Study to Compare Adjuvant Immunotherapy of Bempegaldesleukin Combined With Nivolumab Versus Nivolumab After Complete Resection of Melanoma in Patients at High Risk for Recurrence
- Conditions
- MelanomaMelanoma (Skin)Melanoma Stage IIIMelanoma Stage IV
- Interventions
- Biological: BempegaldesleukinBiological: Nivolumab
- Registration Number
- NCT04410445
- Lead Sponsor
- Nektar Therapeutics
- Brief Summary
The main purpose of this study is to compare the efficacy of bempegaldesleukin plus nivolumab versus nivolumab in patients with completely resected Stage IIIA/B/C/D, or Stage IV cutaneous melanoma who are at high risk for recurrence.
- Detailed Description
The main purpose of this study is to compare the efficacy, as measured by recurrence-free survival (RFS) by blinded independent central review (BICR), of bempegaldesleukin plus nivolumab versus nivolumab in patients with completely resected Stage IIIA (lymph node \[LN\] metastasis \> 1 mm), Stage IIIB/C/D, or Stage IV (American Joint Committee on Cancer \[AJCC\] 8th edition) cutaneous melanoma with no evidence of disease (NED) who are at high risk for recurrence.
Recruitment & Eligibility
- Status
- TERMINATED
- Sex
- All
- Target Recruitment
- 765
- Male or female patients, age 12 years or older at the time of signing the informed consent form (age 18 years or older where local regulations, countries, and/or institutional policies do not allow for patients < 18 years of age (adolescents) to participate). In regions where adolescents are not allowed to participate in the study due to age restrictions, enrolled patients must be ≥ 18 years of age.
- Histologically confirmed Stage IIIA (LN metastasis > 1 mm), IIIB/C/D, or IV (M1a/b/c/d) cutaneous melanoma by AJCC (8th edition) at study entry that has been completely surgically resected within 12 weeks prior to randomization.
- Tumor tissue available from biopsy or resected disease must be provided to central laboratory for PD-L1 status analysis. Must have PD-L1 expression classification for stratification purposes.
- Disease-free status documented by a complete physical examination and imaging studies within 28 days prior to randomization.
- History of ocular/uveal melanoma or mucosal melanoma.
- Active, known or suspected autoimmune disease. Patients with Type I diabetes mellitus, hypothyroidism only requiring hormone replacement, skin disorders not requiring systemic treatment, or conditions not expected to recur in the absence of an external trigger are permitted to enroll.
- Conditions requiring systemic treatment with either corticosteroids (> 10 mg daily prednisone equivalent) or other immunosuppressive medications within 14 days of randomization. Inhaled or topical steroids, and adrenal replacement steroid doses > 10 mg daily prednisone equivalent, are permitted in the absence of active autoimmune disease.
- Prior therapy for melanoma except surgery for the melanoma lesion(s) and/or adjuvant radiation therapy for central nervous system lesions.
- Prior therapy with interferon, talimogene laherparepvec (Imylgic®), interleukin-2 (IL-2) directed therapy, anti-PD-1, anti-PD-L1, anti-PD-L2, anti-CD137, or anti-cytotoxic T lymphocyte-associated protein 4 antibody (including ipilimumab or any other antibody or drug specifically targeting T cell co-stimulation or checkpoint pathways).
- Prior malignancy active within the previous 3 years except for locally potentially curable cancers that have been apparently cured.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Combination of bempegaldesleukin (NKTR-214) + nivolumab Nivolumab Arm A: Participants will receive bempegaldesleukin (NKTR-214) IV in combination with nivolumab every 3 weeks. Nivolumab Nivolumab Arm B: Participants will receive nivolumab IV alone every 4 weeks. Combination of bempegaldesleukin (NKTR-214) + nivolumab Bempegaldesleukin Arm A: Participants will receive bempegaldesleukin (NKTR-214) IV in combination with nivolumab every 3 weeks.
- Primary Outcome Measures
Name Time Method Recurrence-free Survival (RFS) by Blinded Independent Central Review (BICR) of Bempegaldesleukin Plus Nivolumab Versus Nivolumab Alone. Up to 21 months Recurrence-free Survival (RFS) of bempegaldesleukin plus nivolumab versus nivolumab alone is determined based on the disease recurrence date provided by Blinded Independent Central Review (BICR) and is defined as the time between date of randomization and date of first recurrence (local, regional, or distant metastasis by BICR), new primary melanoma (by BICR), or all-cause death, whichever occurs first.
- Secondary Outcome Measures
Name Time Method Programmed Death-Ligand 1 (PD-L1) Expression as a Predictive Biomarker for Recurrence-free Survival (RFS) Up to 21 months The predictive strength of Programmed Death-Ligand 1 (PD-L1) expression as a biomarker will be measured by the endpoint RFS by BICR based on PD-L1 expression level.
Time to Disease Progression After the Next Line of Treatment for Study Patients Following Discontinuation of Bempegaldesleukin Plus Nivolumab Versus Nivolumab Up to 21 months Time to disease progression after the next line of treatment is defined as time from randomization to progression per Investigator after the start of next line of therapy or death, whichever occurs first. Patients who were alive and without progression after the next line of therapy can be censored at last known alive date.
Distant Metastasis-Free Survival (DMFS) by Blinded Independent Central Review (BICR) in Patients Who Are Stage III at Study Entry. Up to 21 months Distant Metastasis-Free Survival (DMFS) by Blinded Independent Central Review (BICR) is defined as the time between the date of randomization and the date of first distant metastasis by BICR or date of death due to any cause, whichever occurs first, in patients who have Stage III melanoma at study entry.
Overall Survival (OS) of Bempegaldesleukin Plus Nivolumab Versus Nivolumab Alone Up to 21 months Overall Survival (OS) is defined as the time between the date of randomization and the date of death due to any cause. Patients who do not have a date of death will be censored on the last date for which a patient was known to be alive.
Distant Metastasis-Free Survival (DMFS) by Investigator in Patients Who Are Stage III at Study Entry. Up to 21 months Distant metastasis-free survival (DMFS) by Investigator is defined as the time between the date of randomization and the date of first distant metastasis by Investigator or date of death due to any cause, in patients who have Stage III melanoma at study entry.
Number of Participants With Treatment-Emergent Adverse Events (TEAEs) Approximately up to 21 months To evaluate safety and tolerability of (NKTR-214) 0.006 mg/kg in combination with nivolumab 360 mg IV infusion (or 4.5 mg/kg IV infusion q3w for patients \<40 kg) and nivolumab 480 mg IV infusion (or 6.0 mg/kg IV infusion q4w for patients \< 40 kg). Treatment-emergent adverse event (TEAE) is defined as an AE that was not present prior to treatment with study drug but appeared following treatment or was present at treatment start date but worsened during treatment-emergent period. The treatment-emergent period is defined as the period from the date of the first dose of study drug up to 30 days after the date of the last dose of study drug or the day prior to the initiation of subsequent anticancer treatment, whichever occurs first.
Changes at 6 Months of Treatment From Baseline in Scores for the Global Health/Quality of Life (GH/QoL) and Physical Functioning Subscales of the European Organisation for Research and Treatment of Cancer Core Quality of Life Questionnaire From baseline, up to approximately 6 months The EORTC QLQ-C30 comprises 30 items (i.e. single questions). 24 of which are aggregated into nine multi-item scales, that is, five functioning scales (physical, role, cognitive, emotional and social), three symptom scales (fatigue, pain and nausea/vomiting) and one global health status scale. Participants rate items and a score ranging from 0 to 100 is calculated. A higher score on the global health status/quality of life scale indicates a better level of functioning, and positive changes from baseline indicate improvement. A change of 5 - 10 points is considered a small change, and a change of 10 - 20 points is considered a moderate change. Due to the study termination, results for the mean change from baseline for GH/QoL and the physical functioning subscale were analyzed at approximately 6 months of treatment.
Recurrence-free Survival (RFS) by Investigator of Bempegaldesleukin Plus Nivolumab Versus Nivolumab Alone. Up to 21 months Recurrence-free Survival by Investigator is defined as the time between the date of randomization and the date of first recurrence (local, regional, or distant metastasis by Investigator), new primary melanoma (by Investigator), or all-cause death, whichever occurs first.
Trial Locations
- Locations (210)
Department of Pharmacy Investigational Drug Services
🇺🇸Dallas, Texas, United States
Southern California Permanente Medical Group
🇺🇸Riverside, California, United States
Texas Oncology (Loop) - USOR
🇺🇸Dallas, Texas, United States
Jefferson University Hospital
🇺🇸Philadelphia, Pennsylvania, United States
University of Texas Southwestern Medical Center
🇺🇸Dallas, Texas, United States
Rush University Medical Center
🇺🇸Chicago, Illinois, United States
The Cleveland Clinic Foundation
🇺🇸Cleveland, Ohio, United States
Massachusetts General Hospital
🇺🇸Boston, Massachusetts, United States
H Lee Moffitt Cancer Center and Research Institute
🇺🇸Pittsburgh, Pennsylvania, United States
Hillman Cancer Center
🇺🇸Pittsburgh, Pennsylvania, United States
Seattle Cancer Care Alliance
🇺🇸Seattle, Washington, United States
Honor Health
🇺🇸Scottsdale, Arizona, United States
Orlando Health Cancer Institute
🇺🇸Longwood, Florida, United States
Hackensack University Medical Center
🇺🇸Hackensack, New Jersey, United States
Charité - Universitätsmedizin Berlin
🇩🇪Berlin, Germany
Universitätsklinikum Essen
🇩🇪Essen, Germany
Chelyabinsk Regional Clinical Oncology Dispensary
🇷🇺Chelyabinsk, Russian Federation
Centre Hospitalier Universitaire (CHU) Amiens-Picardie - Hopital Sud
🇫🇷Amiens, France
Klinikum Mannheim Universitätsklinikum gGmbH
🇩🇪Mannheim, Germany
Affidea Romania SRL
🇷🇴Bucharest, Romania
Clinical Oncology Centre #1
🇷🇺Krasnodar, Russian Federation
Hospital Universitario de Jaen
🇪🇸Jaén, Spain
C.H. Regional Reina Sofia - PPDS
🇪🇸L'Hospitalet De Llobregat, Spain
Hematology Oncology Medical Group of Orange County, Inc.
🇺🇸Orange, California, United States
University of California Irvine
🇺🇸Orange, California, United States
NYU Langone Medical Center
🇺🇸New York, New York, United States
Icon Cancer Care Wesley
🇦🇺Chermside, Australia
Austin Health
🇦🇺Heidelberg, Australia
San Francisco Oncology Associates
🇺🇸San Francisco, California, United States
SCRI Tennessee Oncology Nashville
🇺🇸Nashville, Tennessee, United States
Vanderbilt University Medical Center
🇺🇸Nashville, Tennessee, United States
Utah Cancer Specialists (Salt Lake City)
🇺🇸Salt Lake City, Utah, United States
Washington University School of Medicine
🇺🇸Saint Louis, Missouri, United States
Hospices Civils de Lyon
🇫🇷Pierre-Bénite, France
Rocky Mountain Cancer Centers (Littleton) - USOR
🇺🇸Aurora, Colorado, United States
Nebraska Cancer Specialists
🇺🇸Omaha, Nebraska, United States
Nebraska Methodist Hospital
🇺🇸Omaha, Nebraska, United States
Providence Cancer Institute, Franz Clinic
🇺🇸Portland, Oregon, United States
University of Colorado - Cancer Center - PPDS
🇺🇸Aurora, Colorado, United States
Mayo Clinic - PIN
🇺🇸Rochester, Minnesota, United States
University of Nebraska Medical Center
🇺🇸Omaha, Nebraska, United States
Oregon Health and Science University
🇺🇸Portland, Oregon, United States
Banner MD Anderson Cancer Center
🇺🇸Little Rock, Arkansas, United States
Kaiser Foundation Hospital, Inpatient Pharmacy
🇺🇸Anaheim, California, United States
St. Joseph Heritage Healthcare
🇺🇸Fullerton, California, United States
Kaiser Permanente
🇺🇸San Marcos, California, United States
Emad Ibrahim, MD, Inc
🇺🇸Redlands, California, United States
California Cancer Associates for Research and Excellence
🇺🇸San Marcos, California, United States
Angeles Clinic and Research Institute
🇺🇸Santa Monica, California, United States
John Wayne Cancer Institute
🇺🇸Santa Monica, California, United States
MedStar Georgetown University Hospital
🇺🇸Washington, District of Columbia, United States
Goshen Center For Cancer Care
🇺🇸Goshen, Indiana, United States
Frontier Cancer Center and Blood Institute
🇺🇸Billings, Montana, United States
Atlantic Health System
🇺🇸Morristown, New Jersey, United States
Columbia University Medical Center - PIN
🇺🇸New York, New York, United States
University Hospitals Cleveland Medical Center
🇺🇸Cleveland, Ohio, United States
Duke Cancer Institute
🇺🇸Durham, North Carolina, United States
Icahn School of Medicine at Mount Sinai
🇺🇸New York, New York, United States
Lehigh Valley Physician Group (LVPG) - Hematology Oncology
🇺🇸Allentown, Pennsylvania, United States
Penn State Milton S Hershey Medical Center
🇺🇸Hershey, Pennsylvania, United States
University of Tennessee Medical Center
🇺🇸Knoxville, Tennessee, United States
SCRI Tennessee Oncology Chattanooga
🇺🇸Chattanooga, Tennessee, United States
Prisma Health Cancer Institute
🇺🇸Greenville, South Carolina, United States
MD Anderson Cancer Center
🇺🇸Houston, Texas, United States
University of Virginia Cancer Center
🇺🇸Charlottesville, Virginia, United States
Northwest Medical Specialties
🇺🇸Tacoma, Washington, United States
Royal Adelaide Hospital
🇦🇺Adelaide, Australia
Cairns Hospital
🇦🇺Cairns, Australia
Blue Ridge Cancer Care - USOR
🇺🇸Roanoke, Virginia, United States
Gallipoli Medical Research Foundation
🇦🇺Greenslopes, Australia
Alfred Hospital
🇦🇺Melbourne, Australia
Affinity Clinical Research
🇦🇺Nedlands, Australia
Melanoma Institute Australia
🇦🇺North Sydney, Australia
Sir Charles Gairdner Hospital
🇦🇺Nedlands, Australia
Tasman Oncology Research
🇦🇺Southport, Australia
Gold Coast University Hospital
🇦🇺Southport, Australia
Blacktown Hospital
🇦🇺Westmead, Australia
Princess Alexandra Hospital
🇦🇺Woolloongabba, Australia
Medizinische Universität Graz
🇦🇹Graz, Austria
Ordensklinikum Linz, Krankenhaus der Elisabethinen GmbH
🇦🇹Lienz, Austria
Universitätsklinikum St. Pölten
🇦🇹St.Pölten, Austria
Landeskrankenhaus Feldkirch
🇦🇹Rankweil, Austria
Salzburger Landeskliniken
🇦🇹Salzburg, Austria
Allgemeines Krankenhaus der Stadt Wien
🇦🇹Vienna, Austria
Mou/Mmci - Ppds
🇨🇿Brno, Czechia
Fakultni nemocnice Hradec Kralove
🇨🇿Hradec Králové, Czechia
Nemocnice Na Bulovce
🇨🇿Prague, Czechia
Fakultni nemocnice Olomouc
🇨🇿Olomouc, Czechia
Krajska nemocnice Liberec, a.s.
🇨🇿Liberec, Czechia
Vseobecna Fakultni Nemocnice V Praze
🇨🇿Praha, Czechia
Fakultni nemocnice Ostrava
🇨🇿Ostrava Poruba, Czechia
CHU Angers
🇫🇷Angers, France
Hôpital Saint-André
🇫🇷Bordeau, France
Hôpital Saint Louis
🇫🇷Paris, France
CHU Estaing
🇫🇷Clermont-Ferrand, France
CHRU Lille
🇫🇷Lille, France
CHRU de Tours
🇫🇷Chambray-lès-Tours, France
Hôpital Albert Michallon La Tronche
🇫🇷La Tronche, France
Hôtel Dieu - Nantes
🇫🇷Nantes, France
CHU de Nice
🇫🇷Nice, France
Centre Hospitalier Universitaire de Saint Etienne
🇫🇷Saint-Priest-en-Jarez, France
Groupe Hospitalier Bichat Claude Bernard
🇫🇷Paris, France
Hôpital Charles Nicolle
🇫🇷Rouen, France
Institut Gustave Roussy
🇫🇷Villejuif, France
EDOG - Centre Eugene Marquis Centre Regional de Lutte Contre Le Cancer - PPDS
🇫🇷Rennes, France
Ruhr Universität Bochum
🇩🇪Bochum, Germany
Universitätsklinikum Carl Gustav Carus an der TU Dresden
🇩🇪Dresden, Germany
Elben Klinken Stade - Buxtehude
🇩🇪Buxtehude, Germany
Helios Klinikum Erfurt
🇩🇪Erfurt, Germany
SRH Wald-Klinikum Gera GmbH
🇩🇪Gera, Germany
Universitatsklinikum Halle (Saale)
🇩🇪Halle, Germany
Medizinische Hochschule Hannover
🇩🇪Hannover, Germany
Universitätsklinikum Hamburg Eppendorf
🇩🇪Hamburg, Germany
SLK Kliniken Heilbronn GmbH
🇩🇪Heilbronn, Germany
University Clinic Heidelberg
🇩🇪Heidelberg, Germany
Universitatsklinikum Schleswig-Holstein
🇩🇪Kiel, Germany
Uniklinik Köln
🇩🇪Köln, Germany
Klinikum der Stadt Ludwigshafen gGmbH
🇩🇪Ludwigshafen, Germany
Universitatsklinikum Leipzig
🇩🇪Leipzig, Germany
Universitätsklinik Magdeburg
🇩🇪Magdeburg, Germany
Universitatsklinikum Munster
🇩🇪Münster, Germany
Helios Klinikum Schwerin
🇩🇪Schwerin, Germany
Fachklinik Hornheide
🇩🇪Münster, Germany
University Clinic Regensburg
🇩🇪Regensburg, Germany
Universitätsklinikum Tübingen
🇩🇪Tübingen, Germany
Universitätsklinikum Ulm
🇩🇪Ulm, Germany
Henry Dunant Hospital
🇬🇷Athens, Greece
Universitätsklinikum Würzburg
🇩🇪Würzburg, Germany
Laiko General Hospital of Athens
🇬🇷Ampelokipoi, Greece
Metropolitan Hospital - First Oncology Clinic
🇬🇷Athens, Greece
Metropolitan Hospital - Fourth Oncology Clinic
🇬🇷Athens, Greece
Medical Center of Athens
🇬🇷Maroúsi, Greece
Interbalkan Medical Center of Thessaloniki
🇬🇷Pylaía, Greece
Pepagni Hospital
🇬🇷Heraklion, Greece
Theageneio Anticancer Oncology Hospital of Thessaloniki
🇬🇷Thessaloníki, Greece
Bioclinic Thessaloniki (Galinos clinic)
🇬🇷Thessaloníki, Greece
Papageorgiou General Hospital of Thessaloniki
🇬🇷Thessaloníki, Greece
HaEmek Medical Center
🇮🇱Afula, Israel
Soroka University Medical Centre
🇮🇱Be'er Sheva, Israel
Rambam Medical Center - PPDS
🇮🇱Haifa, Israel
Hadassah Medical Center - PPDS
🇮🇱Jerusalem, Israel
Rabin Medical Center - PPDS
🇮🇱Petah tikva, Israel
Sheba Medical Center - PPDS
🇮🇱Ramat Gan, Israel
IRCCS Giovanni Paolo II Istituto Oncologico
🇮🇹Bari, Italy
Ospedale Policlinico San Martino
🇮🇹Genova, Italy
Istituto Scientifico Romagnolo Per Lo Studio E La Cura Dei Tumori IRST - PPDS
🇮🇹Meldola, Italy
Fondazione del Piemonte per l'Oncologia (IRCCS)
🇮🇹Candiolo, Italy
ASST Papa Giovanni XXIII - Azienda Ospedaliera Papa Giovanni XXIII
🇮🇹Bergamo, Italy
Istituto Europeo Di Oncologia
🇮🇹Milano, Italy
Istituto Nazionale Per Lo Studio E La Cura Dei Tumori Fondazione Giovanni Pascale
🇮🇹Napoli, Italy
Istituto Nazionale Dei Tumori
🇮🇹Milano, Italy
Istituto Oncologico Veneto - I.R.C.C.S.
🇮🇹Padova, Italy
VU Medisch Centrum
🇳🇱Amsterdam, Netherlands
Azienda Ospedaliero Universitaria Di Modena Policlinico
🇮🇹Modena, Italy
Azienda Ospedaliera Universitaria Senese
🇮🇹Siena, Italy
Zuyderland Medisch Centrum
🇳🇱Heerlen, Netherlands
Hospital CUF Tejo
🇵🇹Lisboa, Portugal
Leiden University Medical Center
🇳🇱Leiden, Netherlands
Isala Klinieken
🇳🇱Zwolle, Netherlands
Medisch Centrum Leeuwarden
🇳🇱Leeuwarden, Netherlands
Radboud University Nijmegen Medical Centre
🇳🇱Nijmegen, Netherlands
Universitair Medisch Centrum Utrecht
🇳🇱Utrecht, Netherlands
Maxima Medisch Centrum
🇳🇱Veldhoven, Netherlands
Christchurch Hospital
🇳🇿Christchurch, New Zealand
Tauranga Hospital
🇳🇿Tauranga, New Zealand
Dunedin Hospital
🇳🇿Dunedin, New Zealand
Auckland City Hospital
🇳🇿Heidelberg, New Zealand
Centrum Onkologii im. Prof. Franciszka Lukaszczyka w Bydgoszczy
🇵🇱Bydgoszcz, Poland
Wellington Hospital
🇳🇿Wellington, New Zealand
Bialostockie Centrum Onkologii im. Marii Sklodowskiej-Curie w Bialymstoku
🇵🇱Białystok, Poland
NZOZ NEUROMED M. I M. Nastaj Spolka Partnerska
🇵🇱Lublin, Poland
Uniwersyteckie Centrum Kliniczne
🇵🇱Gdańsk, Poland
Centro Hospitalar E Universitário de Coimbra EPE
🇵🇹Coimbra, Portugal
Szpital Kliniczny im. Heliodora Swiecickiego w Poznaniu
🇵🇱Poznań, Poland
Centro Hospitalar Lisboa Norte, E.P.E. - Hospital de Santa Maria
🇵🇹Lisboa, Portugal
Instituto Português de Oncologia de Lisboa Francisco Gentil, E.P.E.
🇵🇹Lisbon, Portugal
Instituto Portugues de Oncologia Do Porto Francisco Gentil Epe - PPDS
🇵🇹Porto, Portugal
S.C. Medisprof SRL
🇷🇴Cluj-Napoca, Romania
S.C. Onco Clinic Consult SA
🇷🇴Craiova, Romania
Oncology Center Sfantul Nectarie
🇷🇴Craiova, Romania
Kursk Regional Oncology Centre
🇷🇺Kursk, Russian Federation
Krasnoyarsk Regional Oncology Center n.a. A.I. Kryzhanovskiy
🇷🇺Krasnoyarsk, Russian Federation
PMI Euromedservice
🇷🇺Pushkin, Russian Federation
Ryazan Regional Clinical Oncology Dispensary
🇷🇺Ryazan', Russian Federation
Railway Clinical Hospital JSC RZhD
🇷🇺Saint Petersburg, Russian Federation
FSBI National Medical Research Center of Oncology n.a. N.N.Petrov of MHRF
🇷🇺Saint Petersburg, Russian Federation
Hospital Universitario Germans Trias i Pujol
🇪🇸Badalona, Spain
Regional Clinical Oncology Hospital
🇷🇺Yaroslavl, Russian Federation
Hospital Universitario A Coruña
🇪🇸A Coruña, Spain
Hospital de La Santa Creu i Sant Pau
🇪🇸Barcelona, Spain
Hospital Universitari Dexeus - Grupo Quironsalud
🇪🇸Barcelona, Spain
Hospital Universitario Vall d'Hebron - PPDS
🇪🇸Barcelona, Spain
ICO l'Hospitalet - Hospital Duran i Reynals
🇪🇸Córdoba, Spain
Hospital Universitario Virgen de La Arrixaca
🇪🇸El Palmar, Spain
Hospital Universitario 12 de Octubre
🇪🇸Madrid, Spain
Royal Cornwall Hospital
🇬🇧Truro, United Kingdom
Hospital Universitario Virgen Macarena
🇪🇸Sevilla, Spain
Hospital General Universitario Gregorio Maranon
🇪🇸Madrid, Spain
Addenbrooke's Hospital
🇬🇧Cambridge, United Kingdom
Hospital Universitario Virgen de la Victoria
🇪🇸Málaga, Spain
Leicester Royal Infirmary
🇬🇧Leicester, United Kingdom
Consorcio Hospital General Universitario de Valencia
🇪🇸Valencia, Spain
Nottingham City Hospital
🇬🇧Nottingham, United Kingdom
Inova Schar Cancer Institute
🇺🇸Fairfax, Virginia, United States
Hospital Universitario HM Sanchinarro - CIOCC
🇪🇸Madrid, Spain
University of Kentucky
🇺🇸Lexington, Kentucky, United States
Ochsner Clinic Foundation
🇺🇸New Orleans, Louisiana, United States
University of North Carolina at Chapel Hill
🇺🇸Chapel Hill, North Carolina, United States
University of Wisconsin
🇺🇸Madison, Wisconsin, United States
Castle Hill Hospital
🇬🇧Cottingham, United Kingdom