Ignite Creation Date:
2025-12-26 @ 4:00 PM
Ignite Modification Date:
2026-01-13 @ 5:36 AM
Study NCT ID:
NCT04736706
Status:
ACTIVE_NOT_RECRUITING
Last Update Posted:
2024-11-18
First Post:
2021-01-29
Is NOT Gene Therapy:
True
Has Adverse Events:
False
Brief Title:
A Study of Pembrolizumab (MK-3475) in Combination With Belzutifan (MK-6482) and Lenvatinib (MK-7902), or Pembrolizumab/Quavonlimab (MK-1308A) in Combination With Lenvatinib, Versus Pembrolizumab and Lenvatinib, for Treatment of Advanced Clear Cell Renal Cell Carcinoma (MK-6482-012)
Sponsor:
Organization:
Raw JSON
{'hasResults': False, 'derivedSection': {'miscInfoModule': {'versionHolder': '2025-12-24'}, 'conditionBrowseModule': {'meshes': [{'id': 'D002292', 'term': 'Carcinoma, Renal Cell'}, {'id': 'C565324', 'term': 'Parkinson Disease 4, Autosomal Dominant Lewy Body'}], 'ancestors': [{'id': 'D000230', 'term': 'Adenocarcinoma'}, {'id': 'D002277', 'term': 'Carcinoma'}, {'id': 'D009375', 'term': 'Neoplasms, Glandular and Epithelial'}, {'id': 'D009370', 'term': 'Neoplasms by Histologic Type'}, {'id': 'D009369', 'term': 'Neoplasms'}, {'id': 'D007680', 'term': 'Kidney Neoplasms'}, {'id': 'D014571', 'term': 'Urologic Neoplasms'}, {'id': 'D014565', 'term': 'Urogenital Neoplasms'}, {'id': 'D009371', 'term': 'Neoplasms by Site'}, {'id': 'D052776', 'term': 'Female Urogenital Diseases'}, {'id': 'D005261', 'term': 'Female Urogenital Diseases and Pregnancy Complications'}, {'id': 'D000091642', 'term': 'Urogenital Diseases'}, {'id': 'D007674', 'term': 'Kidney Diseases'}, {'id': 'D014570', 'term': 'Urologic Diseases'}, {'id': 'D052801', 'term': 'Male Urogenital Diseases'}]}, 'interventionBrowseModule': {'meshes': [{'id': 'C582435', 'term': 'pembrolizumab'}, {'id': 'C000720612', 'term': 'belzutifan'}, {'id': 'C531958', 'term': 'lenvatinib'}]}}, 'protocolSection': {'designModule': {'phases': ['PHASE3'], 'studyType': 'INTERVENTIONAL', 'designInfo': {'allocation': 'RANDOMIZED', 'maskingInfo': {'masking': 'NONE'}, 'primaryPurpose': 'TREATMENT', 'interventionModel': 'PARALLEL'}, 'enrollmentInfo': {'type': 'ESTIMATED', 'count': 1653}}, 'statusModule': {'overallStatus': 'ACTIVE_NOT_RECRUITING', 'startDateStruct': {'date': '2021-04-14', 'type': 'ACTUAL'}, 'expandedAccessInfo': {'hasExpandedAccess': False}, 'statusVerifiedDate': '2024-11', 'completionDateStruct': {'date': '2026-10-29', 'type': 'ESTIMATED'}, 'lastUpdateSubmitDate': '2024-11-14', 'studyFirstSubmitDate': '2021-01-29', 'studyFirstSubmitQcDate': '2021-01-29', 'lastUpdatePostDateStruct': {'date': '2024-11-18', 'type': 'ACTUAL'}, 'studyFirstPostDateStruct': {'date': '2021-02-03', 'type': 'ACTUAL'}, 'primaryCompletionDateStruct': {'date': '2026-10-29', 'type': 'ESTIMATED'}}, 'outcomesModule': {'primaryOutcomes': [{'measure': 'Progression Free Survival (PFS) According to Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) as Assessed by Blinded Independent Central Review (BICR)', 'timeFrame': 'Up to approximately 46 months', 'description': 'PFS is defined as the time from randomization to the first documented progressive disease (PD) or death due to any cause, whichever occurs first. Per RECIST 1.1, PD is defined as ≥20% increase in the sum of diameters of target lesions. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of ≥5 mm. The appearance of one or more new lesions is also considered PD. PFS as assessed by BICR based on RECIST 1.1 will be presented.'}, {'measure': 'Overall Survival (OS)', 'timeFrame': 'Up to approximately 66 months', 'description': 'OS is defined as the time from randomization to death due to any cause.'}], 'secondaryOutcomes': [{'measure': 'Objective Response Rate (ORR) Per RECIST 1.1 as Assessed by BICR', 'timeFrame': 'Up to approximately 46 months', 'description': 'ORR is defined as the percentage of participants who have a complete response (CR: disappearance of all target lesions) or partial response (PR: at least a 30% decrease in the sum of diameters of target lesions) per RECIST 1.1. The percentage of participants who experience a CR or PR as assessed by BICR based on RECIST 1.1 will be presented.'}, {'measure': 'Duration of Response (DOR) Per RECIST 1.1 as Assessed by BICR', 'timeFrame': 'Up to approximately 66 months', 'description': 'For participants who demonstrate a confirmed CR (disappearance of all target lesions) or confirmed PR (at least a 30% decrease in the sum of diameters of target lesions) per RECIST 1.1, DOR is defined as the time from first documented evidence of CR or PR until PD or death due to any cause, whichever occurs first. Per RECIST 1.1, PD is defined as at least a 20% increase in the sum of diameters of target lesions. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of ≥5 mm. The appearance of one or more new lesions is also considered PD. The DOR as assessed by BICR based on RECIST 1.1 will be presented.'}, {'measure': 'Number of Participants Who Experienced At least One Adverse Event (AE)', 'timeFrame': 'Up to approximately 66 months', 'description': 'An AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. The number of participants who experience at least one AE will be presented.'}, {'measure': 'Number of Participants Who Discontinue Study Treatment Due to an AE', 'timeFrame': 'Up to approximately 66 months', 'description': 'An AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. The number of participants who discontinue study treatment due to an AE will be presented.'}]}, 'oversightModule': {'oversightHasDmc': True, 'isFdaRegulatedDrug': True, 'isFdaRegulatedDevice': False}, 'conditionsModule': {'keywords': ['Programmed Cell Death-1 (PD1, PD-1)', 'Programmed Death-Ligand 1 (PDL1, PD-L1)', 'Hypoxia inducible factor (HIF)', 'Hypoxia inducible factor 1B (HIF-1B)', 'Hypoxia inducible factor 2 alpha (HIF-2 alpha)'], 'conditions': ['Carcinoma, Renal Cell']}, 'referencesModule': {'references': [{'pmid': '37882432', 'type': 'DERIVED', 'citation': 'Choueiri TK, Powles T, Voss MH, Plimack ER, Gurney H, Song Y, Perini RF, Rodriguez-Lopez K, Rini BI. LITESPARK-012: pembrolizumab plus lenvatinib with or without belzutifan or quavonlimab for advanced renal cell carcinoma. Future Oncol. 2023 Dec;19(40):2631-2640. doi: 10.2217/fon-2023-0283. Epub 2023 Oct 26.'}, {'pmid': '36064785', 'type': 'DERIVED', 'citation': 'Ged Y, Markowski MC, Singla N, Rowe SP. The shifting treatment paradigm of metastatic renal cell carcinoma. Nat Rev Urol. 2022 Nov;19(11):631-632. doi: 10.1038/s41585-022-00651-9.'}], 'seeAlsoLinks': [{'url': 'https://merckclinicaltrials.com/', 'label': 'Merck Clinical Trials Information'}, {'url': 'https://msd.trialsummaries.com/Study/StudyDetails?id=26235&tenant=MT_MSD_9011', 'label': 'Plain Language Summary'}]}, 'descriptionModule': {'briefSummary': 'The goal of this study is to evaluate the efficacy and safety of pembrolizumab plus belzutifan plus lenvatinib or pembrolizumab/quavonlimab plus lenvatinib versus pembrolizumab plus lenvatinib as first-line treatment in participants with advanced clear cell renal cell carcinoma (ccRCC).\n\nThe primary hypotheses are (1) pembrolizumab plus belzutifan plus lenvatinib is superior to pembrolizumab plus lenvatinib with respect to progression-free survival (PFS) and overall survival (OS), in advanced ccRCC participants; and (2) pembrolizumab/quavonlimab plus lenvatinib is superior to pembrolizumab plus lenvatinib with respect to PFS and OS, in advanced ccRCC participants.'}, 'eligibilityModule': {'sex': 'ALL', 'stdAges': ['ADULT', 'OLDER_ADULT'], 'minimumAge': '18 Years', 'healthyVolunteers': False, 'eligibilityCriteria': 'Inclusion Criteria:\n\n* Has histologically confirmed diagnosis of RCC with clear cell component.\n* Has received no prior systemic therapy for advanced ccRCC\n* Male participants are abstinent from heterosexual intercourse or agree to use contraception during and for at least 7 days after last dose of study intervention with belzutifan and lenvatinib.\n* Female participants are not pregnant or breastfeeding and are either not a woman of child-bearing potential (WOCBP) or use a contraceptive method that is highly effective or are abstinent from heterosexual intercourse during the intervention period and for at least 120 days after pembrolizumab or pembrolizumab/quavonlimab or for at least 30 days after last dose of lenvatinib or belzutifan, whichever occurs last\n* Has adequately controlled blood pressure with or without antihypertensive medications\n* Has adequate organ function.\n* Participants receiving bone resorptive therapy must have therapy initiated at least 2 weeks prior to randomization/allocation\n\nExclusion Criteria:\n\n* Has a known additional malignancy that is progressing or has required active treatment within the past 3 years\n* Has had major surgery, other than nephrectomy within 4 weeks prior to randomization\n* Has known central nervous system (CNS) metastases and/or carcinomatous meningitis\n* Has received prior radiotherapy within 2 weeks prior to first dose of study intervention\n* Has hypoxia or requires intermittent supplemental oxygen or requires chronic supplemental oxygen\n* Has clinically significant cardiac disease within 12 months from first dose of study intervention\n* Has a history of interstitial lung disease\n* Has symptomatic pleural effusion; a participant who is clinically stable following treatment of this condition is eligible\n* Has preexisting gastrointestinal or non-gastrointestinal fistula\n* Has a diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy or any other form of immunosuppressive therapy within 7 days prior to the first dose of study treatment\n* Has a known psychiatric or substance abuse disorder that would interfere with requirements of the study\n* Has received a live or live-attenuated vaccine within 30 days before the first dose of study drug; killed vaccines are allowed\n* Has an active autoimmune disease that has required systemic treatment in the past 2 years\n* Has a history of noninfectious pneumonitis that required steroids or has current pneumonitis\n* Has an active infection requiring systemic therapy\n* Has a known history of human immunodeficiency virus (HIV) infection\n* Has a known history of Hepatitis B\n* Has radiographic evidence of intratumoral cavitation, encasement or invasion of a major blood vessel\n* Has clinically significant history of bleeding within 3 months prior to randomization\n* Has had an allogenic tissue/solid organ transplant'}, 'identificationModule': {'nctId': 'NCT04736706', 'briefTitle': 'A Study of Pembrolizumab (MK-3475) in Combination With Belzutifan (MK-6482) and Lenvatinib (MK-7902), or Pembrolizumab/Quavonlimab (MK-1308A) in Combination With Lenvatinib, Versus Pembrolizumab and Lenvatinib, for Treatment of Advanced Clear Cell Renal Cell Carcinoma (MK-6482-012)', 'organization': {'class': 'INDUSTRY', 'fullName': 'Merck Sharp & Dohme LLC'}, 'officialTitle': 'An Open-label, Randomized Phase 3 Study to Evaluate Efficacy and Safety of Pembrolizumab (MK-3475) in Combination With Belzutifan (MK-6482) and Lenvatinib (MK-7902), or MK-1308A in Combination With Lenvatinib, Versus Pembrolizumab and Lenvatinib, as First-Line Treatment in Participants With Advanced Clear Cell Renal Cell Carcinoma (ccRCC)', 'orgStudyIdInfo': {'id': '6482-012'}, 'secondaryIdInfos': [{'id': 'MK-6482-012', 'type': 'OTHER', 'domain': 'MSD'}, {'id': 'jRCT2031210435', 'type': 'REGISTRY', 'domain': 'jRCT(Japan Registry of Clinical Trials)'}, {'id': 'PHRR210911-003887', 'type': 'REGISTRY', 'domain': 'Philippine Health Research Registry (PHRR)'}, {'id': '2020-002216-52', 'type': 'EUDRACT_NUMBER'}]}, 'armsInterventionsModule': {'armGroups': [{'type': 'EXPERIMENTAL', 'label': 'Pembrolizumab + Belzutifan + Lenvatinib', 'description': 'Participants will receive pembrolizumab 400 mg PLUS belzutifan 120 mg PLUS lenvatinib 20 mg. Pembrolizumab will be administered intravenously (IV) once every 6 weeks (Q6W) for up to 18 administrations (up to \\~2 years). Belzutifan and lenvatinib will be administered orally once daily (QD) until progressive disease or discontinuation.', 'interventionNames': ['Biological: Pembrolizumab', 'Drug: Belzutifan', 'Drug: Lenvatinib']}, {'type': 'EXPERIMENTAL', 'label': 'Pembrolizumab/Quavonlimab + Lenvatinib', 'description': 'Participants will receive pembrolizumab/quavonlimab (co-formulation of pembrolizumab 400 mg and quavonlimab 25 mg) PLUS lenvatinib 20 mg. Pembrolizumab/quavonlimab will be administered IV Q6W for up to 18 administrations (up to \\~2 years). Lenvatinib will be administered orally QD until progressive disease or discontinuation.', 'interventionNames': ['Biological: Pembrolizumab/Quavonlimab', 'Drug: Lenvatinib']}, {'type': 'ACTIVE_COMPARATOR', 'label': 'Pembrolizumab + Lenvatinib', 'description': 'Participants will receive pembrolizumab 400 mg PLUS lenvatinib 20 mg. Pembrolizumab will be administered IV Q6W for up to 18 administrations (up to \\~2 years). Lenvatinib will be administered orally QD until progressive disease or discontinuation.', 'interventionNames': ['Biological: Pembrolizumab', 'Drug: Lenvatinib']}], 'interventions': [{'name': 'Pembrolizumab', 'type': 'BIOLOGICAL', 'otherNames': ['MK-3475', 'KEYTRUDA®'], 'description': 'Pembrolizumab 400 mg administered Q6W via IV infusion', 'armGroupLabels': ['Pembrolizumab + Belzutifan + Lenvatinib', 'Pembrolizumab + Lenvatinib']}, {'name': 'Belzutifan', 'type': 'DRUG', 'otherNames': ['MK-6482', 'PT2977', 'WELIREG™'], 'description': 'Belzutifan 120 mg administered QD via oral tablet', 'armGroupLabels': ['Pembrolizumab + Belzutifan + Lenvatinib']}, {'name': 'Pembrolizumab/Quavonlimab', 'type': 'BIOLOGICAL', 'otherNames': ['MK-1308A'], 'description': 'Pembrolizumab/quavonlimab is a co-formulated product composed of pembrolizumab 400 mg in combination with quavonlimab 25 mg, administered Q6W via IV infusion', 'armGroupLabels': ['Pembrolizumab/Quavonlimab + Lenvatinib']}, {'name': 'Lenvatinib', 'type': 'DRUG', 'otherNames': ['MK-7902', 'E7080', 'LENVIMA®'], 'description': 'Lenvatinib 20 mg administered QD via oral capsule', 'armGroupLabels': ['Pembrolizumab + Belzutifan + Lenvatinib', 'Pembrolizumab + Lenvatinib', 'Pembrolizumab/Quavonlimab + Lenvatinib']}]}, 'contactsLocationsModule': {'locations': [{'zip': '35294-3300', 'city': 'Birmingham', 'state': 'Alabama', 'country': 'United States', 'facility': 'The University of Alabama at Birmingham ( Site 0010)', 'geoPoint': {'lat': 33.52066, 'lon': -86.80249}}, {'zip': '92037', 'city': 'La Jolla', 'state': 'California', 'country': 'United States', 'facility': 'UC San Diego ( Site 0050)', 'geoPoint': {'lat': 32.84727, 'lon': -117.2742}}, {'zip': '90048', 'city': 'Los Angeles', 'state': 'California', 'country': 'United States', 'facility': 'Cedars Sinai Medical Center ( Site 0027)', 'geoPoint': {'lat': 34.05223, 'lon': -118.24368}}, {'zip': '92868', 'city': 'Orange', 'state': 'California', 'country': 'United States', 'facility': 'University of California Irvine ( Site 0029)', 'geoPoint': {'lat': 33.78779, 'lon': -117.85311}}, {'zip': '90404', 'city': 'Santa Monica', 'state': 'California', 'country': 'United States', 'facility': 'UCLA Hematology Oncology Santa Monica ( Site 0048)', 'geoPoint': {'lat': 34.01949, 'lon': -118.49138}}, {'zip': '06102', 'city': 'Hartford', 'state': 'Connecticut', 'country': 'United States', 'facility': 'Hartford Hospital ( Site 0024)', 'geoPoint': {'lat': 41.76371, 'lon': -72.68509}}, {'zip': '32804', 'city': 'Orlando', 'state': 'Florida', 'country': 'United States', 'facility': 'Advent Health Hematology & Oncology ( Site 0003)', 'geoPoint': {'lat': 28.53834, 'lon': -81.37924}}, {'zip': '30607', 'city': 'Athens', 'state': 'Georgia', 'country': 'United States', 'facility': 'University Cancer & Blood Center, LLC ( Site 0057)', 'geoPoint': {'lat': 33.96095, 'lon': -83.37794}}, {'zip': '30322', 'city': 'Atlanta', 'state': 'Georgia', 'country': 'United States', 'facility': 'Emory University Winship Cancer Institute ( Site 0012)', 'geoPoint': {'lat': 33.749, 'lon': -84.38798}}, {'zip': '60607', 'city': 'Chicago', 'state': 'Illinois', 'country': 'United States', 'facility': 'Rush University Medical Center ( Site 0040)', 'geoPoint': {'lat': 41.85003, 'lon': -87.65005}}, {'zip': '46845', 'city': 'Fort Wayne', 'state': 'Indiana', 'country': 'United States', 'facility': 'Parkview Cancer Institute ( Site 0088)', 'geoPoint': {'lat': 41.1306, 'lon': -85.12886}}, {'zip': '40207', 'city': 'Louisville', 'state': 'Kentucky', 'country': 'United States', 'facility': 'Norton Cancer Institute - St. Matthews ( Site 0065)', 'geoPoint': {'lat': 38.25424, 'lon': -85.75941}}, {'zip': '70121', 'city': 'New Orleans', 'state': 'Louisiana', 'country': 'United States', 'facility': 'Ochsner Medical Center ( Site 0049)', 'geoPoint': {'lat': 29.95465, 'lon': -90.07507}}, {'zip': '04074', 'city': 'Scarborough', 'state': 'Maine', 'country': 'United States', 'facility': 'New England Cancer Specialists ( Site 0082)', 'geoPoint': {'lat': 43.57814, 'lon': -70.32172}}, {'zip': '02114', 'city': 'Boston', 'state': 'Massachusetts', 'country': 'United States', 'facility': 'Massachusetts General Hospital ( Site 0094)', 'geoPoint': {'lat': 42.35843, 'lon': -71.05977}}, {'zip': '02215', 'city': 'Boston', 'state': 'Massachusetts', 'country': 'United States', 'facility': 'Beth Israel Deaconess Medical Center ( Site 0089)', 'geoPoint': {'lat': 42.35843, 'lon': -71.05977}}, {'zip': '02215', 'city': 'Boston', 'state': 'Massachusetts', 'country': 'United States', 'facility': 'Dana Farber Cancer Institute ( Site 0093)', 'geoPoint': {'lat': 42.35843, 'lon': -71.05977}}, {'zip': '01805', 'city': 'Burlington', 'state': 'Massachusetts', 'country': 'United States', 'facility': 'Lahey Hospital & Medical Center ( Site 0090)', 'geoPoint': {'lat': 42.50482, 'lon': -71.19561}}, {'zip': '48202', 'city': 'Detroit', 'state': 'Michigan', 'country': 'United States', 'facility': 'Henry Ford Hospital ( Site 0038)', 'geoPoint': {'lat': 42.33143, 'lon': -83.04575}}, {'zip': '49503', 'city': 'Grand Rapids', 'state': 'Michigan', 'country': 'United States', 'facility': 'Cancer & Hematology Centers of Western Michigan ( Site 0018)', 'geoPoint': {'lat': 42.96336, 'lon': -85.66809}}, {'zip': '55426', 'city': 'Saint Louis Park', 'state': 'Minnesota', 'country': 'United States', 'facility': 'HealthPartners Cancer Research Center-HealthPartners Frauenshuh Cancer Center ( Site 0005)', 'geoPoint': {'lat': 44.9483, 'lon': -93.34801}}, {'zip': '55101', 'city': 'Saint Paul', 'state': 'Minnesota', 'country': 'United States', 'facility': 'Regions Hospital ( Site 0095)', 'geoPoint': {'lat': 44.94441, 'lon': -93.09327}}, {'zip': '39216', 'city': 'Jackson', 'state': 'Mississippi', 'country': 'United States', 'facility': 'University of Mississippi Medical Center ( Site 0037)', 'geoPoint': {'lat': 32.29876, 'lon': -90.18481}}, {'zip': '03756', 'city': 'Lebanon', 'state': 'New Hampshire', 'country': 'United States', 'facility': 'Dartmouth Hitchcock Medical Center ( Site 0075)', 'geoPoint': {'lat': 43.64229, 'lon': -72.25176}}, {'zip': '14203', 'city': 'Buffalo', 'state': 'New York', 'country': 'United States', 'facility': 'Roswell Park Cancer Institute ( Site 0032)', 'geoPoint': {'lat': 42.88645, 'lon': -78.87837}}, {'zip': '11042', 'city': 'Lake Success', 'state': 'New York', 'country': 'United States', 'facility': 'R.J. Zuckerberg Cancer Center-Medical Oncology ( Site 0013)', 'geoPoint': {'lat': 40.77066, 'lon': -73.71763}}, {'zip': '10065', 'city': 'New York', 'state': 'New York', 'country': 'United States', 'facility': 'Sidney Kimmel Center for Prostate and Urologic Cancers ( Site 0055)', 'geoPoint': {'lat': 40.71427, 'lon': -74.00597}}, {'zip': '97239', 'city': 'Portland', 'state': 'Oregon', 'country': 'United States', 'facility': 'Oregon Health & Science University ( Site 0071)', 'geoPoint': {'lat': 45.52345, 'lon': -122.67621}}, {'zip': '29401', 'city': 'Charleston', 'state': 'South Carolina', 'country': 'United States', 'facility': 'Ralph H. Johnson VA Center ( Site 0073)', 'geoPoint': {'lat': 32.77632, 'lon': -79.93275}}, {'zip': '37920', 'city': 'Knoxville', 'state': 'Tennessee', 'country': 'United States', 'facility': 'University of Tennessee Medical Center Knoxville ( Site 0019)', 'geoPoint': {'lat': 35.96064, 'lon': -83.92074}}, {'zip': '37232', 'city': 'Nashville', 'state': 'Tennessee', 'country': 'United States', 'facility': 'Vanderbilt University Medical Center ( Site 0069)', 'geoPoint': {'lat': 36.16589, 'lon': -86.78444}}, {'zip': '75390', 'city': 'Dallas', 'state': 'Texas', 'country': 'United States', 'facility': 'UTSW Medical Center ( Site 0015)', 'geoPoint': {'lat': 32.78306, 'lon': -96.80667}}, {'zip': '98801', 'city': 'Wenatchee', 'state': 'Washington', 'country': 'United States', 'facility': 'Central Washington Health Services Association d/b/a Confluence Health ( Site 0061)', 'geoPoint': {'lat': 47.42346, 'lon': -120.31035}}, {'zip': '2170', 'city': 'Liverpool', 'state': 'New South Wales', 'country': 'Australia', 'facility': 'Liverpool Hospital ( Site 4006)', 'geoPoint': {'lat': -33.91938, 'lon': 150.92588}}, {'zip': '2109', 'city': 'Macquarie University', 'state': 'New South Wales', 'country': 'Australia', 'facility': 'Macquarie University ( Site 4007)'}, {'zip': '5112', 'city': 'Elizabeth Vale', 'state': 'South Australia', 'country': 'Australia', 'facility': 'Lyell McEwin Hospital ( Site 4004)', 'geoPoint': {'lat': -34.74857, 'lon': 138.66819}}, {'zip': '3168', 'city': 'Clayton', 'state': 'Victoria', 'country': 'Australia', 'facility': 'Monash Health ( Site 4008)', 'geoPoint': {'lat': -37.91667, 'lon': 145.11667}}, {'zip': '6150', 'city': 'Murdock', 'state': 'Western Australia', 'country': 'Australia', 'facility': 'Fiona Stanley Hospital ( Site 4009)'}, {'zip': '60135-237', 'city': 'Fortaleza', 'state': 'Ceará', 'country': 'Brazil', 'facility': 'Oncocentro Ceara ( Site 0309)', 'geoPoint': {'lat': -3.71722, 'lon': -38.54306}}, {'zip': '29308-014', 'city': 'Cachoeiro de Itapemirim', 'state': 'Espírito Santo', 'country': 'Brazil', 'facility': 'Centro de Pesquisas Clinicas em Oncologia ( Site 0306)', 'geoPoint': {'lat': -20.84889, 'lon': -41.11278}}, {'zip': '30130090', 'city': 'Belo Horizonte', 'state': 'Minas Gerais', 'country': 'Brazil', 'facility': 'Centro Avançado de Tratamento Oncológico- CENATRON-Clinical Research ( Site 0303)', 'geoPoint': {'lat': -19.92083, 'lon': -43.93778}}, {'zip': '59075-740', 'city': 'Natal', 'state': 'Rio Grande do Norte', 'country': 'Brazil', 'facility': 'Liga Norte Riograndense Contra o Cancer ( Site 0308)', 'geoPoint': {'lat': -5.795, 'lon': -35.20944}}, {'zip': '90035-903', 'city': 'Porto Alegre', 'state': 'Rio Grande do Sul', 'country': 'Brazil', 'facility': 'Hospital de Clinicas de Porto Alegre ( Site 0310)', 'geoPoint': {'lat': -30.03283, 'lon': -51.23019}}, {'zip': '01246-000', 'city': 'São Paulo', 'country': 'Brazil', 'facility': 'Instituto do Cancer do Estado de Sao Paulo - ICESP ( Site 0302)', 'geoPoint': {'lat': -23.5475, 'lon': -46.63611}}, {'zip': '01321-001', 'city': 'São Paulo', 'country': 'Brazil', 'facility': 'BP - A Beneficencia Portuguesa de São Paulo-Medical Oncology ( Site 0300)', 'geoPoint': {'lat': -23.5475, 'lon': -46.63611}}, {'zip': '01525-001', 'city': 'São Paulo', 'country': 'Brazil', 'facility': 'A.C. 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