MK-7684A With or Without Other Anticancer Therapies in Participants With Selected Solid Tumors (MK-7684A-005) (KEYVIBE-005)

Sponsor

Merck Sharp & Dohme LLC (Industry)

Overall Status

Recruiting

CT.gov ID

NCT05007106

Collaborator

(none)

610

Enrollment

Locations

Arms

41.1

Anticipated Duration (Months)

9.5

Patients Per Site

0.2

Patients Per Site Per Month

Study Details

Study Description

Brief Summary

The purpose of this study is to determine the safety, tolerability, and preliminary efficacy of pembrolizumab/vibostolimab co-formulation (MK-7684A) with or without other anticancer therapies in participants with selected advanced solid tumors. The primary hypothesis is that pembrolizumab/vibostolimab co-formulation is superior to pembrolizumab alone in terms of objective response rate or progression-free survival in participants with cervical cancer.

Condition or Disease	Intervention/Treatment	Phase
Uterine Cervical Neoplasms Endometrial Neoplasms Squamous Cell Carcinoma of Head and Neck Gallbladder Neoplasms Cholangiocarcinoma Esophageal Neoplasms Triple Negative Breast Neoplasms Hepatocellular Carcinoma Urinary Bladder Neoplasms Ovarian Neoplasms Stomach Neoplasms	Biological: Pembrolizumab/Vibostolimab Co-Formulation Biological: Pembrolizumab Drug: Lenvatinib Drug: 5-Fluorouracil Drug: Cisplatin Drug: Paclitaxel Drug: Gemcitabine Drug: Carboplatin Drug: Docetaxel Drug: Bevacizumab Drug: Capecitabine Drug: Oxaliplatin	Phase 2

Study Design

Study Type:

Interventional

Anticipated Enrollment :

610 participants

Allocation:

Randomized

Intervention Model:

Parallel Assignment

Intervention Model Description:

Participants with locally recurrent unresectable or metastatic cervical cancer whose tumors express programmed cell death 1 ligand 1 (PD-LI) and have a combined positive score (CPS) ≥1 will be randomly assigned to treatment with either pembrolizumab/vibostolimab co-formulation or pembrolizumab only. The other study intervention arms will be assigned to participants depending on the selected cancer type.Participants with locally recurrent unresectable or metastatic cervical cancer whose tumors express programmed cell death 1 ligand 1 (PD-LI) and have a combined positive score (CPS) ≥1 will be randomly assigned to treatment with either pembrolizumab/vibostolimab co-formulation or pembrolizumab only. The other study intervention arms will be assigned to participants depending on the selected cancer type.

Masking:

None (Open Label)

Primary Purpose:

Treatment

Official Title:

A Multicenter, Open-label, Phase 2 Basket Study of MK-7684A, a Co-formation of Vibostolimab (MK-7684) With Pembrolizumab (MK-3475), With or Without Other Anticancer Therapies in Participants With Selected Solid Tumors

Actual Study Start Date :

Sep 16, 2021

Anticipated Primary Completion Date :

Feb 19, 2025

Anticipated Study Completion Date :

Feb 19, 2025

Arms and Interventions

Arm	Intervention/Treatment
Experimental: Pembrolizumab/Vibostolimab Co-Formulation Participants receive pembrolizumab/vibostolimab (coformulation of 200 mg pembrolizumab and 200 mg vibostolimab) via intravenous (IV) infusion every 3 weeks (Q3W) up to 35 cycles.	Biological: Pembrolizumab/Vibostolimab Co-Formulation Pembrolizumab 200 mg plus vibostolimab 200 mg administered via IV infusion Q3W Other Names: MK-7684A
Experimental: Pembrolizumab Participants receive pembrolizumab 200 mg via IV infusion Q3W up to 35 cycles.	Biological: Pembrolizumab Pembrolizumab 200 mg administered via IV infusion Q3W. Other Names: MK-3475 KEYTRUDA®
Experimental: Pembrolizumab/Vibostolimab Co-Formulation + Lenvatinib (Endometrial Cancer Cohort) Participants receive pembrolizumab/vibostolimab (coformulation of 200 mg pembrolizumab and 200 mg vibostolimab) via intravenous IV infusion Q3W up to 35 cycles, plus lenvatinib 20 mg once daily (qd) until meeting discontinuation criteria.	Biological: Pembrolizumab/Vibostolimab Co-Formulation Pembrolizumab 200 mg plus vibostolimab 200 mg administered via IV infusion Q3W Other Names: MK-7684A Drug: Lenvatinib Lenvatinib 20 mg, 12 mg, or 8 mg (dependent on cancer type and body weight) administered via oral capsule QD Other Names: Lenvima E7080 MK-7902
Experimental: Pembrolizumab/Vibostolimab Co-Formulation + Lenvatinib (Hepatocellular Cancer Cohort) Participants receive pembrolizumab/vibostolimab (coformulation of 200 mg pembrolizumab and 200 mg vibostolimab) via intravenous IV infusion Q3W up to 35 cycles, plus lenvatinib 12 mg (body weight [BW] ≥60 kg) or lenvatinib 8 mg (BW <60 kg) qd until meeting discontinuation criteria.	Biological: Pembrolizumab/Vibostolimab Co-Formulation Pembrolizumab 200 mg plus vibostolimab 200 mg administered via IV infusion Q3W Other Names: MK-7684A Drug: Lenvatinib Lenvatinib 20 mg, 12 mg, or 8 mg (dependent on cancer type and body weight) administered via oral capsule QD Other Names: Lenvima E7080 MK-7902
Experimental: Pembrolizumab/Vibostolimab + 5-Fluorouracil + Cisplatin Participants receive pembrolizumab/vibostolimab (coformulation of 200 mg pembrolizumab and 200 mg vibostolimab) via IV infusion Q3W, plus 5-fluorouracil (5-FU), plus Cisplatin as background therapy.	Biological: Pembrolizumab/Vibostolimab Co-Formulation Pembrolizumab 200 mg plus vibostolimab 200 mg administered via IV infusion Q3W Other Names: MK-7684A Drug: 5-Fluorouracil 5-FU 800 mg/m^2/day administered via continuous IV infusion on each of days 1 to 5 Q3W for up to 35 cycles Other Names: 5-FU Fluracil Drug: Cisplatin Cisplatin administered via IV infusion Other Names: Platinol cis Platinum
Experimental: Pembrolizumab/Vibostolimab Co-Formulation + Paclitaxel Participants receive pembrolizumab/vibostolimab (coformulation of 200 mg pembrolizumab and 200 mg vibostolimab) via IV infusion Q3W up to 35 cycles, plus paclitaxel as background therapy until meeting discontinuation criteria.	Biological: Pembrolizumab/Vibostolimab Co-Formulation Pembrolizumab 200 mg plus vibostolimab 200 mg administered via IV infusion Q3W Other Names: MK-7684A Drug: Paclitaxel Paclitaxel administered via IV infusion at investigator's choice of dose Other Names: Taxol Abraxane Anzatax
Experimental: Pembrolizumab/Vibostolimab Co-Formulation + Gemcitabine/Cisplatin Participants receive pembrolizumab/vibostolimab (coformulation of 200 mg pembrolizumab and 200 mg vibostolimab) via IV infusion Q3W up to 35 cycles, plus gemcitabine (until disease progression or unacceptable toxicity) and cisplatin (up to 8 cycles) as background therapy.	Drug: Cisplatin Cisplatin administered via IV infusion Other Names: Platinol cis Platinum Drug: Gemcitabine Gemcitabine administered via IV infusion on Day 1 and Day 8 of each 3-week cycle, until PD or unacceptable toxicity
Experimental: Pembrolizumab/Vibostolimab Co-Formulation+ Carboplatin/Paclitaxel/Bevacizumab Participants receive pembrolizumab/vibostolimab (coformulation of 200 mg pembrolizumab and 200 mg vibostolimab) via IV infusion Q3W up to 35 cycles, plus carboplatin, paclitaxel, and bevacizumab as background therapy.	Drug: Paclitaxel Paclitaxel administered via IV infusion at investigator's choice of dose Other Names: Taxol Abraxane Anzatax Drug: Carboplatin Carboplatin administered via IV infusion at investigator's choice of dose and frequency Drug: Docetaxel For participants who cannot receive paclitaxel due to hypersensitivity or adverse event (AE), docetaxel administered via IV infusion Q3W, Day 1 of each cycle for up to 5 cycles Drug: Bevacizumab Bevacizumab administered via IV infusion Q3W; Day 1 of each 3-week cycle for up to 15 cycles
Experimental: Pembrolizumab/Vibostolimab Co-Formulation + Capecitabine/Oxaliplatin Participants receive pembrolizumab/vibostolimab (coformulation of 200 mg pembrolizumab and 200 mg vibostolimab) via IV infusion Q3W up to 35 cycles, plus capecitabine and oxaliplatin as background therapy.	Drug: Capecitabine Capecitabine administered via oral tablet twice daily on Days 1 to 14 of each cycle (Q3W) for up to 35 cycles Drug: Oxaliplatin Oxaliplatin administered via IV infusion Q3W up to 35 cycles

Outcome Measures

Primary Outcome Measures

Objective Response Rate (ORR) per Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 as Assessed by Blinded Independent Central Review (BICR) [Up to approximately 2 years]
ORR is defined as the percentage of participants who have a Complete Response (CR: Disappearance of all target lesions) or a Partial Response (PR: At least a 30% decrease in the sum of diameters of target lesions) per RECIST 1.1. The percentage of participants who experience a CR or PR as assessed by blinded independent central review based on RECIST 1.1 will be presented.
Progression-Free Survival (PFS) per RECIST 1.1 as Assessed by BICR [Up to approximately 2 years]
PFS is defined as the time from randomization to the first documented progressive disease (PD) or death due to any cause, whichever occurs first. Per RECIST 1.1, PD is defined as ≥20% increase in the sum of diameters of target lesions. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of ≥5 mm. The appearance of one or more new lesions is also considered PD. PFS as assessed by BICR will be presented.
ORR per RECIST 1.1 as Assessed by Investigator [Up to approximately 2 years]
ORR is defined as the percentage of participants who have a CR (Disappearance of all target lesions) or a PR (At least a 30% decrease in the sum of diameters of target lesions) per RECIST 1.1. The percentage of participants who experience a CR or PR as assessed by investigator based on RECIST 1.1 will be presented.
PFS per RECIST 1.1 as Assessed by Investigator at 9 months [9 months]
PFS is defined as the time from randomization to the first documented progressive disease (PD) or death due to any cause, whichever occurs first. Per RECIST 1.1, PD is defined as ≥20% increase in the sum of diameters of target lesions. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of ≥5 mm. The appearance of one or more new lesions is also considered PD.
PFS per RECIST 1.1 as Assessed by Investigator at 12 months [12 months]
PFS is defined as the time from randomization to the first documented progressive disease (PD) or death due to any cause, whichever occurs first. Per RECIST 1.1, PD is defined as ≥20% increase in the sum of diameters of target lesions. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of ≥5 mm. The appearance of one or more new lesions is also considered PD.

Secondary Outcome Measures

Overall Survival (OS) [Up to approximately 3 years]
OS is defined as the time from randomization to death due to any cause.
PFS per RECIST 1.1 as Assessed by Investigator [Up to approximately 2 years]
PFS is defined as the time from first dose of study treatment to the first documented progressive disease (PD) or death due to any cause, whichever occurs first. Per RECIST 1.1, PD is defined as ≥20% increase in the sum of diameters of target lesions. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of ≥5 mm. The appearance of one or more new lesions is also considered PD. PFS as assessed by investigator will be presented.
Duration of Response (DOR) per RECIST 1.1 as Assessed by BICR [Up to approximately 2 years]
For participants who demonstrate a confirmed CR (disappearance of all target lesions) or confirmed PR (at least a 30% decrease in the sum of diameters of target lesions) per RECIST 1.1, DOR is defined as the time from first documented evidence of CR or PR until PD or death. Per RECIST 1.1, PD is defined as at least a 20% increase in the sum of diameters of target lesions. In addition to the relative increase of 20%, the sum must also have demonstrated an absolute increase of at least 5 mm. The appearance of one or more new lesions is also considered PD. The DOR as assessed by BICR will be presented.
DOR per RECIST 1.1 as Assessed by Investigator [Up to approximately 2 years]
For participants who demonstrate a confirmed CR (disappearance of all target lesions) or confirmed PR (at least a 30% decrease in the sum of diameters of target lesions) per RECIST 1.1, DOR is defined as the time from first documented evidence of CR or PR until PD or death. Per RECIST 1.1, PD is defined as at least a 20% increase in the sum of diameters of target lesions. In addition to the relative increase of 20%, the sum must also have demonstrated an absolute increase of at least 5 mm. The appearance of one or more new lesions is also considered PD. The DOR as assessed by investigator will be presented.
ORR per RECIST 1.1 as Assessed by Investigator [Up to approximately 2 years]
ORR is defined as the percentage of participants who have a CR (Disappearance of all target lesions) or a PR (At least a 30% decrease in the sum of diameters of target lesions) per RECIST 1.1. The percentage of participants who experience a CR or PR as assessed by investigator based on RECIST 1.1 will be presented.
Change from Baseline in Global Health Status/Quality of Life Score (European Organisation for Research and Treatment of Cancer Quality-of-Life Questionnaire Core 30 [EORTC QLQ-C30] Items 29 and 30) [Baseline and up to approximately 2 years]
The EORTC QLQ-C30 is a questionnaire to assess the overall quality of life of cancer patients. Participant responses to the questions "How would you rate your overall health during the past week?" and "How would you rate your overall quality of life during the past week?" are scored on a 7-point scale (1= Very poor to 7=Excellent). Using linear transformation, raw scores are standardized, so that scores range from 0 to 100. A higher score indicates a better overall health status. The change from baseline in EORTC QLQ-C30 Items 29 and 30 combined score will be presented.
Change from Baseline in Physical Functioning Score (EORTC QLQ-C30 Items 1-5) [Baseline and up to approximately 2 years]
The EORTC QLQ-C30 is a questionnaire to assess the overall quality of life of cancer patients. Participant responses to 5 questions about their physical functioning are scored on a 4-point scale (1=Not at All to 4=Very Much). Using linear transformation, raw scores are standardized, so that scores range from 0 to 100. A higher score indicates a better quality of life. The change from baseline in Physical Functioning (EORTC QLQ-C30 Items 1-5) score will be presented.
Number of Participants Who Experienced One or More Adverse Events (AEs) [Up to approximately 2 years]
An AE is defined as any unfavorable and unintended sign including an abnormal laboratory finding, symptom or disease associated with the use of a medical treatment or procedure, regardless of whether it is considered related to the medical treatment or procedure, that occurs during the course of the study.
Number of Participants Who Discontinued Study Intervention Due to an AE [Up to approximately 2 years]
An AE is defined as any unfavorable and unintended sign including an abnormal laboratory finding, symptom or disease associated with the use of a medical treatment or procedure, regardless of whether it is considered related to the medical treatment or procedure, that occurs during the course of the study.

Eligibility Criteria

Criteria

Ages Eligible for Study:

18 Years and Older

Sexes Eligible for Study:

All

Accepts Healthy Volunteers:

Inclusion Criteria:

One of the following histologically or cytologically confirmed, advanced (locally recurrent unresectable or metastatic) solid tumors:
Squamous cell carcinoma, adenosquamous carcinoma, or adenocarcinoma of the cervix
Endometrial cancer
Head and neck squamous cell carcinoma (HNSCC)
Unresectable biliary adenocarcinoma (gallbladder or biliary tree [intrahepatic or extrahepatic] cholangiocarcinoma)
Adenocarcinoma or squamous cell carcinoma of the esophagus or advanced/metastatic Siewert type 1 adenocarcinoma of the gastroesophageal junction (GEJ).
Triple-negative breast cancer (TNBC)
Hepatocellular carcinoma (HCC)
Urothelial carcinoma of the renal pelvis, ureter, bladder, or urethra
Ovarian cancer
Gastric cancer
Measurable disease per RECIST v1.1 as assessed by BICR or local site investigator.
Adequately controlled blood pressure (BP) with or without antihypertensive medications.
Human immunodeficiency virus (HIV)-infected participants must have well controlled HIV on anti-retroviral therapy (ART).
Male participants must agree to follow contraceptive guidance.
Female participants are not pregnant or breastfeeding, not a woman of child-bearing potential (WOCBP) or is a WOCBP and agrees to follow contraceptive guidance.
Adequate organ function.

Exclusion Criteria:

History of a second malignancy, unless potentially curative treatment has been completed with no evidence of malignancy for 3 years.
Prior therapy with anti-programmed cell-death (PD-1), anti-PD-L1, anti-PD-L2, or anti-T-cell immunoreceptor with Ig and ITIM domains (TIGIT) agent.
Prior systemic anticancer therapy including investigational agents within 4 weeks before randomization/allocation.
Received a live or live-attenuated vaccine within 30 days before the first dose of study intervention. Administration of killed vaccines are allowed.
Diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy or any other form of immunosuppressive therapy within 7 days before the first dose of study medication.
Active autoimmune disease that has required systemic treatment in past 2 years.
Active infection requiring systemic therapy.
Concurrent active hepatitis B and hepatitis C virus infection.
History of allogenic tissue/solid organ transplant.
Previous treatment with lenvatinib (for participants who will receive lenvatinib in their assigned treatment arm).
Has clinically significant cardiovascular disease within 12 months from first dose of study intervention.

Contacts and Locations

Locations

	Site	City	State	Country	Postal Code
1	Alaska Womens Cancer Care ( Site 1016)	Anchorage	Alaska	United States	99508
2	City of Hope Comprehensive Cancer Center ( Site 1001)	Duarte	California	United States	91010
3	University of California, Irvine (UCI) Health - UC Irvine Me-Chao Family Comprehensive Cancer Cente	Orange	California	United States	92868
4	Karmanos Cancer Institute ( Site 1007)	Detroit	Michigan	United States	48201
5	Memorial Sloan Kettering - Monmouth ( Site 1022)	Middletown	New Jersey	United States	07748
6	Memorial Sloan Kettering- Commack ( Site 1021)	Commack	New York	United States	11725
7	Memorial Sloan Kettering - Westchester ( Site 1020)	Harrison	New York	United States	10604
8	Memorial Sloan Kettering Cancer Center ( Site 1002)	New York	New York	United States	10065
9	Sanford Cancer Center-Gynecologic Oncology ( Site 1015)	Sioux Falls	South Dakota	United States	57104
10	Houston Methodist Hospital ( Site 1017)	Houston	Texas	United States	77030
11	Kingston Health Sciences Centre-Kingston General Hospital Site ( Site 1051)	Kingston	Ontario	Canada	K7L 2V7
12	Princess Margaret Cancer Centre-Division of Medical Oncology and Hematology ( Site 1056)	Toronto	Ontario	Canada	M5G 2M9
13	James Lind Centro de Investigación del Cáncer ( Site 1404)	Temuco	Araucania	Chile	4780000
14	FALP-UIDO ( Site 1401)	Santiago	Region M. De Santiago	Chile	6900941
15	Oncovida ( Site 1405)	Santiago	Region M. De Santiago	Chile	7510032
16	Bradfordhill-Clinical Area ( Site 1402)	Santiago	Region M. De Santiago	Chile	8420383
17	Clínica Vida Fundación - Sede Poblado ( Site 1422)	Medellin	Antioquia	Colombia	050030
18	Clinica de la Costa LTDA ( Site 1421)	Barranquilla	Atlantico	Colombia	080020
19	Instituto Nacional de Cancerología-Clinical Oncology ( Site 1425)	Bogotá	Cundinamarca	Colombia	111511
20	Oncologos del Occidente ( Site 1424)	Pereira	Risaralda	Colombia	660001
21	Fundación Cardiovascular de Colombia ( Site 1423)	Piedecuesta	Santander	Colombia	681017
22	Centre Georges François Leclerc ( Site 1155)	Dijon	Cote-d Or	France	21079
23	Institut Régional du Cancer Montpellier ( Site 1157)	Montpellier	Herault	France	34298
24	Gustave Roussy-medicine departement ( Site 1153)	Villejuif	Paris	France	94800
25	CENTRE LEON BERARD-Medical oncology ( Site 1151)	Lyon	Rhone-Alpes	France	69008
26	Sainte Catherine Institut du Cancer Avignon Provence-Oncologie médicale ( Site 1156)	Avignon	Vaucluse	France	84918
27	Institut Curie ( Site 1152)	Paris		France	75005
28	Universitaetsklinikum Heidelberg-Nationales Centrum für Tumorerkrankungen ( Site 1180)	Heidelberg	Baden-Wurttemberg	Germany	69120
29	Universitaetsklinikum Tuebingen-Department of Internal Medicine VIII - Medical Oncology, ECTU, Pne	Tübingen	Baden-Wurttemberg	Germany	72076
30	Klinikum der Universität München Großhadern ( Site 1176)	München	Bayern	Germany	81337
31	Universitaetsklinikum Duesseldorf-Gastroenterology, Hepatology and Infectiology ( Site 1172)	Düsseldorf	Nordrhein-Westfalen	Germany	40225
32	Charite Universitätsmedizin Berlin Campus Benjamin Franklin ( Site 1171)	Berlin		Germany	12203
33	Rambam Health Care Campus-Oncology ( Site 1141)	Haifa		Israel	3109601
34	Hadassah Medical Center-Oncology ( Site 1142)	Jerusalem		Israel	9112001
35	Sheba Medical Center-ONCOLOGY ( Site 1144)	Ramat Gan		Israel	5262100
36	Sourasky Medical Center-Oncology ( Site 1143)	Tel Aviv		Israel	6423906
37	Ospedale San Raffaele-Oncologia Medica ( Site 1135)	Milano		Italy	20132
38	Istituto Europeo di Oncologia IRCCS-Divisione di Sviluppo di Nuovi Farmaci per Terapie Innovative (	Milano		Italy	20141
39	Istituto Nazionale Tumori IRCCS Fondazione Pascale-S.C. Sperimentazioni Cliniche ( Site 1134)	Napoli		Italy	80131
40	National Cancer Center Hospital East ( Site 1321)	Kashiwa	Chiba	Japan	277-8577
41	National Cancer Center Hospital ( Site 1322)	Tokyo		Japan	104-0045
42	Seoul National University Hospital-Internal Medicine ( Site 1312)	Seoul		Korea, Republic of	03080
43	Severance Hospital, Yonsei University Health System-Medical oncology ( Site 1311)	Seoul		Korea, Republic of	03722
44	Asan Medical Center ( Site 1313)	Seoul		Korea, Republic of	05505
45	Nederlands Kanker Instituut - Antoni van Leeuwenhoek (NKI-AVL) ( Site 1121)	Amsterdam	Noord-Holland	Netherlands	1066 CX
46	Erasmus Medisch Centrum-Medical Oncology ( Site 1122)	Rotterdam	Zuid-Holland	Netherlands	3015 GD
47	Narodowy Instytut Onkologii im. Marii Sklodowskiej-Curie - P-Oddzial Badan Wczesnych Faz ( Site 1101	Warszawa	Mazowieckie	Poland	02-781
48	Uniwersyteckie Centrum Kliniczne-Early Clinical Trials Unit ( Site 1103)	Gdańsk	Pomorskie	Poland	80-952
49	Szpital Wojewódzki im. Mikoaja Kopernika w Koszalinie-Oddzial Dzienny Chemioterapii ( Site 1104)	Koszalin	Zachodniopomorskie	Poland	75-581
50	Instituto Catalan de Oncologia - Hospital Duran i Reynals-Medical Oncology ( Site 1113)	Hospitalet	Barcelona	Spain	08907
51	Hospital Universitario Ramón y Cajal-Medical Oncology ( Site 1111)	Madrid	Madrid, Comunidad De	Spain	28034
52	HOSPITAL UNIVERSITARIO QUIRONSALUD MADRID-ONCOLOGIA MEDICA ( Site 1117)	Pozuelo de Alarcon	Madrid	Spain	28223
53	HOSPITAL UNIVERSITARIO VIRGEN DEL ROCIO ( Site 1114)	Sevilla		Spain	41013
54	NATIONAL CHENG-KUNG UNI. HOSP.-clinical trial center ( Site 1302)	Tainan		Taiwan	704
55	National Taiwan University Hospital-Oncology ( Site 1301)	Taipei		Taiwan	10002
56	Mackay Memorial Hospital ( Site 1305)	Taipei		Taiwan
57	Chang Gung Medical Foundation-Linkou Branch ( Site 1304)	Taoyuan		Taiwan	333
58	Istanbul Universitesi Cerrahpasa ( Site 1203)	Istanbul- Fatih	Istanbul	Turkey	34098
59	Baskent University Dr. Turgut Noyan Research and Training Center ( Site 1201)	Adana		Turkey	01250
60	Hacettepe Universitesi-oncology hospital ( Site 1209)	Ankara		Turkey	06230
61	Ankara City Hospital-Medical Oncology ( Site 1202)	Ankara		Turkey	06800
62	Trakya University-Medical Oncology ( Site 1207)	Edirne		Turkey	22030
63	Acibadem Universitesi Atakent Hastanesi ( Site 1208)	Istanbul		Turkey	34303
64	TC Saglik Bakanligi Goztepe Prof. Dr. Suleyman Yalcin Sehir Hastanesi-oncology ( Site 1204)	Istanbul		Turkey	34722