A Study of Atezolizumab in Combination With Carboplatin Plus (+) Paclitaxel With or Without Bevacizumab Compared With Carboplatin+Paclitaxel+Bevacizumab in Participants With Stage IV Non-Squamous Non-Small Cell Lung Cancer (NSCLC)
- Conditions
- Carcinoma, Non-Small-Cell Lung
- Interventions
- Registration Number
- NCT02366143
- Lead Sponsor
- Hoffmann-La Roche
- Brief Summary
This randomized, open-label study evaluated the safety and efficacy of atezolizumab (an engineered anti-programmed death-ligand 1 \[PD-L1\] antibody) in combination with carboplatin+paclitaxel with or without bevacizumab compared with treatment with carboplatin+paclitaxel+bevacizumab in chemotherapy-naïve participants with Stage IV non-squamous NSCLC. Participants were randomized in a 1:1:1 ratio to Arm A (Atezolizumab+Carboplatin+Paclitaxel), Arm B (Atezolizumab+Carboplatin+Paclitaxel+Bevacizumab), or Arm C (Carboplatin+Paclitaxel+Bevacizumab).
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 1202
- Eastern Cooperative Oncology Group performance status 0 or 1
- Histologically or cytologically confirmed, Stage IV non-squamous NSCLC
- Participants with no prior treatment for Stage IV non-squamous NSCLC
- Known PD-L1 status as determined by immunohistochemistry assay performed on previously obtained archival tumor tissue or tissue obtained from a 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 B (Atezolizumab+Bevacizumab+Paclitaxel + Carboplatin) Atezolizumab (MPDL3280A), an engineered anti-PD-L1 antibody Participants received IV infusion of atezolizumab and bevacizumab on Day 1 of each 21-day cycle followed by IV infusion of paclitaxel and carboplatin on Day 1 of each 21-day cycle for 4 or 6 cycles or until loss of clinical benefit whichever occurs first, during induction treatment phase. Participants received IV infusion of atezolizumab until loss of clinical benefit and bevacizumab until progressive disease, unacceptable toxicity, or death during maintenance treatment phase. Arm A (Atezolizumab+Paclitaxel+Carboplatin) Atezolizumab (MPDL3280A), an engineered anti-PD-L1 antibody Participants received intravenous (IV) infusion of atezolizumab on Day 1 of each 21-day cycle followed by IV infusion of paclitaxel and carboplatin on Day 1 of each 21-day cycle for 4 or 6 cycles or until loss of clinical benefit whichever occurs first, during induction treatment phase. Participants received IV infusion of atezolizumab during maintenance treatment phase until loss of clinical benefit. Arm A (Atezolizumab+Paclitaxel+Carboplatin) Carboplatin Participants received intravenous (IV) infusion of atezolizumab on Day 1 of each 21-day cycle followed by IV infusion of paclitaxel and carboplatin on Day 1 of each 21-day cycle for 4 or 6 cycles or until loss of clinical benefit whichever occurs first, during induction treatment phase. Participants received IV infusion of atezolizumab during maintenance treatment phase until loss of clinical benefit. Arm A (Atezolizumab+Paclitaxel+Carboplatin) Paclitaxel Participants received intravenous (IV) infusion of atezolizumab on Day 1 of each 21-day cycle followed by IV infusion of paclitaxel and carboplatin on Day 1 of each 21-day cycle for 4 or 6 cycles or until loss of clinical benefit whichever occurs first, during induction treatment phase. Participants received IV infusion of atezolizumab during maintenance treatment phase until loss of clinical benefit. Arm B (Atezolizumab+Bevacizumab+Paclitaxel + Carboplatin) Bevacizumab Participants received IV infusion of atezolizumab and bevacizumab on Day 1 of each 21-day cycle followed by IV infusion of paclitaxel and carboplatin on Day 1 of each 21-day cycle for 4 or 6 cycles or until loss of clinical benefit whichever occurs first, during induction treatment phase. Participants received IV infusion of atezolizumab until loss of clinical benefit and bevacizumab until progressive disease, unacceptable toxicity, or death during maintenance treatment phase. Arm B (Atezolizumab+Bevacizumab+Paclitaxel + Carboplatin) Carboplatin Participants received IV infusion of atezolizumab and bevacizumab on Day 1 of each 21-day cycle followed by IV infusion of paclitaxel and carboplatin on Day 1 of each 21-day cycle for 4 or 6 cycles or until loss of clinical benefit whichever occurs first, during induction treatment phase. Participants received IV infusion of atezolizumab until loss of clinical benefit and bevacizumab until progressive disease, unacceptable toxicity, or death during maintenance treatment phase. Arm B (Atezolizumab+Bevacizumab+Paclitaxel + Carboplatin) Paclitaxel Participants received IV infusion of atezolizumab and bevacizumab on Day 1 of each 21-day cycle followed by IV infusion of paclitaxel and carboplatin on Day 1 of each 21-day cycle for 4 or 6 cycles or until loss of clinical benefit whichever occurs first, during induction treatment phase. Participants received IV infusion of atezolizumab until loss of clinical benefit and bevacizumab until progressive disease, unacceptable toxicity, or death during maintenance treatment phase. Arm C (Bevacizumab+Paclitaxel+Carboplatin) Carboplatin Participants received IV infusion of bevacizumab on Day 1 of each 21-day cycle followed by IV infusion of paclitaxel and carboplatin on Day 1 of each 21-day cycle for 4 or 6 cycles or loss of clinical benefit whichever occurs first, during induction treatment phase. Participants received IV infusion of bevacizumab during maintenance treatment phase until progressive disease, unacceptable toxicity, or death. Arm C (Bevacizumab+Paclitaxel+Carboplatin) Bevacizumab Participants received IV infusion of bevacizumab on Day 1 of each 21-day cycle followed by IV infusion of paclitaxel and carboplatin on Day 1 of each 21-day cycle for 4 or 6 cycles or loss of clinical benefit whichever occurs first, during induction treatment phase. Participants received IV infusion of bevacizumab during maintenance treatment phase until progressive disease, unacceptable toxicity, or death. Arm C (Bevacizumab+Paclitaxel+Carboplatin) Paclitaxel Participants received IV infusion of bevacizumab on Day 1 of each 21-day cycle followed by IV infusion of paclitaxel and carboplatin on Day 1 of each 21-day cycle for 4 or 6 cycles or loss of clinical benefit whichever occurs first, during induction treatment phase. Participants received IV infusion of bevacizumab during maintenance treatment phase until progressive disease, unacceptable toxicity, or death.
- Primary Outcome Measures
Name Time Method Overall Survival (OS) in Arm B Versus Arm C in ITT-WT Population Baseline until death until data cut-off on 22 January 2018 (up to approximately 34 months) Overall Survival (OS) in Arm B Versus Arm C in ITT-WT Population
Overall Survival (OS) in Arm A Versus Arm C in ITT-WT Population Baseline until death (up approximately 53 months) Overall Survival (OS) in Arm A Versus Arm C in ITT-WT Population
Progression Free Survival (PFS), as Determined by the Investigator in Arm B Versus Arm C in the Teff-high WT Population and ITT-WT Population Baseline until disease progression or death, whichever occurs first until data cut-off on 15 September 2017 (up to approximately 29 months) Progression Free Survival (PFS), as Determined by the Investigator using Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) in Arm B versus Arm C in the T-effector (Teff)-high wild type (WT) population and the intent-to-treat (ITT)-WT population.
- Secondary Outcome Measures
Name Time Method OS in Arm A Versus Arm C by PD-L1 Subgroup Baseline until death (up approximately 53 months) OS in Arm A Versus Arm C by PD-L1 Subgroup: TC2/3 or 1C2/3 and TC1/2/3 or IC1/2/3 (ITT-WT Population)
PFS, as Determined by the Investigator in Arm B Versus Arm C in Teff High Population and ITT Population Baseline until disease progression or death, whichever occurs first (up to approximately 29 months) PFS, as determined by the investigator according to RECIST v1.1, in Arm B versus C in the Teff high population and ITT population.
PFS, as Determined by the Investigator in Arm A Versus Arm B in Teff High-WT Population and ITT-WT Population Baseline until disease progression or death, whichever occurs first (up to approximately 29 months) PFS, as determined by the investigator according to RECIST v1.1, in Arm A versus B in the Teff high-WT population and ITT-WT population.
PFS, as Determined by the Investigator in Arm B Versus Arm C by PD-L1 Subgroup Baseline until disease progression or death, whichever occurs first (up to approximately 29 months) PFS as Determined by the Investigator according to RECIST v1.1, in Arm B Versus Arm C by PD-L1 Subgroup: TC2/3 or 1C2/3 and TC1/2/3 or IC1/2/3 (ITT-WT Population)
OS in Arm B Versus Arm C by PD-L1 Subgroup Baseline until death (up to approximately 34 months) OS in Arm B Versus Arm C by PD-L1 Subgroup: TC2/3 or 1C2/3 and TC1/2/3 or IC1/2/3 (ITT-WT Population)
OS in Arm B Versus Arm C in Teff High-WT Population, Teff High Population, and ITT Population Baseline until death (up to approximately 34 months) OS in Arm A Versus Arm C in Teff High-WT Population, Teff High Population, and ITT Population Baseline until death (up approximately 53 months) OS in Arm A Versus Arm B in Teff High-WT Population and ITT-WT Population Baseline until death (up approximately 53 months) Duration of Response (DOR), as Determined By Investigator in Arm B Versus Arm C Baseline until disease progression or death, whichever occurs first (up to approximately 29 months) DOR, as determined by investigator according to RECIST v1.1 in Arm B versus Arm C in the Teff high-WT population and the ITT-WT population.
Percentage of Participants With an Objective Response (OR) (Complete Response [CR] or Partial Response [PR]) as Determined by the Investigator in the Teff-High-WT Population and ITT-WT Population Baseline until disease progression or death, whichever occurs first (up to approximately 29 months) 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 Teff-High-WT population and ITT-WT population.
OS Rates at Years 1 and 2 in Arm B Versus Arm C Baseline to 2 years or death, whichever occurs first. OS at 1- and 2-year landmark timepoints in Teff-high WT population and ITT-WT population.
OS Rates at Years 1 and 2 in Arm A Versus Arm C Baseline to 2 years or death, whichever occurs first. OS at 1- and 2-year landmark timepoints in Teff-high WT population and ITT-WT population.
Time to Deterioration (TTD) in Patient-Reported Lung Cancer Symptoms Determined by European Organization for Research and Treatment of Cancer (EORTC) Quality-of-Life Questionnaire-Core 30 (QLQ-C30) Score Baseline up to approximately 29 months EORTC QLQ-C30 is a validated \& reliable self-report measure (Aaronson et al.1993;Fitzsimmons et al.1999) that consists of 30 questions that assess 5 aspects of patient functioning (physical,emotional,role, cognitive,and social), 3 symptom scales (fatigue,nausea \& vomiting, pain),global health/quality of life,and six single items (dyspnea,insomnia, appetite loss,constipation,diarrhea, and financial difficulties). EORTC QLQ-C30 is scored according to the EORTC scoring manual (Fayers et al. 2001). All EORTC scales and single-item measures are linearly transformed so that each score has a range of 0-100. A high score for a functional/global health status scale represents a high or healthy level of functioning/HRQoL (Health-Related Quality of Life);however a high score for a symptom scale or item represents a high level of symptomatology or problems. A ≥10-point change in the symptoms subscale score is perceived by patients as clinically significant (Osoba et al.1998).
TTD in Patient-Reported Lung Cancer Symptoms as Determined by EORTC Quality-of-Life Questionnaire-Core Lung Cancer Module 13 (QLQ-LC13) Score Baseline up to approximately 29 months QLQ-LC13 Quality-of-Life Questionnaire Lung Cancer Module incorporates one multiple-item scale to assess dyspnea and a series of single items assessing pain, coughing, sore mouth, dysphagia, peripheral neuropathy, alopecia, and hemoptysis. The EORTC QLQ-LC13 is scored according to the EORTC scoring manual (Fayers et al. 2001). All EORTC scales and single-item measures are linearly transformed so that each score has a range of 0-100. A high score for a functional/global health status scale represents a high or healthy level of functioning/HRQoL (Health-Related Quality of Life); however, a high score for a symptom scale or item represents a high level of symptomatology or problems. A ≥10-point change in the symptoms subscale score is perceived by patients as clinically significant (Osoba et al. 1998).
PFS, as Determined by the Independent Review Facility (IRF) in Arm B Versus Arm C in Teff-High-WT Population and ITT-WT Population Baseline until disease progression or death, whichever occurs first (up to approximately 29 months) PFS, as determined by the independent review facility (IRF) Using RECIST v1.1 in Arm B versus Arm C in the T-effector (Teff)-high wild type (WT) population and the intent-to-treat (ITT)-WT population.
Change From Baseline in Patient-Reported Lung Cancer Symptoms Score Using the Symptoms in Lung Cancer (SILC) Scale Baseline up to approximately 29 months The SILC (Symptoms in Lung Cancer) scale was used to assess patient-reported severity of lung cancer symptoms (chest pain, dyspnea, and cough). The SILC scale is a 9-item content validated self-report measure of lung cancer symptoms. It measures severity of cough, dyspnea, and chest pain with a symptom severity score. The SILC questionnaire comprises three individual symptoms (dyspnea, cough, chest pain) and are scored at the individual symptom level, thus have a dyspnea score, chest pain score, and cough score. Each individual symptom score is calculated as the average of responses for the symptom items \[e.g. Chest Pain Score=mean (item 1; item 2)\]. An increase in score is suggestive of a worsening in symptomology (i.e. frequency or severity). A score change of ≥0.3 points for the dyspnea and cough symptom scores is considered to be clinically significant; whereas a score change of ≥0.5 points for the chest pain score is considered to be clinically significant.
Percentage of Participants With Adverse Events Baseline up to data cutoff date 7 December 2020 (up to approximately 68 months) Percentage of participants with at least one adverse event.
Percentage of Participants With Anti-Therapeutic Antibodies (ATAs) to Atezolizumab Baseline up to approximately 29 months Maximum Observed Serum Concentration (Cmax) of Atezolizumab in Arm A and Arm B Day 1 of Cycle 1 and 3 (Cycle length=21 days) The 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 Arm A and Arm B Day 21 of Cycles 1, 2 3, and 7 (Cycle length=21 days) Plasma Concentrations for Carboplatin in Arm A, Arm B, and Arm C Predose (same day of treatment administration), 5-10 minutes before end of carboplatin infusion, 1 h after carboplatin infusion (infusion duration=15 to 30 minutes) on D1 of Cy1,3 (Cycle length=21 days) Plasma Concentrations for Paclitaxel in Arm A, Arm B, and Arm C Predose (same day of treatment administration), 5-10 minutes before end of paclitaxel infusion, 1 h after paclitaxel infusion (infusion duration=3 h) on D1 of Cy1,3 (Cycle length=21 days) Cmax of Bevacizumab in Arm B and Arm C Cycle 1 Day 1 and Cycle 3 Day 1 (Cycle length=21 days) Cmin of Bevacizumab in Arm B and Arm C Cycle 1 Day 1 and Cycle 2 Day 21 (Cycle length=21 days)
Trial Locations
- Locations (240)
Piedmont Cancer Institute, PC
🇺🇸Atlanta, Georgia, United States
Univ of Pittsburgh Medical Ctr
🇺🇸Pittsburgh, Pennsylvania, United States
Rush University Medical Center
🇺🇸Chicago, Illinois, United States
Mercy Medical Center
🇺🇸Baltimore, Maryland, United States
Virginia Mason Medical Center
🇺🇸Seattle, Washington, United States
Maastricht University Medical Center
🇳🇱Maastricht, Netherlands
St. Antonius Ziekenhuis; R&D Long
🇳🇱Nieuwegein, Netherlands
Municipal Institution SubCarpathian Clinical Oncological Centre; Surgical department#2
🇺🇦Ivano-Frankivsk, KIEV Governorate, Ukraine
SI Institute of Medical Radiology n.a. S.P. Hryhoriev of NAMS of Ukraine
🇺🇦Kharkiv, Ukraine
ME Kryviy Rih Oncology Dispensary of Dnipropetrovs'k Regional Council; Chemotherapy Department
🇺🇦Kryvyi Rih, Ukraine
Kyiv City Clinical Oncological Center
🇺🇦Kyiv, Ukraine
Virginia Cancer Institute
🇺🇸Richmond, Virginia, United States
Hopital Nord AP-HM
🇫🇷Marseille, France
Holy Cross Hospital Inc
🇺🇸Fort Lauderdale, Florida, United States
Southern CA Permanente Med Grp
🇺🇸Bellflower, California, United States
Mount Sinai Medical Center
🇺🇸Miami Beach, Florida, United States
Univ of Chicago
🇺🇸Chicago, Illinois, United States
Hospital Provincial del Centenario
🇦🇷Rosario, Argentina
Ironwood Cancer & Research Centers
🇺🇸Chandler, Arizona, United States
Longview Cancer Center
🇺🇸Longview, Texas, United States
Houston Methodist Cancer Center
🇺🇸Houston, Texas, United States
Billings Clinic
🇺🇸Billings, Montana, United States
Virginia Cancer Specialists, PC
🇺🇸Fairfax, Virginia, United States
Scripps Health
🇺🇸La Jolla, California, United States
Valley Hospital; Oncology Research
🇺🇸Paramus, New Jersey, United States
West Clinic
🇺🇸Germantown, Tennessee, United States
Blue Ridge Cancer Care
🇺🇸Roanoke, Virginia, United States
Tennessee Cancer Specialists
🇺🇸Knoxville, Tennessee, United States
Providence Regional Cancer Partnership
🇺🇸Everett, Washington, United States
Hospital de Cancer de Barretos
🇧🇷Barretos, SP, Brazil
Sir Charles Gairdner Hospital
🇦🇺Nedlands, Western Australia, Australia
Instituto Do Cancer Delondrina_X; Unidade De Pesquisa Clinica
🇧🇷Londrina, PR, Brazil
Hôpital Larrey;Université Paul Sabatier
🇫🇷Toulouse, France
Hôpital d'Instruction des Armées de Sainte Anne; Service de Pneumologie
🇫🇷Toulon, France
Universitätsklinikum "Carl Gustav Carus" der Technischen Universität Dresden
🇩🇪Dresden, Germany
Klinikum der Universität Regensburg
🇩🇪Regensburg, Germany
Stiftung Mathias-Spital Rheine
🇩🇪Rheine, Germany
Kliniken der Stadt Koln gGmbH; Lungenklinik Onkologische Ambulanz
🇩🇪Koln, Germany
Krankenhaus Barmherzige Bruder Regensburg
🇩🇪Regensburg, Germany
Istituto Nazionale per la Ricerca sul Cancro di Genova
🇮🇹Genova, Liguria, Italy
Azienda Unita Sanitaria Locale N1 Sassari; Unita Operativa Di Oncologia Medica
🇮🇹Sassari, Sardegna, Italy
Tergooiziekenhuizen
🇳🇱Hilversum, Netherlands
Erasmus MC; Afdeling Longziekten
🇳🇱Rotterdam, Netherlands
Centro Medico Monte Carmelo
🇵🇪Arequipa, Peru
Hospital Universitario La Paz
🇪🇸Madrid, Spain
Hospital Univ Vall d'Hebron; Servicio de Oncologia
🇪🇸Barcelona, Spain
Chang Gung Memorial Hospital Chiayi
🇨🇳Putzu, Taiwan
Universitair Medisch Centrum Utrecht
🇳🇱Utrecht, Netherlands
Centro Especializado de Enfermedades Neoplásicas
🇵🇪Arequipa, Peru
Centro Hospitalar E Universitário de Coimbra EPE
🇵🇹Coimbra, Portugal
Hospital de Sao Joao; Servico de Pneumologia
🇵🇹Porto, Portugal
National Cancer Centre; Medical Oncology
🇸🇬Singapore, Singapore
Hospital Universitario HM Sanchinarro-CIOCC
🇪🇸Madrid, Spain
ME Bukovinian Clinical Oncology Center
🇺🇦Chernivtsi, Chernihiv Governorate, Ukraine
Tri-Service General Hospital
🇨🇳Taipei, Taiwan
Regional Municipal Institution Sumy Regional Clinical Oncology Dispensary
🇺🇦Sumy, Ukraine
University of Texas Health Science Center at San Antonio
🇺🇸San Antonio, Texas, United States
Policlinico Universitario Campus Biomedico; Uoc Oncologia Medica
🇮🇹Roma, Lazio, Italy
Centro Hemato Oncologico Privado; Oncologia
🇲🇽Toluca, Mexico
Danbury Hospital
🇺🇸Danbury, Connecticut, United States
University of Cincinnati
🇺🇸Cincinnati, Ohio, United States
Paracelsus Medizinische Privatuniversität
🇦🇹Salzburg, Austria
Chi Mei Medical Center Liou Ying Campus
🇨🇳Liuying Township, Taiwan
Luzerner Kantonsspital Sursee
🇨🇭Luzern, Switzerland
Kantonsspital St. Gallen; Onkologie/Hämatologie
🇨🇭St. Gallen, Switzerland
Hospital Universitario Son Espases
🇪🇸Palma De Mallorca, Islas Baleares, Spain
Cancerologia de Queretaro
🇲🇽Queretaro, Mexico
Hospital Pulido Valente; Servico de Pneumologia
🇵🇹Lisboa, Portugal
Kanagawa Cardiovascular and Respiratory Center
🇯🇵Kanagawa, Japan
Concord Repatriation General Hospital
🇦🇺Concord, New South Wales, Australia
Centro de Investigacion; Clinica - Clinica Viedma S.A.
🇦🇷Viedma, Argentina
Arizona Oncology Associates
🇺🇸Flagstaff, Arizona, United States
Marin Cancer Care Inc
🇺🇸Greenbrae, California, United States
Rocky Mountain Cancer Center
🇺🇸Denver, Colorado, United States
Kaiser Permanente
🇺🇸Lonetree, Colorado, United States
Cancer Specialists of North Florida - Baptist South
🇺🇸Jacksonville, Florida, United States
Chao Family Comprehensive Cancer Center UCI
🇺🇸Orange, California, United States
Hematology Oncology Associates of the Treasure Coast
🇺🇸Port Saint Lucie, Florida, United States
Ingalls Memorial Hospital
🇺🇸Harvey, Illinois, United States
Oncology Specialists, S.C.
🇺🇸Park Ridge, Illinois, United States
Hematology-Oncology; Associates of the Quad Cities
🇺🇸Bettendorf, Iowa, United States
New England Cancer Specialists
🇺🇸Scarborough, Maine, United States
St. Luke's Regional Cancer Center
🇺🇸Duluth, Minnesota, United States
Maryland Oncology Hematology, P.A.
🇺🇸Columbia, Maryland, United States
Park Nicolett - Frauenshuh Cancer Center
🇺🇸Saint Louis Park, Minnesota, United States
Missouri Baptist Medical Center
🇺🇸Saint Louis, Missouri, United States
Montana Cancer Specialists
🇺🇸Missoula, Montana, United States
Comprehensive Cancer Centers of Nevada
🇺🇸Henderson, Nevada, United States
Regional Cancer Care Associates LLC
🇺🇸Sewell, New Jersey, United States
First Health of the Carolinas
🇺🇸Pinehurst, North Carolina, United States
Summit Medical Group
🇺🇸Berkeley Heights, New Jersey, United States
Mercy St Anne Hospital
🇺🇸Toledo, Ohio, United States
St. Charles Medical Center Bend; Cancer Care Of The Cascades
🇺🇸Bend, Oregon, United States
Bend Memorial Clinic
🇺🇸Bend, Oregon, United States
Allegheny Cancer Center
🇺🇸Pittsburgh, Pennsylvania, United States
Willamette Valley Cancer Insitute and Research Center
🇺🇸Springfield, Oregon, United States
St. Luke's Cancer Care Associates
🇺🇸Bethlehem, Pennsylvania, United States
Virginia Oncology Associates
🇺🇸Norfolk, Virginia, United States
MultiCare Regional Cancer Center - Auburn
🇺🇸Auburn, Washington, United States
West Virginia University; Mary Babb Randolph Can Ctr
🇺🇸Morgantown, West Virginia, United States
Medical Oncology Associates
🇺🇸Spokane, Washington, United States
Centro Medico Austral
🇦🇷Buenos Aires, Argentina
Centro Oncologico Riojano Integral (CORI)
🇦🇷La Rioja, Argentina
Sanatorio Allende
🇦🇷Cordoba, Argentina
Fundación CENIT para la Investigación en Neurociencias
🇦🇷Buenos Aires, Argentina
Fundacion Koriza
🇦🇷Santa Rosa, Argentina
Chris O'Brien Lifehouse
🇦🇺Camperdown, New South Wales, Australia
Nepean Cancer Care Centre
🇦🇺Sydney, New South Wales, Australia
Prince Charles Hospital; Department of Medical Oncology
🇦🇺Chermside, Queensland, Australia
Royal Adelaide Hospital
🇦🇺Adelaide, South Australia, Australia
Townsville Hospital
🇦🇺Townsville, Queensland, Australia
Princess Alexandra Hospital
🇦🇺Woolloongabba, Queensland, Australia
Royal Hobart Hospital
🇦🇺Hobart, Tasmania, Australia
Adelaide Cancer Centre
🇦🇺Kurralta Park, South Australia, Australia
Launceston General Hospital
🇦🇺Launceston, Tasmania, Australia
Austin Health
🇦🇺Heidelberg, Victoria, Australia
Frankston Hospital
🇦🇺Frankston, Victoria, Australia
Cabrini Hospital Malvern
🇦🇺Malvern, Victoria, Australia
Sunshine Hospital
🇦🇺St Albans, Victoria, Australia
The Alfred Hospital
🇦🇺Prahan, Victoria, Australia
Klinikum Wels-Grieskirchen
🇦🇹Wels, Austria
IPCEM; Instituto de Pesquisa de Estudos Multicêntricos
🇧🇷Caxias do Sul, RS, Brazil
CHU de Liège
🇧🇪Liège, Belgium
Clinique Ste-Elisabeth
🇧🇪Namur, Belgium
Liga Norte Riograndense Contra O Câncer
🇧🇷Natal, RN, Brazil
Hospital Mae de Deus
🇧🇷Porto Alegre, RS, Brazil
CETUS Hospital Dia Oncologia
🇧🇷Uberaba, MG, Brazil
Instituto Ribeirãopretano de Combate Ao Câncer; Centro Especializado De Oncologia
🇧🇷Ribeirão Preto, SP, Brazil
Hospital de Base de Sao Jose do Rio Preto
🇧🇷Sao Jose do Rio Preto, SP, Brazil
Hospital A. C. Camargo; Oncologia
🇧🇷Sao Paulo, SP, Brazil
MHAT Serdika, EOOD
🇧🇬Sofia, Bulgaria
Multiprofile Hospital for Active Treatment Central Onco Hospital OOD
🇧🇬Plovdiv, Bulgaria
Lakeridge Health Center
🇨🇦Oshawa, Ontario, Canada
Clinica Santa Maria
🇨🇱Santiago, Chile
Health & Care SPA
🇨🇱Santiago, Chile
Institut Bergonié Centre Régional de Lutte Contre Le Cancer de Bordeaux Et Sud Ouest
🇫🇷Bordeaux, France
CHU de Grenoble
🇫🇷Grenoble, France
Sociedad de Investigaciones Medicas Ltda (SIM)
🇨🇱Temuco, Chile
Hôpital Saint Joseph
🇫🇷Marseille, France
Centre Jean Bernard Clinique Victor Hugo
🇫🇷Le Mans, France
CHU de Bordeaux
🇫🇷Pessac, France
CH de Saint Quentin
🇫🇷Saint Quentin, France
Hôpital Européen Georges Pompidou
🇫🇷Paris, France
Service de Pneumologie Centre Hospitalier Régional La Réunion Site Felix Guyon
🇫🇷Saint Denis Cedex, France
Centre Hospitalier Intercommunal Toulon - La Seyne sur Mer
🇫🇷Toulon, France
Zentralklinikum Augsburg
🇩🇪Augsburg, Germany
Ev.Krankenhaus Bielefeld gGmbH; Klinik für Innere Medizin und Geriatrie
🇩🇪Bielefeld, Germany
Helios Klinikum Emil von Behring GmbH
🇩🇪Berlin, Germany
Augusta Kranken-Anstalt gGmbH
🇩🇪Bochum, Germany
LungenClinic Großhansdorf GmbH
🇩🇪Großhansdorf, Germany
Krankenhaus Martha-Maria; Halle-Dolau gGmbH
🇩🇪Halle, Germany
St. Elisabethen Krankenhaus
🇩🇪Frankfurt am Main, Germany
Universität Des Saarlandes; Klinik für Innere Medizin V
🇩🇪Homburg, Germany
Asklepios Klinik Harburg
🇩🇪Hamburg, Germany
Lungenklinik Hemer
🇩🇪Hemer, Germany
Klinik Loewenstein gGmbH; Onk & Pal
🇩🇪Loewenstein, Germany
Klinikum Bogenhausen
🇩🇪München, Germany
AORN A Cardarelli
🇮🇹Napoli, Campania, Italy
Università Cattolica Del S Cuore
🇮🇹Roma, Lazio, Italy
Azienda Ospedaliera San Camillo Forlanini
🇮🇹Roma, Lazio, Italy
Policlinico Vittorio Emanuele
🇮🇹Catania, Sicilia, Italy
ASL 3 Genovese; DSM
🇮🇹Genova, Liguria, Italy
A.O.U. Maggiore della Carità
🇮🇹Novara, Piemonte, Italy
Ospedale Civile - Livorno
🇮🇹Livorno, Toscana, Italy
Ospedale Versilia
🇮🇹Lido Di Camaiore, Toscana, Italy
National Hospital Organization Shikoku Cancer Center
🇯🇵Ehime, Japan
National Hospital Organization Kyushu Medical Center
🇯🇵Fukuoka, Japan
Kurume University Hospital
🇯🇵Fukuoka, Japan
NHO Kyushu Cancer Center
🇯🇵Fukuoka, Japan
Kyoto University Hospital
🇯🇵Kyoto, Japan
Kitasato University Hospital
🇯🇵Kanagawa, Japan
Miyagi Cancer Center
🇯🇵Miyagi, Japan
Kyorin University Hospital
🇯🇵Tokyo, Japan
Osaka City University Hospital
🇯🇵Osaka, Japan
Center Hospital of the National Center for Global Health and Medicine
🇯🇵Tokyo, Japan
Niigata Cancer Center Hospital
🇯🇵Niigata, Japan
National Hospital Organization Osaka Toneyama Medical Center
🇯🇵Osaka, Japan
Wakayama Medical University Hospital
🇯🇵Wakayama, Japan
Toranomon Hospital
🇯🇵Tokyo, Japan
Riga East Clinical University Hospital Latvian Oncology Centre
🇱🇻Riga, Latvia
Pauls Stradins Clinical University Hospital
🇱🇻Rīga, Latvia
Jeroen Bosch Ziekenhuis
🇳🇱'S Hertogenbosch, Netherlands
National Cancer Institute
🇱🇹Vilnius, Lithuania
Centro Universitario Contra El Cancer
🇲🇽Monterrey, Mexico
Amsterdam UMC Location VUMC
🇳🇱Amsterdam, Netherlands
Amphia Ziekenhuis; Afdeling Longziekten
🇳🇱Breda, Netherlands
Spaarne Gasthuis; Spaarne Ziekenhuis
🇳🇱Hoofddorp, Netherlands
Ziekenhuis Gelderse Vallei
🇳🇱EDE, Netherlands
Gelre Ziekenhuizen, Zutphen
🇳🇱Zutphen, Netherlands
Maasstad ziekenhuis
🇳🇱Rotterdam, Netherlands
Instituto Nacional de Enfermedades Neoplasicas
🇵🇪Lima, Peru
Instituto Portugues Oncologia de Lisboa Francisco Gentil EPE
🇵🇹Lisboa, Portugal
Centro Hospitalar do Porto - Hospital de Santo António
🇵🇹Porto, Portugal
Instituto Portugues de Oncologia Do Porto Francisco Gentil Epe
🇵🇹Porto, Portugal
Moscow City Oncology Hospital #62
🇷🇺Moscovskaya Oblast, Moskovskaja Oblast, Russian Federation
Clinical Oncology Dispensary
🇷🇺Omsk, Russian Federation
Russian Oncology Research Center n.a. N.N. Blokhin
🇷🇺Moscow, Russian Federation
Evromedservis LCC
🇷🇺Pushkin, Russian Federation
City Clinical Oncology Dispensary
🇷🇺Saint-Petersburg, Russian Federation
Univerzitna nemocnica Bratislava
🇸🇰Bratislava, Slovakia
Narodny onkologicky ustav
🇸🇰Bratislava, Slovakia
POKO Poprad s.r.o.
🇸🇰Poprad, Slovakia
Hospital del Mar
🇪🇸Barcelona, Spain
Instituto Catalan de Oncologia de Hospitalet (ICO); Servicio de Farmacia
🇪🇸L'Hospitalet de Llobregat, Barcelona, Spain
Corporacio Sanitaria Parc Tauli; Servicio de Oncologia
🇪🇸Sabadell, Barcelona, Spain
Hospital Universitario Marques de Valdecilla
🇪🇸Santander, Cantabria, Spain
Hospital Universitario Insular de Gran Canaria
🇪🇸Las Palmas de Gran Canaria, LAS Palmas, Spain
Hospital Lluis Alcanyis De Xativa
🇪🇸Xativa, Valencia, Spain
Complejo Hospitalario U. de Ourense
🇪🇸Ourense, Orense, Spain
Hospital General Universitario Gregorio Marañon; Servicio de Oncologia
🇪🇸Madrid, Spain
Hospital Universitario Reina Sofia
🇪🇸Cordoba, Spain
Hospital Clinic de Barcelona
🇪🇸Barcelona, Spain
Hospital Lucus Augusti; Servicio de Oncologia
🇪🇸Lugo, Spain
Hospital Ramon y Cajal; Servicio de Oncologia
🇪🇸Madrid, Spain
Hospital Clinico San Carlos; Servicio de Oncologia
🇪🇸Madrid, Spain
Hospital Universitario Fundación Jimenez Díaz
🇪🇸Madrid, Spain
Kantonsspital Baselland
🇨🇭Bruderholz, Switzerland
Hospital Clinico Universitario de Valencia
🇪🇸Valencia, Spain
Changhua Christian Hospital; Hematology-Oncology
🇨🇳Changhua, Taiwan
Kaohsiung Medical University Hospital; Department of Urology
🇨🇳Kaohsiung City, Taiwan
National Cheng Kung Univ Hosp
🇨🇳Tainan, Taiwan
National Taiwan Uni Hospital
🇨🇳Taipei City, Taiwan
Chang Gung Medical Foundation Linkou Branch
🇨🇳Taoyuan City, Taiwan
Cheng Hsin General Hospital
🇨🇳Taipei, Taiwan
Taichung Veterans General Hospital
🇨🇳Xitun Dist., Taiwan
Municipal Institution City Clinical Hospital #4 of Dnipro City Council - PPDS; Dept of Chemotherapy
🇺🇦Dnipropetrovsk, Katerynoslav Governorate, Ukraine
MNPE Zaporizhzhia Regional Antitumor Center ZRC
🇺🇦Zaporizhzhia, Katerynoslav Governorate, Ukraine
Communal Non profit Enterprise Regional Center of Oncology; Oncosurgical dept of thoracic organs
🇺🇦Kharkiv, Kharkiv Governorate, Ukraine
Regional Cancer Care Associates
🇺🇸Bethesda, Maryland, United States
St. Joseph Mercy Health System
🇺🇸Ann Arbor, Michigan, United States
Hospital Universitario 12 de Octubre
🇪🇸Madrid, Spain
Maimonides Medical Center
🇺🇸Brooklyn, New York, United States
MNPE Transcarpathian Antitumor Center of the Transcarpathian Regional Council; Chemotherapy Dept
🇺🇦Uzhhorod, Kherson Governorate, Ukraine
Uzhgorod Central City Clinical Hospital
🇺🇦Uzhhorod, Katerynoslav Governorate, Ukraine
Communal Nonprofit Enterprise Podilsky Regional Center Of Oncology OfTheVinnytsia Regional Council
🇺🇦Vinnytsia, KIEV Governorate, Ukraine
Poltava Regional Clinical Oncology Dispensary of Poltava Regional Council; Thoracic department
🇺🇦Poltava, Ukraine
Yale Cancer Center
🇺🇸New Haven, Connecticut, United States
Norton Cancer Institute
🇺🇸Louisville, Kentucky, United States
St. Luke's Cancer Institute
🇺🇸Kansas City, Missouri, United States
Montefiore Medical Center
🇺🇸Bronx, New York, United States