Ignite Creation Date:
2025-12-25 @ 1:45 AM
Ignite Modification Date:
2025-12-26 @ 12:03 AM
Study NCT ID:
NCT04767594
Status:
ACTIVE_NOT_RECRUITING
Last Update Posted:
2025-07-08
First Post:
2021-01-21
Is NOT Gene Therapy:
True
Has Adverse Events:
False
Brief Title:
First-line Palbociclib and Endocrine Therapy for Patients With HR+/HER2- Advanced Breast Cancer in the Real-world Setting.
Sponsor:
Organization:
Raw JSON
{'hasResults': False, 'derivedSection': {'miscInfoModule': {'versionHolder': '2025-12-24'}, 'conditionBrowseModule': {'meshes': [{'id': 'D001943', 'term': 'Breast Neoplasms'}], 'ancestors': [{'id': 'D009371', 'term': 'Neoplasms by Site'}, {'id': 'D009369', 'term': 'Neoplasms'}, {'id': 'D001941', 'term': 'Breast Diseases'}, {'id': 'D012871', 'term': 'Skin Diseases'}, {'id': 'D017437', 'term': 'Skin and Connective Tissue Diseases'}]}, 'interventionBrowseModule': {'meshes': [{'id': 'C500026', 'term': 'palbociclib'}]}}, 'protocolSection': {'designModule': {'studyType': 'OBSERVATIONAL', 'designInfo': {'timePerspective': 'PROSPECTIVE', 'observationalModel': 'COHORT'}, 'enrollmentInfo': {'type': 'ACTUAL', 'count': 1409}, 'patientRegistry': False}, 'statusModule': {'overallStatus': 'ACTIVE_NOT_RECRUITING', 'startDateStruct': {'date': '2020-10-27', 'type': 'ACTUAL'}, 'expandedAccessInfo': {'hasExpandedAccess': False}, 'statusVerifiedDate': '2025-07', 'completionDateStruct': {'date': '2029-04-30', 'type': 'ESTIMATED'}, 'lastUpdateSubmitDate': '2025-07-02', 'studyFirstSubmitDate': '2021-01-21', 'studyFirstSubmitQcDate': '2021-02-22', 'lastUpdatePostDateStruct': {'date': '2025-07-08', 'type': 'ACTUAL'}, 'studyFirstPostDateStruct': {'date': '2021-02-23', 'type': 'ACTUAL'}, 'primaryCompletionDateStruct': {'date': '2029-04-30', 'type': 'ESTIMATED'}}, 'outcomesModule': {'primaryOutcomes': [{'measure': 'Progression-free survival (PFS)', 'timeFrame': 'from date of start of first-line treatment until the date of first documented disease progression or date of death from any cause, whichever came first, assessed up to 7.5 years'}], 'secondaryOutcomes': [{'measure': 'Cohort-specific PFS of second-line treatment', 'timeFrame': 'from date of start of second-line treatment until the date of first subsequent documented disease progression or date of death from any cause, whichever came first, assessed up to 7.5 years', 'description': 'Cohorts are defined by substance class of second-line therapy following first-line endocrine-based palbociclib therapy'}, {'measure': 'Cohort-specific PFS2', 'timeFrame': 'from date of start of first-line treatment until the date of documented disease progression on the respective second-line treatment or date of death from any cause, whichever came first, assessed up to 7.5 years'}, {'measure': 'Landmark progression-free survival rates (PFSR) of first- and second-line treatment', 'timeFrame': 'proportion of patients without documented disease progression or death due to any cause at defined intervals after start of first-/second-line treatment (at 6, 12, 18, 24, 30, 36 months)'}, {'measure': 'Overall survival (OS)', 'timeFrame': 'from date of start of first-line treatment until the date of documented death from any cause, assessed up to 7.5 years'}, {'measure': 'Landmark overall survival rates (OSR)', 'timeFrame': 'proportion of patients without documented death due to any cause at defined intervals (at 12, 24, 36, 48, 60 months after start of first-line treatment)'}, {'measure': 'Objective response rate (ORR) of first- and second-line treatment', 'timeFrame': 'from date of start of first-/ second-line treatment until the date of first subsequent documented disease progression or date of death from any cause, whichever came first, assessed up to 7.5 years'}, {'measure': 'Duration of response (DoR) of first- and second-line treatment', 'timeFrame': 'from the date of first documented tumor response during first-/ second-line treatment until to the date of first subsequent documented disease progression or to death due to any cause, whichever came first, assessed up to 7.5 years'}, {'measure': 'Disease control rate (DCR) of first- and second-line treatment', 'timeFrame': 'proportion of patients with documented tumor response during first-/second-line treatment (as assessed by local investigator in routine clinical practice) or stable disease (SD) over a period of at least 24 weeks after start of first-line treatment'}, {'measure': 'Progression-free survival (PFS) of third-line treatment', 'timeFrame': 'from date of start of third-line treatment until the date of first subsequent documented disease progression or date of death from any cause, whichever came first, assessed up to 7.5 years'}, {'measure': 'Time to first subsequent therapy (TFST)', 'timeFrame': 'from date of start of first-line treatment until the date of start of first subsequent systemic antineoplastic treatment, assessed up to 7.5 years'}, {'measure': 'Time to first subsequent chemotherapy (TFSC)', 'timeFrame': 'from date of start of first-line treatment until the date of start of first subsequent systemic chemotherapy or chemotherapy-based antineoplastic treatment, assessed up to 7.5 years'}, {'measure': 'Change from baseline in the FACT-B total score', 'timeFrame': 'from the date of first questionnaire assessment until the date of last questionnaire assessment, assessed at baseline, thereafter 3-monthly until end of study, and at the end of palbociclib treatment, up to 7.5 years.', 'description': "The FACT-B is a 37-item instrument designed to measure five domains of Health-Related Quality of Life (HRQOL) in breast cancer patients: Physical Well-being (PWB), Social/family Well-being (SWB), Emotional Well-being (EWB), Functional Well-being (FWB) as well as a Breast Cancer Subscale (BCS).\n\nUtilized with the 27 core FACT-G items, the FACT-B was developed with an emphasis on patients' values and brevity.\n\nFor all questions, participants are asked to respond to a 5-point Likert-type scale where 0=not at all, 1=a little bit, 2=somewhat, 3=quite a bit, and 4=very much. The higher the score, the better the QOL (minimum 0; maximum 148)."}, {'measure': 'Change from baseline in the FACT-G total score', 'timeFrame': 'from the date of first questionnaire assessment until the date of last questionnaire assessment, assessed at baseline, thereafter 3-monthly until end of study, and at the end of palbociclib treatment, up to 7.5 years.', 'description': 'The FACT-G is a 27-item instrument designed to measure four domains of HRQOL in breast cancer patients: PWB, SWB, EWB, and FWB.\n\nFor all questions, participants are asked to respond to a 5-point Likert-type scale where 0=not at all, 1=a little bit, 2=somewhat, 3=quite a bit, and 4=very much. The higher the score, the better the QOL (minimum 0; maximum 108).'}, {'measure': 'Change from baseline in the FACT-B subscales scores: PWB, SWB, EWB, FWB and additional concerns for BCS.', 'timeFrame': 'from the date of first questionnaire assessment until the date of last questionnaire assessment, assessed at baseline, thereafter 3-monthly until end of study, and at the end of palbociclib treatment, up to 7.5 years.', 'description': "The FACT-B is a 37-item instrument designed to measure five domains of HRQOL in breast cancer patients: PWB, SWB, EWB, FWB as well as a BCS. Utilized with the 27 core FACT-G items, the FACT-B was developed with an emphasis on patients' values and brevity.\n\nFor all questions, participants are asked to respond to a 5-point Likert-type scale where 0=not at all, 1=a little bit, 2=somewhat, 3=quite a bit, and 4=very much. The higher the score, the better the QOL (PWB: minimum 0; maximum 28. SWB: minimum 0; maximum 28. EWB: minimum 0; maximum 24. FWB: minimum 0; maximum 28. BCS: minimum 0; maximum 40)."}, {'measure': 'Change from baseline in FACT-B Trial Outcome Index (TOI)', 'timeFrame': 'from the date of first questionnaire assessment until the date of last questionnaire assessment, assessed at baseline, thereafter 3-monthly until end of study, and at the end of palbociclib treatment, up to 7.5 years.', 'description': "The FACT-B is a 37-item instrument designed to measure five domains of HRQOL in breast cancer patients: PWB, SWB, EWB, FWB as well as a BCS. Utilized with the 27 core FACT-G items, the FACT-B was developed with an emphasis on patients' values and brevity. The TOI combines the PWB+FWB+BCS items, making it 24-items altogether.\n\nFor all questions, participants are asked to respond to a 5-point Likert-type scale where 0=not at all, 1=a little bit, 2=somewhat, 3=quite a bit, and 4=very much. The higher the score, the better the QOL (minimum 0; maximum 96)."}, {'measure': 'Time to deterioration (TTD) in FACT-B total score', 'timeFrame': 'From the date of first questionnaire assessment until the date of first subsequent questionnaire with a decrease of ≥ 7 points in FACT-B total score or death, whichever came first, assessed up to 7.5 years.', 'description': "The FACT-B is a 37-item instrument designed to measure five domains of HRQOL in breast cancer patients: PWB, SWB, EWB, FWB as well as a BCS. Utilized with the 27 core FACT-G items, the FACT-B was developed with an emphasis on patients' values and brevity.\n\nFor all questions, participants are asked to respond to a 5-point Likert-type scale where 0=not at all, 1=a little bit, 2=somewhat, 3=quite a bit, and 4=very much. The higher the score, the better the QOL (minimum 0; maximum 148)."}, {'measure': 'Landmark analyses of cohort-specific Area Under the Curve (AUC) in the Functional Assessment of Cancer Therapy - Breast (FACT-B) TOI-Physical/Functional/Breast (TOI-PFB)', 'timeFrame': 'From the date of first questionnaire assessment until 12, 24, 36, 48 months thereafter (irrespective of disease or treatment situation at that time point)', 'description': 'Cohorts are defined by substance class of second-line therapy following first-line endocrine-based palbociclib therapy.'}]}, 'oversightModule': {'oversightHasDmc': False}, 'conditionsModule': {'conditions': ['Breast Neoplasms']}, 'referencesModule': {'references': [{'pmid': '36427183', 'type': 'DERIVED', 'citation': "Lux MP, Runkel ED, Glastetter E, Vannier C, Buncke J, Frank M, Bartsch R, Thill M, Wockel A. PERFORM: a non-interventional study assessing the patients' treatment starting with 1L palbociclib in HR+/HER2- ABC. Future Oncol. 2022 Nov;18(36):3971-3982. doi: 10.2217/fon-2022-0552. Epub 2022 Nov 25."}], 'seeAlsoLinks': [{'url': 'https://pmiform.com/clinical-trial-info-request?StudyID=A5481152', 'label': 'To obtain contact information for a study center near you, click here.'}]}, 'descriptionModule': {'briefSummary': 'This is a prospective, single-arm, multi-center observational non-interventional study (NIS) in Germany and Austria.', 'detailedDescription': "Patients diagnosed with HR+/HER2- locally advanced or metastatic breast cancer indicated by their treating physicians for first line endocrine-based palbociclib combination therapy and who meet eligibility criteria will be invited to participate in this study. The key objectives of this study are to describe clinical, scientific and patient reported outcomes for patients with HR+/HER2- locally advanced or metastatic breast cancer initiating treatment with first line endocrine-based palbociclib combination therapy in the real-world setting in Germany and Austria. Patient characteristics, real-world treatment patterns, treatment sequences and reasons for the physician's treatment decisions will be collected. Additional real-world research questions are to explore patient-focused parameters such as longitudinal follow-up data on patient-reported outcomes beyond disease progression and by treatment sequence or to analyze the time from the start of first line treatment to the first administered palliative chemotherapy. Clinical outcome by treatment sequences will be described. Routinely assessed biomarkers and diagnostic procedures applied for treatment sequence decisions will be collected."}, 'eligibilityModule': {'sex': 'ALL', 'stdAges': ['ADULT', 'OLDER_ADULT'], 'minimumAge': '18 Years', 'samplingMethod': 'NON_PROBABILITY_SAMPLE', 'studyPopulation': 'Patients diagnosed with HR+/HER2- locally advanced or metastatic breast cancer indicated by their treating physicians for first line endocrine-based palbociclib combination therapy and who meet eligibility criteria will be invited to participate in this study.', 'healthyVolunteers': False, 'eligibilityCriteria': "Patients must meet all of the following inclusion criteria to be eligible for inclusion in the study:\n\n1. Evidence of a personally signed and dated informed consent document indicating that the patient has been informed of all pertinent aspects of the study.\n2. Diagnosis of HR+/HER2- locally advanced, inoperable or metastatic breast cancer.\n3. Physician has determined that first-line treatment with palbociclib (i) in combination with an aromatase inhibitor, or (ii) in combination with fulvestrant in women who received prior endocrine therapy as per current local product label is indicated. In pre- or perimenopausal women, the endocrine therapy should be combined with a luteinizing hormone-releasing hormone (LHRH) agonist.\n4. Patients who in the opinion of the investigator are willing and able to comply with regular clinic visits as per local standard of care practice at the study site.\n5. Age of 18 years or older.\n\nPatients meeting any of the following criteria will not be included in the study:\n\n1. Any contraindication as per current local product label.\n2. Prior systemic antineoplastic treatment for advanced disease. Exception: Start of first line treatment with palbociclib in combination with aromatase inhibitor or fulvestrant as per current local product label is allowed up to 4 weeks prior to inclusion.\n3. Patients currently participating in any interventional clinical trial that includes investigational or marketed products at the time of enrollment. Note: A concomitant participation in other non-interventional/observational studies, registries and translational research networks (e.g., PRAEGNANT, OPAL) or chart reviews is allowed.\n4. Patients who are unable to understand the nature of the study or are unwilling to sign an informed consent.\n\nPatient eligibility should be reviewed, documented, and confirmed by an appropriately qualified member of the investigator's study team before patients are enrolled in the study."}, 'identificationModule': {'nctId': 'NCT04767594', 'acronym': 'PERFORM', 'briefTitle': 'First-line Palbociclib and Endocrine Therapy for Patients With HR+/HER2- Advanced Breast Cancer in the Real-world Setting.', 'organization': {'class': 'INDUSTRY', 'fullName': 'Pfizer'}, 'officialTitle': 'PERFORM: An EPidEmiological, PRospective Cohort Study to Generate Real-world Evidence in Patients With HR+/HER2- Advanced Breast Cancer Treated in the First Line Setting as Per Current Standard Of Care With an EndocRine-based Palbociclib CoMbination Therapy', 'orgStudyIdInfo': {'id': 'A5481152'}, 'secondaryIdInfos': [{'id': 'PERFORM-NIS', 'type': 'OTHER', 'domain': 'Alias Study Number'}]}, 'armsInterventionsModule': {'armGroups': [{'label': 'First-line Palbociclib + endocrine therapy', 'description': 'Palbociclib + letrozole, or Palbociclib + anastrozole, or Palbociclib + exemestane, or Palbociclib + fulvestrant after prior endocrine therapy', 'interventionNames': ['Drug: Palbociclib + endocrine therapy']}], 'interventions': [{'name': 'Palbociclib + endocrine therapy', 'type': 'DRUG', 'description': 'Palbociclib + letrozole, or Palbociclib + anastrozole, or Palbociclib + exemestane, or Palbociclib + fulvestrant after prior endocrine therapy In pre- or perimenopausal women, the endocrine therapy should be combined with a luteinizing hormone-releasing hormone (LHRH) agonist.', 'armGroupLabels': ['First-line Palbociclib + endocrine therapy']}]}, 'contactsLocationsModule': {'locations': [{'zip': '5280', 'city': 'Braunau am Inn', 'country': 'Austria', 'facility': 'Sankt Josef Hospital Braunau', 'geoPoint': {'lat': 48.25628, 'lon': 13.04343}}, {'zip': '6020', 'city': 'Innsbruck', 'country': 'Austria', 'facility': 'Medizinische Universität Innsbruck', 'geoPoint': {'lat': 47.26266, 'lon': 11.39454}}, {'zip': '9020', 'city': 'Klagenfurt', 'country': 'Austria', 'facility': 'Klinikum Klagenfurt am Woerthersee', 'geoPoint': {'lat': 46.62472, 'lon': 14.30528}}, {'zip': '5020', 'city': 'Salzburg', 'country': 'Austria', 'facility': 'Country Hospital Salzburg', 'geoPoint': {'lat': 47.79941, 'lon': 13.04399}}, {'zip': '3100', 'city': 'Sankt Pölten', 'country': 'Austria', 'facility': 'Universitaetsklinikum Sankt Poelten', 'geoPoint': {'lat': 48.20762, 'lon': 15.63725}}, {'zip': '6130', 'city': 'Schwaz', 'country': 'Austria', 'facility': 'Priv. Doz. OA Dr. Michael Hubalek', 'geoPoint': {'lat': 47.35169, 'lon': 11.71014}}, {'zip': '1090', 'city': 'Vienna', 'country': 'Austria', 'facility': 'Medizinische Universität Wien, Abteilung Innere Medizin I', 'geoPoint': {'lat': 48.20849, 'lon': 16.37208}}, {'zip': '1090', 'city': 'Vienna', 'country': 'Austria', 'facility': 'Medizinische Universität Wien', 'geoPoint': {'lat': 48.20849, 'lon': 16.37208}}, {'zip': '1140', 'city': 'Vienna', 'country': 'Austria', 'facility': 'Oesterreichische Gesundheitskasse Hanusch-Krankenhaus', 'geoPoint': {'lat': 48.20849, 'lon': 16.37208}}, {'zip': '95445', 'city': 'Bayreuth', 'state': 'Bavaria', 'country': 'Germany', 'facility': 'Klinikum Bayreuth GmbH', 'geoPoint': {'lat': 49.94782, 'lon': 11.57893}}, {'zip': '90419', 'city': 'Nuremberg', 'state': 'Bavaria', 'country': 'Germany', 'facility': 'Klinikum Nürnberg', 'geoPoint': {'lat': 49.45421, 'lon': 11.07752}}, {'zip': '03048', 'city': 'Cottbus', 'state': 'Brandenburg', 'country': 'Germany', 'facility': 'Medizinische Universität Lausitz Carl Thiem', 'geoPoint': {'lat': 51.75769, 'lon': 14.32888}}, {'zip': '38642', 'city': 'Goslar', 'state': 'Lower Saxony', 'country': 'Germany', 'facility': 'Onkologische Kooperation Harz', 'geoPoint': {'lat': 51.90425, 'lon': 10.42766}}, {'zip': '97980', 'city': 'Bad Mergentheim', 'state': 'Other', 'country': 'Germany', 'facility': 'Caritas-Krankenhaus Bad Mergentheim', 'geoPoint': {'lat': 49.4925, 'lon': 9.77361}}, {'zip': '12107', 'city': 'Berlin', 'state': 'Other', 'country': 'Germany', 'facility': 'Mvz Etgo Gmbh', 'geoPoint': {'lat': 52.52437, 'lon': 13.41053}}, {'zip': '28209', 'city': 'Bremen', 'state': 'Other', 'country': 'Germany', 'facility': 'Onkologisch-Hämatologische Schwerpunktpraxis', 'geoPoint': {'lat': 53.07582, 'lon': 8.80717}}, {'zip': '91522', 'city': 'Ansbach', 'country': 'Germany', 'facility': 'ANregiomed gKU', 'geoPoint': {'lat': 49.30481, 'lon': 10.5931}}, {'zip': '59759', 'city': 'Arnsberg', 'country': 'Germany', 'facility': 'Alexianer Klinikum Hochsauerland GmbH', 'geoPoint': {'lat': 51.38333, 'lon': 8.08333}}, {'zip': '86150', 'city': 'Augsburg', 'country': 'Germany', 'facility': 'Group practice Heinrich', 'geoPoint': {'lat': 48.37154, 'lon': 10.89851}}, {'zip': '86150', 'city': 'Augsburg', 'country': 'Germany', 'facility': 'Group Practice Steinfeld-Birg', 'geoPoint': {'lat': 48.37154, 'lon': 10.89851}}, {'zip': '83435', 'city': 'Bad Reichenhall', 'country': 'Germany', 'facility': 'Group practice Tanzer', 'geoPoint': {'lat': 47.72947, 'lon': 12.87819}}, {'zip': '65812', 'city': 'Bad Soden a.T.', 'country': 'Germany', 'facility': 'Group practice Seipelt'}, {'zip': '76532', 'city': 'Baden-Baden', 'country': 'Germany', 'facility': 'Klinikum Mittelbaden Baden-Baden Balg', 'geoPoint': {'lat': 48.7606, 'lon': 8.23975}}, {'zip': '96049', 'city': 'Bamberg', 'country': 'Germany', 'facility': 'Sozialstiftung Bamberg Klinikum am Bruderwald', 'geoPoint': {'lat': 49.89873, 'lon': 10.90067}}, {'zip': '95445', 'city': 'Bayreuth', 'country': 'Germany', 'facility': 'Private Practice Bayreuth', 'geoPoint': {'lat': 49.94782, 'lon': 11.57893}}, {'zip': '10117', 'city': 'Berlin', 'country': 'Germany', 'facility': 'Charité Campus Mitte', 'geoPoint': {'lat': 52.52437, 'lon': 13.41053}}, {'zip': '10117', 'city': 'Berlin', 'country': 'Germany', 'facility': 'Hämatologie Onkologie Berlin-Mitte', 'geoPoint': {'lat': 52.52437, 'lon': 13.41053}}, {'zip': '10367', 'city': 'Berlin', 'country': 'Germany', 'facility': 'MediOnko-Institut GbR', 'geoPoint': {'lat': 52.52437, 'lon': 13.41053}}, {'zip': '12559', 'city': 'Berlin', 'country': 'Germany', 'facility': 'DRK Kliniken Berlin-Köpenick Brustzentrum', 'geoPoint': {'lat': 52.52437, 'lon': 13.41053}}, {'zip': '12683', 'city': 'Berlin', 'country': 'Germany', 'facility': 'Vivantes MVZ Hellersdorf - Zweigpraxis Biesdorf', 'geoPoint': {'lat': 52.52437, 'lon': 13.41053}}, {'zip': '13156', 'city': 'Berlin', 'country': 'Germany', 'facility': 'Group practice Morack', 'geoPoint': {'lat': 52.52437, 'lon': 13.41053}}, {'zip': '13407', 'city': 'Berlin', 'country': 'Germany', 'facility': 'Vivantes Netzwerk für Gesundheit GmbH', 'geoPoint': {'lat': 52.52437, 'lon': 13.41053}}, {'zip': '14169', 'city': 'Berlin', 'country': 'Germany', 'facility': 'Frauenarzt-Zentrum-Zehlendorf', 'geoPoint': {'lat': 52.52437, 'lon': 13.41053}}, {'zip': '85400', 'city': 'Biberach an der Riss', 'country': 'Germany', 'facility': 'Dr. Leonid Basovski Hämatologikum Biberach', 'geoPoint': {'lat': 48.09345, 'lon': 9.79053}}, {'zip': '33617', 'city': 'Bielefeld', 'country': 'Germany', 'facility': 'Evangelisches Klinikum Bethel gGmbH, Klinik für Innere Medizin, Hämatologie, Onkologie', 'geoPoint': {'lat': 52.03333, 'lon': 8.53333}}, {'zip': '44787', 'city': 'Bochum', 'country': 'Germany', 'facility': 'Group practice Bueckner', 'geoPoint': {'lat': 51.48165, 'lon': 7.21648}}, {'zip': '53123', 'city': 'Bonn', 'country': 'Germany', 'facility': 'Praxiskooperation Onkologie Bonn / Euskirchen / Rheinbach / Wesseling GbR', 'geoPoint': {'lat': 50.73438, 'lon': 7.09549}}, {'zip': '46236', 'city': 'Bottrop', 'country': 'Germany', 'facility': 'Group practice Hannig', 'geoPoint': {'lat': 51.52392, 'lon': 6.9285}}, {'zip': '46236', 'city': 'Bottrop', 'country': 'Germany', 'facility': 'Marienhospital Bottrop gGmbH', 'geoPoint': {'lat': 51.52392, 'lon': 6.9285}}, {'zip': '46236', 'city': 'Bottrop', 'country': 'Germany', 'facility': 'ONKO DOK GbR', 'geoPoint': {'lat': 51.52392, 'lon': 6.9285}}, {'zip': '71032', 'city': 'Böblingen', 'country': 'Germany', 'facility': 'Kliniken Boeblingen', 'geoPoint': {'lat': 48.68212, 'lon': 9.01171}}, {'zip': '14770', 'city': 'Brandenburg', 'country': 'Germany', 'facility': 'Staedtisches Klinikum Brandenburg GmbH', 'geoPoint': {'lat': 52.41667, 'lon': 12.55}}, {'zip': '14770', 'city': 'Brandenburg a.d.H.', 'country': 'Germany', 'facility': 'Private practice Brandenburg a.d.H.'}, {'zip': '27574', 'city': 'Bremerhaven', 'country': 'Germany', 'facility': 'Klinikum Bremerhaven Reinkenheide gGmbH', 'geoPoint': {'lat': 53.55357, 'lon': 8.57553}}, {'zip': '76646', 'city': 'Bruchsal', 'country': 'Germany', 'facility': 'Fürst-Stirum-Klinik Bruchsal Klinik für Frauenheilkunde und Geburtshilfe', 'geoPoint': {'lat': 49.12426, 'lon': 8.59804}}, {'zip': '29223', 'city': 'Celle', 'country': 'Germany', 'facility': 'AKH-Gruppe-Allgemeines Krankenhaus Celle + MVZ gGmbH', 'geoPoint': {'lat': 52.62264, 'lon': 10.08047}}, {'zip': '09116', 'city': 'Chemnitz', 'country': 'Germany', 'facility': 'Klinikum Chemnitz gGmbH', 'geoPoint': {'lat': 50.8357, 'lon': 12.92922}}, {'zip': '09117', 'city': 'Chemnitz', 'country': 'Germany', 'facility': 'Private Practice Jungberg', 'geoPoint': {'lat': 50.8357, 'lon': 12.92922}}, {'zip': '50679', 'city': 'Cologne', 'country': 'Germany', 'facility': 'private practice Ziegler-Loehr', 'geoPoint': {'lat': 50.93333, 'lon': 6.95}}, {'zip': '50935', 'city': 'Cologne', 'country': 'Germany', 'facility': 'St. Elisabeth Krankenhaus GmbH', 'geoPoint': {'lat': 50.93333, 'lon': 6.95}}, {'zip': '45711', 'city': 'Datteln', 'country': 'Germany', 'facility': 'St. Vincenz-Krankenhaus', 'geoPoint': {'lat': 51.65598, 'lon': 7.3453}}, {'zip': '86609', 'city': 'Donauwörth', 'country': 'Germany', 'facility': 'Onkologiezentrum Donauwoerth', 'geoPoint': {'lat': 48.71804, 'lon': 10.7793}}, {'zip': '44137', 'city': 'Dortmund', 'country': 'Germany', 'facility': 'Klinikum Dortmund Frauenklinik', 'geoPoint': {'lat': 51.51494, 'lon': 7.466}}, {'zip': '44263', 'city': 'Dortmund', 'country': 'Germany', 'facility': 'Studiengesellschaft Gefos Dortmund mbH', 'geoPoint': {'lat': 51.51494, 'lon': 7.466}}, {'zip': '01127', 'city': 'Dresden', 'country': 'Germany', 'facility': 'Group practice Goehler', 'geoPoint': {'lat': 51.05089, 'lon': 13.73832}}, {'zip': '01307', 'city': 'Dresden', 'country': 'Germany', 'facility': 'Gemeinschaftspraxis', 'geoPoint': {'lat': 51.05089, 'lon': 13.73832}}, {'zip': '01307', 'city': 'Dresden', 'country': 'Germany', 'facility': 'Group practice Jacobasch', 'geoPoint': {'lat': 51.05089, 'lon': 13.73832}}, {'zip': '47166', 'city': 'Duisburg', 'country': 'Germany', 'facility': 'Naedler GmbH', 'geoPoint': {'lat': 51.43247, 'lon': 6.76516}}, {'zip': '52353', 'city': 'Düren', 'country': 'Germany', 'facility': 'St. Marien-Hospital', 'geoPoint': {'lat': 50.80434, 'lon': 6.49299}}, {'zip': '85560', 'city': 'Ebersberg', 'country': 'Germany', 'facility': 'Private Practice Groell', 'geoPoint': {'lat': 48.0771, 'lon': 11.97063}}, {'zip': '84307', 'city': 'Eggenfelden', 'country': 'Germany', 'facility': 'Studienzentrale für das MVZ Eggenfelde e.K.', 'geoPoint': {'lat': 48.40509, 'lon': 12.75752}}, {'zip': '99817', 'city': 'Eisenach', 'country': 'Germany', 'facility': 'St. Georg Klinikum Eisenach gGmbH', 'geoPoint': {'lat': 50.9807, 'lon': 10.31522}}, {'zip': '99085', 'city': 'Erfurt', 'country': 'Germany', 'facility': 'Group practice Weniger', 'geoPoint': {'lat': 50.97734, 'lon': 11.03536}}, {'zip': '91052', 'city': 'Erlangen', 'country': 'Germany', 'facility': 'Group practice Haecker', 'geoPoint': {'lat': 49.59099, 'lon': 11.00783}}, {'zip': '24787', 'city': 'Fockbek', 'country': 'Germany', 'facility': 'imland gGmbH', 'geoPoint': {'lat': 54.30501, 'lon': 9.59884}}, {'zip': '60590', 'city': 'Frankfurt am Main', 'country': 'Germany', 'facility': 'Universitaetsklinikum Frankfurt Frauenheilkunde', 'geoPoint': {'lat': 50.11552, 'lon': 8.68417}}, {'zip': '50226', 'city': 'Frechen', 'country': 'Germany', 'facility': 'pioh Studien und Management GbR', 'geoPoint': {'lat': 50.91485, 'lon': 6.8118}}, {'zip': '79110', 'city': 'Freiburg im Breisgau', 'country': 'Germany', 'facility': 'Group Practice Dr. med. M. 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