Study to Evaluate the Efficacy and Safety of Camidanlumab Tesirine (ADCT-301) in Patients With Relapsed or Refractory Hodgkin Lymphoma

Phase 2

Completed

• Conditions: Relapsed Hodgkin Lymphoma; Refractory Hodgkin Lymphoma
• Interventions: Drug: Camidanlumab Tesirine

• Registration Number: NCT04052997
• Lead Sponsor: ADC Therapeutics S.A.

Brief Summary

The purpose of this study is to evaluate the clinical efficacy and safety of Camidanlumab Tesirine (ADCT-301) in participants with relapsed or refractory Hodgkin Lymphoma (HL).

Detailed Description

This is a phase 2, multi-center, open-label, single-arm study of efficacy and safety of Camidanlumab Tesirine (ADCT-301) in participants with relapsed or refractory Hodgkin lymphoma. This study will enroll approximately 100 participants.

Camidanlumab Tesirine (ADCT-301) is an antibody drug conjugate (ADC), composed of the human monoclonal antibody, HuMax®-TAC, which is directed against human CD25. The antibody is conjugated through a protease cleavable linker to SG3199, a pyrrolobenzodiazepine (PBD) dimer cytotoxin.

For each participant the study will include a screening period (of up to 28 days), a treatment period (cycles of 3 weeks), and a follow-up period (approximately every 12-week visits) for up to 3 years after treatment discontinuation.

Participants may continue treatment for up to 1 year or until disease progression, unacceptable toxicity, or other discontinuation criteria, whichever occurs first.

Additionally, patients benefiting clinically at 1 year may continue treatment after a case by case review with the Sponsor.

Study Timeline

• Study First Submitted: 2019-08-07
• Study First Submitted QC: 2019-08-08
• Study First Posted: 2019-08-12
• Study Start: 2019-09-13
• Primary Completion: 2023-01-19
• Study Completion: 2023-01-19
• Results First Submitted: 2024-01-16
• Status Verified: 2024-03
• Results First Submitted QC: 2024-03-01
• Last Update Submitted: 2024-03-01
• Results First Posted: 2024-03-28
• Last Update Posted: 2024-03-28

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 117

Inclusion Criteria

1. Written informed consent must be obtained prior to any procedures.

2. Male or female participant aged 18 years or older. (16 years or older at US based sites)

3. Pathologic diagnosis of classical Hodgkin lymphoma (cHL).

4. Patients with relapsed or refractory cHL, who have received at least 3 prior lines of systemic therapy (or at least 2 prior lines in HSCT ineligible patients) including brentuximab vedotin and a checkpoint inhibitor approved for cHL (e.g., nivolumab or pembrolizumab). Note 1: Receipt of HSCT to be included in the number of prior therapies needed to meet eligibility.

5. Measurable disease as defined by the 2014 Lugano Classification.

6. Availability of formalin-fixed paraffin-embedded (FFPE) tumor tissue block (or minimum 10 freshly cut unstained slides if block is not available).

   Note 1: Any biopsy since initial diagnosis is acceptable, but if several samples are available, the most recent sample is preferred.

   Note 2: If a sufficient amount of tissue is not available, a fresh biopsy may be taken, provided the procedure is not deemed high-risk and is clinically feasible, and provided it is approved locally.

7. Eastern Cooperative Oncology Group (ECOG) performance status 0-2.

8. Adequate organ function as defined by Screening laboratory values within the following parameters:

   1. Absolute neutrophil count (ANC) ≥ 1.0 × 103/μL (off growth factors at least 72 h).
   2. Platelet count ≥ 75 × 103/μL without transfusion in the past 2 weeks.
   3. ALT, AST, or GGT ≤ 2.5 × the upper limit of normal (ULN) if there is no liver involvement; ALT or AST ≤ 5 × ULN if there is liver involvement.
   4. Total bilirubin ≤ 1.5 × ULN (participants with known Gilbert's syndrome may have a total bilirubin up to ≤ 3 × ULN with direct bilirubin ≤ 1.5 × ULN).
   5. Blood creatinine ≤ 3.0 × ULN or calculated creatinine clearance ≥ 30 mL/min by the Cockcroft-Gault equation.

   Note: A laboratory assessment may be repeated a maximum of two times during the Screening Period to confirm eligibility.

9. Negative beta-human chorionic gonadotropin (β-HCG) pregnancy test within 7 days prior to start of study drug for women of childbearing potential.

10. Women of childbearing potential (WOCBP) must agree to use a highly effective method of contraception from the time of giving informed consent until at least 9.5 months after the last dose of Camidanlumab Tesirine. Men with female partners who are of childbearing potential must agree to use a highly effective method of contraception from the time of giving informed consent until at least 6.5 months after the participants receives his last dose of Camidanlumab Tesirine.

Exclusion Criteria

1. Previous treatment with Camidanlumab Tesirine.

2. Participation in another investigational interventional study. Being in follow-up of another investigational study is allowed.

3. Known history of hypersensitivity to or positive serum human anti-drug antibody (ADA) to a CD25 antibody.

4. Allogenic or autologous transplant within 60 days prior to start of study drug.

5. Active graft-versus-host disease (GVHD), except for non-neurologic symptoms as a manifestation of mild (≤ Grade 1) chronic GVHD.

6. Post-transplantation lymphoproliferative disorders.

7. Active second primary malignancy other than non-melanoma skin cancers, non-metastatic prostate cancer, in situ cervical cancer, ductal or lobular carcinoma in situ of the breast, or other malignancy that the Sponsor's medical monitor and Investigator agree and document should not be exclusionary.

8. History of symptomatic autoimmune disease (e.g., rheumatoid arthritis, systemic progressive sclerosis [scleroderma], systemic lupus erythematosus, Sjögren's syndrome, autoimmune vasculitis [e.g., Wegener's granulomatosis]) (subjects with vitiligo, type 1 diabetes mellitus, residual hypothyroidism, hypophysitis due to autoimmune condition only requiring hormone replacement may be enrolled).

9. History of neuropathy considered of autoimmune origin (e.g., polyradiculopathy including Guillain-Barré syndrome and myasthenia gravis) or other central nervous system autoimmune disease (e.g., poliomyelitis, multiple sclerosis).

10. History of recent infection (within 4 weeks of Cycle 1, Day 1 [C1D1]) considered to be caused by one of the following pathogens: HSV1, HSV2, VZV, EBV, CMV, measles, Influenza A, Zika virus, Chikungunya virus, mycoplasma pneumonia, Campylobacter jejuni, or enterovirus D68, or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

    Note: An influenza test and a pathogendirected SARS CoV-2 test (such as polymerase chain reaction) are mandatory and must be negative before initiating study treatment (tests to be performed 3 days or less prior to dosing on C1D1; an additional 2 days are allowed in the event of logistical issues for receiving the results on time).

11. Participants known to be or having been infected with human immunodeficiency (HIV) virus, hepatitis B virus (HBV), or hepatitis C virus (HCV), and require anti-viral therapy or prophylaxis. Note: Serology testing is mandatory for patients with unknown status.

12. History of Stevens-Johnson syndrome or toxic epidermal necrolysis.

13. Failure to recover ≤ Grade 1 (Common Terminology Criteria for Adverse Events version 4.0 [CTCAE v4.0]) from acute non-hematologic toxicity (except ≤ Grade 2 neuropathy or alopecia), due to previous therapy, prior to screening.

14. Hodgkin lymphoma (HL) with central nervous system involvement, including leptomeningeal disease.

15. Clinically significant third space fluid accumulation (i.e., ascites requiring drainage or pleural effusion that is either requiring drainage or associated with shortness of breath).

16. Breastfeeding or pregnant.

17. Significant medical comorbidities, including uncontrolled hypertension (blood pressure [BP] ≥ 160/100 mmHg repeatedly), unstable angina, congestive heart failure (greater than New York Heart Association class II), electrocardiographic evidence of acute ischemia, coronary angioplasty or myocardial infarction within 3 months prior to screening, severe uncontrolled atrial or ventricular cardiac arrhythmia, poorly controlled diabetes, or severe chronic pulmonary disease.

18. Major surgery, radiotherapy, chemotherapy, or other anti-neoplastic therapy, within 14 days prior to start of study drug, except shorter if approved by the Sponsor.

19. Use of any other experimental medication within 30 days prior to start of study drug.

20. Any live vaccine within 4 weeks prior to start of study drug and planned live vaccine administration after starting study drug.

21. Congenital long QT (measure between Q wave and T wave in the electrocardiogram) syndrome, or a corrected QTc interval of ≥ 480 ms, at screening (unless secondary to pacemaker or bundle branch block).

22. Any other significant medical illness, abnormality, or condition that would, in the Investigator's judgment, make the participants inappropriate for study participation or put the participant at risk.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
Camidanlumab Tesirine	Camidanlumab Tesirine	Camidanlumab Tesirine is administered as a 30- minute intravenous (IV) infusion on Day 1 of each cycle (every 3 weeks). Camidanlumab Tesirine will be administered at a dose of 45 μg/kg every 3 weeks for 2 cycles, then 30 μg/kg for subsequent cycles.

Primary Outcome Measures

Name	Time	Method
Overall Response Rate (ORR)	Up to 3 years	ORR according to the 2014 Lugano classification as determined by central review in all-treated participants.ORR will be defined as the proportion of participants with a best overall response (BOR) of complete response (CR) or partial response (PR). Data from the All-treated Population.

Secondary Outcome Measures

Name	Time	Method
Area Under the Plasma Concentration-Time Curve From Time 0 to the End of the Dosing Interval (AUCtau) For Camidanlumab Tesirine Total Antibody	Cycle 2 (one cycle = 21 days): day 1 (predose, EOI, 4h postdose), day 8 (168h), day 15 (336h)
AUCtau For Camidanlumab Tesirine Unconjugated Warhead SG3199	Cycle 2 (one cycle = 21 days): day 1 (predose, EOI, 4h postdose), day 8 (168h), day 15 (336h)	No data collected for this endpoint.
AUCtau For Camidanlumab Tesirine PBD-Conjugated Antibody	Cycle 2 (one cycle = 21 days): day 1 (predose, EOI, 4h postdose), day 8 (168h), day 15 (336h)
Cmax of Camidanlumab Tesirine Unconjugated Warhead SG3199	Cycle 1 (one cycle = 21 days): day 1 (predose, EOI, 4h postdose), day 8 (168h), day 15 (336h). Cycle 2: day 1 (predose, EOI, 4h postdose), day 8 (168h), day 15 (336h)
Area Under the Plasma Concentration-Time Curve From Time 0 to the Time of the Last Quantifiable Concentration (AUClast) For Camidanlumab Tesirine Total Antibody	Cycle 1 (one cycle = 21 days): day 1 (predose, EOI, 4h postdose), day 8 (168h), day 15 (336h). Cycle 2: day 1 (predose, EOI, 4h postdose), day 8 (168h), day 15 (336h)
AUClast For Camidanlumab Tesirine PBD-Conjugated Antibody	Cycle 1 (one cycle = 21 days): day 1 (predose, EOI, 4h postdose), day 8 (168h), day 15 (336h). Cycle 2: day 1 (predose, EOI, 4h postdose), day 8 (168h), day 15 (336h)
Area Under the Plasma Concentration-Time Curve From Time 0 to Infinity (AUCinf) For Camidanlumab Tesirine Total Antibody	Cycle 1 (one cycle = 21 days): day 1 (predose, EOI, 4h postdose), day 8 (168h), day 15 (336h)
Duration of Response (DOR)	Up to 3 years	DOR defined as the time from the first documentation of tumor response to disease progression or death.
Relapse-Free Survival (RFS)	Up to 3 years	RFS defined as the time from the documentation of CR to disease progression or death.
Progression-Free Survival (PFS)	Up to 3 years	PFS defined as the time from first dose of study drug until the first date of either disease progression or death due to any cause.
Number of Participants Who Experienced At Least One Serious Adverse Event (SAE)	Up to 3 years	An SAE is defined as any adverse event (AE) that: * results in death.; * is life threatening.; * requires inpatient hospitalization or prolongation of existing hospitalization (hospitalization for elective procedures or for protocol compliance is not considered an SAE).; * results in persistent or significant disability/incapacity.; * is a congenital anomaly/birth defect.; * important medical events that do not meet the preceding criteria but based on appropriate medical judgement may jeopardize the participant or may require medical or surgical intervention to prevent any of the outcomes listed above. Clinically significant changes in vital signs, clinical laboratory results, and electrocardiogram were reported as AEs.
Maximum Observed Plasma Concentration (Cmax) of Camidanlumab Tesirine Total Antibody	Cycle 1 (one cycle = 21 days): day 1 (predose, EOI, 4h postdose), day 8 (168h), day 15 (336h). Cycle 2: day 1 (predose, EOI, 4h postdose), day 8 (168h), day 15 (336h)
AUClast For Camidanlumab Tesirine Unconjugated Warhead SG3199	Cycle 1 (one cycle = 21 days): day 1 (predose, EOI, 4h postdose), day 8 (168h), day 15 (336h). Cycle 2: day 1 (predose, EOI, 4h postdose), day 8 (168h), day 15 (336h)
AUCinf For Camidanlumab Tesirine PBD-Conjugated Antibody	Cycle 1 (one cycle = 21 days): day 1 (predose, EOI, 4h postdose), day 8 (168h), day 15 (336h)
CR Rate	Up to 3 years	CR rate defined as the number of treated participants with a best overall response (BOR) of CR.
Number of Participants Who Received Hematopoietic Stem Cell Transplant (HSCT)	Up to 3 years	Participants receiving HSCT following camidanlumab tesirine, and without any other anticancer therapy in between, other than the therapies preparing for HSCT, were included in this analysis.
Cmax of Camidanlumab Tesirine PBD-Conjugated Antibody	Cycle 1 (one cycle = 21 days): day 1 (predose, EOI, 4h postdose), day 8 (168h), day 15 (336h). Cycle 2: day 1 (predose, EOI, 4h postdose), day 8 (168h), day 15 (336h)
CLss For Camidanlumab Tesirine Unconjugated Warhead SG3199	Cycle 2 (one cycle = 21 days): day 1 (predose, EOI, 4h postdose), day 8 (168h), day 15 (336h)
Number of Participants With Confirmed Positive Anti-Drug Antibody (ADA) Responses Post Dose	Up to 3 years	Detection of ADAs was performed by using a screening assay for identification of antibody positive samples/participants, a confirmation assay, and titer assessment.
Change From Baseline in HRQoL as Measured by Functional Assessment of Cancer Therapy - Lymphoma (FACT-Lym)	Baseline, Day 1 of Cycles 2 to 15 (one cycle = 21 days) and EOT (up to 3 years)	The FACT-Lym consists of a 27-item general core questionnaire (i.e., Functional Assessment of Cancer Therapy - General \[FACT-G\]) and a 15-item disease-specific questionnaire (Lymphoma Subscale). The FACT-G includes 4 domains: physical well-being, social/family well-being, emotional well-being, and functional well-being. The total FACT-Lym score (0-168) was obtained by summing individual subscale scores. Higher scores for the scales indicate better quality of life. Change was calculated as the value at the last observation minus the value at baseline.
Overall Survival (OS)	Up to 3 years	OS defined as the time from first dose of study drug until death due to any cause.
CL For Camidanlumab Tesirine Unconjugated Warhead SG3199	Cycle 1 (one cycle = 21 days): day 1 (predose, EOI, 4h postdose), day 8 (168h), day 15 (336h)
Apparent Terminal Elimination Half-Life (T1/2) For Camidanlumab Tesirine Total Antibody	Cycle 1 (one cycle = 21 days): day 1 (predose, EOI, 4h postdose), day 8 (168h), day 15 (336h). Cycle 2: day 1 (predose, EOI, 4h postdose), day 8 (168h), day 15 (336h)
T1/2 For Camidanlumab Tesirine PBD-Conjugated Antibody	Cycle 1 (one cycle = 21 days): day 1 (predose, EOI, 4h postdose), day 8 (168h), day 15 (336h). Cycle 2: day 1 (predose, EOI, 4h postdose), day 8 (168h), day 15 (336h)
Volume of Distribution at Steady State (Vss) For Camidanlumab Tesirine Total Antibody	Cycle 1 (one cycle = 21 days): day 1 (predose, EOI, 4h postdose), day 8 (168h), day 15 (336h). Cycle 2: day 1 (predose, EOI, 4h postdose), day 8 (168h), day 15 (336h)
Vss For Camidanlumab Tesirine PBD-Conjugated Antibody	Cycle 1 (one cycle = 21 days): day 1 (predose, EOI, 4h postdose), day 8 (168h), day 15 (336h). Cycle 2: day 1 (predose, EOI, 4h postdose), day 8 (168h), day 15 (336h)
Vss For Camidanlumab Tesirine Unconjugated Warhead SG3199	Cycle 1 (one cycle = 21 days): day 1 (predose, EOI, 4h postdose), day 8 (168h), day 15 (336h). Cycle 2: day 1 (predose, EOI, 4h postdose), day 8 (168h), day 15 (336h)
Number of Participants Who Experienced At Least One Treatment-Emergent Adverse Event (TEAE)	Up to 3 years	An adverse event (AE) is defined as any untoward medical occurrence in a participant or clinical investigation where participants are administered a pharmaceutical product, which does not necessarily have to have a causal relationship with this treatment. A TEAE is defined as an AE that occurs or worsens in the period extending from the first dose of study drug to 30 days after the last dose of study drug in this study or start of a new anticancer therapy/procedure, whichever comes earlier. Clinically significant changes in vital signs, clinical laboratory results, and electrocardiogram were reported as AEs.
Number of Participants With ECOG Performance Status Score of 0-3 at the End of Trial (EOT)	EOT (up to 3 years)	The ECOG Performance Status is a scale used to asses a person's level of functioning in terms of their ability to care for themselves, daily activity, and physical ability. The scale consists of 6 grades, ranging from 0 to 5. A grade of 0 indicates the person is fully active and able to carry on as normal, and a grade of 5 indicates death.
Clearance (CL) For Camidanlumab Tesirine Total Antibody	Cycle 1 (one cycle = 21 days): day 1 (predose, EOI, 4h postdose), day 8 (168h), day 15 (336h)
Clearance at Steady State (CLss) For Camidanlumab Tesirine Total Antibody	Cycle 2 (one cycle = 21 days): day 1 (predose, EOI, 4h postdose), day 8 (168h), day 15 (336h)
Change From Baseline in Health-Related Quality of Life (HRQoL) as Measured by EuroQoL-5 Dimensions-5 Levels (EQ-5D-5L) Visual Analog Scale (VAS)	Baseline, Day 1 of Cycles 2 to 15 (one cycle = 21 days) and EOT (up to 3 years)	Participants were asked to indicate their health state on a VAS with scores ranging from 'the worst health you can imagine' (score 0) to 'the best health you can imagine' (score 100). Participants are asked to mark an "X" on the VAS to indicate their own health and then to report the score in a text box. Positive changes from Baseline represent an an improvement in heath.
AUCinf For Camidanlumab Tesirine Unconjugated Warhead SG3199	Cycle 1 (one cycle = 21 days): day 1 (predose, EOI, 4h postdose), day 8 (168h), day 15 (336h)
CL For Camidanlumab Tesirine PBD-Conjugated Antibody	Cycle 1 (one cycle = 21 days): day 1 (predose, EOI, 4h postdose), day 8 (168h), day 15 (336h)
Accumulation Index (AI) For Camidanlumab Tesirine Total Antibody	Cycle 1 and 2: day 0 to 21	AI is the ratio of area under the serum concentration-time curve (AUC) from 0 to 21 days for Cycle 2 divided by AUC from 0 to 21 days for Cycle 1.
AI For Camidanlumab Tesirine Unconjugated Warhead SG3199	Cycle 1 and 2: day 0 to 21	AI is the ratio of AUC from 0 to 21 days for Cycle 2 divided by AUC from 0 to 21 days for Cycle 1.
T1/2 For Camidanlumab Tesirine Unconjugated Warhead SG3199	Cycle 1 (one cycle = 21 days): day 1 (predose, EOI, 4h postdose), day 8 (168h), day 15 (336h). Cycle 2: day 1 (predose, EOI, 4h postdose), day 8 (168h), day 15 (336h)
CLss For Camidanlumab Tesirine PBD-Conjugated Antibody	Cycle 2 (one cycle = 21 days): day 1 (predose, EOI, 4h postdose), day 8 (168h), day 15 (336h)
AI For Camidanlumab Tesirine PBD-Conjugated Antibody	Cycle 1 and 2: day 0 to 21	AI is the ratio of AUC from 0 to 21 days for Cycle 2 divided by AUC from 0 to 21 days for Cycle 1.

Trial Locations

Locations (73)

Hackensack University Medical Center; 🇺🇸 Hackensack, New Jersey, United States

The University of Texas Health Science Center at San Antonio; 🇺🇸 San Antonio, Texas, United States

Cleveland Clinic - Taussig Cancer Center; 🇺🇸 Cleveland, Ohio, United States

Hospital Universitari i Politècnic La Fe; 🇪🇸 Valencia, Spain

UCSF Health - Hematology and Blood and Marrow Transplant Clinic; 🇺🇸 San Francisco, California, United States

Stanford University Medical Center; 🇺🇸 Stanford, California, United States

City of Hope Comprehensive Cancer Center; 🇺🇸 Duarte, California, United States

Baptist MD Anderson Cancer Center; 🇺🇸 Jacksonville, Florida, United States

Northside Hospital - Atlanta; 🇺🇸 Atlanta, Georgia, United States

The University of Chicago Medicine; 🇺🇸 Chicago, Illinois, United States

University Hospitals Seidman Cancer Center; 🇺🇸 Cleveland, Ohio, United States

Stony Brook University Cancer Center; 🇺🇸 Stony Brook, New York, United States

The Ohio State University Comprehensive Cancer Center; 🇺🇸 Columbus, Ohio, United States

University of Texas Southwestern Medical Center; 🇺🇸 Dallas, Texas, United States

Virginia Cancer Specialists; 🇺🇸 Fairfax, Virginia, United States

The University of Texas MD Anderson Cancer Center; 🇺🇸 Houston, Texas, United States

Algemeen Ziekenhuis Sint-Jan Brugge-Oostende - Campus Sint-Jan; 🇧🇪 Brugge, Belgium

Grand Hôpital de Charleroi - Notre Dame; 🇧🇪 Charleroi, Belgium

Hôpital de Jolimont; 🇧🇪 La Louvière, Belgium

Centre Hospitalier Universitaire Universite Catholique de Louvain - Site Godinne; 🇧🇪 Yvoir, Belgium

The Ottawa Hospital - General Campus; 🇨🇦 Ottawa, Canada

Princess Margaret Cancer Centre; 🇨🇦 Toronto, Canada

Fakultní Nemocnice Brno; 🇨🇿 Brno, Czechia

Vseobecna fakultni nemocnice v Praze; 🇨🇿 Prague, Czechia

Hôpital Saint-Eloi; 🇫🇷 Montpellier, France

Hôpital François Mitterrand; 🇫🇷 Dijon, France

Hôpitaux Universitaires Henri Mondor; 🇫🇷 Créteil, France

Clinique Victor Hugo Le Mans; 🇫🇷 Le Mans, France

Hôpital Haut-Lévêque; 🇫🇷 Pessac, France

Centre Hospitalier Lyon-Sud; 🇫🇷 Pierre-Bénite, France

Universitätsklinikum Halle; 🇩🇪 Halle, Germany

Azienda Ospedaliera Nazionale SS. Antonio e Biagio e C. Arrigo - Alessandria; 🇮🇹 Alessandria, Italy

Istituto Oncologico Veneto - IRCCS; 🇮🇹 Padova, Italy

Azienda Ospedaliero-Universitaria di Bologna Policlinico Sant Orsola-Malpighi; 🇮🇹 Bologna, Italy

Istituto Nazionale Tumori IRCCS Fondazione G. Pascale; 🇮🇹 Napoli, Italy

Szpital Wojewódzki w Opolu; 🇵🇱 Opole, Poland

Hospital de la Santa Creu i Sant Pau; 🇪🇸 Barcelona, Spain

Hospital Universitari Vall d'Hebrón; 🇪🇸 Barcelona, Spain

Hospital General Universitario Gregorio Marañón; 🇪🇸 Madrid, Spain

Hospital Clínic de Barcelona; 🇪🇸 Barcelona, Spain

Institut Català d'Oncologia - Hospital Duran i Reynals (ICO L'Hospitalet); 🇪🇸 Barcelona, Spain

Hospital Universitario La Paz; 🇪🇸 Madrid, Spain

Complejo Asistencial Universitario de Salamanca - Hospital Clínico; 🇪🇸 Salamanca, Spain

Hospital Universitario Fundación Jiménez Díaz; 🇪🇸 Madrid, Spain

Hospital Universitario HM Sanchinarro; 🇪🇸 Madrid, Spain

Hospital Universitario 12 de Octubre; 🇪🇸 Madrid, Spain

Hospital Universitario Quirónsalud Madrid; 🇪🇸 Pozuelo De Alarcón, Spain

Hospital Clínico Universitario de Valencia; 🇪🇸 València, Spain

NHS Greater Glasgow and Clyde; 🇬🇧 Glasgow, United Kingdom

The Royal Marsden NHS Foundation Trust; 🇬🇧 London, United Kingdom

Oxford University Hospitals NHS Foundation Trust; 🇬🇧 Oxford, United Kingdom

The Christie NHS Foundation Trust; 🇬🇧 Manchester, United Kingdom

University Hospitals Plymouth NHS Trust; 🇬🇧 Plymouth, United Kingdom

University of Minnesota; 🇺🇸 Minneapolis, Minnesota, United States

Mayo Clinic - Arizona; 🇺🇸 Scottsdale, Arizona, United States

Mayo Clinic - Jacksonville; 🇺🇸 Jacksonville, Florida, United States

Washington University School of Medicine in Saint Louis; 🇺🇸 Saint Louis, Missouri, United States

Memorial Sloan-Kettering Cancer Center - New York; 🇺🇸 New York, New York, United States

Fakultní Nemocnice Královské Vinohrady; 🇨🇿 Praha 10, Czechia

Centre de Lutte Contre le Cancer - Centre Henri-Becquerel; 🇫🇷 Rouen, France

Hôpital Pontchaillou; 🇫🇷 Rennes, France

Pécsi Tudományegyetem; 🇭🇺 Pécs, Hungary

Debreceni Egyetem Klinikai Központ; 🇭🇺 Debrecen, Hungary

Istituto Clinico Humanitas; 🇮🇹 Milan, Italy

Dolnośląskie Centrum Transplantacji Komórkowych z Krajowym Bankiem Dawców Szpiku; 🇵🇱 Wrocław, Poland

Hospital Universitario Ramón y Cajal; 🇪🇸 Madrid, Spain

British Columbia Cancer Agency; 🇨🇦 Vancouver, British Columbia, Canada

University College London Hospitals NHS Foundation Trust; 🇬🇧 London, United Kingdom

Norton Cancer Institute - Saint Matthews; 🇺🇸 Louisville, Kentucky, United States

Hollings Cancer Center; 🇺🇸 Charleston, South Carolina, United States

Mayo Clinic; 🇺🇸 Rochester, Minnesota, United States

Froedtert Hospital; 🇺🇸 Milwaukee, Wisconsin, United States

Cliniques Universitaires Saint-Luc; 🇧🇪 Brussels, Belgium