A Study of Atezolizumab in Combination With Carboplatin Plus (+) Nab-Paclitaxel Compared With Carboplatin+Nab-Paclitaxel in Participants With Stage IV Non-Squamous Non-Small Cell Lung Cancer (NSCLC)
- Conditions
- Carcinoma, Non-Squamous Non-Small Cell Lung
- Interventions
- Registration Number
- NCT02367781
- Lead Sponsor
- Hoffmann-La Roche
- Brief Summary
This randomized Phase III, multicenter, open-label study designed to evaluate the safety and efficacy of atezolizumab (an engineered anti-programmed death-ligand 1 \[PD-L1\] antibody) in combination with carboplatin+nab-paclitaxel compared with treatment with carboplatin+nab-paclitaxel in chemotherapy-naive participants with Stage IV non-squamous NSCLC. Participants were randomized in a 2:1 ratio to Arm A (Atezolizumab+Nab-Paclitaxel+Carboplatin) or Arm B (Nab-Paclitaxel+Carboplatin).
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 723
- Eastern Cooperative Oncology Group performance status of 0 or 1
- Histologically or cytologically confirmed, Stage IV non-squamous NSCLC
- Participants with no prior treatment for Stage IV non-squamous NSCLC
- Previously obtained archival tumor tissue or tissue obtained from fresh biopsy at screening
- Measurable disease, as defined by RECIST v1.1
- Adequate hematologic and end organ function
Cancer-Specific Exclusions:
- Active or untreated central nervous system metastases
- 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
General Medical Exclusions:
- 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 computed tomography scan. History of radiation pneumonitis in the radiation field (fibrosis) is permitted
- Positive test for human immunodeficiency virus
- Active hepatitis B or hepatitis C
- Severe infection within 4 weeks prior to randomization
- Significant cardiovascular disease
- Illness or condition that interferes with the participant's capacity to understand, follow and/or comply with study procedures
Exclusion Criteria Related to Medications:
- Prior treatment with cluster of differentiation 137 agonists or immune checkpoint blockade therapies, anti-programmed death-1, and anti-PD-L1 therapeutic antibodies
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Arm A (Atezolizumab+Nab-Paclitaxel+Carboplatin) Atezolizumab (MPDL3280A), an engineered anti-PD-L1 antibody Participants received intravenous (IV) infusion of atezolizumab and carboplatin on Day 1 of each 21-day cycle, and nab-paclitaxel on Days 1, 8, and 15 of each 21-day cycle for 4 or 6 cycles or until loss of clinical benefit whichever occurred first during induction treatment phase. Participants received IV infusion of atezolizumab during maintenance treatment phase until loss of clinical benefit. Arm A (Atezolizumab+Nab-Paclitaxel+Carboplatin) Carboplatin Participants received intravenous (IV) infusion of atezolizumab and carboplatin on Day 1 of each 21-day cycle, and nab-paclitaxel on Days 1, 8, and 15 of each 21-day cycle for 4 or 6 cycles or until loss of clinical benefit whichever occurred first during induction treatment phase. Participants received IV infusion of atezolizumab during maintenance treatment phase until loss of clinical benefit. Arm B (Nab-Paclitaxel+Carboplatin) Atezolizumab (MPDL3280A), an engineered anti-PD-L1 antibody Participants received IV infusion of carboplatin on Day 1 and nab-paclitaxel on Days 1, 8, and 15 of each 21-day cycle for 4 or 6 cycles or until disease progression whichever occurred first during induction treatment phase. Participants received best supportive care during maintenance treatment phase. Switch maintenance to pemetrexed was also permitted. Participants who were consented prior to approval of protocol Version 5 were given the option to cross over to receive atezolizumab as monotherapy until disease progression. Arm B (Nab-Paclitaxel+Carboplatin) Carboplatin Participants received IV infusion of carboplatin on Day 1 and nab-paclitaxel on Days 1, 8, and 15 of each 21-day cycle for 4 or 6 cycles or until disease progression whichever occurred first during induction treatment phase. Participants received best supportive care during maintenance treatment phase. Switch maintenance to pemetrexed was also permitted. Participants who were consented prior to approval of protocol Version 5 were given the option to cross over to receive atezolizumab as monotherapy until disease progression. Arm B (Nab-Paclitaxel+Carboplatin) Pemetrexed Participants received IV infusion of carboplatin on Day 1 and nab-paclitaxel on Days 1, 8, and 15 of each 21-day cycle for 4 or 6 cycles or until disease progression whichever occurred first during induction treatment phase. Participants received best supportive care during maintenance treatment phase. Switch maintenance to pemetrexed was also permitted. Participants who were consented prior to approval of protocol Version 5 were given the option to cross over to receive atezolizumab as monotherapy until disease progression. Arm B (Nab-Paclitaxel+Carboplatin) Nab-Paclitaxel Participants received IV infusion of carboplatin on Day 1 and nab-paclitaxel on Days 1, 8, and 15 of each 21-day cycle for 4 or 6 cycles or until disease progression whichever occurred first during induction treatment phase. Participants received best supportive care during maintenance treatment phase. Switch maintenance to pemetrexed was also permitted. Participants who were consented prior to approval of protocol Version 5 were given the option to cross over to receive atezolizumab as monotherapy until disease progression. Arm A (Atezolizumab+Nab-Paclitaxel+Carboplatin) Nab-Paclitaxel Participants received intravenous (IV) infusion of atezolizumab and carboplatin on Day 1 of each 21-day cycle, and nab-paclitaxel on Days 1, 8, and 15 of each 21-day cycle for 4 or 6 cycles or until loss of clinical benefit whichever occurred first during induction treatment phase. Participants received IV infusion of atezolizumab during maintenance treatment phase until loss of clinical benefit.
- Primary Outcome Measures
Name Time Method Progression-Free Survival (PFS) as Determined by the Investigator Using Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1) in the ITT-WT Population Up to approximately 35 months after first patient enrolled PFS is defined as the time between the date of randomization and the date of first documented disease progression as determined by the investigator according to RECIST v1.1 or death from any cause, whichever occurs first in the ITT-WT population.
Overall Survival (OS) in the ITT-WT Population Up to approximately 35 months after first patient enrolled OS is defined as the time between the date of randomization and date of death from any cause in the ITT-WT population.
- Secondary Outcome Measures
Name Time Method Event Free Rate (%) at Year 1 and 2 in ITT-WT Population and ITT Population Up to 41 months after first patient enrolled, years 1 and 2 reported The OS rate at the 1- and 2-year landmark time points after randomization.
OS as Determined by the Investigator Using Recist v1.1 in the ITT Population Up to approximately 41 months after first subject enrolled OS is defined as the time between the date of randomization and date of death from any cause in the ITT population.
OS as Determined by the Investigator Using RECIST v1.1 in the PD-L1 Expression Population and PD-L1 Expression WT Population Up to approximately 35 months after first patient enrolled OS is defined as the time between the date of randomization and date of death from any cause in the PD-L1 Expression Population and PD-L1 Expression WT Population. The PD-L1 expression population is defined as one of the following: PD-L1 IHC TC1/2/3 or IC1/2/3 population, defined as ITT participants with PD-L1 IHC TC1/2/3 or IC1/2/3 expression in baseline tumor tissue; PD-L1 IHC TC2/3 or IC2/3 population, defined as ITT participants with PD-L1 IHC TC2/3 or IC2/3 expression in baseline tumor tissue; PD-L1 IHC TC3 or IC3 population, defined as ITT participants with PD-L1 IHC TC3 or IC3 expression in baseline tumor tissue. The PD-L1 expression WT population is defined as the PD-L1 expression population excluding participants with an activating EGFR mutation or ALK translocation.
Percentage of Participants With an Objective Response (OR) (Complete Response [CR] or Partial Response [PR]) as Determined by the Investigator Using RECIST v1.1 in the ITT-WT Population Up to approximately 41 months after first subject enrolled ORR (confirmation not required) is defined as the proportion of participants with an objective response, either CR or PR, with the use of RECIST v1.1, as determined by the investigator in the ITT-WT population.
Duration of Response (DOR) as Determined by the Investigator Using RECIST v1.1 in ITT-WT Population, ITT Population, and PD-L1 Expression Population and PD-L1 Expression WT Population Up to approximately 35 months after first subject enrolled DOR,defined for participants with objective response (OR) as time from 1st documented OR to documented disease progression as determined by investigator using RECIST v1.1,or death from any cause,whichever occurs 1st.ITT defined as all randomized participants,regardless of receipt of assigned treatment.ITT-WT defined as ITT population excluding participants with activating EGFR mutation or ALK translocation.PD-L1 expression population is defined as one of following:PD-L1 IHC TC1/2/3 or IC1/2/3 population,defined as ITT participants with PD-L1 IHC TC1/2/3 or IC1/2/3 expression in baseline tumor tissue;PD-L1 IHC TC2/3 or IC2/3 population, defined as ITT participants with PD-L1 IHC TC2/3 or IC2/3 expression in baseline tumor tissue;PD-L1 IHC TC3 or IC3 population,defined as ITT participants with PD-L1 IHC TC3 or IC3 expression in baseline tumor tissue.PD-L1 expression WT is defined as PD-L1 expression population excluding participants with activating EGFR mutation or ALK translocation.
Event Free Rate (%) at Year 1 and 2 in PD-L1 Expression Population and PD-L1 Expression WT Population Up to 35 months after first patient enrolled, years 1 and 2 reported The OS rate at the 1- and 2-year landmark time points after randomization in the PD-L1 Expression Population and PD-L1 Expression WT Population. The PD-L1 expression population is defined as one of the following: PD-L1 IHC TC1/2/3 or IC1/2/3 population, defined as ITT participants with PD-L1 IHC TC1/2/3 or IC1/2/3 expression in baseline tumor tissue; PD-L1 IHC TC2/3 or IC2/3 population, defined as ITT participants with PD-L1 IHC TC2/3 or IC2/3 expression in baseline tumor tissue; PD-L1 IHC TC3 or IC3 population, defined as ITT participants with PD-L1 IHC TC3 or IC3 expression in baseline tumor tissue. The PD-L1 expression WT population is defined as the PD-L1 expression population excluding participants with an activating EGFR mutation or ALK translocation.
Time to Deterioration (TTD) in Patient-Reported Lung Cancer Symptoms in the ITT-WT Population Up to approximately 35 months after first subject enrolled Defined as time from randomization to confirmed deterioration (10-point change) on the combined European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire-Core (EORTC QLQ-C30) and supplemental lung cancer module (EORTC QLQ-LC13) symptom subscales.
PFS as Determined by the Investigator Using Recist v1.1 in the ITT Population, PD-L1 Expression Population, and PD-L1 Expression WT Population Up to approximately 35 months after first subject enrolled PFS is defined as the time between the date of randomization and the date of first documented disease progression as determined by the investigator according to RECIST v1.1 or death from any cause, whichever occurs first. The ITT population was defined as all randomized participants, regardless of receipt of the assigned treatment. The PD-L1 expression population is defined as one of the following: PD-L1 IHC TC1/2/3 or IC1/2/3 population, defined as ITT participants with PD-L1 IHC TC1/2/3 or IC1/2/3 expression in baseline tumor tissue; PD-L1 IHC TC2/3 or IC2/3 population, defined as ITT participants with PD-L1 IHC TC2/3 or IC2/3 expression in baseline tumor tissue; PD-L1 IHC TC3 or IC3 population, defined as ITT participants with PD-L1 IHC TC3 or IC3 expression in baseline tumor tissue. The PD-L1 expression WT population is defined as the PD-L1 expression population excluding participants with an activating EGFR mutation or ALK translocation.
Percentage of Participants With an Objective Response (OR) (Complete Response [CR] or Partial Response [PR]) as Determined by the Investigator Using RECIST v1.1 in the ITT Population, PD-L1 Expression Population, and PD-L1 Expression WT Population Up to approximately 35 months after first subject enrolled ORR (confirmation not required) is defined as proportion of participants with an objective response, either CR or PR, with the use of RECIST v1.1, as determined by investigator in ITT population, PD-L1 Expression population, and PD-L1 Expression WT population. ITT population was defined as all randomized participants, regardless of receipt of the assigned treatment. PD-L1 expression population is defined as one of the following: PD-L1 IHC TC1/2/3 or IC1/2/3 population, defined as ITT participants with PD-L1 IHC TC1/2/3 or IC1/2/3 expression in baseline tumor tissue; PD-L1 IHC TC2/3 or IC2/3 population, defined as ITT participants with PD-L1 IHC TC2/3 or IC2/3 expression in baseline tumor tissue; PD-L1 IHC TC3 or IC3 population, defined as ITT participants with PD-L1 IHC TC3 or IC3 expression in baseline tumor tissue. PD-L1 expression WT population is defined as PD-L1 expression population excluding participants with an activating EGFR mutation or ALK translocation.
Change From Baseline in Patient-Reported Lung Cancer Symptoms Score Using the Symptoms in Lung Cancer (SILC) Scale Up to approximately 35 months after first subject enrolled Change from baseline per SILC scale will be analyzed for each lung cancer symptoms scores. SILC questionnaire comprises 3 individual symptoms \& are scored at individual symptom level, thus have a dyspnea score, chest pain score, \& cough score. There are a total of 9 questions in SILC questionnaire, each question has a minimum value of 0 \& maximum value of 4. Each individual symptom score is calculated as average of responses for symptom items. 'Chest pain' score is mean of question 1 \& 2, 'Cough' score is mean of question 3 \& 4 and 'Dyspnea' score is mean of question 5 to 9 in SILC questionnaire. An increase in score is suggestive of a worsening in symptomology. A score change of ≥0.3 points for dyspnea \& cough symptom scores is considered to be clinically significant; whereas a score change of≥0.5 points for chest pain score is considered to be clinically significant.
Percentage of Participants With Adverse Events Up to approximately 69 months after first patient enrolled Percentage of participants with at least one adverse event. Adverse event onset date before cross over.
Percentage of Participants With Anti-Therapeutic Antibodies (ATAs) to Atezolizumab Up to approximately 35 months after first subject enrolled Baseline prevalence and post-baseline incidence of anti-drug antibodies (ADA) to Atezolizumab in the Arm A (Atezolizumab + Carboplatin or Cisplatin + Pemetrexed) and Arm B Carboplatin+nab-paclitaxel Crossover Participants
Maximum Observed Serum Concentration (Cmax) of Atezolizumab for Patients in Atezolizumab+Carboplatin+Nab-Paclitaxel Arm Cycle 1 Day 1 and Cycle 3 Day 1 (Cycle length = 21 days) Predose samples will be collected on the same day of treatment administration. The infusion duration of atezolizumab will be of 30-60 minutes.
Minimum Observed Serum Concentration (Cmin) of Atezolizumab Prior to Infusion in Atezolizumab+Carboplain+Nab-Paclitaxel Cycle 1 Day 21, Cycle 2 Day 21, Cycle 3 Day 21, and Cycle 7 Day 21 (Cycle length = 21 days) Predose samples will be collected on the same day of treatment administration.
Plasma Concentrations of Carboplatin Predose (same day of treatment administration), 5-10 minutes before end of carboplatin infusion, 1 hour after carboplatin infusion (infusion duration=15 to 30 minutes) on Day 1 of Cycle 1 and 3 (1 Cycle=21 days) (up to approximately 35 months) Plasma Concentrations of Nab-Paclitaxel Reported as Total Paclitaxel Predose (same day of treatment administration), 5-10 minutes before end of nab-paclitaxel infusion, 1 hour after nab-paclitaxel infusion (infusion duration=30 minutes) on Day 1 of Cycle 1 and 3 (1 Cycle=21 days) (up to approximately 35 months)
Trial Locations
- Locations (132)
University of Miami School of Medicine - Sylvester at Deerfield
🇺🇸Deerfield Beach, Florida, United States
Fort Wayne Med Oncology & Hematology Inc
🇺🇸Fort Wayne, Indiana, United States
SCRI Florida Cancer Specialists East
🇺🇸West Palm Beach, Florida, United States
SCRI Tennessee Oncology Chattanooga
🇺🇸Chattanooga, Tennessee, United States
Istituto Nazionale per lo Studio e la Cura dei Tumori Fondazione G. Pascale
🇮🇹Napoli, Campania, Italy
Mark H. Zangmeister Center
🇺🇸Columbus, Ohio, United States
University of Texas M.D. Anderson Cancer Center
🇺🇸Houston, Texas, United States
Kaiser Permanente - San Leandro Medical Center
🇺🇸San Leandro, California, United States
Duke University Medical Center; Department of Medicine
🇺🇸Durham, North Carolina, United States
The Christ Hospital
🇺🇸Cincinnati, Ohio, United States
Cancer Care Network of South Texas - SAT & BC
🇺🇸San Antonio, Texas, United States
Hospital Son Llatzer
🇪🇸Palma de Mallorca, Islas Baleares, Spain
Mayo Clinic
🇺🇸Rochester, Minnesota, United States
Saint Barnabas Medical Center
🇺🇸Livingston, New Jersey, United States
Kaiser Permanente - San Francisco Medical Center
🇺🇸San Francisco, California, United States
Kaiser Permanente - Sacramento Medical Center and Medical Offices
🇺🇸Sacramento, California, United States
Kaiser Permanente - San Jose Medical Center
🇺🇸San Jose, California, United States
Kaiser Permanente Medical Center - Roseville
🇺🇸Roseville, California, United States
Kaiser Permanente - Santa Clara
🇺🇸Santa Clara, California, United States
Kaiser Permanente; Oncology Clinical Trials
🇺🇸Vallejo, California, United States
Va Sierra Nevada Health Care System
🇺🇸Reno, Nevada, United States
W.G. Bill Hefner VA Medical Center
🇺🇸Salisbury, North Carolina, United States
Eastern Connecticut Hematology and Oncology Associates; (ECHO)
🇺🇸Norwich, Connecticut, United States
Cancer Inst. of New Jersey
🇺🇸New Brunswick, New Jersey, United States
University of Iowa Hospitals and Clinics
🇺🇸Iowa City, Iowa, United States
Clinical Research Alliance
🇺🇸Westbury, New York, United States
Pinnacle Health
🇺🇸Harrisburg, Pennsylvania, United States
Northwest Georgia Oncology Centers, a Service of Wellstar Cobb Hospital
🇺🇸Carrollton, Georgia, United States
Greenville Health System; Cancer Center
🇺🇸Greenville, South Carolina, United States
SCRI The Center For Cancer and Blood Disorders
🇺🇸Denton, Texas, United States
Southeast Nebraska Cancer Ctr
🇺🇸Lincoln, Nebraska, United States
Joliet Oncology-Hematology; Associates, Ltd.
🇺🇸Joliet, Illinois, United States
Lancaster General Hospital
🇺🇸Lancaster, Pennsylvania, United States
Southcoast Health System
🇺🇸Fairhaven, Massachusetts, United States
Englewood Hospital and Medical Center
🇺🇸Englewood, New Jersey, United States
University Oncology Associates
🇺🇸Chattanooga, Tennessee, United States
Hôpital Maisonneuve - Rosemont
🇨🇦Montreal, Quebec, Canada
CHU Ambroise Paré
🇧🇪Mons, Belgium
Galilee Medical Center
🇮🇱Nahariya, Israel
Cite de La Sante de Laval; Hemato-Oncologie
🇨🇦Laval, Quebec, Canada
Asklepios Fachkliniken GmbH
🇩🇪Gauting, Germany
St. Antonius Hospital
🇩🇪Eschweiler, Germany
Bezirksklinikum Obermain
🇩🇪Ebensfeld, Germany
Chaim Sheba Medical Center
🇮🇱Ramat Gan, Israel
Hadassah Ein Karem Hospital; Oncology Dept
🇮🇱Jerusalem, Israel
Hopital American de Paris (American Hospital of Paris)
🇫🇷Neuilly sur Seine, France
BC Cancer - Surrey
🇨🇦Surrey, British Columbia, Canada
HOPITAL DE LA SOURCE; Service de Cardiologie, Point Jaune
🇫🇷Orleans, France
Rabin Medical Center
🇮🇱Petach Tiqwa, Israel
Medizinische Hochschule Hannover
🇩🇪Hannover, Germany
Helios Klinikum Erfurt
🇩🇪Erfurt, Germany
Rambam Health Corporation; Oncology Institute
🇮🇱Rambam, Israel
Meir Medical Center; Oncology
🇮🇱Kfar-Saba, Israel
Katholisches Klinikum Marienhof
🇩🇪Koblenz Am Rhein, Germany
Hospital Universitario de Torrejon
🇪🇸Torrejon de Ardoz, Madrid, Spain
Krankenhaus Nordwest
🇩🇪Frankfurt am Main, Germany
Soroka University Medical Centre
🇮🇱Beer Sheva, Israel
Praxis fur Haematologie und Internistische Onkologie
🇩🇪Velbert, Germany
Hospital Universitario de Canarias
🇪🇸S. Cristobal De La Laguna, Tenerife, Spain
Johannes Wesling Klinikum Minden
🇩🇪Minden, Germany
Ospedale Di Macerata; Oncologia
🇮🇹Macerata, Marche, Italy
Hospital de San Pedro de Alcantara
🇪🇸Caceres, Spain
Ospedale Santa Maria Della; Misericordia Di Perugia; Farmacia Ospedaliera
🇮🇹Perugia, Umbria, Italy
Azienda Osp Uni Seconda Università Degli Studi Di Napoli; Unità Operativa Oncologia Medica
🇮🇹Napoli, Campania, Italy
Azienda Ospedaliera di Rilievo Nazionale e di Alta Specialita San Giuseppe Moscati
🇮🇹Avellino, Campania, Italy
Polyclinique Bordeaux Nord Aquitaine
🇫🇷Bordeaux, France
Institut Hospitalier Franco-Britannique; Cancerologie
🇫🇷Levallois-Perret, France
Fondation Hopital Saint Joseph;Cardiologie Clinique
🇫🇷Marseille, France
Clinique Clementville; Hopital De Jour
🇫🇷Montpellier, France
Clinique Catherine de Sienne
🇫🇷Nantes, France
Centre D'oncologie de Gentilly; Service Oncologie Medicale
🇫🇷Nancy, France
Hopital Pontchaillou
🇫🇷Rennes, France
Centre Hospitalier Regional Sud Reunion; Service de Pneumologie
🇫🇷Saint Pierre, France
Hopital d'Instruction des Armees de Begin
🇫🇷Saint-Mande, France
Robert Bosch Krankenhaus; Pneumologie und pneumologische Onkologie
🇩🇪Gerlingen, Germany
SRH Wald-Klinikum Gera; Klinik für Hautkrankheiten und Allergologie
🇩🇪Gera, Germany
Universitatsklinikum Schleswig-Holstein; Klinik fuer Innere Medizin I
🇩🇪Lubeck, Germany
Klinikum Kassel; Hautklinik
🇩🇪Kassel, Germany
St. Vincentius Kliniken Karlsruhe
🇩🇪Karlsruhe, Germany
LMU Klinikum der Universitat Munchen
🇩🇪Munchen, Germany
Helios Klinik Wuppertal
🇩🇪Wuppertal, Germany
Assaf Harofeh Medical Center
🇮🇱Beer Yaakov, Israel
Kaplan Medical Center
🇮🇱Rehovot, Israel
Tel Aviv Sourasky Medical Ctr; Oncology
🇮🇱Tel Aviv, Israel
Hospital NisA 9 de Octubre
🇪🇸Valencia, Spain
Consorcio Hospitalario Provincial de Castellon
🇪🇸Castellon DE LA Plana/castello DE LA Plana, Castellon, Spain
Complejo Hospitalario Universitario A Coruña
🇪🇸A Coruña, LA Coruña, Spain
Complejo Hospitalario de Jaen
🇪🇸Jaen, Spain
Hospital General Universitario de Valencia
🇪🇸Valencia, Spain
Hospital General Universitario de Guadalajara
🇪🇸Guadalajara, Spain
Hospital Santa Creu i Sant Pau
🇪🇸Barcelona, Spain
Schwarzwald-Baar Klinikum/VS GmbH; Onkologie/Hämatologie/Infektologie
🇩🇪Villingen-Schwenningen, Germany
Fachklinik für Lungenerkrankungen
🇩🇪Immenhausen, Germany
Highlands Oncology Group
🇺🇸Springdale, Arkansas, United States
Kaiser Permanente Oakland Medical Center
🇺🇸Oakland, California, United States
Kaiser Permanente - Walnut Creek
🇺🇸Walnut Creek, California, United States
Banner MD Anderson Cancer Center
🇺🇸Greeley, Colorado, United States
Kaiser Permanente - South San Francisco
🇺🇸South San Francisco, California, United States
Florida Cancer Specialists (St. Petersburg - St. Anthony's Professional Building)
🇺🇸Saint Petersburg, Florida, United States
SCRI Florida Cancer Specialists South
🇺🇸Fort Myers, Florida, United States
Florida Hospital
🇺🇸Orlando, Florida, United States
University of Illinois at Chicago
🇺🇸Chicago, Illinois, United States
University Cancer & Blood Center, LLC; Research
🇺🇸Athens, Georgia, United States
Southeastern Regional Medical Center, Inc.
🇺🇸Newnan, Georgia, United States
Suburban Hematology / Oncology Associates
🇺🇸Lawrenceville, Georgia, United States
Quincy Medical Group
🇺🇸Quincy, Illinois, United States
Illinois Cancer Care
🇺🇸Peoria, Illinois, United States
Southern Illinois University, Simmons Cancer Institute
🇺🇸Springfield, Illinois, United States
Lahey Clinic Med Ctr
🇺🇸Lexington, Kentucky, United States
Walter Reed National Military Medical Center
🇺🇸Bethesda, Maryland, United States
Center For Cancer and Blood Disorders
🇺🇸Bethesda, Maryland, United States
Hematology and Oncology Associates at Bridgepoint
🇺🇸Tupelo, Mississippi, United States
Laura and ISAAC Perlmutter Cancer Center at NYU Langone.
🇺🇸New York, New York, United States
Oncology Hematology Care, Inc.
🇺🇸Hamilton, Ohio, United States
GasthuisZusters Antwerpen
🇧🇪Wilrijk, Belgium
Royal Victoria Regional Health Centre
🇨🇦Barrie, Ontario, Canada
William Osler Health Centre
🇨🇦Etobicoke, Ontario, Canada
CHRU Nancy; Pneumologie
🇫🇷Vandoeuvre-lès-nancy, France
Klinikum Esslingen GmbH; Frauenklinik
🇩🇪Esslingen Am Neckar, Germany
Klinikum Chemnitz gGmbH
🇩🇪Chemnitz, Germany
Charite - Universitätsmedizin Berlin; Klinik fur Infektiologie und Pneumologie
🇩🇪Berlin, Germany
Malteser Krankenhaus St. Franziskus-Hospital
🇩🇪Flensburg, Germany
Thoraxklinik Heidelberg gGmbH
🇩🇪Heidelberg, Germany
Klinikum Mannheim GmbH Universitätsklinikum
🇩🇪Mannheim, Germany
Universitätsklinikum Tübingen
🇩🇪Tuebingen, Germany
Ospedale Clinicizzato SS Annunziata
🇮🇹Chieti, Abruzzo, Italy
Hospital Universitario Virgen de Las Nieves
🇪🇸Granada, Spain
Hospital Universitario Miguel Servet; Servicio Oncologia
🇪🇸Zaragoza, Spain
Werken Glorieux VZW
🇧🇪Ronse, Belgium
Cliniques Universitaires St-Luc
🇧🇪Bruxelles, Belgium
Presbyterian Hospital
🇺🇸Charlotte, North Carolina, United States
Rhode Island Hospital
🇺🇸Providence, Rhode Island, United States