Study of Oral Navitoclax Tablet In Combination With Oral Ruxolitinib Tablet When Compared With Oral Ruxolitinib Tablet To Assess Change In Spleen Volume In Adult Participants With Myelofibrosis
- Conditions
- Myelofibrosis (MF)
- Interventions
- Registration Number
- NCT04472598
- Lead Sponsor
- AbbVie
- Brief Summary
Myelofibrosis is a type of bone marrow cancer that usually develops slowly and disrupts body's normal production of blood cells. It causes bone marrow scarring, leading to severe anemia that can cause weakness and fatigue. It can also cause a low number of blood-clotting cells called platelets, which increases risk of bleeding. Myelofibrosis often causes an enlarged spleen. The purpose of this study is to see if a combination of navitoclax and ruxolitinib is more effective and safe in assessment of change in spleen volume when compared to ruxolitinib in participants with myelofibrosis.
Navitoclax is an investigational drug for the treatment of myelofibrosis. Participants in this study are divided into two groups, called treatment arms. Each group receives a different treatment. Adult participants with a diagnosis of myelofibrosis will be enrolled. Around 230 participants will be enrolled in approximately 190 sites worldwide.
Participants will receive oral navitoclax tablet with oral ruxolitinib tablet or oral ruxolitinib tablet with oral placebo (no active drug) tablet and treatment may continue untill the participant cannot tolerate the study drug, or benefit is not achieved, or other reasons which qualify for discontinuation of the study drug.
There may be a higher treatment burden for participants in this trial compared to their standard of care. Participants will attend regular visits during the course of the study at a hospital or clinic. The effect of the treatment will be checked by medical assessments, blood tests, magnetic resonance imaging (MRI) or computed tomography (CT) scan, bone marrow tests, checking for side effects, and completing questionnaires.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- ACTIVE_NOT_RECRUITING
- Sex
- All
- Target Recruitment
- 252
-
Documented diagnosis of Primary MyeloFibrosis (MF) as defined by World Health Organization (WHO) classification or Secondary MF (post polycythemia vera [PPV] - MF or Post Essential Thrombocytopenia [PET] - MF) .
-
Must be able to complete the MF Symptom Assessment Form (MFSAF) v4.0 on at least 4 out of 7 days immediately preceding the date of randomization.
-- Must have at least 2 symptoms with a score >=3 or a total score of >=12, as measured by the MFSAF v4.0.
-
Classified as intermediate-2, or high-Risk MF as defined by the Dynamic International Prognostic Scoring System Plus (DIPSS+).
-
Has splenomegaly defined as spleen palpation measurement >= 5 centimeters (cm) below costal margin or spleen volume greater than or equal to 450 cubic cm as assessed centrally by magnetic resonance imaging (MRI) or computed tomography (CT) scan.
-
Ineligible for stem cell transplantation at time of study entry due to age, comorbidities, or unfit for unrelated or unmatched donor transplant and other criteria per National Comprehensive Cancer Network guidelines.
-
Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1, or 2.
- Prior treatment with a Janus Kinase-2 (JAK-2) inhibitor.
- Prior treatment with a B-cell lymphoma 2 homology 3 (BH3)-mimetic compound or bromodomain and extra-terminal motif (BET) inhibitor or stem cell transplant.
- Receiving medication that interferes with coagulation or platelet function within 3 days prior to the first dose of study drug or during the study treatment period except for low dose aspirin (up to 100 milligram daily) and low molecular weight heparin (LMWH).
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Placebo for Navitoclax + Ruxolitinib Placebo for Navitoclax Participants will receive placebo for Navitoclax and Ruxolitinib Navitoclax + Ruxolitinib Ruxolitinib Participants will receive Navitoclax in combination with Ruxolitinib Placebo for Navitoclax + Ruxolitinib Ruxolitinib Participants will receive placebo for Navitoclax and Ruxolitinib Navitoclax + Ruxolitinib Navitoclax Participants will receive Navitoclax in combination with Ruxolitinib
- Primary Outcome Measures
Name Time Method Percentage of Participants who achieve Spleen Volume Reduction of at least 35% at Week 24 (SVR35W24) At Week 24 Reduction in spleen volume is measured by magnetic resonance imaging (MRI) or computed tomography (CT), per International Working Group (IWG) criteria.
- Secondary Outcome Measures
Name Time Method Duration of 35% Spleen Volume Reduction (SVR35) Baseline (Week 0) Up to Week 96 Duration of SVR35 is defined as the time between the date of first response of spleen volume reduction of 35% achievement to the date of the first assessment where the spleen volume is less than 35% reduction from baseline and is at least 25% increase from the nadir (the lowest spleen volume).
Change in Physical Functioning Baseline (Week 0) Up to Week 24 Change in physical functioning is measured by the physical functioning domain of the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ)-C30 or death.
Percentage of Participants who achieve Anemia Response Baseline (Week 0) Up to Week 96 The rate of anemia response will be assessed according to current International Working Group-Myeloproliferative Neoplasms Research and European LeukemiaNet (IWG-MRT/ELN) criteria.
Change in Total Symptom Score (TSS) Baseline (Week 0) Up to Week 24 Reduction in TSS is measured by Myelofibrosis Symptom Assessment Form (MFSAF) v4.0.
Percentage of Participants who achieve Spleen Volume Reduction of at least 35% (SVR35) Baseline (Week 0) Up to Week 96 Reduction in spleen volume is measured by MRI or CT, per IWG criteria.
Change In Fatigue Baseline (Week 0) Up to Week 24 Change in fatigue will be assessed using the Patient-Reported Outcomes Measurement Information System (PROMIS) Fatigue SF 7a.
Overall Survival (OS) Up To approximately 8 Years OS is defined as the time from the date of randomization to the date of death from any cause.
Leukemia-Free Survival Up To approximately 8 Years Leukemia-free survival is defined as the number of days from the date of randomization to the onset date of documented leukemia, disease progression due to leukemia, or death due to leukemia, whichever occurs first.
Percentage of Participants who Achieve Reduction in Grade of Bone Marrow Fibrosis Baseline (Week 0) Up to Week 96 Change in grade of bone marrow fibrosis will be measured per the European consensus grading system through bone marrow biopsy.
Trial Locations
- Locations (194)
Lakeridge Health - Oshawa /ID# 222080
🇨🇦Oshawa, Ontario, Canada
Indiana Blood & Marrow Transpl /ID# 221586
🇺🇸Indianapolis, Indiana, United States
University of Texas MD Anderson Cancer Center /ID# 217994
🇺🇸Houston, Texas, United States
Royal Perth Hospital /ID# 223203
🇦🇺Perth, Western Australia, Australia
CHU UCL Namur - site Godinne /ID# 221127
🇧🇪Godinne, Namur, Belgium
Rocky Mountain Cancer Centers, LLP- Littleton /ID# 222562
🇺🇸Littleton, Colorado, United States
Minnesota Oncology Hematology /ID# 227357
🇺🇸Edina, Minnesota, United States
Oncology Hematology Care, Inc. /ID# 222556
🇺🇸Cincinnati, Ohio, United States
Chu Angers /Id# 219115
🇫🇷Angers, France
Moores Cancer Center at UC San Diego /ID# 218012
🇺🇸La Jolla, California, United States
Providence Medical Foundation /ID# 241646
🇺🇸Fullerton, California, United States
Emory University /ID# 221562
🇺🇸Atlanta, Georgia, United States
Florida Cancer Specialist - South /ID# 221726
🇺🇸Fort Myers, Florida, United States
Florida Cancer Specialists - East /ID# 221728
🇺🇸West Palm Beach, Florida, United States
Columbus Regional Research Institute /ID# 227272
🇺🇸Columbus, Georgia, United States
Rush University Medical Center /ID# 221581
🇺🇸Chicago, Illinois, United States
Mid Illinois Hematology & Oncology Associates, Ltd /ID# 224204
🇺🇸Normal, Illinois, United States
University of Kansas Cancer Center /ID# 218144
🇺🇸Fairway, Kansas, United States
Hackensack Univ Med Ctr /ID# 221654
🇺🇸Hackensack, New Jersey, United States
Weill Cornell Medical College /ID# 220933
🇺🇸New York, New York, United States
Northwell Health - Monter Cancer Center /ID# 222996
🇺🇸Lake Success, New York, United States
Gabrail Cancer Center Research /ID# 230488
🇺🇸Canton, Ohio, United States
Thompson Cancer Survival Ctr /ID# 231689
🇺🇸Knoxville, Tennessee, United States
The Ohio State University /ID# 221584
🇺🇸Columbus, Ohio, United States
UPMC Hillman Cancer Ctr /ID# 218134
🇺🇸Pittsburgh, Pennsylvania, United States
Virginia Cancer Specialists - Fairfax /ID# 242682
🇺🇸Fairfax, Virginia, United States
University of Utah /ID# 221009
🇺🇸Salt Lake City, Utah, United States
Texas Oncology - Northeast Texas /ID# 241813
🇺🇸Tyler, Texas, United States
Utah Cancer Specialists Salt Lake Clinic /ID# 221961
🇺🇸Salt Lake City, Utah, United States
Border Medical Oncology Research Unit Albury Wodonga Regional Cancer Centre /ID# 231311
🇦🇺East Albury, New South Wales, Australia
VA Puget Sound Health Care System /ID# 231691
🇺🇸Seattle, Washington, United States
The Kinghorn Cancer Centre /ID# 221503
🇦🇺Darlinghurst, New South Wales, Australia
Gosford Hospital /ID# 221499
🇦🇺Gosford, New South Wales, Australia
Liverpool Hospital /ID# 221803
🇦🇺Liverpool, New South Wales, Australia
Peter MacCallum Cancer Ctr /ID# 229795
🇦🇺Melbourne, Victoria, Australia
Alfred Health /ID# 221501
🇦🇺Melbourne, Victoria, Australia
Townsville University Hospital /ID# 229794
🇦🇺Douglas, Queensland, Australia
Klinikum Wels-Grieskirchen GmbH /ID# 220901
🇦🇹Wels, Oberoesterreich, Austria
Medizinische Universitaet Wien /ID# 220906
🇦🇹Vienna, Wien, Austria
UZ Gent /ID# 221125
🇧🇪Gent, Oost-Vlaanderen, Belgium
Medizinische Universitaet Graz /ID# 220910
🇦🇹Graz, Steiermark, Austria
Hanusch Krankenhaus /ID# 220909
🇦🇹Wien, Austria
Universitair Ziekenhuis Leuven /ID# 218806
🇧🇪Leuven, Vlaams-Brabant, Belgium
Vitaz /Id# 229861
🇧🇪Sint-Niklaas, Belgium
ZNA Stuivenberg /ID# 221465
🇧🇪Antwerp, Belgium
AZ Sint-Jan Brugge /ID# 218805
🇧🇪Brugge, Belgium
Centre Hospitalier Universitaire du Sart Tilman CHU de Liege /ID# 218874
🇧🇪Liege, Belgium
UMHAT Alexandrovska EAD /ID# 231056
🇧🇬Sofiya, Sofia, Bulgaria
AZ-Delta /ID# 221466
🇧🇪Roeselare, West-Vlaanderen, Belgium
UMHAT Dr Georgi Stranski EAD /ID# 231161
🇧🇬Pleven, Bulgaria
UMHAT Sveti Georgi /ID# 231053
🇧🇬Plovdiv, Bulgaria
Acibadem City Clinic Tokuda University Hospital EAD /ID# 231036
🇧🇬Sofia, Bulgaria
UMHAT Sveti Ivan Rilski /ID# 231028
🇧🇬Sofia, Bulgaria
Royal Victoria Hospital /ID# 222636
🇨🇦Barrie, Ontario, Canada
Juravinski Cancer Centre /ID# 221752
🇨🇦Hamilton, Ontario, Canada
Niagara Health System /ID# 230994
🇨🇦St Catharines, Ontario, Canada
CHUQ- Hôpital de l'Enfant-Jesus /ID# 221754
🇨🇦Quebec City, Quebec, Canada
Klinicki bolnicki centar Zagreb /ID# 230793
ðŸ‡ðŸ‡·Zagreb, Grad Zagreb, Croatia
Klinicka bolnica Merkur /ID# 231155
ðŸ‡ðŸ‡·Zagreb, Grad Zagreb, Croatia
HCL - Hopital Lyon Sud /ID# 222913
🇫🇷Pierre Benite CEDEX, Auvergne-Rhone-Alpes, France
Klinicki bolnicki centar Split /ID# 230796
ðŸ‡ðŸ‡·Split, Splitsko-dalmatinska Zupanija, Croatia
CHU NIMES - Hopital Caremeau /ID# 219114
🇫🇷Nimes CEDEX 9, Gard, France
CHU Bordeaux - Hopital Haut Leveque /ID# 222518
🇫🇷Pessac, Gironde, France
CH Roubaix - Hopital Victor Provo /ID# 219116
🇫🇷Roubaix Cedex 1, Hauts-de-France, France
Hopital Avicenne - APHP /ID# 221286
🇫🇷Bobigny, Ile-de-France, France
AP-HP - Hopital Necker /ID# 231318
🇫🇷Paris, France
Centre Hospitalier de CHAMBERY /ID# 224506
🇫🇷Chambery, Savoie, France
ICANS - Institut de Cancérologie Strasbourg Europe /ID# 229978
🇫🇷Strasbourg Cedex, France
AP-HP - Hopital Saint-Louis /ID# 221288
🇫🇷Paris, France
OncoResearch Lerchenfeld GmbH /ID# 230867
🇩🇪Hamburg, Germany
Universitaetsklinikum Aachen /ID# 221519
🇩🇪Aachen, Nordrhein-Westfalen, Germany
BAG Freiberg-Richter, Jacobasch, Illmer, Wolf /ID# 221347
🇩🇪Dresden, Sachsen, Germany
Universitaetsklinikum Essen /ID# 221522
🇩🇪Essen, Germany
Klinikum rechts der Isar - Technische Universitaet Muenchen /ID# 221520
🇩🇪Munich, Germany
University General Hospital Attikon /ID# 230784
🇬🇷Athens, Attiki, Greece
General Hospital of Athens Evaggelismos and Ophthalmiatrio of Athens Polyclinic /ID# 230786
🇬🇷Athens, Greece
The Chaim Sheba Medical Center /ID# 219137
🇮🇱Ramat Gan, Tel-Aviv, Israel
Hadassah Medical Center-Hebrew University /ID# 219110
🇮🇱Jerusalem, Yerushalayim, Israel
Rambam Health Care Campus /ID# 219120
🇮🇱Haifa, Israel
Assaf Harofeh Medical Center /ID# 222957
🇮🇱Be'Er Ya'Akov, Israel
Meir Medical Center /ID# 221374
🇮🇱Kfar Saba, Israel
ASST Spedali civili di Brescia /ID# 241273
🇮🇹Brescia, Italy
Azienda Ospedaliero Universitaria Careggi /ID# 219086
🇮🇹Florence, Italy
Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII (Presidio Papa Giovanni /ID# 221907
🇮🇹Bergamo, Italy
IRCCS Azienda Ospedaliero-Universitaria di Bologna /ID# 220867
🇮🇹Bologna, Italy
A.O.U. Policlinico G. Rodolico S.Marco- Presidio G.Rodolico /ID# 219085
🇮🇹Catania, Italy
Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital /ID# 239100
🇯🇵Nagoya-shi, Aichi, Japan
ASST Sette Laghi /ID# 219084
🇮🇹Varese, Italy
Fujita Health University Hospital /ID# 221537
🇯🇵Toyoake-shi, Aichi, Japan
Chiba University Hospital /ID# 239345
🇯🇵Chiba-shi, Chiba, Japan
Ehime University Hospital /ID# 221443
🇯🇵Toon-shi, Ehime, Japan
National Cancer Center Hospital East /ID# 226093
🇯🇵Kashiwa-shi, Chiba, Japan
Kyushu University Hospital /ID# 221783
🇯🇵Fukuoka-shi, Fukuoka, Japan
Fukushima Medical University Hospital /ID# 222752
🇯🇵Fukushima-shi, Fukushima, Japan
Ogaki Municipal Hospital /ID# 240173
🇯🇵Ogaki-shi, Gifu, Japan
Gunma University Hospital /ID# 221480
🇯🇵Maebashi-shi, Gunma, Japan
Gunmaken Saiseikai Maebashi Hospital /ID# 242806
🇯🇵Maebashi-shi, Gunma, Japan
Hokkaido University Hospital /ID# 242667
🇯🇵Sapporo-shi, Hokkaido, Japan
Hitachi General Hospital /ID# 240048
🇯🇵Hitachi-shi, Ibaraki, Japan
Medical Corporation Seijinkai Ikeda Hospital /ID# 242172
🇯🇵Kanoya-shi, Kagoshima, Japan
Kobe University Hospital /ID# 246236
🇯🇵Kobe-shi, Hyogo, Japan
Kanazawa University Hospital /ID# 238424
🇯🇵Kanazawa-shi, Ishikawa, Japan
Kyoto University Hospital /ID# 238423
🇯🇵Kyoto-shi, Kyoto, Japan
University of Miyazaki Hospital /ID# 221483
🇯🇵Miyazaki-shi, Miyazaki, Japan
Kawasaki Medical School Hospital /ID# 221481
🇯🇵Kurashiki-shi, Okayama, Japan
Kurashiki Central Hospital /ID# 221692
🇯🇵Kurashiki-shi, Okayama, Japan
Kansai Medical University Hospital /ID# 221482
🇯🇵Hirakata-shi, Osaka, Japan
Kindai University Hospital /ID# 221479
🇯🇵Osakasayama-shi, Osaka, Japan
Osaka University Hospital /ID# 221478
🇯🇵Suita-shi, Osaka, Japan
Dokkyo Medical University Saitama Medical Center /ID# 222333
🇯🇵Koshigaya-shi, Saitama, Japan
Juntendo University Hospital /ID# 221405
🇯🇵Bunkyo-ku, Tokyo, Japan
Nippon Medical School Hospital /ID# 221674
🇯🇵Bunkyo-ku, Tokyo, Japan
Inje University Busan Paik Hospital /ID# 231667
🇰🇷Busan, Korea, Republic of
Seoul National University Bundang Hospital /ID# 219053
🇰🇷Seongnam, Gyeonggido, Korea, Republic of
Gachon University Gil Medical Center /ID# 222089
🇰🇷Incheon, Korea, Republic of
Kyungpook National University Hospital /ID# 231666
🇰🇷Daegu, Korea, Republic of
Seoul National University Hospital /ID# 219055
🇰🇷Seoul, Korea, Republic of
Asan Medical Center /ID# 219054
🇰🇷Seoul, Korea, Republic of
Middlemore Clinical Trials /ID# 230770
🇳🇿Papatoetoe, Auckland, New Zealand
Radboud Universitair Medisch Centrum /ID# 218948
🇳🇱Nijmegen, Gelderland, Netherlands
Samsung Medical Center /ID# 221068
🇰🇷Seoul, Korea, Republic of
The Catholic University of Korea, Seoul St. Mary's Hospital /ID# 219056
🇰🇷Seoul, Korea, Republic of
Albert Schweitzer Ziekenhuis /ID# 224015
🇳🇱Dordrecht, Zuid-Holland, Netherlands
Universitair Medisch Centrum Groningen /ID# 218947
🇳🇱Groningen, Netherlands
Universitair Medisch Centrum Utrecht /ID# 218949
🇳🇱Utrecht, Netherlands
Moscow State budget healthcare /ID# 221025
🇷🇺Moscow, Moskva, Russian Federation
University Clinical Center Serbia /ID# 230854
🇷🇸Belgrade, Beograd, Serbia
Leningrad Regional Clinical Hospital /ID# 221028
🇷🇺Saint Petersburg, Russian Federation
Clinical Center Vojvodina /ID# 230853
🇷🇸Novi Sad, Vojvodina, Serbia
University Clinical Center Kragujevac /ID# 230855
🇷🇸Kragujevac, Sumadijski Okrug, Serbia
Wits Clinical Research Site /ID# 232072
🇿🇦Johannesburg, Gauteng, South Africa
Clin Hosp Ctr Bezanijska Kosa /ID# 230946
🇷🇸Belgrade, Beograd, Serbia
Albert Alberts Stem Cell Transplant Centre /ID# 232073
🇿🇦Pretoria, Gauteng, South Africa
Hospital Universitario Vall d'Hebron /ID# 229690
🇪🇸Barcelona, Spain
Hospital Parc de Salut del Mar /ID# 220913
🇪🇸Barcelona, Spain
Hospital ClÃnico Universitario de Santiago-CHUS /ID# 222264
🇪🇸Santiago de Compostela, A Coruna, Spain
Hospital Universitario Dr. Negrin /ID# 220897
🇪🇸Las Palmas de Gran Canaria, Las Palmas, Spain
CLINICA UNIVERSIDAD DE NAVARRA-Pamplona /ID# 230720
🇪🇸Pamplona, Navarra, Spain
CLINICA UNIVERSIDAD DE NAVARRA-Madrid /ID# 230721
🇪🇸Madrid, Spain
Hospital Universitario Virgen de la Victoria /ID# 220878
🇪🇸Malaga, Spain
Hospital Universitario 12 de Octubre /ID# 229691
🇪🇸Madrid, Spain
Hospital Universitario Ramon y Cajal /ID# 220877
🇪🇸Madrid, Spain
Hospital Clinico Universitario de Valencia /ID# 220875
🇪🇸Valencia, Spain
Orebro Universitetssjukhuset /ID# 220829
🇸🇪Orebro, Orebro Lan, Sweden
National Taiwan University Hospital /ID# 218976
🇨🇳Taipei City, Taiwan
China Medical University Hospital /ID# 218978
🇨🇳Taichung City, Taiwan
Skane University Hospital Lund /ID# 220835
🇸🇪Lund, Skane Lan, Sweden
Sahlgrenska University Hospital /ID# 218776
🇸🇪Gothenburg, Vastra Gotalands Lan, Sweden
Chi Mei Hospital - Liouying /ID# 221145
🇨🇳Tainan City, Taiwan
Linkou Chang Gung Memorial Hospital /ID# 218983
🇨🇳Taoyuan City, Taiwan
Bagcilar Medipol Mega Universite Hastanesi /ID# 230757
🇹🇷Istanbul, Turkey
Taipei Veterans General Hosp /ID# 221146
🇨🇳Taipei City, Taiwan
Trakya University Medical Facu /ID# 230754
🇹🇷Edirne, Istanbul, Turkey
Hacettepe University Medical Faculty /ID# 230759
🇹🇷Ankara, Turkey
Communal non-profit enterprise Regional Center of Oncology /ID# 230832
🇺🇦Kharkiv, Ukraine
Inonu University Medical Faculty /ID# 230758
🇹🇷Malatya, Turkey
Medical Center "OK!Clinic+" /ID# 230834
🇺🇦Kyiv, Ukraine
Feofaniya Clinical Hospital of State Management of Affairs /ID# 232370
🇺🇦Kyiv, Ukraine
SI Institute of Blood Pathology and Transfusion Medicine of NAMS of Ukraine /ID# 230833
🇺🇦Lviv, Ukraine
United Lincolnshire Hospitals NHS Trust /ID# 231471
🇬🇧Lincoln, Lincolnshire, United Kingdom
Oxford University Hospitals NHS Foundation Trust /ID# 219192
🇬🇧Oxford, Oxfordshire, United Kingdom
Guys and St Thomas NHS Foundation Trust /ID# 219185
🇬🇧London, London, City Of, United Kingdom
Augusta University Georgia Cancer Center /ID# 221551
🇺🇸Augusta, Georgia, United States
Massachusetts General Hospital /ID# 221559
🇺🇸Boston, Massachusetts, United States
Clinical Hospital Dubrava /ID# 230795
ðŸ‡ðŸ‡·Zagreb, Grad Zagreb, Croatia
Juntendo University Shizuoka Hospital /ID# 221782
🇯🇵Izunokuni-shi, Shizuoka, Japan
Pusan National University Hospital /ID# 222087
🇰🇷Busan, Korea, Republic of
Russian Research Institute of Hematology and Transfusiology of the FMBA /ID# 221029
🇷🇺Sankt-Peterburg, Russian Federation
Republican hospital named after V.A. Baranov /ID# 221412
🇷🇺Petrozavodsk, Russian Federation
Wits Clinical Research Site /ID# 232071
🇿🇦Johannesburg, Gauteng, South Africa
Hospital Universitario Germans Trias i Pujol /ID# 229936
🇪🇸Badalona, Barcelona, Spain
University Hospitals Birmingham NHS Foundation Trust /ID# 221333
🇬🇧Birmingham, United Kingdom
The Christie Hospital /ID# 219191
🇬🇧Manchester, United Kingdom
University of Michigan Comprehensive Cancer Center Michigan Medicine /ID# 221658
🇺🇸Ann Arbor, Michigan, United States
Haemato-Onkologie /ID# 221061
🇩🇪Muenchen, Bayern, Germany
Tel Aviv Sourasky Medical Center /ID# 219134
🇮🇱Tel Aviv-Yafo, Tel-Aviv, Israel
Highlands Oncology Group, PA /ID# 221824
🇺🇸Springdale, Arkansas, United States
Dana-Farber Cancer Institute /ID# 218010
🇺🇸Boston, Massachusetts, United States
Lynn Cancer Institute, Boca /ID# 230687
🇺🇸Boca Raton, Florida, United States
Clinic UZI 4D /ID# 221024
🇷🇺Pyatigorsk, Stavropol Skiy Kray, Russian Federation
Tula Regional Clinical Hospital /ID# 221027
🇷🇺Tula, Russian Federation
Beth Israel Deaconess Medical Center /ID# 224261
🇺🇸Boston, Massachusetts, United States
Florida Cancer Specialists - North /ID# 221727
🇺🇸Saint Petersburg, Florida, United States
Ordensklinikum Linz GmbH Elisabethinen /ID# 220813
🇦🇹Linz, Oberoesterreich, Austria
University of Yamanashi Hospital /ID# 221701
🇯🇵Chuo-shi, Yamanashi, Japan
Fondazione Policlinico Universitario Agostino Gemelli IRCCS-Università Cattolica /ID# 219083
🇮🇹Rome, Lazio, Italy
Universitatsklinikum Mannheim /ID# 221523
🇩🇪Mannheim, Baden-Wuerttemberg, Germany
General Hospital of Athens Laiko /ID# 230785
🇬🇷Athens, Attiki, Greece
Almazov National Medical Research Centre /ID# 221033
🇷🇺Sankt-Peterburg, Russian Federation
CHU de Nantes, Hotel Dieu -HME /ID# 219113
🇫🇷Nantes, Pays-de-la-Loire, France
Mie University Hospital /ID# 221664
🇯🇵Tsu-shi, Mie, Japan
Ege University Medical Faculty /ID# 230753
🇹🇷Izmir, Turkey
Kaohsiung Chang Gung Memorial Hospital /ID# 218984
🇨🇳Kaohsiung City, Kaohsiung, Taiwan
MidAmerica Division, Inc. /ID# 221743
🇺🇸Kansas City, Missouri, United States