A Study of Atezolizumab Versus Placebo in Combination With Paclitaxel, Carboplatin, and Bevacizumab in Participants With Newly-Diagnosed Stage III or Stage IV Ovarian, Fallopian Tube, or Primary Peritoneal Cancer

NCT03038100CompletedPHASE3INTERVENTIONAL

Summary

This is a Phase III, global, double-blind, 2-arm randomized study designed to compare the efficacy and safety of atezolizumab + paclitaxel + carboplatin + bevacizumab versus placebo + paclitaxel + carboplatin + bevacizumab. Study participants will have Stage 3 or 4 ovarian cancer (OC), fallopian tube cancer (FTC), or primary peritoneal cancer (PPC) with macroscopic residual disease postoperatively (i.e., after primary tumor reductive surgery) or who will undergo neoadjuvant therapy followed by interval surgery.

Key Facts

Lead Sponsor

Hoffmann-La Roche

Enrollment

1301

Start Date

2017-03-08

Completion Date

2022-02-08

Study Type

INTERVENTIONAL

Official Title

A Phase III, Multicenter, Randomized, Study of Atezolizumab Versus Placebo Administered in Combination With Paclitaxel, Carboplatin, and Bevacizumab to Patients With Newly-Diagnosed Stage III or Stage IV Ovarian, Fallopian Tube, or Primary Peritoneal Cancer

Interventions

PaclitaxelCarboplatinAtezolizumabBevacizumabAtezolizumab Placebo

Conditions

Ovarian CancerFallopian Tube CancerPeritoneal Neoplasms

Eligibility

Age Range

18 Years+

Sex

FEMALE

Inclusion Criteria:

* Participants receiving a histologic diagnosis of epithelial ovarian cancer (EOC), peritoneal primary carcinoma, or fallopian tube cancer
* Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1, or 2
* Life expectancy greater than (\>) 12 weeks
* For participants who receive therapeutic anticoagulation: stable anticoagulant regimen
* Availability of a representative formalin-fixed, paraffin-embedded (FFPE) tumor specimen in paraffin blocks (preferred) or at least 20 unstained slides (for detailed tissue requirements at screening)

Exclusion Criteria:

* Received a current diagnosis of borderline epithelial ovarian tumor (formerly tumors of low malignant potential)
* Have recurrent invasive epithelial ovarian, fallopian tube, or primary peritoneal cancer that was treated only with surgery (example \[e.g.\], participants with Stage IA or Stage IB epithelial ovarian or fallopian tube cancers)
* Have non-epithelial ovarian tumors (e.g., germ cell tumors, sex cord stromal tumors)
* Received prior radiotherapy to any portion of the abdominal cavity or pelvis
* Received prior chemotherapy for any abdominal or pelvic tumor that include neoadjuvant chemotherapy (NACT) for ovarian, primary peritoneal or fallopian tube cancer
* Received any biological and/or targeted therapy (including but not limited to vaccines, antibodies, tyrosine kinase inhibitors) or hormonal therapy for management and/or treatment of epithelial ovarian or peritoneal primary cancer
* Have synchronous primary endometrial cancer
* Have a prior history of primary endometrial cancer, except: Stage IA cancer; superficial myometrial invasion, without lymphovascular invasion; grade less than (\<) 3 or poorly differentiated subtypes, and this includes papillary serous, clear cell or other International Federation of Gynecological Oncologists (FIGO) Grade 3 lesions
* With the exception of non-melanoma skin cancer and other specific malignancies as noted above, other invasive malignancies with any evidence of other cancers present within the last 5 years or previous cancer treatment that contraindicates this protocol therapy
* Have a known hypersensitivity or allergy to biopharmaceutical agents produced in Chinese hamster ovary cells or any component of the atezolizumab and/or bevacizumab formulations
* Undergo major surgical procedure within 28 days prior to first bevacizumab dose, or anticipation of the need for a major surgical procedure during the course of the study except participants who receive NACT and will need interval surgery. This may include but is not limited to laparotomy.
* Have prior allogeneic bone marrow transplantation or solid organ transplant
* Have any other diseases, metabolic dysfunction, physical examination finding, or clinical laboratory finding giving reasonable suspicion of a disease or condition that contraindicates the use of an investigational drug or that may affect the interpretation of the results
* Have any approved or investigational anti-cancer therapy, including chemotherapy or hormonal therapy, with exceptions: Hormone-replacement therapy or oral contraceptives
* Are administered treatment with any other investigational agent or participation in another clinical study with anti-cancer therapeutic intent
* Have core biopsy or other minor surgical procedures within 7 days prior to the first dose of bevacizumab
* Have known sensitivity to any component of bevacizumab
* Have known sensitivity to any component of paclitaxel
* Current treatment with anti-viral therapy for hepatitis B virus (HBV)
* History of leptomeningeal disease

Outcome Measures

Primary Outcomes

Progression-Free Survival (PFS) Assessed by Investigator as Per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1) - Intent-to-Treat (ITT) Population

Investigator-assessed PFS is defined as the time from randomization to the occurrence of disease progression, as determined by the investigator from tumor assessments per RECIST v1.1, or death from any cause during the study, whichever occurs first.

Time frame: From randomization until disease progression or death from any cause (up to approximately 55 months)

PFS Assessed by Investigator as Per RECIST v1.1 - Programmed Death-Ligand 1 (PD-L1)-Positive Subpopulation

Investigator-assessed PFS is defined as the time from randomization to the occurrence of disease progression, as determined by the investigator from tumor assessments per RECIST v1.1, or death from any cause during the study, whichever occurs first.

Time frame: From randomization until disease progression or death from any cause (up to approximately 55 months)

Overall Survival - ITT Population

Overall Survival (OS) is defined as the time from randomization to death from any cause.

Time frame: From randomization up to death from any cause (up to approximately 59 months)

Overall Survival - PD-L1-Positive Subpopulation

Overall Survival (OS) is defined as the time from randomization to death from any cause.

Time frame: From randomization up to death from any cause (up to approximately 59 months)

Secondary Outcomes

Percentage of Participants With Objective Response (OR) Assessed by Investigator as Per RECIST v1.1 - Primary Tumor-Reductive Surgery Group in ITT Population

OR is defined as either a CR or PR as determined by the investigator with the use of RECIST v1.1 for patients with measurable residual disease after primary surgery.

Time frame: From randomization until disease progression or death from any cause (up to approximately 55 months)

Percentage of Participants With Objective Response (OR) Assessed by Investigator as Per RECIST v1.1 - Primary Tumor-Reductive Surgery Group in PD-L1-Positive Population

OR is defined as either a CR or PR as determined by the investigator with the use of RECIST v1.1 for patients with measurable residual disease after primary surgery.

Time frame: From randomization until disease progression or death from any cause (up to approximately 55 months)

Duration of Response Assessed by Investigator as Per RECIST v1.1 - Primary Tumor-Reductive Surgery (Having Residual Measurable Disease) Group in ITT Population

DOR is defined as the time interval from first occurrence of a CR or PR to the time of disease progression, as determined by the investigator with the use of RECIST v1.1, or death from any cause, whichever comes first for patients with measurable residual disease after primary surgery.

Time frame: From the date of first occurrence of a confirmed complete or partial response until disease progression or death from any cause (up to approximately 55 months)

Duration of Response Assessed by Investigator as Per RECIST v1.1 - Primary Tumor-Reductive Surgery (Having Residual Measurable Disease) Group in PD-L1-Positive Population

DOR is defined as the time interval from first occurrence of a CR or PR to the time of disease progression, as determined by the investigator with the use of RECIST v1.1, or death from any cause, whichever comes first for patients with measurable residual disease after primary surgery.

Time frame: From the date of first occurrence of a confirmed complete or partial response until disease progression or death from any cause (up to approximately 55 months)

Percentage of Participants Who Achieve a Clinically-Meaningful Improvement in Patient-Reported Abdominal Pain and Bloating - Neoadjuvant Group

Clinically-meaningful improvement defined as a \>=10-point decrease from the baseline score in patient-reported abdominal pain or bloating will be assessed using European Organisation for Research and Treatment of Cancer Quality-of-Life Questionnaires Ovarian Cancer Module 28 (EORTC QLQ-OV28) Abdominal/Gastrointestinal Symptom Scale (Items 31 and 31).

Time frame: From randomization to the end of treatment/discontinuation (up to approximately 66 weeks), and during follow-up period (up to approximately 55 months). Cycle length=21 days.

Percentage of Participants Who Achieve a Clinically-Meaningful Improvement in Patient-Reported Function and Health Related Quality of Life (HRQoL) - Neoadjuvant Group

Clinically-meaningful improvement in patient-reported function and HRQoL during the treatment period, defined as a \>=10-point increase from the baseline score on each of the functional (social, emotional, physical, role) and GHS/QoLscales of the European Organisation for Research and Treatment of Cancer Quality-of-Life Questionnaires Core 30 (EORTC QLQ-C30).

Time frame: From randomization to the end of treatment/discontinuation (up to approximately 66 weeks), and during follow-up period (up to approximately 55 months). Cycle length=21 days.

Percentage of Participants Who Achieve a Clinically-Meaningful Improvement in Patient-Reported Function and HRQoL - Primary Tumor-Reductive Surgery Group

Percentage of participants with clinical improvement, defined as \>= 10-point increase from the baseline score on each of the functional (physical, role, emotional, and social) and GHS/QoL scales of the EORTC QLQ-C30.

Time frame: From randomization to the end of treatment/discontinuation (up to approximately 66 weeks), and during follow-up period (up to approximately 55 months). Cycle length=21 days.

Percentage of Participants Who Remain Stable in Patient-Reported Function and HRQoL - Primary Tumor-Reductive Surgery Group

Percentage of participants who remain stable defined as changes within 10 points from the baseline score on each of the functional (physical, role, emotional, and social) and GHS/QoL scales of the EORTC QLQ-C30.

Time frame: From randomization to the end of treatment/discontinuation (up to approximately 66 weeks), and during follow-up period (up to approximately 55 months). Cycle length=21 days.

Percentage of Participants With Deterioration in Patient-Reported Function and HRQoL - Primary Tumor-Reductive Surgery Group

Percentage of participants with deterioration in patient-reported function and HRQoL, defined as \>= 10 points decrease from the baseline score on each of the functional (physical, role, emotional, and social) and GHS/QoL scales of the EORTC QLQ-C30.

Time frame: From randomization to the end of treatment/discontinuation (up to approximately 66 weeks), and during follow-up period (up to approximately 60 months). Cycle length=21 days.

Percentage of Participants With at Least One Adverse Event

Percentage of participants with at least one adverse event.

Time frame: From randomization up to approximately 59 months

Maximum Serum Concentration (Cmax) of Atezolizumab

Time frame: Cycle 1 Day 1 post dose and Cycle 3 Day 1 post dose

Minimum Serum Concentration (Cmin) of Atezolizumab

Time frame: Cycle 2 Day 1 predose, Cycle 3 Day 1 Predose, Cycle 4 Day 1 predose, Cycle 8 Day 1 predose, Cycle 16 Day 1 predose

Percentage of Participants With Anti-Drug Antibodies (ADAs) to Atezolizumab

Time frame: Baseline to approximately 55 months

Locations

St. Joseph'S Hospital & Medical Center, Phoenix, United States

Arizona Oncology Associates, PC - HAL, Scottsdale, United States

Arizona Oncology - HOPE Wilmot, Tucson, United States

Moores Cancer Center at UC San Diego Health, La Jolla, United States

LAC + USC Medical Center, Los Angeles, United States

UCLA - School of Medicine, Los Angeles, United States

Kaiser Permanente - Oakland, Oakland, United States

The Center for Cancer Prevention and Treatment at St.Joseph Hospital of Orange, Orange, United States

UC Irvine Medical Center, Orange, United States

Stanford University, Palo Alto, United States

Kaiser Permanente - Sacramento, Roseville, United States

Southern California Kaiser Permanente, San Diego, United States

California Pacific Medical Center Research Institute, San Francisco, United States

K. Permanente - San Fransisco, San Francisco, United States

University of California San Francisco Cancer Center, San Francisco, United States

Kaiser Permanente - Santa Clara, Santa Clara, United States

Olive View/Ucla Medical Center, Sylmar, United States

Kaiser Permanente - Walnut Creek, Walnut Creek, United States

University of Colorado Hospital - Anschutz Cancer Pavilion, Aurora, United States

Danbury Hospital, Danbury, United States

Eastern Connecticut Hematology and Oncology Associates; (ECHO), Norwich, United States

Sylvester Comprehensive Cent., Miami, United States

Miami Cancer Institute of Baptist Health, Inc., Miami, United States

Sarasota Memorial Health Care System; Cancer Research Program, Sarasota, United States

Women's Cancer Associates, St. Petersburg, United States

Northside Hospital, Atlanta, United States

Northeast Georgia Medical Center; Oncology Research Dept-5C, Gainesville, United States

Women's Cancer Center, Honolulu, United States

Rush University Medical Center, Chicago, United States

Univ of Chicago, Chicago, United States

Sudarshan K. Sharma, MD, Ltd., Hinsdale, United States

Parkview Research Center, Fort Wayne, United States

St.Vincent Health System; Gynecologic Oncology, Indianapolis, United States

University of Iowa Hospital & Clinic; Division of Hematology/Oncology, Iowa City, United States

University of Kentucky; Gynecologic Oncology, Lexington, United States

St. Elizabeth Edgewood; Cancer Care Center? for Account St. Elizabeth Edgewood, Edgewood, United States

Woman's Hospital, Baton Rouge, United States

Maine Medical Partners Women's Health; Gyn-Oncology, Scarborough, United States

Greater Baltimore Medical Center, Baltimore, United States

Sinai Hospital of Baltimore, Baltimore, United States

Weinberg CA Inst Franklin Sq, Baltimore, United States

Frederick Health Hospital, Frederick, United States

Massachusetts General Hospital, Boston, United States

Baystate Medical Center, Springfield, United States

St. Joseph Mercy Hospital, Ann Arbor, United States

Karmanos Cancer Institute, Detroit, United States

Munson Medical Center, Traverse City, United States

Sanford Health Bemidji, Bemidji, United States

University of Minnesota, Minneapolis, United States

Metro-Minnesota Community Oncology Research Consortium, Saint Louis Park, United States

Minnesota Oncology Hematology Woodbury, Woodbury, United States

St. Dominic-Jackson Memorial Hospital, Jackson, United States

Washington University School of Medicine; Dept of Medicine/Div of Medical Oncology, St Louis, United States

Billings Clinic; Cancer Center, Billings, United States

Community Cancer Care, Missoula, United States

Nebraska Methodist Hospital, Omaha, United States

University of Nebraska Medical Center, Omaha, United States

Women's Cancer Center, Las Vegas, United States

Center of Hope, Reno, United States

Dartmouth Hitchcock Medical Center, Lebanon, United States

MSK @Basking Ridge, Basking Ridge, United States

Cooper Health System; MD Anderson Cancer Center, Camden, United States

John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, United States

Memorial Sloan Kettering Cancer Center; MSK Monmouth, Middletown, United States

Jersey Shore Med Ctr; OB/GYN, Neptune City, United States

Holy Name Hospital, Teaneck, United States

Southwest Gynecologic Oncology Associates, Inc., Albuquerque, United States

University of New Mexico Cancer Center, Albuquerque, United States

Womens Cancer Care Association, Albany, United States

New York Presbyterian Queens, Flushing, United States

Northwell Health; Monter Cancer Center, Lake Success, United States

New York Univ Medical Center; Obstetrics & Gynecolog, New York, United States

Mount Sinai Downtown Chelsea Centre, New York, United States

Icahn School of Medicine at Mount Sinai, New York, United States

Memorial Sloan Kettering Cancer Center, New York, United States

Memorial Sloan-Kettering CC, Rockville Centre, United States

Levine Cancer Institute, Charlotte, United States

Novant Health Presbyterain Medical Center, Charlotte, United States

Duke Medical Center, Durham, United States

Forsythe Memorial Hospital Inc., dba Novant Health Oncology Specialists, Winston-Salem, United States

Wake Forest Baptist Medical Center, Winston-Salem, United States

Sanford Health Bismarck, Bismarck, United States

Sanford Roger Maris Cancer Center, Fargo, United States

University of Cincinnati, Cincinnati, United States

Cleveland Clinic, Cleveland, United States

Univ Hospitals of Cleveland, Cleveland, United States

Fairview Hospital; Cleveland Clinic Cancer Center, Cleveland, United States

Columbus NCORP, Columbus, United States

Ohio State University, Arthur James Cancer Hospital, Columbus, United States

Kettering Medical Center, Kettering, United States

University of Oklahoma; Stephenson Oklahoma Canc Ctr, Oklahoma City, United States

Oklahoma Cancer Specialists and Research Institute, Tulsa, United States

Oncology Associates of Oregon, P.C.; Willamette Valley Cancer Institute, Springfield, United States

Northwest Cancer Specialists, P.C., Tigard, United States

University of Pennsylvania Health System; Cancer Center, Philadelphia, United States

Thomas Jefferson University, Philadelphia, United States

Temple University Hospital, Philadelphia, United States

Magee-Woman's Hospital, Pittsburgh, United States

Western Pennsylvania Hospital, Pittsburgh, United States

Abington Mem Hosp-Abington; Rose. Can Ctr,Gyn Onc Ins, Willow Grove, United States

WellSpan Gynecologic Oncology, York, United States

Women & Infants Hospital, Providence, United States

Bon Secours - St. Francis Hospital, Greenville, United States

Monument Health Rapid City Hospital, Inc., Rapid City, United States

Sanford Health System, Sioux Falls, United States

Dell Seton Medical Center at UT-Seton Infusion Center; Research Department, Austin, United States

Texas Oncology Cancer Center, Austin, United States

Texas Oncology, Bedford, United States

UT Southwestern Medical Center at Dallas; Department of Pathology, Dallas, United States

Texas Oncology, P.A. - Fort Worth, Fort Worth, United States

The University of Texas MD Anderson Cancer Center, Houston, United States

Houston Methodist Hospital, Houston, United States

Rocky Mountain Cancer Centers, LLP, Irving, United States

Texas Oncology San Antonio Medical Center, San Antonio, United States

Texas Oncology, P.A., The Woodlands, United States

Texas Oncology- Northeast Texas, Tyler, United States

Huntsman Cancer Institute; Oncology, Salt Lake City, United States

Dixie Medical Center, St. George, United States

University of Virginia, Charlottesville, United States

Virginia Cancer Specialists, PC, Fairfax, United States

Virginia Oncology Associates, Norfolk, United States

Henrico Doctors' Hospital - Forest, Richmond, United States

Shenandoah Oncology Associates, Winchester, United States

University of Washington Seattle Cancer Care Alliance, Seattle, United States

University of Wisconsin Hospital and Clinics, Madison, United States

DN Greenwald Center, Mukwonago, United States

Aspirus Regional Cancer Center, Wausau, United States

The Royal North Shore Hospital; Northern Sydney Cancer Centre, St Leonards, Australia

Cabrini Hospital; Cabrini Foundation, Malvern, Australia

Peter MacCallum Cancer Center, North Melbourne, Australia

Krankenhaus Der Barmherzigen Brüder Graz; Gynäkologie, Graz, Austria

Tiroler Landeskrankenanstalten Ges.M.B.H.; Abt. Für Gynäkologie, Innsbruck, Austria

Landeskrankenhaus Salzburg; Gynäkologie Und Onkologie, Salzburg, Austria

Medizinische Universität Wien; Univ.Klinik für Frauenheilkunde - Klinik für Gynäkologie, Vienna, Austria

AZ Maria Middelares, Ghent, Belgium

UZ Gent, Ghent, Belgium

UZ Leuven Gasthuisberg, Leuven, Belgium

Sint Augustinus Wilrijk, Wilrijk, Belgium

Instituto Nacional de Cancer - INCa; Oncologia, Rio de Janeiro, Brazil

Clinica de Pesquisa e Centro de Estudos em Oncologia Ginecologica e Mamaria Ltda, São Paulo, Brazil

Peking Union Medical College Hospital, Beijing, China

Beijing Cancer Hospital, Beijing, China

West China Second University Hospital, Chengdu, China

Chongqing Cancer Hospital, Chongqing, China

Sun Yet-sen University Cancer Center, Guangzhou, China

Women's hospital school of medicine Zhejiang University, Hangzhou, China

Harbin Medical University Cancer Hospital, Harbin, China

Zhongda Hospital Affiliated to Southeast University, Nanjing, China

Jiangsu Province Hospital (the First Affiliated Hospital With Nanjing Medical University), Nanjing, China

Guangxi Cancer Hospital of Guangxi Medical University, Nanning, China

Fudan University Shanghai Cancer Center, Shanghai, China

Tianjin Central Hospital of Gynecology Obstetrics., Tianjin, China

Zhejiang Cancer Hospital, Zhejiang, China

Henan Cancer Hospital, Zhengzhou, China

Fakultni nemocnice Olomouc; Onkologicka klinika, Olomouc, Czechia

University Hospital Ostrava; Fakultní nemocnice, Ostrava-Poruba, Czechia

Gynekologicko-porodnicka klinika, Prague, Czechia

Onkologicka klinika UK 2.LF a FN v Motole, Prague, Czechia

Rigshospitalet; Onkologisk Klinik, København Ø, Denmark

Kuopio University Hospital, Kuopio, Finland

Tampereen yliopistollinen sairaala, Tampere, Finland

Turku Uni Central Hospital; Gynaecology Dept, Turku, Finland

Clinique Sainte Catherine; Hopital De Semaine, Avignon, France

Ctr Jean Bernard Clin V. Hugo; Service d'Oncologie Méd, Le Mans, France

Centre Léon Bérard; Centre régional; le cancer Rhône-Alpes, Lyon, France

l'Hôpital privé du Confluent SAS, Nantes, France

Hopital Des Diaconesses; Oncologie, Paris, France

Centre Hospitalier Lyon Sud, Pierre-Bénite, France

Centre Rene Huguenin; CONSULT SPECIALISEES, Saint-Cloud, France

Institut Gustave Roussy, Villejuif, France

Campus Virchow-Klinikum Charité; Centrum 17; Klinik für Gynäkologie, Berlin, Germany

Universitätsklinikum Dresden; Klinik für Frauenheilkunde und Geburtshilfe, Dresden, Germany

Universitätsklinikum Essen; Zentrum Für Frauenheilkunde, Essen, Germany

Kliniken Essen Mitte Evang. Huyssens Stiftung/Knappschaft GmbH, Essen, Germany

Universitätsklinikum Freiburg; Frauenklinik, Freiburg im Breisgau, Germany

Universitätsklinikum Greifswald; Klinik für Frauenheilkunde und Brustzentrum, Greifswald, Germany

Universitätsklinikum Hamburg-Eppendorf (UKE); Klinik und Poliklinik für Gynäkologie, Hamburg, Germany

Medizinische Hochschule Hannover, Klinik für Frauenheilkunde und Geburtshilfe, Hanover, Germany

Universitätsklinikum Heidelberg; Nationales Centrum für Tumorerkrankungen (NCT), Heidelberg, Germany

Klinikum Konstanz, Frauenklinik, Konstanz, Germany

Universitätsklinikum Schleswig-Holstein / Campus Lübeck; Klinik für Frauenheilkunde und Geburtshilfe, Lübeck, Germany

Universitätsmedizin Mainz; Klinik u. Poliklinik f. Geburtshilfe u. Frauenheilkunde, Mainz, Germany

Klinikum der Universität München; Campus Großhadern; Klinik und Poliklinik für Frauenheilkunde, München, Germany

Klinikum rechts der Isar der TU München; Klinik und Poliklinik für Frauenheilkunde, München, Germany

Klinikum Südstadt, Rostock, Germany

Universitätsklinikum Ulm Am Michelsberg; Frauenklinik, Ulm, Germany

HELIOS Dr. Horst Schmidt Kliniken Wiesbaden; Klinik für Gynäkologie und gynäkologische Onkologie, Wiesbaden, Germany

Alexandras Hospital; Dept. of Clin. Therapeutics, Athens Uni School of Medicine, Athens, Greece

Uni Hospital of Ioannina; Oncology Dept., Ioannina, Greece

Agioi Anargyroi Cancer Hospital; 2Nd Oncology Dept., Kifissia, Greece

University Hospital of Patras Medical Oncology, Pátrai, Greece

EUROMEDICA General Clinic of Thessaloniki; Medical Oncology Dept - Oncomedicare, Thessaloniki, Greece

Hillel Yaffe MC; Gynaecology, Hadera, Israel

Shaare Zedek Medical Center; Oncology Dept, Jerusalem, Israel

Meir Medical Center; Obstetrics and Gynecology, Kfar Saba, Israel

Chaim Sheba Medical Center; Obstetrics and Gynecology, Ramat Gan, Israel

Kaplan Medical Center; Oncology Inst., Rehovot, Israel

Ospedale Antonio Perrino; Oncologia Medica, Brindisi, Italy

Azienda Ospedaliera Universitaria Federico II, Naples, Italy

ISTITUTO NAZIONALE TUMORI IRCCS FONDAZIONE G. PASCALE; Dipartimento Uro-Ginecologico, Naples, Italy

Policlinico S.Orsola-Malpighi; Istituto Oncologia R. Addarii, Bologna, Italy

Ospedale Degli Infermi - Faenza; Oncologia Medica, Faenza, Italy

IRST Istituto Scientifico Romagnolo Per Lo Studio E Cura Dei Tumori, Sede Meldola; Oncologia Medica, Meldola, Italy

Arcispedale Santa Maria Nuova; Oncologia, Reggio Emilia, Italy

Policlinico A. Gemelli e C.I.C.; Area Salute della Donna, Rome, Italy

A.O.Spedali Civili; Ostetricia e Ginecologia, Brescia, Italy

IRCCS S. Raffaele; Ginecologia Oncologica, Milan, Italy

Istituto Nazionale dei Tumori; Divisione Oncologia Chirurgica e Ginecologica, Milan, Italy

Irccs Istituto Europeo Di Oncologia (IEO); Oncologia Medica, Milan, Italy

Asst Grande Ospedale Metropolitano Niguarda; Dipartimento Di Ematologia Ed Oncologia, Milan, Italy

A.O. San Gerardo; Ginecologia, Monza, Italy

A. O. Città della Salute e della Scienza; Unità di Oncologia Ginecologica, Turin, Italy

Ospedale Mauriziano Umberto 1; Ginecologia - Oncologia, Turin, Italy

Ospedale Silvestrini; Oncologia ed Ematologia, Perugia, Italy

IRCCS Istituto Oncologico Veneto (IOV); Oncologia Medica Seconda, Padua, Italy

Nagoya University Hospital, Aichi, Japan

National Hospital Organization Shikoku Cancer Center, Ehime, Japan

Ehime University Hospital, Ehime, Japan

NHO Kyushu Cancer Center, Fukuoka, Japan

Kyushu University Hospital, Fukuoka, Japan

Kurume University Hospital, Fukuoka, Japan

Kure Medical Center, Hiroshima, Japan

National Hospital Organization Hokkaido Cancer Center, Hokkaido, Japan

Hyogo Cancer Center, Hyōgo, Japan

Kagoshima University Hospital, Kagoshima, Japan

Yokohama City University Hospital, Kanagawa, Japan

Kyoto University Hospital, Kyoto, Japan

Mie University Hospital, Mie, Japan

Tohoku University Hospital, Miyagi, Japan

Niigata University Medical & Dental Hospital, Niigata, Japan

Iwate Medical University Hospital, Numakunai, Japan

Osaka International Cancer Institute, Osaka, Japan

Shizuoka Cancer Center, Shizuoka, Japan

The Jikei University Hospital, Tokyo, Japan

The University of Tokyo Hospital, Tokyo, Japan

The Cancer Institute Hospital of JFCR, Tokyo, Japan

Keio University Hospital, Tokyo, Japan

Oslo Universitetssykehus HF; Radiumhospitalet, Oslo, Norway

St. Olavs Hospital, Trondheim, Norway

Centrum Onkologii Instytut im. M.Sklodowskiej-Curie; Klinika Ginekologii Onkologicznej, Krakow, Poland

Szpital Kliniczny im. Heliodora ?wi?cickiego UM w Poznaniu; Oddzia? Ginekologii Onkologicznej, Późna, Poland

Icu Spsk - 2, Szczecin, Poland

Narodowy Instytut Onkologii im. M.Sklodowskiej-Curie;Klinika Ginekologii Onkologicznej, Warsaw, Poland

Moscow City Oncology Hospital #62, Moscovskaya Oblast, Russia

Clinical Oncology Dispensary of Ministry of Health of Tatarstan, Kazan', Russia

N.N.Burdenko Main Military Clinical Hospital; Oncology Dept, Moscow, Russia

St. Petersburg Oncology & Gynecology; City Clinical Oncology Dispensary, Saint Petersburg, Russia

National Cancer Center, Goyang-si, South Korea

Seoul National University Hospital, Seoul, South Korea

Asan Medical Center, Seoul, South Korea

Samsung Medical Center, Seoul, South Korea

Hospital Universitario Son Espases, Palma de Mallorca, Spain

Corporacio Sanitaria Parc Tauli; Servicio de Oncologia, Sabadell, Spain

Fundacion Hospital de Alcorcon; Servicio de Oncologia, Alcorcón, Spain

Hospital Universitari Dexeus - Grupo Quironsalud; Servicio de Oncologia Medica, Barcelona, Spain

Hospital General Universitario Gregorio Marañon; Servicio de Oncologia, Madrid, Spain

Centro Integral Oncologico Clara Campal; Servicio de Oncología, Madrid, Spain

Hospital Clinico Universitario Virgen de la Victoria; Servicio de Oncologia, Málaga, Spain

Hospital Universitario la Fe; Servicio de Oncologia, Valencia, Spain

Hospital Universitario Miguel Servet; Servicio Oncologia, Zaragoza, Spain

Uni Hospital Linkoeping; Dept. of Oncology, Linköping, Sweden

Karolinska Hospital; Oncology - Radiumhemmet, Stockholm, Sweden

Baskent University Adana Dr. Turgut Noyan Practice and Research Hospital; Medical Oncology, Adana, Turkey (Türkiye)

Ankara University Medical Faculty; Medikal Onkoloji, Ankara, Turkey (Türkiye)

Baskent Universitesi Ankara Hastanesi; T?bbi Onkoloji Bölümü, Ankara, Turkey (Türkiye)

Koc University Medical Faculty; Department of Gynecology & Obstetrics, Istanbul, Turkey (Türkiye)

Istanbul Uni Istanbul Medical Faculty, Istanbul, Turkey (Türkiye)

Istanbul University Cerrahpasa Medical Faculty; Obstetrics and Gynecology, Istanbul, Turkey (Türkiye)

A Study of Atezolizumab Versus Placebo in Combination With Paclitaxel, Carboplatin, and Bevacizumab in Participants With Newly-Diagnosed Stage III or Stage IV Ovarian, Fallopian Tube, or Primary Peritoneal Cancer