Ignite Creation Date:
2025-12-25 @ 12:27 AM
Ignite Modification Date:
2025-12-25 @ 10:33 PM
Study NCT ID:
NCT00290667
Status:
COMPLETED
Last Update Posted:
2021-05-18
First Post:
2006-02-09
Is NOT Gene Therapy:
False
Has Adverse Events:
False
Brief Title:
Rituximab and Combination Chemotherapy in Treating Older Patients With Previously Untreated B-Cell Lymphoma
Sponsor:
Organization:
Raw JSON
{'hasResults': False, 'derivedSection': {'miscInfoModule': {'versionHolder': '2025-12-24'}, 'conditionBrowseModule': {'meshes': [{'id': 'D008223', 'term': 'Lymphoma'}, {'id': 'D016403', 'term': 'Lymphoma, Large B-Cell, Diffuse'}, {'id': 'D016400', 'term': 'Lymphoma, Large-Cell, Immunoblastic'}, {'id': 'D002051', 'term': 'Burkitt Lymphoma'}, {'id': 'D008228', 'term': 'Lymphoma, Non-Hodgkin'}, {'id': 'D008224', 'term': 'Lymphoma, Follicular'}], 'ancestors': [{'id': 'D009370', 'term': 'Neoplasms by Histologic Type'}, {'id': 'D009369', 'term': 'Neoplasms'}, {'id': 'D008232', 'term': 'Lymphoproliferative Disorders'}, {'id': 'D008206', 'term': 'Lymphatic Diseases'}, {'id': 'D006425', 'term': 'Hemic and Lymphatic Diseases'}, {'id': 'D007160', 'term': 'Immunoproliferative Disorders'}, {'id': 'D007154', 'term': 'Immune System Diseases'}, {'id': 'D016393', 'term': 'Lymphoma, B-Cell'}, {'id': 'D020031', 'term': 'Epstein-Barr Virus Infections'}, {'id': 'D006566', 'term': 'Herpesviridae Infections'}, {'id': 'D004266', 'term': 'DNA Virus Infections'}, {'id': 'D014777', 'term': 'Virus Diseases'}, {'id': 'D007239', 'term': 'Infections'}, {'id': 'D014412', 'term': 'Tumor Virus Infections'}]}, 'interventionBrowseModule': {'meshes': [{'id': 'C455861', 'term': 'pegfilgrastim'}, {'id': 'D000069283', 'term': 'Rituximab'}, {'id': 'D003520', 'term': 'Cyclophosphamide'}, {'id': 'D004317', 'term': 'Doxorubicin'}, {'id': 'D011241', 'term': 'Prednisone'}, {'id': 'D014750', 'term': 'Vincristine'}, {'id': 'D011878', 'term': 'Radiotherapy'}], 'ancestors': [{'id': 'D058846', 'term': 'Antibodies, Monoclonal, Murine-Derived'}, {'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'}, {'id': 'D010752', 'term': 'Phosphoramide Mustards'}, {'id': 'D009588', 'term': 'Nitrogen Mustard Compounds'}, {'id': 'D009150', 'term': 'Mustard Compounds'}, {'id': 'D006846', 'term': 'Hydrocarbons, Halogenated'}, {'id': 'D006838', 'term': 'Hydrocarbons'}, {'id': 'D009930', 'term': 'Organic Chemicals'}, {'id': 'D063088', 'term': 'Phosphoramides'}, {'id': 'D009943', 'term': 'Organophosphorus Compounds'}, {'id': 'D003630', 'term': 'Daunorubicin'}, {'id': 'D018943', 'term': 'Anthracyclines'}, {'id': 'D009279', 'term': 'Naphthacenes'}, {'id': 'D011084', 'term': 'Polycyclic Aromatic Hydrocarbons'}, {'id': 'D006841', 'term': 'Hydrocarbons, Aromatic'}, {'id': 'D006844', 'term': 'Hydrocarbons, Cyclic'}, {'id': 'D011083', 'term': 'Polycyclic Compounds'}, {'id': 'D000617', 'term': 'Aminoglycosides'}, {'id': 'D006027', 'term': 'Glycosides'}, {'id': 'D002241', 'term': 'Carbohydrates'}, {'id': 'D011244', 'term': 'Pregnadienediols'}, {'id': 'D011245', 'term': 'Pregnadienes'}, {'id': 'D011278', 'term': 'Pregnanes'}, {'id': 'D013256', 'term': 'Steroids'}, {'id': 'D000072473', 'term': 'Fused-Ring Compounds'}, {'id': 'D014748', 'term': 'Vinca Alkaloids'}, {'id': 'D046948', 'term': 'Secologanin Tryptamine Alkaloids'}, {'id': 'D026121', 'term': 'Indole Alkaloids'}, {'id': 'D000470', 'term': 'Alkaloids'}, {'id': 'D006571', 'term': 'Heterocyclic Compounds'}, {'id': 'D007211', 'term': 'Indoles'}, {'id': 'D006574', 'term': 'Heterocyclic Compounds, 2-Ring'}, {'id': 'D000072471', 'term': 'Heterocyclic Compounds, Fused-Ring'}, {'id': 'D054836', 'term': 'Indolizidines'}, {'id': 'D007212', 'term': 'Indolizines'}, {'id': 'D013812', 'term': 'Therapeutics'}]}}, 'protocolSection': {'designModule': {'phases': ['PHASE2'], 'studyType': 'INTERVENTIONAL', 'designInfo': {'allocation': 'RANDOMIZED', 'maskingInfo': {'masking': 'NONE'}, 'primaryPurpose': 'TREATMENT', 'interventionModel': 'PARALLEL'}, 'enrollmentInfo': {'type': 'ACTUAL', 'count': 586}}, 'statusModule': {'overallStatus': 'COMPLETED', 'startDateStruct': {'date': '2004-02'}, 'expandedAccessInfo': {'hasExpandedAccess': False}, 'statusVerifiedDate': '2021-05', 'completionDateStruct': {'date': '2015-11', 'type': 'ACTUAL'}, 'lastUpdateSubmitDate': '2021-05-14', 'studyFirstSubmitDate': '2006-02-09', 'studyFirstSubmitQcDate': '2006-02-09', 'lastUpdatePostDateStruct': {'date': '2021-05-18', 'type': 'ACTUAL'}, 'studyFirstPostDateStruct': {'date': '2006-02-13', 'type': 'ESTIMATED'}, 'primaryCompletionDateStruct': {'date': '2013-12', 'type': 'ACTUAL'}}, 'outcomesModule': {'primaryOutcomes': [{'measure': 'Pharmacokinetics (in first 20 patients of each cohort with a distinct variation of the rituximab schedule) assessed on days -4, -1, 10, 29, 57, 99, 155, 239, 267, 295, 407, and 491 of treatment', 'timeFrame': '-4 to 491 days of treatment'}, {'measure': 'Safety and treatment related deaths at 3 months after study completion', 'timeFrame': '3 months after study completion'}, {'measure': 'Toxicity assessed by NCI criteria, adverse events, serious adverse events, protocol adherence, and treatment-related deaths at 3 months after study completion', 'timeFrame': '3 months after study completion'}], 'secondaryOutcomes': [{'measure': 'Time to treatment failure assessed at 2 years within the study and periodically thereafter', 'timeFrame': 'at 2 years within the study and periodically thereafterlif'}, {'measure': 'Complete response rate assessed at 2 years within the study and periodically thereafter', 'timeFrame': 'at 2 years within the study and periodically thereafter'}, {'measure': 'Progression rate', 'timeFrame': 'life-long'}, {'measure': 'Survival time', 'timeFrame': 'life-long'}, {'measure': 'Progression-free survival', 'timeFrame': 'life-long'}]}, 'oversightModule': {'oversightHasDmc': True}, 'conditionsModule': {'keywords': ['contiguous stage II adult diffuse large cell lymphoma', 'noncontiguous stage II adult diffuse large cell lymphoma', 'stage I adult diffuse large cell lymphoma', 'stage III adult diffuse large cell lymphoma', 'stage IV adult diffuse large cell lymphoma', 'contiguous stage II adult immunoblastic large cell lymphoma', 'noncontiguous stage II adult immunoblastic large cell lymphoma', 'stage I adult immunoblastic large cell lymphoma', 'stage III adult immunoblastic large cell lymphoma', 'stage IV adult immunoblastic large cell lymphoma', 'contiguous stage II adult Burkitt lymphoma', 'noncontiguous stage II adult Burkitt lymphoma', 'stage I adult Burkitt lymphoma', 'stage III adult Burkitt lymphoma', 'stage IV adult Burkitt lymphoma', 'contiguous stage II adult diffuse mixed cell lymphoma', 'noncontiguous stage II adult diffuse mixed cell lymphoma', 'stage I adult diffuse mixed cell lymphoma', 'stage III adult diffuse mixed cell lymphoma', 'stage IV adult diffuse mixed cell lymphoma', 'contiguous stage II adult diffuse small cleaved cell lymphoma', 'noncontiguous stage II adult diffuse small cleaved cell lymphoma', 'stage I adult diffuse small cleaved cell lymphoma', 'stage III adult diffuse small cleaved cell lymphoma', 'stage IV adult diffuse small cleaved cell lymphoma', 'contiguous stage II grade 1 follicular lymphoma', 'contiguous stage II grade 2 follicular lymphoma', 'contiguous stage II grade 3 follicular lymphoma', 'noncontiguous stage II grade 1 follicular lymphoma', 'noncontiguous stage II grade 2 follicular lymphoma', 'noncontiguous stage II grade 3 follicular lymphoma', 'stage I grade 1 follicular lymphoma', 'stage I grade 2 follicular lymphoma', 'stage I grade 3 follicular lymphoma', 'stage III grade 1 follicular lymphoma', 'stage III grade 2 follicular lymphoma', 'stage III grade 3 follicular lymphoma', 'stage IV grade 1 follicular lymphoma', 'stage IV grade 2 follicular lymphoma', 'stage IV grade 3 follicular lymphoma'], 'conditions': ['Lymphoma']}, 'descriptionModule': {'briefSummary': 'RATIONALE: Monoclonal antibodies, such as rituximab, can block cancer growth in different ways. Some find cancer cells and kill them or carry cancer-killing substances to them. Others interfere with the ability of cancer cells to grow and spread. Drugs used in chemotherapy, such as cyclophosphamide, doxorubicin, vincristine, and prednisone, work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Giving rituximab together with combination chemotherapy may kill more cancer cells.\n\nPURPOSE: This phase II trial is studying how well giving rituximab together with combination chemotherapy works in treating older patients with previously untreated B-cell lymphoma.', 'detailedDescription': 'OBJECTIVES:\n\nPrimary\n\n* Determine a pharmacokinetic profile for pharmacokinetics-based or rituximab within a CHOP-14 regimen comprising cyclophosphamide, doxorubicin hydrochloride, vincristine, and prednisone in elderly patients with previously untreated aggressive B-cell lymphoma.\n* To determine whether increased single-doses of rituximab for males can compensate their lower serum levels.\n* Evaluate the safety and toxicity profile of this regimen in male patients.\n\nSecondary\n\n* Determine the rate of complete responses, primary progressions under therapy, event-free survival, progression-free survival, and overall survival in patients treated with this regimen.\n* Determine the rate of primary progression in patients treated with this regimen.\n\nOUTLINE: This is a multicenter study. All patients undergo the following treatment.\n\n* Prephase treatment: Patients receive vincristine subcutaneously on day -6 and oral prednisone on days -6 to 0.\n* Immunochemotherapy and radiotherapy: Patients receive CHOP chemotherapy comprising cyclophosphamide IV over 15 minutes, doxorubicin hydrochloride IV, and vincristine IV on day 1 and oral prednisone once daily on days 1-5. Patients also receive pegfilgrastim subcutaneously on days 4, 18, 32, 46, 60, and 74. Treatment with CHOP chemotherapy repeats every 14 days for up to 6 courses in the absence of disease progression or unacceptable toxicity. Patients who show no response after course 4 of CHOP chemotherapy proceed to salvage chemotherapy off study.\n\nPatients are evaluated 2-4 weeks after completion of CHOP. Patients with initial bulky disease (i.e., diameter ≥ 7.5 cm) or extranodal involvement AND achieving complete remission (CR), unconfirmed CR (CRu), or partial remission undergo radiotherapy 5 days a week for 4 weeks. Patients who do not achieve CR or CRu 2 months after completion of radiotherapy proceed to salvage chemotherapy off study.\n\nPatients are then stratified according to center, International Prognostic Index (1-2 vs 3-5), disease involvement (bulky vs extranodal vs bulky and/or extranodal), age (61-70 years old vs 71-80 years old), and gender. Patients are randomized to 1 of 2 treatment arms.\n\n* Arm I (2-weekly rituximab): Patients receive rituximab IV 375 mg/m\\^2 (females) and 500 mg/m\\^2 (males) over 4 hours on days 0, 14, 28, 42, 56, 70, 84, and 98. Patients also receive pegfilgrastim subcutaneously on day 4 of each course.\n* Arm II (pharmacokinetic-based dose-dense rituximab): Patients receive rituximab IV 375 mg/m\\^2 (females) and 500 mg/m\\^2 (males) over 4 hours on days -1, 0, 3, 7, 14, 21, 28, and 42. Patients also receive pegfilgrastim subcutaneously on day 4 of each course.\n\nSome patients undergo blood sample collection periodically during and after treatment for pharmacokinetic studies.\n\nAfter completion of study treatment, patients are followed every 3 months for 2 years, every 6 months for 3 years, and then once a year therafter.'}, 'eligibilityModule': {'sex': 'ALL', 'stdAges': ['ADULT', 'OLDER_ADULT'], 'maximumAge': '80 Years', 'minimumAge': '61 Years', 'healthyVolunteers': False, 'eligibilityCriteria': 'DISEASE CHARACTERISTICS:\n\n* Histological diagnosis of aggressive B-cell lymphoma\n\n * Previously untreated disease\n * Stage I-IV disease\n* CD20-positive disease\n* Any International Prognostic Index (IPI) score\n* No secondary lymphoma after prior chemotherapy or radiotherapy\n* No primary CNS lymphoma\n* No primary gastrointestinal (MALT) lymphoma\n\nPATIENT CHARACTERISTICS:\n\n* ECOG performance status 0-2\n* Life expectancy ≥ 3 months\n* AST and ALT ≤ 3 times normal unless related to lymphoma\n* Bilirubin ≤ 2 mg/dL unless related to lymphoma\n* Creatinine ≤ 2 times normal unless related to lymphoma\n* Fertile patients must use effective contraception\n* No known allergic reactions against foreign proteins\n* No active infections requiring systemically administered antibiotics or antiviral medications\n* No noncompensated heart failure\n* No dilatative cardiomyopathy\n* No coronary heart disease with ST-segment depression in ECG\n* No myocardial infarction during the past 6 months\n* No chronic lung disease with hypoxemia\n* No severe noncompensated hypertension\n* No severe noncompensated diabetes mellitus\n* No clinical signs of cerebral dysfunction\n* No severe psychiatric disease\n* No known HIV infection\n* No active chronic hepatitis B or C infection\n* No other concurrent diseases that exclude the administration of therapy as outlined by the study protocol\n\nPRIOR CONCURRENT THERAPY:\n\n* See Disease Characteristics\n* More than 12 weeks since prior clinical trial participation\n* No prior participation in this study\n* No prior therapy, including murine antibody, for this cancer\n* No prior organ transplantation\n* No concurrent response-adapted radiotherapy ("iceberg radiotherapy")\n* No other concurrent anticancer chemotherapy or other study medication'}, 'identificationModule': {'nctId': 'NCT00290667', 'briefTitle': 'Rituximab and Combination Chemotherapy in Treating Older Patients With Previously Untreated B-Cell Lymphoma', 'organization': {'class': 'OTHER', 'fullName': 'Universität des Saarlandes'}, 'officialTitle': '2-Weekly CHOP Chemotherapy With Dose-Dense Rituximab for the Treatment of Patients Aged 61 to 80 Years With Aggressive CD-20 Positive B-Cell Lymphomas: A Phase-II/Pharmacokinetic Study (CHOP-R-ESC)', 'orgStudyIdInfo': {'id': 'CDR0000454505'}, 'secondaryIdInfos': [{'id': 'DSHNHL-2004-1'}, {'id': 'EU-20536'}, {'id': 'DSHNHL-CHOP-R-ESC'}, {'id': 'EUDRACT-2005-00529-68'}]}, 'armsInterventionsModule': {'armGroups': [{'type': 'ACTIVE_COMPARATOR', 'label': 'Interventional: CHOP-14 + 8 x 2-weekly rituximab', 'description': 'Arm I (2-weekly rituximab): Patients receive rituximab IV 375 mg/m\\^2 (females) and 500 mg/m\\^2 (males) over 4 hours on days 0, 14, 28, 42, 56, 70, 84, and 98. Patients also receive pegfilgrastim subcutaneously on day 4 of each course.', 'interventionNames': ['Biological: pegfilgrastim', 'Biological: rituximab', 'Drug: cyclophosphamide', 'Drug: doxorubicin hydrochloride', 'Drug: prednisone', 'Drug: vincristine sulfate', 'Other: pharmacological study', 'Radiation: radiation therapy']}, {'type': 'ACTIVE_COMPARATOR', 'label': 'Interventional: CHOP-14 + 8 x dose-dense rituximab', 'description': 'Arm II (pharmacokinetic-based dose-dense rituximab): Patients receive rituximab IV 375 mg/m\\^2 (females) and 500 mg/m\\^2 (males) over 4 hours on days -1, 0, 3, 7, 14, 21, 28, and 42. Patients also receive pegfilgrastim subcutaneously on day 4 of each course.', 'interventionNames': ['Biological: pegfilgrastim', 'Biological: rituximab', 'Drug: cyclophosphamide', 'Drug: doxorubicin hydrochloride', 'Drug: prednisone', 'Drug: vincristine sulfate', 'Other: pharmacological study', 'Radiation: radiation therapy']}], 'interventions': [{'name': 'pegfilgrastim', 'type': 'BIOLOGICAL', 'armGroupLabels': ['Interventional: CHOP-14 + 8 x 2-weekly rituximab', 'Interventional: CHOP-14 + 8 x dose-dense rituximab']}, {'name': 'rituximab', 'type': 'BIOLOGICAL', 'armGroupLabels': ['Interventional: CHOP-14 + 8 x 2-weekly rituximab', 'Interventional: CHOP-14 + 8 x dose-dense rituximab']}, {'name': 'cyclophosphamide', 'type': 'DRUG', 'armGroupLabels': ['Interventional: CHOP-14 + 8 x 2-weekly rituximab', 'Interventional: CHOP-14 + 8 x dose-dense rituximab']}, {'name': 'doxorubicin hydrochloride', 'type': 'DRUG', 'armGroupLabels': ['Interventional: CHOP-14 + 8 x 2-weekly rituximab', 'Interventional: CHOP-14 + 8 x dose-dense rituximab']}, {'name': 'prednisone', 'type': 'DRUG', 'armGroupLabels': ['Interventional: CHOP-14 + 8 x 2-weekly rituximab', 'Interventional: CHOP-14 + 8 x dose-dense rituximab']}, {'name': 'vincristine sulfate', 'type': 'DRUG', 'armGroupLabels': ['Interventional: CHOP-14 + 8 x 2-weekly rituximab', 'Interventional: CHOP-14 + 8 x dose-dense rituximab']}, {'name': 'pharmacological study', 'type': 'OTHER', 'armGroupLabels': ['Interventional: CHOP-14 + 8 x 2-weekly rituximab', 'Interventional: CHOP-14 + 8 x dose-dense rituximab']}, {'name': 'radiation therapy', 'type': 'RADIATION', 'armGroupLabels': ['Interventional: CHOP-14 + 8 x 2-weekly rituximab', 'Interventional: CHOP-14 + 8 x dose-dense rituximab']}]}, 'contactsLocationsModule': {'locations': [{'zip': 'CZ-662 63', 'city': 'Brno', 'country': 'Czechia', 'facility': 'University Hospital Brno', 'geoPoint': {'lat': 49.19522, 'lon': 16.60796}}, {'zip': 'CZ-150 06', 'city': 'Prague', 'country': 'Czechia', 'facility': 'Charles University Hospital', 'geoPoint': {'lat': 50.08804, 'lon': 14.42076}}, {'zip': '69322', 'city': 'Lyon', 'country': 'France', 'facility': 'Hopital Debrousse', 'geoPoint': {'lat': 45.74906, 'lon': 4.84789}}, {'zip': '52070', 'city': 'Aachen', 'country': 'Germany', 'facility': 'Haematologisch Onkologische Praxis', 'geoPoint': {'lat': 50.77664, 'lon': 6.08342}}, {'zip': 'D-73430', 'city': 'Aalen', 'country': 'Germany', 'facility': 'Ostalb-Klinikum Aalen', 'geoPoint': {'lat': 48.83777, 'lon': 10.0933}}, {'zip': 'D-92224', 'city': 'Amberg', 'country': 'Germany', 'facility': 'Klinikum St. Marien', 'geoPoint': {'lat': 49.44287, 'lon': 11.86267}}, {'zip': '91522', 'city': 'Ansbach', 'country': 'Germany', 'facility': 'Gemeinschaftspraxis Fuer Innere Medizin, Haematologie Und Internistische Onkologie', 'geoPoint': {'lat': 49.30481, 'lon': 10.5931}}, {'zip': '63739', 'city': 'Aschaffenburg', 'country': 'Germany', 'facility': 'Specialist Practice for Oncology', 'geoPoint': {'lat': 49.97704, 'lon': 9.15214}}, {'zip': 'RG 63739', 'city': 'Aschaffenburg', 'country': 'Germany', 'facility': 'II. Medizinische Klinik', 'geoPoint': {'lat': 49.97704, 'lon': 9.15214}}, {'zip': '86150', 'city': 'Augsburg', 'country': 'Germany', 'facility': 'Haematologische Praxis', 'geoPoint': {'lat': 48.37154, 'lon': 10.89851}}, {'zip': '86150', 'city': 'Augsburg', 'country': 'Germany', 'facility': 'Hamatologische/Onkologische Gemeinschaftspraxis - Augsburg', 'geoPoint': {'lat': 48.37154, 'lon': 10.89851}}, {'zip': 'DOH-86156', 'city': 'Augsburg', 'country': 'Germany', 'facility': 'Klinikum Augsburg', 'geoPoint': {'lat': 48.37154, 'lon': 10.89851}}, {'zip': '26603', 'city': 'Aurich', 'country': 'Germany', 'facility': 'Kreiskrankenhaus Aurich', 'geoPoint': {'lat': 53.46963, 'lon': 7.48239}}, {'zip': '36251', 'city': 'Bad Hersfeld', 'country': 'Germany', 'facility': 'Regional Hospital Bad Hersfeld', 'geoPoint': {'lat': 50.87197, 'lon': 9.70891}}, {'zip': '15526', 'city': 'Bad Saarow', 'country': 'Germany', 'facility': 'HELIOS Klinikum Bad Saarow', 'geoPoint': {'lat': 52.28333, 'lon': 14.06667}}, {'zip': '32105', 'city': 'Bad Salzuflen', 'country': 'Germany', 'facility': 'Internistische Praxis - Bad Salzuflen', 'geoPoint': {'lat': 52.0862, 'lon': 8.74434}}, {'zip': '79704', 'city': 'Bad Säckingen', 'country': 'Germany', 'facility': 'Kreiskrankenhaus Bad Saeckingen', 'geoPoint': {'lat': 47.55371, 'lon': 7.94612}}, {'zip': '65812', 'city': 'Bad Soden', 'country': 'Germany', 'facility': 'Onkologische Schwerpunktpraxis und Tagesklinik Dres', 'geoPoint': {'lat': 50.28857, 'lon': 9.36404}}, {'zip': 'D-72574', 'city': 'Bad Urach', 'country': 'Germany', 'facility': 'Ermstalklinik Bad Urach', 'geoPoint': {'lat': 48.49107, 'lon': 9.40009}}, {'zip': '96049', 'city': 'Bamberg', 'country': 'Germany', 'facility': 'Klinikum am Bamberg', 'geoPoint': {'lat': 49.89873, 'lon': 10.90067}}, {'zip': '95445', 'city': 'Bayreuth', 'country': 'Germany', 'facility': 'Krankenhaus Hohe Warte Mediziniche Klinik', 'geoPoint': {'lat': 49.94782, 'lon': 11.57893}}, {'zip': 'D-95445', 'city': 'Bayreuth', 'country': 'Germany', 'facility': 'Klinikum Bayreuth', 'geoPoint': {'lat': 49.94782, 'lon': 11.57893}}, {'zip': 'D-51429', 'city': 'Bergisch Gladbach', 'country': 'Germany', 'facility': 'Praxis Dr. med. Stefan Korsten', 'geoPoint': {'lat': 50.9856, 'lon': 7.13298}}, {'zip': '10249', 'city': 'Berlin', 'country': 'Germany', 'facility': 'Onkologisches Versorgungszentrum Friedrichshain', 'geoPoint': {'lat': 52.52437, 'lon': 13.41053}}, {'zip': '12559', 'city': 'Berlin', 'country': 'Germany', 'facility': 'DRK Kliniken Berlin - Koepenick', 'geoPoint': {'lat': 52.52437, 'lon': 13.41053}}, {'zip': '13347', 'city': 'Berlin', 'country': 'Germany', 'facility': 'Internistische Gemeinschaftspraxis - Berlin', 'geoPoint': {'lat': 52.52437, 'lon': 13.41053}}, {'zip': '13357', 'city': 'Berlin', 'country': 'Germany', 'facility': 'Haematologisch-Onkologische Schwerpunktpraxis', 'geoPoint': {'lat': 52.52437, 'lon': 13.41053}}, {'zip': '13589', 'city': 'Berlin', 'country': 'Germany', 'facility': 'Evang. 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