Neoplasms

Respiratory Tract (Lung and Bronchial) Diseases

All Conditions

Lung Neoplasms

Multiple Pulmonary Nodules

Solitary Pulmonary Nodule

The guide sheath(GS) is introduced into the lesion via Electromagnetic Navigation System. The locatable guide(LG) and GS are confirmed to reach the lesion by radiograph fluoroscopy, pathologic specimens are obtained with fluoroscopic guidance.

The GS is introduced into the lesion via the working channel of a bronchoscope with radiographic fluoroscopy. Once the location of the lesion is identified by fluoroscopy, pathologic specimens are obtained under fluoroscopic guidance.

ENB is performed using an electromagnetic navigation system (LK-DW-NK-Z; Suzhou Lungcare Medical Technology Inc., China) with an internal locatable guide (LG; Lungcare) with diameter of 1.45 mm. Bronchoscopes with a working channel diameter of 2.0 mm are used (BF-260 and BF-P260F; Olympus, Japan). The LG is inserted into the GS(K-201; Olympus) beforehand, and the GS-covered LG is introduced via the working channel of the bronchoscope and navigated to the PPL finally. The LG and GS are confirmed to reach the lesion by radiograph fluoroscopy.

A GS is introduced in the working channel of the bronchoscope alone. The GS is confirmed to reach the lesion by radiograph fluoroscopy, pathologic specimens are obtained under fluoroscopic guidance.

GS-TBLB-X-ray

Jiayuan Sun, MD

The purpose of this study is to evaluate the efficacy and safety of electromagnetic navigation bronchoscopy with a Guide Sheath(ENB-GS) for the diagnosis of peripheral pulmonary lesions (PPLs) .

The investigators evaluated the efficacy and safety of transbronchial lung biopsy (TBLB) and bronchial brushing using electromagnetic navigation bronchoscopy (ENB) with a guide sheath (GS) for the diagnosis of peripheral pulmonary lesions (PPLs) with radiographic fluoroscopy.The study is designed as a two-center prospective randomized controlled trial. The participating centers are Department of pulmonary medicine and endoscope department, Shanghai chest Hospital affiliated to Shanghai JiaoTong University, China. Department of pulmonary medicine, Shanghai ZhongShan Hospitial affiliated to Shanghai FuDan University, China.Patients are divided into two groups, ENB-GS-TBLB-X-ray group and GS-TBLB-X-ray group.Each subject will be randomized to each group.The study is expected to enroll 60 patients at 2 centers (Shanghai Chest Hospital: 40, Shanghai Zhongshan Hospital: 20).

ENB-GS-TBLB for the Diagnosis of PPLs

Diagnostic Value of Electromagnetic Navigation Bronchoscopy With a Guide Sheath for Peripheral Pulmonary Lesions : a Randomized Controlled Trial

The diagnostic yield in the ENB-GS-TBLB and GS-TBLB group was 87.2% and 61% individually.

Including total procedure time，total X-ray time, duration time for finding lesions and X-ray time for finding lesions.

Fudan University

Shanghai Chest Hospital

Director, Endoscope Center, Shanghai Chest Hospita

The guide sheath(GS) is introduced into the lesion via Electromagnetic Navigation System. The locatable guide(LG) and GS are confirmed to reach the lesion by radiograph fluoroscopy, pathologic specimens are obtained with fluoroscopic guidance.

GS-TBLB-X-ray: A GS is introduced in the working channel of the bronchoscope alone. The GS is confirmed to reach the lesion by radiograph fluoroscopy, pathologic specimens are obtained under fluoroscopic guidance.

ENB-GS-TBLB-X-ray Group

The GS is introduced into the lesion via the working channel of a bronchoscope with radiographic fluoroscopy. Once the location of the lesion is identified by fluoroscopy, pathologic specimens are obtained under fluoroscopic guidance.

GS-TBLB-X-ray: A GS is introduced in the working channel of the bronchoscope alone. The GS is confirmed to reach the lesion by radiograph fluoroscopy, pathologic specimens are obtained under fluoroscopic guidance.

GS-TBLB-X-ray Group

Total

Age, Continuous

Sex: Female, Male

lesion size(long axis)

lesion size(short axis)

Upper Lobes

Middle Lobes

Lower lobes

lesion location

distance of the nodule to the pleural surface

distance from the lesion to the pleural

The bronchus sign on CT represents the presence of a bronchus leading directly to a peripheral pulmonary lesion.

bronchus sign

Dr. Jiayuan Sun

Diagnosed by TBLB

Not Diagnosed by TBLB

The Difference of Diagnostic Value of ENB-GS-TBLB as Compared to GS-TBLB

Total procedure time

Total X-ray time

Duration time for finding lesion

X-ray time for finding lesion

The Duration Time Difference of ENB-GS-TBLB With Fluoroscopy as Compared to GS-TBLB With Fluoroscopy Alone

The guide sheath(GS) is introduced into the lesion via Electromagnetic Navigation System.

ENB: ENB is performed using an electromagnetic navigation system (LK-DW-NK-Z; Suzhou Lungcare Medical Technology Inc., China) with an internal locatable guide (LG; Lungcare) with diameter of 1.45 mm. Bronchoscopes with a working channel diameter of 2.0 mm are used (BF-260 and BF-P260F; Olympus, Japan). The LG is inserted into the GS(K-201; Olympus) beforehand, and the GS-covered LG is introduced via the working channel of the bronchoscope and navigated to the PPL finally. The LG and GS are confirmed to reach the lesion by radiograph fluoroscopy.

GS-TBLB-X-ray: A GS is introduced in the working channel of the bronchoscope alone. The GS is confirmed to reach the lesion by radiograph fluoroscopy, pathologic specimens are obtained under fluoroscopic guidance.

Overall Study

Respiratory Tract Neoplasms

Thoracic Neoplasms

Lung Diseases

Respiratory Tract Diseases

Patients meeting the inclusion criteria will be enrolled in the study and undergo ENB guided MWA. Chest CT will be performed at 1 day after the procedure to confirm the complications and then at 1 month, every 3 months for 2 years, and every 6 months for 3 years thereafter after the procedure. PET/CT will be performed 3 months after MWA to assess the treatment response.

Patients diagnosed with early-stage NSCLC and signing the informed consent will undergo MWA with the guidance of ENB.

ENB (LungCare Medical Technologies Ltd., Inc, Suzhou, China)will be used to guide bronchoscope into the accurate location of the lesion during MWA.

Jiayuan Sun, MD, PhD

Jiayuan Sun, MD,PhD

The objective of the study was to evaluate the efficacy and safety of electromagnetic navigation bronchoscopy (ENB) guided microwave ablation (MWA) for the treatment of early-stage peripheral lung cancer.

The study is designed as a multi-center prospective trial with one arm. There will be 5 centers participating the study. Patients diagnosed with early-stage non-small cell lung cancer (NSCLC) that are nonsurgical candidate will be enrolled in the study. Sixty patients are expected to be enrolled in the study. The purpose of the study is to evaluate the efficacy and safety of ENB guided MWA for the treatment of patients with early-stage nonsurgical NSCLC.

ENB Guided MWA for Early-stage Peripheral Lung Cancer

A Multi-center Study of Electromagnetic Navigation Bronchoscopy (ENB) Guided Microwave Ablation for Early-stage Peripheral Lung Cancer

Tumor response will be evaluated at 3 months after ablation. Objective response rate（ORR） is the proportion of patients with complete responses and partial responses according to the modified RECIST criteria.

Disease progression is evaluated based on the changes of the tumor on computed The arrival rate is the proportion of the locatable wire reaching the location of the tumor accurately.

Disease progression is evaluated based on the changes of the tumor on computed tomography (CT) and/or positron emission tomography/computed tomography (PET/CT) according to modified RECIST criteria.

Overall survival（OS) is evaluated after the treatment of ablation until the patient death.

Complications refer to serious operation-related adverse events during and after the operation, such as pneumothorax, bleeding and infection.

Director, Department of Respiratory Endoscopy

Symptoms and General Pathology

Neoplasm Metastasis

patients with small peripheral lesions who need bronchoscopy for diagnostic purposes

piero em balbo, md

piero em balbo, MD

The aim of this study is to evaluate if Electromagnetic navigation (ENB) in combination with rapid on site evaluation (ROSE) can improve diagnostic accuracy in those patients who fail to be diagnosed with conventional fluoroscopic assisted bronchoscopy (FBS) in combination with ROSE.

Conventional Bronchoscopy Plus Rose Versus Electromagnetic Navigation (EMN) Plus Rose in Small Peripheral Lesions

Comparison of the Electromagnetic Navigation System and Rapid on Site Evaluation Versus Conventional Bronchoscopy and Rapid on Site Evaluation: Improved Yield in Small Peripheral Lung Lesions(Original Investigation)

Azienda Ospedaliero Universitaria Maggiore della Carita

Balbo Piero

ENB is used in this group.EBUS and GS are inserted into bronchi in the assistance of ENB. The EBUS probe and GS are confirmed to reach the lesion by EBUS images.

ENB isn't used in this group.EBUS and GS are inserted into bronchi according to the chest CT that judged by the doctor. The EBUS probe and GS are confirmed to reach the lesion by EBUS images.

ENB is carried out by a ENB system（LungCare, China) which can offer real-time navigation for bronchoscopy reaching peripheral pulmonary nodules.

EBUS is performed using an endoscope ultrasound system , which is equipped with a 20-MHz mechanical radial-type probe (UM-S20-17S;Olympus) with an external diameter of 1.4 mm and a GS (K-201; Olympus).

EBUS-GS

The study is designed as a multi-center prospective trial with two arms, ENB-EBUS-GS group and EBUS-GS group, and aimed to evaluate the diagnostic yield and operation time between the two groups.

The study is designed as a multi-center prospective trial with two arms, ENB-EBUS-GS group and EBUS-GS group, and aimed to evaluate the diagnostic yield and operation time between the two groups. Patients with peripheral pulmonary nodules that need to be confirmed by pathology will be enrolled in the study. A total of 400 patients are expected to be enrolled. EBUS will be used in both group. Biopsy, brushing and washing will be performed when EBUS image present. Brushing, washing and lavage will be performed when EBUS image absent.

ENB in the Diagnosis of Peripheral Pulmonary Nodules

Electromagnetic Navigation Bronchoscopy in the Diagnosis of Peripheral Pulmonary Nodules

Diagnostic yield is defined as proportion of true positive and true negative.

The operation time includes total operation time,total GS time and total EBUS time

Complications mean a composite of operation-related serious adverse events (pneumothorax, bleeding, etc.) during and after the operation

Air Force Military Medical University, China

Xiangya Hospital of Central South University

Director, Department of Endoscopy

Central Nervous System Depressants

All Drugs and Chemicals

Antineoplastic Agents

Dermatologic Agents

Anesthetics

Dihematoporphyrin Ether

Trioxsalen

Hematoporphyrin Derivative

To test the feasibility of super-D ENB guided-PDT to treat small lung cancer which cannot be eradicated through surgical resection.

PDT with super-D EBN localization will be given for treating the target lung lesion. Intrvenous photofrin (2mg/kg) will be given 48 hours before intervention. After localization of the tumor by ENB, a 630nm of light will be give for the lesion with the dosage of 2oo J/cm. Intravenous general anesthesia and endobronchial intubation will be performed under the whole procedure.

super-D ENB guided-PDT

Jang-Ming Lee, MD. PhD.

Peiwen Yang, PhD.

Jang-Ming Lee

With the increased incidence of lung cancer and prevalence of low dose CT screening, treating of early lung cancer has becoming an important issue in the clinical practice of thoracic oncology. In this clinical study, the investigators will evaluate whether superDimension (superD) ENB (Electromagnetic navigation bronchoscopy) in combination with interstitial photodynamic therapy can provide the chance of tumor eradication.

Lung cancer is the one the major cause of cancer death all over the world especially in Asia. The prevalence of low dose CT screening has made more patients of lung cancer treated in the early stage. The treatment of choice for of early lung cancer is surgical resection. However, several difficulties exist in surgery for treating early lung cancer. eg. Some presenting as multi-focal lesions, which cannot be completely eradicated by surgical resection.

Electromagnetic navigation bronchoscopy (ENB)（superDimension™ Navigation System, super-D ENB) is a novel technique, which uses an image guided localization system to direct steerable bronchoscopic tools to predetermined points within the bronchial tree. This technology allows improved access to peripheral lesions in particular.

Photodynamic therapy (PDT) has been adopted an effective treatment option for the central located lung cancer by using photosensitizer which is focally retained in the tumor leading to tumor-specific abrasion by irradiating with a certain wave-length of light. The most frequently used and commercially available photosensitizer for lung cancer is PDT with Photofrin under 623 nm red light irradiation. For the peripheral lung cancer which cannot be approached by bronchoscopy, interstitial PDT with the aids of CT guided catheter implantation has been adopted. However, there are potential disadvantages of such approach including 1) bleeding or hemothorax during CT-guided catheter implantation; 2) dislodging of the catheter after lung collapse in the procedure; 3) unable to treat other lesion after pneumothorax.

In the current proposal, the investigators use ENB in combination with PDT to handle to test the feasibility of super-D ENB guided-PDT to treat small lung cancer which cannot be eradicated through surgical resection.

ENB and Photodynamic Therapy in the Treatment for Early Lung Cancer

The Application of Electro-magnetic Navigation Bronchoscopy (ENB) and Photodynamic Therapy in the Treatment for Early Lung Cancer

The time interval between enrollment and the earliest onset of any of the following events,: tumor local recurrence , distant metastasis, and mortality

defined as any deviation from the normal postoperative course

the pulmonary function at 6, 12, and 24 months post-operation

The time interval between enrollment and death

National Taiwan University Hospital

Patients with early-stage peripheral lung cancer will be performed RFA with the guidance of ENB. Post treatment response and follow up will be evaluated and carried out according to the standard procedure.

Patients diagnosed with early-stage NSCLC and signing the informed consent will be performed RFA under the guidance of ENB.

ENB will be used to guide bronchoscope into the accurate location of the lesion during RFA.

The objective of the study was to evaluate the efficacy and safety of electromagnetic navigation bronchoscopy (ENB) guided radiofrequency ablation (RFA) for the treatment of early-stage peripheral lung cancer.

The study is aimed to evaluate the efficacy and safety of ENB guided RFA for the treatment of patients with early-stage non-small cell lung cancer (NSCLC). The study is designed as a single-center prospective trial with one arm. The participating centers are Department of pulmonary medicine and endoscopy, Shanghai Chest Hospital affiliated to Shanghai Jiao Tong University, China. Patients diagnosed with early-stage NSCLC will be enrolled into the study. Fifty patients are expected to be enrolled totally.

ENB Guided RFA for Early-stage Peripheral Lung Cancer

The Clinical Study of Electromagnetic Navigation Bronchoscopy (ENB) Guided Radiofrequency Ablation (RFA) for the Treatment of Early-stage Peripheral Lung Cancer

Complications refer to serious operation-related adverse events during and after the operation,such as pneumothorax, bleeding and infection.

Objective response rate（ORR） is the proportion of patients with complete responses and partial responses according to the modified RECIST criteria.

Disease progression is evaluated by the variation of the tumor on computed tomography (CT) and/or positron emission tomography/computed tomography (PET/CT) according to modified RECIST criteria.

Director, Endoscopy Department

Patients undergoing examination for lung cancer with the use of electromagnetic navigation bronchoscopy for biopsy sampling

Patients undergoing examination for lunge cancer with the use of electromagnetic navigation bronchoscopy and radial endobronchial ultrasound for biopsy sampling.

ENB for biopsy sampling of peripheral lung lesion

The combination of ENB and rEBUS for biopsy sampling of peripheral lung lesions

ENB in combination with rEBUS

Amanda Dandanell Juul, MD

Christian Borbjerg Laursen, MD, PhD

Amanda Juul, Md

Lung cancer is the primary cause of cancer related deaths in Denmark. In order to improve the prognosis diagnosis in earlier stages are needed. This will however require improved sampling techniques from very small lung lesions.

One method involves the use of a radial ultrasound probe inserted in the working channel of the bronchoscope, to more accurately identify the lung lesions before sampling them (rEBUS). The other method involves the use of electromagnetic navigation bronchoscopy (ENB) to guide the operator to the lung lesion.

This study aims to determine whether a combination of rEBUS and ENB is superior to ENB alone in biopsy sampling. The study will be conducted as a non-blinded RCT. Furthermore, we will make an estimate of the hospital costs of the entire diagnostic work up for lung cancer when combining ENB and rEBUS compared to ENB alone.

Background:

Despite recent years' improvement regarding the treatment of lung cancer, it remains the leading cause of cancer deaths in Denmark. This is partly due to many patients being diagnosed in an advanced stage limiting the possibilities of curative treatment. Much attention has therefore been aimed at developing tools for early identification of patients with possible lung cancer . Screening or easy access to CT of the chest may help to identify patients with possible early stage lung cancer. Performing biopsies of small lung lesions in a safe manner without inexpedient complications, however, is an ongoing diagnostic challenge especially for the increasing elderly patient population and patients with decreased lung function. If patients are to benefit from an improved identification of possible early stage lung cancer, it is necessary to also further improve the methods for obtaining biopsies in this patient population in order to decrease the morbidity during the diagnostic work-up and to prepare the patients for treatment in a secure manner.

Current methods for performing biopsies of small lung lesions are transthoracic, endoscopic or surgical. When compared to surgery, the endoscopic methods have the advantages of being easily accessible, cheap, safe with a very low risk of complications, and have limited patient discomfort following the procedure. The major drawback is the diagnostic yield still being significantly lower than surgery.

In recent years, two methods have been developed which seem to improve the diagnostic yield of bronchoscopy for diagnosing peripheral lung lesions. The rationale behind both techniques is to improve identification of the lung lesions prior to performing the biopsies and thereby improving the chance of obtaining representative tissue samples. One method involves the use of a radial ultrasound probe inserted in the working channel of the bronchoscope, which enables the proceduralist to perform radial endobronchial ultrasound (rEBUS) to more accurately identify the lung lesions before sampling them. The other method involves the use of electromagnetic navigation bronchoscopy (ENB) to guide the operator to the lung lesion. One small randomised clinical trial has indicated that the diagnostic yield can be further improved by a multimodal approach, which combines both rEBUS and ENB in the same procedure. The drawbacks of such a combination are however increased costs and procedure time, thus limiting the number of procedures which can be performed within a given time frame.

This PhD thesis aims to determine whether a combination of rEBUS and ENB is superior to ENB alone in patients with suspected lung cancer due to a peripheral lung lesion as well as an estimate of the hospital costs of the entire diagnostic work up for lung cancer when combining ENB and rEBUS as compared to ENB alone.

Hypotheses:

1. The diagnostic yield of ENB in combination with rEBUS is equal to ENB alone in patients with peripheral lung lesions or solitary lung nodules (null hypothesis)
2. The hospital costs of the entire diagnostic work up for lung cancer when combining ENB and rEBUS is the same when compared to an approach with ENB alone (null hypothesis)

Research questions:

1. Is the diagnostic yield of ENB in combination with rEBUS different from ENB alone in diagnosing lung lesions?
2. What are the hospital costs of the entire diagnostic workup for lung cancer when combining ENB and rEBUS in comparing with ENB alone?

Navigation EndoBronchial ULtrAsound (NEBULA):

Hypotheses The study examines the following null-hypothesis: The diagnostic yield of ENB in combination with rEBUS is not superior to ENB alone in patients with peripheral lung lesions or solitary lung nodules.

Objectives To determine which bronchoscopy approach should be considered standard for examining patients with suspected lung cancer due to a peripheral lung lesion.

Methods Study design Multicentre, randomized, non-blinded clinical trial Pre- and post-procedure Preparations prior and following the bronchoscopy procedure are done in accordance with local guidelines. Procedures will be performed either under conscious sedation using midazolam and fentanyl or in general anesthetic depending on the set up of the center performing the procedures. Other medication given during the procedure is also given accordance with local guidelines.

Reference test Histology or cytology results will be used as the reference test for all malignant as well as non-malignant conditions that could be diagnosed based on these. Clinical follow-up including imaging for at least 6 months with no signs of malignancy and results of additional diagnostic procedures will be used as the reference test in patients in which a final diagnosis cannot be established based on histology or cytology results.

Sample size and statistics In a previous study by Eberhardt et al. the diagnostic yield of ENB and combined rEBUS/ENB was 59 % and 88 %, respectively. The diagnostic yield of the intervention arm in the planned study may be lower due to selection of patients with smaller lesions and multicentre approach rather than a single centre study performed by experts. If the total diagnostic yield is 60 % in the control group (ENB) and 80 % in the intervention group (rEBUS/ENB), then a power of 80 % at the 5 % level is obtained with a sample size of 184 patients. Allowing for a 10 % dropout it is planned to enroll 200 patients in the study. The χ2 test, alternatively the Fischer exact test will be used to establish whether there is a difference in the primary endpoint. All results will be assessed using intention to treat principles.

Ethics:

The studies and analyses will be conducted in accordance with the amended Declaration of Helsinki and Data Protection Agency in Denmark and the Medical Ethics Committee.:

The studies do not interfere with choice of other diagnostic tests performed in the patients (e.g. EBUS / EUS-b for mediastinal staging). The patients are treated and followed up according to national and institutional guidelines. The protocols for studies II and III do not influence treatment or follow-up.

Clinical relevance:

The results will help to clarify how one of the most important diagnostic procedures for patients with suspected lung cancer due to a peripheral lung lesion should be used in clinical practice. The results of the project can be directly implemented at a national scale once the results are available.

Economy:

Project expenses are expected to be partially covered by funds from the Kræftens Bekæmpelse - Centre for Lung Cancer Research with a grant of 1 mill. DKK. Funding of expenses for procedures (e.g. scans and invasive procedures) will be covered as part of the lung cancer diagnostic work up "package" covered by the department.

Participating departments:

Currently the following departments have agreed to participate:

* Department of Respiratory Medicine, Bispebjerg Hospital
* Department of Respiratory Medicine, Aalborg University Hospital
* Department of Respiratory Medicine, Odense University Hospital

Navigation Endobronchial Ultrasound

The Efficacy of Combining Endoscopic Modalities for the Diagnosis of Solitary Pulmonary Lesions

Total diagnostic yield, being defined as a tissue biopsy allowing a definite diagnosis of either a malignant or benign condition in the lung in proportion to the total number of procedures performed.

Diagnostic yield of malignant conditions, being defined as a tissue biopsy allowing a definite diagnosis of a malignant condition in the lung

Diagnostic yield of non-malignant conditions, being defined as a tissue biopsy allowing a definite diagnosis of a benign condition in the lung

Total proportion of patients with procedure complications

Total proportion of patients with severe procedure complications

Patient reported procedure discomfort during the endoscopic procedure. Reported in a questionnaire efter the procedure.

Patient reported procedure satisfaction. Reported in a questionnaire after the procedure in a scale from 1 -10.

Procedure time differens between the two arms

Differens in procedure cost for the two arms, reported in daniske kroner or converted to euro for publications

Hospital costs of the entire diagnostic workup incl. admissions and expenses for treating adverse events from referral to end of "cancer package". Reported in danish kroner or converted to euro for publication.

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
ENB-GS-TBLB for the Diagnosis of PPLs	NCT02207478	Lung Cancer	ENB GS-TBLB-X-ray	18 Years - 80 Years	Shanghai Chest Hospital
ENB Guided MWA for Early-stage Peripheral Lung Cancer	NCT04005157	Lung Cancer	MWA ENB	18 Years -	Shanghai Chest Hospital
Conventional Bronchoscopy Plus Rose Versus Electromagnetic Navigation (EMN) Plus Rose in Small Peripheral Lesions	NCT00880945	Lung Cancer Secondary Lung ... Benign Lung Les...		18 Years - 80 Years	Azienda Ospedaliero Universitaria Maggiore della Carita
ENB in the Diagnosis of Peripheral Pulmonary Nodules	NCT03569306	Peripheral Pulm...	ENB EBUS-GS	18 Years -	Shanghai Chest Hospital
ENB and Photodynamic Therapy in the Treatment for Early Lung Cancer	NCT03211078	Lung Cancer	super-D ENB gui...	20 Years -	National Taiwan University Hospital
ENB Guided RFA for Early-stage Peripheral Lung Cancer	NCT03009630	Lung Cancer	RFA ENB	18 Years -	Shanghai Chest Hospital
Navigation Endobronchial Ultrasound	NCT04553809	Lung Cancer	ENB ENB in combinat...	18 Years -	University of Southern Denmark
ENB Guided MWA for Early-stage Peripheral Lung Cancer	NCT04005157	Lung Cancer	MWA ENB	18 Years -	Shanghai Chest Hospital
ENB in the Diagnosis of Peripheral Pulmonary Nodules	NCT03569306	Peripheral Pulm...	ENB EBUS-GS	18 Years -	Shanghai Chest Hospital

Spots Global Cancer Trial Database for enb

Every month we try and update this database with for enb cancer trials from around the world to help patients and their families find trials that might be right for them.
We offer this 100% free of charge and do not endorse any of the trials listed here, we hope it helps you or a loved one.

Spots Global Cancer Trial Database for enb

Every month we try and update this database with for enb cancer trials from around the world to help patients and their families find trials that might be right for them. We offer this 100% free of charge and do not endorse any of the trials listed here, we hope it helps you or a loved one.

Every month we try and update this database with for enb cancer trials from around the world to help patients and their families find trials that might be right for them.
We offer this 100% free of charge and do not endorse any of the trials listed here, we hope it helps you or a loved one.