Safety and Efficacy Study of Abraxane as Maintenance Treatment After Abraxane Plus Carboplatin in 1st Line Stage IIIB / IV Squamous Cell Non-small Cell Lung Cancer

Phase 3

Completed

Conditions: Squamous Cell Carcinoma, Non-Small-Cell Lung

Interventions: Drug: Abraxane (Induction)
Drug: Carboplatin (Induction)
Drug: Abraxane (Maintenance)
Other: Best Supportive Care (Maintenance)

Registration Number: NCT02027428

Lead Sponsor: Celgene

Brief Summary: Maintenance treatment of advanced stage squamous cell NSCLC.

Phase III, randomized, open-label, multi-center study of nab-paclitaxel with best supportive care (BSC) or BSC alone as maintenance treatment after response or stable disease (SD) with nab-paclitaxel plus carboplatin as induction in subjects with stage IIIB/IV squamous cell NSCLC.

Subjects who discontinued treatment from the maintenance part for any reason other than withdrawal of consent, lost to follow-up, or death, were entered into a Follow-up period that had a visit 28 days after progression or discontinuation.

Those who entered Follow-up without progression continued with follow-up scans according to standard of care (SOC) until documentation of progression of disease. Additionally, subjects were followed for OS by phone approximately every 90 days for a minimum of 18 months, for up to approximately 5 years after the last subject was randomized.

Detailed Description: The sponsor used 15 Sep 2017 as the database cut-off date.

Recruitment & Eligibility

Status: COMPLETED

Sex: All

Target Recruitment: 427

Inclusion Criteria

Age ≥ 18 years of age at the time of signing the Informed Consent Form.
Understand and voluntarily provide written consent to the Informed Consent Form prior to conducting any study related assessments/procedures.
Able to adhere to the study visit schedule and other protocol requirements

Disease Specific
Histologically or cytologically confirmed Stage IIIB or IV squamous cell Non Small Cell Lung Cancer at study entry.
No other current active malignancy requiring anticancer therapy.
Radiographically documented measurable disease at study entry (as defined by the Response Evaluation Criteria In Solid Tumors [RECIST] v1.1 criteria).
No prior chemotherapy for the treatment of metastatic disease at study entry. Adjuvant chemotherapy is permitted providing cytotoxic chemotherapy was completed 12 months prior to starting the study and without disease recurrence.
Absolute neutrophil count ≥ 1500 cells/mm^3.
Platelets ≥ 100,000 cells/mm^3.
Hemoglobin ≥ 9 g/dL.
Aspartate transaminase/serum glutamic oxaloacetic transaminase, alanine transaminase/serum glutamic pyruvic transaminase ≤ 2.5 × upper limit of normal range or ≤ 5.0 × upper limit of normal range if liver metastases.
Total bilirubin ≤ 1.5 × upper limit of normal range except in cases of Gilbert's disease and liver metastases.
Creatinine ≤ 1.5 mg/dL.
Expected survival of > 12 weeks for the Induction part of the study.
Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1.
For Maintenance part of the study, subjects must have received at least one dose of nab-paclitaxel in each of the 4 cycles during Induction

Pregnancy
Females of childbearing potential [defined as a sexually mature woman who (1) have not undergone hysterectomy (the surgical removal of the uterus) or bilateral oophorectomy (the surgical removal of both ovaries) or (2) have not been naturally postmenopausal for at least 24 consecutive months (i.e., has had menses at any time during the preceding 24 consecutive months)] must:
1. agree to take a pregnancy test prior to starting study medication and throughout the study participation.
2. commit to complete abstinence from heterosexual contact, or agree to use medical doctor-approved contraception throughout the study without interruption, and while receiving study medication or for a longer period if required by local regulations.
Male subjects must:

c. agree to complete abstinence from heterosexual contact or use a condom during sexual contact with a female of child bearing potential while receiving study medication and within 6 months after last dose of study medication, even if he has undergone a successful vasectomy.
Females must abstain from breastfeeding during study participation and 3 months after IP discontinuation.

Exclusion Criteria

The presence of any of the following will exclude a subject from enrollment into the Induction and Maintenance parts of the study (except if specified at study entry only):

Evidence of active brain metastases, including leptomeningeal involvement (prior evidence of brain metastasis are permitted only if treated and stable and off therapy for ≥ 4 weeks prior to first dose of study drug).
Only evidence of disease is non-measurable at study entry.
Preexisting peripheral neuropathy of Grade 2, 3, or 4 (per Common Terminology Criteria for Adverse Events v4.0).
Venous thromboembolism within 6 months prior to signing Informed Consent Form.
Current congestive heart failure (New York Heart Association class II-IV).
History of the following within 6 months prior to first administration of a study drug: 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 clinically significant electrocardiogram (ECG) abnormality, cerebrovascular accident, transient ischemic attack, or seizure disorder.
Treatment with any investigational product within 28 days prior to signing Informed Consent Form.
History of allergy or hypersensitivity to nab-paclitaxel or carboplatin.
Currently enrolled in any other clinical protocol or investigational trial that involved administration of experimental therapy and/or therapeutic devices.
Any other clinically significant medical condition and/or organ dysfunction that will interfere with the administration of the therapy according to this protocol.
Subject has any other malignancy within 5 years prior to randomization. Exceptions include the following: squamous cell carcinoma of the skin, in-situ carcinoma of the cervix, uteri, non-melanomatous skin cancer, carcinoma in situ of the breast, or incidental histological finding of prostate cancer (TNM stage of T1a or T1b) - all treatments that should have been completed 6 months prior to signing informed consent form (ICF).
Subject has received radiotherapy ≤ 4 weeks or limited field radiation for palliation ≤ 2 weeks prior to starting investigational product (IP), and/or from whom ≥ 30% of the bone marrow was irradiated. Prior radiation therapy to a target lesion is permitted only if there has been clear progression of the lesion since radiation was completed.
Pregnant and nursing females.

Study & Design

Study Type: INTERVENTIONAL

Study Design: CROSSOVER

Arm && Interventions

Group	Intervention	Description
Abraxane + Best Supportive Care (BSC)	Carboplatin (Induction)	Dosing will occur in two phases - induction and maintenance. During induction, the subject will receive Abraxane plus carboplatin as standard of care. At the end of 4 cycles, if the subject has a complete response, partial response, or stable disease, he/she will continue on to the maintenance phase. Maintenance dosing on this arm includes Abraxane plus best supportive care.
Abraxane + Best Supportive Care (BSC)	Best Supportive Care (Maintenance)	Dosing will occur in two phases - induction and maintenance. During induction, the subject will receive Abraxane plus carboplatin as standard of care. At the end of 4 cycles, if the subject has a complete response, partial response, or stable disease, he/she will continue on to the maintenance phase. Maintenance dosing on this arm includes Abraxane plus best supportive care.
Best Supportive Care (BSC)	Best Supportive Care (Maintenance)	Dosing will occur in two phases - induction and maintenance. During induction, the subject will receive Abraxane plus carboplatin as standard of care. At the end of 4 cycles, if the subject has a complete response, partial response, or stable disease, he/she will continue on to the maintenance phase. Maintenance dosing on this arm includes best supportive care only.
Abraxane + Best Supportive Care (BSC)	Abraxane (Maintenance)	Dosing will occur in two phases - induction and maintenance. During induction, the subject will receive Abraxane plus carboplatin as standard of care. At the end of 4 cycles, if the subject has a complete response, partial response, or stable disease, he/she will continue on to the maintenance phase. Maintenance dosing on this arm includes Abraxane plus best supportive care.
Best Supportive Care (BSC)	Abraxane (Induction)	Dosing will occur in two phases - induction and maintenance. During induction, the subject will receive Abraxane plus carboplatin as standard of care. At the end of 4 cycles, if the subject has a complete response, partial response, or stable disease, he/she will continue on to the maintenance phase. Maintenance dosing on this arm includes best supportive care only.
Best Supportive Care (BSC)	Carboplatin (Induction)	Dosing will occur in two phases - induction and maintenance. During induction, the subject will receive Abraxane plus carboplatin as standard of care. At the end of 4 cycles, if the subject has a complete response, partial response, or stable disease, he/she will continue on to the maintenance phase. Maintenance dosing on this arm includes best supportive care only.
Abraxane + Best Supportive Care (BSC)	Abraxane (Induction)	Dosing will occur in two phases - induction and maintenance. During induction, the subject will receive Abraxane plus carboplatin as standard of care. At the end of 4 cycles, if the subject has a complete response, partial response, or stable disease, he/she will continue on to the maintenance phase. Maintenance dosing on this arm includes Abraxane plus best supportive care.

Primary Outcome Measures

Name	Time	Method
Kaplan-Meier Estimate of Progression-Free Survival (PFS) From Randomization Into Maintenance	From the date of randomization to the date of disease progression or death of any cause; up to data cut off date of 15 September 2017; up to 27.6 months	Progression-free survival is defined as the time in months from the date of randomization to the date of disease progression based on the investigator's assessment according to Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1 criteria (documented by computerized axial tomography \[CT scan\], not including symptomatic deterioration) or death (any cause) on or prior to 01 Aug 2019. RECIST 1.1 Definition: - Complete response (CR) -disappearance of all target lesions; - Partial response (PR) -at least a 30% decrease in the sum of diameters of target lesions from baseline - Stable disease (SD) -neither sufficient shrinkage to qualify for partial response (PR) nor sufficient increase of lesions to qualify for progressive disease (PD) - Progressive Disease (PD) - At least a 20% increase in the sum of diameters of target lesions from nadir, and/or the appearance of new lesions.

Secondary Outcome Measures

Name	Time	Method
Kaplan-Meier Estimate of Overall Survival (OS) From Randomization Into Maintenance	From the date of randomization to death from any cause; up to 01 August 2019; survival follow up was 55.89 months	Overall survival was defined as the duration in months between randomization and death from any cause. Participants who were still alive as of the clinical cut-off date had their OS censored at the date of last contact or clinical cut-off (01 August 2019 whichever was earlier. The last contact date was the date of the last record in the database, or if the subject was lost to follow-up, the last known date that the subject was alive.
Percentage of Participants Who Achieved a Confirmed Overall Response of Complete Response or Partial Response (Overall Response Rate) Over Entire Study	Day 1 of treatment in the induction period and subsequent anticancer therapy, death or discontinuation up to 01 August 2019; maximum treatment duration was 234.1 weeks for entire study	Overall response was defined as the percentage of participants with a confirmed assessment of complete response (CR) or partial response (PR) according to RECIST 1.1 criteria and confirmed in no less than 28 days. The 95% confidence interval (CI) was calculated using Clopper-Pearson method. RECIST 1.1 Definition: - Complete response-disappearance of all target lesions; any pathological lymph nodes (whether target or non target) must have reduction in short axis to \< 10 mm. - Partial response-at least a 30% decrease in the sum of diameters of target lesions from baseline.
Kaplan-Meier Estimate of Progression-Free Survival (PFS) Over Entire Study	Between Day 1 of the Induction Part through to the date of disease progression or death; up to 01 August 2019; the maximum treatment duration was 234.1 weeks for entire study	PFS was defined as the time in months from Day 1 of treatment for the Induction part to the date of disease progression according to RECIST 1.1 criteria (documented by CT-scan, not including symptomatic deterioration) or death (any cause) on or prior to 01 August 2019, whichever occurred earlier. RECIST 1.1 Definition: - Progressive Disease (PD) - At least a 20% increase in the sum of diameters of target lesions from nadir; the sum must also demonstrate an absolute increase of at least 5 mm. The appearance of new lesions is also considered progression.
Kaplan-Meier Estimate of Overall Survival (OS) Over Entire Study	Between Day 1 of treatment in the Induction Part to death from any cause; up to 01 August 2019; survival follow up was 55.89 months	Overall survival was defined as the time in months from Day 1 of treatment for the Induction part to death from any cause. Subjects who were alive at the time of analysis had their OS censored at the date or last contact of 01 August 2019, whichever was earlier. The last contact date was the date of the last record in the database, or if the subject was lost to follow-up, the last known date that the subject was alive.
Percentage of Participants Who Achieved a Confirmed Overall Response of Complete Response or Partial Response (Overall Response Rate) In Maintenance Beyond the Response in Induction	For the induction period the maximum treatment was 19 weeks for the maintenance period the maximum treatment was 150 weeks.	Overall response in the maintenance period was defined as the percentage of participants who showed an improvement in best overall response from stable disease (SD) or partial response (PR) during Induction to a Complete Response (CR) or PR during Maintenance according to RECIST 1.1 criteria and confirmed in no less than 28 days. Evaluation takes as reference the lesion measurement or status at the last tumor assessment before randomization to Maintenance. The 95% CI was calculated using Clopper-Pearson method. RECIST 1.1 Definition: - Complete response-disappearance of all target lesions; any pathological lymph nodes (whether target or non-target) must have reduction in short axis to \< 10 mm. - Partial response-at least a 30% decrease in the sum of diameters of target lesions from baseline. - Stable disease-neither sufficient shrinkage to qualify for PR nor sufficient increase of lesions to qualify for progressive disease.
Percentage of Participants Who Achieved Disease Control (Disease Control Rate) by Investigator Assessment During Induction and Over the Entire Study	Induction is from Day 1 to a maximum treatment time of 19 weeks; entire study from Day 1 induction through maintenance up to PD; up to 01 August 2019; maximum treatment duration was 234.1 weeks for entire study	Disease control rate was defined as the percentage of participants who had radiologic CR, PR or SD for \>= 6 weeks according to RECIST 1.1 criteria as determined by the investigator. Only participants with a confirmed CR/PR are included in this summary. Two timeframes are offered: - Time to confirmed response within the Induction timeframe. - Time to Confirmed Response Over the Entire Study, i.e. the time from Day 1 of treatment in Induction to the first occurrence of confirmed CR/PR any time during the study. RECIST 1.1 Definition: - CR- disappearance of all target lesions; any pathological lymph nodes (whether target or non target) must have reduction in short axis to \< 10 mm. - PR- at least a 30% decrease in the sum of diameters of target lesions from baseline; - SD- neither sufficient shrinkage to qualify for PR nor sufficient increase of lesions to qualify for PD. The 95% CI was calculated using Clopper-Pearson method.
Time to Confirmed Response During Induction and Over the Entire Study	Induction is from Day 1 to a maximum treatment time of 19 weeks; entire study from Day 1 Induction through Maintenance up to PD; up to 01 August 2019; maximum treatment duration was 234.1 weeks for entire study	Time to confirmed complete or partial response (CR/PR) is defined as the time from day 1 of treatment in Induction to the first occurrence of confirmed CR/PR. Two timeframes are offered: - Time to confirmed response within the Induction timeframe. - Time to Confirmed Response Over the Entire Study, i.e. the time from Day 1 of treatment in Induction to the first occurrence of confirmed CR/PR any time during the study. Only participants with a confirmed CR or PR are included in this summary.
Kaplan-Meier Estimate for Duration of Response Over the Entire Study	Between Day 1 of the Induction Period through to the date of disease progression or death; up to 01 August 2019; maximum treatment duration was 234.1 weeks for entire study.	Duration of overall response was measured from the time criteria were first met for CR/PR until the first date the recurrent or progressive disease (PD) was radiologically documented. Participants who did not have PD after the response were censored on the date of last tumor assessment. If a participant died before PD, the participant was censored on the date of death.
Participants With Treatment-Emergent Adverse Events (TEAEs) in the Induction Period	Day 1 of Induction up to Week 23 (maximum treatment in Induction plus 4 weeks if not continuing into Maintenance)	TEAE in the Induction part is defined as any adverse event (AE) with an onset on or after Day 1 of treatment for the Induction part, and on or before the day of randomization for subjects who entered into the Maintenance part, or, for subjects who did not enter into the Maintenance part, before the treatment discontinuation date plus 28 days or any serious AE which occurred thereafter but was determined to be related to any study drug by the investigator. 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.
Participants With Treatment-Emergent Adverse Events (TEAEs) Over the Entire Study	From Day 1 up to 01 August 2019; (maximum treatment length plus 28 days); the maximum treatment duration was 234.1 weeks for entire study	TEAE over entire study is defined as any adverse event (AE) with an onset on or after Day 1 of treatment for the Induction part, and before the treatment discontinuation date plus 28 days, or any serious AE which occurred thereafter but was determined to be related to any study drug by the investigator. 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.

Trial Locations

Locations (116): SUNY Upstate Medical University
🇺🇸
Syracuse, New York, United States
Hematology and Oncology Associates, Inc.
🇺🇸
Canton, Ohio, United States
University of Chicago
🇺🇸
Chicago, Illinois, United States
University Hospitals Case Medical Center
🇺🇸
Cleveland, Ohio, United States
University of Pittsburgh Medical Center - Cancer Pavilion
🇺🇸
Pittsburgh, Pennsylvania, United States
The Mark H. Zangmeister Center
🇺🇸
Columbus, Ohio, United States
Abramson Cancer Center
🇺🇸
Philadelphia, Pennsylvania, United States
Indiana University Medical Center
🇺🇸
Indianapolis, Indiana, United States
Investigative Clinical Research of Indiana, LLC
🇺🇸
Indianapolis, Indiana, United States
Massachusetts General Hospital
🇺🇸
Boston, Massachusetts, United States
Swedish Cancer Institute
🇺🇸
Seattle, Washington, United States
Beth Israel Deaconess Medical Center
🇺🇸
Boston, Massachusetts, United States
Oncology Hematology Care, Inc.
🇺🇸
Cincinnati, Ohio, United States
Houston Methodist Cancer Center
🇺🇸
Houston, Texas, United States
UT Health Oncology
🇺🇸
Houston, Texas, United States
Millenium Oncology
🇺🇸
Houston, Texas, United States
Arizona Clinical Research Center
🇺🇸
Tucson, Arizona, United States
University Cancer and Blood Center, LLC
🇺🇸
Athens, Georgia, United States
Cancer Care Associates of Fresno Medical Group Inc
🇺🇸
Fresno, California, United States
Palo Verde Hematology Oncology, Ltd.
🇺🇸
Glendale, Arizona, United States
Eastern Maine Medical Center
🇺🇸
Brewer, Maine, United States
Cancer Center of Kansas (MAT)
🇺🇸
Wichita, Kansas, United States
Lynn Cancer Institute
🇺🇸
Boca Raton, Florida, United States
City of Hope Cancer Center
🇺🇸
Duarte, California, United States
University of California San Diego Moores Cancer Center
🇺🇸
La Jolla, California, United States
Clearview Cancer Institute Oncology Specialties, P.C
🇺🇸
Huntsville, Alabama, United States
Memorial Cancer Institute West
🇺🇸
Pembroke Pines, Florida, United States
Genesis Cancer Center
🇺🇸
Hot Springs, Arkansas, United States
Joliet Oncology-Hematology Associates, Ltd.
🇺🇸
Joliet, Illinois, United States
Kansas University Medical Center
🇺🇸
Westwood, Kansas, United States
VA Palo Alto Health Care System
🇺🇸
Palo Alto, California, United States
Florida Cancer Specialists
🇺🇸
Saint Petersburg, Florida, United States
Illinois Cancer Specialists
🇺🇸
Niles, Illinois, United States
Mercy Clinic Oklahoma Communities, Inc.
🇺🇸
Oklahoma City, Oklahoma, United States
Sarah Cannon Cancer Center
🇺🇸
Nashville, Tennessee, United States
Azienda Ospedaliero Universitaria Di Bologna - Policlinico S.Orsola Malpighi
🇮🇹
Bologna, Italy
Rocky Mountain Cancer Centers, LLP
🇺🇸
Denver, Colorado, United States
Moffitt Cancer Center
🇺🇸
Tampa, Florida, United States
Ocala Oncology Center
🇺🇸
Ocala, Florida, United States
St Joseph Oncology
🇺🇸
Saint Joseph, Missouri, United States
Moses H. Cone Regional Cancer Center
🇺🇸
Greensboro, North Carolina, United States
Clinical Trials and Research Associates
🇺🇸
Montebello, California, United States
University of Miami Miller School of Medicine Jackson Memorial Hospital
🇺🇸
Miami, Florida, United States
Watson Clinic, LLP Center for Cancer Care and Research
🇺🇸
Lakeland, Florida, United States
Kentucky Cancer Clinic
🇺🇸
Hazard, Kentucky, United States
Center For Cancer and Blood Disorders
🇺🇸
Bethesda, Maryland, United States
Meritus Medical Center
🇺🇸
Hagerstown, Maryland, United States
Detroit Clinical Research Center
🇺🇸
Farmington Hills, Michigan, United States
Mercy Medical Research Institute
🇺🇸
Springfield, Missouri, United States
Englewood Hospital and Medical Center
🇺🇸
Englewood, New Jersey, United States
Hematology-Oncology Associates of NNJ, P
🇺🇸
Morristown, New Jersey, United States
Washington University School of Medicine
🇺🇸
Saint Louis, Missouri, United States
New York Oncology Hematology P.C.
🇺🇸
Albany, New York, United States
Rochester General Hospital
🇺🇸
Rochester, New York, United States
Clinical Research Alliance
🇺🇸
Lake Success, New York, United States
Icahn School of Medicine at Mount Sinai Medical Center
🇺🇸
New York, New York, United States
NYU Langone Medical Center
🇺🇸
New York, New York, United States
Beth Israel Medical Centers
🇺🇸
New York, New York, United States
Southeastern Medical Oncology Center
🇺🇸
Goldsboro, North Carolina, United States
Tri-County Hematology and Oncology Associates
🇺🇸
Massillon, Ohio, United States
Toledo Community Oncology Program
🇺🇸
Toledo, Ohio, United States
University of Oklahoma Peggy and Charles Stephenson Cancer Center
🇺🇸
Oklahoma City, Oklahoma, United States
University of Pennsylvania Health Systems
🇺🇸
Philadelphia, Pennsylvania, United States
Allegheny Singer Research Institute
🇺🇸
Pittsburgh, Pennsylvania, United States
Greenville Hospital System
🇺🇸
Greenville, South Carolina, United States
Chattanooga Oncology Hematology Care
🇺🇸
Chattanooga, Tennessee, United States
Associates in Oncology and Hematology
🇺🇸
Chattanooga, Tennessee, United States
Thompson Cancer Survival Center
🇺🇸
Knoxville, Tennessee, United States
Vanderbilt University Medical Center
🇺🇸
Nashville, Tennessee, United States
TX Onc, PA- Beaumont
🇺🇸
Beaumont, Texas, United States
Brooke Army Medical Center Francis Street Medical Center
🇺🇸
Fort Sam Houston, Texas, United States
Center for Cancer and Blood Disorders
🇺🇸
Fort Worth, Texas, United States
TX Onc Tyler Cancer Center
🇺🇸
Tyler, Texas, United States
Kliniken der Stadt Koln gGmbH - Krankenhaus Merheim
🇩🇪
Koln, Germany
Columbia Basin Hematology and Oncology
🇺🇸
Kennewick, Washington, United States
St Mary's Medical Center
🇺🇸
Huntington, West Virginia, United States
Medical College of Wisconsin
🇺🇸
Milwaukee, Wisconsin, United States
Universitatsklinikum Halle Saale
🇩🇪
Halle, Germany
West Virginia University, Berkeley Medical Center, Cancer and Infusion Center
🇺🇸
Morgantown, West Virginia, United States
St. Antonius Hospital
🇩🇪
Eschweiler, Germany
Diakoniekrankenhaus Halle
🇩🇪
Halle (Saale), Germany
Asklepios Fachkliniken Muenchen Gauting
🇩🇪
Gauting, Germany
Lungenklinik Lostau gGmbH
🇩🇪
Lostau, Germany
Klinik Loewenstein gGmbH
🇩🇪
Loewenstein, Germany
Thorax Klinik
🇩🇪
Heidelberg, Germany
Universitat Des Saarlandes
🇩🇪
Homburg, Germany
Universitatsklinikum Ulm
🇩🇪
Ulm, Germany
Azienda Ospedaliera di Rilievo Nazionale e di Alta Specialita San Giuseppe Moscati
🇮🇹
Avellino, Italy
Istituto Nazionale Per La Ricerca Sul Cancro
🇮🇹
Genova, Italy
Azienda Ospedaliera San Gerardo
🇮🇹
Monza, Italy
Azienda Ospedaliera Istituti Ospitalieri di Cremona
🇮🇹
Cremona, Italy
Istituto Europeo di Oncologia
🇮🇹
Milano, Italy
Istituto Nazionale Tumori Regina Elena di Roma
🇮🇹
Roma, Italy
Intituto Catalán de Oncología de Girona
🇪🇸
Girona, Spain
Hospital Clinico San Carlos
🇪🇸
Madrid, Spain
Ospedale San Vincenzo Taormina
🇮🇹
Taormina, Italy
Hospital Universitario Puerta de Hierro Majadahonda
🇪🇸
Majadahonda, Madrid, Spain
Hospital Universitario 12 de Octubre
🇪🇸
Madrid, Spain
Hospital Universitario Central de Asturias
🇪🇸
Oviedo, Spain
Hospital Universitari i Politecnic La Fe de Valencia
🇪🇸
Valencia, Spain
Hospital General Universitario de Valencia
🇪🇸
Valencia, Spain
Hospital Universitario Lozano Blesa
🇪🇸
Zaragoza, Spain
Churchhill Hospital
🇬🇧
Oxford, United Kingdom
Royal Marsden Hospital
🇬🇧
Sutton, United Kingdom
Maine Research Associates
🇺🇸
Auburn, Maine, United States
Western Michigan Cancer Center
🇺🇸
Kalamazoo, Michigan, United States
Carolinas Medical Center
🇺🇸
Charlotte, North Carolina, United States
Erie Regional Cancer Center
🇺🇸
Erie, Pennsylvania, United States
Yale Cancer Center
🇺🇸
New Haven, Connecticut, United States
Orlando Health, Inc
🇺🇸
Orlando, Florida, United States
Norton Cancer Institute Louisville Oncology
🇺🇸
Louisville, Kentucky, United States
LSU Health Sciences Center
🇺🇸
New Orleans, Louisiana, United States
Norton Healthcare
🇺🇸
Louisville, Kentucky, United States
University of Louisville, J.G. Brown Cancer Center
🇺🇸
Louisville, Kentucky, United States
Montefiore Medical Center Albert Einstein Cancer Center
🇺🇸
Bronx, New York, United States
Montefiore Medical Center
🇺🇸
Bronx, New York, United States