Ignite Creation Date:
2025-12-25 @ 3:19 AM
Ignite Modification Date:
2025-12-30 @ 4:09 AM
Study NCT ID:
NCT04035005
Status:
ACTIVE_NOT_RECRUITING
Last Update Posted:
2025-08-26
First Post:
2019-07-17
Is NOT Gene Therapy:
True
Has Adverse Events:
False
Brief Title:
A Study to Evaluate the Efficacy and Safety of Ocrelizumab in Adults With Primary Progressive Multiple Sclerosis
Sponsor:
Organization:
Raw JSON
{'hasResults': False, 'derivedSection': {'miscInfoModule': {'versionHolder': '2025-12-24', 'removedCountries': ['Austria', 'Brazil', 'Egypt', 'Germany', 'Hungary', 'Ireland', 'Netherlands']}, 'conditionBrowseModule': {'meshes': [{'id': 'D020528', 'term': 'Multiple Sclerosis, Chronic Progressive'}], 'ancestors': [{'id': 'D009103', 'term': 'Multiple Sclerosis'}, {'id': 'D020278', 'term': 'Demyelinating Autoimmune Diseases, CNS'}, {'id': 'D020274', 'term': 'Autoimmune Diseases of the Nervous System'}, {'id': 'D009422', 'term': 'Nervous System Diseases'}, {'id': 'D003711', 'term': 'Demyelinating Diseases'}, {'id': 'D001327', 'term': 'Autoimmune Diseases'}, {'id': 'D007154', 'term': 'Immune System Diseases'}, {'id': 'D002908', 'term': 'Chronic Disease'}, {'id': 'D020969', 'term': 'Disease Attributes'}, {'id': 'D010335', 'term': 'Pathologic Processes'}, {'id': 'D013568', 'term': 'Pathological Conditions, Signs and Symptoms'}]}, 'interventionBrowseModule': {'meshes': [{'id': 'C533411', 'term': 'ocrelizumab'}]}}, 'protocolSection': {'designModule': {'phases': ['PHASE3'], 'studyType': 'INTERVENTIONAL', 'designInfo': {'allocation': 'RANDOMIZED', 'maskingInfo': {'masking': 'DOUBLE', 'whoMasked': ['PARTICIPANT', 'INVESTIGATOR']}, 'primaryPurpose': 'TREATMENT', 'interventionModel': 'PARALLEL'}, 'enrollmentInfo': {'type': 'ACTUAL', 'count': 1013}}, 'statusModule': {'overallStatus': 'ACTIVE_NOT_RECRUITING', 'startDateStruct': {'date': '2019-08-12', 'type': 'ACTUAL'}, 'expandedAccessInfo': {'hasExpandedAccess': False}, 'statusVerifiedDate': '2025-08', 'completionDateStruct': {'date': '2028-01-19', 'type': 'ESTIMATED'}, 'lastUpdateSubmitDate': '2025-08-20', 'studyFirstSubmitDate': '2019-07-17', 'studyFirstSubmitQcDate': '2019-07-25', 'lastUpdatePostDateStruct': {'date': '2025-08-26', 'type': 'ESTIMATED'}, 'studyFirstPostDateStruct': {'date': '2019-07-29', 'type': 'ACTUAL'}, 'primaryCompletionDateStruct': {'date': '2025-01-15', 'type': 'ACTUAL'}}, 'outcomesModule': {'primaryOutcomes': [{'measure': 'Time to Onset of Composite 12-week Confirmed Disability Progression (CDP)', 'timeFrame': 'Baseline up to approximately 144 weeks'}], 'secondaryOutcomes': [{'measure': 'Time to 12-week CDP in 9-Hole Peg Test (9-HPT)', 'timeFrame': 'Baseline up to approximately 144 weeks', 'description': 'The 9-HPT is a quantitative measure of upper extremity (arm and hand) function (Goodkin et al. 1988; Fischer et al. 1999b).'}, {'measure': 'Time to 12-week CDP in EDSS', 'timeFrame': 'Baseline up to approximately 144 weeks', 'description': 'Disability progression was measured by EDSS and is defined as an increase of ≥1 point from baseline EDSS score in participants with a baseline EDSS score ≤ 5.5 or an increase of ≥ 0.5 point in participants with a baseline EDSS score of \\< 5.5 that is confirmed for at least 12 weeks. The EDSS is an ordinal clinical rating scale ranging from 0 (normal neurologic examination) to 10 (death due to MS) in half-point increments.'}, {'measure': 'Time to 24-week CDP in 9-HPT', 'timeFrame': 'Baseline up to approximately 144 weeks', 'description': 'The 9-HPT is a quantitative measure of upper extremity (arm and hand) function (Goodkin et al. 1988; Fischer et al. 1999b).'}, {'measure': 'Time to 24-week CDP in EDSS', 'timeFrame': 'Baseline up to approximately 144 weeks', 'description': 'Disability progression was measured by EDSS and is defined as an increase of ≥1 point from baseline EDSS score in participants with a baseline EDSS score ≤ 5.5 or an increase of ≥ 0.5 point in participants with a baseline EDSS score of \\< 5.5 that is confirmed for at least 12 weeks. The EDSS is an ordinal clinical rating scale ranging from 0 (normal neurologic examination) to 10 (death due to MS) in half-point increments.'}, {'measure': 'Annual Rate of Percent Change From Baseline in Total Volume of T2 Lesions on Magnetic Resonance Imaging (MRI) Scans', 'timeFrame': 'Baseline up to approximately 8.5 years'}, {'measure': 'Annual Rate of Percent Change From 24 Week in Total Brain Volume on MRI Scans', 'timeFrame': 'Week 24 up to approximately 8.5 years'}, {'measure': 'Percentage of Participants with Adverse Events (AEs)', 'timeFrame': 'Up to approximately 8.5 years'}, {'measure': 'Percentage of Participants With Serious Adverse Events (SAEs)', 'timeFrame': 'Up to approximately 8.5 years'}, {'measure': 'Percentage of Participants With AEs Leading to Study Treatment Withdrawal', 'timeFrame': 'Up to approximately 8.5 years'}, {'measure': 'Number of Participants With Anti-Drug Antibodies (ADAs) to Ocrelizumab', 'timeFrame': 'Up to approximately 8.5 years'}, {'measure': 'Plasma Concentration of Ocrelizumab', 'timeFrame': 'Baseline, Weeks 2, 12, 24, 48, 60, 72, and every 12 weeks till the end of the double-blind period and Weeks 0 and 48 of the OLE period'}, {'measure': 'Evaluation of Ocrelizumab Pharmacodynamics, as Measured by B-Cell Levels in Blood', 'timeFrame': 'Baseline, Weeks 2, 24, 48, 72 and every 12 weeks till the end of the double-blind period and Weeks 0, 22, 46, 70 and 96 of the OLE period'}]}, 'oversightModule': {'oversightHasDmc': True, 'isFdaRegulatedDrug': True, 'isFdaRegulatedDevice': False}, 'conditionsModule': {'conditions': ['Multiple Sclerosis, Primary Progressive']}, 'descriptionModule': {'briefSummary': 'This study will evaluate the efficacy and safety of ocrelizumab (Ocrevus®) compared with placebo in participants with primary progressive multiple sclerosis (PPMS), including participants later in their disease course. This study will consist of the following phases: screening, double-blind treatment, an optional post-double-progression ocrelizumab (PDP OCR) treatment, follow-up 1 (FU1), an optional open-label extension (OLE), and follow-up 2 (FU2).', 'detailedDescription': 'The screening phase will last up to 24 weeks. In the double-blind treatment phase, participants will undergo at least 144 weeks of study treatment. Study drug (ocrelizumab or placebo) will be administered every 24 weeks. All participants who discontinue prematurely from the double-blind treatment phase will enter the FU1 phase, including participants receiving other immunomodulatory or immunosuppressive treatment(s) for MS, commercial ocrelizumab, or no treatment. The FU1 phase will run in parallel with the double-blind treatment phase for 144 weeks or until the primary analysis is performed, whichever occurs first. An optional OLE phase is planned for eligible participants who either have either completed 144 weeks of the double-blind treatment phase or are ongoing in the double-blind treatment phase at the time of the primary analysis and, in the opinion of the investigator, could benefit from ocrelizumab treatment. The following participants will move into the FU2 phase: participants who are ongoing in the FU1 at 144 weeks from randomization or at the time of the primary analysis; participants who have either completed 144 weeks of the double-blind treatment phase or are ongoing in the double-blind treatment phase at the time of the primary analysis and will not enter the OLE phase; participants who have completed or withdrawn from the OLE phase or from PDP OCR treatment phase.'}, 'eligibilityModule': {'sex': 'ALL', 'stdAges': ['ADULT', 'OLDER_ADULT'], 'maximumAge': '65 Years', 'minimumAge': '18 Years', 'healthyVolunteers': False, 'eligibilityCriteria': 'Inclusion Criteria:\n\n* EDSS score at screening and baseline \\>= 3.0 to 8.0, inclusive\n* Disease duration from the onset of MS symptoms relative to randomization date:\n\nLess than 20 years in participants with an EDSS score at screening 7.0 - 8.0 Less than 15 years in participants with an EDSS at screening 5.5 - 6.5 Less than 10 years in participants with an EDSS at screening \\<= 5.0\n\n* Documented history or presence at screening of at least one of the following laboratory findings in a cerebrospinal fluid specimen: Elevated immunoglobulin G (IgG) index or one or more IgG oligoclonal bands detected by isoelectric focusing\n* Screening and baseline 9-HPT completed in \\> 25 seconds (average of the two hands)\n* Neurological stability for ≥ 30 days prior to baseline\n* Ability to complete the 9-HPT within 240 seconds with each hand at screening and baseline\n* Neurological stability for \\>/= 30 days prior to baseline\n* Participants previously treated with immunosuppressants, immunomodulators, or other immunomodulatory therapies must undergo an appropriate washout period according to the local label of the immunosuppressant/immunomodulatory drug used\n* For women of childbearing potential: agreement to remain abstinent (refrain from heterosexual intercourse) or use adequate contraceptive methods during the treatment period and for 6 or 12 months after the final dose of ocrelizumab. Adherence to local requirements, if more stringent, is required.\n* For female participants without reproductive potential: Women may be enrolled if surgically sterile (i.e hysterectomy, complete bilateral oophorectomy) or post-menopausal unless the participant is receiving a hormonal therapy for her menopause or if surgically sterile\n\nExclusion Criteria:\n\n* History of relapsing-remitting or secondary progressive MS at screening\n* Confirmed serious opportunistic infection including: active bacterial, viral, fungal, mycobacterial infection or other infection, including tuberculosis or atypical mycobacterial disease\n* Participants who have or have had confirmed or a high degree of suspicion of progressive multifocal leukoencephalopathy (PML)\n* Known active malignancy or are being actively monitored for recurrence of malignancy\n* Immunocompromised state\n* Receipt of a live-attenuated vaccine within 6 weeks prior to randomization\n* Inability to complete an MRI or contraindication to Gd administration.\n* Participants requiring symptomatic treatment of MS and/or physiotherapy who are not on a stable regimen. Participants must not initiate symptomatic treatment of MS or physiotherapy within 4 weeks of randomization.\n* Contraindications to mandatory premedications for infusion-related reactions, including:\n\nuncontrolled psychosis for corticosteroids and closed-angle glaucoma for antihistamines\n\n* Known presence of other neurologic disorders\n* Pregnant or breastfeeding, or intending to become pregnant during the study and for 6 or 12 months after last infusion of the study drug\n* Lack of peripheral venous access\n* Significant, uncontrolled disease, such as cardiovascular, pulmonary, renal, hepatic, endocrine or gastrointestinal, or any other significant disease that may preclude participant from participating in the study\n* Any concomitant disease that may require chronic treatment with systemic corticosteroids or immunosuppressants during the course of the study\n* History of alcohol or other drug abuse\n* History of primary or secondary immunodeficiency\n* Treatment with any investigational agent within 24 weeks prior to screening (Visit 1) or 5 half-lives of the investigational drug (whichever is longer), or treatment with any experimental procedure for MS\n* Previous treatment with B-cell targeting therapies\n* Any previous treatment with bone marrow transplantation and hematopoietic stem cell transplantation\n* Any previous history of transplantation or anti-rejection therapy\n* Treatment with IV Ig or plasmapheresis within 12 weeks prior to randomization\n* Systemic corticosteroid therapy within 4 weeks prior to screening\n* Positive serum human chorionic gonadotropin (hCG) measured at screening or positive urine β-hCG at baseline\n* Positive screening tests for hepatitis B\n* Any additional exclusionary criterion as per ocrelizumab (Ocrevus®) local label, if more stringent than the above\n* Lack of MRI activity at screening/baseline if more than 650 participants without MRI activity have already been enrolled, as defined by T1 Gd+ lesion(s) and/or new and/or enlarged T2 lesion(s) in the screening, to ensure that at least 350 participants with MRI activity will be randomized\n\nEligibility Criteria for OLE Phase:\n\n* Completed the 144 weeks of double-blind treatment phase of the trial or are ongoing in the double blind treatment phase at the time of the primary analysis, and who, in the opinion of the investigator, may benefit from treatment with Ocrelizumab. Participants who withdrew from study treatment and received another DMT or commercial ocrelizumab will not be allowed to enter in the OLE phase.\n* For women of childbearing potential: agreement to remain abstinent (refrain from heterosexual intercourse) or use adequate contraceptive methods during the treatment period and for 6 or 12 months after the final dose of ocrelizumab. Adherence to local requirements, if more stringent, is required.\n* For female participants without reproductive potential: Women may be enrolled if surgically sterile (i.e. hysterectomy, complete bilateral oophorectomy) or post-menopausal unless the participant is receiving a hormonal therapy for her menopause or if surgically sterile'}, 'identificationModule': {'nctId': 'NCT04035005', 'acronym': "O'HAND", 'briefTitle': 'A Study to Evaluate the Efficacy and Safety of Ocrelizumab in Adults With Primary Progressive Multiple Sclerosis', 'organization': {'class': 'INDUSTRY', 'fullName': 'Hoffmann-La Roche'}, 'officialTitle': 'A Phase IIIb Multicenter, Randomized, Double-Blind, Placebo-Controlled Study to Evaluate the Efficacy and Safety of Ocrelizumab in Adults With Primary Progressive Multiple Sclerosis', 'orgStudyIdInfo': {'id': 'WA40404'}, 'secondaryIdInfos': [{'id': '2018-001511-73', 'type': 'EUDRACT_NUMBER'}, {'id': '2023-505980-36-00', 'type': 'CTIS'}]}, 'armsInterventionsModule': {'armGroups': [{'type': 'EXPERIMENTAL', 'label': 'Ocrelizumab', 'description': 'Participants will receive ocrelizumab by intravenous (IV) infusion every 24 weeks.', 'interventionNames': ['Drug: Ocrelizumab']}, {'type': 'PLACEBO_COMPARATOR', 'label': 'Placebo', 'description': 'Participants will receive placebo matched to ocrelizumab by IV infusion every 24 weeks.', 'interventionNames': ['Drug: Placebo']}], 'interventions': [{'name': 'Ocrelizumab', 'type': 'DRUG', 'otherNames': ['Ocrevus'], 'description': 'The first dose of ocrelizumab will be administered as two 300 milligrams (mg), IV infusions given 14 days apart. For the subsequent doses, ocrelizumab will be administered as a single 600 mg infusion every 24 weeks. A minimum interval of 20 or 22 weeks, depending on if the previous dose was administered in one or two infusion, should be maintained between each infusion.', 'armGroupLabels': ['Ocrelizumab']}, {'name': 'Placebo', 'type': 'DRUG', 'description': 'The first dose of placebo will be administered as two IV infusions given 14 days apart. For the subsequent doses, placebo will be administered as a single infusion every 24 weeks, with a minimum interval of 20 or 22 weeks, depending on if the previous dose was administered in one or two infusions, maintained between each infusion.', 'armGroupLabels': ['Placebo']}]}, 'contactsLocationsModule': {'locations': [{'zip': '92653', 'city': 'Laguna Hills', 'state': 'California', 'country': 'United States', 'facility': 'Multiple Sclerosis Center of California', 'geoPoint': {'lat': 33.61252, 'lon': -117.71283}}, {'zip': '20007', 'city': 'Washington D.C.', 'state': 'District of Columbia', 'country': 'United States', 'facility': 'Georgetown University Medical Center', 'geoPoint': {'lat': 38.89511, 'lon': -77.03637}}, {'zip': '33761', 'city': 'Clearwater', 'state': 'Florida', 'country': 'United States', 'facility': 'MS and Neuromuscular Center of Excellence', 'geoPoint': {'lat': 27.96585, 'lon': -82.8001}}, {'zip': '32806', 'city': 'Orlando', 'state': 'Florida', 'country': 'United States', 'facility': 'Neurological Services of Orlando', 'geoPoint': {'lat': 28.53834, 'lon': -81.37924}}, {'zip': '32960', 'city': 'Vero Beach', 'state': 'Florida', 'country': 'United States', 'facility': 'Vero Neurology', 'geoPoint': {'lat': 27.63864, 'lon': -80.39727}}, {'zip': '66160', 'city': 'Kansas City', 'state': 'Kansas', 'country': 'United States', 'facility': 'University of Kansas Medical Center', 'geoPoint': {'lat': 39.11417, 'lon': -94.62746}}, {'zip': '48035', 'city': 'Clinton Township', 'state': 'Michigan', 'country': 'United States', 'facility': 'Michigan Neurology Associates P.C.', 'geoPoint': {'lat': 42.58698, 'lon': -82.91992}}, {'zip': '43235-5422', 'city': 'Columbus', 'state': 'Ohio', 'country': 'United States', 'facility': 'The Boster Center for MS', 'geoPoint': {'lat': 39.96118, 'lon': -82.99879}}, {'zip': '43082-6910', 'city': 'Westerville', 'state': 'Ohio', 'country': 'United States', 'facility': 'Columbus Neuroscience', 'geoPoint': {'lat': 40.12617, 'lon': -82.92907}}, {'zip': '19141', 'city': 'Philadelphia', 'state': 'Pennsylvania', 'country': 'United States', 'facility': 'Albert Einstein Medical Center', 'geoPoint': {'lat': 39.95238, 'lon': -75.16362}}, {'zip': '77030', 'city': 'Houston', 'state': 'Texas', 'country': 'United States', 'facility': 'Maxine Mesinger MS Clinic/Baylor College of Medicine', 'geoPoint': {'lat': 29.76328, 'lon': -95.36327}}, {'zip': '2050', 'city': 'Camperdown', 'state': 'New South Wales', 'country': 'Australia', 'facility': 'Brain and Mind Research Institute', 'geoPoint': {'lat': -33.88965, 'lon': 151.17642}}, {'zip': '3084', 'city': 'Heidelberg', 'state': 'Victoria', 'country': 'Australia', 'facility': 'Austin Hospital', 'geoPoint': {'lat': -37.75, 'lon': 145.06667}}, {'zip': '3050', 'city': 'Parkville', 'state': 'Victoria', 'country': 'Australia', 'facility': 'Royal Melbourne Hospital', 'geoPoint': {'lat': -37.78333, 'lon': 144.95}}, {'zip': '2650', 'city': 'Edegem', 'state': 'Antwerpen', 'country': 'Belgium', 'facility': 'UZ Antwerpen', 'geoPoint': {'lat': 51.15662, 'lon': 4.44504}}, {'zip': '1200', 'city': 'Brussels', 'country': 'Belgium', 'facility': 'Cliniques Universitaires St-Luc', 'geoPoint': {'lat': 50.85045, 'lon': 4.34878}}, {'zip': '3900', 'city': 'Overpelt', 'country': 'Belgium', 'facility': 'MS & Neurologisch Revalidatie Centrum', 'geoPoint': {'lat': 51.21038, 'lon': 5.41557}}, {'zip': '5800', 'city': 'Pleven', 'country': 'Bulgaria', 'facility': 'Military Medical Academy HBAT', 'geoPoint': {'lat': 43.41791, 'lon': 24.61666}}, {'zip': '5800', 'city': 'Pleven', 'country': 'Bulgaria', 'facility': 'Multiprofile Hospital For Active Treatment Avis Medica', 'geoPoint': {'lat': 43.41791, 'lon': 24.61666}}, {'zip': '1113', 'city': 'Sofia', 'country': 'Bulgaria', 'facility': 'Multiprofile Hospital for Active Treatment of Neurology and Psychiatry Sv. Naum EAD', 'geoPoint': {'lat': 42.69751, 'lon': 23.32415}}, {'zip': 'T6G 2G3', 'city': 'Edmonton', 'state': 'Alberta', 'country': 'Canada', 'facility': 'University of Alberta', 'geoPoint': {'lat': 53.55014, 'lon': -113.46871}}, {'zip': 'B3H 4K4', 'city': 'Halifax', 'state': 'Nova Scotia', 'country': 'Canada', 'facility': 'Dalhousie Multiple Sclerosis Research Unit', 'geoPoint': {'lat': 44.64269, 'lon': -63.57688}}, {'zip': 'M5B 1W8', 'city': 'Toronto', 'state': 'Ontario', 'country': 'Canada', 'facility': "St. Michael's Hospital", 'geoPoint': {'lat': 43.70643, 'lon': -79.39864}}, {'zip': 'J4V 2J2', 'city': 'Greenfield Park', 'state': 'Quebec', 'country': 'Canada', 'facility': 'Recherche Sepmus Inc.', 'geoPoint': {'lat': 45.48649, 'lon': -73.46223}}, {'zip': '50012', 'city': 'Medellín', 'state': 'Antioquia', 'country': 'Colombia', 'facility': 'Instituto Neurologico de Colombia INDEC', 'geoPoint': {'lat': 6.245, 'lon': -75.57151}}, {'zip': '111321', 'city': 'Bogotá', 'country': 'Colombia', 'facility': 'Clinica Colsanitas S.A. sede Clinica Universitaria Colombia', 'geoPoint': {'lat': 4.60971, 'lon': -74.08175}}, {'zip': '31000', 'city': 'Osijek', 'country': 'Croatia', 'facility': 'Clinical Hospital Centre Osijek', 'geoPoint': {'lat': 45.55066, 'lon': 18.6942}}, {'zip': '42000', 'city': 'Varaždin', 'country': 'Croatia', 'facility': 'General Hospital Varazdin', 'geoPoint': {'lat': 46.30444, 'lon': 16.33778}}, {'zip': '10000', 'city': 'Zagreb', 'country': 'Croatia', 'facility': 'Clinical Hospital Sestre Milosrdnice', 'geoPoint': {'lat': 45.81444, 'lon': 15.97798}}, {'zip': '10000', 'city': 'Zagreb', 'country': 'Croatia', 'facility': 'University Hospital Center Zagreb', 'geoPoint': {'lat': 45.81444, 'lon': 15.97798}}, {'zip': '33076', 'city': 'Bordeaux', 'country': 'France', 'facility': 'CHU de Bordeaux - Hôpital Pellegrin', 'geoPoint': {'lat': 44.84124, 'lon': -0.58046}}, {'zip': '63003', 'city': 'Clermont-Ferrand', 'country': 'France', 'facility': 'Centre Hospitalier Universitaire de Clermont Ferrand', 'geoPoint': {'lat': 45.77969, 'lon': 3.08682}}, {'zip': '54035', 'city': 'Nancy', 'country': 'France', 'facility': 'CHRU Nancy', 'geoPoint': {'lat': 48.68439, 'lon': 6.18496}}, {'zip': '44805', 'city': 'Nantes', 'country': 'France', 'facility': 'Hopital Guillaume Et Rene Laennec', 'geoPoint': {'lat': 47.21725, 'lon': -1.55336}}, {'zip': '30900', 'city': 'Nîmes', 'country': 'France', 'facility': 'CHU de Nimes - Hopital Universitaire Caremeau', 'geoPoint': {'lat': 43.83665, 'lon': 4.35788}}, {'zip': '67098', 'city': 'Strasbourg', 'country': 'France', 'facility': 'Hopital Civil', 'geoPoint': {'lat': 48.58392, 'lon': 7.74553}}, {'zip': '0114', 'city': 'Tbilisi', 'country': 'Georgia', 'facility': 'Pineo Medical Ecosystem LTD', 'geoPoint': {'lat': 41.69143, 'lon': 44.83412}}, {'zip': '0141', 'city': 'Tbilisi', 'country': 'Georgia', 'facility': 'The First University Clinic of Tbilisi State Medical University', 'geoPoint': {'lat': 41.69143, 'lon': 44.83412}}, {'zip': '179', 'city': 'Tbilisi', 'country': 'Georgia', 'facility': 'Khechinashvili University Hospital', 'geoPoint': {'lat': 41.69143, 'lon': 44.83412}}, {'zip': '80138', 'city': 'Napoli', 'state': 'Campania', 'country': 'Italy', 'facility': 'AOU dell Universita degli Studi della Campania Luigi Vanvitelli Piazza Luigi Miraglia 2', 'geoPoint': {'lat': 40.87618, 'lon': 14.5195}}, {'zip': '00133', 'city': 'Rome', 'state': 'Lazio', 'country': 'Italy', 'facility': 'Fondazione PTV Policlinico Tor Vergata', 'geoPoint': {'lat': 41.89193, 'lon': 12.51133}}, {'zip': '00189', 'city': 'Rome', 'state': 'Lazio', 'country': 'Italy', 'facility': "Azienda Ospedaliera Sant'andrea", 'geoPoint': {'lat': 41.89193, 'lon': 12.51133}}, {'zip': '16132', 'city': 'Genoa', 'state': 'Liguria', 'country': 'Italy', 'facility': 'IRCCS Ospedale Policlinico San Martino', 'geoPoint': {'lat': 44.40478, 'lon': 8.94439}}, {'zip': '20132', 'city': 'Milan', 'state': 'Lombardy', 'country': 'Italy', 'facility': 'Ospedale San Raffaele S.r.l. - PPDS', 'geoPoint': {'lat': 45.46427, 'lon': 9.18951}}, {'zip': '27100', 'city': 'Pavia', 'state': 'Lombardy', 'country': 'Italy', 'facility': 'Fondazione Istituto Neurologico Mondino IRCCS', 'geoPoint': {'lat': 45.19205, 'lon': 9.15917}}, {'zip': '10043', 'city': 'Orbassano', 'state': 'Piedmont', 'country': 'Italy', 'facility': 'Azienda Ospedaliero-Universitaria San Luigi Gonzaga', 'geoPoint': {'lat': 45.00547, 'lon': 7.53813}}, {'zip': '90015', 'city': 'Cefalù', 'state': 'Sicily', 'country': 'Italy', 'facility': 'Fondazione Istituto G. 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