A Study of Nivolumab or Placebo in Combination With Docetaxel in Men With Advanced Castration-resistant Prostate Cancer
- Conditions
- Prostate Cancer
- Interventions
- Registration Number
- NCT04100018
- Lead Sponsor
- Bristol-Myers Squibb
- Brief Summary
The purpose of this study is to assess the safety and effectiveness of nivolumab with docetaxel in men with advanced castration resistant prostate cancer who have progressed after second-generation hormonal manipulation.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- Male
- Target Recruitment
- 1030
- Histologic confirmation of adenocarcinoma of the prostate without small cell features
- Current evidence of metastatic disease documented by either bone lesions on radionuclide bone scan and/or soft tissue lesions on computerized tomography/magnetic resonance imaging (CT/MRI)
- Eastern Cooperative Oncology Group (ECOG) performance status 0-1
- Ongoing androgen deprivation therapy (ADT) with a gonadotropin-releasing hormone (GnRH) analogue or bilateral orchiectomy
- Documented prostate cancer progression per Prostate Cancer Working Group (PCWG3) criteria within 6 months prior to screening
- Chemotherapy-naïve for metastatic castration-resistant prostate cancer (mCRPC), with 1 to 2 prior second generation hormonal therapies in the recurrent non-metastatic setting and/or metastatic setting, and no more than 1 second generation hormonal therapy in the mCRPC setting. Must have progressed during or after second generation hormonal therapy or have documented intolerance to second generation hormonal therapy
- Participants must meet one of the following criteria regarding tissue submission: Sufficient tumor samples from a newly obtained ("fresh") biopsy (obtained during screening); or archival tumor tissue in the form of formalin-fixed paraffin-embedded (FFPE) block or unstained tumor tissue slides. For participants with bone-only disease or inaccessible soft tissue lesions or if the biopsy procedure would pose an unacceptable clinical risk for the participant, submission of tumor tissue obtained from a fresh biopsy is not required.
- Men must agree to follow specific methods of contraception, if applicable
- Active brain metastases
- Active, known, or suspected autoimmune disease
- Condition requiring systemic treatment with corticosteroids (> 10 mg daily prednisone equivalent) or other immunosuppressive medications within 14 days of start of study treatment. Inhaled or topical steroids or adrenal replacement steroid doses are permitted in the absence of active autoimmune disease
- Prior treatment with an anti-PD-1, anti-PD-L1, anti-PD-L2, anti-CTLA-4 antibody, or any other antibody or drug specifically targeting T-cell co-stimulation or checkpoint pathways
- Prior treatment with docetaxel or other chemotherapy for mCRPC. Prior docetaxel for metastatic castration-sensitive prostate cancer is permitted if at least 12 months have elapsed from last dose of docetaxel
Other protocol-defined inclusion/exclusion criteria apply
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Arm A: Nivolumab + docetaxel + prednisone Nivolumab - Arm B: Placebo + docetaxel + prednisone Placebo - Arm A: Nivolumab + docetaxel + prednisone Docetaxel - Arm A: Nivolumab + docetaxel + prednisone Prednisone - Arm B: Placebo + docetaxel + prednisone Prednisone - Arm B: Placebo + docetaxel + prednisone Docetaxel -
- Primary Outcome Measures
Name Time Method Radiographic Progressive Free Survival (rPFS) Assessed by Blinded Independent Central Review (BICR) Per Prostate Cancer Working Group 3 (PCWG3) from randomization to the first date of documented progression or death due to any cause, whichever occurs first (up to approximately 31 months) rPFS for randomized participants is the time between randomization and the first date of documented progression or death due to any cause, whichever occurs first. The rPFS was censored at the last radiographic tumor assessment up to the start of subsequent cancer therapy for those without progression or death. It was also censored at the date of last radiographic tumor assessment prior to the missed tumor assessments for participants who had progressive disease (PD) or death immediately after more than one consecutive missed tumor assessments. Radiographic progression is defined as at least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study). In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 millimeter (mm). The appearance of one or more new lesions is also considered progression.
Overall Survival (OS) From randomization to the date of death from any cause (Up to approximately 31 months) OS for all randomized participants is the time between randomization and the date of death from any cause. For participants who are alive, their survival time was censored at the last date that they were known to be alive. OS was censored for participants at the date of randomization if they had no follow-up.
- Secondary Outcome Measures
Name Time Method Time to Response (TTR) Assessed by Blinded Independent Central Review (BICR) Per Prostate Cancer Working Group (PCWG3) From randomization to the date of the first documented CR or PR (Up to approximately 31 months) Time to Response per PCWG3 (TTR-PCWG3) is the time from randomization to the date of the first documented CR or PR per PCWG3, as determined by BICR. Complete Response (CR) is defined as 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 (PR) is defined as at least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters.
Time to PSA Progression (TTP-PSA) from randomization to the date of PSA Progression (Up to approximately 31 months) Time to PSA Progression (TTP-PSA) is the time between randomization to the date of PSA progression per PCWG3 in randomized participants. PSA Progression: For participants with an initial PSA decline from baseline, the date of PSA progression is the date that an increase of 25% or more and an absolute increase of 2 ng/mL or more from the nadir are documented and confirmed by a second consecutive PSA value at least 3 weeks later. For participants with no PSA decline from baseline, the date of PSA progression is date that an increase of 25% or more and an absolute increase of 2 ng/mL or more from baseline are documented at or beyond Week 13. Baseline was defined as valuations or events that occur before the date and time of the first dose of study treatment or evaluations on the same date and time of the first dose of study treatment were also considered as baseline evaluations. Censored at date of last PSA evaluation on/prior to start of subsequent cancer therapy.
Objective Response Rate (ORR) Assessed by Blinded Independent Central Review (BICR) Per Prostate Cancer Working Group (PCWG3) From date of randomization to the date of objectively documented progression per PCWG3 or the date of subsequent systemic cancer therapy, whichever occurs first (Up to approximately 31 months) Objective Response Rate per PCWG3 (ORR-PCWG3) is the percentage of participants who have a confirmed complete or partial best overall response (BOR) per PCWG3 among randomized participants who have measurable disease at baseline. Complete Response (CR) is defined as 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 (PR) is defined as at least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters. Baseline was defined as evaluations or events that occur before the date and time of the first dose of study treatment or evaluations on the same date and time of the first dose of study treatment were also considered as baseline evaluations.
Prostate-specific Antigen (PSA) Response Rate (PSA-RR) Up to approximately 31 months PSA Response Rate (PSA-RR) is the percentage of randomized participants with a 50% or greater decrease in PSA from baseline to the lowest post-baseline PSA result. A second consecutive value obtained 3 or more weeks later is required to confirm the PSA response. Baseline was defined as valuations or events that occur before the date and time of the first dose of study treatment or evaluations on the same date and time of the first dose of study treatment were also considered as baseline evaluations.
Duration of Response Assessed by Blinded Independent Central Review (BICR) Per Prostate Cancer Working Group (PCWG3) From randomization date to the date of first documented radiographic progression or death due to any cause whichever occurs first (Up to approximately 31 months) Duration of Response per PCWG3 (DOR-PCWG3) is time between the date of first response (CR/PR per PCWG3) to the date of first documented radiographic progression per PCWG3,as determined by BICR, or death due to any cause whichever occurs first. Complete Response (CR) is defined as 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 (PR) is defined as at least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters. Radiographic 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 (this includes the baseline sum if that is the smallest on study). In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 millimeter (mm). The appearance of one or more new lesions is also considered progression.
Number of Participants Who Died Up to approximately 31 months Number of Participants With Adverse Events From first dose and 30 days after last dose of study therapy (Up to approximately 11 months) An Adverse Event (AE) is defined as any new untoward medical occurrence or worsening of a preexisting medical condition in a clinical investigation participant administered study treatment and that does not necessarily have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign (such as an abnormal laboratory finding), symptom, or disease temporally associated with the use of study treatment, whether or not considered related to the study treatment.
Number of Participants With Adverse Events Leading to Discontinuation From first dose and 30 days after last dose of study therapy (Up to approximately 11 months) An Adverse Event (AE) is defined as any new untoward medical occurrence or worsening of a preexisting medical condition in a clinical investigation participant administered study treatment and that does not necessarily have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign (such as an abnormal laboratory finding), symptom, or disease temporally associated with the use of study treatment, whether or not considered related to the study treatment.
Number of Participants With Serious Adverse Events From first dose and 30 days after last dose of study therapy (Up to approximately 11 months) Serious Adverse Event (SAE) is defined as any untoward medical occurrence that, at any dose results in death or Is life-threatening or requires inpatient hospitalization or causes prolongation of existing hospitalization or results in persistent or significant disability/incapacity or is a congenital anomaly/birth defect.
Number of Participants With Endocrine Immune-Mediated Adverse Events From first dose and 100 days after last dose of study therapy (Up to approximately 13 months) Immune-mediated adverse events are AEs consistent with an immune-mediated mechanism or immune-mediated component for which non-inflammatory etiologies (eg, infection or tumor progression) have been ruled out. IMAEs can include events with an alternate etiology which were exacerbated by the induction of autoimmunity. An Adverse Event (AE) is defined as any new untoward medical occurrence or worsening of a preexisting medical condition in a clinical investigation participant administered study treatment and that does not necessarily have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign (such as an abnormal laboratory finding), symptom, or disease temporally associated with the use of study treatment, whether or not considered related to the study treatment.
Number of Participants With Non-Endocrine Immune-Mediated Adverse Events From first dose and 100 days after last dose of study therapy (Up to approximately 13 months) Immune-mediated adverse events are AEs consistent with an immune-mediated mechanism or immune-mediated component for which non-inflammatory etiologies (eg, infection or tumor progression) have been ruled out. IMAEs can include events with an alternate etiology which were exacerbated by the induction of autoimmunity. An Adverse Event (AE) is defined as any new untoward medical occurrence or worsening of a preexisting medical condition in a clinical investigation participant administered study treatment and that does not necessarily have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign (such as an abnormal laboratory finding), symptom, or disease temporally associated with the use of study treatment, whether or not considered related to the study treatment.
Number of Participants With Worst Common Terminology Criteria (CTC) Grade Laboratory Test Results From first dose and 30 days after last dose of study therapy (Up to approximately 11 months) The severity of laboratory test results were graded based upon the participants symptoms according to the Common Terminology Criteria for Adverse Events (CTCAE, Version 5.0); Hematology parameters were evaluated for severity according to the following scale: Grade 0 is defined as absence of an AE or within normal limits; Grade 1 = Mild - transient or mild discomfort; no medical intervention required; Grade 2 = Moderate - mild to moderate limitation in activity; Grade 3 = Severe; Grade 4 = Life threatening. Number of participants with worst grade laboratory test results is presented.
Number of Participants With Select Adverse Events From first dose and 30 days after last dose of study therapy (Up to approximately 11 months) An Adverse Event (AE) is defined as any new untoward medical occurrence or worsening of a preexisting medical condition in a clinical investigation participant administered study treatment and that does not necessarily have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign (such as an abnormal laboratory finding), symptom, or disease temporally associated with the use of study treatment, whether or not considered related to the study treatment.
Number of Participants With Laboratory Abnormalities in Specific Thyroid Tests From first dose and 30 days after last dose of study therapy (Up to approximately 11 months) Blood samples were collected for conducting specific thyroid test. Baseline is defined as evaluations or events that occur before the date and time of the first dose of study treatment. Baseline was defined as evaluations or events that occur before the date and time of the first dose of study treatment or evaluations on the same date and time of the first dose of study treatment were also considered as baseline evaluations.
Time to Pain Progression as Assessed by Brief Pain Inventory-Short Form (BPI-SF) From randomization to 1st pain symptoms at their worst over the last 24 hours (Up to approximately 31 months The BPI-SF is an instrument to assess pain and includes severity and interference scores. BPI-SF is an 11-item self-report questionnaire designed to assess severity and impact of pain on daily function. Participants rate severity of pain at its "worst," "least," and "average" in last 24 hours using an 11-point numerical rating scale with anchors of "no pain" and "pain as bad. The participant's assessment of pain with BPI-SF Item number 3 (pain symptoms at their worst over the last 24 hours) form basis for analysis. Time to pain progression is time between date of randomization and date of first increase in worst pain intensity. Pain progression occurred if an increase in worst pain intensity of \>= 2 points is observed from baseline and maintained over 2 consecutive time periods. Baseline was evaluations or events that occur before date and time of first dose of study treatment or evaluations on same date and time of first dose of study treatment were also considered as baseline.
Trial Locations
- Locations (293)
Local Institution - 0011
🇺🇸San Antonio, Texas, United States
Local Institution - 0081
🇺🇸Santa Monica, California, United States
Local Institution - 0055
🇺🇸Rancho Mirage, California, United States
Local Institution - 0260
🇺🇸Redondo Beach, California, United States
Local Institution - 0382
🇺🇸Thomasville, Georgia, United States
Local Institution - 0287
🇺🇸Niles, Illinois, United States
Local Institution - 0126
🇺🇸Marietta, Georgia, United States
Local Institution - 0117
🇺🇸Atlanta, Georgia, United States
Local Institution - 0183
🇺🇸Fort Wayne, Indiana, United States
Local Institution - 0150
🇺🇸Baltimore, Maryland, United States
Local Institution - 0365
🇺🇸East Brunswick, New Jersey, United States
Local Institution - 0300
🇺🇸Albany, New York, United States
Local Institution - 0292
🇺🇸Pittsburgh, Pennsylvania, United States
Local Institution - 0074
🇺🇸Bala-Cynwyd, Pennsylvania, United States
Local Institution - 0195
🇺🇸Houston, Texas, United States
The University of Texas Health Science Center at Tyler DBA UT Health East Texas Hope Cancer Center
🇺🇸Tyler, Texas, United States
Local Institution - 0110
🇺🇸Seattle, Washington, United States
Local Institution - 0289
🇺🇸Spokane, Washington, United States
Local Institution - 0153
🇦🇷Parana, Cordoba, Argentina
Local Institution - 0083
🇦🇷Viedma, RIO Negro, Argentina
Local Institution - 0393
🇦🇷Rio Cuarto, Cordoba, Argentina
Local Institution - 0178
🇦🇷Buenos Aires, Argentina
Local Institution - 0185
🇦🇷Buenos Aires, Argentina
Local Institution - 0152
🇦🇺Gosford, New South Wales, Australia
Local Institution - 0091
🇦🇺Lismore, New South Wales, Australia
Local Institution - 0132
🇦🇺Wahroonga, New South Wales, Australia
Local Institution - 0127
🇦🇺Westmead, New South Wales, Australia
Local Institution - 0006
🇦🇺South Brisbane, Queensland, Australia
Local Institution - 0010
🇦🇺North Adelaide, South Australia, Australia
Local Institution - 0040
🇦🇺Frankston, Victoria, Australia
Local Institution - 0032
🇦🇺Malvern, Victoria, Australia
Local Institution - 0131
🇦🇹Wien, Austria
Local Institution - 0114
🇧🇪Gent, Belgium
Local Institution - 0097
🇧🇷Belo Horizonte, Minas Gerais, Brazil
Local Institution - 0162
🇧🇪Gent, Belgium
Local Institution - 0082
🇧🇷Curitiba, Parana, Brazil
Local Institution - 0100
🇧🇷Curitiba, Parana, Brazil
Local Institution - 0086
🇧🇷Campinas, SAO Paulo, Brazil
Local Institution - 0063
🇧🇷Porto Alegre, RS, Brazil
Local Institution - 0096
🇧🇷Sao Jose Do Rio Preto, Sao Paulo, Brazil
Local Institution - 0059
🇧🇷Santo Andre, SP, Brazil
Local Institution - 0189
🇧🇷Rio de Janeiro, Brazil
Local Institution - 0060
🇧🇷Rio de Janeiro, Brazil
Local Institution - 0273
🇧🇷Sao Paulo, Brazil
Local Institution - 0080
🇧🇷Sao Paulo, Brazil
Local Institution - 0191
🇨🇦Toronto, Ontario, Canada
Local Institution - 0328
🇧🇷Sao Paulo, Brazil
Local Institution - 0143
🇨🇦Montreal, Quebec, Canada
Local Institution - 0378
🇨🇱Providencia, Metropolitana, Chile
Local Institution - 0377
🇨🇱Santiago de Chile, Metropolitana, Chile
Local Institution - 0025
🇨🇱Santiago de Chile, Metropolitana, Chile
Local Institution - 0026
🇨🇱Santiago, RM, Chile
Local Institution - 0027
🇨🇱Vina del Mar, Valparaiso, Chile
Local Institution - 0245
🇨🇳Beijing, Beijing, China
Local Institution - 0140
🇨🇳Beijing Shi, Beijing, China
Local Institution - 0337
🇨🇳Beijing, Beijing, China
Local Institution - 0254
🇨🇳Beijing, Beijing, China
Local Institution - 0345
🇨🇳Beijing, Beijing, China
Local Institution - 0312
🇨🇳Beijing, Bei, China
Local Institution - 0256
🇨🇳Fuzhou, Fujian, China
Local Institution - 0320
🇨🇳Baoding Shi, Hebei, China
Local Institution - 0319
🇨🇳Guangzhou, Guangdong, China
Local Institution - 0224
🇨🇳Harbin Shi, Heilongjiang, China
Local Institution - 0314
🇨🇳Henan Sheng, Henan, China
Local Institution - 0275
🇨🇳Zhengzhou, Henan, China
Local Institution - 0313
🇨🇳Wu Han, Hubei, China
Local Institution - 0168
🇨🇳Changsha, Hunan, China
Local Institution - 0165
🇨🇳Nanjing, Jiangsu, China
Local Institution - 0317
🇨🇳Nanjing, Jiangsu, China
Local Institution - 0347
🇨🇳Nanchang, Jiangxi, China
Local Institution - 0325
🇨🇳Nanjing, Jiangsu, China
Local Institution - 0330
🇨🇳Nanchang, Jiangxi, China
Local Institution - 0326
🇨🇳Jinan, Shandong, China
Local Institution - 0155
🇨🇳Shanghai, Shanghai, China
Local Institution - 0161
🇨🇳Shenyang, Liaoning, China
Local Institution - 0353
🇨🇳Xian, Shannxi, China
Local Institution - 0253
🇨🇳Chengdu, Sichuan, China
Local Institution - 0310
🇨🇳Urumqi, Xinjiang, China
Local Institution - 0344
🇨🇳Hangzhou, Zhejiang, China
Local Institution - 0108
🇨🇿Brno, Czechia
Local Institution - 0316
🇨🇳Hangzhou, Zhejiang, China
Local Institution - 0093
🇨🇿Brno, Czechia
Local Institution - 0049
🇨🇿Olomouc, Czechia
Local Institution - 0361
🇨🇿Prague, Czechia
Local Institution - 0088
🇨🇿Ostrava, Czechia
Local Institution - 0050
🇨🇿Praha, Czechia
Local Institution - 0105
🇫🇷Strasbourg, Alsace, France
Local Institution - 0079
🇫🇷Lille, Nord, France
Local Institution - 0167
🇫🇷Le Mans, Sarthe, France
Local Institution - 0107
🇫🇷Angers Cedex 02, France
Local Institution - 0202
🇫🇷Brest, France
Local Institution - 0030
🇫🇷Hyeres, France
Local Institution - 0398
🇫🇷Dijon, France
Local Institution - 0395
🇫🇷Montpellier, France
Local Institution - 0384
🇫🇷Nice cedex 2, France
Local Institution - 0109
🇫🇷Montpellier, France
Local Institution - 0068
🇫🇷Nimes Cedex 9, France
Local Institution - 0106
🇫🇷Paris, France
Local Institution - 0071
🇫🇷Paris, France
Local Institution - 0381
🇫🇷Paris, France
Local Institution - 0133
🇫🇷Pierre-Benite, France
Local Institution - 0399
🇫🇷Reims, France
Local Institution - 0380
🇫🇷Rennes, France
Local Institution - 0387
🇫🇷Strasbourg, France
Local Institution - 0023
🇩🇪Nuertingen, Baden-Wuerttemberg, Germany
Local Institution - 0271
🇫🇷Villejuif Cedex, France
Local Institution - 0014
🇩🇪Koblenz, Rheinland Pfa, Germany
Local Institution - 0089
🇩🇪Bonn, Germany
Local Institution - 0090
🇩🇪Dresden, Saxony, Germany
Local Institution - 0376
🇩🇪Duesseldorf, Germany
Local Institution - 0172
🇩🇪Emmendingen, Germany
Local Institution - 0142
🇩🇪Erlangen, Germany
Local Institution - 0018
🇩🇪Frankfurt am Main, Germany
Local Institution - 0064
🇩🇪Hamburg, Germany
Local Institution - 0069
🇩🇪Hamburg, Germany
Local Institution - 0389
🇩🇪Heidelberg, Germany
Local Institution - 0004
🇩🇪Magdeburg, Germany
Local Institution - 0372
🇩🇪Marburg, Germany
Local Institution - 0204
🇩🇪Muenchen, Germany
Local Institution - 0036
🇩🇪Muenster, Germany
Local Institution - 0145
🇭🇰Hong Kong, Hong Kong
Local Institution - 0169
🇩🇪Tuebingen, Germany
Local Institution - 0045
🇭🇰Hong Kong, Hong Kong
Local Institution - 0146
🇭🇰Hong Kong, Hong Kong
Local Institution - 0072
🇮🇱Haifa, Israel
Local Institution - 0388
🇮🇱Jerusalem, Israel
Local Institution - 0128
🇮🇱Petach tikva, Israel
Local Institution - 0368
🇮🇱Kfar Saba, Israel
Local Institution - 0135
🇮🇱Ramat Gan, Israel
Local Institution - 0138
🇮🇱Tel Aviv, Israel
Local Institution - 0099
🇮🇹Benevento, Italy
Local Institution - 0001
🇮🇹Bergamo, Italy
Local Institution - 0111
🇮🇹Bologna, Italy
Local Institution - 0039
🇮🇹Brescia, Italy
Local Institution - 0066
🇮🇹Milan, Italy
Local Institution - 0053
🇮🇹Cremona, Italy
Local Institution - 0070
🇮🇹Orbassano, Italy
Local Institution - 0120
🇮🇹Napoli, Italy
Local Institution - 0037
🇮🇹Parma, Italy
Local Institution - 0199
🇮🇹Pisa, Italy
Local Institution - 0046
🇮🇹Rome, Italy
Local Institution - 0385
🇮🇹Rome, Italy
Local Institution - 0067
🇮🇹Trento, Italy
Local Institution - 0358
🇯🇵Hirosaki-shi, Aomori, Japan
Local Institution - 0362
🇯🇵Nagoya-shi, Aichi, Japan
Local Institution - 0340
🇯🇵Akita-shi, Akita, Japan
Local Institution - 0346
🇯🇵Chiba-shi, Chiba, Japan
Local Institution - 0296
🇯🇵Sapporo-shi, Hokkaido, Japan
Local Institution - 0339
🇯🇵Sakura-Shi, Chiba, Japan
Local Institution - 0307
🇯🇵Matsuyama-shi, Ehime, Japan
Local Institution - 0280
🇯🇵Fukuoka-shi, Fukuoka, Japan
Local Institution - 0281
🇯🇵Sapporo, Hokkaido, Japan
Local Institution - 0283
🇯🇵Yokohama-shi, Kanagawa, Japan
Local Institution - 0324
🇯🇵Kumamoto-Shi, Kumamoto, Japan
Local Institution - 0342
🇯🇵Kamigyo-ku, Kyoto, Japan
Local Institution - 0323
🇯🇵Osaka Sayama, Osaka, Japan
Local Institution - 0355
🇯🇵Kashihara-shi, Nara, Japan
Local Institution - 0343
🇯🇵Osaka shi, Osaka, Japan
Local Institution - 0309
🇯🇵Hamamatsu, Shizuoka, Japan
Local Institution - 0279
🇯🇵Toyama-shi, Toyama, Japan
Local Institution - 0282
🇯🇵Ube shi, Yamaguchi, Japan
Local Institution - 0341
🇯🇵Nagasaki, Japan
Local Institution - 0308
🇯🇵Tokyo, Japan
Local Institution - 0338
🇯🇵Osaka, Japan
Local Institution - 0354
🇯🇵Okayama, Japan
Local Institution - 0278
🇯🇵Wakayama, Japan
Local Institution - 0297
🇰🇷Jung-gu, Daejeon, Korea, Republic of
Local Institution - 0391
🇰🇷Daegu, Korea, Republic of
Local Institution - 0186
🇰🇷Songnam-si, Gyeonggi-do, Korea, Republic of
Local Institution - 0298
🇰🇷Incheon, Korea, Republic of
Local Institution - 0375
🇰🇷Jeollanam-do, Korea, Republic of
Local Institution - 0374
🇰🇷Seodaemun-Gu, Korea, Republic of
Local Institution - 0370
🇰🇷Seoul, Korea, Republic of
Local Institution - 0193
🇰🇷Seoul, Korea, Republic of
Local Institution - 0171
🇰🇷Seoul, Korea, Republic of
Local Institution - 0187
🇰🇷Seoul, Korea, Republic of
Local Institution - 0373
🇰🇷Seoul, Korea, Republic of
Local Institution - 0158
🇰🇷Yangsan Si, Korea, Republic of
Local Institution - 0017
🇲🇽Mexico City, D.f., Mexico
Local Institution - 0016
🇲🇽Zapopan, Jalisco, Mexico
Local Institution - 0062
🇲🇽Morelia, Michoacan, Mexico
Local Institution - 0184
🇳🇿Palmerston North, Manawatu-Wanganui, New Zealand
Local Institution - 0102
🇳🇿Tauranga, New Zealand
Local Institution - 0101
🇳🇿Hamilton, New Zealand
Local Institution - 0136
🇵🇱Koszalin, Poland
Local Institution - 0383
🇵🇱Bydgoszcz, Poland
Local Institution - 0095
🇵🇱Warszawa, Poland
Local Institution - 0009
🇵🇱Lodz, Poland
Local Institution - 0013
🇵🇱Lublin, Poland
Local Institution - 0065
🇵🇱Poznan, Poland
Local Institution
🇵🇱Warsaw, Poland
Local Institution - 0329
🇵🇷Rio Piedras, Puerto Rico
Local Institution - 0041
🇷🇴Cluj, Cluj-Napoca, Romania
Local Institution - 0043
🇷🇴Cluj Napoca, Romania
Local Institution - 0359
🇵🇷San Juan, Puerto Rico
Local Institution - 0020
🇷🇴Constanta, Romania
Local Institution - 0035
🇷🇴Timisoara, Romania
SBHI Arkhangelsk Region - Arkhangelsk Clinical Oncological Dispensary
🇷🇺Arkhangelsk, Russian Federation
SAHI Republican Clinical Oncology Dispensary of MoH of RT
🇷🇺Kazan, Russian Federation
Sechenov University
🇷🇺Moscow, Russian Federation
Clinical Hospital MEDSI in Otradnoye
🇷🇺Krasnogorsk Moscow Region, Russian Federation
Federal State Budgetary Institution N.N. Blokhin National Medical Research Center of Oncology of the
🇷🇺Moscow, Russian Federation
P.A. Herzen Moscow Oncology Research Institute
🇷🇺Moscow, Russian Federation
FSBI National Medical Research Radiology Center NMRRC - A. Tsyb Medical Radiological Research Centre
🇷🇺Obninsk, Russian Federation
Budgetary Healthcare Institution of Omsk Region ",Clinical Oncological Dispensary",
🇷🇺Omsk, Russian Federation
Local Institution - 0116
🇸🇬Singapore, Singapore
Local Institution - 0005
🇸🇬Singapore, Singapore
Local Institution - 0141
🇪🇸Manresa, Barcelona, Spain
Local Institution - 0073
🇪🇸Barcelona, Spain
Local Institution - 0123
🇪🇸Barcelona, Spain
Local Institution - 0360
🇪🇸Cordoba, Spain
Local Institution - 0034
🇪🇸Lugo, Spain
Local Institution - 0076
🇪🇸Madrid, Spain
Local Institution - 0003
🇪🇸Madrid, Spain
Local Institution - 0024
🇪🇸Madrid, Spain
Local Institution - 0364
🇪🇸Madrid, Spain
Local Institution - 0363
🇪🇸Sevilla, Spain
Local Institution - 0124
🇪🇸Sabadell (Barcelona), Spain
Local Institution - 0192
🇨🇳Niaosng, Kaohsiung, Taiwan
Local Institution - 0386
🇨🇳Tainan, Taiwan
Local Institution - 0194
🇨🇳Taichung, Taiwan
Local Institution - 0371
🇨🇳Taichung, Taiwan
Local Institution - 0094
🇹🇷Adana, Turkey
Local Institution - 0188
🇨🇳Taipei, Taiwan
Local Institution - 0119
🇹🇷Ankara, Turkey
Local Institution - 0130
🇹🇷Ankara, Turkey
Local Institution - 0113
🇹🇷Istanbul, Turkey
Local Institution - 0112
🇹🇷Malatya, Turkey
Local Institution - 0173
🇬🇧London, Greater London, United Kingdom
Local Institution - 0098
🇬🇧Manchester, Lancashire, United Kingdom
Local Institution - 0265
🇬🇧Oxford, Oxfordshire, United Kingdom
Local Institution - 0051
🇬🇧Nottingham, Nottinghamshire, United Kingdom
Local Institution - 0048
🇬🇧Guildford, Surrey, United Kingdom
Local Institution - 0333
🇺🇸Columbus, Ohio, United States
Local Institution - 0179
🇺🇸Orange, California, United States
Local Institution - 0305
🇺🇸Mobile, Alabama, United States
Local Institution - 0180
🇺🇸Allentown, Pennsylvania, United States
Local Institution - 0303
🇺🇸Dallas, Texas, United States
Local Institution - 0028
🇺🇸Port Jefferson Station, New York, United States
Local Institution - 0284
🇺🇸Houston, Texas, United States
Local Institution - 0058
🇧🇷Ijui, Rio Grande Do Sul, Brazil
Local Institution - 0057
🇧🇷Porto Alegre, Rio Grande Do Sul, Brazil
Local Institution - 0056
🇧🇷Porto Alegre, RIO Grande DO SUL, Brazil
Local Institution - 0321
🇧🇷Natal, Rio Grande Do Norte, Brazil
Local Institution - 0022
🇧🇷Belo Horizonte, Minas Gerais, Brazil
Local Institution - 0129
🇦🇷Mar del Plata, Buenos Aires, Argentina
Local Institution - 0061
🇦🇷Pergamino, Buenos Aires, Argentina
Local Institution - 0137
🇧🇪Turnhout, Belgium
Local Institution - 0366
🇺🇸Washington, District of Columbia, United States
Local Institution - 0269
🇺🇸Jonesboro, Arkansas, United States
Local Institution - 0122
🇧🇪Anderlecht, Brussel, Belgium
Local Institution - 0139
🇺🇸Florham Park, New Jersey, United States
Local Institution - 0118
🇦🇹Linz, Upper Austria, Austria
Local Institution - 0332
🇺🇸Brandywine, Maryland, United States
Local Institution - 0196
🇺🇸Hollywood, Florida, United States
Local Institution - 0077
🇦🇷Buenos Aires, Argentina
Local Institution - 0285
🇺🇸Pensacola, Florida, United States
Local Institution - 0164
🇺🇸Lakeland, Florida, United States
Local Institution - 0177
🇺🇸Weston, Florida, United States
Local Institution - 0190
🇺🇸West Haven, Connecticut, United States
Local Institution - 0397
🇺🇸Jacksonville, Florida, United States
Local Institution - 0327
🇯🇵Niigata, Japan
Local Institution - 0052
🇷🇴Craiova, Romania
Russian Scientific Centre of Radiology and Surgical Technologies n.a. acad. M.A.
🇷🇺Saint-Petersburg, Russian Federation
Local Institution - 0104
🇹🇷Izmir, Turkey
Local Institution - 0012
🇺🇸Anchorage, Alaska, United States
Local Institution - 0115
🇺🇸Myrtle Beach, South Carolina, United States
Local Institution - 0369
🇦🇷La Rioja, Argentina
Local Institution - 0038
🇦🇹Salzburg, Austria
Local Institution - 0157
🇦🇹Wien, Austria
Local Institution - 0149
🇺🇸Germantown, Tennessee, United States
Local Institution - 0293
🇺🇸Tucson, Arizona, United States
Local Institution - 0084
🇦🇺Woolloongabba, Queensland, Australia
Local Institution - 0175
🇨🇳Taipei, Taiwan
Local Institution - 0170
🇸🇬Singapore, Singapore
Local Institution - 0394
🇦🇷San Juan, Argentina
Local Institution - 0121
🇧🇪Brugge, Belgium
Andros Clinic LLC
🇷🇺Saint-Petersburg, Russian Federation
Local Institution - 0379
🇦🇺Ballarat, Victoria, Australia
Local Institution - 0042
🇷🇴Bucharest, Romania
Local Institution - 0031
🇪🇸Madrid, Spain
Local Institution - 0029
🇧🇪Wilrijk, Belgium
Local Institution - 0087
🇺🇸Denver, Colorado, United States
Local Institution - 0008
🇬🇧Northwood, Middlesex, United Kingdom
Local Institution - 0154
🇬🇧London, United Kingdom
Local Institution - 0299
🇺🇸Omaha, Nebraska, United States
Local Institution - 0044
🇪🇸Girona, Spain
Local Institution - 0151
🇨🇦Brampton, Ontario, Canada
Local Institution - 0181
🇺🇸Orlando, Florida, United States
Local Institution - 0302
🇺🇸Louisville, Kentucky, United States
Local Institution - 0286
🇺🇸Austin, Texas, United States
Local Institution - 0233
🇺🇸Charleston, South Carolina, United States
Local Institution - 0015
🇲🇽Zapopan, Jalisco, Mexico