MedPath

An Efficacy and Safety Study of Oral Netupitant and Palonosetron for the Prevention of Nausea and Vomiting

Phase 3
Completed
Conditions
Chemotherapy-Induced Nausea and Vomiting
Interventions
Registration Number
NCT01339260
Lead Sponsor
Helsinn Healthcare SA
Brief Summary

NETU-08-18 is a two-arm clinical study assessing efficacy and safety of a single oral dose of netupitant and palonosetron, two antiemetic drugs, versus oral palonosetron, both given with oral dexamethasone. The objective of the study is to demonstrate that netupitant and palonosetron are more effective than palonosetron alone, to prevent nausea and vomiting induced by moderately emetogenic cancer chemotherapy after administration of repeated cycles of chemotherapy.

Detailed Description

NETU-08-18 is a two-arm clinical study assessing efficacy and safety of a single oral dose of netupitant and palonosetron, two antiemetic drugs, versus oral palonosetron, both given with oral dexamethasone. Study is organised in two phases: cycle-1 and a multi-cycle extension. Safety assessment is performed separately in cycle 1 (arm 1 and arm 2) and in multi-cycle extension (arm 3 and arm 4).

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
1455
Inclusion Criteria
  • Naïve to cytotoxic chemotherapy. Previous biological or hormonal therapy will be permitted.
  • Scheduled to receive first course of an anthracycline and cyclophosphamide containing moderately emetogenic chemotherapy (MEC) regimen for the treatment of a solid malignant tumor: cyclophosphamide I.V. (500 to 1500 mg/m2) and I.V. doxorubicin (more or equal to 40 mg/m2) or cyclophosphamide I.V. (500 to 1500 mg/m2) and I.V. epirubicin (more or equal to 60 mg/m2).
  • If scheduled to receive chemotherapy agents of minimal to low emetogenic potential they could be given on any day.
  • Eastern Cooperative Oncology Group (ECOG) Performance Status of 0, 1, or 2.
  • Female patients of either non-childbearing potential or child-bearing potential with a commitment to use contraceptive methods throughout the clinical trial
  • Hematologic and metabolic status adequate for receiving a moderately emetogenic regimen based on laboratory criteria (Total Neutrophils,Platelets, Bilirubin, Liver enzymes, Serum Creatinine or Creatinine Clearance)

The following inclusion criteria must be checked prior inclusion at each cycle of the Multiple-Cycle Extension:

  • Participation in the study during the next cycle of chemotherapy is considered appropriate by the investigator Satisfactory study compliance in the preceding cycle of chemotherapy and related study procedures.
  • Scheduled to receive the same chemotherapy regimen as cycle 1
  • Adequate hematologic and metabolic status as defined for cycle 1
Exclusion Criteria
  • If female, pregnant or lactating.
  • Current use of illicit drugs or current evidence of alcohol abuse.
  • Scheduled to receive any highly emetogenic chemotherapy (HEC) from Day 1 to Day 5 or moderately emetogenic chemotherapy (MEC) from Day 2 to Day 5 following the allowed MEC regimen.
  • Received or is scheduled to receive radiation therapy to the abdomen or the pelvis within 1 week prior to Day 1 or between Days 1 to 5 in cycle 1.
  • Any vomiting, retching, or mild nausea within 24 hours prior to Day 1.
  • Symptomatic primary or metastatic central nervous system (CNS) malignancy.
  • Active peptic ulcer disease, gastrointestinal obstruction, increased intracranial pressure, hypercalcemia, an active infection or any uncontrolled medical condition (other than malignancy) that, in the opinion of the investigator, may confound the results of the study, represent another potential etiology for emesis and nausea (other than chemotherapy-induced nausea and vomiting, CINV) or pose unwarranted risks in administering the study drugs to the patient.
  • Known hypersensitivity or contraindication to 5-HT3 receptor antagonists or dexamethasone.
  • Previously received a neurokin-1 (NK1) receptor antagonist
  • Participation in a clinical trial involving oral netupitant administered in combination with palonosetron.
  • Any investigational drugs taken within 4 weeks prior to Day 1 of cycle 1, and/or is scheduled to receive any investigational drug during the study.
  • Systemic corticosteroid therapy at any dose within 72 hours prior to Day 1 of cycle 1.
  • Scheduled to receive bone marrow transplantation and/or stem cell rescue therapy.
  • Any medication with known or potential antiemetic activity within 24 hours prior to Day 1 of cycle 1
  • Scheduled to receive any strong or moderate inhibitor of cytocrome P450 3A4 (CYP3A4) or its intake within 1 week prior to Day 1.
  • Scheduled to receive any of the following CYP3A4 substrates: terfenadine, cisapride, astemizole, pimozide.
  • Scheduled to receive any CYP3A4 inducer or its intake within 4 weeks prior to Day 1.
  • History or predisposition to cardiac conduction abnormalities, except for incomplete right bundle branch block.
  • History of risk factors for Torsade de Point (heart failure, hypokalemia, family history of Long QT Syndrome).
  • Severe cardiovascular diseases, including myocardial infarction within 3 months prior to Day 1, unstable angina pectoris, significant valvular or pericardial disease, history of ventricular tachycardia, symptomatic Congestive Heart Failure (CHF) New York Heart Association (NYHA) class III-IV, and severe uncontrolled arterial hypertension.
  • Any illness or condition that, in the opinion of the investigator, may confound the results of the study or pose unwarranted risks in administering the investigational product to the patient.
  • Concurrent medical condition that would preclude administration of dexamethasone such as systemic fungal infection or uncontrolled diabetes.

The following exclusion criteria must be checked prior inclusion at each cycle of the Multiple-Cycle Extension:

  • If female, pregnant or lactating
  • Active infection or uncontrolled disease except for malignancy.
  • Started any of the restricted medications.
  • Any vomiting, retching, or mild nausea within 24 hours prior to Day 1.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Netupitant and Palonosetron+dexamethasone-cycle 1Netupitant and PalonosetronOral netupitant/palonosetron (300 mg/0.50 mg) hard capsule with oral dexamethasone (12 mg), both given on Day 1, prior to each scheduled chemotherapy cycle
Palonosetron+dexamethasone-cycle 1PalonosetronOral palonosetron 0.50 mg (Aloxi) with oral dexamethasone (20 mg) both given on Day 1, prior to each scheduled chemotherapy cycle
Netupitant and Palonosetron+dexamethasone-cycle 1DexamethasoneOral netupitant/palonosetron (300 mg/0.50 mg) hard capsule with oral dexamethasone (12 mg), both given on Day 1, prior to each scheduled chemotherapy cycle
Netupitant and Palonosetron+dexamethasone-multicycle extensionNetupitant and PalonosetronOral netupitant/palonosetron (300 mg/0.50 mg) hard capsule with oral dexamethasone (12 mg), both given on Day 1, prior to each scheduled chemotherapy cycle
Palonosetron+dexamethasone-cycle 1DexamethasoneOral palonosetron 0.50 mg (Aloxi) with oral dexamethasone (20 mg) both given on Day 1, prior to each scheduled chemotherapy cycle
Netupitant and Palonosetron+dexamethasone-multicycle extensionDexamethasoneOral netupitant/palonosetron (300 mg/0.50 mg) hard capsule with oral dexamethasone (12 mg), both given on Day 1, prior to each scheduled chemotherapy cycle
Palonosetron+dexamethasone-multicycle extensionPalonosetronOral palonosetron 0.50 mg (Aloxi) with oral dexamethasone (20 mg) both given on Day 1, prior to each scheduled chemotherapy cycle
Palonosetron+dexamethasone-multicycle extensionDexamethasoneOral palonosetron 0.50 mg (Aloxi) with oral dexamethasone (20 mg) both given on Day 1, prior to each scheduled chemotherapy cycle
Primary Outcome Measures
NameTimeMethod
Percentage of Patients With Complete Response (CR) Defined as no Emesis, no Rescue Medication, at Cycle 125-120 hours
Secondary Outcome Measures
NameTimeMethod
Percentage of Patients With Complete Response (CR) Defined as no Emesis, no Rescue Medication at Cycle 10-24 hours
Percentage of Patients With Complete Response (CR) Defined as no Emesis, no Rescue Medication, at Cycle 10-120 hours

Trial Locations

Locations (171)

Cancer Specialists of South Texas, P.A.

🇺🇸

Corpus Christi, Texas, United States

The John R Marsh Cancer Center

🇺🇸

Hagerstown, Maryland, United States

Compassionate Cancer Centre Medical Group

🇺🇸

Fountain Valley, California, United States

Signal Point Clinical Research Center LLC

🇺🇸

Middletown, Ohio, United States

Centro Oncologico de Integracion Regional (COIR)

🇦🇷

Mendoza, Argentina

Centro Medico San Roque

🇦🇷

San Miguel de Tucuman, Argentina

Mogilev Regional Oncological Dispensary [Oncology]

🇧🇾

Mogilev, Belarus

IPCEM - Centro de Ciências da Saúde - Universidade de Caxias

🇧🇷

Caxias do Sul, Brazil

Hospital Araújo Jorge

🇧🇷

Goiânia, Brazil

Hospital Santa Cruz

🇧🇷

São Paulo, Brazil

Klinika za tumore [Odjel za kemoter. i internisticku onkolog

🇭🇷

Zagreb, Croatia

Bács-Kiskun Megyei Önkormányzat Kórháza, Szegedi

🇭🇺

Kecskemet, Hungary

Josa Andras Oktato Korhaz [Onkologiai Osztaly]

🇭🇺

Nyíregyháza, Hungary

BIBI General Hospital & Cancer Centre [Oncology]

🇮🇳

Hyderabad, India

Grant Medical Foundation - Ruby Hall Clinic

🇮🇳

Pune, India

Ospedale Sacro Cuore e Don Calabria - Negrar

🇮🇹

Negrar, Italy

Ospedale S.Carlo di Potenza [U.O. di Oncologia Medica]

🇮🇹

Potenza, Italy

Hospital de Jesus

🇲🇽

Mexico, Mexico

OCA Hospital/Monterrey International Research Center

🇲🇽

Monterrey, Mexico

Szpital Wojewodzki w Lomzy im. Kardynala S. Wyszynskiego

🇵🇱

Lomza, Poland

Centrum Onkologii - Instytut im. Marii Sklodowskiej - Curie

🇵🇱

Warszawa, Poland

Spitalul Judetean de Urgenta "Dr. Constantin Opris" Baia-Mare [Oncologie Medicala]

🇷🇴

Baia-Mare, Romania

Oncolab - Oncology Center Craiova

🇷🇴

Craiova, Romania

Ivanovo Regional Oncological Dispensary [Chemotherapy]

🇷🇺

Ivanovo, Russian Federation

SBHI of Moscow City Oncology Clinical Hospital #62

🇷🇺

Moscow, Russian Federation

GOU VPO Krasnoyarsk State Medical University n.a. prof. V.F.

🇷🇺

Krasnoyarsk, Russian Federation

GUZ Regional Oncology Dispensary #2

🇷🇺

Magnitogorsk, Russian Federation

Russian Cancer Research Center

🇷🇺

Moscow, Russian Federation

GUZ Pyatigorsk Oncology Dispensary [Outpatient Department]

🇷🇺

Pyatigorsk, Russian Federation

GUZ Perm Regional Oncology Dispensary

🇷🇺

Perm, Russian Federation

FGBU Medical Radiology Scientific Center

🇷🇺

Obninsk, Russian Federation

GOU VPO - Ryazan State Med. Univer. n.a. I.I.Pavlov based Ryazan Regio

🇷🇺

Ryazan, Russian Federation

City Oncology Dispensary

🇷🇺

Saint Petersburg, Russian Federation

FGU Research Institute of Oncology n.a. N.N.Petrov of Rosmed

🇷🇺

St. Petersburg, Russian Federation

GUZ Republican Clinical Oncological Dispensary of public

🇷🇺

Ufa, Russian Federation

Donetskyi oblasnyi protypukhlynnyi tsentr

🇺🇦

Donetsk, Ukraine

Kharkivskyi oblasnyi onkologichnyi klinichnyi tsentr

🇺🇦

Kharkiv, Ukraine

KZ KOR Kyivskyi oblasnyi onkologichnyi dyspanser

🇺🇦

Kyiv, Ukraine

Odeska oblasna klinichna likarnia

🇺🇦

Odessa, Ukraine

MHAT Dr. Tota Venkova [Oncology]

🇧🇬

Gabrovo, Bulgaria

Apollo Gleneagles Hospitals Kolkata

🇮🇳

Kolkata, India

UMHAT "Sveti Georgi" [Clinic of Oncology and Hematology]

🇧🇬

Plovdiv, Bulgaria

Specialized Hospital for Active Treatment in Oncology

🇧🇬

Sofia, Bulgaria

Specialized Hospital for Active Treatment of Onclogy Diseases - Sofia City

🇧🇬

Sofia, Bulgaria

Pécsi Tudományegyetem Klinikai Köpont

🇭🇺

Pécs, Hungary

SHATO "Sveti Mina"

🇧🇬

Blagoevgrad, Bulgaria

Comprehensive Cancer Center - Vratsa Dept. of Palliative Care

🇧🇬

Vratsa, Bulgaria

HCG - Multy Speciality Hospital

🇮🇳

Ahmedabad, India

Centro Oncologico De Chihuahua

🇲🇽

Chihuahua, Mexico

Spitalul Universitar de Urgenta Bucuresti

🇷🇴

Bucuresti, Romania

Institutul Oncologic "Prof. Dr. Alex. Trestioreanu" [Sectia Clinica Radioterapie II]

🇷🇴

Bucuresti, Romania

Specialized Hospital for Active Treatment of Oncology

🇧🇬

Haskovo, Bulgaria

UMHAT ""Dr. Georgi Stranski"" Dept. Medical Oncology

🇧🇬

Pleven, Bulgaria

UMHAT "Tsaritsa Yoanna - ISUL" Ltd.Medical Oncology Clinic

🇧🇬

Sofia, Bulgaria

Borsod-Abaúj-Zemplén Megyei Kórház és Egyetemi Oktató Kórház

🇭🇺

Miskolc, Hungary

B.P.Poddar Hospital and Medical Research Ltd

🇮🇳

Kolkata, India

City Cancer Centre [Surgical and Medical Oncology]

🇮🇳

Vijayawada, India

NZOZ Magodent - Centrum Medczyne Ostrobramska

🇵🇱

Warszawa, Poland

Spitalul Clinic CF nr.2 Bucuresti [Oncologie Medicala]

🇷🇴

Bucuresti, Romania

Gomel Regional Clinical Oncological Dispensary

🇧🇾

Brest, Belarus

District Dispensery with Stationary - Sofia District

🇧🇬

Sofia, Bulgaria

COC - Veliko Tarnovo Dept. Medical Oncology

🇧🇬

Veliko Tarnovo, Bulgaria

Centro Medico Quirurgico

🇲🇽

Mexico, Mexico

Institutul Regional de Oncologia

🇷🇴

Iasi, Romania

Hemato-Oncology Clinic Ahmedabad Pvt Ltd

🇮🇳

Ahmedabad, India

Dr. Kamahshi Memorial Hospital [Oncology]

🇮🇳

Chennai, India

Yashoda B-Block Hospital

🇮🇳

Hyderabad, India

Spitalul Universitar de Urgenta Elias [Oncologie Medicala]

🇷🇴

Bucuresti, Romania

Wojewodzki Szpital Specjalistyczny im. M.Kopernika

🇵🇱

Lodz, Poland

Charleston Hematology Oncology

🇺🇸

Charleston, South Carolina, United States

Northwest Alabama Cancer Center

🇺🇸

Muscle Shoals, Alabama, United States

Genesis Cancer Centre

🇺🇸

Hot Springs, Arkansas, United States

Deaconess Clinic Downtown

🇺🇸

Evansville, Indiana, United States

Compassionate Cancer Care Medical Group

🇺🇸

Riverside, California, United States

Anniston Oncology/Regional Medical Center

🇺🇸

Anniston, Alabama, United States

Compassionate Cancer Care Medical Group Inc

🇺🇸

Corona, California, United States

Fallon Clinic at Worcester Medical Center

🇺🇸

Worcester, Massachusetts, United States

Denver Health and Hospital Authority

🇺🇸

Denver, Colorado, United States

Baptist Cancer Institute

🇺🇸

Jacksonville, Florida, United States

American Institute of Research

🇺🇸

Whittier, California, United States

Facey Medical Group

🇺🇸

Mission Hills, California, United States

Floyd Memorial Cancer Center of Indiana

🇺🇸

New Albany, Indiana, United States

Tri-County Hematology and Oncolgy Associates Inc.

🇺🇸

Massillon, Ohio, United States

Instituto Ribeirãopretano de Combate ao Cancer

🇧🇷

Ribeirão Preto, Brazil

Clinica de Neoplasias do Litoral

🇧🇷

ItajaÃ, Brazil

Northern Utah Associates Hematology / Oncology

🇺🇸

Ogden, Utah, United States

Oncotrat Oncologia Medica Ltda [Oncology]

🇧🇷

Rio de Janeiro, Brazil

Hospital Italiano de Cordoba

🇦🇷

Córdoba, Argentina

ISIS Clinica Especializada

🇦🇷

Santa Fe, Argentina

OXION-Medicina Oncológica

🇧🇷

Belo Horizonte, Brazil

Centro Oncológico Integral (COI)

🇦🇷

Mar del Plata, Argentina

Hospital Moinhos de Vento

🇧🇷

Porto Alegre, Brazil

Clínica Universitaria Reina Fabiola (Universidad Católica de Córdoba)

🇦🇷

Córdoba, Argentina

The University of Texas Health Center

🇺🇸

Tyler, Texas, United States

Instituto Oncológico de Córdoba - Sanatorio Aconcagua

🇦🇷

Cordoba, Argentina

Instituto Médico CER [Oncology]

🇦🇷

Quilmes, Argentina

Bobruisk Interregional Oncological Dispensary

🇧🇾

Bobruisk, Belarus

Nucleo de Oncologia da Bahia

🇧🇷

Salvador Bahia, Brazil

Brest Regional Oncological Dispensary

🇧🇾

Brest, Belarus

Centro de Pesquisas Clínicas em Oncologia

🇧🇷

Cachoeiro de Itapemirim, Brazil

State institution N.N. Alexandrov Republican Scientific and Practical Center of Oncology and Medical Radiology

🇧🇾

Minsk, Belarus

Klinicki bolnicki centar Osijek [Oncology]

🇭🇷

Osijek, Croatia

Minsk city Clinical Oncological Dispensary [Oncology]

🇧🇾

Minsk, Belarus

Presidio Ospedaliero "Alessandro Manzoni", AO Provincia di Lecco

🇮🇹

Lecco, Italy

Casa de Saude Santa Marcelina

🇧🇷

São Paulo, Brazil

Opca bolnica Varazdin [Odjel za hem.onko i klin.imun.]

🇭🇷

Varazdin, Croatia

Clinica De Oncologia De Porto Alegre S S Ltda

🇧🇷

Porto Alegre, Brazil

Petz Aladár Megyei Oktató Kórház [Onkoradiológiai Oszt

🇭🇺

Győr, Hungary

Apollo Speciality Hospital

🇮🇳

Chennai, India

Shatabdhi Superspeciality Hospital

🇮🇳

Nashik, India

Tumorzentrum Munchen Sued - Städtisches Klinikum [Hämato-, Onkologie + Palliativmed]

🇩🇪

München, Germany

Županijska bolnica Cakovec

🇭🇷

Cakovec, Croatia

KBC Rijeka [Gastroenterology]

🇭🇷

Rijeka, Croatia

Opca Bolnica Zadal Ulica

🇭🇷

Zadar, Croatia

Klinički bolnički centar Zagreb [Oncology]

🇭🇷

Zagreb, Croatia

Opca bolnica Pula [Odjel za onklologiju]

🇭🇷

Pula, Croatia

Complex Oncology Centre

🇧🇬

Stara Zagora, Bulgaria

Staedtisches Krankenhaus Muenchen Neuperlach

🇩🇪

München, Germany

Onkologische Gemeinschaftspraxis Dr. med M. Perker / PF Dr. med M. Sandherr

🇩🇪

Weilheim, Germany

Klinik und Poliklinik für Onkologie und Hämatologie Universitatsmedizin Charite Mitte

🇩🇪

Berlin, Germany

Gynäkologische Arztpraxis

🇩🇪

Berlin, Germany

Jasz-Nagykun-Szolnok Megyei Hetenyi Geza Korhaz

🇭🇺

Szolnok, Hungary

Sri Venkateshwara Hospital [Medical Oncology]

🇮🇳

Bangalore, India

Klinicka bolnica [Sestre milosrdnice]

🇭🇷

Zagreb, Croatia

OncoResearch Lerchenfeld UG

🇩🇪

Hamburg, Germany

Semmelweis Egyetem Kútvölgyi Klinikai Tömb

🇭🇺

Budapest, Hungary

Fővárosi Önkormányzat Uzsoki utcai Kórház

🇭🇺

Budapest, Hungary

Schwerpktprxs gynäkolog Onkologie Prof. Dr. Diel, Dr. Gebert

🇩🇪

Mannheim, Germany

Sujan Surgical Cancer Hospital and Amracvati Cancer Foundation

🇮🇳

Amravati, India

Fondazione Poliambulanza Istituto Ospedaliero

🇮🇹

Brescia, Italy

Ospedale Vito Fazzi, ASL Lecce

🇮🇹

Lecce, Italy

Centro Regiomontano de Investigación Clínica

🇲🇽

Monterrey, Mexico

Wojewodzki Szpital Zespolony w Elblagu, Oddzial Onkologiczny

🇵🇱

Elblag, Poland

MBUZ City Clinical Hospital #1

🇷🇺

Novosibirsk, Russian Federation

Niepubliczny Specjalist. Onkol. Zaklad Opieki Zdrowotnej

🇵🇱

Koscierzyna, Poland

Olsztynski Osrodek Onkologiczny "KOPERNIK"

🇵🇱

Olsztyn, Poland

Spitalul Clinic Judetean Mures

🇷🇴

Tg Mures, Romania

Bialostockie Centrum Onkologii im. M.Sklodowskiej-Curie

🇵🇱

Bialystok, Poland

Szpital Rejonowy im. dr J. Rostka w Raciborzu

🇵🇱

Raciborz, Poland

Wojewodzki Szpital Specjalistyczny im. J. Korczaka

🇵🇱

Slupsk, Poland

Oncomed SRL

🇷🇴

Timisoara, Romania

GUZ Arkhangelsk Regional Clinical Oncological Dispensary

🇷🇺

Arkhangelsk, Russian Federation

Spitalul Municipal Onesti [Sectia Oncologie Medicala]

🇷🇴

Onesti, Romania

GAUZ Republic Clinical Oncology Dispensary of Ministry of Health of Republic Tatarstan

🇷🇺

Kazan, Russian Federation

GUZ Lipetsk Regional Oncology Dispensary [General Oncology]

🇷🇺

Lipetsk, Russian Federation

GOU VPO Saint-Petersburg State Medical University n.a. acad.

🇷🇺

Saint Petersburg, Russian Federation

St. Petersburg Clinical Oncology Dispesary - 3rd Gynecology D

🇷🇺

Saint Petersburg, Russian Federation

GUZ "Leningrad Regional Oncology Dispensary"

🇷🇺

Saint-Petersburg, Russian Federation

GUZ Samara Regional Clinical Oncology Dispensary

🇷🇺

Samara, Russian Federation

Komunalnyizaklad Miska bahatoprofilna klinichna likarnia #4

🇺🇦

Dnipropetrovks, Ukraine

Stavropol Regional Clinical Oncology Dispensary

🇷🇺

Stavropol, Russian Federation

GBUZ - Clinical Oncology Dispensary of MoH of Republic Bahkortostan

🇷🇺

Ufa, Russian Federation

Komunalnyi "Cherkaskyi oblasnyi onkolohichnyi dyspanser" Cherkaskoi oblasnoi rady, oblasnyi onkokhimioterapevtychnyi tsentr, m. Cherkasy

🇺🇦

Cherkasy, Ukraine

Rotkreuzklinikum [München]

🇩🇪

München, Germany

OncoPRO GbR Dr. R. Dengler, Dr. A. Kröber Gesellschaft für klinische Studien in der ambulanten Hämatologie und Onkologie

🇩🇪

Regensburg, Germany

Praxis Dr. G. Dresemann

🇩🇪

Velen, Germany

Universitätsklinikum Tübingen

🇩🇪

Tübingen, Germany

Wellmont Medical Associates-Oncology and Hematology

🇺🇸

Bristol, Tennessee, United States

Sanatorio Parque

🇦🇷

Rosario, Argentina

Kentucky Cancer Clinic

🇺🇸

Hazard, Kentucky, United States

Northwest Medical Specialties

🇺🇸

Tacoma, Washington, United States

Chmelnytskyi Regional Clinical Oncology Centre [Oncology]

🇺🇦

Chmelnytskyi, Ukraine

Lvivskyi derzhavnyi onkologichnyi regionalnyi likuvalno diahnostychyi tsentr

🇺🇦

Lviv, Ukraine

Zakarpatskyi oblasnyi klinichnyi onkodyspanser

🇺🇦

Uzhgorod, Ukraine

Kyirskyi Miskyi klinichnyi onkolohichnyi tsentr

🇺🇦

Kyiv, Ukraine

Poltavskyi oblasnyi klinichnyi onkolohichnyi dyspanser Pol

🇺🇦

Poltava, Ukraine

Komunalnyi likuvalno-profilaktychnyi zaklad "Chernigivskyi

🇺🇦

Chernigiv, Ukraine

Duke University Medical Center

🇺🇸

Durham, North Carolina, United States

Piedmont Hematology Oncology Associates PA

🇺🇸

Winston-Salem, North Carolina, United States

Charleston Cancer Center

🇺🇸

Charleston, South Carolina, United States

Palm Beach Institute of Hematology and Oncology

🇺🇸

Boynton Beach, Florida, United States

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