SKYSCRAPER-06: A Study of Tiragolumab in Combination With Atezolizumab Plus Pemetrexed and Carboplatin/Cisplatin Versus Pembrolizumab Plus Pemetrexed and Carboplatin/Cisplatin in Participants With Previously Untreated Advanced Non-Squamous Non-Small Cell Lung Cancer

Sponsor

Hoffmann-La Roche (Industry)

Overall Status

Recruiting

CT.gov ID

NCT04619797

Collaborator

(none)

500

Enrollment

Locations

Arms

Anticipated Duration (Months)

5.4

Patients Per Site

0.1

Patients Per Site Per Month

Study Details

Study Description

Brief Summary

The purpose of this study is to evaluate the efficacy, safety, and pharmacokinetics of tiragolumab in combination with atezolizumab plus pemetrexed and carboplatin/cisplatin (Arm

compared with placebo in combination with pembrolizumab plus pemetrexed and carboplatin/cisplatin (Arm B) in participants with previously untreated, locally advanced unresectable or metastatic non-squamous non-small cell lung cancer (NSCLC).

Eligible participants will be randomized in a 1:1 ratio to receive one of the following treatment regimens during the induction phase:

Arm A: Tiragolumab plus atezolizumab plus pemetrexed and carboplatin or cisplatin
Arm B: Placebo plus pembrolizumab plus pemetrexed and carboplatin or cisplatin

Following the induction phase, participants will continue maintenance therapy with either tiragolumab in combination with atezolizumab and pemetrexed (Arm A) or placebo in combination with pembrolizumab and pemetrexed (Arm B).

Condition or Disease	Intervention/Treatment	Phase
Non-small Cell Lung Cancer (NSCLC)	Drug: Tiragolumab Drug: Atezolizumab Drug: Pemetrexed Drug: Carboplatin Drug: Cisplatin Drug: Tiragolumab Matching Placebo Drug: Pembrolizumab	Phase 2

Study Design

Study Type:

Interventional

Anticipated Enrollment :

500 participants

Allocation:

Randomized

Intervention Model:

Parallel Assignment

Masking:

Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)

Primary Purpose:

Treatment

Official Title:

A Phase II/III, Randomized, Double-Blind, Placebo-Controlled Study of Tiragolumab in Combination With Atezolizumab Plus Pemetrexed and Carboplatin/Cisplatin Versus Pembrolizumab Plus Pemetrexed and Carboplatin/Cisplatin in Patients With Previously Untreated Advanced Non-Squamous Non-Small-Cell Lung Cancer

Actual Study Start Date :

Dec 14, 2020

Anticipated Primary Completion Date :

Mar 14, 2024

Anticipated Study Completion Date :

Nov 14, 2026

Arms and Interventions

Arm	Intervention/Treatment
Experimental: Tiragolumab+Atezolizumab+Pemetrexed+Carboplatin or Cisplatin Induction treatment with tiragolumab in combination with atezolizumab plus pemetrexed and cisplatin or carboplatin will be administered to participants on Day 1 of each 21-day cycle for 4 cycles. Following the induction phase, participants will continue maintenance therapy with tiragolumab in combination with atezolizumab and pemetrexed on Day 1 of each 21-day cycle.	Drug: Tiragolumab Tiragolumab at a fixed dose of 600 milligrams (mg), administered by intravenous (IV) infusion, every 3 weeks (Q3W) on Day 1 of each 21-day cycle. Other Names: MTIG7192A Drug: Atezolizumab Atezolizumab at a fixed dose of 1200 mg, administered by IV infusion, Q3W on Day 1 of each 21-day cycle. Other Names: Tecentriq Drug: Pemetrexed Pemetrexed 500 milligrams per square meter (mg/m^2), administered by IV infusion, Q3W on Day 1 of each 21-day cycle. Drug: Carboplatin Carboplatin at dose of area under the concentration-time curve (AUC) of 5, administered by IV infusion, Q3W on Day 1 of each 21-day cycle for 4 cycles. Drug: Cisplatin Cisplatin 75 mg/m^2, administered by IV infusion, Q3W on Day 1 of each 21-day cycle for 4 cycles.
Placebo Comparator: Placebo+Pembrolizumab+Pemetrexed+Carboplatin or Cisplatin Induction treatment with placebo in combination with pembrolizumab plus pemetrexed and cisplatin or carboplatin will be administered to participants on Day 1 of each 21-day cycle for 4 cycles. Following the induction phase, participants will continue maintenance therapy with placebo in combination with pembrolizumab and pemetrexed on Day 1 of each 21-day cycle.	Drug: Pemetrexed Pemetrexed 500 milligrams per square meter (mg/m^2), administered by IV infusion, Q3W on Day 1 of each 21-day cycle. Drug: Carboplatin Carboplatin at dose of area under the concentration-time curve (AUC) of 5, administered by IV infusion, Q3W on Day 1 of each 21-day cycle for 4 cycles. Drug: Cisplatin Cisplatin 75 mg/m^2, administered by IV infusion, Q3W on Day 1 of each 21-day cycle for 4 cycles. Drug: Tiragolumab Matching Placebo Matching placebo, administered by IV infusion, Q3W on Day 1 of each 21-day cycle. Drug: Pembrolizumab Pembrolizumab at a fixed dose of 200 mg, administered by IV infusion, Q3W, on Day 1 of each 21-day cycle.

Arm

Intervention/Treatment

Experimental: Tiragolumab+Atezolizumab+Pemetrexed+Carboplatin or Cisplatin

Induction treatment with tiragolumab in combination with atezolizumab plus pemetrexed and cisplatin or carboplatin will be administered to participants on Day 1 of each 21-day cycle for 4 cycles. Following the induction phase, participants will continue maintenance therapy with tiragolumab in combination with atezolizumab and pemetrexed on Day 1 of each 21-day cycle.

Drug: Tiragolumab

Tiragolumab at a fixed dose of 600 milligrams (mg), administered by intravenous (IV) infusion, every 3 weeks (Q3W) on Day 1 of each 21-day cycle.

Other Names:

MTIG7192A

Drug: Atezolizumab

Atezolizumab at a fixed dose of 1200 mg, administered by IV infusion, Q3W on Day 1 of each 21-day cycle.

Other Names:

Tecentriq

Drug: Pemetrexed

Pemetrexed 500 milligrams per square meter (mg/m^2), administered by IV infusion, Q3W on Day 1 of each 21-day cycle.

Drug: Carboplatin

Carboplatin at dose of area under the concentration-time curve (AUC) of 5, administered by IV infusion, Q3W on Day 1 of each 21-day cycle for 4 cycles.

Drug: Cisplatin

Cisplatin 75 mg/m^2, administered by IV infusion, Q3W on Day 1 of each 21-day cycle for 4 cycles.

Placebo Comparator: Placebo+Pembrolizumab+Pemetrexed+Carboplatin or Cisplatin

Induction treatment with placebo in combination with pembrolizumab plus pemetrexed and cisplatin or carboplatin will be administered to participants on Day 1 of each 21-day cycle for 4 cycles. Following the induction phase, participants will continue maintenance therapy with placebo in combination with pembrolizumab and pemetrexed on Day 1 of each 21-day cycle.

Drug: Pemetrexed

Pemetrexed 500 milligrams per square meter (mg/m^2), administered by IV infusion, Q3W on Day 1 of each 21-day cycle.

Drug: Carboplatin

Carboplatin at dose of area under the concentration-time curve (AUC) of 5, administered by IV infusion, Q3W on Day 1 of each 21-day cycle for 4 cycles.

Drug: Cisplatin

Cisplatin 75 mg/m^2, administered by IV infusion, Q3W on Day 1 of each 21-day cycle for 4 cycles.

Drug: Tiragolumab Matching Placebo

Matching placebo, administered by IV infusion, Q3W on Day 1 of each 21-day cycle.

Drug: Pembrolizumab

Pembrolizumab at a fixed dose of 200 mg, administered by IV infusion, Q3W, on Day 1 of each 21-day cycle.

Outcome Measures

Primary Outcome Measures

Investigator-Assessed Confirmed Objective Response Rate (ORR) (Phase 2) [Up to approximately 5 years]
Investigator-Assessed Progression-Free Survival (PFS) (Phase 2 and Phase 3) [From randomization to the first occurrence of disease progression or death from any cause, whichever occurs first (up to approximately 5 years [Phase 2], up to approximately 6 years [Phase 3])]
Overall Survival (Phase 3) [From randomization to death from any cause (up to approximately 6 years)]

Secondary Outcome Measures

Overall survival (Phase 2) [From randomization to death from any cause (up to approximately 5 years)]
PFS as Determined by an Independent Review Facility (IRF) (Phase 3) [From randomization to the first occurrence of disease progression or death from any cause, whichever occurs first (up to approximately 6 years)]
PFS in Participants With PD-L1 Expression at TC ≥50% and TC ≥1% Cut-off, as Determined by Central Testing With Ventana PD-L1 (SP263) Assay (Phase 3) [From randomization to the first occurrence of disease progression or death from any cause, whichever occurs first (up to approximately 6 years)]
OS in Participants With PD-L1 Expression at TC ≥50% and TC ≥1% Cut-off, as Determined by Central Testing With Ventana PD-L1 (SP263) Assay (Phase 3) [From randomization to death from any cause (up to approximately 6 years)]
Investigator-Assessed PFS at 6 Months and 12 Months (Phase 3) [6 months, 12 months]
OS Rate at 12 Months and 24 Months (Phase 3) [12 months, 24 months]
Investigator-Assessed Confirmed ORR (Phase 3) [Up to approximately 6 years]
Investigator-Assessed Duration of Response (DOR) (Phase 2 and Phase 3) [From first occurrence of a documented confirmed objective response to the first occurrence of disease progression or death from any cause, whichever occurs first (up to approximately 5 years [Phase 2]; up to approximately 6 years [Phase 3])]
Time to Confirmed Deterioration (TTCD) in Participant-Reported Physical Functioning and Global Health Status (GHS)/Quality of Life (QoL) as Measured by European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 (Phase 2 and Phase 3) [Up to approximately 5 years (Phase 2); up to approximately 6 years (Phase 3)]
TTCD using EORTC Quality-of-Life Questionnaire Core 30 (QLQ-C30) is an initial 10-point decrease in GHS and physical functioning from baseline that must be held for at least two consecutive assessments or an initial clinically meaningful decrease above baseline followed by death. EORTC QLQ-C30: a self-reported measure, consisting of 30 questions that assess 5 aspects of participants functioning (physical, emotional, role, cognitive and social), 3 symptom scales (fatigue, nausea/vomiting and pain), GHS and QoL, and 6 single items (dyspnea, insomnia, appetite loss, constipation, diarrhea and financial difficulties) with a recall period of the previous week. Functioning items are scored on a 4-point scale: 1=Not at all to 4=Very much, with higher score indicating worse outcome. Symptom items (GHS and QoL) are scored on a 7-point scale: 1=Very poor to 7=Excellent. Scores will be linearly transformed with a minimum score of 0 and maximum score of 100. Higher score indicates better outcome.
TTCD in Participant-Reported Lung Cancer Symptoms for Cough, Dyspnea, and Chest Pain, as Measured by EORTC QLQ-LC13 (Phase 2 and Phase 3) [Up to approximately 5 years (Phase 2); up to approximately 6 years (Phase 3)]
TTCD using EORTC Quality-of-Life Questionnaire Lung Cancer Module (QLQ-LC13) is an initial 10-point increase in symptom score from baseline that must be held for at least two consecutive assessments or an initial clinically meaningful decrease above baseline followed by death. EORTC QLQ-LC13 consists of 13 lung cancer specific items and includes 11 disease-specific scales/items (dyspnea, coughing, hemoptysis, sore mouth, dysphagia, peripheral neuropathy, alopecia, pain in chest, pain in arm or shoulder, pain in other parts, pain medication). Each item is scored on a 4-point scale of 1=Not at all to 4=Very much. Scores will be linearly transformed to a score range of 0 to 100. Higher score indicates worsening of symptoms.
Percentage of Participants With Adverse Events (AEs) (Phase 2 and Phase 3) [Up to approximately 5 years (Phase 2); up to approximately 6 years (Phase 3)]
Participants' Response to Side Effects of Treatment as Assessed by EORTC IL46 (Phase 2 and Phase 3) [Up to approximately 5 years (Phase 2); up to approximately 6 years (Phase 3)]
EORTC Item List 46 (IL46) is a validated single-item question that assesses overall side effect impact. Each item is scored on a 4-point scale of 1=Not at all to 4=Very much. Scores will be linearly transformed to a score range of 0 to 100. Higher score indicates a worse outcome.
Serum Concentration of Tiragolumab (Phase 2 and Phase 3) [Cycle 1 (each cycle=21 days), Day 1: predose, 0.5 hour (h) postdose; Cycles 2, 3, 4, 8, 12, 16, Day 1: predose and at treatment discontinuation (TD) visit (Up to approximately 5 years [Phase 2]; up to approximately 6 years [Phase 3])]
Serum Concentration of Atezolizumab (Phase 2 and Phase 3) [Cycle 1 (each cycle=21 days), Day 1: predose, 0.5 hour (h) postdose; Cycles 2, 3, 4, 8, 12, 16, Day 1: predose and at TD visit (Up to approximately 5 years [Phase 2]; up to approximately 6 years [Phase 3])]
Percentage of Participants With Anti-Drug Antibodies (ADAs) to Tiragolumab (Phase 2 and Phase 3) [Predose on Day 1 of Cycles (each cycle=21 days) 1, 2, 3, 4, 8, 12, 16 and at TD visit (up to approximately 5 years [Phase 2]; up to approximately 6 years [Phase 3])]
Percentage of Participants With ADAs to Atezolizumab (Phase 2 and Phase 3) [Predose on Day 1 of Cycles (each cycle=21 days) 1, 2, 3, 4, 8, 12, 16 and at TD visit (up to approximately 5 years [Phase 2]; up to approximately 6 years [Phase 3])]

Eligibility Criteria

Criteria

Ages Eligible for Study:

18 Years and Older

Sexes Eligible for Study:

All

Accepts Healthy Volunteers:

Key Inclusion Criteria:

Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 or 1
Histologically or cytologically documented locally advanced unresectable or metastatic non-squamous NSCLC that is not eligible for curative surgery and/or definitive chemoradiotherapy
No prior systemic treatment for metastatic non-squamous NSCLC
Known tumor programmed death-ligand 1 (PD-L1) status
Measurable disease, as defined by Response Evaluation Criteria in Solid Tumors, version 1.1 (RECIST v1.1)
Life expectancy >= 12 weeks
Adequate hematologic and end-organ function
Negative human immunodeficiency virus (HIV) test at screening
Serology test negative for active hepatitis B virus or active hepatitis C virus at screening.

Key Exclusion Criteria:

Mutations in epidermal growth factor receptor (EGFR) gene or anaplastic lymphoma kinase (ALK) fusion oncogene
Pulmonary lymphoepithelioma-like carcinoma subtype of NSCLC
Symptomatic, untreated, or actively progressing central nervous system (CNS) metastases
Active or history of autoimmune disease or immune deficiency
History of idiopathic pulmonary fibrosis, organizing pneumonia, drug-induced pneumonitis, or idiopathic pneumonitis, or evidence of active pneumonitis
History of malignancy other than NSCLC within 5 years prior to randomization, with the exception of malignancies with a negligible risk of metastasis or death
Severe infection within 4 weeks prior to initiation of study treatment or any active infection that, in the opinion of the investigator, could impact patient safety
Treatment with investigational therapy within 28 days prior to initiation of study treatment
Prior treatment with CD137 agonists or immune checkpoint blockade therapies, including anti-cytotoxic T lymphocyte-associated protein 4, anti-TIGIT, anti-PD-1, and anti-PD-L1 therapeutic antibodies
Treatment with systemic immunostimulatory agents within 4 weeks or 5 drug-elimination half-lives (whichever is longer) prior to initiation of study treatment
Treatment with systemic immunosuppressive medication within 2 weeks prior to initiation of study treatment, or anticipation of need for systemic immunosuppressive medication during study treatment
Known allergy or hypersensitivity or other contraindication to any component of the chemotherapy regimen the participant may receive during the study
Women who are pregnant, or breastfeeding
Known targetable c-ROS oncogene 1 (ROS1) or BRAFV600E genomic aberration.

Contacts and Locations

Locations

	Site	City	State	Country	Postal Code
1	St. Bernard's Hospital, Inc. d/b/a St. Bernards Medical Center	Jonesboro	Arkansas	United States	72401
2	UCLA	Los Angeles	California	United States	90095
3	Kaiser Permanente - Oakland	Oakland	California	United States	94611
4	Torrance Health Association	Redondo Beach	California	United States	90277
5	Kaiser Permanente - Roseville	Roseville	California	United States	95661
6	Kaiser Permanente - Sacramento; Oncology Pharmacy	Sacramento	California	United States	95814
7	Kaiser Permanente - San Francisco (2238 Geary)	San Francisco	California	United States	94115
8	Kaiser Permanente - San Jose Medical Center	San Jose	California	United States	95119
9	Kaiser Permanente - San Leandro	San Leandro	California	United States	94577
10	Kaiser Permanente - Santa Clara; Oncology Clinical trials	Santa Clara	California	United States	95051
11	Kaiser Permanente - South San Francisco	South San Francisco	California	United States	94080
12	Kaiser Permanente - Vallejo	Vallejo	California	United States	94589
13	Kaiser Permanente - Walnut Creek	Walnut Creek	California	United States	94596
14	PIH Health Whittier Hospital; NC	Whittier	California	United States	90602
15	SCRI Florida Cancer Specialists South	Fort Myers	Florida	United States	33916
16	Orlando Health Inc.	Orlando	Florida	United States	32806
17	SCRI Florida Cancer Specialists North; Research Office North Region.	Saint Petersburg	Florida	United States	33705
18	Northwest Georgia Oncology Centers PC - Marietta	Marietta	Georgia	United States	30060
19	Fort Wayne Medical Oncology and Hematology, Inc	Fort Wayne	Indiana	United States	46804
20	Cancer Center of Kansas	Wichita	Kansas	United States	67214
21	Memorial Sloan Kettering Cancer Center	New York	New York	United States	10065
22	SCRI Tennessee Oncology Chattanooga	Chattanooga	Tennessee	United States	37404
23	Sarah Cannon Res. Inst. Onc.	Nashville	Tennessee	United States	37203
24	Summit Cancer Centers	Spokane	Washington	United States	99208
25	Onze Lieve Vrouwziekenhuis Aalst	Aalst		Belgium	9300
26	Cliniques Universitaires St-Luc	Bruxelles		Belgium	1200
27	CHU de Liège	Herstal		Belgium	4040
28	CHU UCL Mont-Godinne	Mont-godinne		Belgium	5530
29	Vitaz	Sint Niklaas		Belgium	9100
30	Cross Cancer Institute	Edmonton	Alberta	Canada	T6G 1Z2
31	Royal Victoria Regional Health Centre	Barrie	Ontario	Canada	L4M 6M2
32	Victoria Hospital - London Health Sciences Centre	London	Ontario	Canada	N6A 4G5
33	Lakeridge Health Oshawa	Oshawa	Ontario	Canada	L1G 2B9
34	Sault Area Hospital; Algoma District Cancer Program	Sault Ste. Marie	Ontario	Canada	P6B 0A8
35	Princess Margaret Cancer Center	Toronto	Ontario	Canada	M5G 1Z5
36	Universite de Montreal - Hopital Maisonneuve-Rosemont	Montreal	Quebec	Canada	H1T 2M4
37	Institut Bergonie; Pneumology	Bordeaux		France	33076
38	Hopital Nord; Pneumologie	Marseille cedex 20		France	13915
39	Institut Curie; Oncologie Medicale	Paris		France	75231
40	Hopital de Pontchaillou; Service de Pneumologie	Rennes		France	35033
41	CHU Strasbourg - Nouvel Hopital Civil	Strasbourg		France	67091
42	CHU de Toulouse - Hôpital Larrey; Service de pneumologie et oncologie pneumologique	Toulouse cedex 9		France	31100
43	Helios Klinikum Emil von Behring GmbH	Berlin		Germany	14165
44	Augusta-Kranken-Anstalt gGmbH; Klinik für Hämatologie, Onkologie & Palliativmedizin	Bochum		Germany	44791
45	Klinikum Chemnitz gGmbH	Chemnitz		Germany	09116
46	St. Vincentius Kliniken Karlsruhe	Karlsruhe		Germany	76137
47	Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Medizinische Klinik, Pneumologie	Mainz		Germany	55131
48	Klinikum der Philipps-Universität Marburg	Marburg		Germany	35032
49	Queen Mary Hospital; Dept. of Clinical Oncology	Hong Kong		Hong Kong
50	Queen Mary Hospital; Medicine & Respiratory	Hong Kong		Hong Kong
51	Tuen Mun Hospital; Clinical Onc	Hong Kong		Hong Kong
52	Prince of Wales Hospital; Department of Clinical Onocology	Shatin		Hong Kong
53	Azienda Ospedaliero-Universitaria S.Orsola-Malpighi; Unità Operativa Oncologia Medica	Bologna	Emilia-Romagna	Italy	40138
54	Centro Di Riferimento Oncologico; Struttura Operativa Complessa Di Oncologia Medica B	Aviano	Friuli-Venezia Giulia	Italy	33081
55	A.O. Villa Scassi; Oncologia Medica	Genova	Liguria	Italy	16149
56	Asst Papa Giovanni XXIII; Oncologia Medica	Bergamo	Lombardia	Italy	24127
57	ASST Spedali Civili di Brescia	Brescia	Lombardia	Italy	25123
58	Azienda Ospedaliero-Universitaria Careggi;S.C. Oncologia Medica 1	Firenze	Toscana	Italy	50139
59	Kosin University Gospel Hospital	Busan		Korea, Republic of	49267
60	Kyungpook National University Chilgok Hospital	Daegu		Korea, Republic of	41404
61	Chungnam National University Hospital	Daejeon		Korea, Republic of	35015
62	Samsung Changwon Hospital	Gyeongsangnam-do		Korea, Republic of	51353
63	Seoul National University Hospital	Seoul		Korea, Republic of	03080
64	Asan Medical Center	Seoul		Korea, Republic of	05505
65	Seoul St Mary's Hospital	Seoul		Korea, Republic of	06591
66	Auckland City Hospital, Cancer and Blood Research	Auckland		New Zealand	1023
67	Waikato Hospital - Cancer and Blood Research Trials Unit; Regional Cancer Centre	Hamilton		New Zealand	3204
68	Palmerston North Hospital	Palmerston North		New Zealand	4410
69	Tauranga Hospital, Clinical Trials Unit; BOP Clinical School	Tauranga		New Zealand	3112
70	ICO L'Hospitalet; Servicio de oncologia medica	L Hospitalet De Llobregat	Barcelona	Spain	08908
71	Hospital Son Llatzer; Servicio de Oncologia	Palma de Mallorca	Islas Baleares	Spain	07198
72	Complejo Hospitalario Universitario A Coruña (CHUAC); Servicio de Oncologia	A Coruña	LA Coruña	Spain	15006
73	Complejo Hospitalario Universitario Insular-Materno Infantil; Servicio de Oncologia	Las Palmas de Gran Canaria	LAS Palmas	Spain	35016
74	Hospital del Mar; Servicio de Oncologia	Barcelona		Spain	08003
75	Hospital Clinic Barcelona; Servicio de oncologia	Barcelona		Spain	08036
76	Hospital Lucus Augusti; Servicio de Oncologia	Lugo		Spain	27003
77	Hospital General Universitario Gregorio Marañon; Servicio de Oncologia	Madrid		Spain	28007
78	Hospital Universitario La Paz; Servicio de Oncologia	Madrid		Spain	28046
79	Hospital Univ. Nuestra Señora de Valme; Servicio de Oncologia	Sevilla		Spain	41014
80	Hospital Clinico Universitario de Valencia; Servicio de Onco-hematologia	Valencia		Spain	46010
81	Kantonsspital Aarau	Aarau		Switzerland	5001
82	Kantonsspital Graubünden Medizin Onkologie; Onkologie und Hämatologie	Chur		Switzerland	7000
83	UniversitätsSpital Zürich; Zentrum für Hämatologie und Onkologie, Klinik für Onkologie	Zürich		Switzerland	8091
84	Changhua Christian Hospital	Chang Hua		Taiwan	500
85	China Medical University Hospital	Taichung		Taiwan	40447
86	Taipei Veterans General Hospital	Taipei City		Taiwan	11217
87	Royal Cornwall Hospital; Dept of Clinical Oncology	Cornwall		United Kingdom	TR1 3LQ
88	Castle Hill Hospital; The Queen's Centre for Oncology & Haematology	Hull		United Kingdom	HU16 5JQ
89	Barts & London School of Med; Medical Oncology	London		United Kingdom	EC1A 7BE
90	Guy'S Hospital; Oncology Unit	London		United Kingdom	SE1 9RT
91	Christie Hospital Nhs Trust; Medical Oncology	Manchester		United Kingdom	M2O 4BX
92	Nottingham City Hospital	Nottingham		United Kingdom	NG5 1PB
93	New Cross Hospital	Wolverhampton		United Kingdom	WV10 0QP