<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT03834493</url>
  </required_header>
  <id_info>
    <org_study_id>3475-641</org_study_id>
    <secondary_id>MK-3475-641</secondary_id>
    <secondary_id>KEYNOTE-641</secondary_id>
    <secondary_id>195005</secondary_id>
    <secondary_id>2022-500785-10-00</secondary_id>
    <secondary_id>2018-004117-40</secondary_id>
    <nct_id>NCT03834493</nct_id>
  </id_info>
  <brief_title>Study of Pembrolizumab (MK-3475) Plus Enzalutamide Versus Placebo Plus Enzalutamide in Participants With Metastatic Castration-resistant Prostate Cancer (mCRPC) (MK-3475-641/KEYNOTE-641)</brief_title>
  <official_title>A Phase 3, Randomized, Double-blind Trial of Pembrolizumab (MK-3475) Plus Enzalutamide Versus Placebo Plus Enzalutamide in Participants With Metastatic Castration-Resistant Prostate Cancer (mCRPC) (KEYNOTE-641)</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>Merck Sharp &amp; Dohme LLC</agency>
      <agency_class>Industry</agency_class>
    </lead_sponsor>
  </sponsors>
  <source>Merck Sharp &amp; Dohme LLC</source>
  <oversight_info>
    <has_dmc>Yes</has_dmc>
    <is_fda_regulated_drug>Yes</is_fda_regulated_drug>
    <is_fda_regulated_device>No</is_fda_regulated_device>
  </oversight_info>
  <brief_summary>
    <textblock>
      The purpose of this study is to assess the efficacy and safety of the combination of&#xD;
      pembrolizumab (MK-3475) and enzalutamide in the treatment of men with metastatic&#xD;
      castration-resistant prostate cancer (mCRPC) who have not received chemotherapy for mCRPC,&#xD;
      are abiraterone-naïve, or are intolerant to or progressed on abiraterone acetate. There are&#xD;
      two primary study hypotheses.&#xD;
&#xD;
      Hypothesis 1: The combination of pembrolizumab plus enzalutamide is superior to placebo plus&#xD;
      enzalutamide with respect to Overall Survival (OS).&#xD;
&#xD;
      Hypothesis 2: The combination of pembrolizumab plus enzalutamide is superior to placebo plus&#xD;
      enzalutamide with respect to Radiographic Progression-free Survival (rPFS) per Prostate&#xD;
      Cancer Working Group (PCWG)-modified Response Evaluation Criteria in Solid Tumors Version 1.1&#xD;
      (RECIST 1.1) as assessed by blinded independent central review.&#xD;
    </textblock>
  </brief_summary>
  <overall_status>Active, not recruiting</overall_status>
  <start_date type="Actual">July 28, 2019</start_date>
  <completion_date type="Anticipated">May 31, 2024</completion_date>
  <primary_completion_date type="Actual">December 12, 2022</primary_completion_date>
  <phase>Phase 3</phase>
  <study_type>Interventional</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <allocation>Randomized</allocation>
    <intervention_model>Parallel Assignment</intervention_model>
    <primary_purpose>Treatment</primary_purpose>
    <masking>Triple (Participant, Investigator, Outcomes Assessor)</masking>
    <masking_description>Study became unblinded in February 2023.</masking_description>
  </study_design_info>
  <primary_outcome>
    <measure>Overall Survival (OS)</measure>
    <time_frame>Up to ~ 41 months</time_frame>
    <description>Time from randomization to death due to any cause</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Radiographic Progression-free Survival (rPFS) Per Prostate Cancer Working Group (PCWG)-modified Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) as Assessed by Blinded Independent Central Review</measure>
    <time_frame>Up to ~ 41 months</time_frame>
    <description>Time from randomization to radiographic progression, or death due to any cause, whichever occurs first</description>
  </primary_outcome>
  <secondary_outcome>
    <measure>Time to Initiation of the First Subsequent Anti-cancer Therapy or Death (TFST)</measure>
    <time_frame>Up to ~ 46 months</time_frame>
    <description>Time from randomization to initiation of the first subsequent anti-cancer therapy or death, whichever occurs first</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Prostate-specific Antigen (PSA) Response Rate</measure>
    <time_frame>Up to ~ 46 months</time_frame>
    <description>Percentage of participants in the analysis population who have a negative change (decrease) in PSA level of ≥50% measured twice ≥3 weeks apart</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Prostate-specific Antigen (PSA) Undetectable Rate</measure>
    <time_frame>Up to ~ 46 months</time_frame>
    <description>Percentage of participants in the analysis population with PSA &lt;0.2 ng/mL during study treatment</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Objective Response Rate (ORR) Per Prostate Cancer Working Group (PCWG)-modified Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) as Assessed by Blinded Independent Central Review</measure>
    <time_frame>Up to ~ 46 months</time_frame>
    <description>Percentage of participants in the analysis population who have a best overall response of either confirmed Complete Response (CR) or a confirmed Partial Response (PR) per PCWG-modified RECIST 1.1</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Duration of Response (DOR) Per Prostate Cancer Working Group (PCWG)-modified Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) as Assessed by Blinded Independent Central Review</measure>
    <time_frame>Up to ~ 46 months</time_frame>
    <description>Time from first documented evidence of confirmed Complete Response (CR) or Partial Response (PR) per PCWG-modified RECIST 1.1 until disease progression or death from any cause, whichever occurs first</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Time to Prostate-specific Antigen (PSA) Progression</measure>
    <time_frame>Up to ~ 46 months</time_frame>
    <description>Time from randomization to PSA progression. PSA progression date is defined as the date of 1) ≥25% increase and ≥2 ng/mL above the nadir, confirmed by a second value ≥3 weeks later if there is PSA decline from baseline, or 2) ≥25% increase and ≥2 ng/mL increase from baseline beyond 12 weeks if there is no PSA decline from baseline</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Time to Radiographic Soft Tissue Progression Per Soft Tissue Rules of Prostate Cancer Working Group (PCWG)-modified Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) as Assessed by Blinded Independent Central Review</measure>
    <time_frame>Up to ~ 46 months</time_frame>
    <description>Time from randomization to radiographic soft tissue progression per PCWG-modified RECIST 1.1</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Time to Pain Progression (TTPP) as Assessed by Brief Pain Inventory-Short Form (BPI-SF) Item 3 (&quot;Worst Pain in 24 Hours&quot;) and Opiate Analgesic Use (Analgesic Quantification Algorithm [AQA] Score)</measure>
    <time_frame>Up to ~ 46 months</time_frame>
    <description>Time from randomization to pain progression. In this study, pain progression will be assessed by participant responses to Item 3 of the BPI-SF and participant AQA Scores which are both assessed by participants daily for 7 consecutive days</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Time to First Symptomatic Skeletal-related Event (SSRE)</measure>
    <time_frame>Up to ~ 46 months</time_frame>
    <description>Time from randomization to the first SSRE. SSRE is defined as radiation to prevent or relieve skeletal symptoms, occurrence of new symptomatic pathological fracture, spinal cord compression, or surgery to bone</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Number of Participants Who Experience an Adverse Event (AE)</measure>
    <time_frame>Up to ~ 53 months</time_frame>
    <description>An AE is defined as any untoward medical occurrence in a participant, temporally associated with the use of study treatment, whether or not considered related to the study treatment</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Number of Participants Who Discontinue Study Treatment Due to an Adverse Event (AE)</measure>
    <time_frame>Up to ~ 53 months</time_frame>
    <description>The number of participants who discontinue study treatment due to an AE will be presented</description>
  </secondary_outcome>
  <number_of_arms>2</number_of_arms>
  <enrollment type="Actual">1244</enrollment>
  <condition>Prostatic Neoplasms</condition>
  <arm_group>
    <arm_group_label>Pembrolizumab + Enzalutamide</arm_group_label>
    <arm_group_type>Experimental</arm_group_type>
    <description>Participants receive 200 mg pembrolizumab by intravenous (IV) infusion administered on Day 1 of each 21-day cycle (Q3W) for up to 35 cycles (approximately 2 years) PLUS enzalutamide 160 mg administered orally (PO) once a day (QD) continuously until progression.</description>
  </arm_group>
  <arm_group>
    <arm_group_label>Placebo + Enzalutamide</arm_group_label>
    <arm_group_type>Placebo Comparator</arm_group_type>
    <description>Participants receive placebo by IV infusion administered on Day 1 Q3W for up to 35 cycles (approximately 2 years) PLUS enzalutamide 160 mg administered PO QD continuously until progression.</description>
  </arm_group>
  <intervention>
    <intervention_type>Biological</intervention_type>
    <intervention_name>Pembrolizumab</intervention_name>
    <description>IV infusion</description>
    <arm_group_label>Pembrolizumab + Enzalutamide</arm_group_label>
    <other_name>KEYTRUDA®</other_name>
    <other_name>MK-3475</other_name>
  </intervention>
  <intervention>
    <intervention_type>Drug</intervention_type>
    <intervention_name>Enzalutamide</intervention_name>
    <description>Capsules/Tablets</description>
    <arm_group_label>Pembrolizumab + Enzalutamide</arm_group_label>
    <arm_group_label>Placebo + Enzalutamide</arm_group_label>
    <other_name>XTANDI®</other_name>
  </intervention>
  <intervention>
    <intervention_type>Drug</intervention_type>
    <intervention_name>Placebo</intervention_name>
    <description>IV infusion</description>
    <arm_group_label>Placebo + Enzalutamide</arm_group_label>
    <other_name>Normal saline or dextrose infusion</other_name>
  </intervention>
  <eligibility>
    <criteria>
      <textblock>
        The main inclusion and exclusion criteria include but are not limited to the following:&#xD;
&#xD;
        Inclusion Criteria:&#xD;
&#xD;
          -  Has histologically- or cytologically-confirmed adenocarcinoma of the prostate without&#xD;
             small cell histology&#xD;
&#xD;
          -  Has prostate cancer progression while on androgen deprivation therapy (or post&#xD;
             bilateral orchiectomy) within 6 months prior to randomization&#xD;
&#xD;
          -  Has current evidence of metastatic disease documented by either bone lesions on bone&#xD;
             scan and/or soft tissue disease by computed tomography/magnetic resonance imaging&#xD;
             (CT/MRI)&#xD;
&#xD;
          -  Has met one of the following criteria with regard to abiraterone acetate exposure: (1)&#xD;
             is abiraterone-naïve; (2) received prior abiraterone acetate for the treatment of&#xD;
             mHSPC or mCRPC, for a minimum of 4 weeks and not progressed while on treatment; or (3)&#xD;
             received prior abiraterone acetate for the treatment of mHSPC or mCRPC and progressed&#xD;
             on treatment after a minimum of 8 weeks treatment (minimum 14 weeks for those with&#xD;
             bone progression)&#xD;
&#xD;
          -  Has ongoing androgen deprivation with serum testosterone &lt;50 ng/dL (&lt;2.0 nM)&#xD;
&#xD;
          -  Participants receiving bone resorptive therapy (including, but not limited to,&#xD;
             bisphosphonate or denosumab) must have been on stable doses prior to randomization&#xD;
&#xD;
          -  Participants must agree to the following during the study treatment period and for at&#xD;
             least 90 days after the last dose of enzalutamide: Refrain from donating sperm, plus&#xD;
             EITHER be abstinent OR must agree to use male condom&#xD;
&#xD;
          -  Has provided newly obtained core or excisional biopsy (obtained within 12 months of&#xD;
             screening) from soft tissue not previously irradiated (samples from tumors progressing&#xD;
             in a prior site of radiation are allowed). Participants with bone only or bone&#xD;
             predominant disease may provide a bone biopsy sample&#xD;
&#xD;
          -  Has an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 assessed&#xD;
             within 7 days of randomization&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
          -  Has a known additional malignancy that is progressing or has required active treatment&#xD;
             in the last 3 years&#xD;
&#xD;
          -  Has an active autoimmune disease that has required systemic treatment in past 2 years&#xD;
&#xD;
          -  Has a diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy&#xD;
&#xD;
          -  Has undergone major surgery including local prostate intervention (excluding prostate&#xD;
             biopsy) within 28 days prior to randomization and not recovered adequately from the&#xD;
             toxicities and/or complications&#xD;
&#xD;
          -  Has a gastrointestinal disorder affecting absorption or is unable to swallow&#xD;
             tablets/capsules&#xD;
&#xD;
          -  Has an active infection (including tuberculosis) requiring systemic therapy&#xD;
&#xD;
          -  Has a history of (noninfectious) pneumonitis/interstitial lung disease that required&#xD;
             steroids or current pneumonitis/interstitial lung disease&#xD;
&#xD;
          -  Has known active human immunodeficiency virus (HIV), concurrent active hepatitis B&#xD;
             virus (HBV) or known active hepatitis C virus (HCV) infection&#xD;
&#xD;
          -  Has known active central nervous system (CNS) metastases and/or carcinomatous&#xD;
             meningitis&#xD;
&#xD;
          -  Has hypersensitivity to pembrolizumab and/or enzalutamide and/or any of their&#xD;
             excipients&#xD;
&#xD;
          -  Has a history of seizure or any condition that may predispose to seizure&#xD;
&#xD;
          -  Has a history of loss of consciousness within 12 months of screening&#xD;
&#xD;
          -  Has hypotension (systolic blood pressure &lt;86 millimeters of mercury [mmHg]) or&#xD;
             uncontrolled hypertension (systolic blood pressure &gt;170 mmHg or diastolic blood&#xD;
             pressure &gt;105 mmHg) at the screening visit&#xD;
&#xD;
          -  Has bradycardia (heart rate of &lt;50 beats per minute) on the screening&#xD;
             electrocardiogram (ECG)&#xD;
&#xD;
          -  Has history of prostate cancer progression on ketoconazole&#xD;
&#xD;
          -  Has had prior treatment with enzalutamide, apalutamide, darolutamide or cytochrome&#xD;
             P450 (CYP) 17 inhibitor other than abiraterone acetate&#xD;
&#xD;
          -  Has received prior therapy with an anti-programmed cell death-1 (anti-PD-1),&#xD;
             anti-programmed cell death-ligand 1 (anti-PD-L1), or anti-PD-L2 agent or with an agent&#xD;
             directed to another stimulatory or coinhibitory T-cell receptor&#xD;
&#xD;
          -  Has received prior treatment with radium or other therapeutic radiopharmaceuticals for&#xD;
             prostate cancer&#xD;
&#xD;
          -  Has received prior treatment with docetaxel or another chemotherapy agent for mCRPC&#xD;
&#xD;
          -  Has had a prior anti-cancer monoclonal antibody (mAb) prior to randomization&#xD;
&#xD;
          -  Has used herbal products that may have hormonal anti-prostate cancer activity and/or&#xD;
             are known to decrease PSA levels (eg, saw palmetto) prior to randomization&#xD;
&#xD;
          -  Has received a live or live attenuated vaccine within 30 days prior to randomization&#xD;
&#xD;
          -  Is currently participating in or has participated in a study of an investigational&#xD;
             agent or has used an investigational device within 4 weeks prior to the first dose of&#xD;
             study treatment&#xD;
&#xD;
          -  Has a &quot;superscan&quot; bone scan&#xD;
&#xD;
          -  Is expecting to conceive or father children within the projected duration of the&#xD;
             study, starting with the screening visit through 90 days after the last dose of&#xD;
             enzalutamide&#xD;
&#xD;
          -  Has had an allogenic tissue/solid organ transplant&#xD;
      </textblock>
    </criteria>
    <gender>Male</gender>
    <minimum_age>18 Years</minimum_age>
    <maximum_age>N/A</maximum_age>
    <healthy_volunteers>No</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Medical Director</last_name>
    <role>Study Director</role>
    <affiliation>Merck Sharp &amp; Dohme LLC</affiliation>
  </overall_official>
  <location>
    <facility>
      <name>University of South Alabama, Mitchell Cancer Institute ( Site 0065)</name>
      <address>
        <city>Mobile</city>
        <state>Alabama</state>
        <zip>36604</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>St. Joseph Heritage Healthcare ( Site 0069)</name>
      <address>
        <city>Fullerton</city>
        <state>California</state>
        <zip>92835</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>UCLA Hematology/Oncology - Santa Monica ( Site 0081)</name>
      <address>
        <city>Los Angeles</city>
        <state>California</state>
        <zip>90404</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>University of Colorado Cancer Center ( Site 0022)</name>
      <address>
        <city>Aurora</city>
        <state>Colorado</state>
        <zip>80045</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Smilow Cancer Hospital at Yale New Haven ( Site 0038)</name>
      <address>
        <city>New Haven</city>
        <state>Connecticut</state>
        <zip>06513</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Moffitt Cancer Center ( Site 0080)</name>
      <address>
        <city>Tampa</city>
        <state>Florida</state>
        <zip>33612</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Georgia Cancer Center at Augusta University ( Site 0026)</name>
      <address>
        <city>Augusta</city>
        <state>Georgia</state>
        <zip>30912</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Mount Sinai Hospital Medical Center ( Site 0042)</name>
      <address>
        <city>Chicago</city>
        <state>Illinois</state>
        <zip>60608</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Methodist Hospitals. ( Site 0008)</name>
      <address>
        <city>Merrillville</city>
        <state>Indiana</state>
        <zip>46410</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Tulane Cancer Center ( Site 0066)</name>
      <address>
        <city>New Orleans</city>
        <state>Louisiana</state>
        <zip>70112</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>University of Massachusetts Worcester ( Site 0053)</name>
      <address>
        <city>Worcester</city>
        <state>Massachusetts</state>
        <zip>01655</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Cancer &amp; Hematology Centers of Western Michigan ( Site 0013)</name>
      <address>
        <city>Grand Rapids</city>
        <state>Michigan</state>
        <zip>49503</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Munson Medical Center ( Site 0030)</name>
      <address>
        <city>Traverse City</city>
        <state>Michigan</state>
        <zip>49684</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>St. Vincent Frontier Cancer Center ( Site 0016)</name>
      <address>
        <city>Billings</city>
        <state>Montana</state>
        <zip>59102</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Oncology Hematology West, PC dba Nebraska Cancer Specialists ( Site 0034)</name>
      <address>
        <city>Omaha</city>
        <state>Nebraska</state>
        <zip>68130</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Comprehensive Cancer Centers of Nevada ( Site 0092)</name>
      <address>
        <city>Las Vegas</city>
        <state>Nevada</state>
        <zip>89169</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>John Theurer Cancer Center at Hackensack University Medical Center ( Site 0004)</name>
      <address>
        <city>Hackensack</city>
        <state>New Jersey</state>
        <zip>07601</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Associated Medical Professionals of NY ( Site 0060)</name>
      <address>
        <city>Syracuse</city>
        <state>New York</state>
        <zip>13210</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>W. G. Bill Hefner VA Medical Center ( Site 0029)</name>
      <address>
        <city>Salisbury</city>
        <state>North Carolina</state>
        <zip>28144</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Gabrail Cancer Center-Research ( Site 0096)</name>
      <address>
        <city>Canton</city>
        <state>Ohio</state>
        <zip>44718</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Tri-State Urologic Services PSC, Inc. ( Site 0094)</name>
      <address>
        <city>Cincinnati</city>
        <state>Ohio</state>
        <zip>45212</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>University Hospitals Cleveland Medical Center ( Site 0036)</name>
      <address>
        <city>Cleveland</city>
        <state>Ohio</state>
        <zip>44106</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Oregon Health Sciences University ( Site 0031)</name>
      <address>
        <city>Portland</city>
        <state>Oregon</state>
        <zip>97239</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Carolina Urologic Research Center ( Site 0070)</name>
      <address>
        <city>Myrtle Beach</city>
        <state>South Carolina</state>
        <zip>29572</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Inova Schar Cancer Institute ( Site 0006)</name>
      <address>
        <city>Fairfax</city>
        <state>Virginia</state>
        <zip>22031</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Virginia Cancer Institute ( Site 0052)</name>
      <address>
        <city>Richmond</city>
        <state>Virginia</state>
        <zip>23230</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Blue Ridge Cancer Care ( Site 0086)</name>
      <address>
        <city>Roanoke</city>
        <state>Virginia</state>
        <zip>24014</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Froedtert Hospital &amp; the Medical College of Wisconsin ( Site 0045)</name>
      <address>
        <city>Milwaukee</city>
        <state>Wisconsin</state>
        <zip>53226</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Centro de Oncologia e Investigacion Buenos Aires COIBA ( Site 1013)</name>
      <address>
        <city>Berazategui</city>
        <state>Buenos Aires</state>
        <zip>B1884BBF</zip>
        <country>Argentina</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Instituto de Investigaciones Clinicas ( Site 1000)</name>
      <address>
        <city>Mar del Plata</city>
        <state>Buenos Aires</state>
        <zip>B7600FZO</zip>
        <country>Argentina</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Centro de Diagnostico Urologico ( Site 1008)</name>
      <address>
        <city>Buenos Aires</city>
        <state>Caba</state>
        <zip>C1120AAT</zip>
        <country>Argentina</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Instituto Medico Alexander Fleming ( Site 1010)</name>
      <address>
        <city>Buenos Aires</city>
        <state>Caba</state>
        <country>Argentina</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Sanatorio Parque ( Site 1002)</name>
      <address>
        <city>Rosario</city>
        <state>Santa Fe</state>
        <zip>S2000DSV</zip>
        <country>Argentina</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Instituto de Oncologia de Rosario ( Site 1015)</name>
      <address>
        <city>Rosario</city>
        <state>Santa Fe</state>
        <zip>S2000KZE</zip>
        <country>Argentina</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Instituto de Investigaciones Metabolicas [Buenos Aires, Argentina] ( Site 1011)</name>
      <address>
        <city>Buenos Aires</city>
        <zip>C1012AAR</zip>
        <country>Argentina</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Hospital Aleman ( Site 1004)</name>
      <address>
        <city>Buenos Aires</city>
        <zip>C1118AAT</zip>
        <country>Argentina</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Centro Medico Dra De Salvo ( Site 1018)</name>
      <address>
        <city>Buenos Aires</city>
        <zip>C1426ANZ</zip>
        <country>Argentina</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>CEMAIC ( Site 1014)</name>
      <address>
        <city>Cordoba</city>
        <zip>X5008HHW</zip>
        <country>Argentina</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Centro Oncologico Riojano Integral ( Site 1005)</name>
      <address>
        <city>La Rioja</city>
        <zip>F5300COE</zip>
        <country>Argentina</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Centro Oncologico de Integracion Regional. COIR ( Site 1007)</name>
      <address>
        <city>Mendoza</city>
        <zip>M5500AYB</zip>
        <country>Argentina</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>St. Vincent's Hospital ( Site 0158)</name>
      <address>
        <city>Darlinghurst</city>
        <state>New South Wales</state>
        <zip>2010</zip>
        <country>Australia</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>St George Hospital ( Site 0157)</name>
      <address>
        <city>Kogarah</city>
        <state>New South Wales</state>
        <zip>2217</zip>
        <country>Australia</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Macquarie University ( Site 0151)</name>
      <address>
        <city>Macquarie University</city>
        <state>New South Wales</state>
        <zip>2109</zip>
        <country>Australia</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Port Macquarie Base Hospital ( Site 0153)</name>
      <address>
        <city>Port Macquarie</city>
        <state>New South Wales</state>
        <zip>2444</zip>
        <country>Australia</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Calvary Mater Newcastle ( Site 0148)</name>
      <address>
        <city>Waratah</city>
        <state>New South Wales</state>
        <zip>2298</zip>
        <country>Australia</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Gallipoli Medical Research Foundation ( Site 0149)</name>
      <address>
        <city>Greenslopes</city>
        <state>Queensland</state>
        <zip>4120</zip>
        <country>Australia</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Gold Coast University Hospital ( Site 0150)</name>
      <address>
        <city>Southport</city>
        <state>Queensland</state>
        <zip>4215</zip>
        <country>Australia</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Royal Adelaide Hospital ( Site 0154)</name>
      <address>
        <city>Adelaide</city>
        <state>South Australia</state>
        <zip>5000</zip>
        <country>Australia</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Monash Health-Monash Medical Centre ( Site 0147)</name>
      <address>
        <city>Clayton</city>
        <state>Victoria</state>
        <zip>3168</zip>
        <country>Australia</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Fiona Stanley Hospital ( Site 0162)</name>
      <address>
        <city>Perth</city>
        <state>Western Australia</state>
        <zip>6150</zip>
        <country>Australia</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Ordensklinikum Linz GmbH Elisabethinen ( Site 0373)</name>
      <address>
        <city>Linz</city>
        <state>Oberosterreich</state>
        <zip>4020</zip>
        <country>Austria</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Medizinische Universität Wien ( Site 0375)</name>
      <address>
        <city>Wien</city>
        <zip>1090</zip>
        <country>Austria</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Hospital Erasto Gaertner-CEPEP - Pesquisa Clínica ( Site 1036)</name>
      <address>
        <city>Curitiba</city>
        <state>Parana</state>
        <zip>81520-060</zip>
        <country>Brazil</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Liga Norte Riograndense Contra o Câncer-Centro de Pesquisa Clínica ( Site 1032)</name>
      <address>
        <city>Natal</city>
        <state>Rio Grande Do Norte</state>
        <zip>59075-740</zip>
        <country>Brazil</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>ONCOSITE - Centro de Pesquisa Clinica em Oncologia ( Site 1038)</name>
      <address>
        <city>Ijui</city>
        <state>Rio Grande Do Sul</state>
        <zip>98700-000</zip>
        <country>Brazil</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Uniao Brasileira de Educacao e Assistencia Hospital Sao Lucas da Pucrs ( Site 1021)</name>
      <address>
        <city>Porto Alegre</city>
        <state>Rio Grande Do Sul</state>
        <zip>90610-000</zip>
        <country>Brazil</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Centro de Novos Tratamentos Itajai - Clinica de Neoplasias Litoral ( Site 1035)</name>
      <address>
        <city>Itajai</city>
        <state>Santa Catarina</state>
        <zip>88301-215</zip>
        <country>Brazil</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Hospital de Base de Sao Jose de Rio Preto ( Site 1022)</name>
      <address>
        <city>Sao Jose do Rio Preto</city>
        <state>Sao Paulo</state>
        <zip>15090-000</zip>
        <country>Brazil</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Núcleo de Pesquisa Clínica da Rede São Camilo ( Site 1040)</name>
      <address>
        <city>São Paulo</city>
        <state>Sao Paulo</state>
        <zip>04014-002</zip>
        <country>Brazil</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>A.C. Camargo Cancer Center ( Site 1026)</name>
      <address>
        <city>Sao Paulo</city>
        <zip>01509-900</zip>
        <country>Brazil</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>MHAT Serdika-Second Department of Medical Oncology ( Site 0505)</name>
      <address>
        <city>Sofia</city>
        <state>Sofia (stolitsa)</state>
        <zip>1301</zip>
        <country>Bulgaria</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>MHAT Central Hospital ( Site 0503)</name>
      <address>
        <city>Plovdiv</city>
        <zip>4000</zip>
        <country>Bulgaria</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Complex Cancer Center Plovdiv-First Medical Oncology Department ( Site 0507)</name>
      <address>
        <city>Plovdiv</city>
        <zip>4004</zip>
        <country>Bulgaria</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>BC Cancer - Victoria ( Site 0111)</name>
      <address>
        <city>Victoria</city>
        <state>British Columbia</state>
        <zip>V8R 6V5</zip>
        <country>Canada</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Hamilton Health Sciences-Juravinski Cancer Centre ( Site 0116)</name>
      <address>
        <city>Hamilton</city>
        <state>Ontario</state>
        <zip>L8V5C2</zip>
        <country>Canada</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Grand River Hospital ( Site 0120)</name>
      <address>
        <city>Kitchener</city>
        <state>Ontario</state>
        <zip>N2G 1G3</zip>
        <country>Canada</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Lakeridge Health ( Site 0117)</name>
      <address>
        <city>Oshawa</city>
        <state>Ontario</state>
        <zip>L1G 2B9</zip>
        <country>Canada</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Health Sciences North ( Site 0122)</name>
      <address>
        <city>Sudbury</city>
        <state>Ontario</state>
        <zip>P3E 5J1</zip>
        <country>Canada</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Sunnybrook Research Institute ( Site 0108)</name>
      <address>
        <city>Toronto</city>
        <state>Ontario</state>
        <zip>M4N 3M5</zip>
        <country>Canada</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Princess Margaret Cancer Centre ( Site 0107)</name>
      <address>
        <city>Toronto</city>
        <state>Ontario</state>
        <zip>M5G 2M9</zip>
        <country>Canada</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>CISSS de la Monteregie-Centre ( Site 0119)</name>
      <address>
        <city>Greenfield Park</city>
        <state>Quebec</state>
        <zip>J4V 2H1</zip>
        <country>Canada</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Centre Hospitalier de l Universite de Montreal - CHUM ( Site 0106)</name>
      <address>
        <city>Montreal</city>
        <state>Quebec</state>
        <zip>H2X 0C1</zip>
        <country>Canada</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>CIUSSS du Bas Saint Laurent - Hopital Regional de Rimouski ( Site 0102)</name>
      <address>
        <city>Rimouski</city>
        <state>Quebec</state>
        <zip>G5L 5T1</zip>
        <country>Canada</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>CIUSSS de l Estrie - CHUS - Centre Hosp. Univ. Sherbrooke ( Site 0105)</name>
      <address>
        <city>Sherbrooke</city>
        <state>Quebec</state>
        <zip>J1H 5N4</zip>
        <country>Canada</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>CHUQ-Univ Laval-Hotel Dieu de Quebec ( Site 0103)</name>
      <address>
        <city>Quebec</city>
        <zip>G1R 2J6</zip>
        <country>Canada</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Centro Investigación del Cáncer James Lind ( Site 1041)</name>
      <address>
        <city>Temuco</city>
        <state>Araucania</state>
        <zip>4780000</zip>
        <country>Chile</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Rey y Oreilly Limitada ( Site 1048)</name>
      <address>
        <city>Temuco</city>
        <state>Araucania</state>
        <zip>4810148</zip>
        <country>Chile</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Fundacion Arturo Lopez Perez ( Site 1049)</name>
      <address>
        <city>Santiago</city>
        <state>Region M. De Santiago</state>
        <zip>7500921</zip>
        <country>Chile</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Pontificia Universidad Catolica de Chile ( Site 1047)</name>
      <address>
        <city>Santiago</city>
        <state>Region M. De Santiago</state>
        <zip>8330032</zip>
        <country>Chile</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Bradfordhill ( Site 1044)</name>
      <address>
        <city>Santiago</city>
        <state>Region M. De Santiago</state>
        <zip>8420383</zip>
        <country>Chile</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Oncocentro ( Site 1045)</name>
      <address>
        <city>Vina del Mar</city>
        <state>Valparaiso</state>
        <zip>2520598</zip>
        <country>Chile</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Hospital Pablo Tobon Uribe ( Site 1066)</name>
      <address>
        <city>Medellin</city>
        <state>Antioquia</state>
        <zip>050034</zip>
        <country>Colombia</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Biomelab S A S ( Site 1067)</name>
      <address>
        <city>Barranquilla</city>
        <state>Atlantico</state>
        <zip>080002</zip>
        <country>Colombia</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Clinica de la Costa Ltda. ( Site 1073)</name>
      <address>
        <city>Barranquilla</city>
        <state>Atlantico</state>
        <zip>080020</zip>
        <country>Colombia</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Sociedad de Oncología Y Hematología del Cesar S.A.S. ( Site 1068)</name>
      <address>
        <city>Valledupar</city>
        <state>Cesar</state>
        <zip>200001</zip>
        <country>Colombia</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Oncomedica S.A. ( Site 1057)</name>
      <address>
        <city>Monteria</city>
        <state>Cordoba</state>
        <zip>230001</zip>
        <country>Colombia</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Clinica Colsanitas S.A. Sede Clinica Universitaria Colombia ( Site 1062)</name>
      <address>
        <city>Bogota</city>
        <state>Distrito Capital De Bogota</state>
        <zip>111321</zip>
        <country>Colombia</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Centro Medico Imbanaco de Cali S.A ( Site 1064)</name>
      <address>
        <city>Cali</city>
        <state>Valle Del Cauca</state>
        <zip>760042</zip>
        <country>Colombia</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Hemato Oncologos S.A. ( Site 1065)</name>
      <address>
        <city>Cali</city>
        <state>Valle Del Cauca</state>
        <zip>760042</zip>
        <country>Colombia</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Fakultni Nemocnice u sv. Anny v Brne-Onkologicko-chirurgicke oddeleni ( Site 1303)</name>
      <address>
        <city>Brno</city>
        <state>Brno-mesto</state>
        <zip>656 91</zip>
        <country>Czechia</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Nemocnice AGEL Novy Jicin a.s. ( Site 1304)</name>
      <address>
        <city>Nový Jičín</city>
        <state>Novy Jicin</state>
        <zip>741 01</zip>
        <country>Czechia</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Fakultni nemocnice Olomouc ( Site 1301)</name>
      <address>
        <city>Olomouc</city>
        <zip>779 00</zip>
        <country>Czechia</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>C.H. de Saint Quentin ( Site 0481)</name>
      <address>
        <city>Saint Quentin</city>
        <state>Aisne</state>
        <zip>02321</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Clinique Sainte Anne ( Site 0431)</name>
      <address>
        <city>Strasbourg</city>
        <state>Alsace</state>
        <zip>67000</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Centre Jean Perrin ( Site 0434)</name>
      <address>
        <city>Clermont-Ferrand</city>
        <state>Auvergne</state>
        <zip>63011</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>CHU de Brest -Site Hopital Morvan ( Site 0441)</name>
      <address>
        <city>Brest</city>
        <state>Bretagne</state>
        <zip>29200</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>CHU Jean Minjoz ( Site 0423)</name>
      <address>
        <city>Besancon</city>
        <state>Doubs</state>
        <zip>25000</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Institut Bergonie ( Site 0421)</name>
      <address>
        <city>Bordeaux</city>
        <state>Gironde</state>
        <zip>33076</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Institut Claudius Regaud IUCT Oncopole ( Site 0418)</name>
      <address>
        <city>Toulouse</city>
        <state>Haute-Garonne</state>
        <zip>31059</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Hopital Foch ( Site 0428)</name>
      <address>
        <city>Suresnes</city>
        <state>Hauts-de-Seine</state>
        <zip>92150</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Institut Regional du Cancer de Montpellier - ICM ( Site 0443)</name>
      <address>
        <city>Montpellier</city>
        <state>Herault</state>
        <zip>34298</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Institut De Cancerologie De L Ouest ( Site 0448)</name>
      <address>
        <city>Saint Herblain</city>
        <state>Loire-Atlantique</state>
        <zip>44805</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Centre Hospitalier Regional du Orleans ( Site 0430)</name>
      <address>
        <city>Orleans</city>
        <state>Loiret</state>
        <zip>45100</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Centre D Oncologie de Gentilly ( Site 0432)</name>
      <address>
        <city>Nancy</city>
        <state>Meurthe-et-Moselle</state>
        <zip>54100</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Centre Hospitalier de Valenciennes ( Site 0439)</name>
      <address>
        <city>Valenciennes</city>
        <state>Nord</state>
        <zip>59300</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>C.H.U. Lyon Sud ( Site 0436)</name>
      <address>
        <city>Pierre Benite</city>
        <state>Rhone</state>
        <zip>69310</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>CHU Amiens Picardie Site Sud Amiens ( Site 0438)</name>
      <address>
        <city>Amiens</city>
        <state>Somme</state>
        <zip>80000</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Institut Gustave Roussy ( Site 0416)</name>
      <address>
        <city>Villejuif</city>
        <state>Val-de-Marne</state>
        <zip>94800</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Institut Sainte Catherine ( Site 0447)</name>
      <address>
        <city>Avignon</city>
        <state>Vaucluse</state>
        <zip>84000</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Institut Mutualiste Montsouris ( Site 0446)</name>
      <address>
        <city>Paris</city>
        <zip>75014</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Universitaetsklinikum Freiburg - Medizinische Klinik ( Site 0304)</name>
      <address>
        <city>Freiburg</city>
        <state>Baden-Wurttemberg</state>
        <zip>79106</zip>
        <country>Germany</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Studienpraxis Urologie ( Site 0309)</name>
      <address>
        <city>Nuertingen</city>
        <state>Baden-Wurttemberg</state>
        <zip>72622</zip>
        <country>Germany</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Universitaetsklinik fuer Urologie ( Site 0307)</name>
      <address>
        <city>Tuebingen</city>
        <state>Baden-Wurttemberg</state>
        <zip>72076</zip>
        <country>Germany</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Klinikum Rechts der Isar ( Site 0300)</name>
      <address>
        <city>Muenchen</city>
        <state>Bayern</state>
        <zip>81675</zip>
        <country>Germany</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Universitaetsklinik der Paracelsus Medizinischen Privatuniversitaet ( Site 0318)</name>
      <address>
        <city>Nuernberg</city>
        <state>Bayern</state>
        <zip>90419</zip>
        <country>Germany</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Universitaetsklinikum Goettingen ( Site 0345)</name>
      <address>
        <city>Goettingen</city>
        <state>Niedersachsen</state>
        <zip>37075</zip>
        <country>Germany</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Uniklinik RWTH Aachen ( Site 0308)</name>
      <address>
        <city>Aachen</city>
        <state>Nordrhein-Westfalen</state>
        <zip>52074</zip>
        <country>Germany</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Universitaetsklinikum Muenster ( Site 0320)</name>
      <address>
        <city>Muenster</city>
        <state>Nordrhein-Westfalen</state>
        <zip>48149</zip>
        <country>Germany</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Krankenhaus der Barmherzigen Brueder Trier ( Site 0310)</name>
      <address>
        <city>Trier</city>
        <state>Rheinland-Pfalz</state>
        <zip>54292</zip>
        <country>Germany</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Universitaetsklinikum des Saarlandes ( Site 0348)</name>
      <address>
        <city>Homburg</city>
        <state>Saarland</state>
        <zip>66421</zip>
        <country>Germany</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Universitaetsklinikum Schleswig Holstein. ( Site 0346)</name>
      <address>
        <city>Luebeck</city>
        <state>Schleswig-Holstein</state>
        <zip>23538</zip>
        <country>Germany</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Universitaetsklinikum Jena ( Site 0305)</name>
      <address>
        <city>Jena</city>
        <state>Thuringen</state>
        <zip>07747</zip>
        <country>Germany</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Charite Universitaetsmedizin Berlin ( Site 0301)</name>
      <address>
        <city>Berlin</city>
        <zip>10117</zip>
        <country>Germany</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Bacs-Kiskun Megyei Korhaz-Onkoradiologiai Kozpont ( Site 1321)</name>
      <address>
        <city>Kecskemét</city>
        <state>Bacs-Kiskun</state>
        <zip>6000</zip>
        <country>Hungary</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Petz Aladár Megyei Oktató Kórház-Onkológiai Osztály ( Site 1324)</name>
      <address>
        <city>Gyor</city>
        <state>Gyor-Moson-Sopron</state>
        <zip>9024</zip>
        <country>Hungary</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Országos Onkológiai Intézet-Urogenital Tumors Department and Clinical Pharmacology ( Site 1325)</name>
      <address>
        <city>Budapest</city>
        <state>Pest</state>
        <zip>1122</zip>
        <country>Hungary</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Magyar Honvedseg Egeszsegugyi Kozpont-Onkologiai Osztaly ( Site 1326)</name>
      <address>
        <city>Budapest</city>
        <zip>1062</zip>
        <country>Hungary</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Beaumont Hospital ( Site 0726)</name>
      <address>
        <city>Dublin</city>
        <zip>D09 V2N0</zip>
        <country>Ireland</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Tallaght University Hospital ( Site 0730)</name>
      <address>
        <city>Dublin</city>
        <zip>D24 NROA</zip>
        <country>Ireland</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Mid Western Cancer Centre ( Site 0728)</name>
      <address>
        <city>Limerick</city>
        <zip>V94 YVH0</zip>
        <country>Ireland</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>HaEmek Medical Center ( Site 0548)</name>
      <address>
        <city>Afula</city>
        <zip>1834111</zip>
        <country>Israel</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Assuta Ashdod Medical Center ( Site 0550)</name>
      <address>
        <city>Ashdod</city>
        <zip>7747629</zip>
        <country>Israel</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Soroka Medical Center ( Site 0549)</name>
      <address>
        <city>Beer Sheva</city>
        <zip>8410101</zip>
        <country>Israel</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Rambam Health Care Campus-Oncology Division ( Site 0543)</name>
      <address>
        <city>Haifa</city>
        <zip>3109601</zip>
        <country>Israel</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Hadassah Ein Kerem Medical Center ( Site 0546)</name>
      <address>
        <city>Jerusalem</city>
        <zip>9112001</zip>
        <country>Israel</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Meir Medical Center ( Site 0544)</name>
      <address>
        <city>Kfar Saba</city>
        <zip>4428164</zip>
        <country>Israel</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Rabin Medical Center ( Site 0545)</name>
      <address>
        <city>Petach-Tikwa</city>
        <zip>4941492</zip>
        <country>Israel</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Chaim Sheba Medical Center ( Site 0541)</name>
      <address>
        <city>Ramat Gan</city>
        <zip>5262000</zip>
        <country>Israel</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Sourasky Medical Center ( Site 0542)</name>
      <address>
        <city>Tel Aviv</city>
        <zip>6423906</zip>
        <country>Israel</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Yitzhak Shamir Medical Center ( Site 0547)</name>
      <address>
        <city>Zerifin</city>
        <zip>7030001</zip>
        <country>Israel</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori-Oncologia Medica ( Site 0464)</name>
      <address>
        <city>Meldola</city>
        <state>Emilia-Romagna</state>
        <zip>47014</zip>
        <country>Italy</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Istituto Clinico Humanitas Research Hospital ( Site 0452)</name>
      <address>
        <city>Rozzano</city>
        <state>Lombardia</state>
        <zip>20089</zip>
        <country>Italy</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Presidio Ospedaliero S. Maria Delle Grazie-U.O.C. ONCOLOGIA ( Site 0802)</name>
      <address>
        <city>Pozzuoli</city>
        <state>Napoli</state>
        <zip>80078</zip>
        <country>Italy</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Centro Di Riferimento Oncologico ( Site 0800)</name>
      <address>
        <city>Aviano</city>
        <state>Pordenone</state>
        <zip>33081</zip>
        <country>Italy</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Azienda Ospedaliera Universitaria Integrata Verona - Ospedale Borgo Roma-Oncology Unit ( Site 0465)</name>
      <address>
        <city>Verona</city>
        <state>Veneto</state>
        <zip>37134</zip>
        <country>Italy</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Medical Oncology Ospedale San Donato ( Site 0461)</name>
      <address>
        <city>Arezzo</city>
        <zip>52100</zip>
        <country>Italy</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Ospedale Policlinico S. Orsola-Malpighi ( Site 0453)</name>
      <address>
        <city>Bologna</city>
        <zip>40138</zip>
        <country>Italy</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Azienda Ospedaliera Cannizzaro ( Site 0458)</name>
      <address>
        <city>Catania</city>
        <zip>95126</zip>
        <country>Italy</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>A.O. Universitaria di Modena ( Site 0454)</name>
      <address>
        <city>Modena</city>
        <zip>41124</zip>
        <country>Italy</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Istituto Nazionale Tumori IRCCS Fondazione Pascale ( Site 0462)</name>
      <address>
        <city>Napoli</city>
        <zip>80131</zip>
        <country>Italy</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Azienda Ospedaliera San Camillo Forlanini ( Site 0455)</name>
      <address>
        <city>Roma</city>
        <zip>00152</zip>
        <country>Italy</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Fondazione Policlinico Universitario Agostino Gemelli ( Site 0801)</name>
      <address>
        <city>Roma</city>
        <zip>00168</zip>
        <country>Italy</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Azienda Ospedaliera Santa Maria Terni ( Site 0456)</name>
      <address>
        <city>Terni</city>
        <zip>05100</zip>
        <country>Italy</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Az. Osp. Univ. Sta Maria della Misericordia di Udine ( Site 0460)</name>
      <address>
        <city>Udine</city>
        <zip>33100</zip>
        <country>Italy</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>National Cancer Center Hospital East ( Site 0702)</name>
      <address>
        <city>Kashiwa</city>
        <state>Chiba</state>
        <zip>277-8577</zip>
        <country>Japan</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Toho University Sakura Medical Center ( Site 0703)</name>
      <address>
        <city>Sakura</city>
        <state>Chiba</state>
        <zip>285-8741</zip>
        <country>Japan</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>National Hospital Organization Shikoku Cancer Center ( Site 0716)</name>
      <address>
        <city>Matsuyama</city>
        <state>Ehime</state>
        <zip>791-0280</zip>
        <country>Japan</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Iizuka Hospital ( Site 0744)</name>
      <address>
        <city>Iizuka</city>
        <state>Fukuoka</state>
        <zip>820-8505</zip>
        <country>Japan</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Hakodate Goryoukaku Hospital ( Site 0739)</name>
      <address>
        <city>Hakodate</city>
        <state>Hokkaido</state>
        <zip>040-8611</zip>
        <country>Japan</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Kanazawa University Hospital ( Site 0701)</name>
      <address>
        <city>Kanazawa</city>
        <state>Ishikawa</state>
        <zip>920-8641</zip>
        <country>Japan</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Kitasato University Hospital ( Site 0705)</name>
      <address>
        <city>Sagamihara</city>
        <state>Kanagawa</state>
        <zip>252-0375</zip>
        <country>Japan</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Yokohama City University Medical Center ( Site 0706)</name>
      <address>
        <city>Yokohama</city>
        <state>Kanagawa</state>
        <zip>232-0024</zip>
        <country>Japan</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Miyagi Cancer Center ( Site 0747)</name>
      <address>
        <city>Natori</city>
        <state>Miyagi</state>
        <zip>981-1293</zip>
        <country>Japan</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Nara Medical University Hospital ( Site 0715)</name>
      <address>
        <city>Kashihara</city>
        <state>Nara</state>
        <zip>634-8522</zip>
        <country>Japan</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Kindai University Hospital ( Site 0714)</name>
      <address>
        <city>Osakasayama</city>
        <state>Osaka</state>
        <zip>589-8511</zip>
        <country>Japan</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Osaka University Hospital ( Site 0713)</name>
      <address>
        <city>Suita</city>
        <state>Osaka</state>
        <zip>565-0871</zip>
        <country>Japan</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Saitama Medical University International Medical Center ( Site 0708)</name>
      <address>
        <city>Hidaka</city>
        <state>Saitama</state>
        <zip>350-1298</zip>
        <country>Japan</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Saitama Medical Center ( Site 0743)</name>
      <address>
        <city>Kawagoe</city>
        <state>Saitama</state>
        <zip>350-8550</zip>
        <country>Japan</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Dokkyo Medical University Saitama Medical Center ( Site 0707)</name>
      <address>
        <city>Koshigaya</city>
        <state>Saitama</state>
        <zip>343-8555</zip>
        <country>Japan</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Hamamatsu University Hospital ( Site 0720)</name>
      <address>
        <city>Hamamatsu</city>
        <state>Shizuoka</state>
        <zip>431-3192</zip>
        <country>Japan</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Yamaguchi University Hospital ( Site 0717)</name>
      <address>
        <city>Ube</city>
        <state>Yamaguchi</state>
        <zip>755-8505</zip>
        <country>Japan</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Chiba Cancer Center ( Site 0704)</name>
      <address>
        <city>Chiba</city>
        <zip>260-8717</zip>
        <country>Japan</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Kyushu University Hospital ( Site 0718)</name>
      <address>
        <city>Fukuoka</city>
        <zip>812-8582</zip>
        <country>Japan</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Hiroshima Prefectural Hospital ( Site 0748)</name>
      <address>
        <city>Hiroshima</city>
        <zip>734-8530</zip>
        <country>Japan</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>University of Miyazaki Hospital ( Site 0721)</name>
      <address>
        <city>Miyazaki</city>
        <zip>889-1692</zip>
        <country>Japan</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Nagasaki University Hospital ( Site 0719)</name>
      <address>
        <city>Nagasaki</city>
        <zip>852-8501</zip>
        <country>Japan</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Toranomon Hospital ( Site 0711)</name>
      <address>
        <city>Tokyo</city>
        <zip>105-8470</zip>
        <country>Japan</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Nippon Medical School Hospital ( Site 0709)</name>
      <address>
        <city>Tokyo</city>
        <zip>113-8603</zip>
        <country>Japan</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Keio University Hospital ( Site 0710)</name>
      <address>
        <city>Tokyo</city>
        <zip>160-8582</zip>
        <country>Japan</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>National Cancer Center ( Site 0174)</name>
      <address>
        <city>Goyang-si</city>
        <state>Kyonggi-do</state>
        <zip>10408</zip>
        <country>Korea, Republic of</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Seoul National University Bundang Hospital ( Site 0175)</name>
      <address>
        <city>Seongnam-si</city>
        <state>Kyonggi-do</state>
        <zip>13620</zip>
        <country>Korea, Republic of</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Asan Medical Center ( Site 0176)</name>
      <address>
        <city>Songpagu</city>
        <state>Seoul</state>
        <zip>05505</zip>
        <country>Korea, Republic of</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Seoul National University Hospital ( Site 0171)</name>
      <address>
        <city>Seoul</city>
        <zip>03080</zip>
        <country>Korea, Republic of</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Samsung Medical Center ( Site 0172)</name>
      <address>
        <city>Seoul</city>
        <zip>06351</zip>
        <country>Korea, Republic of</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Radboud University Medical Center ( Site 0470)</name>
      <address>
        <city>Nijmegen</city>
        <state>Gelderland</state>
        <zip>6525 GA</zip>
        <country>Netherlands</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Maastricht University Medical Centre ( Site 0467)</name>
      <address>
        <city>Maastricht</city>
        <state>Limburg</state>
        <zip>6202AZ</zip>
        <country>Netherlands</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Amphia Hospital Location Molengracht ( Site 0474)</name>
      <address>
        <city>Breda</city>
        <state>Noord-Brabant</state>
        <zip>4818 CK</zip>
        <country>Netherlands</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Catharina Ziekenhuis ( Site 0472)</name>
      <address>
        <city>Eindhoven</city>
        <state>Noord-Brabant</state>
        <zip>5623 EJ</zip>
        <country>Netherlands</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Noordwest Ziekenhuisgroep NWZ ( Site 0468)</name>
      <address>
        <city>Alkmaar</city>
        <state>Noord-Holland</state>
        <zip>1815 JD</zip>
        <country>Netherlands</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Vrije Universiteit Medisch Centrum ( Site 0479)</name>
      <address>
        <city>Amsterdam</city>
        <state>Noord-Holland</state>
        <zip>1081 HV</zip>
        <country>Netherlands</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Tergooiziekenhuizen ( Site 0466)</name>
      <address>
        <city>Hilversum</city>
        <state>Noord-Holland</state>
        <zip>1213 XZ</zip>
        <country>Netherlands</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Spaarne Ziekenhuis ( Site 0473)</name>
      <address>
        <city>Hoofddorp</city>
        <state>Noord-Holland</state>
        <zip>2134TM</zip>
        <country>Netherlands</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Ziekenhuisgroep Twente ( Site 0469)</name>
      <address>
        <city>Hengelo</city>
        <state>Overijssel</state>
        <zip>7555 DL</zip>
        <country>Netherlands</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Haaglanden MC - locatie Antoniushove ( Site 0471)</name>
      <address>
        <city>Leidschendam</city>
        <state>Zuid-Holland</state>
        <zip>2262 BA</zip>
        <country>Netherlands</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Franciscus Gasthuis en Vlietland ( Site 0489)</name>
      <address>
        <city>Schiedam</city>
        <state>Zuid-Holland</state>
        <zip>3118 JH</zip>
        <country>Netherlands</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Tauranga Hospital ( Site 0215)</name>
      <address>
        <city>Tauranga</city>
        <state>Bay Of Plenty</state>
        <zip>3112</zip>
        <country>New Zealand</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Canterbury Regional Cancer &amp; Blood Service ( Site 0195)</name>
      <address>
        <city>Christchurch</city>
        <state>Canterbury</state>
        <zip>8011</zip>
        <country>New Zealand</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Auckland City Hospital ( Site 0193)</name>
      <address>
        <city>Auckland</city>
        <zip>1023</zip>
        <country>New Zealand</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Centrum Onkologii im. Prof. Franciszka Lukaszczyka ( Site 0636)</name>
      <address>
        <city>Bydgoszcz</city>
        <state>Kujawsko-pomorskie</state>
        <zip>85-796</zip>
        <country>Poland</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Salve Medica SP ( Site 0686)</name>
      <address>
        <city>Lodz</city>
        <state>Lodzkie</state>
        <zip>91-211</zip>
        <country>Poland</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Provita Prolife Centrum Medyczne ( Site 0630)</name>
      <address>
        <city>Tomaszow Mazowiecki</city>
        <state>Lodzkie</state>
        <zip>97-200</zip>
        <country>Poland</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Clinical Best Solutions ( Site 0622)</name>
      <address>
        <city>Warszawa</city>
        <state>Mazowieckie</state>
        <zip>02-793</zip>
        <country>Poland</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Przychodnia Lekarska Komed ( Site 0628)</name>
      <address>
        <city>Konin</city>
        <state>Wielkopolskie</state>
        <zip>62-500</zip>
        <country>Poland</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Szpital Wojewodzki im. Mikolaja Kopernika ( Site 0624)</name>
      <address>
        <city>Koszalin</city>
        <state>Zachodniopomorskie</state>
        <zip>75-581</zip>
        <country>Poland</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Puerto Rico Medical Research Center LLC ( Site 1122)</name>
      <address>
        <city>San Juan</city>
        <zip>00918</zip>
        <country>Puerto Rico</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Fundacion de Investigacion de Diego ( Site 1121)</name>
      <address>
        <city>San Juan</city>
        <zip>00927</zip>
        <country>Puerto Rico</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Chelyabinsk Regional Clinical Oncological Dispensary ( Site 0565)</name>
      <address>
        <city>Chelyabinsk</city>
        <state>Chelyabinskaya Oblast</state>
        <zip>454087</zip>
        <country>Russian Federation</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Krasnoyarsk Regional Clinical Oncological Dispensary ( Site 0585)</name>
      <address>
        <city>Krasnoyarsk</city>
        <state>Krasnoyarskiy Kray</state>
        <zip>660133</zip>
        <country>Russian Federation</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Russian Scientific Center of Roentgenoradiology ( Site 0559)</name>
      <address>
        <city>Moscow</city>
        <state>Moskva</state>
        <zip>117485</zip>
        <country>Russian Federation</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Central Clinical Hospital with Polyclinic ( Site 0562)</name>
      <address>
        <city>Moscow</city>
        <state>Moskva</state>
        <zip>121359</zip>
        <country>Russian Federation</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Omsk Clinical Oncology Dispensary ( Site 0568)</name>
      <address>
        <city>Omsk</city>
        <state>Omskaya Oblast</state>
        <zip>644013</zip>
        <country>Russian Federation</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>SBHI Samara Regional Clinical Oncology Dispensary ( Site 0576)</name>
      <address>
        <city>Samara</city>
        <state>Samarskaya Oblast</state>
        <zip>443031</zip>
        <country>Russian Federation</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>SBHI Leningrad Regional Oncology Dispensary ( Site 0588)</name>
      <address>
        <city>Saint Petersburg</city>
        <state>Sankt-Peterburg</state>
        <zip>191104</zip>
        <country>Russian Federation</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Clinical Research Center of specialized types medical care-Oncology ( Site 0570)</name>
      <address>
        <city>Saint Petersburg</city>
        <state>Sankt-Peterburg</state>
        <zip>197758</zip>
        <country>Russian Federation</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Russian Scientific Center of Radiology and Surgical Technologies ( Site 0567)</name>
      <address>
        <city>Saint Petersburg</city>
        <state>Sankt-Peterburg</state>
        <zip>197758</zip>
        <country>Russian Federation</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Tomsk National Scientific Medical Center of Russian Academy of Science ( Site 0579)</name>
      <address>
        <city>Tomsk</city>
        <state>Tomskaya Oblast</state>
        <zip>634050</zip>
        <country>Russian Federation</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Instituto Catalan de Oncologia - ICO ( Site 0330)</name>
      <address>
        <city>L Hospitalet De Llobregat</city>
        <state>Barcelona</state>
        <zip>08908</zip>
        <country>Spain</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Hospital Parc Tauli ( Site 0335)</name>
      <address>
        <city>Sabadell</city>
        <state>Barcelona</state>
        <zip>08208</zip>
        <country>Spain</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Hospital Josep Trueta ( Site 0321)</name>
      <address>
        <city>Girona</city>
        <state>Gerona</state>
        <zip>17007</zip>
        <country>Spain</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Hospital Quiron Madrid ( Site 0325)</name>
      <address>
        <city>Pozuelo de Alarcon</city>
        <state>Madrid</state>
        <zip>28223</zip>
        <country>Spain</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Instituto Valenciano de Oncologia ( Site 0331)</name>
      <address>
        <city>Valencia</city>
        <state>Valenciana, Comunitat</state>
        <zip>46009</zip>
        <country>Spain</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Hospital del Mar ( Site 0333)</name>
      <address>
        <city>Barcelona</city>
        <zip>08003</zip>
        <country>Spain</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Hospital Provincial San Pedro Alcantara ( Site 0326)</name>
      <address>
        <city>Caceres</city>
        <zip>10003</zip>
        <country>Spain</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Hospital Universitario Gregorio Maranon ( Site 0327)</name>
      <address>
        <city>Madrid</city>
        <zip>28007</zip>
        <country>Spain</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>MD Anderson Cancer Center Madrid ( Site 0332)</name>
      <address>
        <city>Madrid</city>
        <zip>28033</zip>
        <country>Spain</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Hospital Clinico San Carlos ( Site 0324)</name>
      <address>
        <city>Madrid</city>
        <zip>28040</zip>
        <country>Spain</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Hospital Universitario HM Sanchinarro ( Site 0322)</name>
      <address>
        <city>Madrid</city>
        <zip>28050</zip>
        <country>Spain</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Hospital Universitario Virgen de la Victoria ( Site 0337)</name>
      <address>
        <city>Malaga</city>
        <zip>29016</zip>
        <country>Spain</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Hospital Virgen del Rocio ( Site 0329)</name>
      <address>
        <city>Sevilla</city>
        <zip>41013</zip>
        <country>Spain</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>National Cheng Kung University Hospital ( Site 0134)</name>
      <address>
        <city>Tainen</city>
        <state>Tainan</state>
        <zip>704</zip>
        <country>Taiwan</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>China Medical University Hospital ( Site 0132)</name>
      <address>
        <city>Taichung</city>
        <zip>40447</zip>
        <country>Taiwan</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Taichung Veterans General Hospital ( Site 0133)</name>
      <address>
        <city>Taichung</city>
        <zip>407</zip>
        <country>Taiwan</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>National Taiwan University Hospital ( Site 0131)</name>
      <address>
        <city>Taipei</city>
        <zip>10048</zip>
        <country>Taiwan</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Taipei Veterans General Hospital ( Site 0135)</name>
      <address>
        <city>Taipei</city>
        <zip>112</zip>
        <country>Taiwan</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Ege University Medicine of Faculty ( Site 0661)</name>
      <address>
        <city>Bornova</city>
        <state>Izmir</state>
        <zip>35100</zip>
        <country>Turkey</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Baskent University Dr. Turgut Noyan Research and Training Center-ONCCOLOGY ( Site 0618)</name>
      <address>
        <city>Adana</city>
        <zip>01250</zip>
        <country>Turkey</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Ankara University Hospital Cebeci ( Site 0613)</name>
      <address>
        <city>Ankara</city>
        <zip>06100</zip>
        <country>Turkey</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Hacettepe Universitesi-oncology hospital ( Site 0615)</name>
      <address>
        <city>Ankara</city>
        <zip>06230</zip>
        <country>Turkey</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Ankara City Hospital-Medical Oncology ( Site 0616)</name>
      <address>
        <city>Ankara</city>
        <zip>06800</zip>
        <country>Turkey</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>T.C. Saglik Bakanligi Turkiye Kamu Hastaneleri Kurumu - Baki-Istanbul Bakirkoy Sadi Konuk Training (</name>
      <address>
        <city>Istanbul</city>
        <zip>34440</zip>
        <country>Turkey</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Acıbadem Maslak Hastanesi ( Site 0660)</name>
      <address>
        <city>İstanbul</city>
        <zip>34457</zip>
        <country>Turkey</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>TC Saglik Bakanligi Goztepe Prof. Dr. Suleyman Yalcin Sehir Hastanesi-oncology ( Site 0619)</name>
      <address>
        <city>Istanbul</city>
        <zip>34722</zip>
        <country>Turkey</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Cherkasy Regional Oncology Dispensary ( Site 1203)</name>
      <address>
        <city>Cherkassy</city>
        <state>Cherkaska Oblast</state>
        <zip>18009</zip>
        <country>Ukraine</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Dnepropetrovsk Regional Clinical Oncology Hospital-Clinical oncological dispensary ( Site 1201)</name>
      <address>
        <city>Dnipropetrovsk</city>
        <state>Dnipropetrovska Oblast</state>
        <zip>49055</zip>
        <country>Ukraine</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Dnepropetrovsk Regional Clinical Hospital Mechnikov-Department of urology ( Site 1205)</name>
      <address>
        <city>Dnipro</city>
        <state>Dnipropetrovska Oblast</state>
        <zip>49005</zip>
        <country>Ukraine</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Ivano-Frankivsk Regional Hospital-Urology department ( Site 1208)</name>
      <address>
        <city>Ivano-Frankivsk</city>
        <state>Ivano-Frankivska Oblast</state>
        <zip>76008</zip>
        <country>Ukraine</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Communal Non-Commercial Enterprise &quot;&quot;Prykarpatski Clinical Oncological Center&quot;&quot; of Ivano-Frankivsk R</name>
      <address>
        <city>Ivano-Frankivsk</city>
        <state>Ivano-Frankivska Oblast</state>
        <zip>76018</zip>
        <country>Ukraine</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>CNPE Regional Center of Oncology-oncourology department ( Site 1202)</name>
      <address>
        <city>Kharkiv</city>
        <state>Kharkivska Oblast</state>
        <zip>61070</zip>
        <country>Ukraine</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>LISOD - Israeli Oncological Hospital &quot;&quot;MedX-ray Internationa-Department of Clinical and Scientific (</name>
      <address>
        <city>Kiev</city>
        <state>Kyivska Oblast</state>
        <zip>08720</zip>
        <country>Ukraine</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Municipal non-profit enterprise Kyiv City Clinical Oncology -Oncourology department ( Site 1204)</name>
      <address>
        <city>Kyiv</city>
        <state>Kyivska Oblast</state>
        <zip>03115</zip>
        <country>Ukraine</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>University Hospitals Bristol NHS Foundation Trust ( Site 0530)</name>
      <address>
        <city>Bristol</city>
        <state>Bristol, City Of</state>
        <zip>BS2 8ED</zip>
        <country>United Kingdom</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Cambridge University Hospitals NHS Trust ( Site 0540)</name>
      <address>
        <city>Cambridge</city>
        <state>Cambridgeshire</state>
        <zip>CB2 0QQ</zip>
        <country>United Kingdom</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Torbay Hospital ( Site 0532)</name>
      <address>
        <city>Torquay</city>
        <state>Devon</state>
        <zip>TQ2 7AA</zip>
        <country>United Kingdom</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>University College London Hospitals NHS Foundation Trust ( Site 0482)</name>
      <address>
        <city>London</city>
        <state>London, City Of</state>
        <zip>NW1 2PG</zip>
        <country>United Kingdom</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Musgrove Park Hospital ( Site 0537)</name>
      <address>
        <city>Taunton</city>
        <state>Somerset</state>
        <zip>TA1 5DA</zip>
        <country>United Kingdom</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Royal Marsden Hospital (Sutton) ( Site 0526)</name>
      <address>
        <city>London</city>
        <state>Sutton</state>
        <zip>SM2 5PT</zip>
        <country>United Kingdom</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Western General Hospital ( Site 0531)</name>
      <address>
        <city>Edinburgh</city>
        <state>Worcestershire</state>
        <zip>EH42XU</zip>
        <country>United Kingdom</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Mount Vernon Cancer Centre ( Site 0536)</name>
      <address>
        <city>Northwood</city>
        <zip>HA6 2RN</zip>
        <country>United Kingdom</country>
      </address>
    </facility>
  </location>
  <location_countries>
    <country>Argentina</country>
    <country>Australia</country>
    <country>Austria</country>
    <country>Brazil</country>
    <country>Bulgaria</country>
    <country>Canada</country>
    <country>Chile</country>
    <country>Colombia</country>
    <country>Czechia</country>
    <country>France</country>
    <country>Germany</country>
    <country>Hungary</country>
    <country>Ireland</country>
    <country>Israel</country>
    <country>Italy</country>
    <country>Japan</country>
    <country>Korea, Republic of</country>
    <country>Netherlands</country>
    <country>New Zealand</country>
    <country>Poland</country>
    <country>Puerto Rico</country>
    <country>Russian Federation</country>
    <country>Spain</country>
    <country>Taiwan</country>
    <country>Turkey</country>
    <country>Ukraine</country>
    <country>United Kingdom</country>
    <country>United States</country>
  </location_countries>
  <link>
    <url>http://merckoncologyclinicaltrials.com</url>
    <description>Merck Oncology Clinical Trial Information</description>
  </link>
  <link>
    <url>https://trialstransparency.merckclinicaltrials.com/Study.aspx?id=3475-641&amp;&amp;kw=3475-641</url>
    <description>Plain Language Summary</description>
  </link>
  <verification_date>June 2023</verification_date>
  <study_first_submitted>February 6, 2019</study_first_submitted>
  <study_first_submitted_qc>February 6, 2019</study_first_submitted_qc>
  <study_first_posted type="Actual">February 8, 2019</study_first_posted>
  <last_update_submitted>June 13, 2023</last_update_submitted>
  <last_update_submitted_qc>June 13, 2023</last_update_submitted_qc>
  <last_update_posted type="Actual">June 15, 2023</last_update_posted>
  <responsible_party>
    <responsible_party_type>Sponsor</responsible_party_type>
  </responsible_party>
  <keyword>Programmed Cell Death-1 (PD1, PD-1)</keyword>
  <keyword>Programmed Death-Ligand 1 (PDL1, PD-L1)</keyword>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Prostatic Neoplasms</mesh_term>
  </condition_browse>
  <intervention_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Pembrolizumab</mesh_term>
  </intervention_browse>
  <patient_data>
    <sharing_ipd>Yes</sharing_ipd>
    <ipd_description>http://engagezone.msd.com/doc/ProcedureAccessClinicalTrialData.pdf</ipd_description>
    <ipd_url>http://engagezone.msd.com/ds_documentation.php</ipd_url>
  </patient_data>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT03834493
org study id: 3475-641
secondary id: MK-3475-641
secondary id: KEYNOTE-641
secondary id: 195005
secondary id: 2022-500785-10-00
secondary id: 2018-004117-40
nct id: NCT03834493
lead sponsor: 
has dmc: Yes
is fda regulated drug: Yes
is fda regulated device: No
The purpose of this study is to assess the efficacy and safety of the combination of
      pembrolizumab (MK-3475) and enzalutamide in the treatment of men with metastatic
      castration-resistant prostate cancer (mCRPC) who have not received chemotherapy for mCRPC,
      are abiraterone-naïve, or are intolerant to or progressed on abiraterone acetate. There are
      two primary study hypotheses.

      Hypothesis 1: The combination of pembrolizumab plus enzalutamide is superior to placebo plus
      enzalutamide with respect to Overall Survival (OS).

      Hypothesis 2: The combination of pembrolizumab plus enzalutamide is superior to placebo plus
      enzalutamide with respect to Radiographic Progression-free Survival (rPFS) per Prostate
      Cancer Working Group (PCWG)-modified Response Evaluation Criteria in Solid Tumors Version 1.1
      (RECIST 1.1) as assessed by blinded independent central review.
allocation: Randomized
intervention model: Parallel Assignment
primary purpose: Treatment
masking: Triple (Participant, Investigator, Outcomes Assessor)
masking description: Study became unblinded in February 2023.
measure: Overall Survival (OS)
time frame: Up to ~ 41 months
description: Time from randomization to death due to any cause
measure: Radiographic Progression-free Survival (rPFS) Per Prostate Cancer Working Group (PCWG)-modified Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) as Assessed by Blinded Independent Central Review
time frame: Up to ~ 41 months
description: Time from randomization to radiographic progression, or death due to any cause, whichever occurs first
measure: Time to Initiation of the First Subsequent Anti-cancer Therapy or Death (TFST)
time frame: Up to ~ 46 months
description: Time from randomization to initiation of the first subsequent anti-cancer therapy or death, whichever occurs first
measure: Prostate-specific Antigen (PSA) Response Rate
time frame: Up to ~ 46 months
description: Percentage of participants in the analysis population who have a negative change (decrease) in PSA level of ≥50% measured twice ≥3 weeks apart
measure: Prostate-specific Antigen (PSA) Undetectable Rate
time frame: Up to ~ 46 months
description: Percentage of participants in the analysis population with PSA <0.2 ng/mL during study treatment
measure: Objective Response Rate (ORR) Per Prostate Cancer Working Group (PCWG)-modified Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) as Assessed by Blinded Independent Central Review
time frame: Up to ~ 46 months
description: Percentage of participants in the analysis population who have a best overall response of either confirmed Complete Response (CR) or a confirmed Partial Response (PR) per PCWG-modified RECIST 1.1
measure: Duration of Response (DOR) Per Prostate Cancer Working Group (PCWG)-modified Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) as Assessed by Blinded Independent Central Review
time frame: Up to ~ 46 months
description: Time from first documented evidence of confirmed Complete Response (CR) or Partial Response (PR) per PCWG-modified RECIST 1.1 until disease progression or death from any cause, whichever occurs first
measure: Time to Prostate-specific Antigen (PSA) Progression
time frame: Up to ~ 46 months
description: Time from randomization to PSA progression. PSA progression date is defined as the date of 1) ≥25% increase and ≥2 ng/mL above the nadir, confirmed by a second value ≥3 weeks later if there is PSA decline from baseline, or 2) ≥25% increase and ≥2 ng/mL increase from baseline beyond 12 weeks if there is no PSA decline from baseline
measure: Time to Radiographic Soft Tissue Progression Per Soft Tissue Rules of Prostate Cancer Working Group (PCWG)-modified Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) as Assessed by Blinded Independent Central Review
time frame: Up to ~ 46 months
description: Time from randomization to radiographic soft tissue progression per PCWG-modified RECIST 1.1
measure: Time to Pain Progression (TTPP) as Assessed by Brief Pain Inventory-Short Form (BPI-SF) Item 3 ("Worst Pain in 24 Hours") and Opiate Analgesic Use (Analgesic Quantification Algorithm [AQA] Score)
time frame: Up to ~ 46 months
description: Time from randomization to pain progression. In this study, pain progression will be assessed by participant responses to Item 3 of the BPI-SF and participant AQA Scores which are both assessed by participants daily for 7 consecutive days
measure: Time to First Symptomatic Skeletal-related Event (SSRE)
time frame: Up to ~ 46 months
description: Time from randomization to the first SSRE. SSRE is defined as radiation to prevent or relieve skeletal symptoms, occurrence of new symptomatic pathological fracture, spinal cord compression, or surgery to bone
measure: Number of Participants Who Experience an Adverse Event (AE)
time frame: Up to ~ 53 months
description: An AE is defined as any untoward medical occurrence in a participant, temporally associated with the use of study treatment, whether or not considered related to the study treatment
measure: Number of Participants Who Discontinue Study Treatment Due to an Adverse Event (AE)
time frame: Up to ~ 53 months
description: The number of participants who discontinue study treatment due to an AE will be presented
arm group label: Pembrolizumab + Enzalutamide
arm group type: Experimental
description: Participants receive 200 mg pembrolizumab by intravenous (IV) infusion administered on Day 1 of each 21-day cycle (Q3W) for up to 35 cycles (approximately 2 years) PLUS enzalutamide 160 mg administered orally (PO) once a day (QD) continuously until progression.
arm group label: Placebo + Enzalutamide
arm group type: Placebo Comparator
description: Participants receive placebo by IV infusion administered on Day 1 Q3W for up to 35 cycles (approximately 2 years) PLUS enzalutamide 160 mg administered PO QD continuously until progression.
intervention type: Biological
intervention name: Pembrolizumab
description: IV infusion
arm group label: Pembrolizumab + Enzalutamide
other name: KEYTRUDA®
other name: MK-3475
intervention type: Drug
intervention name: Enzalutamide
description: Capsules/Tablets
arm group label: Pembrolizumab + Enzalutamide
arm group label: Placebo + Enzalutamide
other name: XTANDI®
intervention type: Drug
intervention name: Placebo
description: IV infusion
arm group label: Placebo + Enzalutamide
other name: Normal saline or dextrose infusion
criteria: 
gender: Male
minimum age: 18 Years
maximum age: N/A
healthy volunteers: No
last name: Medical Director
role: Study Director
affiliation: Merck Sharp & Dohme LLC
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country: Argentina
country: Australia
country: Austria
country: Brazil
country: Bulgaria
country: Canada
country: Chile
country: Colombia
country: Czechia
country: France
country: Germany
country: Hungary
country: Ireland
country: Israel
country: Italy
country: Japan
country: Korea, Republic of
country: Netherlands
country: New Zealand
country: Poland
country: Puerto Rico
country: Russian Federation
country: Spain
country: Taiwan
country: Turkey
country: Ukraine
country: United Kingdom
country: United States
url: http://merckoncologyclinicaltrials.com
description: Merck Oncology Clinical Trial Information
url: https://trialstransparency.merckclinicaltrials.com/Study.aspx?id=3475-641&&kw=3475-641
description: Plain Language Summary
responsible party type: Sponsor
mesh term: Prostatic Neoplasms
mesh term: Pembrolizumab
sharing ipd: Yes
ipd description: http://engagezone.msd.com/doc/ProcedureAccessClinicalTrialData.pdf
ipd url: http://engagezone.msd.com/ds_documentation.php