhou, China
Fundación CTIC - Centro de Tratamiento e Investigación sobre Cáncer Luis Carlos Sarmiento Angulo
🇨🇴Bogota, D.C., Colombia
IPS Salud SURA Chipichape Cali
🇨🇴Cali, Colombia
Oncomedica S.A.
🇨🇴Monteria, Colombia
Sociedad de Oncología y hematología del Cesar Ltda
🇨🇴Valledupar, Colombia
Clinica CIMCA
🇨🇷San José, Costa Rica
ICIMED Instituto de Investigación en Ciencias Médicas
🇨🇷San José, Costa Rica
Proclinical Pharma
🇨🇷San José, Costa Rica
Kuopio Uni Hospital
🇫🇮Kuopio, Finland
Tampere University Hospital
🇫🇮Tampere, Finland
ICO Paul Papin
🇫🇷Angers, France
Institut Sainte Catherine
🇫🇷Avignon, France
Hopital Jean Minjoz
🇫🇷Besancon, France
Centre Francois Baclesse
🇫🇷Caen, France
Centre Jean Perrin
🇫🇷Clermont Ferrand, France
Centre Hospitalier Saint Louis
🇫🇷La Rochelle, France
Centre Oscar Lambret
🇫🇷Lille, France
Centre Leon Berard
🇫🇷Lyon, France
Centre Cancerologie Grand Montpellier
🇫🇷Montpellier, France
Institut Jean Godinot
🇫🇷Reims CEDEX, France
Centre Eugene Marquis
🇫🇷Rennes, France
IUCT Oncopole
🇫🇷Toulouse, France
Gustave Roussy
🇫🇷Villejuif, France
Sozialstiftung Bamberg, Klinikum am Bruderwald, Gynäkologie
🇩🇪Bamberg, Germany
DONAU ISAR Klinikum Deggendorf
🇩🇪Deggendorf, Germany
Gynonco Düsseldorf, MVZ Medical Center GmbH
🇩🇪Düsseldorf, Germany
Universitätsklinikum Erlangen
🇩🇪Erlangen, Germany
Praxis für Interdisziplinäre Onkologie und Hämatologie GbR
🇩🇪Freiburg, Germany
Nationales Centrum für Tumorerkrankungen (NCT)
🇩🇪Heidelberg, Germany
Universitätsklinikum des Saarlandes
🇩🇪Homburg/Saar, Germany
Rotkreuzklinikum München
🇩🇪Muenchen, Germany
Brustzentrum Rhein-Ruhr Servicegesellschaft mbH
🇩🇪Mönchengladbach, Germany
Anticancer Hospital Ag. Savas
🇬🇷Athens, Greece
University Hospital of Larissa
🇬🇷Larissa, Greece
University Hospital of Patras Medical Oncology
🇬🇷Patras, Greece
Celan S.A.
🇬🇹Ciudad de Guatemala, Guatemala
INTEGRA Cancer Institute
🇬🇹Ciudad de Guatemala, Guatemala
Onco Go, S.A.
🇬🇹Ciudad de Guatemala, Guatemala
Medi-k
🇬🇹ciudad de Guatemala, Guatemala
Grupo Angeles
🇬🇹Guatemala City, Guatemala
Oncomedica
🇬🇹Guatemala, Guatemala
Centro Medico Integral de Cancerologia CEMIC
🇬🇹Salcajá, Guatemala
Pamela Youde Nethersole Eastern Hospital
🇭🇰Hong Kong, Hong Kong
Queen Mary Hospital
🇭🇰Hong Kong, Hong Kong
Orszagos Onkologiai Intezet
🇭🇺Budapest, Hungary
Bács-Kiskun Vármegyei Oktatókórház
🇭🇺Kecskemét, Hungary
B-A-Z Vármegyei Központi Kórház és Egyetemi Oktatókórház
🇭🇺Miskolc, Hungary
Nograd Varmegyei Szent Lazar Korhaz
🇭🇺Salgótarján, Hungary
Max Super Speciality Hospital
🇮🇳New Delhi, Delhi, India
HealthCare Global Enterprises Limited
🇮🇳Banglore, Karnataka, India
MVR Cancer Centre and Research Institute
🇮🇳Kozhikode, Kerala, India
Regional Cancer Centre
🇮🇳Trivandrum, Kerala, India
Sir H. N. Reliance Foundation Hospital and Research Centre
🇮🇳Mumbai, Maharashtra, India
Grant Medical Foundation, Ruby Hall Clinic
🇮🇳Pune, Maharashtra, India
Sunact Cancer Institute
🇮🇳Thane, Maharashtra, India
Hadassah Ein Karem Hospital
🇮🇱Jerusalem, Israel
Rabin Medical Center
🇮🇱Petah Tikva, Israel
Azienda Ospedaliera di Rilievo Nazionale e di Alta Specialita San Giuseppe Moscati
🇮🇹Avellino, Campania, Italy
Azienda Ospedaliera Universitaria Federico II
🇮🇹Napoli, Campania, Italy
Policlinico S.Orsola-Malpighi
🇮🇹Bologna, Emilia-Romagna, Italy
I.R.S.T Srl IRCCS
🇮🇹Meldola, Emilia-Romagna, Italy
A.O. Universitaria Di Parma
🇮🇹Parma, Emilia-Romagna, Italy
RCCS - Centro di Riferimento
🇮🇹Aviano (PN), Friuli-Venezia Giulia, Italy
A.O. Universitaria S. Maria Della Misericordia Di Udine
🇮🇹Udine, Friuli-Venezia Giulia, Italy
Policlinico Universitario Agostino Gemelli
🇮🇹Roma, Lazio, Italy
Università Campus Bio-Medico di Roma
🇮🇹Roma, Lazio, Italy
Asst Papa Giovanni XXIII
🇮🇹Bergamo, Lombardia, Italy
Asst Degli Spedali Civili Di Brescia
🇮🇹Brescia, Lombardia, Italy
Irccs Istituto Nazionale Dei Tumori (Int)
🇮🇹Milano, Lombardia, Italy
Istituto Clinico Humanitas
🇮🇹Rozzano, Lombardia, Italy
Ospedale Di Macerata
🇮🇹Macerata, Marche, Italy
A.O.U. Maggiore della Carità
🇮🇹Novara, Piemonte, Italy
Presidio Ospedaliero di Summa-Perrino
🇮🇹Brindisi, Puglia, Italy
Humanitas Centro Catanese Di Oncologia
🇮🇹Misterbianco (CT), Sicilia, Italy
Azienda Ospedaliera Universitaria Careggi
🇮🇹Florence, Toscana, Italy
IOV - Istituto Oncologico Veneto - IRCCS
🇮🇹Padova, Veneto, Italy
University of Nairobi - Institute of Tropical and Infectious Diseases
🇰🇪Nairobi, Kenya
Kyungpook National University Chilgok Hospital
🇰🇷Daegu, Korea, Republic of
Seoul National University Bundang Hospital
🇰🇷Seongnam-si, Korea, Republic of
Korea University Anam Hospital
🇰🇷Seoul, Korea, Republic of
Seoul National University Hospital
🇰🇷Seoul, Korea, Republic of
Severance Hospital, Yonsei University Health System
🇰🇷Seoul, Korea, Republic of
Asan Medical Center
🇰🇷Seoul, Korea, Republic of
Gangnam Severance Hospital
🇰🇷Seoul, Korea, Republic of
Ewha Womans University Mokdong Hospital
🇰🇷Seoul, Korea, Republic of
Samsung Medical Center
🇰🇷Seoul, Korea, Republic of
Ulsan University Hosiptal
🇰🇷Ulsan, Korea, Republic of
Panamerican Clinical Research S.A de C.V.
🇲🇽Guadalajara, Jalisco, Mexico
RENATI INNOVATION S.A.P.I. de C.V
🇲🇽Guadalajara, Jalisco, Mexico
Productos y Servicios Oncologicos Acacias SA de CV
🇲🇽Ciudad de México, Mexico CITY (federal District), Mexico
Centro Oncológico Hematológico Roma
🇲🇽Mexico City, Mexico CITY (federal District), Mexico
Hospital Zambrano Hellion TecSalud
🇲🇽Monterrey, Nuevo LEON, Mexico
Centro de Investigacion Clinica de Oaxaca
🇲🇽Oaxaca de Juárez, Oaxaca, Mexico
PanAmerican Clinical Research, Querétaro
🇲🇽Queréaro, Queretaro, Mexico
CENEIT Oncologicos
🇲🇽Mexico City, Mexico
Centro Medico Dalinde
🇲🇽Mexico City, Mexico
Christchurch Hospital
🇳🇿Christchurch, New Zealand
Palmerston North Hospital
🇳🇿Palmerston North, New Zealand
Whangarei Hospital
🇳🇿Whangarei, New Zealand
Centro Medico Monte Carmelo
🇵🇪Arequipa, Peru
Clínica Santa Beatriz
🇵🇪Lima, Peru
Hospital Nacional Arzobispo Loayza
🇵🇪Lima, Peru
Instituto Nacional de Enfermedades Neoplasicas
🇵🇪Lima, Peru
Clinica Internacional, Sede San Borja
🇵🇪Lima, Peru
Instituto Peruano de Oncología y Radioterapia
🇵🇪Lima, Peru
Clinica Peruana Americana
🇵🇪Trujillo, Peru
Instytut "Centrum Zdrowia Matki Polki"
🇵🇱?ód?, Poland
Centrum Onkologii im. Prof. Franciszka ?ukaszczyka
🇵🇱Bydgoszcz, Poland
Szpital Morski Im. Pck
🇵🇱Gdynia, Poland
Narodowy Instytut Onkologii Odzia? w Gliwicach
🇵🇱Gliwice, Poland
?wi?tokrzyskie Centrum Onkologii
🇵🇱Kielce, Poland
Przychodnia Lekarska KOMED, Roman Karaszewski
🇵🇱Konin, Poland
Szpital Wojewódzki im. Miko?aja Kopernika
🇵🇱Koszalin, Poland
Centrum Onkologii Ziemi Lubelskiej im. sw. Jana z Dukli
🇵🇱Lublin, Poland
Mazowiecki Szpital Wojewódzki im. ?w. Jana Paw?a II
🇵🇱Siedlce, Poland
Zachodniopomorskie Centrum Onkologii
🇵🇱Szczecin, Poland
Narodowy Inst.Onkologii im.Sklodowskiej-Curie Panstw.Inst.Bad
🇵🇱Warszawa, Poland
IPO de Coimbra
🇵🇹Coimbra, Portugal
Hospital de S. Francisco Xavier
🇵🇹Lisboa, Portugal
Hospital da Luz
🇵🇹Lisboa, Portugal
IPO do Porto
🇵🇹Porto, Portugal
CHVNG/E_Unidade 1
🇵🇹Vila Nova de Gaia, Portugal
PanOncology Trials
🇵🇷San Juan, Puerto Rico
Spitalul Clinic Filantropia
🇷🇴Bucuresti, Romania
Amethyst Cluj
🇷🇴Cluj County, Romania
Institutul Oncologic Prof. Dr. Ion Chiricuta Cluj Napoca
🇷🇴Cluj Napoca, Romania
Centrul de Oncologie Sfantul Nectarie
🇷🇴Craiova, Romania
Institutul Regional de Oncologie Iasi
🇷🇴Iasi, Romania
Centrul de Oncologie Oncohelp
🇷🇴Timisoara, Romania
National University Hospital
🇸🇬Singapore, Singapore
National Cancer Centre
🇸🇬Singapore, Singapore
Icon Cancer Centre Gleneagles
🇸🇬Singapore, Singapore
Institute of Oncology Ljubljana
🇸🇮Ljubljana, Slovenia
Cancercare Rondebosch Oncology
🇿🇦Cape Town, South Africa
Cancercare
🇿🇦Port Elizabeth, South Africa
Institut Catala d?Oncologia Hospital Germans Trias i Pujol
🇪🇸Badalona, Barcelona, Spain
Vall d'Hebron Institute of Oncology (VHIO), Barcelona
🇪🇸Sant Andreu de La Barca, Barcelona, Spain
Hospital de Jerez de la Frontera
🇪🇸Jerez de La Frontera, Cadiz, Spain
Hospital Quiron de Madrid
🇪🇸Pozuelo de Alarcon, Madrid, Spain
Hospital Universitario Virgen de La Arrixaca
🇪🇸EL Palmar (EL Palmar), Murcia, Spain
Hospital Alvaro Cunqueiro
🇪🇸Vigo, Pontevedra, Spain
Hospital Universitari Dexeus - Grupo Quironsalud
🇪🇸Barcelona, Spain
Hospital Juan Ramon Jimenez
🇪🇸Huelva, Spain
Complejo Hospitalario de Jaen-Hospital Universitario Medico Quirurgico
🇪🇸Jaen, Spain
Centro Oncologico MD Anderson Internacional
🇪🇸Madrid, Spain
Hospital de Madrid Norte Sanchinarro- Centro Integral Oncologico Clara Campal
🇪🇸Madrid, Spain
Hospital Universitario Virgen Macarena
🇪🇸Sevilla, Spain
Hospital Universitario Virgen del Rocio
🇪🇸Sevilla, Spain
Instituto Valenciano Oncologia
🇪🇸Valencia, Spain
Hospital Arnau de Vilanova (Valencia) Servicio de Oncologia
🇪🇸Valencia, Spain
Hsin-Chu Branch of National Taiwan University Hospital
🇨🇳Hsinchu City, Taiwan
China Medical University Hospital
🇨🇳Taichung, Taiwan
Koo Foundation Sun Yat-Sen Cancer Center
🇨🇳Taipei City, Taiwan
Veterans General Hospital
🇨🇳Taipei, Taiwan
National Taiwan Uni Hospital
🇨🇳Taipei, Taiwan
Veterans General Hospital - Taichung
🇨🇳Xitun Dist., Taiwan
Chulalongkorn Hospital
🇹🇭Bangkok, Thailand
National Cancer Institute
🇹🇭Bangkok, Thailand
Chulabhorn Hospital
🇹🇭Lak Si, Thailand
Maharaj Nakorn Chiang Mai Hospital;Depart of Radiology
🇹🇭Muang Chiang MAI Delivery Branch 3, Thailand
Songklanagarind Hospital
🇹🇭Songkhla, Thailand
Ankara City Hospital
🇹🇷Ankara, Turkey
Bakirkoy Dr. Sadi Konuk Egitim ve Arastirma Hastanesi, Tibbi Onkoloji
🇹🇷Bakirkoy / Istanbul, Turkey
Goztepe Prof.Dr. Suleyman Yalcin City Hospital
🇹🇷Kadiköy, Turkey
Mersin City Education and Research Hospital
🇹🇷Mersin, Turkey