Clinical trial NCT03860883: Melanoma Margins Trial-II: 1cm v 2cm Wide Surgical Excision Margins for AJCC Stage II Primary Cutaneous Melanoma
Official title: Melanoma Margins Trial-II - A Phase III, Multi-centre Randomised Controlled Trial Investigating 1cm v 2cm Wide Surgical Excision Margins for AJCC Stage II Primary Cutaneous Melanoma (02.18 MelMarT-II)
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Cutaneous Melanoma, Stage II
Keywords: Malignant
Melanoma
Cancer
Surgery
Lead sponsor: Melanoma and Skin Cancer Trials Limited
Sponsor class: OTHER
Collaborators: name: Norfolk and Norwich University Hospitals NHS Foundation Trust
name: Canadian Cancer Trials Group
name: Cancer Trials Ireland
name: Zuyderland Medical Centre
First posted: 2019-03-04
Enrollment: 2998
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: Patients with a primary invasive melanoma are recommended to undergo excision of the primary lesion with a wide margin. There is evidence that less radical margins of excision may be just as safe. This is a randomised controlled trial of 1 cm versus 2 cm margin of excision of the primary lesion for adult patients with stage II primary invasive cutaneous melanomas (AJCC 8th edition) to determine differences in disease-free survival. A reduction in margins is expected to improve patient quality of life.

Detailed description: This study will determine whether there is a difference in disease-free survival rates for patients with primary cutaneous melanoma with Breslow thickness \> 2mm or 1-2mm with ulceration (pT2b-pT4b, AJCC 8th edition), treated with either a 1cm excision margin or 2cm margin. The study is designed to be able to prove or disprove that there is no difference in risk of the tumour recurring around the scar or anywhere else in the body between the two groups of patients. If the study shows no risk of tumour recurrence then we will also be able to determine how much of an impact the narrower excision has on patients in terms of improved quality of life and reduced side effects from the surgery and melanoma disease. This trial will also evaluate and determine the economic impact of narrower excision margins on the health services and society in general.

Eligibility criteria: Inclusion Criteria:

Patients may be included in the study if they meet ALL of the following criteria:

1. 1. Patients must have a Stage II primary invasive cutaneous melanoma (pT2b-pT4b, AJCC 8th edition) with Breslow thickness \>1.0mm to 2.0mm; \>2.0mm to 4.0mm or \>4.0mm with ulceration, or \>2.0mm to 4.0mm; or \>4.0mm without ulceration (Table 1) as determined by diagnostic biopsy (narrow excision, incision, shave or punch biopsy) and subsequent histopathological analysis.
2. Must have a primary melanoma that is cutaneous (including head, neck, trunk, extremity, scalp, palm or sole).
3. An uninterrupted 2cm margin must be technically feasible around biopsy scar or primary melanoma.
4. 4. Surgical intervention (which refers to the staging -SLNB and WLE as these are both to be done on the same day) must be completed within 120 days of the original diagnosis. Surgical intervention must also be performed within 28 days of randomisation.
5. Patients must be 18 years or older at time of consent.
6. Patient must be able to give informed consent and comply with the treatment protocol and follow up plan.
7. Life expectancy of at least 5 years from the time of diagnosis, not considering the melanoma in question, as determined by the PI.
8. Patients must have an ECOG performance score between 0 and 1 at screening.
9. A survivor of prior cancer is eligible provided that ALL of the following criteria are met and documented:

   * The patient has undergone potentially curative therapy for all prior malignancies,
   * There has been no evidence of recurrence of any prior malignancies for at least FIVE years (with the exception of successfully treated uterine/cervical or non-melanoma skin cancers (SCCs/BCCs) with no evidence of recurrence), and
   * The patient is deemed by their treating physician to be at low risk of recurrence from previous malignancies.

Exclusion Criteria:

Patients will be excluded from the study for ANY of the following reasons:

1. Uncertain diagnosis of melanoma i.e., so-called 'melanocytic lesion of unknown malignant potential'.
2. Patient has already undergone WLE at the site of the primary index lesion.
3. Patient unable or ineligible to undergo staging SLNB of the primary index lesion.
4. Perineural invasion or neurotropic melanoma: Neurotropism or perineural invasion in any type of melanoma is an exclusion. Perineural invasion does not include entrapment of nerves within the main primary tumour mass.
5. Desmoplastic melanoma: with any patient where pathology determines melanoma as PURE desmoplastic (as per WHO definition of \>90% desmoplasia), they are not eligible for this study. However melanomas with less than 90% desmoplasia or mixed desmoplastic subtypes are eligible unless there is neurotropism present (perineural invasion).
6. Microsatellitosis (a nest of metastatic tumour cells found to be growing away from the primary tumour) as per AJCC 8th edition definition is an exclusion.
7. Subungual melanoma
8. Patient has already undergone a local flap reconstruction of the defect after excision of the primary and determination of an accurate excision margin is impossible.
9. History of previous or concurrent (i.e. \>1 primary melanoma) invasive melanoma.
10. Melanoma located distal to the metacarpophalangeal joint; on the tip of the nose; the eyelids or on the ear; genitalia, perineum or anus; mucous membranes or internal viscera.
11. Physical, clinical, radiographic or pathologic evidence of satellite, in-transit, regional, or distant metastatic melanoma.
12. Patient has undergone surgery on a separate occasion to clear the lymph nodes of the probable draining lymphatic field, including -SLNB, of the index melanoma.
13. Any additional solid tumour or hematologic malignancy during the past 5 years (with exception of non- melanoma skin cancers (T1 skin lesions of squamous cell carcinoma (SCCs), basal cell carcinoma (BCCs)), or uterine/cervical cancer).
14. Melanoma-related operative procedures not corresponding to criteria described in the protocol.
15. Planned adjuvant radiotherapy to the primary melanoma site after wide local excision is not permitted as part of the protocol and any patients given this treatment would be excluded from the study.
16. History of organ transplantation.
17. Oral or parenteral immunosuppressive agents (not topical or inhaled steroids) at enrolment or within 6 months prior to enrolment.

Pregnancy is not a specific exclusion criterion for this trial, though it may not be clinically appropriate to perform a wide excision and SLNB until the pregnancy has been completed, which may exclude the patient due to violation of inclusion criterion 4. We would advise careful counselling of the patient prior to enrolling the patient, which would include a discussion at the treating centre's multidisciplinary team meeting or tumour board. We would strongly advise contacting the central trial office to discuss the case prior to enrolling on the study.

Primary outcomes:
measure: Disease-Free Survival
timeFrame: 0-60 months
Secondary outcomes:
measure: Local Recurrence
timeFrame: Day 0-Trial Completion (max. 120 months)
measure: Distant Disease-Free Survival
timeFrame: Day 0-Trial Completion (max. 120 months)
measure: Melanoma-Specific Survival
timeFrame: Day 0-Trial Completion (max. 120 months)
measure: Overall Survival
timeFrame: Day 0-Trial Completion (max. 120 months)
measure: Melanoma-specific Quality of Life: FACT-M questionnaire
timeFrame: Baseline, 3, 6, 12 & 24 months
measure: Neuropathic Pain: PainDetect questionnaire
timeFrame: Baseline, 3, 6, 12 & 24 months
measure: Health-related Quality of Life: EQ-5D-5L questionnaire
timeFrame: Baseline, 3, 6, 12 & 24 months
measure: Surgery Related Adverse Events
timeFrame: Up to 12-months from the date of surgery
measure: Health Economic Evaluation
timeFrame: Baseline, 3, 6, 12 & 24 months
measure: Serious Adverse Events
timeFrame: from randomisation up to 12-months post-surgery
Other outcomes:
Locations:
city: Mobile
country: United States
facility: University of South Alabama Mitchell Cancer Institute
state: Alabama
city: Gilbert
country: United States
facility: Banner MD Anderson Cancer Center
state: Arizona
city: Phoenix
country: United States
facility: Mayo Clinic Phoenix
state: Arizona
city: Little Rock
country: United States
facility: University of Arkansas for Medical Sciences
state: Arkansas
city: Irvine
country: United States
facility: UCI Health - Chao Family Comprehensive Cancer Center and Ambulatory Care
state: California
city: Los Angeles
country: United States
facility: Los Angeles General Medical Center
state: California
city: Los Angeles
country: United States
facility: Los Angeles General Medical Center
state: California
city: Los Angeles
country: United States
facility: USC Norris Comprehensive Cancer Center
state: California
city: Los Angeles
country: United States
facility: USC Norris Comprehensive Cancer Center
state: California
city: Los Angeles
country: United States
facility: The Angeles (Cedars-Sinai Medical Center and its Affiliates)
state: California
city: Orange
country: United States
facility: UC Irvine Health - Chao Family Comprehensive Cancer Center
state: California
city: Orange
country: United States
facility: UCI Health - Chao Family Comprehensive Cancer Center and Ambulatory Care
state: California
city: Palo Alto
country: United States
facility: Stanford Cancer Institute
state: California
city: Pasadena
country: United States
facility: Huntington Memorial Hospital
state: California
city: San Jose
country: United States
facility: Stanford Cancer Center South Bay
state: California
city: Vallejo
country: United States
facility: Kaiser Permanente - Vallejo Medical Center
state: California
city: Walnut Creek
country: United States
facility: Kaiser Permanente - Walnut Creek Medical Center
state: California
city: Guilford
country: United States
facility: Smilow Hospital Care Center, Guilford
state: Connecticut
city: New Haven
country: United States
facility: Yale University
state: Connecticut
city: Washington
country: United States
facility: MedStar Georgetown University Hospital
state: District of Columbia
city: Washington
country: United States
facility: MedStar Washington Hospital Center
state: District of Columbia
city: Aventura
country: United States
facility: University of Miami Sylvester Comprehensive Cancer Center at Aventura
state: Florida
city: Coral Gables
country: United States
facility: University of Miami Sylvester Comprehensive Cancer Center at Coral Gables
state: Florida
city: Coral Springs
country: United States
facility: University of Miami Sylvester Cancer Center at Coral Springs
state: Florida
city: Deerfield Beach
country: United States
facility: University of Miami Sylvester Comprehensive Center at Deerfield Beach
state: Florida
city: Hollywood
country: United States
facility: University of Miami Sylvester Comprehensive Center at Hollywood
state: Florida
city: Jacksonville
country: United States
facility: Baptist MD Anderson Cancer Center
state: Florida
city: Jacksonville
country: United States
facility: Mayo Clinic in Florida
state: Florida
city: Lakeland
country: United States
facility: Lakeland Regional Health Hollis Cancer Center
state: Florida
city: Miami
country: United States
facility: University of Miami Miller School of Medicine-Sylvester Cancer Centre
state: Florida
city: Miami
country: United States
facility: University of Miami Comprehensive Cancer Center at Kendall
state: Florida
city: Plantation
country: United States
facility: University of Miami Comprehensive Cancer Center at Plantation
state: Florida
city: Tampa
country: United States
facility: Moffitt Cancer Center - McKinley Campus
state: Florida
city: Tampa
country: United States
facility: Moffitt Cancer Center, Magnolia Campus
state: Florida
city: Atlanta
country: United States
facility: Emory University Hospital Midtown
state: Georgia
city: Atlanta
country: United States
facility: Emory University
state: Georgia
city: Atlanta
country: United States
facility: Emory Saint Joseph's Hospital
state: Georgia
city: Atlanta
country: United States
facility: Northside Hospital Atlanta
state: Georgia
city: Atlanta
country: United States
facility: Northside Hospital Cancer Institute
state: Georgia
city: Savannah
country: United States
facility: Nancy N and JC Lewis Cancer & Research Pavilion St. Joseph's/Candler
state: Georgia
city: Chicago
country: United States
facility: Advocate Illinois Masonic Medical Center
state: Illinois
city: DeKalb
country: United States
facility: Northwestern Medicine Cancer Center Kishwaukee
state: Illinois
city: Evanston
country: United States
facility: Northwestern University
state: Illinois
city: Geneva
country: United States
facility: Northwestern Medicine Cancer Center Delnor
state: Illinois
city: Lake Forest
country: United States
facility: Northwestern Medicine Cancer Center Lake Forest Hospital
state: Illinois
city: Park Ridge
country: United States
facility: Advocate Lutheran General Hospital
state: Illinois
city: Warrenville
country: United States
facility: Northwestern Medicine Cancer Center Warrenville
state: Illinois
city: Indianapolis
country: United States
facility: Indiana University - Melvin and Bren Simon Cancer Center
state: Indiana
city: Indianapolis
country: United States
facility: Indiana University Melvin and Bren Simon Comprehensive Cancer Center
state: Indiana
city: Indianapolis
country: United States
facility: Franciscan Health Indianapolis
state: Indiana
city: Overland Park
country: United States
facility: University of Kansas Hospital - Indian Creek Campus
state: Kansas
city: Westwood
country: United States
facility: University of Kansas Hospital- Westwood Cancer Center
state: Kansas
city: Lexington
country: United States
facility: University of Kentucky
state: Kentucky
city: Baltimore
country: United States
facility: MedStar Franklin Square Medical Center
state: Maryland
city: Ann Arbor
country: United States
facility: University of Michigan Medical Center
state: Michigan
city: Brighton
country: United States
facility: University of Michigan - Brighton Center for Specialty Care
state: Michigan
city: Grand Rapids
country: United States
facility: Mercy Health Saint Mary's
state: Michigan
city: Grand Rapids
country: United States
facility: Spectrum Health at Butterworth Campus
state: Michigan
city: Kalamazoo
country: United States
facility: West Michigan Cancer Centre
state: Michigan
city: Creve Coeur
country: United States
facility: Siteman Cancer Centre, Barnes Jewish West County
state: Missouri
city: Kansas City
country: United States
facility: University of Kansas Cancer Center
state: Missouri
city: Saint Louis
country: United States
facility: Washington University School of Medicine
state: Missouri
city: Springfield
country: United States
facility: Cox South Hospital
state: Missouri
city: Bellevue
country: United States
facility: Nebraska Medicine - Bellevue
state: Nebraska
city: Omaha
country: United States
facility: Nebraska Medicine-Village Pointe
state: Nebraska
city: Omaha
country: United States
facility: University of Nebraska Medicine
state: Nebraska
city: Livingston
country: United States
facility: Cooperman Barnabas Medical Center
state: New Jersey
city: Piscataway
country: United States
facility: Rutgers Cancer Institute of New Jersey
state: New Jersey
city: Albuquerque
country: United States
facility: Lovelace Medical Centre-Saint Joseph Square
state: New Mexico
city: Albuquerque
country: United States
facility: Lovelace Women's Hospital
state: New Mexico
city: Bay Shore
country: United States
facility: Northwell Health Imbert Cancer Center
state: New York
city: Buffalo
country: United States
facility: Roswell Park Cancer Institute
state: New York
city: Lake Success
country: United States
facility: Northwell Health/Center for Advanced Medicine
state: New York
city: Mineola
country: United States
facility: NYU Langone Medical Center (Winthrop Hospital)
state: New York
city: Mount Kisco
country: United States
facility: Northern Westchester Hospital
state: New York
city: New York
country: United States
facility: Laura & Isaac Perlmutter Cancer Center at NYU Langone Health
state: New York
city: New York
country: United States
facility: NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center
state: New York
city: New York
country: United States
facility: Memorial Sloan Kettering Cancer Center
state: New York
city: Poughkeepsie
country: United States
facility: Vassar Brothers Medical Center
state: New York
city: Rochester
country: United States
facility: University of Rochester
state: New York
city: Sleepy Hollow
country: United States
facility: Phelps Memorial Hospital Center
state: New York
city: Syracuse
country: United States
facility: State University of New York Upstate Medical University
state: New York
city: Syracuse
country: United States
facility: State University of New York Upstate Medical Center-Community Campus
state: New York
city: Webster
country: United States
facility: Wilmont Cancer Institute at Webster
state: New York
city: Chapel Hill
country: United States
facility: University of North Carolina at Chapel Hill
state: North Carolina
city: Durham
country: United States
facility: Duke University Medical Center
state: North Carolina
city: Greenville
country: United States
facility: East Carolina University
state: North Carolina
city: Hillsborough
country: United States
facility: University of North Carolina Hospitals - Hillsborough Campus
state: North Carolina
city: Fargo
country: United States
facility: Sanford Broadway Medical Centre
state: North Dakota
city: Fargo
country: United States
facility: Sanford Roger Maris Cancer Centre
state: North Dakota
city: Avon
country: United States
facility: University Hospitals Avon Health Center
state: Ohio
city: Centerville
country: United States
facility: Miami Valley Hospital South
state: Ohio
city: Chardon
country: United States
facility: University Hospitals Geauga Medical Center
state: Ohio
city: Cincinnati
country: United States
facility: University of Cincinnati
state: Ohio
city: Cleveland
country: United States
facility: University Hospitals Cleveland Medical Centre
state: Ohio
city: Columbus
country: United States
facility: Ohio State University Comprehensive Cancer Center
state: Ohio
city: Orange Village
country: United States
facility: University Hospitals Chagrin Highlands Medical Centre
state: Ohio
city: West Chester
country: United States
facility: West Chester Hospital (OH394)
state: Ohio
city: Westlake
country: United States
facility: University Hospitals St. John Medical Center
state: Ohio
city: Oklahoma City
country: United States
facility: OUHSC Stephenson Cancer Center
state: Oklahoma
city: Oklahoma City
country: United States
facility: Mercy Health Center - Oncology Hematology
state: Oklahoma
city: Clackamas
country: United States
facility: Kaiser Sunnyside Medical Center
state: Oregon
city: Portland
country: United States
facility: Kaiser Permanente Northwest - Oncology Clinic
state: Oregon
city: Allentown
country: United States
facility: St. Luke's University Health Network - Allentown Cancer Center
state: Pennsylvania
city: Bethlehem
country: United States
facility: St Luke's University Health Network, Bethlehem Campus
state: Pennsylvania
city: Easton
country: United States
facility: St Luke's University Health Network, Anderson Campus
state: Pennsylvania
city: Philadelphia
country: United States
facility: Fox Chase Cancer Center
state: Pennsylvania
city: Quakertown
country: United States
facility: St Luke's University Health Network Quakertown Campus
state: Pennsylvania
city: Quakertown
country: United States
facility: St. Luke's University Health Network - Upper Bucks
state: Pennsylvania
city: Sayre
country: United States
facility: Guthrie Medical Group PC-Robert Packer Hospital
state: Pennsylvania
city: Charleston
country: United States
facility: Medical University of South Carolina
state: South Carolina
city: Sioux Falls
country: United States
facility: Sanford Cancer Center Oncology Clinic
state: South Dakota
city: Sioux Falls
country: United States
facility: Sanford USD Medical Center - Sioux Falls
state: South Dakota
city: Houston
country: United States
facility: The University of Texas MD Anderson Cancer Center
state: Texas
city: San Antonio
country: United States
facility: University of Texas Health Science Center at San Antonio
state: Texas
city: Murray
country: United States
facility: Intermountain Medical Center
state: Utah
city: Salt Lake City
country: United States
facility: Huntsman Cancer Institute (The University of Utah)
state: Utah
city: Burlington
country: United States
facility: University of Vermont Medical Center
state: Vermont
city: Burlington
country: United States
facility: University of Vermount and Sate Agricultural College
state: Vermont
city: Charlottesville
country: United States
facility: University of Virginia Health System
state: Virginia
city: Newport News
country: United States
facility: VCU Massey Cancer Center Peninsula Cancer Institute
state: Virginia
city: Richmond
country: United States
facility: VCU Massey Cancer Center
state: Virginia
city: Roanoke
country: United States
facility: Carilion Roanoke Memorial Hospital
state: Virginia
city: Winchester
country: United States
facility: VCU Massey Cancer Center Affiliate Valley Health
state: Virginia
city: Madison
country: United States
facility: University of Winsconsin Carbone Cancer Center-Eastpark medical Center
state: Wisconsin
city: Madison
country: United States
facility: University of Wisconsin Carbone Cancer Center
state: Wisconsin
city: Marshfield
country: United States
facility: Marshfield Medical Center - Marshfield
state: Wisconsin
city: Milwaukee
country: United States
facility: Aurora St Luke's Medical Center
state: Wisconsin
city: Milwaukee
country: United States
facility: Medical College of Wisconsin
state: Wisconsin
city: Weston
country: United States
facility: Marshfield Medical Center- Weston
state: Wisconsin
city: Bruce
country: Australia
facility: Calvary Public Hospital Bruce
state: Australian Capital Territory
city: Garran
country: Australia
facility: The Canberra Hospital
state: Australian Capital Territory
city: Sydney
country: Australia
facility: Westmead Hospital
state: New South Wales
city: Sydney
country: Australia
facility: Melanoma Institute Australia
state: New South Wales
city: Sydney
country: Australia
facility: Royal Prince Alfred Hospital
state: New South Wales
city: Brisbane
country: Australia
facility: Princess Alexandra Hospital
state: Queensland
city: Gold Coast
country: Australia
facility: Robina Hospital
state: Queensland
city: Adelaide
country: Australia
facility: Royal Adelaide Hospital
state: South Australia
city: Melbourne
country: Australia
facility: Peter MacCallum Cancer Centre
state: Victoria
city: Melbourne
country: Australia
facility: The Alfred Hospital
state: Victoria
city: Calgary
country: Canada
facility: Tom Baker Cancer Centre
state: Alberta
city: Kelowna
country: Canada
facility: BCCA - Cancer Centre for the Southern Interior
state: British Columbia
city: Winnipeg
country: Canada
facility: CancerCare Manitoba
state: Manitoba
city: Barrie
country: Canada
facility: Royal Victoria Regional Health Centre
state: Ontario
city: Hamilton
country: Canada
facility: Hamilton Health Sciences Centre
state: Ontario
city: Markham
country: Canada
facility: Oak Valley Health
state: Ontario
city: Ottawa
country: Canada
facility: Ottawa Hospital Research Institute
state: Ontario
city: Toronto
country: Canada
facility: Sunnybrook Health Sciences Centre
state: Ontario
city: Toronto
country: Canada
facility: UHN - Princess Margaret Cancer Centre
state: Ontario
city: Montreal
country: Canada
facility: Hopital Maisonneuve-Rosemont
state: Quebec
city: Montréal
country: Canada
facility: Centre Hospitalier de l'Universite de Montreal (CHUM)
state: Quebec
city: Québec City
country: Canada
facility: Hotel-Dieu de Quebec
state: Quebec
city: Cork
country: Ireland
facility: Cork University Hospital
city: Dublin
country: Ireland
facility: Mater Misericordiae University Hospital
city: Dublin
country: Ireland
facility: St James Hospital
city: Padova
country: Italy
facility: IOV Istituto Oncologico Veneto IRCCS-Padova
city: Pavia
country: Italy
facility: Fondazione IRCCS Policlinico San Matteo
city: Torino
country: Italy
facility: AOU Città della Salute e della Scienza di Torino
city: Almere
country: Netherlands
facility: Flevo Hospital
state: Flevoland
city: Ede
country: Netherlands
facility: Ziekenhuis Gelderse Vallei
state: Gelderland
city: Zutphen
country: Netherlands
facility: Gelre Hospital
state: Gelderland
city: Eindhoven
country: Netherlands
facility: Maxima Medical Centre, Eindhoven
state: Noord-Brabant
city: Groningen
country: Netherlands
facility: University Medical Centre Groningen
city: Heerlen
country: Netherlands
facility: Zuyderland Medical Center
city: Maastricht
country: Netherlands
facility: Maastricht University Medical Center
city: Utrecht
country: Netherlands
facility: Diakonessenhuis
city: Veldhoven
country: Netherlands
facility: Maxima Medical Center - Veldhoven
city: Zwolle
country: Netherlands
facility: Isala Hospital
city: Auckland
country: New Zealand
facility: North Shore Hospital
city: Ljubljana
country: Slovenia
facility: Institute of Oncology Ljubljana
city: Gothenburg
country: Sweden
facility: Sahlgrenska University Hospital
city: Kristianstad
country: Sweden
facility: Central Hospital Kristianstad
city: Edgbaston
country: United Kingdom
facility: University Hospitals Birmingham NHS Foundation Trust
state: Birmingham
city: Truro
country: United Kingdom
facility: Royal Cornwall Hospital NHS Trust
state: Cornwall
city: Hull
country: United Kingdom
facility: Hull University Teaching Hospitals NHS Trust
state: East Yorkshire
city: Westcliff on Sea
country: United Kingdom
facility: MID & South Essex NHS Foundation Trust
state: Essex
city: Preston
country: United Kingdom
facility: Lancashire Teaching Hospitals NHS Foundation Trust
state: Lancashire
city: Headington
country: United Kingdom
facility: Oxford University Hospitals NHS Foundation Trust
state: Oxford
city: London
country: United Kingdom
facility: Imperial College Healthcare NHS Trust
state: The Bays
city: East Grinstead
country: United Kingdom
facility: Queen Victoria Hospital NHS Foundation Trust
state: West Sussex
city: Bristol
country: United Kingdom
facility: North Bristol NHS Trust
city: Cambridge
country: United Kingdom
facility: Cambridge University Hospitals NHS Foundation Trust
city: Leeds
country: United Kingdom
facility: The Leeds Teaching Hospitals NHS Trust
city: Liverpool
country: United Kingdom
facility: St. Helens & Knowsley Teaching Hospitals NHS Trust
city: London,
country: United Kingdom
facility: The Royal Marsden Hospital NHS Foundation Trust
city: London
country: United Kingdom
facility: Royal Free London NHS Foundation Trust
city: London
country: United Kingdom
facility: Guy's and St Thomas's NHS Foundation Trust, of St Thomas' Hospital
city: London
country: United Kingdom
facility: St George's University Hospitals NHS Foundation Trust
city: Manchester
country: United Kingdom
facility: The Christie NHS Foundation Trust
city: Middlesbrough
country: United Kingdom
facility: South Tees Hospitals NHS Foundation Trust of The James Cook University Hospital
city: Norwich
country: United Kingdom
facility: Norfolk and Norwich University Hospital NHS Trust
city: Nottingham
country: United Kingdom
facility: Nottingham University Hospitals, NHS Trust, Trust HQ, City Hospital
Study officials:
affiliation: Peter MacCallum Cancer Centre, Australia
name: Michael Henderson
role: STUDY_CHAIR
affiliation: Norfolk & Norwich University Hospital
name: Marc Moncrieff
role: STUDY_CHAIR
References: