Ignite Creation Date:
2025-12-24 @ 7:36 PM
Ignite Modification Date:
2026-01-02 @ 1:59 PM
Study NCT ID:
NCT05123703
Status:
ACTIVE_NOT_RECRUITING
Last Update Posted:
2025-09-22
First Post:
2021-11-16
Is Gene Therapy:
True
Has Adverse Events:
False
Brief Title:
A Study to Evaluate Safety and Efficacy of Ocrelizumab in Comparison With Fingolimod in Children and Adolescents With Relapsing-Remitting Multiple Sclerosis (RRMS)
Sponsor:
Organization:
Raw JSON
{'hasResults': False, 'derivedSection': {'miscInfoModule': {'versionHolder': '2025-12-24', 'removedCountries': ['Bulgaria', 'Croatia', 'Denmark', 'Netherlands', 'Russia', 'Turkey (Türkiye)']}, 'conditionBrowseModule': {'meshes': [{'id': 'D020529', 'term': 'Multiple Sclerosis, Relapsing-Remitting'}], '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'}]}, 'interventionBrowseModule': {'meshes': [{'id': 'C533411', 'term': 'ocrelizumab'}, {'id': 'D000068876', 'term': 'Fingolimod Hydrochloride'}], 'ancestors': [{'id': 'D013110', 'term': 'Sphingosine'}, {'id': 'D000605', 'term': 'Amino Alcohols'}, {'id': 'D000438', 'term': 'Alcohols'}, {'id': 'D009930', 'term': 'Organic Chemicals'}, {'id': 'D011409', 'term': 'Propylene Glycols'}, {'id': 'D006018', 'term': 'Glycols'}, {'id': 'D000588', 'term': 'Amines'}]}}, 'protocolSection': {'designModule': {'phases': ['PHASE3'], 'studyType': 'INTERVENTIONAL', 'designInfo': {'allocation': 'RANDOMIZED', 'maskingInfo': {'masking': 'QUADRUPLE', 'whoMasked': ['PARTICIPANT', 'CARE_PROVIDER', 'INVESTIGATOR', 'OUTCOMES_ASSESSOR']}, 'primaryPurpose': 'TREATMENT', 'interventionModel': 'PARALLEL'}, 'enrollmentInfo': {'type': 'ACTUAL', 'count': 188}}, 'statusModule': {'overallStatus': 'ACTIVE_NOT_RECRUITING', 'startDateStruct': {'date': '2022-05-19', 'type': 'ACTUAL'}, 'expandedAccessInfo': {'hasExpandedAccess': False}, 'statusVerifiedDate': '2025-09', 'completionDateStruct': {'date': '2029-09-17', 'type': 'ESTIMATED'}, 'lastUpdateSubmitDate': '2025-09-19', 'studyFirstSubmitDate': '2021-11-16', 'studyFirstSubmitQcDate': '2021-11-16', 'lastUpdatePostDateStruct': {'date': '2025-09-22', 'type': 'ESTIMATED'}, 'studyFirstPostDateStruct': {'date': '2021-11-17', 'type': 'ACTUAL'}, 'primaryCompletionDateStruct': {'date': '2025-06-09', 'type': 'ACTUAL'}}, 'outcomesModule': {'primaryOutcomes': [{'measure': 'Annualized Relapse Rate (ARR)', 'timeFrame': 'Baseline up to approximately 4 years'}], 'secondaryOutcomes': [{'measure': 'Number of New or Enlarging T2-hyperintense Lesions (T2 lesions) as Detected by Brain Magnetic Resonance Imaging (MRI) During the Double-blind Period', 'timeFrame': 'Baseline up to approximately 4 years'}, {'measure': 'Number of New or Enlarging T2 Lesions by Week 96', 'timeFrame': 'Baseline up to Week 96'}, {'measure': 'ARR by Week 96', 'timeFrame': 'Baseline up to Week 96'}, {'measure': 'Number of T1 Gadolinium (Gd) Lesions at Week 12', 'timeFrame': 'Week 12'}, {'measure': 'Incidence and Severity of Adverse Events (AEs), With Severity Determined According to National Cancer Institute Common Terminology Criteria for Adverse Events, Version 5.0 (NCI CTCAE v5.0)', 'timeFrame': 'Baseline up to approximately 8 years'}, {'measure': 'Prevalence of Anti-drug Antibodies (ADAs) at Baseline and Incidence of ADAs During the Study', 'timeFrame': 'Baseline up to approximately 8 years'}]}, 'oversightModule': {'oversightHasDmc': True, 'isFdaRegulatedDrug': True, 'isFdaRegulatedDevice': False}, 'conditionsModule': {'keywords': ['pediatric Multiple Sclerosis', 'pediatric MS', 'children MS', 'children Multiple Sclerosis', 'pediatric ocrelizumab'], 'conditions': ['Relapsing-Remitting Multiple Sclerosis']}, 'referencesModule': {'references': [{'pmid': '39812825', 'type': 'DERIVED', 'citation': 'Mar S, Valeriani M, Steinborn B, Schreiner T, Waubant E, Filippi M, Kotulska K, Mazurkiewicz-Beldzinska M, El Azzouzi B, Lin CJ, Shen YA, Kletzl H, Evershed J, Hogea A, Manlius C, Bonati U, Banwell B. Ocrelizumab dose selection for treatment of pediatric relapsing-remitting multiple sclerosis: results of the OPERETTA I study. J Neurol. 2025 Jan 15;272(2):137. doi: 10.1007/s00415-024-12879-z.'}]}, 'descriptionModule': {'briefSummary': 'This double-blind, double-dummy study will evaluate the safety and efficacy of ocrelizumab compared with fingolimod in children and adolescents with RRMS aged between 10 and \\< 18 years over a flexible duration. The double-blind period will last until after the last participant randomized has completed 24 weeks.', 'detailedDescription': 'This Phase III randomized, double-blind, double-dummy, multicenter study will evaluate the safety and efficacy of ocrelizumab administered by IV infusion every 24 weeks compared with fingolimod taken orally daily, in children and adolescents with RRMS aged between 10 and \\< 18 years. The study plans to enroll 171 participants in a 1:1 randomization (ocrelizumab:fingolimod), globally. This study consists of a double-blind, double dummy period in which participants will be treated with either active ocrelizumab or active fingolimod for a flexible duration. Participants who complete the double-blind period will be offered the possibility to enter an optional open-label extension (OLE) treatment period of at least 144 weeks with ocrelizumab.'}, 'eligibilityModule': {'sex': 'ALL', 'stdAges': ['CHILD'], 'maximumAge': '17 Years', 'minimumAge': '10 Years', 'healthyVolunteers': False, 'eligibilityCriteria': 'Inclusion Criteria:\n\n* Body weight ≥ 25 kilograms (kg)\n* Diagnosis of RRMS in accordance with the International Pediatric Multiple Sclerosis Study Group (IPMSSG) criteria for pediatric Multiple Sclerosis (MS), Version 2012, or McDonald criteria 2017\n* Expanded Disability Status Scale (EDSS) at screening: 0-5.5, inclusive\n* For all countries except Germany, at least one MS relapse during the previous year or two MS relapses in the previous 2 years or evidence of at least one Gd enhancing lesion on MRI within 6 months\n\nInclusion Criteria for Optional OLE Period:\n\n-Participants in Group A (ocrelizumab in the double-blind period \\[DBP\\]) and Group B (fingolimod in the DBP) who, in the opinion of the investigator, may benefit from switching to ocrelizumab and who have completed the DBP with study treatment (ocrelizumab/fingolimod), may participate in the OLE period\n\nExclusion Criteria:\n\n* Known presence or suspicion of other neurologic disorders that may mimic MS\n* Significant uncontrolled somatic diseases, known active infection or any other significant condition that may preclude participant from participating in the study\n* Participants with severe cardiac disease or significant findings on the screening Electrocardiograph (ECG)\n\nExclusion Criteria for Optional OLE Period:\n\n-Participants who have discontinued the study during the DBP'}, 'identificationModule': {'nctId': 'NCT05123703', 'acronym': 'Operetta 2', 'briefTitle': 'A Study to Evaluate Safety and Efficacy of Ocrelizumab in Comparison With Fingolimod in Children and Adolescents With Relapsing-Remitting Multiple Sclerosis (RRMS)', 'organization': {'class': 'INDUSTRY', 'fullName': 'Hoffmann-La Roche'}, 'officialTitle': 'A Phase III Multicenter, Randomized, Double-blind, Double-dummy Study to Evaluate Safety and Efficacy of Ocrelizumab in Comparison With Fingolimod in Children and Adolescents With Relapsing-Remitting Multiple Sclerosis', 'orgStudyIdInfo': {'id': 'WN42086'}, 'secondaryIdInfos': [{'id': '2020-004128-41', 'type': 'EUDRACT_NUMBER'}, {'id': '2023-506516-40-00', 'type': 'REGISTRY', 'domain': 'EU CT Number'}]}, 'armsInterventionsModule': {'armGroups': [{'type': 'EXPERIMENTAL', 'label': 'Ocrelizumab', 'description': 'Participants will receive ocrelizumab by intravenous (IV) infusion every 24 weeks (Q24W). The first dose is given as dual infusions of half the dose of ocrelizumab on Days 1 and 15 and subsequent doses are given as single infusions of ocrelizumab Q24W. Participants will also receive a placebo of fingolimod administered as once a day (QD) capsule.', 'interventionNames': ['Drug: Ocrelizumab', 'Other: Fingolimod Placebo']}, {'type': 'ACTIVE_COMPARATOR', 'label': 'Fingolimod', 'description': 'Participants will receive fingolimod orally (PO) QD as per the prescribing information provided with fingolimod. Participants will also receive a placebo of ocrelizumab administered as IV infusion on Days 1 and 15, and Q24W thereafter.', 'interventionNames': ['Other: Ocrelizumab Placebo', 'Drug: Fingolimod']}], 'interventions': [{'name': 'Ocrelizumab', 'type': 'DRUG', 'description': 'Ocrelizumab 300 milligrams (mg) will be administered by IV infusion to participants who weigh \\< 35 kilograms (kg) and ocrelizumab 600 mg IV will be administered to participants who weigh ≥ 35 kg on Days 1 and 15 (half the dose, 2 weeks apart) and Q24W thereafter.', 'armGroupLabels': ['Ocrelizumab']}, {'name': 'Ocrelizumab Placebo', 'type': 'OTHER', 'description': 'Ocrelizumab matching placebo will be administered by IV infusion on Day 1 and Day 15 and Q24W thereafter.', 'armGroupLabels': ['Fingolimod']}, {'name': 'Fingolimod', 'type': 'DRUG', 'description': 'Fingolimod will be administered daily as a capsule per the prescribing information (0.25 mg to participants who weigh ≤ 40 kg and 0.5 mg to participants who weigh \\> 40 kg).', 'armGroupLabels': ['Fingolimod']}, {'name': 'Fingolimod Placebo', 'type': 'OTHER', 'description': 'Fingolimod matching placebo will be administered daily as a capsule.', 'armGroupLabels': ['Ocrelizumab']}]}, 'contactsLocationsModule': {'locations': [{'zip': '92037-1337', 'city': 'La Jolla', 'state': 'California', 'country': 'United States', 'facility': 'UC San Diego', 'geoPoint': {'lat': 32.84727, 'lon': -117.2742}}, {'zip': '94117', 'city': 'San Francisco', 'state': 'California', 'country': 'United States', 'facility': 'University of California San Francisco', 'geoPoint': {'lat': 37.77493, 'lon': -122.41942}}, {'zip': '80045', 'city': 'Aurora', 'state': 'Colorado', 'country': 'United States', 'facility': "Children's Hospital Colorado", 'geoPoint': {'lat': 39.72943, 'lon': -104.83192}}, {'zip': '20010', 'city': 'Washington D.C.', 'state': 'District of Columbia', 'country': 'United States', 'facility': "Children's National Hospital", 'geoPoint': {'lat': 38.89511, 'lon': -77.03637}}, {'zip': '21287', 'city': 'Baltimore', 'state': 'Maryland', 'country': 'United States', 'facility': 'Johns Hopkins Medicine', 'geoPoint': {'lat': 39.29038, 'lon': -76.61219}}, {'zip': '02115', 'city': 'Boston', 'state': 'Massachusetts', 'country': 'United States', 'facility': "Pediatric Multiple Sclerosis and Related Disorders Program at Boston Children's Hospital", 'geoPoint': {'lat': 42.35843, 'lon': -71.05977}}, {'zip': '63101', 'city': 'St Louis', 'state': 'Missouri', 'country': 'United States', 'facility': 'Washington University', 'geoPoint': {'lat': 38.62727, 'lon': -90.19789}}, {'zip': '08901', 'city': 'New Brunswick', 'state': 'New Jersey', 'country': 'United States', 'facility': 'Robert Wood Johnson Medical School', 'geoPoint': {'lat': 40.48622, 'lon': -74.45182}}, {'zip': '44195-0001', 'city': 'Cleveland', 'state': 'Ohio', 'country': 'United States', 'facility': 'Cleveland Clinic, Mellen Center for Multiple Sclerosis', 'geoPoint': {'lat': 41.4995, 'lon': -81.69541}}, {'zip': '43235', 'city': 'Columbus', 'state': 'Ohio', 'country': 'United States', 'facility': 'The Boster Center for Multiple Sclerosis a Singlepoint Healthcare Company', 'geoPoint': {'lat': 39.96118, 'lon': -82.99879}}, {'zip': '19104', 'city': 'Philadelphia', 'state': 'Pennsylvania', 'country': 'United States', 'facility': "The Children's Hospital of Philadelphia", 'geoPoint': {'lat': 39.95238, 'lon': -75.16362}}, {'zip': '77030-2608', 'city': 'Houston', 'state': 'Texas', 'country': 'United States', 'facility': "Baylor College of Medicine/Texas Children's Hospital", 'geoPoint': {'lat': 29.76328, 'lon': -95.36327}}, {'zip': '22903', 'city': 'Charlottesville', 'state': 'Virginia', 'country': 'United States', 'facility': 'University of Virginia Health System', 'geoPoint': {'lat': 38.02931, 'lon': -78.47668}}, {'zip': '1133', 'city': 'Ciudad de Buenos Aires', 'country': 'Argentina', 'facility': 'Hospital de Pediatría S.A.M.I.C.- Prof. Dr. Juan P. Garrahan'}, {'zip': 'X5000FHP', 'city': 'Córdoba', 'country': 'Argentina', 'facility': 'Clinica Universitaria Reina Fabiola', 'geoPoint': {'lat': -31.40648, 'lon': -64.18853}}, {'zip': 'T4000AXL', 'city': 'San Miguel de Tucumán', 'country': 'Argentina', 'facility': 'Centro de Investigaciones Médicas Tucuman', 'geoPoint': {'lat': -26.81601, 'lon': -65.21051}}, {'zip': '3052', 'city': 'Parkville', 'state': 'Victoria', 'country': 'Australia', 'facility': "Royal Children's Hospital Melbourne - PIN", 'geoPoint': {'lat': -37.78333, 'lon': 144.95}}, {'zip': '1090', 'city': 'Vienna', 'country': 'Austria', 'facility': 'Medizinische Universität Wien', 'geoPoint': {'lat': 48.20849, 'lon': 16.37208}}, {'zip': '1020', 'city': 'Brussels', 'country': 'Belgium', 'facility': 'Hôpital Universitaire des Enfants Reine Fabiola', 'geoPoint': {'lat': 50.85045, 'lon': 4.34878}}, {'zip': '1200', 'city': 'Brussels', 'country': 'Belgium', 'facility': 'Cliniques Universitaires St-Luc', 'geoPoint': {'lat': 50.85045, 'lon': 4.34878}}, {'zip': '9000', 'city': 'Ghent', 'country': 'Belgium', 'facility': 'UZ Gent', 'geoPoint': {'lat': 51.05, 'lon': 3.71667}}, {'zip': '70200-730', 'city': 'Brasília', 'state': 'Federal District', 'country': 'Brazil', 'facility': 'L2 Ip - Instituto de Pesquisas Clinicas Ltda - ME', 'geoPoint': {'lat': -15.77972, 'lon': -47.92972}}, {'zip': '81210-310', 'city': 'Curitiba', 'state': 'Paraná', 'country': 'Brazil', 'facility': 'Instituto de Neurologia de Curitiba', 'geoPoint': {'lat': -25.42778, 'lon': -49.27306}}, {'zip': '95070-560', 'city': 'Caxias do Sul', 'state': 'Rio Grande do Sul', 'country': 'Brazil', 'facility': 'Universidade de Caxias do Sul - Rio Grande do Sul', 'geoPoint': {'lat': -29.16806, 'lon': -51.17944}}, {'zip': '90430-001', 'city': 'Porto Alegre', 'state': 'Rio Grande do Sul', 'country': 'Brazil', 'facility': 'Nucleo de Pesquisa Clinica do Rio Grande do Sul NPCR', 'geoPoint': {'lat': -30.03283, 'lon': -51.23019}}, {'zip': '90610-000', 'city': 'Porto Alegre', 'state': 'Rio Grande do Sul', 'country': 'Brazil', 'facility': 'Hospital Sao Lucas - PUCRS', 'geoPoint': {'lat': -30.03283, 'lon': -51.23019}}, {'zip': '01228-000', 'city': 'São Paulo', 'state': 'São Paulo', 'country': 'Brazil', 'facility': 'CPQuali Pesquisa Clínica Sao Paulo', 'geoPoint': {'lat': -23.5475, 'lon': -46.63611}}, {'zip': '05403-900', 'city': 'São Paulo', 'country': 'Brazil', 'facility': 'Inst. Da Criança- Faculdade de Medicina Usp', 'geoPoint': {'lat': -23.5475, 'lon': -46.63611}}, {'zip': 'T6G 1Z1', 'city': 'Edmonton', 'state': 'Alberta', 'country': 'Canada', 'facility': 'University of Alberta Hospital', 'geoPoint': {'lat': 53.55014, 'lon': -113.46871}}, {'zip': 'K1H 8L1', 'city': 'Ottawa', 'state': 'Ontario', 'country': 'Canada', 'facility': "Children's Hospital of Eastern Ontario", 'geoPoint': {'lat': 45.41117, 'lon': -75.69812}}, {'zip': 'M5G 1X8', 'city': 'Toronto', 'state': 'Ontario', 'country': 'Canada', 'facility': 'The Hospital for Sick Children', 'geoPoint': {'lat': 43.70643, 'lon': -79.39864}}, {'zip': '11315', 'city': 'Tallinn', 'country': 'Estonia', 'facility': 'Astra Kliinik', 'geoPoint': {'lat': 59.43696, 'lon': 24.75353}}, {'zip': '50406', 'city': 'Tartu', 'country': 'Estonia', 'facility': 'Tartu University Hospital', 'geoPoint': {'lat': 58.38062, 'lon': 26.72509}}, {'zip': '69003', 'city': 'Bron', 'state': 'Rhône', 'country': 'France', 'facility': 'Hospices Civils de Lyon - Hôpital Pierre Wertheimer', 'geoPoint': {'lat': 45.73865, 'lon': 4.91303}}, {'zip': '94275', 'city': 'Le Kremlin-Bicêtre', 'country': 'France', 'facility': 'Centre Hospitalier Universitaire de Bicêtre', 'geoPoint': {'lat': 48.81471, 'lon': 2.36073}}, {'zip': '34295', 'city': 'Montpellier', 'country': 'France', 'facility': 'CHRU de Montpellier, Hopital Gui de Chauliac', 'geoPoint': {'lat': 43.61093, 'lon': 3.87635}}, {'zip': '67091', 'city': 'Strasbourg', 'country': 'France', 'facility': 'Hopital de Hautepierre', 'geoPoint': {'lat': 48.58392, 'lon': 7.74553}}, {'zip': '45711', 'city': 'Datteln', 'country': 'Germany', 'facility': 'Vestische Kinder- und Jugendklinik Datteln', 'geoPoint': {'lat': 51.65598, 'lon': 7.3453}}, {'zip': '01307', 'city': 'Dresden', 'country': 'Germany', 'facility': 'Universitaetsklinikum Carl Gustav Carus an der TU Dresden', 'geoPoint': {'lat': 51.05089, 'lon': 13.73832}}, {'zip': '37075', 'city': 'Göttingen', 'country': 'Germany', 'facility': 'Universitätsmedizin Göttingen Georg-August-Universität', 'geoPoint': {'lat': 51.53443, 'lon': 9.93228}}, {'zip': '48129', 'city': 'Münster', 'country': 'Germany', 'facility': 'Universitätsklinikum Münster', 'geoPoint': {'lat': 51.96236, 'lon': 7.62571}}, {'zip': '115 28', 'city': 'Athens', 'state': 'Attica', 'country': 'Greece', 'facility': 'Eginitio University General Hospital of Athens', 'geoPoint': {'lat': 37.98376, 'lon': 23.72784}}, {'zip': '124 62', 'city': 'Chaïdári', 'state': 'Attica', 'country': 'Greece', 'facility': "University General Hospital ''ATTIKON'' - General Hospital of West Attica H AGIA VARVARA", 'geoPoint': {'lat': 38.01135, 'lon': 23.66597}}, {'zip': '552 36', 'city': 'Thessaloniki', 'country': 'Greece', 'facility': "St. Luke's Hospital", 'geoPoint': {'lat': 40.64072, 'lon': 22.93493}}, {'zip': '1094', 'city': 'Budapest', 'country': 'Hungary', 'facility': 'Semmelweis Egyetem', 'geoPoint': {'lat': 47.49835, 'lon': 19.04045}}, {'zip': 'H-4032', 'city': 'Debrecen', 'country': 'Hungary', 'facility': 'Debreceni Egyetem Klinikai Kozpont', 'geoPoint': {'lat': 47.53167, 'lon': 21.62444}}, {'zip': '380054', 'city': 'Ahmedabad', 'state': 'Gujarat', 'country': 'India', 'facility': 'Zydus Hospital', 'geoPoint': {'lat': 23.02579, 'lon': 72.58727}}, {'zip': '122001', 'city': 'Gurugram', 'state': 'Haryana', 'country': 'India', 'facility': 'Artemis Hospital', 'geoPoint': {'lat': 28.4601, 'lon': 77.02635}}, {'zip': '560022', 'city': 'Bangalore North', 'state': 'Karnataka', 'country': 'India', 'facility': 'Sparsh Super Speciality Hospital'}, {'zip': '682001', 'city': 'Kochi', 'state': 'Kerala', 'country': 'India', 'facility': 'Amrita Institute of Medical Sciences and Research Centre', 'geoPoint': {'lat': 9.93988, 'lon': 76.26022}}, {'zip': '411004', 'city': 'Pune', 'state': 'Maharashtra', 'country': 'India', 'facility': 'Deenanath Mangeshkar Hospital & Research Centre', 'geoPoint': {'lat': 18.51957, 'lon': 73.85535}}, {'zip': '110029', 'city': 'New Delhi', 'state': 'National Capital Territory of Delhi', 'country': 'India', 'facility': 'All India Institute Of Medical Sciences (AIIMS)', 'geoPoint': {'lat': 28.62137, 'lon': 77.2148}}, {'zip': '110070', 'city': 'New Delhi', 'state': 'National Capital Territory of Delhi', 'country': 'India', 'facility': 'Fortis Flight Lieutenant Rajan Dhall Hospital', 'geoPoint': {'lat': 28.62137, 'lon': 77.2148}}, {'zip': '400012', 'city': 'Mumbai', 'country': 'India', 'facility': 'Seth G.S Medical College K.E.M Hospital', 'geoPoint': {'lat': 19.07283, 'lon': 72.88261}}, {'zip': '66100', 'city': 'Chieti', 'state': 'Abruzzo', 'country': 'Italy', 'facility': "Universita? G. D'Annunzio", 'geoPoint': {'lat': 42.34827, 'lon': 14.16494}}, {'zip': '70124', 'city': 'Bari', 'state': 'Apulia', 'country': 'Italy', 'facility': 'Azienda Ospedaliero-Universitaria Consorziale Pol. di Bari', 'geoPoint': {'lat': 41.12066, 'lon': 16.86982}}, {'zip': '34137', 'city': 'Trieste', 'state': 'Friuli Venezia Giulia', 'country': 'Italy', 'facility': 'IRCCS Materno Infantile Burlo Garofolo - INCIPIT - PIN', 'geoPoint': {'lat': 45.64953, 'lon': 13.77678}}, {'zip': '00165', 'city': 'Rome', 'state': 'Lazio', 'country': 'Italy', 'facility': 'Ospedale Pediatrico Bambino Gesù', '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 A.O.U.San Martino Ist', 'geoPoint': {'lat': 44.40478, 'lon': 8.94439}}, {'zip': '20133', 'city': 'Milan', 'state': 'Lombardy', 'country': 'Italy', 'facility': 'Fondazione IRCCS Istituto Neurologico Carlo Besta', 'geoPoint': {'lat': 45.46427, 'lon': 9.18951}}, {'zip': '95123', 'city': 'Catania', 'state': 'Sicily', 'country': 'Italy', 'facility': 'Azienda Ospedaliero Universitaria Policlinico Vittorio Emanuele', 'geoPoint': {'lat': 37.49223, 'lon': 15.07041}}, {'zip': 'LV-1004', 'city': 'Riga', 'country': 'Latvia', 'facility': "Children's Clinical University Hospital", 'geoPoint': {'lat': 56.946, 'lon': 24.10589}}, {'zip': '44280', 'city': 'Guadalajara', 'state': 'Jalisco', 'country': 'Mexico', 'facility': 'Hospital Civil Fray Antonio Alcalde', 'geoPoint': {'lat': 20.67738, 'lon': -103.34749}}, {'zip': '06700', 'city': 'Mexico City', 'state': 'Mexico CITY (federal District)', 'country': 'Mexico', 'facility': 'Clinstile S.A de C.V.', 'geoPoint': {'lat': 19.42847, 'lon': -99.12766}}, {'zip': '3310', 'city': 'Mexico City', 'state': 'Mexico CITY (federal District)', 'country': 'Mexico', 'facility': 'Grupo Médico Camino S.C.', 'geoPoint': {'lat': 19.42847, 'lon': -99.12766}}, {'zip': '58260', 'city': 'Morelia', 'state': 'Michoacán', 'country': 'Mexico', 'facility': 'Centro de Investigacion Clinica Chapultepec S. 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