A Study of Atezolizumab Compared With Chemotherapy in Participants With Locally Advanced or Metastatic Urothelial Bladder Cancer [IMvigor211]
- Conditions
- Bladder Cancer
- Interventions
- Registration Number
- NCT02302807
- Lead Sponsor
- Hoffmann-La Roche
- Brief Summary
This is a Phase III, global, multicenter, open-label, two-arm, randomized, controlled study designed to evaluate the efficacy and safety of atezolizumab compared with chemotherapy in participants with locally advanced or metastatic urothelial bladder cancer (UBC) who have progressed during or following a platinum-containing regimen. The anticipated time on study treatment is based on continued clinical benefit, i.e., until disease progression or unacceptable toxicity. The target sample size is 931 participants.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 931
- Histologically or cytologically documented locally advanced or metastatic UBC (including renal pelvis, ureters, urinary bladder, and urethra).
- Representative tumor specimens as specified by the protocol
- Disease progression during or following treatment with at least one platinum-containing regimen for inoperable, locally advanced or metastatic UBC or disease recurrence
- Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
- Life expectancy greater than or equal to (>/=) 12 weeks
- Measurable disease, as defined by RECIST v1.1
- Adequate hematologic and end organ function
- For women of childbearing potential, agreement to refrain from heterosexual intercourse or use contraceptive methods that result in a failure rate of < 1% per year during the treatment period and for at least 5 months after the last dose of atezolizumab, 3 months after the last dose of vinflunine and 6 months from the last dose of paclitaxel or docetaxel.
- For men, agreement to refrain from heterosexual intercourse or use contraceptive methods that result in a failure rate of < 1% per year during the treatment period and for at least 3 months after the last dose of vinflunine and 6 months from the last dose of paclitaxel or docetaxel, and agreement to refrain from donating sperm
- Any approved anti-cancer therapy within 3 weeks prior to initiation of study treatment
- Treatment with any other investigational agent or participation in another clinical trial with therapeutic intent within 28 days prior to enrollment
- Active or untreated central nervous system (CNS) metastases as determined by computed tomography (CT) or magnetic resonance imaging (MRI) evaluation during screening and prior radiographic assessments
- Leptomeningeal disease
- Malignancies other than UBC within 5 years prior to Cycle 1, Day 1, with the exception of those with a negligible risk of metastasis or death and treated with expected curative outcome, or localized prostate cancer treated with curative intent and absence of prostate-specific antigen (PSA) relapse or incidental prostate cancer
- Pregnant and lactating women
- Significant cardiovascular disease
- Severe infections within 4 weeks prior to randomization
- Major surgical procedure other than for diagnosis within 4 weeks prior to randomization
- History of severe allergic, anaphylactic, or other hypersensitivity reactions to chimeric or humanized antibodies or fusion proteins; known hypersensitivity or allergy to biopharmaceuticals produced in Chinese hamster ovary cells or any component of the atezolizumab formulation
- History of autoimmune disease
- Prior allogeneic stem cell or solid organ transplant
- History of idiopathic pulmonary fibrosis, organizing pneumonia, drug-induced pneumonitis, idiopathic pneumonitis, or evidence of active pneumonitis on screening chest CT scan
- Positive test for human immunodeficiency virus (HIV) and/or active hepatitis B or hepatitis C or tuberculosis
- Administration of a live, attenuated vaccine within 4 weeks prior to randomization
- Prior treatment with cluster of differentiation 137 (CD137) agonists or immune checkpoint blockade therapies, including anti-cytotoxic T-lymphocyte-associated protein 4 (anti-CTLA-4), anti-programmed death-1 (anti-PD-1) or anti-programmed death-ligand 1 (anti-PD-L1) therapeutic antibodies
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Arm B: Chemotherapy (Vinflunine, Paclitaxel, or Docetaxel) Vinflunine Participants randomized to the chemotherapy arm will receive vinflunine, paclitaxel, or docetaxel per the investigator's choice. Vinflunine 320 milligrams per square meter (mg/m\^2), paclitaxel 175 mg/m\^2, or docetaxel 75 mg/m\^2 will be administered intravenously on Day 1 of each 21-day cycle until disease progression per standard RECIST v1.1 or unacceptable toxicity. Arm A: Atezolizumab Atezolizumab (MPDL3280A) [TECENTRIQ], an engineered anti-PDL1 antibody Atezolizumab will be administered intravenously at a fixed dose of 1200 milligrams (mg) on Day 1 of each 21-day cycle. Participants will receive atezolizumab as long as they continue to experience clinical benefit in the opinion of the investigator until unacceptable toxicity or symptomatic deterioration attributed to disease progression as determined by the investigator. Arm B: Chemotherapy (Vinflunine, Paclitaxel, or Docetaxel) Paclitaxel Participants randomized to the chemotherapy arm will receive vinflunine, paclitaxel, or docetaxel per the investigator's choice. Vinflunine 320 milligrams per square meter (mg/m\^2), paclitaxel 175 mg/m\^2, or docetaxel 75 mg/m\^2 will be administered intravenously on Day 1 of each 21-day cycle until disease progression per standard RECIST v1.1 or unacceptable toxicity. Arm B: Chemotherapy (Vinflunine, Paclitaxel, or Docetaxel) Docetaxel Participants randomized to the chemotherapy arm will receive vinflunine, paclitaxel, or docetaxel per the investigator's choice. Vinflunine 320 milligrams per square meter (mg/m\^2), paclitaxel 175 mg/m\^2, or docetaxel 75 mg/m\^2 will be administered intravenously on Day 1 of each 21-day cycle until disease progression per standard RECIST v1.1 or unacceptable toxicity.
- Primary Outcome Measures
Name Time Method Overall Survival (OS) Between randomization and death due to any cause, up to approximately 25 months after first participant enrolled OS was defined as time from randomization to death from any cause.
- Secondary Outcome Measures
Name Time Method Progression-free Survival (PFS) as Determined by the Investigator With Use of RECIST v1.1 Up to approximately 25 months after first participant enrolled PFS was defined as the time between the date of randomization and the date of first documented progression of disease (PD) or death, whichever occurred first. PD was determined on the basis of investigator assessment with use of RECIST v1.1. PD: at least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum of diameters on study (including baseline). In addition to the relative increase of 20%, the sum of diameters had to demonstrate an absolute increase of \>/= 5 millimeters (mm).
Percentage of Participants With Post-Baseline Anti-therapeutic Antibodies (ATA) to Atezolizumab Predose (0 hours) on Day 1 of Cycles 1, 2, 3, 4 and every 8 cycles thereafter; at treatment discontinuation (up to 25 months); at 120 days after last dose of atezolizumab (up to 25 months; each cycle is 21 days) Participants were considered post-baseline ATA positive if they had post-baseline ATAs to Atezolizumab that were treatment-induced or treatment-enhanced. Participants had treatment-induced ATAs if they had a baseline-negative ATA result and developed ATAs at any time after initial drug administration. Participants had treatment-enhanced ATAs if they had a baseline-positive ATA result that showed an enhanced signal that was \>/= 0.60 titer units at any time after initial drug initiation.
Change From Baseline in European Organisation for Research and Treatment of Cancer (EORTC) Quality-of-Life Questionnaire Core 30 (QLQ-C30) Score: Fatigue Symptom Scale Cycle 1 Day 1 (prior to any health care interaction), on Day 1 of each subsequent cycle, and at 30 days after the last treatment dose (Up to approximately 25 months; each cycle is 21 days) The EORTC QLQ-C30 includes five functional scales (physical, role, cognitive, emotional, social); a global health status (GHS)/quality of life (QoL) scale; and items measuring fatigue, pain, nausea and vomiting, dyspnea, appetite loss, sleep disturbance, constipation, diarrhea, and financial difficulties. The score range for each scale and single-item measure is 0 to 100, where higher scores indicate a higher response level (i.e., better functioning, better QoL, worse symptoms). Key scales included physical functioning, and fatigue, and GHS.
Percentage of Participants With Unconfirmed Objective Response Rate (ORR) as Determined by the Investigator With Use of Response Evaluation Criteria In Solid Tumors Version 1.1 (RECIST v1.1) Up to approximately 25 months after first participant enrolled ORR was defined as the percentage of participants, who had an objective response. Objective response was defined as either a complete response (CR) or partial response (PR) as determined by the investigator with use of Response Evaluation Criteria in Solid Tumors, Version 1.1 (RECIST v1.1). Objective response in this study did not need to be a confirmed response. CR: disappearance of all target lesions. PR: At least a 30% decrease in the sum of diameters of all target lesions, taking as reference the baseline sum of diameters, in the absence of CR. ORR=CR+PR
Maximum Observed Serum Atezolizumab Concentration (Cmax) 30 minutes post dose on Day 1 of Cycles 1 Cmax was measured for all participants that received at least one dose of Atezolizumab.
Change From Baseline in European Organisation for Research and Treatment of Cancer (EORTC) Quality-of-Life Questionnaire Core 30 (QLQ-C30) Score: Global Health Status Scale Cycle 1 Day 1 (prior to any health care interaction), on Day 1 of each subsequent cycle, and at 30 days after the last treatment dose (Up to approximately 25 months; each cycle is 21 days) The EORTC QLQ-C30 includes five functional scales (physical, role, cognitive, emotional, social); a global health status (GHS)/quality of life (QoL) scale; and items measuring fatigue, pain, nausea and vomiting, dyspnea, appetite loss, sleep disturbance, constipation, diarrhea, and financial difficulties. The score range for each scale and single-item measure is 0 to 100, where higher scores indicate a higher response level (i.e., better functioning, better QoL, worse symptoms). Key scales included physical functioning, and fatigue, and GHS.
Change From Baseline in European Organisation for Research and Treatment of Cancer (EORTC) Quality-of-Life Questionnaire Core 30 (QLQ-C30) Score: Physical Functioning Scale Cycle 1 Day 1 (prior to any health care interaction), on Day 1 of each subsequent cycle, and at 30 days after the last treatment dose (Up to approximately 25 months; each cycle is 21 days) The EORTC QLQ-C30 includes five functional scales (physical, role, cognitive, emotional, social); a global health status (GHS)/quality of life (QoL) scale; and items measuring fatigue, pain, nausea and vomiting, dyspnea, appetite loss, sleep disturbance, constipation, diarrhea, and financial difficulties. The score range for each scale and single-item measure is 0 to 100, where higher scores indicate a higher response level (i.e., better functioning, better QoL, worse symptoms). Key scales included physical functioning, and fatigue, and GHS.
Unconfirmed Duration of Response (DOR) as Determined by the Investigator With Use of RECIST v1.1 Up to approximately 25 months after first participant enrolled DOR was defined as the time from first occurrence of a CR or PR, whichever came first, to first documented PD or death, whichever occurred first. Disease progression was determined on the basis of investigator assessment with use of RECIST v1.1. CR: disappearance of all target lesions. PR: At least a 30% decrease in the sum of diameters of all target lesions, taking as reference the baseline sum of diameters, in the absence of CR. PD: at least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum of diameters on study (including baseline). In addition to the relative increase of 20%, the sum of diameters must also demonstrate an absolute increase of \>/= 5 mm.
Percentage of Participants With Adverse Events (AEs) Up to approximately 46 months after first participant enrolled An adverse event is any untoward medical occurrence in a participant administered a pharmaceutical product and which does not necessarily have to have a causal relationship with the treatment. An adverse event can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding, for example), symptom, or disease temporally associated with the use of a pharmaceutical product, whether or not considered related to the pharmaceutical product. Preexisting conditions which worsen during a study are also considered as adverse events.
Minimum Observed Serum Atezolizumab Concentration (Cmin) Predose (0 hours) on Day 1 of Cycles 1, 2, 3, 4 and every 8 cycles thereafter; at treatment discontinuation (up to 25 months); at 120 days after last dose of atezolizumab (up to 25 months; each cycle is 21 days) Cmin was measured for all participants that received at least one dose of Atezolizumab.
Trial Locations
- Locations (217)
Oncology Institute of Vojvodina
🇷🇸Sremska Kamenica, Serbia
Barts and The London
🇬🇧London, United Kingdom
Tom Baker Cancer Centre-Calgary
🇨🇦Calgary, Alberta, Canada
McGill University; Sir Mortimer B Davis Jewish General Hospital; Oncology
🇨🇦Montreal, Quebec, Canada
Hetenyi Geza County Hospital; Onkologiai Kozpont
ðŸ‡ðŸ‡ºSzolnok, Hungary
Spaarne Ziekenhuis; Inwendige Geneeskunde
🇳🇱Hoofddorp, Netherlands
Maastricht University Medical Centre; Medical Oncology
🇳🇱Maastricht, Netherlands
Uni Hospital of Tromso; Dept. of Oncology
🇳🇴Tromsø, Norway
Bon Secours - St. Francis Hospital
🇺🇸Greenville, South Carolina, United States
Kaiser-Franz-Josef-Spital; Zent.Onkologie und Hamatologie
🇦🇹Wien, Austria
ZNA Middelheim
🇧🇪Antwerpen, Belgium
Azienda Ospedaliera San Camillo Forlanini; Oncologia Medica
🇮🇹Roma, Lazio, Italy
University of Tsukuba Hospital; Urology
🇯🇵Ibaraki, Japan
Yokohama City University Hospital; Urology
🇯🇵Kanagawa, Japan
Kumamoto University Hospital; Urology
🇯🇵Kumamoto, Japan
Monash Medical Centre; Oncology
🇦🇺Clayton, Victoria, Australia
BCCA-Vancouver Cancer Centre
🇨🇦Vancouver, British Columbia, Canada
Institut Jules Bordet
🇧🇪Bruxelles, Belgium
University Hospital of Patras Medical Oncology
🇬🇷Patras, Greece
Sapporo Medical University Hospital; Urology
🇯🇵Hokkaido, Japan
Hokkaido University Hospital; Urology
🇯🇵Hokkaido, Japan
St. Antonius Ziekenhuis Nieuwegein
🇳🇱Nieuwegein, Netherlands
Sørlandet Sykehus Kristiansand
🇳🇴Kristiansand, Norway
St. Olavs Hospital; Kreftavdelingen
🇳🇴Trondheim, Norway
COZL Oddzial Onkologii Klinicznej z pododdzialem Chemioterapii Dziennej
🇵🇱Lublin, Poland
Oddzial Chemioterapii Szpitala Klinicznego Nr 1 w Poznaniu
🇵🇱Poznan, Poland
ONCOMED - Medical Centre
🇷🇴Timisoara, Romania
Institute for Oncology and Radiology of Serbia; Medical Oncology
🇷🇸Belgrade, Serbia
Austin and Repatriation Medical Centre; Cancer Services
🇦🇺Melbourne, Victoria, Australia
The Netherlands Cancer Institute - Antoni Van Leeuwenhoekziekenhuis
🇳🇱Amsterdam, Netherlands
Uniwersyteckie Centrum Kliniczne, Klinika Onkologii i Radioterapii
🇵🇱Gdansk, Poland
Bcca - Cancer Center Southern Interior
🇨🇦Kelowna, British Columbia, Canada
National Hospital Organization Shikoku Cancer Center; Urology
🇯🇵Ehime, Japan
Kyushu University Hospital; Urology
🇯🇵Fukuoka, Japan
Toranomon Hospital; Medical Oncology
🇯🇵Tokyo, Japan
Isala Klinieken
🇳🇱Zwolle, Netherlands
Medical University of Bialystok; Oncology clinic
🇵🇱Bialystok, Poland
Centrum onkologii Instytutu im. Marii Sklodowskiej-Curie; Klinika Nowotworow Ukladu Moczowego
🇵🇱Warszawa, Poland
Euroclinic Center of Oncology SRL
🇷🇴Iasi, Romania
Semmelwies University of Medicine; Urology Dept.
ðŸ‡ðŸ‡ºBudapest, Hungary
Osaka University Hospital; Urology
🇯🇵Osaka, Japan
Hospital Beatriz Angelo; Departamento de Oncologia
🇵🇹Loures, Portugal
Institute Of Oncology Bucharest; Medical Oncology
🇷🇴Bucharest, Romania
St. Petersburg Oncology Hospital
🇷🇺St Petersburg, Russian Federation
Emory University; Winship Cancer Institute
🇺🇸Atlanta, Georgia, United States
Comprehensive Cancer Centers of Nevada
🇺🇸Las Vegas, Nevada, United States
Vanderbilt-Ingram Cancer Ctr
🇺🇸Nashville, Tennessee, United States
Bcca - Vancouver Island Cancer Centre; Oncology
🇨🇦Victoria, British Columbia, Canada
Sahlgrenska Universitetssjukhuset; Jubileumskliniken
🇸🇪Göteborg, Sweden
Duke Cancer Center
🇺🇸Durham, North Carolina, United States
Royal Brisbane and Women's Hospital; Medical Oncology
🇦🇺Herston, Queensland, Australia
Georgetown University Medical Center Lombardi Cancer Center
🇺🇸Washington, District of Columbia, United States
UZ Gent
🇧🇪Gent, Belgium
UZ Leuven Gasthuisberg
🇧🇪Leuven, Belgium
Royal Adelaide Hospital; Oncology
🇦🇺Adelaide, South Australia, Australia
The Ottawa Hospital Cancer Centre; Oncology
🇨🇦Ottawa, Ontario, Canada
Sault Area Hospitals
🇨🇦Sault Ste Marie, Ontario, Canada
Fakultni nemocnice Olomouc
🇨🇿Olomouc, Czechia
Rigshospitalet; Onkologisk Klinik
🇩🇰København Ø, Denmark
Medizinische Universität Wien; Univ.Klinik für Innere Medizin I - Abt. für Onkologie
🇦🇹Wien, Austria
Lakeridge Health Oshawa; Oncology
🇨🇦Oshawa, Ontario, Canada
Institut Sainte Catherine;Recherche Clinique
🇫🇷Avignon, France
London Regional Cancer Centre
🇨🇦London, Ontario, Canada
Vseobecna fakultni nemocnice v Praze
🇨🇿Praha 2, Czechia
Herlev Hospital; Onkologisk afdeling
🇩🇰Herlev, Denmark
Ico - Paul Papin
🇫🇷Angers, France
Masarykuv onkologicky ustav
🇨🇿Brno, Czechia
Sunnybrook Odette Cancer Centre
🇨🇦Toronto, Ontario, Canada
Fakultni nemocnice Kralovske Vinohrady
🇨🇿Praha, Czechia
Docrates Cance Center
🇫🇮Helsinki, Finland
Turku University Central Hospital; Urology clinic
🇫🇮Turku, Finland
Institut J Paolii Calmettes
🇫🇷Marseille, France
MULTISCAN, s.r.o., Radiologicke centrum Pardubice
🇨🇿Pardubice, Czechia
Centre D'Oncologie de Gentilly; Oncology
🇫🇷Nancy, France
Hopital Saint Louis; Oncologie Medicale
🇫🇷Paris, France
Universitätsklinikum des Saarlandes; Klinik für Urologie und Kinderurologie
🇩🇪Homburg/Saar, Germany
Universitätsklinikum Düsseldorf; Urologische Klinik
🇩🇪Düsseldorf, Germany
CHU de Rouen - Hôpital Charles Nicolle
🇫🇷Rouen, France
Charité - Universitätsmedizin Berlin; CC 8: Chirurgische Medizin; Klinik für Urologie
🇩🇪Berlin, Germany
Universitätsklinikum Hamburg-Eppendorf Onkologisches Zentrum Medizinische Klinik II
🇩🇪Hamburg, Germany
Hopital Foch; Oncologie
🇫🇷Suresnes, France
Universitätsmedizin Göttingen Georg-August-Universität; Klinik für Urologie
🇩🇪Göttingen, Germany
Institut Claudius Regaud; Departement Oncologie Medicale
🇫🇷Toulouse, France
Friedrich-Alexander-Universität Erlangen-Nürnberg; Medizinische Klinik V
🇩🇪Erlangen, Germany
Univ General Hosp Heraklion; Medical Oncology
🇬🇷Heraklion, Greece
Nationales Centrum für Tumorerkrankungen Heidelberg (NCT); Thoraxklinik Heidelberg
🇩🇪Heidelberg, Germany
Universitätsklinikum "Carl Gustav Carus"; Klinik und Poliklinik für Urologie
🇩🇪Dresden, Germany
Azienda Ospedaliera A. Cardarelli; Dip. Oncopneumoematologico
🇮🇹Napoli, Campania, Italy
IRST Istituto Scientifico Romagnolo Per Lo Studio E Cura Dei Tumori, Sede Meldola; Oncologia Medica
🇮🇹Meldola, Emilia-Romagna, Italy
Euromedical General Clinic of Thessaloniki; Oncology Department
🇬🇷Thessaloniki, Greece
Kecskemeti Onkoradilogai Centrum
ðŸ‡ðŸ‡ºKecskemét, Hungary
Medizinische Fakultät Mannheim, Universitätsklinikum Mannheim, Klinik für Urologie
🇩🇪Mannheim, Germany
Universitätsklinikum Tübingen; Klinik für Urologie
🇩🇪Tübingen, Germany
Uzsoki Utcai Korhaz
ðŸ‡ðŸ‡ºBudapest, Hungary
Alexandras General Hospital of Athens; Oncology Department
🇬🇷Athens, Greece
IRCCS Ospedale Casa Sollievo Della Sofferenza; Oncologia
🇮🇹San Giovanni Rotondo, Puglia, Italy
Nagoya University Hospital; Urology
🇯🇵Aichi, Japan
National Cancer Center Hospital East; Breast and Medical Oncology
🇯🇵Chiba, Japan
A.O. Universitaria S. Maria Della Misericordia Di Udine; Oncologia
🇮🇹Udine, Friuli-Venezia Giulia, Italy
ASST DI CREMONA; Dip. Medicina - S.C. Oncologia
🇮🇹Cremona, Lombardia, Italy
Orszagos Onkologiai Intezet; "C" Belgyógyászati-Onkológiai és Klinikai Farmakológiai Osztály
ðŸ‡ðŸ‡ºBudapest, Hungary
Harasanshin Hospital; Urology
🇯🇵Fukuoka, Japan
Casa Di Cura Di Alta Specialita La Maddalena; Dept. Oncologico Di Iii Livello
🇮🇹Palermo, Sicilia, Italy
Samsung Medical Center
🇰🇷Seoul, Korea, Republic of
Hirosaki University School of Medicine & Hospital; Urology
🇯🇵Aomori, Japan
Chiba Cancer Center; Urology
🇯🇵Chiba, Japan
Hiroshima City Hiroshima Citizens Hospital; Urology
🇯🇵Hiroshima, Japan
Nippon Medical School Hospital; Urology
🇯🇵Tokyo, Japan
Gunma University Hospital; Urology
🇯🇵Gunma, Japan
Iwate Medical University Hospital; Urology
🇯🇵Iwate, Japan
Shizuoka Cancer Center; Urology
🇯🇵Shizuoka, Japan
Tokushima University Hospital; Urology
🇯🇵Tokushima, Japan
Seoul National University Hospital
🇰🇷Seoul, Korea, Republic of
Osaka International Cancer Institute; Urology
🇯🇵Osaka, Japan
Kindai University Hospital; Urology
🇯🇵Osaka, Japan
National Cancer Center Hospital; Urology
🇯🇵Tokyo, Japan
Asan Medical Center - Oncology
🇰🇷Seoul, Korea, Republic of
The Cancer Institute Hospital, JFCR; Urology
🇯🇵Tokyo, Japan
GBUZ Nizhegorodskay Region: Clinical Diagnostic Center
🇷🇺Nizhni Novgorod, Niznij Novgorod, Russian Federation
Hospital de Santa Maria; Servico de Oncologia Medica
🇵🇹Lisboa, Portugal
IPO do Porto; Servico de Oncologia Medica
🇵🇹Porto, Portugal
Uniwersytecki Szpital Kliniczny im. Jana Miklulicza-Radeckiego we Wrocławiu; Departament Of Urology
🇵🇱Wroclaw, Poland
Oncology Center Sf. Nectarie
🇷🇴Craiova, Romania
Altai Regional Oncological Center
🇷🇺Barnaul, Russian Federation
Spitalul Judetean de Urgenta Dr Constantin Opris
🇷🇴Baia Mare, Romania
Institut Oncologic Ion Chiricuta; Departament Radioterapie
🇷🇴Cluj-napoca, Romania
Hospital Clinico Universitario Virgen de la Victoria; Servicio de Oncologia
🇪🇸Malaga, Spain
SBI of Healthcare of Stavropol region Stavropol Regional Clinical Oncology Dispensary
🇷🇺Stavropol, Russian Federation
Hospital de la Santa Creu i Sant Pau; Servicio de Oncologia
🇪🇸Barcelona, Spain
Hospital San Pedro De Alcantara; Servicio de Oncologia
🇪🇸Caceres, Spain
Hospital Universitario Son Espases; Servicio de Oncologia
🇪🇸Palma De Mallorca, Islas Baleares, Spain
Complejo Hospitalario Universitario de Santiago (CHUS) ; Servicio de Oncologia
🇪🇸Santiago de Compostela, LA Coruña, Spain
Hospital Univ Vall d'Hebron; Servicio de Oncologia
🇪🇸Barcelona, Spain
Kantonsspital St. Gallen; Onkologie/Hämatologie
🇨ðŸ‡St. Gallen, Switzerland
Norrlands Uni Hospital; Onkologi Avd.
🇸🇪Umea, Sweden
Ege Uni Medical Faculty Hospital; Oncology Dept
🇹🇷Izmir, Turkey
Hacettepe Uni Medical Faculty Hospital; Oncology Dept
🇹🇷Sıhhiye, Ankara, Turkey
Hospital Universitario 12 de Octubre; Servicio de Oncologia
🇪🇸Madrid, Spain
UniversitätsSpital Zürich; Zentrum für Hämatologie und Onkologie, Klinik für Onkologie
🇨ðŸ‡Zürich, Switzerland
China Medical University Hospital; Urology
🇨🇳Taichung, Taiwan
Hospital de Navarra; Servicio de Oncologia
🇪🇸Navarra, Spain
Hospital Universitario Virgen del Rocio; Servicio de Oncologia
🇪🇸Sevilla, Spain
Istanbul Uni Cerrahpasa Medical Faculty Hospital; Medical Oncology
🇹🇷Istanbul, Turkey
TAIPEI VETERANS GENERAL HOSPITAL, Urology
🇨🇳Taipei, Taiwan
Inonu University Medical Faculty Turgut Ozal Medical Center Medical Oncology Department
🇹🇷Malatya, Turkey
University Hospital Birmingham The Cancer Centre, Queen Elizabeth Hospital
🇬🇧Birmingham, United Kingdom
Inselspital Bern; Universitätsklinik für medizinische Onkologie
🇨ðŸ‡Bern, Switzerland
Kantonsspital Graubünden;Onkologie und Hämatologie
🇨ðŸ‡Chur, Switzerland
HUG; Oncologie
🇨ðŸ‡Geneve, Switzerland
Taichung Veterans General Hospital; Division of Urology
🇨🇳Taichung, Taiwan
Karolinska Hospital; Oncology - Radiumhemmet
🇸🇪Stockholm, Sweden
National Taiwan Uni Hospital; Dept of Oncology
🇨🇳Taipei, Taiwan
Bristol Haematology and Oncology Centre
🇬🇧Bristol, United Kingdom
Addenbrooke's Hospital
🇬🇧Cambridge, United Kingdom
Northern Centre for Cancer Care; Northern Centre for Cancer Care
🇬🇧Newcastle Upon Tyne, United Kingdom
Leicester Royal Infirmary; Dept. of Medical Oncology
🇬🇧Leicester, United Kingdom
Churchill Hospital
🇬🇧Oxford, United Kingdom
Royal Cornwall Hospital
🇬🇧Truro, United Kingdom
Nottingham City Hospital
🇬🇧Nottingham, United Kingdom
Azienda USL8 Arezzo-Presidio Ospedaliero 1 San Donato;U.O.C. Oncologia
🇮🇹Arezzo, Toscana, Italy
Chr De Besancon - Hopital Jean Minjoz
🇫🇷Besancon, France
Hopital Saint Andre
🇫🇷Bordeaux, France
Institut Bergonie; Oncologie
🇫🇷Bordeaux, France
Centre Francois Baclesse; Recherche Clinique
🇫🇷Caen, France
CHU Henri Mondor; Service d'Oncologie Medicale
🇫🇷Creteil, France
Clinique Chenieux; Oncology
🇫🇷Limoges, France
Centre Leon Berard; Departement Oncologie Medicale
🇫🇷Lyon, France
Hopital Europeen Georges Pompidou; Service D'Oncologie Medicale
🇫🇷Paris, France
Institut régional du Cancer Montpellier
🇫🇷Montpellier, France
CHU De Nimes, Hopital Caremeau; Service De Neurologie Du Prof. Pierre Labauge
🇫🇷Nimes, France
Hopital Cochin; Unite Fonctionnelle D Oncologie
🇫🇷Paris, France
Centre Hospitalier Lyon Sud
🇫🇷Pierre Benite, France
ICO - Site René Gauducheau
🇫🇷Saint Herblain, France
Institut Gustave Roussy; Departement Oncologie Medicale
🇫🇷Villejuif, France
Hopital Hautepierre; Hematologie Oncologie
🇫🇷Strasbourg, France
St James Institute of Oncology
🇬🇧Leeds, United Kingdom
Royal Free Hospital; Dept of Oncology
🇬🇧London, United Kingdom
Royal Victoria Hospital
🇨🇦Barrie, Ontario, Canada
Universitätsklinikum Magdeburg A.ö.R., Klinik f. Urologie u. Kinderurologie
🇩🇪Magdeburg, Germany
Klinikum rechts der Isar der TU München; Urologische Klinik und Poliklinik
🇩🇪München, Germany
Universitätsklinikum Ulm; Klinik für Urologie
🇩🇪Ulm, Germany
Institut Catala d Oncologia Hospital Duran i Reynals
🇪🇸Barcelona, Spain
Centre Antoine Lacassagne
🇫🇷Nice, France
Institut Curie; Recherche Clinique
🇫🇷Paris, France
Uniklinik RWTH Aachen; Klinik für Urologie
🇩🇪Aachen, Germany
Universitätsklinikum Freiburg; Chirurgische Klinik; Abteilung Urologie
🇩🇪Freiburg, Germany
Azienda Ospedaliero-Universitaria Careggi;S.C. Oncologia Medica 1
🇮🇹Firenze, Toscana, Italy
A.O. Universitaria Policlinico Di Modena; Oncologia
🇮🇹Modena, Emilia-Romagna, Italy
Irccs Istituto Nazionale Dei Tumori (Int);S.C. Medicina Oncologica 2
🇮🇹Milano, Lombardia, Italy
Asst Papa Giovanni XXIII; Oncologia Medica
🇮🇹Bergamo, Lombardia, Italy
Fondazione Del Piemonte Per L'oncologia Ircc Di Candiolo; Dipartimento Oncologico
🇮🇹Candiolo, Piemonte, Italy
Niigata Cancer Center Hospital;Urology
🇯🇵Niigata, Japan
Spital Clinic Judetean Mures; Oncologie
🇷🇴Targu Mures, Romania
Federal State Institution, Moscow Research Oncology Institute n.a. P.A. Hertzen; Oncourology
🇷🇺Moscow, Russian Federation
Clinical Center of Serbia; Clinic of Urology
🇷🇸Belgrade, Serbia
Institute of Oncology Ljubljana
🇸🇮Ljubljana, Slovenia
Hospital Universitario Reina Sofia; Servicio de Oncologia
🇪🇸Córdoba, Cordoba, Spain
Corporacio Sanitaria Parc Tauli; Servicio de Oncologia
🇪🇸Sabadell, Barcelona, Spain
Clinica Universitaria de Navarra; Servicio de Oncologia
🇪🇸Pamplona, Navarra, Spain
Hospital Clinic i Provincial; Servicio de Farmacia
🇪🇸Barcelona, Spain
Hospital Universitario ClÃnico San Carlos; Servicio de Oncologia
🇪🇸Madrid, Spain
Hospital ClÃnico Universitario de Valencia; Servicio de OncologÃa
🇪🇸Valencia, Spain
Hospital Ramon y Cajal; Servicio de Oncologia
🇪🇸Madrid, Spain
Hospital General Universitario Gregorio Marañon; Servicio de Oncologia
🇪🇸Madrid, Spain
Bezmialem Vakif Univ Medical
🇹🇷Istanbul, Turkey
Uludag Uni Hospital; Oncology
🇹🇷Bursa, Turkey
Trakya University Medical Faculty Research And Practice Hospital Medical Oncology Department
🇹🇷Edirne, Turkey
Istanbul VKV American Hospital; Medical Oncology
🇹🇷Istanbul, Turkey
Cheltenham General Hospital
🇬🇧Cheltenham, United Kingdom
Royal Devon & Exeter Hospital; Oncology Centre
🇬🇧Exeter, United Kingdom
University Hospital coventry; Oncology Department
🇬🇧Coventry, United Kingdom
Royal Lancaster Infirmary, Morecambe Bay Hospitals Nhs Trust
🇬🇧Lancaster, United Kingdom
Scunthorpe General Hospital; Dept of Oncology
🇬🇧Scunthorpe, United Kingdom
Royal Marsden Hospital; Dept of Medical Oncology
🇬🇧Sutton, United Kingdom
Southampton General Hospital; Medical Oncology
🇬🇧Southampton, United Kingdom
The Clatterbridge Cancer Centre NHS Foundation Trust
🇬🇧Wirral, United Kingdom
Hospital General Universitario de Valencia; Servicio de oncologia
🇪🇸Valencia, Spain