A Study of PEGylated Recombinant Human Hyaluronidase in Combination With Nab-Paclitaxel Plus Gemcitabine Compared With Placebo Plus Nab-Paclitaxel and Gemcitabine in Participants With Hyaluronan-High Stage IV Previously Untreated Pancreatic Ductal Adenocarcinoma
- Conditions
- Pancreatic Ductal Carcinoma
- Interventions
- Registration Number
- NCT02715804
- Lead Sponsor
- Halozyme Therapeutics
- Brief Summary
The purpose of this study is to compare the efficacy and safety of PEGylated Recombinant Human Hyaluronidase (PEGPH20) combined with nab-paclitaxel plus gemcitabine (PAG treatment), compared with placebo combined with nab-paclitaxel plus gemcitabine (AG treatment), in participants with hyaluronan (HA)-high Stage IV previously untreated pancreatic ductal adenocarcinoma (PDA).
- Detailed Description
Participants will be randomized in a 2:1 ratio to PAG or AG treatment.
Recruitment & Eligibility
- Status
- TERMINATED
- Sex
- All
- Target Recruitment
- 492
Not provided
Not provided
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description PAG: PEGPH20 + nab-Paclitaxel + Gemcitabine nab-Paclitaxel Participants will receive 3.0 micrograms/kilogram (μg/kg) PEGPH20 as an intravenous (IV) infusion, twice weekly for Weeks 1 to 3 of Cycle 1 (each cycle consisting of 4 weeks \[Week 4 of every cycle will be a rest week with no treatment\]), then once weekly for Weeks 1 to 3 of Cycle 2 and beyond in combination with 125 milligrams/square meter (mg/m\^2) nab-paclitaxel as an IV infusion and 1000 mg/m\^2 gemcitabine as an IV infusion, once weekly for Weeks 1 to 3 of all treatment cycles. Treatment will continue until disease progression, unacceptable toxicity, death, or withdrawal of consent. AG: Placebo + nab-Paclitaxel + Gemcitabine nab-Paclitaxel Participants will receive placebo matching to PEGPH20 as an IV infusion, twice weekly for Weeks 1 to 3 of Cycle 1 (each cycle consisting of 4 weeks \[Week 4 of every cycle will be a rest week with no treatment\]), then once weekly for Weeks 1 to 3 of Cycle 2 and beyond in combination with 125 mg/m\^2 nab-paclitaxel as an IV infusion and 1000 mg/m\^2 gemcitabine as an IV infusion, once weekly for Weeks 1 to 3 of all treatment cycles. Treatment will continue until disease progression, unacceptable toxicity, death, or withdrawal of consent. AG: Placebo + nab-Paclitaxel + Gemcitabine Placebo Participants will receive placebo matching to PEGPH20 as an IV infusion, twice weekly for Weeks 1 to 3 of Cycle 1 (each cycle consisting of 4 weeks \[Week 4 of every cycle will be a rest week with no treatment\]), then once weekly for Weeks 1 to 3 of Cycle 2 and beyond in combination with 125 mg/m\^2 nab-paclitaxel as an IV infusion and 1000 mg/m\^2 gemcitabine as an IV infusion, once weekly for Weeks 1 to 3 of all treatment cycles. Treatment will continue until disease progression, unacceptable toxicity, death, or withdrawal of consent. PAG: PEGPH20 + nab-Paclitaxel + Gemcitabine Gemcitabine Participants will receive 3.0 micrograms/kilogram (μg/kg) PEGPH20 as an intravenous (IV) infusion, twice weekly for Weeks 1 to 3 of Cycle 1 (each cycle consisting of 4 weeks \[Week 4 of every cycle will be a rest week with no treatment\]), then once weekly for Weeks 1 to 3 of Cycle 2 and beyond in combination with 125 milligrams/square meter (mg/m\^2) nab-paclitaxel as an IV infusion and 1000 mg/m\^2 gemcitabine as an IV infusion, once weekly for Weeks 1 to 3 of all treatment cycles. Treatment will continue until disease progression, unacceptable toxicity, death, or withdrawal of consent. AG: Placebo + nab-Paclitaxel + Gemcitabine Gemcitabine Participants will receive placebo matching to PEGPH20 as an IV infusion, twice weekly for Weeks 1 to 3 of Cycle 1 (each cycle consisting of 4 weeks \[Week 4 of every cycle will be a rest week with no treatment\]), then once weekly for Weeks 1 to 3 of Cycle 2 and beyond in combination with 125 mg/m\^2 nab-paclitaxel as an IV infusion and 1000 mg/m\^2 gemcitabine as an IV infusion, once weekly for Weeks 1 to 3 of all treatment cycles. Treatment will continue until disease progression, unacceptable toxicity, death, or withdrawal of consent.
- Primary Outcome Measures
Name Time Method Overall Survival From randomization until death from any cause (maximum exposure: 150.1 weeks for PAG, and 83.9 weeks for AG) Overall survival was defined as the time from randomization until death from any cause. Overall survival was analyzed using Kaplan-Meier methods.
- Secondary Outcome Measures
Name Time Method Objective Response Rate (ORR): Percentage of Participants With Objective Response From the date of randomization until CR or PR (maximum exposure: 150.1 weeks for PAG, and 83.9 weeks for AG) ORR was defined as percentage of participants who achieved either a complete response (CR) or partial response (PR) as determined by the blinded CIV based on RECIST version 1.1. CR was defined as disappearance of all target and non-target lesions; Any pathological or non-pathological lymph nodes (whether target or non-target) must have reduction in short axis to less than (\<) 10 mm. PR was defined as at least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters.
Number of Participants With Worst Post-Baseline Hematology and Chemistry (Clinical Laboratory Parameters) Severity Grade During the Study From administration of first dose of study drug up to 30 days after last dose of study drug (maximum exposure: 150.1 weeks for PAG, and 83.9 weeks for AG) Severity grade associated with a laboratory parameter value was determined using Common Terminology Criteria for Adverse Events (CTCAE) Version 4.03. Grade 1=mild, Grade 2=moderate, Grade 3=severe, Grade 4=life-threatening. Grade 0 indicates evaluable lab records but not fall into any CTCAE grade for certain CTCAE term. A worst post-baseline grade shift was defined as the worst change that occurred at any measured timepoint during study. Hematology abnormalities: anemia(hemoglobin decreased), lymphocyte count decreased, lymphocyte count increased, neutropenia(neutrophil count decreased), thrombocytopenia(platelet count decreased), and leukopenia(white blood cell decreased). Chemistry abnormalities: hypoalbuminemia, alkaline phosphatase increased, alanine aminotransferase increased, aspartate aminotransferase increased, hyperbilirubinemia, hypo- and hypercalcemia, creatinine increased, hypo- and hyperglycaemia, hypo- and hyperkalemia, hypo- and hypermagnesemia, hypo- and hypernatremia.
Number of Participants With Clinically Significant Abnormalities in Electrocardiogram (ECG) From administration of first dose of study drug up to 30 days after last dose of study drug (maximum exposure: 150.1 weeks for PAG, and 83.9 weeks for AG) ECGs including clinical significance was evaluated by the Investigator. Criteria for clinical significance were as per investigator's discretion.
Progression-Free Survival (PFS) From the date of randomization until disease progression or death from any cause (maximum exposure: 150.1 weeks for PAG, and 83.9 weeks for AG) PFS was defined as the time from randomization until the first occurrence of radiological disease progression, as determined by the blinded Central Imaging Vendor (CIV) based on Response Evaluation Criteria in Solid Tumours (RECIST) version 1.1, or death from any cause during the treatment period. Disease progression was defined as at least a 20 percent (%) increase in sum of diameters of target lesions, taking as reference the smallest sum on study thus far, nadir (this included baseline sum if that was the smallest on study); Sum must also demonstrate an absolute increase of at least 5 millimeters (mm); Appearance of one or more new lesions; Unequivocal progression of existing non-target lesions. Surviving participants without disease progression were censored for PFS analysis at the date of last evaluable post-baseline tumor assessment. Surviving participants without any post-baseline disease assessment were censored on Day 1. PFS was estimated using Kaplan-Meier method.
Duration of Response (DOR) From date of first objective response (CR or PR) until date of first disease progression (maximum exposure: 150.1 weeks for PAG, and 83.9 weeks for AG) DOR was defined as the time from the first objective response of CR or PR until disease progression (as determined by the blinded CIV based on RECIST version 1.1) or death within 14 days of last dose of study treatment or randomization. CR was defined as disappearance of all target and non-target lesions; Any pathological or non-pathological lymph nodes (whether target or non-target) must have reduction in short axis to \<10 mm. PR was defined as at least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters. Disease progression was defined as at least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study thus far, the sum must also demonstrate an absolute increase of at least 5 mm, or the appearance of one or more new lesions; and unequivocal progression of existing non-target lesions. DOR was analyzed using Kaplan-Meier methods.
Number of Participants With Treatment-Emergent Adverse Events (AEs) From administration of first dose of study drug up to 30 days after last dose of study drug (maximum exposure: 150.1 weeks for PAG, and 83.9 weeks for AG) An AE was any untoward medical occurrence in a participant who received study drug without regard to possibility of causal relationship. Serious adverse event (SAE) was an AE resulting in any of the following outcomes or deemed significant for any other reason: death; initial or prolonged inpatient hospitalization; life-threatening experience (immediate risk of dying); persistent or significant disability/incapacity; congenital anomaly. Treatment-emergent AEs were defined as AEs that begin or worsen in severity during or after the participant's first dose of study treatment and no later than 30 days after the date of the last dose of study treatment and/or any treatment-related AE regardless of the onset date. AEs included both SAEs and non-serious AEs. A summary of other non-serious AEs and all SAEs, regardless of causality is located in the 'Reported AE section'.
Number of Participants With Clinically Significant Abnormalities in Vital Signs From administration of first dose of study drug up to 30 days after last dose of study drug (maximum exposure: 150.1 weeks for PAG, and 83.9 weeks for AG) Vital signs included measurement of blood pressure (systolic blood pressure \[SBP\] and diastolic blood pressure \[DBP\]), heart rate, and body weight. Criteria for clinical significance abnormalities were: Heart rate: \<50 beats per minute (bpm), \>120 bpm, \>=30 bpm increase from baseline, \>=30 bpm decrease from baseline. SBP: \>140 millimeters of mercury (mmHg) and increase from baseline \>20 mmHg, \>180 mmHg, \<90 mmHg and decrease from baseline \>10 mmHg. DBP: \>90 mmHg and increase from baseline \>20 mmHg, \>105 mmHg, \<60 mmHg and decrease from baseline \>10 mmHg. Change in weight: \>=5% increase from baseline, \>=5% decrease from baseline.
Trial Locations
- Locations (216)
Allegheny General Hospital
🇺🇸Pittsburgh, Pennsylvania, United States
Beth Israel Deaconess Medical Center
🇺🇸Boston, Massachusetts, United States
Baylor College of Medicine - Baylor Clinic
🇺🇸Houston, Texas, United States
University of Washington (UW) - Seattle Cancer Care Alliance
🇺🇸Seattle, Washington, United States
Virginia Piper Cancer Institute
🇺🇸Minneapolis, Minnesota, United States
Hospital São Lucas da PUCRS
🇧🇷Porto Alegre, Rio Grande Do Sul, Brazil
CENANTRON - Centro Avançado de Tratamento Oncologico
🇧🇷Belo Horizonte, Minas Gerais, Brazil
Jersey Shore University Medical Center
🇺🇸Neptune, New Jersey, United States
Imelda Ziekenhuis
🇧🇪Bonheiden, Antwerpen, Belgium
Rabin Medical Center - Beilinson Hospital
🇮🇱Petah Tikva, HaMerkaz, Israel
Radboud Universiteit Nijmegen
🇳🇱Nijmegen, Netherlands
Veterans General Hospital- Taipei
🇨🇳Taipei, Taiwan
Szegedi Tudomanyegyetem Szent-Gyorgyi Albert Klinikai Kozpo
🇭🇺Szeged, Csongrád, Hungary
Debreceni Egyetem Klinikai Központ
🇭🇺Debrecen, Hajdú-Bihar, Hungary
Somogy Megyei Kaposi Mór Oktató Kórház
🇭🇺Kaposvár, Hungary
Assaf Harofeh Medical Center
🇮🇱Be'er Ya'aqov, HaMerkaz, Israel
Academisch Medisch Centrum Universiteit van Amsterdam
🇳🇱Amsterdam, Netherlands
Maastricht University Medical Centre
🇳🇱Maastricht, Limburg, Netherlands
Shaare Zedek Medical Center
🇮🇱Jerusalem, Israel
UZA
🇧🇪Edegem, Antwerpen, Belgium
Hôpital Erasme
🇧🇪Bruxelles, Brussels Capital Region, Belgium
ICM Val d'Aurelle Saint Eloi - Departement Oncologie
🇫🇷Montpellier, Hérault, France
Vilniaus Universiteto ligonines Santariskiu Klinikos
🇱🇹Vilnius, Vilniaus Apskritis, Lithuania
Cliniques Universitaires Saint-Luc
🇧🇪Brussels, Brussels Capital Region, Belgium
Egyesített Szent István és Szent László Kórház-Rendelőintéze
🇭🇺Budapest, Hungary
Centre Eugene Marquis
🇫🇷Rennes Cedex, Bretagne, France
Petz Aladár Megyei Oktató Kórház
🇭🇺Győr, Gyor-Moson-Sopron, Hungary
Meir Medical Center
🇮🇱Kfar-Saba, HaMerkaz, Israel
Bendigo Health Care Group
🇦🇺Bendigo, Victoria, Australia
Szent Margit Kórház
🇭🇺Budapest, Hungary
AZ Maria Middelares - Campus Maria Middelares
🇧🇪Gent, Oost-Vlaanderen, Belgium
Hillel Yaffe Medical Center
🇮🇱Hadera, Israel
SIA "Rigas Austrumu Kliniska Universitates Slimnica"
🇱🇻Riga, Latvia
Monash Health
🇦🇺Bentleigh East, Victoria, Australia
Occ -Oncologia Clínica De Campinas
🇧🇷Campinas, São Paulo, Brazil
Pécsi Tudományegyetem Klinikai Központ
🇭🇺Pécs, Baranya, Hungary
China Medical University Hospital
🇨🇳Taichung, Taichung Municipality, Taiwan
Samuel Oschin Comprehensive Cancer Institute
🇺🇸Los Angeles, California, United States
St. Jude Hospital Yorba DBA Linda St. Joseph Heritage Health
🇺🇸Fullerton, California, United States
St. Joseph Hospital
🇺🇸Orange, California, United States
David Geffen School of Medicine (DGSOM) at UCLA
🇺🇸Los Angeles, California, United States
Banner MD Anderson Cancer Center
🇺🇸Gilbert, Arizona, United States
Chao Family Comprehensive Cancer Center
🇺🇸Orange, California, United States
St Joseph Heritage Healthcare
🇺🇸Santa Rosa, California, United States
Desert Hematology Oncology Medical Group, Inc.
🇺🇸Rancho Mirage, California, United States
Cancer Care Associates Medical Group, Inc.
🇺🇸Redondo Beach, California, United States
Ochsner Clinic CCOP
🇺🇸New Orleans, Louisiana, United States
Comprehensive Cancer Centers of Nevada
🇺🇸Las Vegas, Nevada, United States
St. Mary's Medical Center
🇺🇸Grand Junction, Colorado, United States
University of Minnesota Medical School
🇺🇸Minneapolis, Minnesota, United States
MedStar Georgetown University Hospital
🇺🇸Washington, District of Columbia, United States
Innovative Clinical Research Institution
🇺🇸Whittier, California, United States
21st Century Oncology
🇺🇸Jacksonville, Florida, United States
Memorial Healthcare System - Memorial Cancer Institute
🇺🇸Hollywood, Florida, United States
Fort Wayne Medical Oncology/Hematology, INC.
🇺🇸Fort Wayne, Indiana, United States
The University Of Kansas Cancer Center
🇺🇸Kansas City, Kansas, United States
Ochsner Health Center
🇺🇸Baton Rouge, Louisiana, United States
The Sidney Kimmel Comprehensive Cancer Center
🇺🇸Baltimore, Maryland, United States
UMass Memorial Medical Center
🇺🇸Worcester, Massachusetts, United States
Renown Regional Medical Center
🇺🇸Reno, Nevada, United States
University of Rochester Medical Center
🇺🇸Rochester, New York, United States
Mount Sinai School of Medicine - The Tisch Cancer Institute
🇺🇸New York, New York, United States
Chris O'Brien Lifehouse
🇦🇺Camperdown, New South Wales, Australia
Flinders Medical Centre
🇦🇺Bedford, South Australia, Australia
Gabrail Cancer Center Research
🇺🇸Canton, Ohio, United States
Northwest Medical Specialties PLLC
🇺🇸Tacoma, Washington, United States
Northwell Health/Monter Cancer Center
🇺🇸Lake Success, New York, United States
Hospital da Cidade de Passo Fundo
🇧🇷Passo Fundo, Rio Grande Do Sul, Brazil
St Vincent's Hospital
🇦🇺Darlinghurst, New South Wales, Australia
Bankstown-Lidcombe Hospital
🇦🇺Bankstown, New South Wales, Australia
Dartmouth Hitchcock Medical Center
🇺🇸Lebanon, New Hampshire, United States
NYU Langone Medical Center - NYU Langone Arena Oncology
🇺🇸New Hyde Park, New York, United States
Virginia Cancer Institute
🇺🇸Mechanicsville, Virginia, United States
Saint Joseph's Ambulatory Clinic
🇺🇸Clifton, New Jersey, United States
Univ of Pittsburgh Cancer institute
🇺🇸Pittsburgh, Pennsylvania, United States
Rex Cancer Center
🇺🇸Raleigh, North Carolina, United States
Swedish Cancer Institute/ Swedish Health Services
🇺🇸Seattle, Washington, United States
Scott and White
🇺🇸Temple, Texas, United States
Peninsula & South Eastern Haematology and Oncology Group
🇦🇺Frankston, Victoria, Australia
Royal North Shore Hospital
🇦🇺St Leonards, New South Wales, Australia
UZ Leuven - Campus Gasthuisberg
🇧🇪Leuven, Vlaams Brabant, Belgium
Centre Hospitalier Universitaire (CHU) de Liege - Domaine Un
🇧🇪Liege, Belgium
Princess Margaret Hospital
🇨🇦Toronto, Ontario, Canada
Fundação Amaral Cravalho / Hospital Amaral Carvalho
🇧🇷Jaú, São Paulo, Brazil
Faculdade de Medicina da Universidade de Sao Paulo
🇧🇷Sao Paulo, São Paulo, Brazil
Hospital de Clinicas de Porto Alegre - UFRGS
🇧🇷Porto Alegre, Rio Grande Do Sul, Brazil
Fundacao Pio XII Hospital De Câncer de Barretos
🇧🇷Barretos, Brazil
Royal Victoria Regional Health Centre
🇨🇦Barrie, Ontario, Canada
Instituto COI
🇧🇷Rio de Janeiro, Brazil
Instituto Nacional de Câncer - INCA
🇧🇷Rio de Janeiro, Brazil
East Tallinn Central Hospital Oncology Center
🇪🇪Tallinn, Harjumaa, Estonia
Klinicki bolnički centar Sestre milosrdnice
🇭🇷Zagreb, Croatia
Nemocnice Na Bulovce (Hospital Na Bulovce)
🇨🇿Prague, Czechia
Odense Universitetshospital
🇩🇰Odense, South Denmark, Denmark
Fakultni nemocnice Olomouc
🇨🇿Olomouc, Olomoucký Kraj, Czechia
North Estonian Medical Centre Foundation Clinic of Oncology
🇪🇪Tallinn, Harjumaa, Estonia
Fakultni nemocnice v Motole
🇨🇿Praha 5, Czechia
ICO - Site Ren Gauducheau
🇫🇷Saint Herblain, Loire-Atlantique, France
CHU Estaing
🇫🇷Clermont-Ferrand, Puy-de-Dôme, France
Hopital Edouard Herriot
🇫🇷Lyon Cedex 03, Rhône, France
Institut De Cancerologie Gustave Roussy
🇫🇷Villejuif, Val-de-Marne, France
Kliniken Essen-Mitte Evang. Huyssens-Stiftung
🇩🇪Essen, Germany
Hôpital Beaujon
🇫🇷Clichy Cedex, Île-de-France, France
Pitié Salpetriere Hospital
🇫🇷Paris, France
Institut de Cancérologie de l'Ouest - Site Paul Papin
🇫🇷Angers Cedex 02, France
Hôpital Haut-Leveque
🇫🇷Bordeaux, France
Centre Lyon Berard
🇫🇷Lyon Cedex, France
Universitätskllinikum Heidelberg
🇩🇪Heidelberg, Germany
Universitätsklinikum Ulm
🇩🇪Ulm, Baden-Württemberg, Germany
Universitätsklinikum Bonn
🇩🇪Bonn, Nordrhein-Westfalen, Germany
Semmelweis Egyetem - Onkohaematológiai Osztály
🇭🇺Budapest, Hungary
Magyar Honvédség Egészségügyi Központ
🇭🇺Budapest, Hungary
Universitätsklinikum Halle-Universitätsklinik und Poliklinik
🇩🇪Halle, Germany
Országos Onkológiai Intézet
🇭🇺Budapest, Hungary
Tel Aviv Sourasky Medical Center
🇮🇱Tel Aviv, Tel-Aviv, Israel
Hadassah Medical Organisation
🇮🇱Jerusalem, Yerushalayim, Israel
Ha'Emek Medical Center
🇮🇱Afula, Israel
Soroka Medical Center [Oncology]
🇮🇱Beer Sheva, Israel
Semmelweis Egyetem - Isz. Bel, Onkológiai Részleg
🇭🇺Budapest, Hungary
AO S. Martino, IRCCS, IST-Istituto Nazionale Ricerca Sul Cancro
🇮🇹Genova, Italy
Ieo, Irccs
🇮🇹Milan, Italy
The Chaim Sheba Medical Center [Oncology]
🇮🇱Tel Hashomer, Israel
U.O. di Oncologia
🇮🇹San Giovanni Rotondo, Foggia, Italy
Dong-A University Hospital
🇰🇷Busan, Busan Gwang'yeogsi, Korea, Republic of
Samsung Medical Center
🇰🇷Seoul, Seoul Teugbyeolsi, Korea, Republic of
P.Stradins Clinical University
🇱🇻Riga, Latvia
National Cancer Institute
🇱🇹Vilnius, Vilniaus Apskritis, Lithuania
Spaarne Gasthuis
🇳🇱Hoofddorp, Netherlands
Institut Català d'Oncologia-Hospital Germans Trias i Pujol
🇪🇸Badalona, Barcelona, Spain
Szpital Specjalistyczny w Brzozowie Podkarpacki Ośrodek Onko
🇵🇱Brzozow, Podkarpackie, Poland
Samodzielny Publiczny Szpital Kliniczny nr 1 w Lublinie
🇵🇱Lublin, Poland
Centrum Onkologii Instytut im. M. Sklodowskiej-Curie
🇵🇱Warszawa, Poland
Institut Catalá d´Oncología (I.C.O.)
🇪🇸L'Hospitalet De Llobregat, Barcelona, Spain
H.del Mar
🇪🇸Barcelona, Spain
H.U. de Fuenlabrada
🇪🇸Fuenlabrada, Madrid, Spain
H.C. S.Carlos
🇪🇸Madrid, Spain
H.U.Vall d'Hebrón
🇪🇸Barcelona, Spain
H.G.U. G. Marañón
🇪🇸Madrid, Spain
F.I. Valenciano de Oncología
🇪🇸Valencia, Spain
H.U. F. Jiménez Díaz
🇪🇸Madrid, Spain
Changhua Christian Hospital
🇨🇳Changhua, Taiwan
Hospital Universitari i Politècnic La Fe
🇪🇸Valencia, Spain
National Taiwan University Hospital
🇨🇳Taipei, Taiwan
H.U. Miguel Servet
🇪🇸Zaragoza, Spain
National Cheng Kung University Hospital
🇨🇳Tainan, Taiwan
Peterborough And Stamford Hospitals
🇬🇧Peterborough, Cambridgeshire, United Kingdom
Beatson West of Scotland Cancer Centre
🇬🇧Glasgow, Glasgow City, United Kingdom
Sarah Cannon Research Institute UK (SCRI UK)
🇬🇧London, London, City Of, United Kingdom
Edinburgh Cancer Centre Western General Hospital
🇬🇧Edinburgh, Midlothian, United Kingdom
The Clatterbridge Cancer Centre NHS Foundation Trust
🇬🇧Wirral, United Kingdom
Queen Elizabeth Hospital Birmingham
🇬🇧Birmingham, United Kingdom
The Royal Marsden NHS Foundation Trust - Chelsea
🇬🇧London, United Kingdom
The Christie NHS Foundation Trust
🇬🇧Withington, United Kingdom
Istituto Clinico Humanitas Rozzano, IRCCS
🇮🇹Rozzano, Milano, Italy
PO di Cremona, ASST di Cremona
🇮🇹Cremona, Italy
IRCCS Ospedale S.Raffaele
🇮🇹Milano, Italy
Henri Mondor - Albert Chevenier
🇫🇷Créteil, France
Hopital Privé Jean Mermoz
🇫🇷Lyon, France
H.Sta.Creu i St.Pau
🇪🇸Barcelona, Spain
H.U. R. y Cajal
🇪🇸Madrid, Spain
Hospital Madrid Norte Sanchinarro
🇪🇸Madrid, Spain
Keimyung University Dongsan Medical Center
🇰🇷Daegu, Daegu Gwang'yeogsi, Korea, Republic of
Pacific Central Coast Health Centers: San Luis Obispo Oncology and Hematology Health Center
🇺🇸San Luis Obispo, California, United States
Universitätsklinik Carl-Gustav-Carus Dresden
🇩🇪Dresden, Sachsen, Germany
Highlands Oncology Group
🇺🇸Fayetteville, Arkansas, United States
Scripps Clinical Research Services
🇺🇸La Jolla, California, United States
Columbia University Medical Center
🇺🇸New York, New York, United States
Penn State Milton S. Hershey Medical Center
🇺🇸Hershey, Pennsylvania, United States
Fort Belvoir Community Hospital
🇺🇸Fort Belvoir, Virginia, United States
University of Wisconsin Health - UW Carbone Cancer Center
🇺🇸Madison, Wisconsin, United States
Inova Dwight and Martha Schar Cancer Institute
🇺🇸Fairfax, Virginia, United States
Fm Abc/ Cepho
🇧🇷Santo Andre, São Paulo, Brazil
FN Hradec Kralove
🇨🇿Hradec Kralove, Královéhradecký Kraj, Czechia
Klinicki bolnicki centar Zagreb
🇭🇷Zagreb, Grad Zagreb, Croatia
Masarykuv onkologicky ustav
🇨🇿Brno, Brno-město, Czechia
Klinikum der Universität München - Campus Grosshadern
🇩🇪München, Bayern, Germany
Hospitalier Jean Minjoz
🇫🇷Besançon cedex, Franche-Comté, France
Institut Mutualiste Montsouris
🇫🇷Paris, France
Uniklinik Köln-Klinik für Gastroenterologie und Hepatologie am Abdominalzentrum
🇩🇪Koeln, Nordrhein-Westfalen, Germany
Universitätsklinikum Leipzig AöR
🇩🇪Leipzig, Sachsen, Germany
Facharztzentrum Eppendorf
🇩🇪Hamburg, Germany
Rambam Health Care Campus
🇮🇱Haifa, Israel
Istituto Oncologico Veneto IOV-IRCCS
🇮🇹Padova, Italy
Borgo Roma, Policlinico G.Rossi, AOU Integrata Verona
🇮🇹Verona, Italy
Regina Elena, Istituto Nazionale dei Tumori, IFO, IRCCS
🇮🇹Roma, Italy
Seoul National University Bundang Hospital
🇰🇷Seongnam, Gyeonggido, Korea, Republic of
Asan Medical Center
🇰🇷Seoul, Seoul Teugbyeolsi, Korea, Republic of
Korea University Anam Hospital
🇰🇷Seoul, Seoul Teugbyeolsi, Korea, Republic of
The Catholic University of Korea, Seoul St.Mary's Hospital
🇰🇷Seoul, Seoul Teugbyeolsi, Korea, Republic of
Gachon University Gil Medical Center
🇰🇷Incheon, Korea, Republic of
Daugavpils Regional Hospital
🇱🇻Daugavpils, Latvia
Severance Hospital, Yonsei University Health System
🇰🇷Seoul, Seoul Teugbyeolsi, Korea, Republic of
Korea University Guro Hospital
🇰🇷Seoul, Korea, Republic of
Seoul National University Hospital
🇰🇷Seoul, Korea, Republic of
Addenbrooke's Hospital, Cambridge
🇬🇧Cambridge, Cambridgeshire, United Kingdom
Hammersmith Hospital
🇬🇧London, United Kingdom
North Wales Cancer Treatment Centre
🇬🇧Rhyl, United Kingdom
Coventry Hospital
🇬🇧Coventry, United Kingdom
The Royal Marsden NHS Foundation - Sutton
🇬🇧London, United Kingdom
University of South Alabama
🇺🇸Mobile, Alabama, United States
Pacific Hematology Oncology Associates
🇺🇸San Francisco, California, United States
University of Louisville
🇺🇸Louisville, Kentucky, United States
UCSF Helen Diller Family Comprehensive Cancer Center
🇺🇸San Francisco, California, United States
University of Michigan Medical Center
🇺🇸Ann Arbor, Michigan, United States
Karmanos Cancer Institute
🇺🇸Detroit, Michigan, United States
Kaiser Permanente Franklin Medical Offices - Denver
🇺🇸Denver, Colorado, United States
US Oncology - Rocky Mountain Cancer Centers - Midtown
🇺🇸Denver, Colorado, United States
MD Anderson Cancer Center Orlando
🇺🇸Orlando, Florida, United States
Yale Cancer Center
🇺🇸New Haven, Connecticut, United States
The University of Oklahoma Health Sciences Center
🇺🇸Oklahoma City, Oklahoma, United States
Medical College of Wisconsin
🇺🇸Milwaukee, Wisconsin, United States
University of Utah - Huntsman Cancer Institute
🇺🇸Salt Lake City, Utah, United States
Columbia St. Marys
🇺🇸Milwaukee, Wisconsin, United States
Charité - Universitätsmedizin Berlin
🇩🇪Berlin, Germany
Clínica Universidad de Navarra
🇪🇸Pamplona, Navarra, Spain
Castle Hill Hospital
🇬🇧Cottingham, United Kingdom