Sponsor: Seagen, a wholly owned subsidiary of Pfizer (industry)
Phase: 2
Start date: May 3, 2022
Planned enrollment: 372
Disitamab vedotin (DV; RC48; Aidixi) is a HER2-directed antibody–drug conjugate developed for HER2-expressing solid tumors. It is approved for several indications in China but remains investigational in the United States; FDA orphan-drug designation does not constitute marketing approval. Clinical development includes urothelial, gastric/gastroesophageal-junction and breast cancers, including some tumors with low HER2 expression. (pubmed.ncbi.nlm.nih.gov)
DV consists of the humanized anti-HER2 antibody disitamab conjugated through a protease-cleavable linker to monomethyl auristatin E (MMAE). After HER2 binding and internalization, MMAE is released and inhibits microtubule polymerization, causing cell-cycle arrest and death. Membrane-permeable MMAE may also kill neighboring cells with lower HER2 expression—the proposed “bystander effect.” (pmc.ncbi.nlm.nih.gov)
Peripheral sensory neuropathy, leukopenia/neutropenia, fatigue or asthenia and elevated liver enzymes are recurring toxicities. In the previously treated urothelial-cancer studies, 54.2% experienced grade 3 or higher treatment-related adverse events, most notably peripheral neuropathy (18.7%) and neutropenia (12.1%). (ascopubs.org)
In first-line urothelial cancer, grade 3 or higher treatment-related events occurred in 55.1% with DV plus toripalimab versus 86.9% with chemotherapy. In the breast-cancer phase III trial, corresponding rates were 37.7% with DV and 36.0% with lapatinib–capecitabine. Rare serious events reported in combination studies include pneumonitis, including a treatment-related death. (nejm.org)
Last updated: Sep 2026
Goal: Evaluate the antitumor activity and safety of disitamab vedotin, alone or with pembrolizumab, in locally advanced unresectable or metastatic urothelial carcinoma.
Patients: Patients have measurable urothelial carcinoma, generally with centrally confirmed HER2 expression (IHC 1+, 2+, or 3+). Cohorts include previously platinum-treated patients; previously untreated, platinum-eligible patients; patients in Japan previously treated with platinum, PD-(L)1 inhibition, and enfortumab vedotin; and patients previously treated with an enfortumab vedotin–containing regimen. ECOG performance status requirements vary by cohort, and baseline neuropathy is restricted.
Design: Multicenter, open-label, multi-cohort study with both nonrandomized groups and a randomized comparison of disitamab vedotin plus pembrolizumab versus disitamab vedotin alone in cohort C. Cohorts A and B distinguish HER2-positive and HER2-low tumors; cohorts D and E are Japan-only.
Treatments: Disitamab vedotin is given alone in cohorts A, B, D, and G, and alone or with pembrolizumab in cohort C; cohort E receives the combination. Disitamab vedotin is an investigational HER2-directed antibody–drug conjugate that delivers the microtubule inhibitor MMAE to HER2-expressing cells. In separate studies of previously treated urothelial carcinoma, it produced an approximately 51% independently assessed response rate; these are not results from the present trial. Pembrolizumab is a PD-1 inhibitor.
Outcomes: The primary efficacy endpoint for cohorts A, B, C, and G is confirmed objective response rate by blinded independent central review using RECIST 1.1. Primary assessments in the Japan-only cohorts D and E focus on adverse events, dose alterations, laboratory and cardiac findings, and pharmacokinetics. Secondary measures include response duration, progression-free and overall survival, disease control, safety, pharmacokinetics, and antidrug antibodies.
Burden on patient: Estimated burden is moderate to high. Participants require tumor tissue for central HER2 assessment, repeated imaging and safety evaluations, blood sampling for pharmacokinetics and immunogenicity, and visits for study-drug administration over potentially prolonged treatment. Visit and sampling schedules are not specified, and a new biopsy is not explicitly required.
Last updated: Sep 2026
Inclusion Criteria:
Cohorts A and B
* Histopathologically-confirmed, locally-advanced, unresectable or metastatic urothelial cancer (LA/mUC), including UC originating from the renal pelvis, ureters, bladder, or urethra
* Participants must have received only 1 or 2 lines of prior systemic treatment for LA/mUC, including 1 line of platinum-containing chemotherapy
* At least one measurable lesion by investigator assessment based on RECIST version 1.1.
* HER2-expression status determined by the central laboratory to be IHC 1+, 2+ or 3+, in the provided tumor sample
* Eastern Cooperative Oncology Group (ECOG) performance status score of 0 or 1
Cohort C
* Histopathologically-confirmed LA/mUC, including UC originating from the renal pelvis, ureters, bladder, or urethra
* No prior systemic therapy for LA/mUC
* Neoadjuvant or adjuvant therapy, including PD-(L)1 inhibitors, is acceptable, if disease recurrence/progression occurred more than 12 months after the last dose of systemic therapy
* At least one measurable lesion by investigator assessment based on RECIST v1.1.
* Participant is eligible to receive cisplatin- or carboplatin- containing chemotherapy per investigator evaluation
* HER2-expression status determined by the central laboratory to be IHC 1+, 2+ or 3+, on the provided tumor tissue sample
* ECOG performance status of 0, 1, or 2
Cohort D
* Histopathologically-confirmed LA/mUC, including UC originating from the renal pelvis, ureters, bladder, or urethra
* Based on a participant's eligibility to receive treatment with standard of care therapies in Japan, participants must have received all of the following lines of therapy for LA/mUC:
* a. One prior line of platinum-containing chemotherapy.
* b. Prior therapy with PD-(L)1 inhibitors as (neo)adjuvant therapy, first-line maintenance therapy or as second line treatment.
* c. Prior enfortumab vedotin therapy.
* At least one measurable lesion by investigator assessment based on RECIST v1.1.
* ECOG performance status of 0 or 1
Cohort E
* Histopathologically-confirmed LA/mUC, including UC originating from the renal pelvis, ureters, bladder, or urethra
* No prior systemic therapy for LA/mUC
* Neoadjuvant or adjuvant therapy, including PD-(L)1 inhibitors, is acceptable, if disease recurrence/progression occurred more than 12 months after the last dose of systemic therapy.
* At least one measurable lesion by investigator assessment based on RECIST v1.1.
* Participant is eligible to receive cisplatin- or carboplatin- containing chemotherapy per investigator evaluation
* HER2-expression status determined by the central laboratory to be IHC 1+, 2+ or 3+, in the provided tumor sample
* ECOG performance status of 0 or 1
Cohort G
* Histopathologically-confirmed, locally-advanced, unresectable or metastatic urothelial cancer (LA/mUC), including UC originating from the renal pelvis, ureters, bladder, or urethra
* Participants must have received only 1 or 2 lines of prior systemic treatment for LA/mUC, including 1 line of therapy containing enfortumab vedotin as monotherapy or in combination with pembrolizumab
* The last administration of enfortumab vedotin must be 90 days from the start of study treatment. Intervening therapies are allowed between the final dose of enfortumab vedotin and the start of disitamab vedotin.
* At least one measurable lesion by investigator assessment based on RECIST version 1.1.
* HER2-expression status determined by the central laboratory to be IHC 1+, 2+ or 3+, in the provided tumor sample
* Eastern Cooperative Oncology Group (ECOG) performance status score of 0 or 1
Exclusion Criteria:
Cohorts A and B
* Known hypersensitivity to disitamab vedotin or any of their components
* Prior antitumor treatment (including chemotherapy, radiotherapy, targeted therapy, immunotherapy etc.) within 2 weeks of start of study (defined as Cycle 1 Day 1 for Cohorts A and B)
* Toxicity from a previous treatment has not returned to Grades 0 or 1 (except for Grade 2 alopecia)
* Prior MMAE-based ADCs (eg, enfortumab vedotin) or HER2-directed therapy
* Major surgery that has not fully recovered within 4 weeks prior to dose administration
* Peripheral sensory or motor neuropathy ≥ Grade 2 at baseline
Cohort C
* Known hypersensitivity to disitamab vedotin, pembrolizumab, or any of their components
* Prior antitumor treatment (including chemotherapy, radiotherapy, targeted therapy, immunotherapy etc.) within 2 weeks of start of study defined as Cycle 1 Day 1 for the single-arm part of Cohort C and as randomization date for the randomized part of Cohort C)
* Toxicity from a previous treatment has not returned to Grades 0 or 1 (except for Grade 2 alopecia)
* Prior MMAE-based ADCs (eg, enfortumab vedotin) or HER2-directed therapy
* Major surgery that has not fully recovered within 4 weeks prior to dose administration
* Peripheral sensory or motor neuropathy ≥ Grade 2 at baseline
* Has a diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy (in dosing exceeding 10 mg daily of prednisone equivalent) or any other form of immunosuppressive therapy within 7 days prior the first dose of study drug
* Participants who have previously received any prior treatment with an agent directed to another stimulatory or co-inhibitory T cell receptor (including but not limited to CD137 agonists, CAR-T cell therapy, CTLA-4 inhibitors, or OX-40 agonists) are excluded.
Cohort D
* Known hypersensitivity to disitamab vedotin or any of their components
* Prior antitumor treatment (including chemotherapy, radiotherapy, targeted therapy, immunotherapy etc.) within 2 weeks of start of study (defined as Cycle 1 Day 1 for Cohort D)
* Toxicity from a previous treatment has not returned to Grades 0 or 1 (except for Grade 2 alopecia)
* Prior HER2-directed therapy
* Any prior history of ≥ Grade 3 non-hematological AEs related to prior therapy
* Major surgery that has not fully recovered within 4 weeks prior to dose administration
* Peripheral sensory or motor neuropathy ≥ Grade 1 at baseline
Cohort E
* Known hypersensitivity to disitamab vedotin, pembrolizumab, or any of their components
* Prior antitumor treatment (including chemotherapy, radiotherapy, targeted therapy, immunotherapy etc.) within 2 weeks of start of study (defined as Cycle 1 Day 1 for Cohort E)
* Toxicity from a previous treatment has not returned to Grades 0 or 1 (except for Grade 2 alopecia)
* Any prior history of ≥ Grade 3 non-hematological AEs related to prior therapy
* Prior MMAE-based ADCs (eg, enfortumab vedotin) or HER2-directed therapy
* Major surgery that has not fully recovered within 4 weeks prior to dose administration
* Peripheral sensory or motor neuropathy ≥ Grade 1 at baseline
* Has a diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy (in dosing exceeding 10 mg daily of prednisone equivalent) or any other form of immunosuppressive therapy within 7 days prior the first dose of study drug
Cohort G
* Known hypersensitivity to disitamab vedotin or any of their components
* Prior antitumor treatment (including chemotherapy, radiotherapy, targeted therapy, immunotherapy etc.) within 2 weeks of start of study (defined as Cycle 1 Day 1 for Cohort G)
* Toxicity from a previous treatment has not returned to Grades 0 or 1 (except for Grade 2 alopecia)
* Prior HER2-directed therapy
* Major surgery that has not fully recovered within 4 weeks prior to dose administration
* Peripheral sensory or motor neuropathy ≥ Grade 2 at baseline
There are additional inclusion and exclusion criteria. The study center will determine if criteria for participation are met.
CABA, C1019ABS, Argentina
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Caba, ZC 1426, Argentina
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Buenos Aires, C1118AAT, Argentina
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Buenos Aires, ZC 1419, Argentina
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Buenos Aires, C1426ANZ, Argentina
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Córdoba, X5000, Argentina
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Viedma, Río Negro Province, R8500ACE, Argentina
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Elizabeth Vale, 5112, Australia
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Alexandria, New South Wales, 2015, Australia
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St Leonards, New South Wales, 2065, Australia
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Sydney, New South Wales, 2109, Australia
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South Brisbane, Queensland, QLD 4101, Australia
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Brisbane, Queensland, 4102, Australia
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Frankston, Victoria, 3199, Australia
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Calgary, Alberta, T3N 4N1, Canada
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Vancouver, British Columbia, V5Z 4E6, Canada
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Vancouver, British Columbia, V5Z 1H7, Canada
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Winnipeg, Manitoba, R3E 0V9, Canada
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Montreal, Quebec, H3T 1E2, Canada
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Providencia, 8320000, Chile
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La Serena, Coquimbo Region, 1720430, Chile
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Santiago, Providencia, 8330032, Chile
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Ankara, 06620, Turkey (Türkiye)
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Izmir, 35575, Turkey (Türkiye)
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Istanbul, 34722, Turkey (Türkiye)
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Edirne, 22030, Turkey (Türkiye)
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London, EC1A 7BE, United Kingdom
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Cambridge, CB2 0QQ, United Kingdom
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London, W6 8RF, United Kingdom
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London, SE1 9RT, United Kingdom
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Merseyside, CH63 4JY, United Kingdom
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Glasgow, Scotland, G12 0YN, United Kingdom
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Gilbert, Arizona, 85234, United States
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Gilbert, Arizona, 85234, United States
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Beverly Hills, California, 90211, United States
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Irvine, California, 92612, United States
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San Gabriel, California, 91776, United States
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Glendora, California, 91741, United States
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Pasadena, California, 91105, United States
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Arcadia, California, 91007, United States
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Irvine, California, 92618, United States
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Anaheim, California, 92806, United States
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Baldwin Park, California, 91706, United States
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Bellflower, California, 90706, United States
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Fontana, California, 92335, United States
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Los Angeles, California, 90027, United States
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Ontario, California, 91761, United States
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Panorama City, California, 91402, United States
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Riverside, California, 92505, United States
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San Diego, California, 92108, United States
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San Marcos, California, 92078, United States
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Harbor City, California, 90710, United States
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Los Angeles, California, 90034, United States
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Woodland Hills, California, 91367, United States
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San Diego, California, 92120, United States
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Newport Beach, California, 92660, United States
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Burbank, California, 91505, United States
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Los Angeles, California, 90095, United States
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San Luis Obispo, California, 93405, United States
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San Gabriel, California, 91776, United States
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Pasadena, California, 91105, United States
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Riverside, California, 92505, United States
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Templeton, California, 93465, United States
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Orange, California, 92868, United States
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Burbank, California, 91505, United States
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Los Angeles, California, 90095, United States
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Los Angeles, California, 90017, United States
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Encino, California, 91436, United States
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Los Angeles, California, 90095, United States
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Porter Ranch, California, 91326, United States
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Valencia, California, 91355, United States
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Pasadena, California, 91105, United States
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Encino, California, 91436, United States
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Burbank, California, 91505, United States
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San Luis Obispo, California, 93401, United States
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Santa Monica, California, 90404, United States
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Torrance, California, 90505, United States
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Ventura, California, 93003, United States
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Westlake Village, California, 91361, United States
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Montecito, California, 93108, United States
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Porter Ranch, California, 91326, United States
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Valencia, California, 91355, United States
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Los Angeles, California, 90404, United States
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Simi Valley, California, 93065, United States
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Thousand Oaks, California, 91360, United States
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Torrance, California, 90505, United States
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Ventura, California, 93003, United States
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Los Angeles, California, 90095, United States
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San Francisco, California, 94115, United States
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San Francisco, California, 94158, United States
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San Francisco, California, 94115, United States
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San Francisco, California, 94143, United States
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San Francisco, California, 94158, United States
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San Francisco, California, 94158, United States
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Bonita Springs, Florida, 34135, United States
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Bradenton, Florida, 34205, United States
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Bradenton, Florida, 34211, United States
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Cape Coral, Florida, 33909, United States
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Fleming Island, Florida, 32003, United States
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Fort Myers, Florida, 33905, United States
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Fort Myers, Florida, 33908, United States
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N. Venice, Florida, 34275, United States
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Naples, Florida, 34102, United States
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Port Charlotte, Florida, 33980, United States
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Sarasota, Florida, 34232, United States
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Tallahassee, Florida, 32308, United States
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Venice, Florida, 34285, United States
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Venice, Florida, 34292, United States
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Sarasota, Florida, 34239, United States
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Tampa, Florida, 33612, United States
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Tampa, Florida, 33612, United States
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Deerfield, Illinois, 60015, United States
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Orland Park, Illinois, 60462, United States
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Chicago, Illinois, 60611, United States
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Harvey, Illinois, 60426, United States
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Flossmoor, Illinois, 60422, United States
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Tinley Park, Illinois, 60477, United States
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New Lenox, Illinois, 60451, United States
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Chicago, Illinois, 60637, United States
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Worcester, Massachusetts, 01655, United States
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Worcester, Massachusetts, 01655, United States
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Grand Rapids, Michigan, 49546, United States
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Detroit, Michigan, 48202, United States
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Detroit, Michigan, 48201, United States
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Farmington Hills, Michigan, 48334, United States
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Lansing, Michigan, 48910, United States
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Holland, Michigan, 49424, United States
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Norton Shores, Michigan, 49444, United States
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Grand Rapids, Michigan, 49546, United States
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Grand Rapids, Michigan, 49503, United States
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Big Rapids, Michigan, 49307, United States
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Basking Ridge, New Jersey, 07920, United States
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Montvale, New Jersey, 07645, United States
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Middletown, New Jersey, 07748, United States
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New York, New York, 10065, United States
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New York, New York, 10029, United States
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Commack, New York, 11725, United States
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Harrison, New York, 10604, United States
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Uniondale, New York, 11553, United States
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Long Island City, New York, 11101, United States
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New York, New York, 10021, United States
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New York, New York, 10065, United States
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New York, New York, 10065, United States
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Concord, North Carolina, 28025, United States
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Charlotte, North Carolina, 28207, United States
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Monroe, North Carolina, 28112, United States
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Charlotte, North Carolina, 28262, United States
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Charlotte, North Carolina, 28203, United States
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Charlotte, North Carolina, 28204, United States
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Charlotte, North Carolina, 28204, United States
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Charlotte, North Carolina, 28277, United States
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Concord, North Carolina, 28025, United States
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Charlotte, North Carolina, 28262, United States
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Gastonia, North Carolina, 28054, United States
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Columbus, Ohio, 43210, United States
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Columbus, Ohio, 43210, United States
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Columbus, Ohio, 43210, United States
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Columbus, Ohio, 43210, United States
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Columbus, Ohio, 43210, United States
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Columbus, Ohio, 43221, United States
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Cleveland, Ohio, 44106, United States
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Oklahoma City, Oklahoma, 73104, United States
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Oklahoma City, Oklahoma, 73104, United States
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Knoxville, Tennessee, 37920, United States
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Houston, Texas, 77030, United States
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Fairfax, Virginia, 22031, United States
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Seattle, Washington, 98109, United States
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Seattle, Washington, 98104, United States
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Seattle, Washington, 98195, United States
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Milwaukee, Wisconsin, 53226, United States
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Buenos Aires, Buenos Aires F.D., 1113, Argentina
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Status: Active, not recruiting
Ghent, 9000, Belgium
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Namur, 5000, Belgium
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Sherbrooke, Quebec, J1H 5N4, Canada
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Status: Active, not recruiting
Petah Tikva, 4941492, Israel
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Status: Active, not recruiting
Haifa, 3109601, Israel
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Ramat Gan, 52621, Israel
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Tel Aviv, 6423906, Israel
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Ramat Gan, 5265601, Israel
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Terni, 05100, Italy
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Status: Active, not recruiting
Pisa, 56126, Italy
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Status: Active, not recruiting
Roma, 00168, Italy
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Status: Active, not recruiting
Padova, 35128, Italy
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Status: Active, not recruiting
Milan, 20132, Italy
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Terni, 05100, Italy
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Milan, Lombardy, 20132, Italy
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Status: Active, not recruiting
Aviano, Pordenone, 33184, Italy
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Roma, ROME, 00168, Italy
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Osaka, 541-8567, Japan
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Kashiwa-shi, Chiba, 277-8577, Japan
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Status: Active, not recruiting
Sapporo, Hokkaido, 060-8543, Japan
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Suita-shi, Osaka, 565-0871, Japan
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Status: Active, not recruiting
Tokushima, Tokushima, 770-8503, Japan
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Koto-ku, Tokyo, 135-8550, Japan
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Barcelona, 08035, Spain
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Seville, 41013, Spain
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Madrid, 28033, Spain
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Madrid, 28033, Spain
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Sabadell, Barcelona, 08208, Spain
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Status: Active, not recruiting
Duarte, California, 91010, United States
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Status: Active, not recruiting
Daytona Beach, Florida, 32117, United States
No email / No phone
Status: Active, not recruiting
Stuart, Florida, 34994, United States
No email / No phone
Status: Active, not recruiting
Vero Beach, Florida, 32960, United States
No email / No phone
Status: Active, not recruiting
West Palm Beach, Florida, 33401, United States
No email / No phone
Status: Active, not recruiting
Wellington, Florida, 33414, United States
No email / No phone
Status: Active, not recruiting
Carrollton, Georgia, 30117, United States
No email / No phone
Status: Active, not recruiting
Cartersville, Georgia, 30121, United States
No email / No phone
Status: Active, not recruiting
Douglasville, Georgia, 30134, United States
No email / No phone
Status: Active, not recruiting
Hiram, Georgia, 30141, United States
No email / No phone
Status: Active, not recruiting
Marietta, Georgia, 30060, United States
No email / No phone
Status: Active, not recruiting
Hiram, Georgia, 30141, United States
No email / No phone
Status: Active, not recruiting
Carrollton, Georgia, 30117, United States
No email / No phone
Status: Active, not recruiting
Lake Success, New York, 11042, United States
No email / No phone
Status: Active, not recruiting
Syracuse, New York, 13210, United States
No email / No phone
Status: Active, not recruiting
Istanbul, 34098, Turkey (Türkiye)
No email / No phone
Status: Not yet recruiting
Manchester, M20 4BX, United Kingdom
No email / No phone
Status: Not yet recruiting
Manchester, M20 4BX, United Kingdom
No email / No phone
Status: Not yet recruiting
Los Angeles, California, 90067, United States
No email / No phone
Status: Not yet recruiting
Washington D.C., District of Columbia, 20010, United States
No email / No phone
Status: Not yet recruiting
Chapel Hill, North Carolina, 27514, United States
No email / No phone
Status: Not yet recruiting
Chapel Hill, North Carolina, 27599, United States
No email / No phone
Status: Not yet recruiting
Temple, Texas, 76508, United States
No email / No phone
Status: Not yet recruiting
Dallas, Texas, 75204, United States
No email / No phone
Status: Not yet recruiting