Ignite Creation Date:
2025-12-24 @ 7:46 PM
Ignite Modification Date:
2026-01-01 @ 10:30 PM
Study NCT ID:
NCT04987203
Status:
ACTIVE_NOT_RECRUITING
Last Update Posted:
2025-08-22
First Post:
2021-07-23
Is NOT Gene Therapy:
True
Has Adverse Events:
False
Brief Title:
Study to Compare Tivozanib in Combination With Nivolumab to Tivozanib Monotherapy in Subjects With Renal Cell Carcinoma
Sponsor:
Organization:
Raw JSON
{'hasResults': False, 'derivedSection': {'miscInfoModule': {'versionHolder': '2025-12-24'}, 'conditionBrowseModule': {'meshes': [{'id': 'D002292', 'term': 'Carcinoma, Renal Cell'}, {'id': 'D018450', 'term': 'Disease Progression'}], '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'}, {'id': 'D020969', 'term': 'Disease Attributes'}, {'id': 'D010335', 'term': 'Pathologic Processes'}, {'id': 'D013568', 'term': 'Pathological Conditions, Signs and Symptoms'}]}, 'interventionBrowseModule': {'meshes': [{'id': 'C553176', 'term': 'tivozanib'}, {'id': 'D000077594', 'term': 'Nivolumab'}], 'ancestors': [{'id': 'D061067', 'term': 'Antibodies, Monoclonal, Humanized'}, {'id': 'D000911', 'term': 'Antibodies, Monoclonal'}, {'id': 'D000906', 'term': 'Antibodies'}, {'id': 'D007136', 'term': 'Immunoglobulins'}, {'id': 'D007162', 'term': 'Immunoproteins'}, {'id': 'D001798', 'term': 'Blood Proteins'}, {'id': 'D011506', 'term': 'Proteins'}, {'id': 'D000602', 'term': 'Amino Acids, Peptides, and Proteins'}, {'id': 'D012712', 'term': 'Serum Globulins'}, {'id': 'D005916', 'term': 'Globulins'}]}}, 'protocolSection': {'designModule': {'phases': ['PHASE3'], 'studyType': 'INTERVENTIONAL', 'designInfo': {'allocation': 'RANDOMIZED', 'maskingInfo': {'masking': 'NONE'}, 'primaryPurpose': 'TREATMENT', 'interventionModel': 'PARALLEL'}, 'enrollmentInfo': {'type': 'ACTUAL', 'count': 343}}, 'statusModule': {'overallStatus': 'ACTIVE_NOT_RECRUITING', 'startDateStruct': {'date': '2021-09-09', 'type': 'ACTUAL'}, 'expandedAccessInfo': {'hasExpandedAccess': False}, 'statusVerifiedDate': '2025-08', 'completionDateStruct': {'date': '2025-12-30', 'type': 'ESTIMATED'}, 'lastUpdateSubmitDate': '2025-08-20', 'studyFirstSubmitDate': '2021-07-23', 'studyFirstSubmitQcDate': '2021-07-23', 'lastUpdatePostDateStruct': {'date': '2025-08-22', 'type': 'ACTUAL'}, 'studyFirstPostDateStruct': {'date': '2021-08-03', 'type': 'ACTUAL'}, 'primaryCompletionDateStruct': {'date': '2025-09-30', 'type': 'ESTIMATED'}}, 'outcomesModule': {'primaryOutcomes': [{'measure': 'Progression free survival', 'timeFrame': 'Until progressive disease [PD] (Approximately 30 months)', 'description': 'Comparison of the PFS of tivozanib in combination with nivolumab to tivozanib in subjects with RCC who have progressed following 1 or 2 lines of therapy. PFS is defined as the time from randomization to first documentation of objective tumor progression (progressive disease \\[PD\\], radiological) according to Response Evaluation Criteria In Solid Tumors (RECIST), or death due to any reasons whichever comes first.'}], 'secondaryOutcomes': [{'measure': 'Overall Survival', 'timeFrame': 'From Screening (Days -28 to -1) until death (Approximately 42 months)', 'description': 'Comparsion of the OS of subjects randomized to treatment with tivozanib in combination with nivolumab compared to tivozanib. OS is defined as the time from the date of randomization to date of death due to any cause.'}, {'measure': 'Progression free survival', 'timeFrame': 'Until progressive disease [PD] (Approximately 30 months)', 'description': 'PFS is defined as the time from randomization to first documentation of objective tumor progression (progressive disease \\[PD\\], radiological) according to RECIST, or death due to any reasons whichever comes first. PFS as assessed by investigator.'}, {'measure': 'Objective Response Rate', 'timeFrame': 'From Screening (Days -28 to -1) until PD (Approximately 30 months)', 'description': 'Comparison of ORR of subjects randomized to treatment with tivozanib in combination with nivolumab compared to tivozanib. ORR is defined as the proportion of subjects with confirmed complete response or confirmed partial response according to RECIST relative to the total population of randomized subjects.'}, {'measure': 'Duration of Response', 'timeFrame': 'From Screening (Days -28 to -1) until PD or death (Approximately 30 months)', 'description': 'Comparison of DoR of subjects randomized to treatment with tivozanib in combination with nivolumab compared to tivozanib. DoR is defined as the time from the first documentation of objective tumor response to the first documentation of objective tumor progression or to death due to any cause.'}, {'measure': 'Number of subjects with serious and non-serious adverse events', 'timeFrame': 'From Screening (Day -28 to Day -1) to Follow-up visit (30 days after last dose of study drug ± 7 days)', 'description': 'Assessment of the safety and tolerability of tivozanib in combination with nivolumab compared to tivozanib.'}]}, 'oversightModule': {'isUsExport': False, 'oversightHasDmc': False, 'isFdaRegulatedDrug': True, 'isFdaRegulatedDevice': False}, 'conditionsModule': {'keywords': ['Immune Checkpoint Inhibitor', 'Open-label', 'Monotherapy', 'Disease Progression'], 'conditions': ['Renal Cell Carcinoma']}, 'referencesModule': {'references': [{'pmid': '39284329', 'type': 'DERIVED', 'citation': 'Choueiri TK, Albiges L, Barthelemy P, Iacovelli R, Emambux S, Molina-Cerrillo J, Garmezy B, Barata P, Basu A, Bourlon MT, Moon H, Ratta R, McKay RR, Chehrazi-Raffle A, Hammers H, Heng DYC, Braendle E, Beckermann KE, McGregor BA, Motzer RJ. Tivozanib plus nivolumab versus tivozanib monotherapy in patients with renal cell carcinoma following an immune checkpoint inhibitor: results of the phase 3 TiNivo-2 Study. Lancet. 2024 Oct 5;404(10460):1309-1320. doi: 10.1016/S0140-6736(24)01758-6. Epub 2024 Sep 13.'}, {'pmid': '35304832', 'type': 'DERIVED', 'citation': 'Yang Y, Psutka SP, Parikh AB, Li M, Collier K, Miah A, Mori SV, Hinkley M, Tykodi SS, Hall E, Thompson JA, Yin M. Combining immune checkpoint inhibition plus tyrosine kinase inhibition as first and subsequent treatments for metastatic renal cell carcinoma. Cancer Med. 2022 Aug;11(16):3106-3114. doi: 10.1002/cam4.4679. Epub 2022 Mar 18.'}]}, 'descriptionModule': {'briefSummary': 'This study will be comparing tivozanib in combination with nivolumab to tivozanib alone in subjects with advanced Renal Cell Carcinoma (RCC) who have had 1 or 2 prior lines of therapy, one of which was an Immune Checkpoint Inhibitor (ICI).', 'detailedDescription': 'This will be an open-label, randomized, controlled, multicenter, multi-national, parallel-arm study. The study is designed to compare the progression free survival (PFS), overall survival (OS), Objective response rate (ORR), duration of response (DoR), and safety of tivozanib and the combination of tivozanib with nivolumab.\n\nApproximately 326 subjects with refractory advanced RCC at approximately 190 sites will be randomized in a 1:1 ratio to treatment with tivozanib plus nivolumab (163 subjects) or tivozanib (163 subjects). Subjects will be randomly assigned to a treatment.\n\nSubjects will receive 1.34 mg/day (monotherapy arm) or 0.89mg/day (combination arm) of tivozanib once daily (QD) for 3 weeks followed by 1 week off study drug. One cycle will be defined as 4 weeks: 3 weeks on treatment and 1 week off treatment. Subjects who receive nivolumab will be infused with 1 treatment of nivolumab at specified dose on specified days of each Cycle.\n\nSubjects with documented stable disease or an objective response may continue to receive both tivozanib and nivolumab therapy at the same dose and schedule until progression as long as the tolerability is acceptable. Nivolumab will be discontinued in all subjects after 2 years; Tivozanib may be continued after discontinuation of nivolumab until other withdrawal criteria are met. A Safety Follow-up Visit will be performed 30 days (± 7 days) after the last dose of study drug.'}, 'eligibilityModule': {'sex': 'ALL', 'stdAges': ['ADULT', 'OLDER_ADULT'], 'maximumAge': '130 Years', 'minimumAge': '18 Years', 'healthyVolunteers': False, 'eligibilityCriteria': 'Inclusion Criteria:\n\n* Radiographic disease progression during or following at least 6 weeks of treatment with ICI for locally advanced or metastatic RCC with a clear cell component either in first- or second-line treatment.\n* Subjects must have recovered from the adverse events of prior therapy to grade ≤ 1 or baseline.\n* Histologically or cytologically confirmed RCC with a clear cell component.\n* Measurable disease per RECIST criteria Version 1.1.\n* Eastern Cooperative Oncology Group performance status of 0 or 1.\n* All participants must follow protocol defined contraceptive measures.\n\nExclusion Criteria:\n\n* Subjects who received: a. A single agent tyrosine kinase inhibitor (TKI) in the first line setting followed by a single agent immune checkpoint inhibitor (ICI) in the second line setting; b. More than 2 prior lines of therapy in the advanced or metastatic setting.\n* History of life-threatening toxicity related to prior immune therapy.\n* Active autoimmune disease as well as those that required discontinuation of prior immuno-oncological (IO) therapy due to immune mediated AEs.\n* Uncontrolled hypertension.\n* More than 1 prior line of therapy with a checkpoint inhibitor in the metastatic setting.\n* Subjects on immune suppressive therapy for organ transplant or subjects with a history of genetic or acquired immune suppression disease such as human immunodeficiency virus (HIV) \\[Patients with HIV who have CD4+ T-cell counts \\>350 cells/µL, without a history of acquired immune deficiency syndrome (AIDS)-defining opportunistic infections, and are on established antiretroviral therapy which does not include a cytochrome P450 (CYP)3A4 inducer, for at least 4 weeks and have an HIV viral load less than 400 copies/mL, are eligible\\].\n* History of clinically significant interstitial lung disease or current non-infectious pneumonitis.'}, 'identificationModule': {'nctId': 'NCT04987203', 'briefTitle': 'Study to Compare Tivozanib in Combination With Nivolumab to Tivozanib Monotherapy in Subjects With Renal Cell Carcinoma', 'organization': {'class': 'INDUSTRY', 'fullName': 'AVEO Pharmaceuticals, Inc.'}, 'officialTitle': 'TiNivo-2: A Phase 3, Randomized, Controlled, Multicenter, Open-label Study to Compare Tivozanib in Combination With Nivolumab to Tivozanib Monotherapy in Subjects With Renal Cell Carcinoma Who Have Progressed Following One or Two Lines of Therapy Where One Line Has an Immune Checkpoint Inhibitor', 'orgStudyIdInfo': {'id': 'AV-951-20-304'}}, 'armsInterventionsModule': {'armGroups': [{'type': 'EXPERIMENTAL', 'label': 'Tivozanib in Combination with Nivolumab', 'description': 'Subjects with advanced RCC will receive 0.89 mg of tivozanib once daily (QD) for 3 weeks followed by 1 week off study drug and nivolumab every 4 weeks on Day 1 of each Cycle, until disease progression or unacceptable toxicities occur, other withdrawal criteria are met, or completion of 2 years of treatment \\[for nivolumab\\] whichever occurs first.', 'interventionNames': ['Drug: Tivozanib', 'Drug: Nivolumab']}, {'type': 'EXPERIMENTAL', 'label': 'Tivozanib', 'description': 'Subjects with advanced RCC will receive 1.34 mg of tivozanib once daily (QD) for 3 weeks followed by 1 week off study drug until disease progression or unacceptable toxicities occur, or other withdrawal criteria are met.', 'interventionNames': ['Drug: Tivozanib']}], 'interventions': [{'name': 'Tivozanib', 'type': 'DRUG', 'description': 'Tivozanib will be administered orally.', 'armGroupLabels': ['Tivozanib', 'Tivozanib in Combination with Nivolumab']}, {'name': 'Nivolumab', 'type': 'DRUG', 'description': 'Nivolumab will be administered via intravenous infusion.', 'armGroupLabels': ['Tivozanib in Combination with Nivolumab']}]}, 'contactsLocationsModule': {'locations': [{'zip': '91010', 'city': 'Duarte', 'state': 'California', 'country': 'United States', 'facility': 'City of Hope Comprehensive Cancer Center', 'geoPoint': {'lat': 34.13945, 'lon': -117.97729}}, {'zip': '92868', 'city': 'Irvine', 'state': 'California', 'country': 'United States', 'facility': 'Chao Family Comprehensive Cancer Center, UC Irvine', 'geoPoint': {'lat': 33.66946, 'lon': -117.82311}}, {'zip': '92037', 'city': 'La Jolla', 'state': 'California', 'country': 'United States', 'facility': 'University of California San Diego', 'geoPoint': {'lat': 32.84727, 'lon': -117.2742}}, {'zip': '94063', 'city': 'Redwood City', 'state': 'California', 'country': 'United States', 'facility': 'Leland Stanford Junior University', 'geoPoint': {'lat': 37.48522, 'lon': -122.23635}}, {'zip': '92505', 'city': 'Riverside', 'state': 'California', 'country': 'United States', 'facility': 'Kaiser Permanente Riverside Medical Center', 'geoPoint': {'lat': 33.95335, 'lon': -117.39616}}, {'zip': '80218-1237', 'city': 'Denver', 'state': 'Colorado', 'country': 'United States', 'facility': 'US Oncology - Rocky Mountain Cancer Centers - Midtown', 'geoPoint': {'lat': 39.73915, 'lon': -104.9847}}, {'zip': '33901', 'city': 'Fort Myers', 'state': 'Florida', 'country': 'United States', 'facility': 'Florida Cancer Specialists & Res Inst', 'geoPoint': {'lat': 26.62168, 'lon': -81.84059}}, {'zip': '33705', 'city': 'St. Petersburg', 'state': 'Florida', 'country': 'United States', 'facility': 'Florida Cancer Specialists & Research Institute (FCS) - Tampa Cancer Center Location', 'geoPoint': {'lat': 27.77086, 'lon': -82.67927}}, {'zip': '66205-2005', 'city': 'Westwood', 'state': 'Kansas', 'country': 'United States', 'facility': 'The University of Kansas Cancer Center', 'geoPoint': {'lat': 39.04056, 'lon': -94.6169}}, {'zip': '40536', 'city': 'Lexington', 'state': 'Kentucky', 'country': 'United States', 'facility': 'University of Kentucky UK Markey Cancer Center', 'geoPoint': {'lat': 37.98869, 'lon': -84.47772}}, {'zip': '70112', 'city': 'New Orleans', 'state': 'Louisiana', 'country': 'United States', 'facility': 'Tulane Cancer Center Clinic - Oncology', 'geoPoint': {'lat': 29.95465, 'lon': -90.07507}}, {'zip': '21201', 'city': 'Baltimore', 'state': 'Maryland', 'country': 'United States', 'facility': 'University of Maryland Medical Center-Greenebaum Cancer Ctr', 'geoPoint': {'lat': 39.29038, 'lon': -76.61219}}, {'zip': '21287', 'city': 'Baltimore', 'state': 'Maryland', 'country': 'United States', 'facility': 'John Hopkins Medicine - Hematology/oncology', 'geoPoint': {'lat': 39.29038, 'lon': -76.61219}}, {'zip': '20735', 'city': 'Clinton', 'state': 'Maryland', 'country': 'United States', 'facility': 'Maryland Oncology Hematology', 'geoPoint': {'lat': 38.76511, 'lon': -76.89831}}, {'zip': '02215', 'city': 'Boston', 'state': 'Massachusetts', 'country': 'United States', 'facility': 'Dana-Farber Cancer Institute - Medicine', 'geoPoint': {'lat': 42.35843, 'lon': -71.05977}}, {'zip': '48202', 'city': 'Detroit', 'state': 'Michigan', 'country': 'United States', 'facility': 'Henry Ford Hospital', 'geoPoint': {'lat': 42.33143, 'lon': -83.04575}}, {'zip': '59102-6746', 'city': 'Billings', 'state': 'Montana', 'country': 'United States', 'facility': 'St. Vincent Frontier Cancer Center', 'geoPoint': {'lat': 45.78329, 'lon': -108.50069}}, {'zip': '68130', 'city': 'Omaha', 'state': 'Nebraska', 'country': 'United States', 'facility': 'Oncology Hematology West PC dba Nebraska Cancer Specialists', 'geoPoint': {'lat': 41.25626, 'lon': -95.94043}}, {'zip': '07748-3052', 'city': 'Middletown', 'state': 'New Jersey', 'country': 'United States', 'facility': 'Memorial Sloan Kettering Cancer Center - Monmouth - Oncology', 'geoPoint': {'lat': 40.39428, 'lon': -74.11709}}, {'zip': '87131-0001', 'city': 'Albuquerque', 'state': 'New Mexico', 'country': 'United States', 'facility': 'University of New Mexico - Comprehensive Cancer Center', 'geoPoint': {'lat': 35.08449, 'lon': -106.65114}}, {'zip': '14263', 'city': 'Buffalo', 'state': 'New York', 'country': 'United States', 'facility': 'Roswell - Roswell Park Cancer Institute - Medical Oncology', 'geoPoint': {'lat': 42.88645, 'lon': -78.87837}}, {'zip': '10604', 'city': 'East White Plains', 'state': 'New York', 'country': 'United States', 'facility': 'Memorial Sloan Kettering Cancer Center - Westchester', 'geoPoint': {'lat': 41.03899, 'lon': -73.74763}}, {'zip': '10065', 'city': 'New York', 'state': 'New York', 'country': 'United States', 'facility': 'Memorial Sloan Kettering Cancer Center (MSKCC) - Memorial Hospital', 'geoPoint': {'lat': 40.71427, 'lon': -74.00597}}, {'zip': '11553', 'city': 'Uniondale', 'state': 'New York', 'country': 'United States', 'facility': 'Memorial Sloan Kettering Cancer Center - Nassau', 'geoPoint': {'lat': 40.70038, 'lon': -73.59291}}, {'zip': '44195-0001', 'city': 'Cleveland', 'state': 'Ohio', 'country': 'United States', 'facility': 'Cleveland Clinic', 'geoPoint': {'lat': 41.4995, 'lon': -81.69541}}, {'zip': '18103-6218', 'city': 'Allentown', 'state': 'Pennsylvania', 'country': 'United States', 'facility': 'Lehigh Valley Physician Group', 'geoPoint': {'lat': 40.60843, 'lon': -75.49018}}, {'zip': '15212-4756', 'city': 'Pittsburgh', 'state': 'Pennsylvania', 'country': 'United States', 'facility': 'Allegheny General Hospital (AGH)', 'geoPoint': {'lat': 40.44062, 'lon': -79.99589}}, {'zip': '29210', 'city': 'Columbia', 'state': 'South Carolina', 'country': 'United States', 'facility': 'UH Cleveland Medical Center', 'geoPoint': {'lat': 34.00071, 'lon': -81.03481}}, {'zip': '37404', 'city': 'Chattanooga', 'state': 'Tennessee', 'country': 'United States', 'facility': 'Chattanooga Oncology and Hematology Associates', 'geoPoint': {'lat': 35.04563, 'lon': -85.30968}}, {'zip': '37203', 'city': 'Nashville', 'state': 'Tennessee', 'country': 'United States', 'facility': 'Tennessee Oncology, PLLC', 'geoPoint': {'lat': 36.16589, 'lon': -86.78444}}, {'zip': '37232', 'city': 'Nashville', 'state': 'Tennessee', 'country': 'United States', 'facility': 'Vanderbilt-Ingram Cancer Center', 'geoPoint': {'lat': 36.16589, 'lon': -86.78444}}, {'zip': '78731', 'city': 'Austin', 'state': 'Texas', 'country': 'United States', 'facility': 'Texas Oncology - Central Austin Cancer Center', 'geoPoint': {'lat': 30.26715, 'lon': -97.74306}}, {'zip': '75246', 'city': 'Dallas', 'state': 'Texas', 'country': 'United States', 'facility': 'Texas Oncology - Baylor Charles A. Sammons Cancer Center', 'geoPoint': {'lat': 32.78306, 'lon': -96.80667}}, {'zip': '78240', 'city': 'San Antonio', 'state': 'Texas', 'country': 'United States', 'facility': 'US Oncology Texas Oncology (CCC of South Texas) - San Antonio Medical Center', 'geoPoint': {'lat': 29.42412, 'lon': -98.49363}}, {'zip': '98109', 'city': 'Seattle', 'state': 'Washington', 'country': 'United States', 'facility': 'University Of Washington - Medical Center', 'geoPoint': {'lat': 47.60621, 'lon': -122.33207}}, {'zip': '98405-5016', 'city': 'Tacoma', 'state': 'Washington', 'country': 'United States', 'facility': 'Northwest Medical Specialties PLLC', 'geoPoint': {'lat': 47.25288, 'lon': -122.44429}}, {'zip': 'C1280AEB', 'city': 'Buenos Aires', 'state': 'Ciudad Autónoma de Buenos Aire', 'country': 'Argentina', 'facility': 'Centro Oncológico Korben', 'geoPoint': {'lat': -34.61315, 'lon': -58.37723}}, {'zip': 'R8500JYJ', 'city': 'Viedma', 'state': 'Río Negro Province', 'country': 'Argentina', 'facility': 'Clínica Viedma', 'geoPoint': {'lat': -40.81519, 'lon': -63.0004}}, {'zip': 'S2000KZE', 'city': 'Rosario', 'state': 'Santa Fe Province', 'country': 'Argentina', 'facility': 'Centro Oncologico de Rosario', 'geoPoint': {'lat': -32.94682, 'lon': -60.63932}}, {'zip': 'T4000GTB', 'city': 'San Miguel de Tucumán', 'state': 'Tucumán Province', 'country': 'Argentina', 'facility': 'Centro para la Atención Integral del paciente Oncológico', 'geoPoint': {'lat': -26.81601, 'lon': -65.21051}}, {'zip': '2170', 'city': 'Liverpool', 'state': 'New South Wales', 'country': 'Australia', 'facility': 'Liverpool Hospital Cancer Therapy Centre', 'geoPoint': {'lat': -33.91938, 'lon': 150.92588}}, {'zip': '4101', 'city': 'Brisbane', 'state': 'Queensland', 'country': 'Australia', 'facility': 'Mater Misericordiae Limited', 'geoPoint': {'lat': -27.46794, 'lon': 153.02809}}, {'zip': '4102', 'city': 'Woolloongabba', 'state': 'Queensland', 'country': 'Australia', 'facility': 'Princess Alexandra Hospital', 'geoPoint': {'lat': -27.48855, 'lon': 153.03655}}, {'zip': '3220', 'city': 'Geelong', 'state': 'Victoria', 'country': 'Australia', 'facility': 'Sunshine Hospital', 'geoPoint': {'lat': -38.14711, 'lon': 144.36069}}, {'zip': '2170', 'city': 'Merksen', 'state': 'Antwerpen', 'country': 'Belgium', 'facility': 'ZNA Jan Palfijn'}, {'zip': '1070', 'city': 'Anderlecht', 'state': 'Brussels Capital', 'country': 'Belgium', 'facility': 'Institut Jules Bordet - Oncologie Médicale', 'geoPoint': {'lat': 50.83619, 'lon': 4.31454}}, {'zip': '3500', 'city': 'Hasselt', 'state': 'Limburg', 'country': 'Belgium', 'facility': 'Jessa Ziekenhuis - Campus Virga Jesse - Medische Oncologie', 'geoPoint': {'lat': 50.93106, 'lon': 5.33781}}, {'zip': '9000', 'city': 'Ghent', 'state': 'Oost-Vlaanderen', 'country': 'Belgium', 'facility': 'UZ Gent - Medische Oncologie', 'geoPoint': {'lat': 51.05, 'lon': 3.71667}}, {'zip': '1020', 'city': 'Brussels', 'country': 'Belgium', 'facility': 'CHU Brugmann - Victor Horta', 'geoPoint': {'lat': 50.85045, 'lon': 4.34878}}, {'zip': '8500', 'city': 'Kortrijk', 'country': 'Belgium', 'facility': 'AZ Groeninge - Campus Kennedylaan', 'geoPoint': {'lat': 50.82803, 'lon': 3.26487}}, {'zip': '90110-270', 'city': 'Porto Alegre', 'state': 'Rio Grande do Sul', 'country': 'Brazil', 'facility': 'Centro Gaucho Integrado de Onc', 'geoPoint': {'lat': -30.03283, 'lon': -51.23019}}, {'zip': '88301-220', 'city': 'Itajaí', 'state': 'Santa Catarina', 'country': 'Brazil', 'facility': 'Clinica de Neoplasias Litoral', 'geoPoint': {'lat': -26.90778, 'lon': -48.66194}}, {'zip': '13083-970', 'city': 'Campinas', 'state': 'São Paulo', 'country': 'Brazil', 'facility': 'Universidade Estadual de Campi', 'geoPoint': {'lat': -22.90556, 'lon': -47.06083}}, {'zip': '03102-002', 'city': 'São Paulo', 'state': 'São Paulo', 'country': 'Brazil', 'facility': 'Instituto Brasileiro de Controle do Cancer - 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