A Study of Neoadjuvant Letrozole + Taselisib Versus Letrozole + Placebo in Post-Menopausal Women With Breast Cancer (LORELEI)
- Registration Number
- NCT02273973
- Lead Sponsor
- Genentech, Inc.
- Brief Summary
This is a two-arm, randomized, double-blind, multicenter, pre-operative study to evaluate the effect of combining letrozole and GDC-0032 (also known as taselisib) versus letrozole and placebo in postmenopausal women with estrogen receptor-positive (ER+)/human epidermal growth factor receptor 2 (HER2) untreated, Stage I-III operable breast cancer. Participants will be randomized into one of the two treatment arms with a 1:1 randomization ratio. Letrozole at 2.5 milligrams (mg) will be dosed once daily plus either Taselisib at 4 mg (two 2-mg tablets) or placebo on a 5 days-on/ 2 days-off schedule for a total of 16 weeks.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- Female
- Target Recruitment
- 334
- Female participants
- Postmenopausal status
- Histologically confirmed invasive breast carcinoma, with all of the following characteristics: (i) Primary tumor greater than or equal to (>/=) 2 centimeters (cm) in largest diameter (cT1-3) by MRI; (ii) Stage I to operable Stage III breast cancer; (iii) Documented absence of distant metastases (M0)
- Estrogen receptor-positive (ER+) and human epidermal growth factor receptor 2-negative (HER2-) breast cancer
- Breast cancer eligible for primary surgery
- Tumor tissue from formalin-fixed paraffin-embedded cores (FFPE) core biopsy of breast primary tumor that is confirmed as evaluable for phosphatidylinositol-4,5-bisphosphate 3-kinase, catalytic subunit alpha (PIK3CA) mutation status by central histopathology laboratory
- Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
- Fasting glucose less than or equal to (</=) 125 milligrams per deciliter (mg/dL)
- Adequate hematological, renal, and hepatic function
- Absence of any psychological, familial, sociological, or geographical condition potentially hampering compliance with the study protocol and follow-up schedule
- Ability and willingness to comply with study visits, treatment, testing, and to comply with the protocol, in the investigator's judgment
- Any prior treatment for primary invasive breast cancer
- Participants with cT4 or cN3 stage breast tumors
- Bilateral invasive, multicentric, or metastatic breast cancer
- Participants who have undergone excisional biopsy of primary tumor and/or axillary lymph nodes or sentinel lymph node biopsy
- Type 1 or 2 diabetes requiring antihyperglycemic medication
- Inability or unwillingness to swallow pills
- Malabsorption syndrome or other condition that would interfere with enteric absorption
- History of prior or currently active small or large intestine inflammation (such as Crohn's disease or ulcerative colitis). Any predisposition for gastrointestinal (GI) toxicity requires prior approval from the Medical Monitor.
- Congenital long QT syndrome or QT interval corrected using Fridericia's formula (QTcF) >470 milliseconds (msec)
- Diffusing capacity of the lungs for carbon monoxide (DLCO) <60% of the predicted values
- Clinically significant (i.e., active) cardiovascular disease, uncontrolled hypertension, unstable angina, history of myocardial infarction, cardiac failure class II-IV
- Any contraindication to MRI examination
- Active infection requiring intravenous antibiotics
- Participants requiring any daily supplemental oxygen
- Clinically significant history of liver disease, including viral or other known hepatitis, current alcohol abuse, or cirrhosis
- Any other diseases, active or uncontrolled pulmonary dysfunction, metabolic dysfunction, physical examination finding, or clinical laboratory finding giving reasonable suspicion of a disease or condition that contraindicates the use of an investigational drug, that may affect the interpretation of the results, or renders the participants at high risk from treatment complications
- Significant traumatic injury within 3 weeks prior to initiation of study treatment
- Major surgical procedure within 4 weeks prior to initiation of study treatment
- Inability to comply with study and follow-up procedures
- History of other malignancy within 5 years prior to screening, except for appropriately treated carcinoma in situ of the cervix, non-melanoma skin carcinoma, or Stage I uterine cancer
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Letrozole + Placebo Placebo Participants will receive 2.5 mg letrozole tablets orally QD along with placebo on a 5-days-on/2-days-off schedule for a total of 16 weeks. Letrozole + Placebo Letrozole Participants will receive 2.5 mg letrozole tablets orally QD along with placebo on a 5-days-on/2-days-off schedule for a total of 16 weeks. Letrozole + Taselisib Letrozole Participants will receive 2.5 milligrams (mg) letrozole tablets orally once daily (QD) along with taselisib tablets at 4 mg (two 2 mg tablets) orally on a 5 days-on/2 days-off schedule for a total of 16 weeks. Letrozole + Taselisib Taselisib Participants will receive 2.5 milligrams (mg) letrozole tablets orally once daily (QD) along with taselisib tablets at 4 mg (two 2 mg tablets) orally on a 5 days-on/2 days-off schedule for a total of 16 weeks.
- Primary Outcome Measures
Name Time Method Percentage of Participants With Total Pathologic Complete Response (Total pCR), Defined as Having pCR in Both Breast and Axilla, Using American Joint Committee on Cancer (AJCC) Staging System From Baseline to 16 weeks Total pCR was assessed by local pathology review on samples taken at surgery following completion of neoadjuvant therapy. tpCR was defined as the absence of any residual invasive cancer on hematoxylin and eosin evaluation of the resected breast specimen and all sampled ipsilateral lymph nodes ( i.e., ypT0/Tis, ypN0 in the AJCC staging system, 7th edition).
Percentage of Participants With OR by Centrally Assessed Breast MRI Via mRECIST Version 1.1 in Phosphatidylinositol-4,5-Bisphosphate 3-Kinase, Catalytic Subunit Alpha (PIK3CA) Mutant (MT) Participants From Baseline to 16 weeks ORR was defined as proportion of participants achieving CR or PR. As per modified RECIST v1.1, CR: disappearance of all target lesions, PR: at least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum of diameters.
Percentage of Participants With Objective Response (OR) by Centrally Assessed Breast Magnetic Resonance Imaging (MRI) Via Modified Response Evaluation Criteria in Solid Tumors (mRECIST) Version 1.1 From Baseline to 16 weeks Objective response rate (ORR) was defined as proportion of participants achieving complete response (CR) or partial response (PR). As per modified RECIST v1.1, CR: disappearance of all target lesions, PR: at least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum of diameters.
Percentage of Participants With Total pCR , Defined as Having pCR in Both Breast and Axilla, Using AJCC Staging System in PIK3CA MT Participants From Baseline to 16 weeks Total pCR was assessed by local pathology review on samples taken at surgery following completion of neoadjuvant therapy. tpCR was defined as the absence of any residual invasive cancer on hematoxylin and eosin evaluation of the resected breast specimen and all sampled ipsilateral lymph nodes (i.e., ypT0/Tis, ypN0 in the AJCC staging system, 7th edition).
- Secondary Outcome Measures
Name Time Method Percentage of Participants With OR by Breast Ultrasound Via mRECIST Version 1.1 in PIK3CA WT Participants From Baseline to 16 weeks ORR was defined as proportion of participants achieving CR or PR. As per modified RECIST v1.1, CR: disappearance of all target lesions, PR: at least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum of diameters.
Percentage of Participants With OR by Mammography Via mRECIST Version 1.1 in PIK3CA WT Participants From Baseline to 16 weeks ORR was defined as proportion of participants achieving CR or PR. As per modified RECIST v1.1, CR: disappearance of all target lesions, PR: at least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum of diameters.
Percentage of Participants With OR by Clinical Breast Exam (Palpation) Via mRECIST Version 1.1 in PIK3CA WT Participants From Baseline to 16 weeks ORR was defined as proportion of participants achieving CR or PR. As per modified RECIST v1.1, CR: disappearance of all target lesions, PR: at least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum of diameters.
Percent Change From Baseline to Surgery in Enhancing Tumor Volume as Measured by Breast MRI From Baseline to Surgery (Weeks 17-18) Percentage of Participants With OR by Mammography Via mRECIST Version 1.1 in PIK3CA MT Participants From Baseline to 16 weeks ORR was defined as proportion of participants achieving CR or PR. As per modified RECIST v1.1, CR: disappearance of all target lesions, PR: at least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum of diameters.
Percentage of Participants With OR by Clinical Breast Exam (Palpation) Via mRECIST Version 1.1 in PIK3CA MT Participants From Baseline to 16 weeks ORR was defined as proportion of participants achieving CR or PR. As per modified RECIST v1.1, CR: disappearance of all target lesions, PR: at least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum of diameters.
Percentage of Participants With Total pCR Defined as Having pCR in Both Breast and Axilla, Using AJCC Staging System in PIK3CA WT Participants From Baseline to 16 weeks Total pCR was assessed by local pathology review on samples taken at surgery following completion of neoadjuvant therapy. tpCR was defined as the absence of any residual invasive cancer on hematoxylin and eosin evaluation of the resected breast specimen and all sampled ipsilateral lymph nodes (i.e., ypT0/Tis, ypN0 in the AJCC staging system, 7th edition).
Preoperative Endocrine Prognostic Index (PEPI ) Score Week 16 To obtain the PEPI score, risk points for relapse-free survival (RFS) and breast cancer-specific survival (BCSS) are assigned depending on the hazard ratio (HR) from the multivariable analysis. The total PEPI score assigned to each participant is the sum of the risk points derived from the primary tumor (pT) stage, regional lymph nodes (pN) stage, Ki67 level, and estrogen receptor status of the surgical specimen. A HR in the range of 1 to 2 receives one risk point; a HR in the 2 to 2.5 range, two risk points; a HR greater than 2.5, three risk points. The total risk point score for each participant is the sum of all the risk points accumulated from the four factors in the model, ranges from 0 (best possible outcome) to 12 (worst possible outcome).
Percentage of Participants With OR by Centrally Assessed Breast MRI Via mRECIST Version 1.1 in PIK3CA Wildtype (WT) Participants From Baseline to 16 weeks ORR was defined as proportion of participants achieving CR or PR. As per modified RECIST v1.1, CR: disappearance of all target lesions, PR: at least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum of diameters.
Percentage of Participants With OR by Breast Ultrasound Via mRECIST Version 1.1 in PIK3CA MT Participants From Baseline to 16 weeks ORR was defined as proportion of participants achieving CR or PR. As per modified RECIST v1.1, CR: disappearance of all target lesions, PR: at least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum of diameters.
Central Assessments of Changes in Ki67 Levels From Baseline to Week 3 and Surgery (Weeks 17-18); and Week 3 to Surgery (Weeks 17-18) Ki67 is a prognostic marker and is used to evaluate the proliferative activity of breast cancer.
Mean Score for Health-Related Quality of Life Measured by the European Organization for Research C30 (EORTC QLQ-C30) Weeks 1, 5, 9, 13, 16, 4-week Post-Surgery EORTC QLQ-C30 is a cancer-specific instrument with 30 questions used to assess the overall quality of life (QOL) in cancer participants. The first 28 questions used a 4-point scale (1=not at all, 2=a little, 3=quite a bit, 4=very much) for evaluating 5 functional scales (physical, role, social, cognitive, emotional), 8 symptom scales/items (diarrhea, fatigue, dyspnea, appetite loss, insomnia, nausea and vomiting \[N/V\], constipation, and pain) and a single item (financial difficulties). The last 2 questions represented the participant's assessment of overall health and quality of life, used 7-point scale (1=very poor to 7=excellent). EORTC QLQ-C30 global scores were linearly transformed on a scale of 0 to 100, with a high score indicating better QOL. Negative change from Baseline values indicated deterioration in QOL or functioning and positive values indicated improvement. Here, Post surgery= PS.
Mean Score for Treatment of Cancer Quality of Life Questionnaire BR23 (QLQ-BR23) Weeks 1, 5, 9, 13, 16, 4-week Post-Surgery EORTC-QLQ-BR23 is a 23-item breast cancer-specific companion module to the EORTC-QLQ-C30 and consists of four functional scales (body image, sexual enjoyment, sexual functioning, future perspective \[FP\]) and four symptom scales (systemic side effects \[SE\], upset by hair loss, arm symptoms, breast symptoms). Questions used 4-point scale (1=not at all, 2=a little, 3=quite a bit, 4=very much). Scores were averaged and transformed to 0-100 scale. High score for functional scale indicated high/better level of functioning/healthy functioning. Negative change from Baseline indicated deterioration in QOL and positive change from Baseline indicated an improvement in QOL. Here, Post surgery= PS.
Percentage of Participants With Adverse Events Baseline up to 22 weeks An adverse event (AE) is any untoward medical occurrence in a participant, temporally associated with the use of a medicinal product, whether or not considered related to the medicinal product.
Trial Locations
- Locations (117)
Lkh-Univ. Klinikum Graz; Klinik Für Gynäkologie
🇦🇹Graz, Austria
Cliniques Universitaires St-Luc
🇧🇪Bruxelles, Belgium
Debreceni Egyetem, Klinikai Kozpont, Onkologiai Klinika
ðŸ‡ðŸ‡ºDebrecen, Hungary
Bacs-Kiskun Megyei Korhaz, SZTE AOK Oktato Korhaza, Onkoradiologiai Kozpont
ðŸ‡ðŸ‡ºKecskemet, Hungary
Centro Estatal de CancerologÃa
🇲🇽Chihuahua, Mexico
Europejskie Centrum Zdrowia Otwock Szpital im. Fryderyka Chopina, Klinika Onkologii
🇵🇱Otwock, Poland
B-A-Z County Hospital
ðŸ‡ðŸ‡ºMiskolc, Hungary
Hospital Nacional Cayetano Heredia; Hematology - Oncology
🇵🇪Lima, Peru
Oncosalud Sac; OncologÃa
🇵🇪Lima, Peru
Wielkopolskie Centrum Onkologii; im. Marii Skłodowskiej-Curie
🇵🇱Poznan, Poland
IPO do Porto; Servico de Oncologia Medica
🇵🇹Porto, Portugal
Uni Degli Studi Di Genova ; Clinica Di Medicina Interna Ad Indirizzo Oncologico
🇮🇹Genova, Liguria, Italy
Wojewódzki Szpital Specjalistyczny im. M. Kopernika; Oddział Chemioterapii
🇵🇱Lodz, Poland
Kantonsspital Baden; Frauenklinik
🇨ðŸ‡Baden, Switzerland
Centro Clinico Champalimaud; Oncologia Medica
🇵🇹Lisboa, Portugal
Breastlink Med Group Inc
🇺🇸Santa Ana, California, United States
Hospital de Cancer de Barretos
🇧🇷Barretos, SP, Brazil
MULTISCAN, s.r.o., Radiologicke centrum Pardubice
🇨🇿Pardubice, Czechia
Hospital Sao Lucas - PUCRS
🇧🇷Porto Alegre, RS, Brazil
MGH Cancer Center
🇺🇸Boston, Massachusetts, United States
MSKCC at Basking Ridge
🇺🇸Basking Ridge, New Jersey, United States
Institut Jules Bordet
🇧🇪Brussels, Belgium
CHU Brugmann (Victor Horta)
🇧🇪Bruxelles, Belgium
Institut Curie; Oncologie Medicale
🇫🇷Paris, France
Szent Margit Hospital; Dept. of Oncology
ðŸ‡ðŸ‡ºBudapest, Hungary
Instituto do Cancer do Estado de Sao Paulo - ICESP
🇧🇷Sao Paulo, SP, Brazil
UZ Antwerpen
🇧🇪Edegem, Belgium
Clinique Ste-Elisabeth
🇧🇪Namur, Belgium
Institut de Cancérologie de Lorraine
🇫🇷Vandoeuvre-Les-Nancy, France
Universitätsklinikum "Carl Gustav Carus" der Technischen Universität Dresden
🇩🇪Dresden, Germany
Studienzentrum Berlin City
🇩🇪Berlin, Germany
Instituto Brasileiro De Controle Do Câncer - IBCC; Laboratório De Patologia
🇧🇷São Paulo, SP, Brazil
Hospital Oncologia; Oncology
🇸🇻Salvador, El Salvador
Hopital Saint Louis; Service Onco Thoracique
🇫🇷Paris, France
Clinica de Neoplasias Litoral
🇧🇷Itajai, SC, Brazil
Fakultni Nemocnice Hradec Kralove; Dept of Radiotherapy & Oncology
🇨🇿Hradec Kralove, Czechia
Oblastni nemocnice Pribram
🇨🇿Pribram, Czechia
Onkologische Schwerpunktpraxis Bielefeld
🇩🇪Bielefeld, Germany
Fakultni nemocnice Olomouc; Onkologicka klinika
🇨🇿Olomouc, Czechia
Hospital Clinico Vina del Mar
🇨🇱Viña del Mar, Chile
Fundación IVO
🇪🇸Valencia, Spain
Hospital Universitario de Fuenlabrada; Servicio de Oncologia
🇪🇸Madrid, Spain
Grupo Angeles
🇬🇹Guatemala City, Guatemala
Praxisklinik Krebsheilkunde für Frauen / Brustzentrum (Dres. Kittel/Klare)
🇩🇪Berlin, Germany
Ospedale degli Infermi
🇮🇹Rimini, Emilia-Romagna, Italy
Centre Jean Bernard
🇫🇷Le Mans, France
Seoul National Uni Hospital; Dept. of Internal Medicine/Hematology/Oncology
🇰🇷Seoul, Korea, Republic of
Universitätsklinikum Ulm Am Michelsberg; Frauenklinik
🇩🇪Ulm, Germany
Consultorio de Medicina Especializada; Dentro de Condominio San Francisco
🇲🇽Mexico City, Mexico
Centro Oncologico America
🇵🇦Panama, Panama
Uniwersyteckie Centrum Kliniczne, Klinika Onkologii i Radioterapii
🇵🇱Gdańsk, Poland
Kantonsspital Graubünden;Onkologie und Hämatologie
🇨ðŸ‡Chur, Switzerland
Universitätsklinikum Hamburg-Eppendorf (UKE); Klinik und Poliklinik für Gynäkologie
🇩🇪Hamburg, Germany
Institut Catala d Oncologia Hospital Duran i Reynals
🇪🇸Barcelona, Spain
Yonsei University Severance Hospital; Medical Oncology
🇰🇷Seoul, Korea, Republic of
Centre Jean Perrin; Division De Recherche Clinique
🇫🇷Clermont Ferrand, France
Centre Rene Huguenin; ONCOLOGIE GENETIQUE
🇫🇷Saint Cloud, France
CHI de Toulon - Hôpital Sainte Musse
🇫🇷Toulon, France
Instituto Universitario Dexeus; Servicio de OncologÃa
🇪🇸Barcelona, Spain
Szegedi Tudomanyegyetem, AOK, Szent-Gyorgyi Albert Klinikai Kozpont, Onkoterapias Klinika
ðŸ‡ðŸ‡ºSzeged, Hungary
Instituto Nacional De Cancerologia; Oncology; Tumores Mamarios
🇲🇽Distrito Federal, Mexico
Universitätsklinikum Münster; Klinik für Frauenheilkunde und Geburtshilfe
🇩🇪Münster, Germany
Evangelische Kliniken Gelsenkirchen GmbH; Brustzentrum
🇩🇪Gelsenkirchen, Germany
Klinikum Essen-Mitte Ev. Huyssens-Stiftung / Knappschafts GmbH; Klinik für Senologie / Brustzentrum
🇩🇪Essen, Germany
Centro Integral Oncologico Clara Campal (CIOCC); Dirección Médica
🇪🇸Madrid, Spain
Hospital Universitario Reina Sofia; Servicio de Oncologia
🇪🇸Córdoba, Cordoba, Spain
Centro Oncológico Sixtino / Centro Oncológico SA
🇬🇹Guatemala, Guatemala
Irccs Istituto Nazionale Dei Tumori (Int);S.C. Medicina Oncologica 1
🇮🇹Milano, Lombardia, Italy
Hospital Universitari de Girona Dr. Josep Trueta; Servicio de Oncologia
🇪🇸Girona, Spain
Hospital Provincial de Castellon; Servicio de Oncologia
🇪🇸Castellon, Spain
Samsung Medical Centre; Division of Hematology/Oncology
🇰🇷Seoul, Korea, Republic of
Hospital Universitari Arnau de Vilanova de Lleida; Servicio de Oncologia
🇪🇸Lerida, Spain
Hospital Universitario Virgen del Rocio; Servicio de Oncologia
🇪🇸Sevilla, Spain
Centrum Onkologii;Im. Franciszka Lukaszczyka;Onkologii
🇵🇱Bydgoszcz, Poland
Hospital Clinico Universitario; Oncologia
🇪🇸Valencia, Spain
IPO de Lisboa; Servico de Oncologia Medica
🇵🇹Lisboa, Portugal
Hospital Arnau de Vilanova (Valencia) Servicio de Oncologia
🇪🇸Valencia, Spain
National Cancer Center; Medical Oncology
🇰🇷Gyeonggi-do, Korea, Republic of
Hospital San Pedro De Alcantara; Servicio de Oncologia
🇪🇸Caceres, Spain
Hospital Universitario 12 de Octubre; Servicio de Oncologia
🇪🇸Madrid, Spain
Beatson West of Scotland Cancer Centre
🇬🇧Glasgow, United Kingdom
Azienda Ospedaliero-Universitaria S.Orsola-Malpighi; Unità Operativa Oncologia Medica
🇮🇹Bologna, Emilia-Romagna, Italy
ASST DI CREMONA; Dip. Medicina - S.C. Oncologia
🇮🇹Cremona, Lombardia, Italy
Ospedale Per Acuti Mater Salutis Di Legnago
🇮🇹Legnago, Lombardia, Italy
Irccs Istituto Europeo Di Oncologia (IEO); Ricerca Di Senologia Medica
🇮🇹Milano, Lombardia, Italy
Christie Hospital
🇬🇧Manchester, United Kingdom
Medizinische Hochschule Hannover, Klinik für Frauenheilkunde und Geburtshilfe
🇩🇪Hannover, Germany
Rotkreuzklinikum München; Frauenklinik
🇩🇪Muenchen, Germany
Marien-Hospital Witten; Frauenklinik Brustzentrum
🇩🇪Witten, Germany
MSKCC @ West Harrison
🇺🇸Harrison, New York, United States
MSKCC @ Commack
🇺🇸Commack, New York, United States
Memorial Sloan-Kettering Cancer Center; Hematology/Oncology
🇺🇸New York, New York, United States
MSKC @ Rockville
🇺🇸Rockville Centre, New York, United States
MD Anderson Cancer Center
🇺🇸Houston, Texas, United States
Kinghorn Cancer Centre; St Vincents Hospital
🇦🇺Darlinghurst, New South Wales, Australia
Victorian Breast and Oncology Care
🇦🇺East Melbourne, Victoria, Australia
Newcastle Mater Misericordiae Hospital; Oncology
🇦🇺Waratah, New South Wales, Australia
Cabrini Medical Centre; Oncology
🇦🇺Malvern, Victoria, Australia
Fiona Stanley Hospital
🇦🇺Murdoch, Western Australia, Australia
LKH-UNIV. KLINIKUM GRAZ; Klinische Abteilung für Onkologie
🇦🇹Graz, Austria
Tiroler Landeskrankenanstalten Ges.M.B.H.; Abt. Für Gynäkologie
🇦🇹Innsbruck, Austria
Ordensklinikum Linz Barmherzige Schwestern ; Abt. f. Allgemein- und Viszeralchirurgie
🇦🇹Linz, Austria
Brustzentrum - Ordination Dr. Wette
🇦🇹St. Veit/Glan, Austria
Lkh Salzburg - Univ. Klinikum Salzburg; Iii. Medizinische Abt.
🇦🇹Salzburg, Austria
Klinikum Kreuzschwestern Wels; Iii. Interne Abt.
🇦🇹Wels, Austria
Medizinische Universität Wien; Univ.Klinik für Chirurgie - Abt. für Allgemeinchirurgie
🇦🇹Wien, Austria
Medizinische Universität Wien; Univ.Klinik für Frauenheilkunde - Klinik für Gynäkologie
🇦🇹Wien, Austria
Krankenhaus Der Stadt Wien-Hietzing; Abt. Für Gynäkologie U. Geburtshilfe
🇦🇹Wien, Austria
Universitätsklinikum Schleswig-Holstein / Campus Lübeck; Klinik für Frauenheilkunde und Geburtshilfe
🇩🇪Lübeck, Germany
Clinica Internacional, Sede San Borja; Unidad de Investigacion de ClÃnica Internacional
🇵🇪Lima, Peru
Cent.Onkologii-Instytut im. M. S-Curie, Klinika Now. Piersi i Chirurgii Rekon
🇵🇱Warszawa, Poland
Complejo Hospitalario Universitario de Santiago (CHUS) ; Servicio de Oncologia
🇪🇸Santiago de Compostela, LA Coruña, Spain
Hospital Univ Vall d'Hebron; Servicio de Oncologia
🇪🇸Barcelona, Spain
Complejo Hospitalario de Jaen-Hospital Universitario Medico Quirurgico; Servicio de Oncologia
🇪🇸Jaen, Spain
Fondazione Oncologia Lago Maggiore
🇨ðŸ‡Locarno, Switzerland
Royal Bournemouth General Hospital; Oncology
🇬🇧Bournemouth, United Kingdom
Frimley Park Hospital; Breast Resaerch Team
🇬🇧Camberley, United Kingdom