MedPath

Nab-paclitaxel and Gemcitabine vs Gemcitabine Alone as Adjuvant Therapy for Patients With Resected Pancreatic Cancer (the "Apact" Study)

Phase 3
Completed
Conditions
Pancreatic Neoplasms
Neoplasms
Endocrine Gland Neoplasms
Pancreatic Diseases
Digestive System Neoplasms
Neoplasms by Site
Digestive System Diseases
Endocrine System Diseases
Gemcitabine
Antimetabolites, Antineoplastic
Interventions
Registration Number
NCT01964430
Lead Sponsor
Celgene
Brief Summary

The purpose of this study is to compare whether there is a delay or prevention of recurrence or death in participants with surgically removed pancreatic cancer who then take nab-Paclitaxel in combination with gemcitabine compared to those who take gemcitabine alone.

Detailed Description

ABI-007-PANC-003 is a Phase 3, international, multicenter, randomized, open-label, controlled study that will compare the efficacy of nab-paclitaxel in combination with gemcitabine to gemcitabine alone as adjuvant treatment for 6 cycles in patients with surgically resected pancreatic adenocarcinoma.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
866
Inclusion Criteria
  1. Histologically confirmed resected ductal pancreatic adenocarcinoma with macroscopic complete resection (R0 and R1). Subjects with neuroendocrine (and mixed type) tumors are excluded.

  2. Pancreatic cancer surgical staging: Tumor (T) 1-3, Lymph Node (LN) N0-1, Metastasis (M) 0.

  3. Subject should be able to start treatment no later than 12 weeks postsurgery.

  4. ≥18 years of age at the time of signing the informed consent form (ICF).

  5. Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.

  6. Acceptable hematology parameters:

    • Absolute neutrophil count (ANC) ≥1500 cell/mm^3
    • Platelet count ≥100,000/mm^3
    • Hemoglobin (Hgb) ≥9 g/dL
  7. Acceptable blood chemistry levels:

    • Aspartate aminotransferase (AST)/ serum glutamic oxaloacetic transaminase (SGOT) and alanine transaminase (ALT)/ serum glutamic -pyruvic transaminase (SGPT) ≤2.5 × upper limit of normal range (ULN)
    • Total bilirubin ≤ upper limit of normal (participants with Gilbert's syndrome can have bilirubin of up to 1.5 x ULN)
    • Alkaline phosphatase ≤ 2.5 x ULN
    • Serum creatinine within upper limits of normal or calculated clearance ≥50 mL/min/1.73 m^2. If using creatinine clearance, actual body weight should be used for calculating creatinine clearance (eg, using the Cockroft-Gault formula). For subjects with a body mass index (BMI) >30 kg/m2, lean body weight should be used instead
  8. Cancer antigen (CA)19-9 <100 U/mL assessed within 14 days of randomization

  9. Acceptable coagulation studies as demonstrated by prothrombin time (PT) and partial thromboplastin time (PTT) within normal limits (±15%)

Exclusion Criteria

A subject will not be eligible for inclusion in this study if any of the following criteria apply:

  1. Prior neo-adjuvant treatment or radiation therapy for pancreatic adenocarcinoma

  2. Presence of or history of metastatic pancreatic adenocarcinoma

  3. Any other malignancy within 5 years prior to randomization, with the exception of adequately treated in-situ carcinoma of the cervix, uteri, or nonmelanomatous skin cancer (all treatment of which should have been completed 6 months prior to randomization)

  4. Active, uncontrolled bacterial, viral, or fungal infection(s) requiring systemic therapy, defined as ongoing signs/symptoms related to the infection without improvement despite appropriate antibiotics, antiviral therapy, and/or other treatment

  5. Known infection with hepatitis B or C, or history of human immunodeficiency virus (HIV) infection, or subject receiving immunosuppressive or myelosuppressive medications that would in the opinion of the investigator, increase the risk of serious neutropenic complications

  6. History of allergy or hypersensitivity to nab-paclitaxel or gemcitabine or any of their excipients

  7. Serious medical risk factors involving any of the major organ systems, or serious psychiatric disorders, which could compromise the subject's safety or the study data integrity. These include, but are not limited to:

    1. History of connective tissue disorders (eg, lupus, scleroderma, arteritis nodosa)
    2. History of interstitial lung disease, slowly progressive dyspnea and unproductive cough, sarcoidosis, silicosis, idiopathic pulmonary fibrosis, pulmonary hypersensitivity pneumonitis or multiple allergies
    3. History of the following within 6 months prior to Cycle 1 Day 1: a myocardial infarction, severe/unstable angina pectoris, coronary/peripheral artery bypass graft, New York Heart Association (NYHA) Class III-IV heart failure, uncontrolled hypertension, clinically significant cardiac dysrhythmia or electrocardiogram (ECG) abnormality, cerebrovascular accident, transient ischemic attack, or seizure disorder

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
nab-Paclitaxel 125 mg/m^2 plus gemcitabine 1000 mg/m2nab-PaclitaxelParticipants received nab-Paclitaxel 125 mg/m\^2 administered as an intravenous (IV) infusion over 30 to 40 minutes, followed by gemcitabine 1000 mg/m\^2 as an IV infusion over 30 to 40 minutes on Days 1, 8 and 15 of each 28-day treatment cycle for 6 cycles, unless there was evidence of radiologic disease recurrence, unacceptable toxicity, subject or physician decision, withdrawal of consent, or death.
nab-Paclitaxel 125 mg/m^2 plus gemcitabine 1000 mg/m2GemcitabineParticipants received nab-Paclitaxel 125 mg/m\^2 administered as an intravenous (IV) infusion over 30 to 40 minutes, followed by gemcitabine 1000 mg/m\^2 as an IV infusion over 30 to 40 minutes on Days 1, 8 and 15 of each 28-day treatment cycle for 6 cycles, unless there was evidence of radiologic disease recurrence, unacceptable toxicity, subject or physician decision, withdrawal of consent, or death.
Gemcitabine 1000 mg/m^2GemcitabineParticipants received gemcitabine 1000 mg/m\^2 administered as an IV infusion over 30 to 40 minutes on Days 1, 8 and 15 of each 28-day treatment cycle for 6 cycles, unless there was evidence of radiologic disease recurrence, unacceptable toxicity, subject or physician decision, withdrawal of consent, or death.
Primary Outcome Measures
NameTimeMethod
Kaplan Meier Estimate for Disease Free Survival (DFS) According to the Independent Radiological Review CommitteeDate of randomization up to data cut off date of 31 December 2018; median DFS follow-up time for censored participants was 22.242 months for nab-Paclitaxel and gemcitabine and 13.832 months for gemcitabine alone

Disease free survival was defined as the time from the date of randomization to the date of disease recurrence or death, whichever occurred earlier. Disease recurrence was determined by the independent radiological review of computed tomography (CT) or magnetic resonance imaging (MRI) scans. Participants who did not have disease recurrence or did not die were censored at the last tumor assessment date with disease-free status or the randomization date if the last tumor assessment with disease-free status was missing. Disease-free status referred to a status that was neither being disease recurrent nor indeterminate or not evaluable. Participants who received new anti-cancer therapy or cancer-related surgery prior to disease recurrence or death were censored at the date of last tumor assessment with disease-free status prior to the start of new anti-cancer therapy or cancer-related surgery or the randomization date.

Secondary Outcome Measures
NameTimeMethod
Number of Participants With Treatment Emergent Adverse Events (TEAE's)From day 1 of study drug up to 28 days after the last dose of study drug; up to the data cut off date of 31 December 2018 (up to approximately 37 weeks).

TEAEs are defined as any adverse event (AE) that begin or worsen on or after the start of study drug or procedure of the study period through the maximum duration of the period plus 28 days. The severity of AEs was graded based on National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE), Version 4.0 and the scale: Grade 1 = Mild Grade 2 = Moderate Grade 3 = Severe Grade 4 = Life threatening Grade 5 = Death. Relation to study drug was determined by the investigator. A treatment-related TEAE is defined as TEAE which was considered to be related to one or both of the study drugs and reported as 'Suspected' on the case report form. AEs with a missing relationship were treated as 'treatment-related' in data summaries. IP (investigational product) refers to nab-Paclitaxel and/or Gemcitabine. "Related" TEAE refers to relation to study drug (IP).

The Number of Participants With Clinical Chemistry Laboratory-Detected Abnormalities (Grade 3-4)From day 1 of study drug up to 28 days after the last dose of study drug, or the treatment discontinuation date, whichever was later (up to approximately 37 weeks).

The number of participants with grade 3-4 laboratory abnormalities in selected clinically significant parameters. Grades for chemistry parameters were coded using National Cancer Institute Common Terminology Criteria for Adverse Events (Grade 3= severe, Grade 4= life-threatening).

Kaplan Meier Estimate of Overall Survival (OS)From randomization to date of death; median OS follow-up time for censored participants was 77.832 months for nab-Paclitaxel and gemcitabine and 77.799 months for gemcitabine alone

Overall survival was defined as the time from the date of randomization to the date of death. Participants who were alive at the end of study or clinical data cut were censored on the last-known-to-be-alive date or the clinical cutoff date, whichever was earlier.

Trial Locations

Locations (341)

Local Institution - 016

🇺🇸

Philadelphia, Pennsylvania, United States

Local Institution - 023

🇺🇸

Chattanooga, Tennessee, United States

Local Institution - 010

🇺🇸

Dallas, Texas, United States

UT Southwestern Medical Center

🇺🇸

Dallas, Texas, United States

Princess Margaret Hospital

🇨🇦

Toronto, Ontario, Canada

Centro Integral

🇪🇸

Madrid, Spain

State University of New York Upstate Medical Center

🇺🇸

Syracuse, New York, United States

Roswell Park Cancer Institute

🇺🇸

Buffalo, New York, United States

Case Western Reserve Center

🇺🇸

Cleveland, Ohio, United States

Local Institution - 022

🇺🇸

Boca Raton, Florida, United States

Florida Cancer Institute Cancer Spec

🇺🇸

Fort Myers, Florida, United States

Local Institution - 032

🇺🇸

New York, New York, United States

University of California Los Angeles

🇺🇸

Santa Monica, California, United States

Local Institution - 025

🇺🇸

Buffalo, New York, United States

Illinois Cancer Specialists

🇺🇸

Niles, Illinois, United States

Local Institution - 066

🇺🇸

Rockville Center, New York, United States

Local Institution - 064

🇺🇸

Basking Ridge, New Jersey, United States

Local Institution - 050

🇺🇸

Fort Worth, Texas, United States

Memorial Sloan-Kettering Cancer Center - NYC

🇺🇸

New York, New York, United States

Local Institution - 013

🇺🇸

Rochester, New York, United States

Local Institution - 054

🇺🇸

Cleveland, Ohio, United States

University of Rochester Cancer Center, James P. Wilmot Cancer Center

🇺🇸

Rochester, New York, United States

MSKCC at Phelps Memorial Hospital Center. Phelps Sleepy Hollow

🇺🇸

Sleepy Hollow, New York, United States

Texas Oncology, P.A. - Tyler

🇺🇸

Tyler, Texas, United States

Hospital Virgen del Rocio

🇪🇸

Sevilla, Spain

Local Institution - 062

🇺🇸

Dallas, Texas, United States

Texas Oncology

🇺🇸

Dallas, Texas, United States

The Center for Cancer and Blood Disorders - Fort Worth

🇺🇸

Fort Worth, Texas, United States

Local Institution - 507

🇦🇺

St Leonards, New South Wales, Australia

ICON Cancer Center

🇦🇺

Milton, Queensland, Australia

Austin Hospital

🇦🇺

Heidelberg, Australia

Local Institution - 0271

🇩🇪

Tübingen, Germany

Local Institution - 293

🇭🇺

Budapest, Hungary

Klinikum der Universitat Munchen-Grosshadern

🇩🇪

München, Germany

Local Institution - 282

🇩🇪

München, Germany

Praxis Internistischer Onkologie und Hamatologie Koln

🇩🇪

Köln, Germany

Universitatsklinikum Würzburg

🇩🇪

Würzburg, Germany

Local Institution - 270

🇩🇪

Würzburg, Germany

Azienda Ospedaliera Niguarda Ca Granda

🇮🇹

Milano, Italy

Arcispedale Santa Maria Nuova

🇮🇹

Reggio Emilia, Italy

Local Institution - 323

🇮🇹

Roma, Italy

Fovarosi Szent Istvan es Szent Laszlo Korhaz es Rendelointezet

🇭🇺

Budapest, Hungary

Local Institution - 329

🇮🇹

Terni, Umbria, Italy

Local Institution - 642

🇰🇷

Seoul, Korea, Republic of

Azienda Ospedaliero-Universitaria Careggi

🇮🇹

Firenze, Italy

Local Institution - 328

🇮🇹

Firenze, Italy

Petz Aladar Megyei Oktato Korhaz,II. Belgyogyaszat

🇭🇺

Gyor, Hungary

Universitatsklinik Magdeburg

🇩🇪

Magdeburg, Germany

Local Institution - 276

🇩🇪

München, Germany

Klinikum der Johannes Gutenberg Uniervsitaet ,Haematologie

🇩🇪

Mainz, Germany

Szegedi Tudomanyegyetem Szent-Gyorgyi Albert Klinikai Kozpont Szent-Gyorgyi Albert TE AOK Borgyogy

🇭🇺

Szeged, Hungary

Azienda Ospedaliera S Maria di Terni

🇮🇹

Terni, Italy

Uzsoki Utcai Korhaz

🇭🇺

Budapest, Hungary

Klinikum Neuperlach

🇩🇪

München, Germany

Local Institution - 640

🇰🇷

Seoul, Korea, Republic of

Local Institution - 274

🇩🇪

Magdeburg, Germany

Local Institution - 283

🇩🇪

Mainz, Germany

Local Institution - 324

🇮🇹

Pisa, Italy

Local Institution - 291

🇭🇺

Budapest, Hungary

Hospital Da Luz

🇵🇹

Lisboa, Portugal

National Cancer Center

🇸🇬

Singapore, Singapore

Clinic Barcelona Hospital Universitari

🇪🇸

Barcelona, Spain

Azienda Ospedaliera Universitaria Integrata di Verona

🇮🇹

Verona, Italy

Local Institution - 295

🇭🇺

Szeged, Hungary

Local Institution - 340

🇵🇹

Lisboa, Portugal

Local Institution - 341

🇵🇹

Lisboa, Portugal

Local Institution - 292

🇭🇺

Gyor, Hungary

Local Institution - 403

🇳🇱

Eindhoven, Netherlands

Local Institution - 361

🇪🇸

Madrid, Spain

Seoul National University Hospital

🇰🇷

Seoul, Korea, Republic of

Asan Medical Center

🇰🇷

Seoul, Korea, Republic of

Hospital General Gregorio Maranon

🇪🇸

Madrid, Spain

Local Institution - 610

🇸🇬

Singapore, Singapore

Local Institution - 625

🇨🇳

Tainan, Taiana, Taiwan

Local Institution - 327

🇮🇹

Roma, Italy

Local Institution - 641

🇰🇷

Seoul, Korea, Republic of

Local Institution - 320

🇮🇹

Verona, Italy

Local Institution - 371

🇪🇸

Santander, Cantabria, Spain

Taipei Veterans General Hospital

🇨🇳

Taipei, Taiwan

Local Institution - 363

🇪🇸

Barcelona, Spain

Ramon y Cajal Univeresity Hospital

🇪🇸

Madrid, Spain

Local Institution - 370

🇪🇸

Barcelona, Spain

Hospital 12 de Octubre

🇪🇸

Madrid, Spain

Hospital Universitari Vall d'Hebron

🇪🇸

Barcelona, Spain

Local Institution - 400

🇳🇱

Amsterdam, Netherlands

Local Institution - 342

🇵🇹

Porto, Portugal

Taichung Veterans General Hospital

🇨🇳

Taichung, Taiwan

Chang Gung Medical Foundation-Linkou Branch

🇨🇳

Taoyuan, Taiwan

Local Institution - 362

🇪🇸

Madrid, Spain

Local Institution - 369

🇪🇸

Malaga, Spain

Centro Hospitalar de Lisboa Central - Hospital de Santo António dos Capuchos

🇵🇹

Lisboa, Portugal

National University Hospital

🇸🇬

Singapore, Singapore

Local Institution - 372

🇪🇸

Madrid, Spain

Tri-Service General Hospital

🇨🇳

Taipei, Taiwan

Addenbrookes Hospital

🇬🇧

Cambridge, United Kingdom

Local Institution - 621

🇨🇳

Tapei, Taiwan

Local Institution - 365

🇪🇸

Madrid, Spain

Local Institution - 620

🇨🇳

Taichung, Taiwan

Local Institution - 624

🇨🇳

Taoyuan, Taiwan

Hospital Universitario Marques de Valdecilla

🇪🇸

Santander, Spain

Local Institution - 382

🇬🇧

Cambridge, United Kingdom

Local Institution - 366

🇪🇸

Santiago De Compostela, Spain

National Cheng Kung University Hospital

🇨🇳

Tainan, Taiana, Taiwan

Local Institution - 623

🇨🇳

Taipei, Taiwan

Local Institution - 380

🇬🇧

Glasgow, United Kingdom

Local Institution - 381

🇬🇧

Sheffield, United Kingdom

Glasgow Royal Infirmary

🇬🇧

Glasgow, United Kingdom

University of Chicago Medical Center

🇺🇸

Chicago, Illinois, United States

Cleveland Clinic - Taussig Cancer Institute

🇺🇸

Cleveland, Ohio, United States

Cleveland Clinic Foundation IRB

🇺🇸

Cleveland, Ohio, United States

Cleveland Clinic Foundation

🇺🇸

Cleveland, Ohio, United States

Local Institution - 020

🇺🇸

Cleveland, Ohio, United States

Local Institution - 005

🇺🇸

Columbus, Ohio, United States

Ohio State University Medical Center

🇺🇸

Columbus, Ohio, United States

Local Institution - 027

🇺🇸

Pittsburgh, Pennsylvania, United States

UPMC Cancer Pavillion

🇺🇸

Pittsburgh, Pennsylvania, United States

Dana Farber Cancer Institute

🇺🇸

Boston, Massachusetts, United States

Local Institution - 045

🇺🇸

Boston, Massachusetts, United States

Massachusetts General Hospital

🇺🇸

Boston, Massachusetts, United States

Beth Israel-Deaconess Medical Center

🇺🇸

Boston, Massachusetts, United States

Baylor College of Medicine

🇺🇸

Houston, Texas, United States

Local Institution - 003

🇺🇸

Seattle, Washington, United States

Seattle Cancer Care Alliance - Seattle

🇺🇸

Seattle, Washington, United States

Virginia Mason Cancer Center

🇺🇸

Seattle, Washington, United States

University of Miami and Sylvester Cancer Center

🇺🇸

Miami, Florida, United States

University of Cincinnati Medical CenterDivsion of Hematology OncologyThe Barrett Center

🇺🇸

Cincinnati, Ohio, United States

Local Institution - 030

🇺🇸

Cincinnati, Ohio, United States

Oncology Hematology Care, Inc.

🇺🇸

Cincinnati, Ohio, United States

Local Institution - 241

🇫🇮

Helsinki, Finland

Salzburger Landkliniken St. Johanns-Spital

🇦🇹

Salzburg, Austria

Local Institution - 242

🇫🇮

Turku, Finland

St Vincent's University Hospital

🇮🇪

Dublin 4, Ireland

Academisch Medisch Centrum Amsterdam

🇳🇱

Amsterdam, Netherlands

Catharina Hospital

🇳🇱

Eindhoven, Netherlands

Isala Klinieken

🇳🇱

Zwolle, Netherlands

Local Institution - 402

🇳🇱

Zwolle, Netherlands

Local Institution - 508

🇦🇺

Subiaco, Western Australia, Australia

Saint Barnabas Medical Center

🇺🇸

Livingston, New Jersey, United States

University of California, San Francisco Cutaneous Oncology and Melanoma Center

🇺🇸

San Francisco, California, United States

Local Institution - 004

🇺🇸

Nashville, Tennessee, United States

Local Institution - 049

🇺🇸

Oklahoma City, Oklahoma, United States

Local Institution - 002

🇺🇸

Nashville, Tennessee, United States

Vanderbilt- Ingram Cancer Center

🇺🇸

Nashville, Tennessee, United States

Karmanos Cancer Center Wayne State University

🇺🇸

Detroit, Michigan, United States

Sarah Cannon Research Inst

🇺🇸

Nashville, Tennessee, United States

University of Oklahoma Peggy and Charles Stephenson Cancer Center

🇺🇸

Oklahoma City, Oklahoma, United States

Onk.Dep., Odense Universitets hospital

🇩🇰

Odense C, Denmark

Local Institution - 326

🇮🇹

Rozzano (MI), Italy

Rocky Mountain Cancer Centers, LLP [Denver-Midtown]

🇺🇸

Denver, Colorado, United States

Local Institution - 019

🇺🇸

Portland, Oregon, United States

Oregon Health and Science University OHSU

🇺🇸

Portland, Oregon, United States

Local Institution - 275

🇩🇪

Friedrichshafen, Germany

Hospital General Carlos Haya

🇪🇸

Malaga, Spain

Local Institution - 367

🇪🇸

Madrid, Spain

Hospital Clinico San Carlos

🇪🇸

Madrid, Spain

Local Institution - 368

🇪🇸

Pamplona/ Navarra, Spain

Hospital Clinico Universitario De Santiago De Compostela

🇪🇸

Santiago De Compostela, Spain

University of Colorado Cancer Center

🇺🇸

Aurora, Colorado, United States

Local Institution - 021

🇺🇸

Rochester, Minnesota, United States

Mayo Clinic

🇺🇸

Rochester, Minnesota, United States

Nebraska Methodist Hospital

🇺🇸

Omaha, Nebraska, United States

Instituto Catalan de Oncologia-Hospital Duran

🇪🇸

Barcelona, Spain

H Lee Moffitt Cancer Center

🇺🇸

Tampa, Florida, United States

Local Institution - 048

🇺🇸

Omaha, Nebraska, United States

Georgia Cancer Specialist

🇺🇸

Atlanta, Georgia, United States

Local Institution - 040

🇺🇸

Boston, Massachusetts, United States

Local Institution - 321

🇮🇹

Milano, Italy

Baylor Sammons Cancer Center

🇺🇸

Dallas, Texas, United States

Saint Vincent's Hospital

🇦🇺

Darlinghurst, Australia

Local Institution - 509

🇦🇺

Heidelberg, Australia

Local Institution - 059

🇺🇸

Denver, Colorado, United States

UCSD Moores Cancer Center

🇺🇸

La Jolla, California, United States

Local Institution - 001

🇺🇸

San Francisco, California, United States

Local Institution - 043

🇺🇸

Scottsdale, Arizona, United States

Mayo Clinic - Arizona

🇺🇸

Scottsdale, Arizona, United States

Lynn Cancer Institute

🇺🇸

Boca Raton, Florida, United States

Local Institution - 031

🇺🇸

Fort Myers, Florida, United States

Northshore University Healthsystem Research Institute

🇺🇸

Evanston, Illinois, United States

MSKCC Basking Ridge

🇺🇸

Basking Ridge, New Jersey, United States

Columbia University Medical Center

🇺🇸

New York, New York, United States

Memorial Sloan Kettering Cancer Center West Harrison

🇺🇸

Harrison, New York, United States

NYU Langone Medical Center

🇺🇸

Lake Success, New York, United States

Local Institution - 008

🇺🇸

New York, New York, United States

MSKCC at Mercy Medical Center Mercy RockvilleCenter

🇺🇸

Rockville Center, New York, United States

Local Institution - 047

🇺🇸

Cleveland, Ohio, United States

Chattanooga Oncology Hematology Care

🇺🇸

Chattanooga, Tennessee, United States

Local Institution - 038

🇺🇸

Charlottesville, Virginia, United States

University of Virginia

🇺🇸

Charlottesville, Virginia, United States

Local Institution - 041

🇺🇸

Houston, Texas, United States

Local Institution - 501

🇦🇺

Darlinghurst, New South Wales, Australia

Northern Cancer Institute

🇦🇺

St Leonards, New South Wales, Australia

Local Institution - 502

🇦🇺

Milton, Queensland, Australia

Local Institution - 504

🇦🇺

Herston, Queensland, Australia

Local Institution - 506

🇦🇺

Bentleigh East, Victoria, Australia

Monash Medical Centre Moorabbin Campus

🇦🇺

Bentleigh East, Australia

St John of God Subiaco Hospital

🇦🇺

Subiaco, Western Australia, Australia

Local Institution - 503

🇦🇺

Malvern, Australia

Royal Brisbane and Women's Hospital

🇦🇺

Herston, Australia

Cabrini Hospital

🇦🇺

Malvern, Australia

Local Institution - 500

🇦🇺

Randwick, Australia

Prince of Wales Hospital

🇦🇺

Randwick, Australia

The Queen Elizabeth Hospital

🇦🇺

Woodville South, Australia

Local Institution - 205

🇦🇹

Graz, Austria

Medical University of Graz

🇦🇹

Graz, Austria

Local Institution - 206

🇦🇹

Linz, Austria

Local Institution - 203

🇦🇹

Innsbruck, Austria

Medical University Innsbruck

🇦🇹

Innsbruck, Austria

Hospital of Elisabethinen Linz

🇦🇹

Linz, Austria

Local Institution - 204

🇦🇹

Salzburg, Austria

Hospital Wiener Neustadt

🇦🇹

Wiener Neustadt, Austria

Klinikum Wels-Grieskirchen GmbH

🇦🇹

Wels, Austria

Local Institution - 202

🇦🇹

Wiener Neustadt, Austria

Local Institution - 200

🇦🇹

Wien, Austria

Medizinische Universitat Wien

🇦🇹

Wien, Austria

Kaiser-Franz-Josef Spital

🇦🇹

Wien, Austria

Local Institution - 201

🇦🇹

Wien, Austria

Local Institution - 213

🇧🇪

Gent, Belgium

Hopital Erasme

🇧🇪

Brussels, Belgium

Local Institution - 211

🇧🇪

Brussels, Belgium

UZ Antwerpen

🇧🇪

Edegem, Belgium

Local Institution - 210

🇧🇪

Leuven, Belgium

UZ Leuven

🇧🇪

Leuven, Belgium

UZ Gent

🇧🇪

Gent, Belgium

Local Institution - 102

🇨🇦

Calgary, Alberta, Canada

Tom Baker Cancer Center

🇨🇦

Calgary, Alberta, Canada

Local Institution - 101

🇨🇦

Toronto, Ontario, Canada

Sunnybrook Health Sciences Centre

🇨🇦

Toronto, Ontario, Canada

Local Institution - 100

🇨🇦

Toronto, Ontario, Canada

Centre Hospitalier de L'Universite de Montreal St-Luc

🇨🇦

Montreal, Quebec, Canada

Local Institution - 104

🇨🇦

Montreal, Quebec, Canada

Local Institution - 103

🇨🇦

Montreal, Quebec, Canada

Jewish General Hospital

🇨🇦

Montreal, Quebec, Canada

Local Institution - 220

🇨🇿

Hradec Kralove, Czechia

Krajska nemocnice Liberec, a.s.

🇨🇿

Liberec, Czechia

Fakultni nemocnice Hradec Kralove

🇨🇿

Hradec Kralove, Czechia

Local Institution - 221

🇨🇿

Zlin, Czechia

Hæmatologisk afd. B Aalborg Sygehus Syd

🇩🇰

Aalborg, Denmark

Local Institution - 231

🇩🇰

Aalborg, Denmark

Krajska nemocnice T. Bati a.s.

🇨🇿

Zlin, Czechia

Herlev Hospital

🇩🇰

Herlev, Denmark

Tampereen yliopistollinen sairaala

🇫🇮

Tampere, Finland

Local Institution - 232

🇩🇰

Herlev, Denmark

Helsingin yliopistollinen keskussairaala

🇫🇮

Helsinki, Finland

Local Institution - 240

🇫🇮

Tampere, Oulun Lääni, Finland

Local Institution - 230

🇩🇰

Odense C, Denmark

Turku University Hospital

🇫🇮

Turku, Finland

Center Hospitalier Universitaire d' Angers

🇫🇷

Angers cedex 09, France

Local Institution - 253

🇫🇷

Angers cedex 09, France

CHRU de Lille France

🇫🇷

Lille, France

Hopital Henri Mondor

🇫🇷

Creteil, France

Local Institution - 257

🇫🇷

Lille, France

Hopital Edouard Herriot - Hepato-gastroenterologie

🇫🇷

Lyon Cedex 3, France

Local Institution - 258

🇫🇷

Lyon Cedex 3, France

Hopital prive Jean Mermoz

🇫🇷

Lyon, France

Local Institution - 252

🇫🇷

Lyon, France

Hopital Europeen Georges Pompidou

🇫🇷

Paris, France

Hopital Saint Antoine

🇫🇷

Paris, France

Hopital Pitie Salpetriere

🇫🇷

Paris, France

Local Institution - 250

🇫🇷

Paris, France

Local Institution - 259

🇫🇷

Paris, France

CHU La Miletrie

🇫🇷

Poitiers Cedex, France

Local Institution - 251

🇫🇷

Poitiers Cedex, France

Local Institution - 256

🇫🇷

Toulose, France

Pole Des Specialites Medicales, Hopital Purpan

🇫🇷

Toulose, France

Kliniken Essen-Mitte

🇩🇪

Essen, Germany

Universitatsklinikum Carl Gustav Carus an der TU Dresden

🇩🇪

Dresden, Germany

Klinikum Weiden

🇩🇪

Bayern, Germany

Charite - Universitätsmedizin Berlin

🇩🇪

Berlin, Germany

Local Institution - 280

🇩🇪

Bayern, Germany

Local Institution - 272

🇩🇪

Berlin, Germany

Local Institution - 278

🇩🇪

Dresden, Germany

Universitatsklinkum Frankfurt

🇩🇪

Frankfurt, Germany

Local Institution - 277

🇩🇪

Frankfurt, Germany

Local Institution - 284

🇩🇪

Frechen, Germany

Praxis Internistischer Onkologie und Hamatologie Frechen

🇩🇪

Frechen, Germany

Ernst-Moritz-Arndt-Universität Greifswald

🇩🇪

Greifswald, Germany

Praxis für Innere Medizin, Dr.Oettle Helmut

🇩🇪

Friedrichshafen, Germany

Local Institution - 279

🇩🇪

Greifswald, Germany

Local Institution - 273

🇩🇪

Hamburg, Germany

Universitaetsklinik Hamburg - Eppendorf

🇩🇪

Hamburg, Germany

Local Institution - 281

🇩🇪

Köln, Germany

University of Tubingen

🇩🇪

Tübingen, Germany

Prince of Wales Hospital the Chinese University of Hong Kong

🇭🇰

Sha Tin, Hong Kong

Debreceni Egyetem Orvos- es Egeszsegtudomanyi Centrum

🇭🇺

Debrecen, Hungary

Local Institution - 290

🇭🇺

Debrecen, Hungary

Local Institution - 310

🇮🇪

Dublin 4, Ireland

Jasz-Nagykun-Szolnok Megyei Hetenyi Geza Korhaz-Rendelointezet

🇭🇺

Szolnok, Hungary

Local Institution - 311

🇮🇪

Cork, Ireland

Local Institution - 325

🇮🇹

Ancona, Italy

Ospedali Riuniti Umberto I GM Lancisi

🇮🇹

Ancona, Italy

Azienda Ospedaliero-Universitaria di Bologna - Policlinico S.Orsola-Malpighi

🇮🇹

Bologna, Italy

Local Institution - 330

🇮🇹

Bologna, Italy

Istituto Scientifico Romagnolo Per Lo Studio e La Cura Dei Tumori (I.R.S.T.)

🇮🇹

Meldola, Italy

Local Institution - 322

🇮🇹

Milano, Italy

Local Institution - 331

🇮🇹

Meldola, Italy

Ospedale San Raffaele S.r.l.

🇮🇹

Milano, Italy

Local Institution - 333

🇮🇹

Reggio Emilia, Italy

Azienda Ospedaliero-Universitaria Pisana

🇮🇹

Pisa, Italy

Istituto Clinico Humanitas

🇮🇹

Rozzano (MI), Italy

IRCCS Casa Sollievo della Sofferenza

🇮🇹

San Giovanni Rotondo, Italy

Local Institution - 332

🇮🇹

San Giovanni Rotondo, Italy

Policlinico Universitario Agostino Gemelli

🇮🇹

Roma, Italy

Istituto Nazionale Tumori Regina Elena

🇮🇹

Roma, Italy

Samsung Medical Center

🇰🇷

Seoul, Korea, Republic of

Hospital de Sao Joao

🇵🇹

Porto, Portugal

Local Institution - 611

🇸🇬

Singapore, Singapore

Local Institution - 360

🇪🇸

Barcelona, Spain

Complejo Hospitalario de Navarra

🇪🇸

Pamplona/ Navarra, Spain

Local Institution - 364

🇪🇸

Sevilla, Spain

Local Institution - 622

🇨🇳

Taipei, Taiwan

Weston Park Hospital

🇬🇧

Sheffield South Yorkshire, United Kingdom

National Taiwan University Hospital

🇨🇳

Tapei, Taiwan

Memorial Sloan-Kettering Cancer Center

🇺🇸

Commack, New York, United States

University of Southern California

🇺🇸

Los Angeles, California, United States

Cork University Hospital

🇮🇪

Cork, Ireland

Local Institution - 0207

🇦🇹

Wels, Austria

Fox Chase Cancer Center

🇺🇸

Philadelphia, Pennsylvania, United States

Canberra Hospital

🇦🇺

Garran, Australian Capital Territory, Australia

Local Institution - 505

🇦🇺

Garran, Australian Capital Territory, Australia

Local Institution - 044

🇺🇸

Sacramento, California, United States

UC Davis Cancer Center

🇺🇸

Sacramento, California, United States

Yale Cancer Center

🇺🇸

New Haven, Connecticut, United States

Gainesville Heme Oncology Associates

🇺🇸

Gainesville, Florida, United States

Local Institution - 011

🇺🇸

Gainesville, Florida, United States

University of Florida

🇺🇸

Gainesville, Florida, United States

Florida Hospital Cancer Institute

🇺🇸

Orlando, Florida, United States

Local Institution - 039

🇺🇸

Orlando, Florida, United States

University of Louisville

🇺🇸

Louisville, Kentucky, United States

Ochsner Clinic Foundation

🇺🇸

New Orleans, Louisiana, United States

Ochsner Medical Center - Jefferson Highway

🇺🇸

New Orleans, Louisiana, United States

Local Institution - 036

🇺🇸

Ann Arbor, Michigan, United States

University of Michigan

🇺🇸

Ann Arbor, Michigan, United States

Local Institution - 051

🇺🇸

Winston-Salem, North Carolina, United States

Wake Forest Univ. Health Sciences Outpatient Comprehensive Cancer Center

🇺🇸

Winston-Salem, North Carolina, United States

Local Institution - 014

🇺🇸

Madison, Wisconsin, United States

University of Wisconsin - Madison Cancer Center

🇺🇸

Madison, Wisconsin, United States

Thomas Jefferson University

🇺🇸

Philadelphia, Pennsylvania, United States

Queen Mary Hospital

🇭🇰

Hong Kong, Hong Kong

Tuen Mun Hospital

🇭🇰

Hong Kong, Hong Kong

Local Institution - 601

🇭🇰

Hong Kong, Hong Kong

Local Institution - 602

🇭🇰

Sha Tin, Hong Kong

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