venicci carbo 3 in 1 travel system

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Venicci Carbo 3in1 Lux - Black

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• £749.00 £624.17
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Venicci Carbo Lux Travel System Includes

• Graphite chassis
• Pushchair seat unit
• Group 0+ car seat with apron
• Car seat adaptors
• Changing bag
• Seat unit apron
• Mosquito Net

Pram Mode Features

• Carrycot is suitable from birth to 6 months
• Baby can lie-flat in this spacious carrycot - Newborn babies should ideally lie completely flat, as recommended by health officials.
• Includes mattress
• 4 position adjustable backrest - ideal for babies who have colic
• Strong, durable, UPF 50+ fabric
• Weather-resistant fabric
• Adjustable hood with ventilation system - helps to keep baby cool in the summer
• Luxury cotton lining
• Leather finish handle
• Detachable apron included
• Easy to click on and off mode

Pushchair Mode Features

• Suitable from 6 months - 3 years
• Multifunction seat which faces both ways – face parent for interaction or face the world
• Multi-position reclining backrest
• 5-point fixed safety harness
• Adjustable, extendable hood
• Adjustable leg rest, handle height and harness height
• Ventilation System in the back of the hood keep baby cool
• Comfortable seat for baby with extra liner
• CLICK-MODE Easy release from the chassis
• Comes complete with Hood and seat unit apron
• Leather finish gated bumper bar

Car Seat Travel System Mode Features

• From birth to 13kg
• Lightweight and easy to carry
• Comfortable seat adapts as your child grows
• Foldable handle
• Comfortable padded liner
• Foam wedge head support
• Padded adjustable harness
• Travel system compatible
• Can be fitted on its own, with the cars seat belts, or with the optional extra Venicci ISOFIX Base.
• Only compatible with the Venicci Isofix base
• Weighs only 3.9kgs
• Safety Standard Approved - E20 44r-04 2064

Specifications

• Pram Mode (unfolded) L95 x H110 x W61 (cm)
• Chassis folded (with wheels) L82 x H31 x W61 (cm)
• Chassis folded (no wheels) L81 x H26 x W50 (cm)
• Carry Cot Internal – L79 x H20 x W36 (cm)
• Wheel size – Front 23cm , Back 28cm
• Handle adjustment – from 75cm to 110cm
• Carry Cot – 4.4kg
• Car Seat – 3kg
• Seat Unit - 4.8kg

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• Car Seat Fitting Appointment
• Please click here to book an appointment using our online form.

Glasgow Pram Centre 25 - 29 McFarlane Street Glasgow G4 0TL

• For Sales advice: please email [email protected] or telephone 0141 552 3998 and press option 1.
• For Customer services and after sales: please email [email protected] or telephone 0141 552 3998 and press option 3.
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• Call now: 01275 342111

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Venicci 3 in 1 Travel Systems

Designed for every time and space

VENICCI VERO

#newproduct

Many dimensions of one colour

UPLINE MOONSTONE

Inspired by your family’s needs

Stylish / unique / exceptional

Tinum Edge SE

About Venicci

Made for walking

British class, Italian trends, the highest safety standards. This is the unique Venicci Upline, in which we have combined values and functions that make up the perfect stroller. It combines luxurious finishing inspired by Italian trends and high British safety standards. This is a stroller from parents for parents, because the solutions used in it were based on their suggestions. Therefore, it meets the expectations of the most demanding parents.

Upline SE Powder Pram

Upline SE Lava Pram

Vero Night Stroller

Vero Blush Beige Stroller

Vero Sand Stroller

Vero Sage Stroller

Upline Moonstone Pram

Upline Classic Grey Pram

Upline Slate Grey Pram

Upline All Black Pram

is renowned for working closely with parents to ensure complete trust in its products and innovations

Discover Engo - a car seat you can rely on

Safety is one of the fundamental values of Venicci, which is why we entrust you with the new Venicci Engo car seat. Take care of your little one on the go, thanks to the highest safety standards that have been important to us for years. Dedicated for children from 40 to 87 centimeters , up to 13 kilograms . Engo can also accompany you during quick shopping trips or short walks. You can conveniently attach it to the chassis using car seat adapters

Pram and Pushchair Store – Where Dreams Come True

The Venicci online shop is a place where every parent can find the perfect pram and pushchair for their family. We wanted our collection to be more than just prams and pushchairs – we wanted it to be a dream come true for comfortable, safe, and fashionable strolls with your baby.

Buy Your Pram and Pushchair Online – In An Easy And Convenient Way

We know that every parent, new or expectant, cares about daily convenience. This is reflected not only in our products but also in the way you can buy them. You can purchase our prams and pushchairs or strollers from anywhere – be it home, work, or even when travelling! Moreover, you can do it at any time, thanks to our online store’s no opening hours, which is ideal for busy people who may not have the luxury of visiting a nursery store in person.

Our pram and pushchair shop offers you a broad choice of products. The most important among these are the different types of prams and pushchairs. The variety of designs and colours allows you to choose a model that suits your style and your family’s lifestyle , making the pram or pushchair a practical companion for family activities and a representation of who you are.

But that’s not all – in our online shop, you can also find all kinds of accessories to make everyday journeys with your baby an even more enjoyable adventure. Pram and pushchair bags , gloves, or parasols give you the opportunity to share new experiences with your child, regardless of the weather conditions outside.

Pushchairs and Prams – Online Shopping for Today’s World

Our brand knows and understands the needs of today’s parents. We realize that comfort and safety are just as important as style, so we have combined all these elements. The result? Trendy with a touch of classic design, high-quality materials, and refined details, functionality (including easy folding and compactness), and much more.

Our words are confirmed by the number of awards we have won and the positive feedback from customers who have found our pram and pushchair store to be the best choice. And nothing brings us more satisfaction than knowing that our prams and pushchairs help you to enjoy parenthood fully.

We ensure that our products and services reflect our customers’ newest trends and needs, and we listen to them carefully. After all, we are here for them!

Find Out What Our Online Pram and Pushchair Store Can Offer You!

We would like to warmly welcome you to our online pram and pushchair store – a kingdom dedicated to children and their parents. Here, you will find prams and pushchairs suitable for every stage of your little one’s development – from the newborn stage to toddlerhood and even beyond!

Choosing a baby pram or pushchair is not just a purchase – it’s an investment in your child’s well-being and safety. That’s what we want for you and your family because we are convinced that parenthood should be pure happiness. We believe that our products make this time even more precious.

The trust placed in us by parents is a special honour for us

Modern and safe technical solutions, attention to detail are the hallmarks of Venicci, which has received numerous European awards and certificates.

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Venicci Gusto 2.0 Azzuro – 3-in-1 Travel System (10 Piece Bundle)

£ 799.00

• Product Features
• Pram mode with included carrycot is suitable from birth up to six months
• Pushchair mode is suitable for use from six months up to three years
• Front swivel wheels with optional locking for convenient ease of use
• Shock-absorption system provides added manoeuvrability on all terrain
• Stylish aluminium frame with leatherette details and included matching car seat

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• Description
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• Additional information
• Reviews (0)

Meet the  Venicci Gusto 3-in-1 Travel System – a versatile pushchair with a new design that includes a stylish gloss black chassis and a brown leatherette finish, which provides the stroller with both a luxurious and elegant look. The luxury pram mode is suited for your little one straight from birth up to approximately six months old, providing a space of tranquility and comfort. A soft mattress is included and is combined with a high-quality cotton lining to ensure the best quality and maximum comfort throughout. The large, lie-flat carrycot provides support and protection for your baby throughout the early months and the ventilation within it will keep them cool and comfortable on every journey whilst you are out and about. As your child grows, you can raise the backrest in the carrycot for if they wish to be in a more upright position. Also included is an infant car seat that can be easily attached to the pushchair unit for seamless transitions between your vehicle and outside, without disturbing your little one.

The secondary pushchair mode features a multi-functional seat unit that can be positioned to face both you for interaction and the world for stimulation. The multiple position backrest adapts and adjusts to suit the needs of your growing baby and provides you with several custom options to ensure the comfort of your child. In addition to this, the leg rest, handle height and harness height are all fully adjustable. The five-point fixed safety harness will keep your little one safe and secure whilst you are on the go. Suitable from six months to approximately three years, this will be the perfect addition to any family adventure with your baby.

With a simple click motion onto the frame, swapping and changing between components is now easier than ever. Included in this system is a changing bag, footmuff, raincover, mosquito net and cup holder. With a range of other innovative features, including a shock-absorption system, direction memory system, UPF50+ fabrics, waterproof materials and a stylish aluminium frame, you can rest assured that the  Venicci Gusto 3-in-1 Travel System will be the very best for your baby.

Carrycot | 102cm x 61cm x 112cm | 13.8kg

Car Seat | 95cm x 61cm x 112cm | 12.3kg

Seat Unit | 95cm x 61cm x 112cm | 13.4kg

1-3 Working Days UK Mainland. Order before 3.45pm Monday – Friday for delivery Monday – Friday; this excludes Bank Holidays. Scottish Highlands & Highlands extra 2 days.

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• Pushchairs, Prams & Accessories
• Pushchairs & Prams
• Travel Systems

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Venicci Soft Vento 3-in-1 Travel System (9 Piece Bundle) - Denim Grey/White - with Carrycot + Car Seat + Changing Bag + Footmuff + Raincover + 5-Point Harness and UV 50+ Fabric + Car Seat Adapters

About this item.

• 5-Point Safety Harness

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Technical details, additional information, warranty & support, product description.

Venicci Soft Vento 3-in-1 Travel System (9 Piece Bundle) – Denim Black/White- with Carrycot + Car Seat + Changing Bag + Footmuff + Raincover + 5-Point Harness and UV 50+ Fabric + Car Seat Adapters

Venicci Soft Vento 3-in-1 Travel System (9 Piece Bundle)

Discover a new style Venicci Soft Collection. Designed with Love. From innnovative technology to the unique gorgeous design. Create an iconic look with our pram. Perfection is when the project has all the ingredients needed and nothing moe than that and this is what our pure prams are. They constitute a set of brilliant, practical and simple ideas. We put safety, comfort and aesthetics first. No compromises.

The most stylish Changing Bag:

In the Pure Collection, you will find a stylish, matching changing bag. There are two options for the handles: short and long ones so you can varry your bag in the way you like

The one and only iconic model:

We're proud present our bestselling Pure collection in the new way. We've introudced new, technological solutions such as imporved folding mechanism keeping still the iconic look of our pram.

The Seleciotn of materials:

The choice of perfect fabrics for a new pram take sweeks or even months of our desiner's work.

Easy click mode

Click mode on the frame makes swapping between the different settings much easier.

UV 50+ fabric

Walk with no worries. We take care of your child’s protection. The sun UV 50+ filter is a special, permanent protection from sun’s damaging radiations.

Water-Repellent

Fabrics with a special water-repellent impregnation designed to keep your child safe and different weather conditions.

DMS - Direction Memory System

The DMS prevents the front wheels from spinning, when the front of the frame is lifted up on to another surface.

Rotary front wheels 360°

Simplicity makes life easier. The front whee

ls can move in any direction that you need to go. Get ready for a walk!

Aluminium frame

Aluminium alloy significantly reduce total weight and makes pram unusual light-weighted and easy to push.

5 - point harness

Venicci seat unit features 5 - point harness preventing the child from the risk of falling out of the seat unit.

SAS - Shock Absorption System

The Shock Absorption System is in place to prevent the frame from shaking when pushed through the rough terrain.

Leatherette

An innovative letherette boasts of high anti-allergenic specs, doesn’t overheat in the sun and doesn’t grow hard in the cold.

3in1 Travel System includes: Carry Cot & Seat Unit & Car Seat 2in1 includes: Carry Cot & Seat Unit

𝐂𝐎𝐍𝐕𝐄𝐍𝐈𝐄𝐍𝐂𝐄 𝐀𝐍𝐃 𝐋𝐈𝐆𝐇𝐓𝐖𝐄𝐈𝐆𝐇𝐓: This pushchair and pram are designed with busy parents in mind. One hand quick fold close operation for a self-standing position allows you to carry it when you are going outside or travelling.

𝐒𝐄𝐓 𝐎𝐅 9 𝐏𝐈𝐄𝐂𝐄𝐒: Comes with a set of 9 pieces including carrycot, car seat, seat unit, apron, changing bag, car seat adapters, raincover, mosquito net, cup holder & back wheel covers.

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Delivery & Returns

Delivery & returns, current delivery states 2024.

If you wish to return your order you can use the link:  https://www.evri.com/return-a-parcel  and search For Your Little One. Please make sure your order fits under the maximum measurements for Evri if it doesnt fit their sizing please contact us via email. If your item is faulty there will be no charge for returns but for any other returns a payment of £4.49 will be deducted from your refund. Please make sure all returns are sent back as new and in a resaleable condition. 

Collection of items

Collection of the product(s) will only take place from the delivery address to which they were delivered and will be subject to the following:

You agree to provide us with as much detail as possible of relevant features of the delivery address which floor the items are to be collected from, whether there are any narrow doors etc) in order to help our representative courier prepare for the collection and you agree to ensure that there is suitable access to the chosen collection location.

You agree to give our courier representative all products which are being returned, including all component parts of such products and all related items or accessories (and if possible the original packaging) which are included in the price of the products being returned

If you are not personally available to accept collection of the products you may appoint a representative to do so on your behalf. The representative must be an adult capable of supervising collection on your behalf, and you agree that we will be entitled to rely on the representative's instructions as if they were your own.

If for-your-little-one are arranging a collection due to a fault with the product we allow upto a maximum of two failed delivery attempts.

After this it will be the responsibility of the buyer to return the products back to us at their cost.

If you would like for-your-little-one to arrange a 3rd or more collecting this will be at the cost of £25 for each attempt.

We will charge a fee of £26.50 for a failed collection attempt, this will be deducted from your refund once the item has been returned.

Failure in Guarantee Period.

Guarantee is only available to the original purchaser of the item(s) and must be accompanied by the original receipt and is non-transferable

If you feel that your product is faulty we will ask you to send photographs and we will determine the best solution. Proof of purchase must accompany any warranty claim. We guarantee our products for six months. This does not affect your statutory rights. If a fault develops within the guarantee period, we will contact the manufacturer and supply you with spare parts or direct you to a service centre if applicable for major repairs the product must be examined.

We regret we are unable to supply loan products whilst inspection and repairs are carried out.

If the failure is confirmed to be due to a manufacturing fault we will arrange the repair. If however the fault is due to fair wear and tear/accidental damage or misuse we will quote for rectification and you will also be liable for carriage and delivery charges.

Delivery for orders over £50: Free delivery applies to UK mainland, this excludes Southern Ireland, the Channel Isles and all the Islands. Please select the international postage tab to pay for an International delivery.

Delivery to Ireland is £7.99

All goods are dispatched within 24 hours of the confirmed paid order- with the exception of Bank Holidays.

Goods will be delivered between 9.00 am-5.00 pm Monday to Friday. We do not deliver on Saturday or Sundays. Our courier are allowed to leave parcels with your neighbour.

Goods will be delivered to the address registered and provided by PayPal, Klarna Shopify Pay, Amazon Pay, Apple Pay, Android Pay Or Google Pay unless we are emailed by you to request for the delivery to be sent elsewhere. Once the order has been dispatched we cannot change the address. Our courier will attempt delivery to your address twice and if there is no one in to accept the delivery they will return the goods to us, in this instance of a failed delivery you are responsible to pay a failed delivery charge of £8. This charge of £8 covers you for redelivery. If however you wish to cancel your order following a failed delivery you are responsible to pay £6. In the instance of a failed delivery the parcel will be returned to us. You are responsible for the cost of re delivery.

Please note on all special offer/voucher codes free delivery may not be applicable.

£3.99 Delivery charge for orders under £100 : This section of Terms & Conditions applies to: all products under £100

Please note for Moses Baskets we charge £5.99

A £3.99 delivery charge on orders under £100 applies to UK mainland only this excludes Southern Ireland, the Channel Isles and all the Islands. For Ireland please select the international postage tab to pay for your delivery.

Goods will be delivered to the address registered and provided by PayPal , Klarna or Amazon Pay unless we are emailed by you to request for the delivery to be sent elsewhere. Once the order has been dispatched we cannot change the address.

In the instance of a failed delivery the parcel will be returned to us. You are responsible for the cost of re delivery for £4.99. Payment is to be made via our Pay pal account.

We aim to dispatch of orders within 24 hours of confirmed paid order if Goods ARE IN STOCK, please allow 5-14 working days for delivery IF OUT OF STOCK. Orders may be marked as dispatched on Saturdays and Sundays but will not be shipped until the Monday.

Both courier’s will endeavor to deliver your order within the timescale stated in your order acknowledgment. However, due to circumstances beyond our (and their) control, such as extreme weather conditions, security checks, unforeseen incidents, miss-route of parcels, delays may occur. If you are working to a set deadline (e.g. holiday departure, a birthday) please allow for extra time to cover any eventualities that may arise.

For-Your-Little-One cannot be held responsible for any inconveniences caused in the unlikely event of a delayed delivery. In these instances our courier will deliver your parcel(s) the next available working day. If you provide us with any incorrect delivery details which results in the order being delivered to an incorrect address, For-Your-Little-One cannot be held responsible for any loss you may incur as a result.

If you have not received your item within 10 days from the date that we dispatched your order please email to inform us of this. For smaller items delivered by Royal Mail, it is your responsibility to make contact with your local Royal Mail delivery office, as Royal Mail often attempt delivery and fail to leave a calling card. They take the parcel to your nearest delivery office and hold the parcel for you there. If you have not received a calling card, please ask the delivery office "If they are holding a parcel for your address?” If your parcel is not at the delivery office, it is there policy that we do need to allow them 14 working days for the item to be delivered before we can escalate the matter further. The 14th working day is the 14th day after your order was marked as dispatched. Working days are Monday-Friday.

Any orders that are reported as not received after 14 working days of dispatch we are not responsible for the loss of parcel delivery.

We strictly do not allow customer pick-ups. For insurance purposes, the public are prohibited on site where distribution takes place for health and safety reasons.

Description

A stylish and functional travel system for your newest addition. Keep your little one comfortable and safe on your travels with this all-in-one Venicci travel system. Its sleek pink design makes it the perfect choice for any mommy on the go. With a convenient car seat, stroller and bassinet all included, this system has everything you need to make travelling with your baby a breeze.

WHAT’S INCLUDED WITH THE BUNDLE?

TECHNICAL SPECIFICATION

Carrycot • Length — 99 cm • Width — 60 cm • Height — 112 cm • Weight (without the chassis) — 4,7 kg • Weight limit — max 9 kg Seat unit • Length — 92 cm • Width — 60 cm • Height — 107 cm • Weight (with the chassis) — 12,9 kg • Weight limit — max 22 kg 

Warranty Information:  The Guarantee period is 12 months (hereinafter: “Guarantee Period“), and the Guarantee Period starts on the day of conclusion of the sales contract of the Product by the Guarantor and the Purchaser, being the basis of purchase of the Product by the Purchaser (date of transaction is indicated on the purchase document (invoice or receipt).

Payment & Security

Your payment information is processed securely. We do not store credit card details nor have access to your credit card information.

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2 Universidad Complutense, CUBERONC, GEICAM, Madrid, Spain

Kyung Hae Jung

3 Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

Chiun-Sheng Huang

4 National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Republic of China

Nadia Harbeck

5 University of Munich, Munich, Germany

Vicente Valero

6 The University of Texas MD Anderson Cancer Center, Houston, TX

Daniil Stroyakovskiy

7 Moscow City Oncology Hospital 62, Moscow, Russia

Hans Wildiers

8 University Hospitals Leuven, Leuven, Belgium

Mario Campone

9 Centre René Gauducheau, Saint-Herblain, France

Jean-François Boileau

10 McGill University, Jewish General Hospital Segal Cancer Centre, Montréal, Québec, Canada

Peter A. Fasching

11 University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany

Karen Afenjar

12 Translational Research in Oncology, Paris, France

Gonzalo Spera

13 Translational Research in Oncology, Montevideo, Uruguay

Vanesa Lopez-Valverde

14 PAREXEL International GmbH, Berlin, Germany

Chunyan Song

15 Genentech, South San Francisco, CA

Peter Trask

Thomas boulet, joseph a. sparano.

16 Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY

W. Fraser Symmans

Alastair m. thompson.

17 Baylor College of Medicine, Houston, TX

Dennis Slamon

The KRISTINE study compared neoadjuvant trastuzumab emtansine plus pertuzumab (T-DM1+P) with docetaxel, carboplatin, trastuzumab plus P (TCH+P) for the treatment human epidermal growth factor receptor 2–positive stage II to III breast cancer. T-DM1+P led to a lower pathologic complete response rate (44.4% v 55.7%; P = .016), but fewer grade 3 or greater and serious adverse events (AEs). Here, we present 3-year outcomes from KRISTINE.

Patients were randomly assigned to neoadjuvant T-DM1+P or TCH+P every 3 weeks for six cycles. Patients who received T-DM1+P continued adjuvant T-DM1+P, and patients who received TCH+P received adjuvant trastuzumab plus pertuzumab. Secondary end points included event-free survival (EFS), overall survival, patient-reported outcomes (measured from random assignment), and invasive disease-free survival (IDFS; measured from surgery).

Of patients, 444 were randomly assigned (T-DM1+P, n = 223; TCH+P, n = 221). Median follow-up was 37 months. Risk of an EFS event was higher with TDM-1+P (hazard ratio [HR], 2.61 [95% CI, 1.36 to 4.98]) with more locoregional progression events before surgery (15 [6.7%] v 0). Risk of an IDFS event after surgery was similar between arms (HR, 1.11 [95% CI, 0.52 to 2.40]). Pathologic complete response was associated with a reduced risk of an IDFS event (HR, 0.24 [95% CI, 0.09 to 0.60]) regardless of treatment arm. Overall, grade 3 or greater AEs (31.8% v 67.7%) were less common with T-DM1+P. During adjuvant treatment, grade 3 or greater AEs (24.5% v 9.9%) and AEs leading to treatment discontinuation (18.4% v 3.8%) were more common with T-DM1+P. Patient-reported outcomes favored T-DM1+P during neoadjuvant treatment and were similar to trastuzumab plus pertuzumab during adjuvant treatment.

Compared with TCH+P, T-DM1+P resulted in a higher risk of an EFS event owing to locoregional progression events before surgery, a similar risk of an IDFS event, fewer grade 3 or greater AEs during neoadjuvant treatment, and more AEs leading to treatment discontinuation during adjuvant treatment.

INTRODUCTION

Current standard-of-care neoadjuvant regimens for the treatment of human epidermal growth factor receptor 2 (HER2) –positive breast cancer consist of conventional systemic chemotherapy plus trastuzumab-based therapy. 1 Pathologic complete response (pCR) rates with conventional systemic chemotherapy plus HER2 blockade have ranged from 25% to 65%, 2 - 8 with dual HER2-targeted regimens producing increased pCR rates compared with trastuzumab alone. 5 , 6 pCR in the breast and nodes is associated with prolonged event-free survival (EFS) and overall survival (OS) in patients with HER2-positive breast cancer. 9

Despite the pCR benefits of dual HER2-targeted neoadjuvant therapy, approximately 15% of patients will experience disease relapse or death within 3 to 5 years. 10 , 11 In addition, these regimens are accompanied by toxicities that are associated with conventional systemic chemotherapy, such as neutropenia and febrile neutropenia. 4 , 5 , 10 Improving outcomes and safety among patients with HER2-positive early breast cancer remain important goals when developing neoadjuvant and adjuvant therapies.

The KRISTINE study is a phase III, randomized, multicenter, open-label study that evaluated a neoadjuvant regimen in which conventional systemic chemotherapy is replaced with trastuzumab emtansine (T-DM1), an antibody–drug conjugate that provides targeted delivery of chemotherapy to HER2-overexpressing cells, as well as HER2 blockade, 12 and is associated with a lower incidence of adverse events (AEs) that are typically observed with conventional chemotherapy. 13 , 14 KRISTINE compared neoadjuvant T-DM1 plus pertuzumab (T-DM1+P) with conventional systemic chemotherapy—docetaxel plus carboplatin—plus dual HER2-targeted blockade—trastuzumab and pertuzumab—in patients with HER2-positive breast cancer. As reported previously, the T-DM1–based regimen led to a statistically significantly lower pCR rate in the breast and nodes (ypT0/is, ypN0) than the conventional systemic chemotherapy–based regimen (44.4% v 55.7%; difference of 11.3 percentage points [95% CI, −20.5 to −2.0] P = .016); however, fewer grade 3 or greater (13.0% v 64.4%) and serious AEs (4.9% v 28.8%) were observed with the T-DM1–based regimen in the neoadjuvant phase. 12 Here, we report the final results, which include 3-year efficacy, safety, and patient-reported outcomes (PROs) from KRISTINE.

Study Design

Comprehensive methods were published with the primary results. 12 KRISTINE is a randomized, open-label, multicenter, phase III study that was conducted at 68 Translational Research In Oncology centers in 10 countries and in accordance with the International Council on Harmonization Good Clinical Practice guidelines and the Declaration of Helsinki. The institutional review board and/or ethics committee at each site approved the protocol and all patients provided written informed consent.

Eligible patients were age 18 years or older with clinical stage cT2 to cT4 (> 2 cm)/cN0 to cN3/cM0 (> 2 cm) disease confirmed by a central laboratory (Targos Molecular Pathology, Kassel, Germany), to be HER2-positive breast cancer (immunohistochemistry 3+ [PATHWAY anti-HER2/neu {4B5} assay; Ventana Medical Systems, Santa Clara, CA]), or in situ hybridization–positive, defined as a HER2/CEP17 ratio of 2 or greater (INFORM HER2 Dual ISH assay; Ventana Medical Systems). 15 Both tests were conducted in parallel for all patients; however, only one test needed to be positive to establish HER2-positive status.

Patients were randomly assigned 1:1 to neoadjuvant treatment with T-DM1+P or docetaxel, carboplatin, trastuzumab plus pertuzumab (TCH+P) under a permuted block randomization scheme. Random assignment was stratified by hormone receptor status (estrogen receptor and/or progesterone receptor positive v estrogen receptor negative and progesterone receptor negative on local assessment), clinical stage at presentation (II to IIIA v IIIB to IIIC), and geographic location (North America v Western Europe v rest of world).

Patients who were randomly assigned to T-DM1+P received T-DM1 (3.6 mg/kg) and P (840-mg loading dose and 420-mg maintenance doses) during both the neoadjuvant and adjuvant phases of the study. Patients who were randomly assigned to TCH+P received TC+H (8-mg/kg loading dose and 6-mg/kg maintenance doses), and P (840-mg loading dose and 420-mg maintenance doses) during the neoadjuvant phase and continued trastuzumab plus pertuzumab (H+P) only during the adjuvant phase. In both study arms, HER2-targeted treatment was administered every 3 weeks for a total of 18 cycles—inclusive of neoadjuvant and adjuvant therapy—or until disease progression/recurrence, unacceptable toxicity, or withdrawal of consent. Patients who discontinued T-DM1 before treatment completion could switch treatment to trastuzumab with continuation of pertuzumab when clinically appropriate to complete 18 cycles of HER2-targeted therapy.

Patients underwent definitive breast cancer surgery between 14 days and 6 weeks after the last dose of neoadjuvant therapy. Within 9 weeks of surgery, patients resumed HER2-targeted therapy to which they had been previously randomly assigned—T-DM1+P or H+P—for 12 cycles. Additional adjuvant chemotherapy was permitted in the T-DM1+P arm at the discretion of the treating physician before adjuvant HER2-targeted therapy; it was recommended for patients in the T-DM1+P arm with residual tumor greater than 1 cm and/or residual nodal disease (greater than ypN0). Adjuvant radiotherapy and endocrine therapy were administered as clinically indicated per local practice.

The primary efficacy end point was locally determined pCR (ypT0/is, ypN0), as described previously. 12 Protocol-defined secondary efficacy end points included EFS, defined as the time from random assignment to disease progression, including local progression before surgery; disease recurrence—local, regional, distant, ipsilateral noninvasive, or contralateral (invasive or noninvasive)—or death from any cause; invasive disease-free survival (IDFS), defined as the time from surgery to the first documented occurrence of an event defined as ipsilateral invasive local recurrence, ipsilateral locoregional invasive recurrence, distant recurrence, contralateral invasive breast cancer, or death from any cause; and OS. The definition of IDFS was consistent with the standardized definitions for efficacy end points (STEEP) criteria, with the exception that nonbreast second primary invasive cancer was not included. 16 Protocol-defined PRO objectives included assessment of global health status/health-related quality of life, patient functioning, disease- and treatment-related symptoms as measured by the European Organization for Research and Treatment of Cancer (EORTC) Quality-of-Life Questionnaire (QLQ)-C30 and breast cancer module (QLQ-BR23). Severity of AEs were categorized on the basis of on National Cancer Institute Common Terminology Criteria for Adverse Events, version 4.0.

Statistical Analysis

Secondary efficacy end points, including EFS and OS, were analyzed in the intention-to-treat population. Analysis of IDFS was completed only for patients who underwent surgery as recorded in the database—that is, the IDFS-evaluable population—consistent with the IDFS definition. Analysis of secondary end points was not event driven, but, rather, preplanned to occur approximately 36 months after random assignment. The study was not powered to detect statistically significant differences between treatment arms in EFS, IDFS, or OS; therefore, these end points were analyzed descriptively without formal α allocation and P values are not presented. We used the stratified Cox proportional hazards regression model to estimate hazard ratios (HRs) and CIs, using TCH+P as the reference arm. Analyses were stratified for hormone receptor status and clinical stage at presentation. Kaplan-Meier estimates for 3-year event-free rates were reported for EFS, IDFS, and OS, along with corresponding 95% CIs that were calculated using the linear transformation. For the primary analysis of EFS and IDFS, patients were not censored for the initiation of nonprotocol anticancer therapy. Sensitivity analyses of EFS and IDFS were performed when patients were censored for the initiation of nonprotocol anticancer therapy. We performed additional post hoc analysis of IDFS according to pCR status and hormone receptor status.

Analysis of PRO end points was completed in patients who had both baseline and one or more postbaseline assessment. In accordance with the scoring manual, summary statistics of linear transformed scores were computed for the QLQ-C30 and QLQ-BR23 scales for each assessment timepoint. If more than 50% of the constituent items on the QLQ-C30 and QLQ-BR23 scales were completed, a prorated score was computed. 17 For scales with less than 50% of the items completed, the scale was considered missing. Mean change of the linear transformed scores from baseline—and SEs—were computed for each assessment timepoint.

From June 2014 to June 2015, 444 patients were randomly assigned (T-DM1+P, n = 223; TCH+P, n = 221; Fig 1 and Appendix Table A1 , online only), and all but two patients in the TCH+P arm received one or more dose of study medication. 12 Baseline characteristics were balanced between arms (Appendix Table A2 , online only). Hormone receptor–positive disease was present in 62.2% of patients, and 83.1% had clinical stage IIA to IIIA disease, 66.4% were white, and 25.2% were Asian. Median duration of follow-up was 36.8 months (95% CI, 36.5 to 37.2 months) in the T-DM1+P arm and 36.9 months (95% CI, 36.5 to 37.4 months) in the TCH+P arm.

Patient disposition. EFS, event-free survival; IDFS, invasive disease-free survival; TCH+P, docetaxel, carboplatin, and trastuzumab plus pertuzumab; T-DM1+P, trastuzumab emtansine plus pertuzumab.

Risk of an EFS event was greater in the T-DM1+P arm than in the TCH+P arm (stratified HR, 2.61 [95% CI, 1.36 to 4.98]; Fig 2 ) as a result of more locoregional progression events in the T-DM1+P arm before surgery (15 [6.7%] v 0) and noninvasive recurrence events after surgery (3 [1.3%] v 0; Table 1 ). Three-year EFS event-free rates were 85.3% (95% CI, 80.5% to 90.1%) with T-DM1+P and 94.2% (95% CI, 91.0% to 97.4%) with TCH+P.

(A) Kaplan-Meier analysis of event-free survival in the intention-to-treat population. Event-free survival was defined as the time from random assignment to disease progression (including local progression before surgery), disease recurrence (local, regional, distant, ipsilateral noninvasive, or contralateral [invasive or noninvasive]), or death from any cause. (B-D) Kaplan-Meier analysis of invasive disease-free survival in the intention-to-treat population who underwent surgery according to (B) treatment arm, (C) pathologic complete response (pCR) status, and (D) treatment arm and pCR status. Invasive disease-free survival was defined as the time from surgery to the first documented occurrence of ipsilateral invasive local recurrence, ipsilateral locoregional invasive recurrence, distant recurrence, contralateral invasive breast cancer, or death from any cause. TCH+P, docetaxel, carboplatin, and trastuzumab plus pertuzumab; T-DM1+P, trastuzumab emtansine plus pertuzumab.

Time-to-Event Efficacy End Points

Risk of an IDFS event in the IDFS-evaluable population was similar between study arms (stratified HR, 1.11 [95% CI, 0.52 to 2.40]; Table 1 and Fig 3A ). Three-year IDFS event-free rates were 93.0% (95% CI, 89.4% to 96.7%) with T-DM1+P and 92.0% (95% CI, 86.7% to 97.3%) with TCH+P. OS was also similar between arms—six deaths in the T-DM1+P arm and five in the TCH+P arm ( Table 1 ) —but the number of deaths was too low to draw meaningful conclusions.

Patient-reported outcomes during the overall study period for patients in the intention-to-treat population. Graphs depict mean change from baseline in European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire−C30 for domains of (A) global health status, (B) physical functioning, (C) cognitive functioning, and (D) diarrhea. Baseline is defined as neoadjuvant cycle 1, day 1. TCH+P, docetaxel, carboplatin, and trastuzumab plus pertuzumab; T-DM1+P, trastuzumab emtansine plus pertuzumab.

IDFS was analyzed according to pCR status in the IDFS-evaluable population ( Table 2 and Figs 2C and 2D ). Among all patients who underwent surgery (n = 418), pCR was associated with a reduced risk of an IDFS event regardless of treatment arm or hormone receptor status (stratified HR, 0.24 [95% CI, 0.09 to 0.60]). In patients with a pCR, risk of an IDFS event was similar between treatment arms (stratified HR, 0.99 [95% CI, 0.20 to 4.96]). The 3-year IDFS event-free rate was similarly high in the T-DM1+P arm (96.7% [95% CI, 93.0% to 100.0%]) and TCH+P arm (97.5% [95% CI, 94.7% to 100.0%]). In patients with residual disease—regardless of whether they received optional adjuvant chemotherapy—risk of an IDFS event was also similar between treatment arms (stratified HR, 0.94 [95% CI, 0.38 to 2.33]). The 3-year IDFS event-free rate was 89.4% (95% CI, 83.1% to 95.6%) in the T-DM1+P arm and 84.2% (95% CI, 72.5% to 96.0%) in the TCH+P arm. A similar risk of an IDFS event in both arms was also observed in subgroups defined by hormone receptor status (Appendix Table A3 , online only).

IDFS According to pCR Status in the IDFS-Evaluable Population

Sensitivity analyses for EFS and IDFS were conducted that censored patients at the time that they initiated nonprotocol anticancer therapy. Results of these sensitivity analyses were completely aligned with the results of the primary analyses for both EFS and IDFS (Appendix Table A4 , online only).

Adjuvant chemotherapy, endocrine therapy, and/or radiation therapy—in addition to T-DM1+P or H+P—was received on study by 159 (77.9%) of 204 patients in the T-DM1+P arm and 178 (83.2%) of 214 patients in the TCH+P arm (Appendix Table A5 , online only). Chemotherapy was administered to 50 patients (24.5%) in the T-DM1+P arm (41 [33.1%] of 124 patients with residual disease and nine [9.1%] of 99 patients with pCR) and to no patients in the TCH+P arm.

In the T-DM1+P arm, median treatment durations were 12.6 months (range, 0.7 to 18.6 months) for T-DM1 and 12.9 months (range, 0.7 to 18.6 months) for P (Appendix Table A6 , online only). In the TCH+P arm, median treatment durations were 3.5 months (range, 0 to 4.8 months) for T and C, and 12.9 months (range, 0 to 16.6 months) for H and P. Dose reductions of T-DM1 occurred in 19.3% of patients. Of 196 patients who received adjuvant T-DM1+P, 17 (8.7%) switched to H+P as a result of AEs.

During the overall study period, including both neoadjuvant and adjuvant phases, there was a lower incidence of serious (13.5% v 32.4%) and grade 3 or greater (31.8% v 67.6%) AEs in the T-DM1+P arm compared with the TCH+P arm, driven by the better safety profile of T-DM1+P compared with TCH+P in the neoadjuvant phase ( Table 3 ). Throughout the study, the four most commonly occurring grade 3 or greater AEs in the T-DM1+P arm were anemia (5.8%), neutropenia (3.6%), peripheral neuropathy (3.1%), and decreased platelet count (2.2%). The four most commonly occurring grade 3 or greater AEs in the TCH+P arm were neutropenia (25.1%), diarrhea (15.5%), febrile neutropenia (15.1%), and anemia (11%). Throughout the study, serious AEs that occurred in 1% or more of the T-DM1+P arm were febrile neutropenia (1.3%), anemia (1.3%), and wound infection (1.3%). In the TCH+P arm, these were febrile neutropenia (11.9%), diarrhea (4.1%), neutropenia (3.2%), vomiting (1.8%), colitis (1.4%), and decreased neutrophil count (1.4%). Symptomatic New York Health Association Class III or IV heart failure was reported in no patients receiving T-DM1+P and in three patients (1.4%) receiving TCH+P.

During adjuvant treatment, grade 3 or greater AEs, serious AEs, and AEs leading to the discontinuation of any component of treatment were more common in patients who received T-DM1+P (25.5% [50 of 196 patients in the safety population] of whom also received adjuvant conventional systemic chemotherapy) versus those who received H+P ( Table 3 ). Grade 3 or greater AEs occurred in 48 patients (24.5%) and 21 patients (9.9%), respectively. Serious AEs occurred in 13 patients (6.6%) and 10 patients (4.7%), respectively. AEs that led to the discontinuation of any component of treatment occurred in 36 patients (18.4%) and eight patients (3.8%), respectively. Those occurring in at least two patients are shown in Appendix Table A7 (online only). Among the 146 patients in the T-DM1+P arm who received no adjuvant chemotherapy, serious AEs occurred in six patients (4.1%), grade 3 or greater AEs occurred in 25 patients (17.1%), and AEs leading to the discontinuation of any component of treatment occurred in 22 patients (15.1%). During the adjuvant phase, one patient in the T-DM1+P arm died of an ileus AE after starting adjuvant chemotherapy that was deemed related to adjuvant chemotherapy.

Across visits, more than 80% of patients completed one or more question on the EORTC QLQ-C30 and QLQ-BR23. The response rate was similar between treatment arms. An optional assessment was administered to patients who received adjuvant chemotherapy in the T-DM1+P arm. Of 50 patients, 44 were eligible to complete the optional cycle 4 assessment, which occurred before cycle 4 of chemotherapy and 28 (63.6%) completed one or more question.

Baseline scores were well balanced between study arms (Appendix Table A8 , online only). Patients who received T-DM1+P reported fewer impairments on the QLQ-C30 and QLQ-BR23 during neoadjuvant treatment than did patients who received TCH+P, including on assessments of global health status, physical functioning, cognitive functioning, and diarrhea ( Fig 3 ). Similar scores were observed in each treatment arm on the QLQ-C30 and QLQ-BR23 scales during adjuvant treatment, and impairments generally resolved to baseline levels during follow-up; however, slight impairment in cognitive functioning remained at the final follow-up visit in both treatment arms. For the group of T-DM1+P patients who received adjuvant chemotherapy, impairments were observed in global health status, physical functioning, and cognitive functioning, as well as an increase in diarrhea at the optional assessment.

This phase III randomized study demonstrated that replacing systemic chemotherapy with T-DM1 in an HER2-targeted neoadjuvant regimen led to a greater risk of an EFS event (HR, 2.61 [95% CI, 1.36 to 4.98]), but a similar risk of an IDFS event (HR, 1.11 [95% CI, 0.52 to 2.40]) compared with TCH+P in patients with operable, HER2-positive stage II to III breast cancer. The higher risk of an EFS event in the T-DM1+P arm was driven by investigator-assessed locoregional progression before surgery (n = 15 [6.7%]) and noninvasive recurrence postsurgery (n = 3 [1.3%]) in the T-DM1+P arm, whereas no such events occurred in the TCH+P arm. Tumors from the 15 patients who experienced locoregional progression had lower HER2 expression and higher HER2 heterogeneity relative to those from other patients in the T-DM1 arm (Appendix Tables A9 and A10 , online only). These data suggest that patients with low and/or heterogenous HER2 expression may require conventional systemic chemotherapy combined with HER2 blockade. A relationship between the level of HER2 expression and the extent of T-DM1 benefit has also been noted in the metastatic setting. Whereas T-DM1 therapy was superior to conventional therapy in all patient subsets, the benefits were greater in those with HER2 mRNA expression greater than the median for the study population. 18 , 19

After surgery, analysis of the IDFS-evaluable population showed no difference between arms in the risk of an IDFS event; however, 95% CI is wide for the IDFS HR (0.52 to 2.40), and the 15 patients who experienced locoregional progression in the T-DM1+P arm before surgery were not included in the IDFS-evaluable population; therefore, IDFS results should be interpreted with caution. In addition, within the T-DM1+P arm, patients who had residual disease were more likely to have received adjuvant chemotherapy than patients who had a pCR (33.1% v 9.1%). Lack of randomization to adjuvant chemotherapy and the small number of patients who received it preclude meaningful analyses of this subgroup. Consistent with other data, 9 pCR conferred a favorable long-term outcome compared with no pCR (stratified HR, 0.24 [95% CI, 0.09 to 0.60]) regardless of treatment arm, with 3-year IDFS event-free rates of 96.7% in the T-DM1+P arm and 97.5% in the TCH+P arm. A relationship between pCR and a favorable 3-year outcome was also apparent regardless of hormone receptor status.

During the overall study period, T-DM1+P was associated with fewer grade 3 or greater and serious AEs than TCH+P followed by adjuvant H+P, which was driven by a better safety profile in the T-DM1+P arm compared with the TCH+P arm during the neoadjuvant treatment phase. However, during the adjuvant phase, compared with H+P, T-DM1+P was associated with a greater incidence of grade 3 or greater AEs, serious AEs, and AEs that led to treatment discontinuation. The increased incidence of these AEs in the T-DM1+P arm seem to be driven, at least in part, by adjuvant chemotherapy. Serious AEs occurred in 14.0% (seven of 50) of patients who received adjuvant chemotherapy versus in 4.1% (six of 146) of patients who did not. Grade 3 or greater AES occurred in 46.0% (23 of 50) of patients who received adjuvant chemotherapy versus in 17.1% (25 of 146) of patients who did not, and AEs leading to treatment discontinuation occurred in 28.0% (14 of 50) of patients who received adjuvant chemotherapy versus in 15.1% (22 of 146) of patients who did not.

Treatment with T-DM1+P resulted in less functional impairment and less impact from symptoms compared with TCH+P during the neoadjuvant phase of treatment, as assessed by EORTC QLQ-C30 ( Fig 3 ) and QLQ-BR23 (data not shown). Although impairments in cognitive functioning and certain symptoms remained through the adjuvant phase and follow-up in both arms, a large negative impact on physical or role functioning or global health status was not observed.

The role of T-DM1 in early HER2-positive breast cancer is evolving, with two trials evaluating this agent in the adjuvant setting. The KATHERINE trial demonstrates that patients who had residual disease after neoadjuvant systemic chemotherapy plus single or dual HER2-directed therapy had a lower risk of invasive breast cancer recurrence or death with adjuvant T-DM1 compared with adjuvant trastuzumab (HR, 0.50 [95% CI, 0.39 to 0.64]; P < .001). 20 The ongoing KAITLIN trial (ClinicalTrials.gov identifier: {"type":"clinical-trial","attrs":{"text":"NCT01966471","term_id":"NCT01966471"}} NCT01966471 ) will compare T-DM1+P with taxane plus P+H after anthracyclines as adjuvant therapy for patients who have not received prior neoadjuvant therapy and will thus provide additional information on outcomes with adjuvant T-DM1+P.

Strengths of the current study were its rigorous randomized controlled design and its use of dual HER2-targeted therapy as the control in both the neoadjuvant and adjuvant phases. Limitations were that the end points of EFS, IDFS, and OS were secondary and the study was not powered to detect differences in these end points. In addition, the 15 patients who experienced locoregional progression in the T-DM1+P arm were not included in the IDFS analysis because they did not have surgery recorded in the case report form and their disease recurrence status was not available; however, some of these patients were still in the OS follow-up.

Three-year results from KRISTINE demonstrate that neoadjuvant and adjuvant T-DM1+P was associated with a higher risk of an EFS event, a similar risk of an IDFS event, and less quality-of-life impairment in the neoadjuvant phase compared with neoadjuvant TCH+P followed by adjuvant H+P. Furthermore, relative to TCH+P followed by adjuvant H+P, the conventional systemic chemotherapy–sparing regimen of T-DM1+P was associated with fewer serious AEs, grade 3 or greater AEs, and more AEs leading to treatment discontinuation. Overall, the observed worse EFS and similar IDFS associated with T-DM1+P might suggest the importance of selecting patients for a conventional chemotherapy–sparing neoadjuvant regimen. Data from KAITLIN will further define the clinical utility of adjuvant T-DM1+P in patients with HER2-positive early breast cancer.

ACKNOWLEDGMENT

The authors thank the patients who participated in this trial, the clinical site teams, and Holly Strausbaugh, PhD, and Laura Evans, PharmD, of Twist Medical, for medical writing assistance (funded by F Hoffmann-La Roche/Genentech).

Treatment Disposition During Overall Study

Baseline Characteristics

IDFS According to Tumor Hormone Receptor Status in the IDFS-Evaluable Population

Sensitivity Analysis for EFS and IDFS Censoring at Start of Nonprotocol Anticancer Therapy

Additional Adjuvant Treatments in the IDFS-Evaluable Population

Treatment Exposure During Overall Study (safety population)

Adverse Events Leading to Treatment Discontinuation in at Least Two Patients in the Adjuvant Phase

Baseline Scores (ie, before cycle 1 neoadjuvant treatment) on the European Organization for Research and Treatment of Cancer QLQ-C30 and QLQ-BR23 by Study Arm

HER2 Expression in T-DM1+P Arm by Disease Progression Status Before Surgery

Baseline ER and HER2 Status of Patients With Locoregional Progression in the T-DM1+P Arm

Presented in part at the American Society of Clinical Oncology Annual Meeting, Chicago IL, May 31-June 4, 2019.

Processed as a Rapid Communication manuscript.

Funded by F Hoffman-La Roche/Genentech.

Clinical trial information: {"type":"clinical-trial","attrs":{"text":"NCT02131064","term_id":"NCT02131064"}} NCT02131064 .

See accompanying Editorial on page 2189

AUTHOR CONTRIBUTIONS

Conception and design: Sara A. Hurvitz, Miguel Martin, Nadia Harbeck, Karen Afenjar, Joseph A. Sparano, W. Fraser Symmans, Alastair M. Thompson, Dennis Slamon

Administrative support: Sara A. Hurvitz, Gonzalo Spera

Provision of study materials or patients: Miguel Martin, Kyung Hae Jung, Chiun-Sheng Huang, Nadia Harbeck, Vicente Valero, Daniil Stroyakovskiy, Hans Wildiers, Mario Campone, Jean-François Boileau, Peter A. Fasching, Joseph A. Sparano

Collection and assembly of data: Miguel Martin, Chiun-Sheng Huang, Nadia Harbeck, Vicente Valero, Daniil Stroyakovskiy, Mario Campone, Jean-François Boileau, Peter A. Fasching, Gonzalo Spera, Vanesa Lopez-Valverde, Chunyan Song, Joseph A. Sparano, Alastair M. Thompson, Dennis Slamon

Data analysis and interpretation: Sara A. Hurvitz, Miguel Martin, Kyung Hae Jung, Chiun-Sheng Huang, Nadia Harbeck, Vicente Valero, Hans Wildiers, Mario Campone, Jean-François Boileau, Peter A. Fasching, Karen Afenjar, Gonzalo Spera, Vanesa Lopez-Valverde, Chunyan Song, Peter Trask, Thomas Boulet, Joseph A. Sparano, Alastair M. Thompson, Dennis Slamon

Manuscript writing: All authors

Final approval of manuscript: All authors

Accountable for all aspects of the work: All authors

AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST

The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc .

Research Funding: Genentech (Inst), Novartis (Inst), GlaxoSmithKline (Inst), Sanofi (Inst), Pfizer (Inst), Amgen (Inst), OBI Pharma (Inst), Puma Biotechnology (Inst), Dignitana (Inst), Bayer (Inst), Biomarin (Inst), Eli Lilly (Inst), Merrimack Pharmaceuticals (Inst), Cascadian Therapeutics (Inst), Seattle Genetics (Inst), Daiichi Sankyo (Inst), Macrogenics (Inst), Ambryx (Inst), Immunomedics (Inst), Pieris (Inst), Radius (Inst)

Consulting or Advisory Role: Genentech, Novartis, Pfizer, Eli Lilly, AstraZeneca, Taiho Pharmaceutical, PharmaMar

Research Funding: Novartis (Inst), Roche (Inst)

Honoraria: Amgen, Roche, Pfizer, AstraZeneca, Novartis

Consulting or Advisory Role: Amgen, Pfizer, Roche

Speakers' Bureau: Amgen, Pfizer, Roche

Research Funding: Amgen (Inst), AstraZeneca (Inst), Eli Lilly (Inst), MSD (Inst), Novartis (Inst), Pfizer (Inst), Roche (Inst)

Travel, Accommodations, Expenses: Pfizer, Roche, Amgen

Stock and Other Ownership Interests: West German Study Group

Honoraria: Roche, Novartis, Amgen, Pfizer, Genomic Health, AstraZeneca, Zodiac Pharma

Consulting or Advisory Role: Genentech, Novartis, Celgene, Pfizer, Eli Lilly, Sandoz, Daiichi Sankyo, Agendia, AstraZeneca, Merck Sharp & Dohme, Odonate Therapeutics, Seattle Genetics

Consulting or Advisory Role: West German Study Group (I)

Research Funding: Genentech (Inst), Novartis (Inst), Pfizer (Inst), Eli Lilly (Inst), Merck Sharp & Dohme (Inst)

Honoraria: Genentech

Consulting or Advisory Role: Genentech

Travel, Accommodations, Expenses: Genentech

Speakers' Bureau: Genentech, Bristol-Myers Squibb, BioCad, AstraZeneca

Travel, Accommodations, Expenses: AstraZeneca, Novartis, Roche

Honoraria: Roche, Amgen, Novartis

Consulting or Advisory Role: Amgen (Inst), Roche (Inst), Eli Lilly (Inst), AstraZeneca (Inst), AbbVie (Inst), Vifor Pharma (Inst), Roche (Inst)

Expert Testimony: AbbVie, TRM Oncology

Travel, Accommodations, Expenses: Pfizer, Roche, Puma Biotechnology, TRM Oncology

Honoraria: Novartis, Eli Lilly

Consulting or Advisory Role: Novartis (Inst), Servier (Inst), Menarini, Sanofi (Inst), Eli Lilly (Inst), Pfizer (Inst), AstraZeneca (Inst), MedImmune (Inst), AbbVie (Inst)

Speakers' Bureau: Novartis, Amgen

Research Funding: Novartis (Inst)

Travel, Accommodations, Expenses: Novartis, AstraZeneca, Pfizer

Other Relationship: Roche

Honoraria: Genentech, Amgen

Consulting or Advisory Role: Genentech, Genomic Health, NanoString Technologies, Eli Lilly

Speakers' Bureau: Roche, Novartis, Genomic Heath, Pfizer

Research Funding: Genentech (Inst), Novartis (Inst), Pfizer (Inst), AbbVie (Inst), Merck (Inst), Eli Lilly (Inst), RNA Diagnostics (Inst)

Travel, Accommodations, Expenses: Roche, GlaxoSmithKline, Novartis, Eli Lilly

Honoraria: Roche, Amgen, Novartis, Pfizer, Celgene, Puma Biotechnology, Daiichi Sankyo, Eisai, Merck Sharp & Dohme, AstraZeneca, Teva, Hexal, Myelo Therapeutics

Consulting or Advisory Role: Amgen, Teva, Celgene, Novartis, Pfizer, Roche, Puma Biotechnology, Daiichi Sankyo, Eisai, Merck Sharp & Dohme, AstraZeneca, Hexal, Myelo Therapeutics, Macrogenics

Research Funding: Novartis (Inst), BioNTech (Inst), Cepheid (Inst)

Travel, Accommodations, Expenses: Novartis

Employment: F Hoffmann-La Roche

Honoraria: F Hoffmann-La Roche

Travel, Accommodations, Expenses: F Hoffmann-La Roche

Employment: Genentech

Stock and Other Ownership Interests: Genentech

Stock and Other Ownership Interests: Genentech, Pfizer

Stock and Other Ownership Interests: Metastat

Consulting or Advisory Role: Genentech, Novartis, AstraZeneca, Celgene, Eli Lilly, Celldex, Pfizer, Prescient Therapeutics, Juno Therapeutics, Merrimack Pharmaceuticals, Adgero Biopharmaceuticals, Cardinal Health

Research Funding: Prescient Therapeutics (Inst), Deciphera (Inst), Genentech (Inst), Merck (Inst), Novartis (Inst), Merrimack Pharmaceuticals (Inst), Radius Health (Inst)

Travel, Accommodations, Expenses: Menarini Silicon Biosystems, Genentech, Adgero Biopharmaceuticals, Myriad Genetics, Pfizer, AstraZeneca

Stock and Other Ownership Interests: ISIS Pharmaceuticals, Nuvera Biosciences, Delphi Diagnostics

Consulting or Advisory Role: Merck, Almac Diagnostics

Patents, Royalties, Other Intellectual Property: Intellectual property, intellectual Property (expired)

Travel, Accommodations, Expenses: Luminex, Merck

Honoraria: Novartis (I), Pfizer

Research Funding: Genentech (Inst)

Travel, Accommodations, Expenses: Novartis (I), Pfizer

Leadership: Biomarin

Stock and Other Ownership Interests: Pfizer

Honoraria: Novartis

Consulting or Advisory Role: Novartis, Eli Lilly

Research Funding: Novartis, Pfizer

Travel, Accommodations, Expenses: Pfizer, Biomarin, Novartis

No other potential conflicts of interest were reported.

Shooter Files by f.d. walker

Street Photography Tips, Interaction, Travel, Guides

Apr 24 2017

City Street Guides by f.d. walker: A Street Photography Guide to Moscow, Russia

*A series of guides on shooting Street Photography in cities around the world. Find the best spots to shoot, things to capture, street walks, street tips, safety concerns, and more for cities around the world. I have personally researched, explored and shot Street Photography in every city that I create a guide for. So you can be ready to capture the streets as soon as you step outside with your camera!

At over 12 million people, Moscow is the largest city in Russia and second largest in Europe by population ( Istanbul is #1). An urban, cosmopolitan metropolis with more than enough glitz and glam to cater to the elite, but without losing its fair share of Soviet era roughness around the edges. It can be fast paced, brash, busy, and trendy like other big cities, but it has its blend of West meets Russia atmosphere and beauty that provides plenty of unique interest. The Red Square is as famous as it gets, but there’s so much more to this city, including the most beautiful subway system you’ve ever seen. It would take years to capture all of Moscow, but that means you have an endless amount of areas to discover.

So here’s a Street Photography guide so you can be ready to capture all that Moscow has to offer before you even arrive!

• Patriarch’s Pond
• Old Arbat Street
• Maroseyka Street
• Tverskoy Boulevard

Top 5 Street Spots:

1. red square.

The Red Square is the most famous square in not just Russia, but all of Eastern Europe. The name actually doesn’t come from the color of the bricks or communism, but from the name in Russian, Krásnaya, once meaning “beautiful” before its meaning changed to “red.” This large plaza is what you see on the cover of guide books and magazines for Moscow, with St. Basil’s Cathedral being the center piece next to Lenin’s Mausoleum surrounded by the Kremlin Wall. Of course, the Red Square attracts hordes of tourist due to the main attractions, but all that activity around an interesting atmosphere does provide street photo opportunities. It’s also the central square connecting to the city’s major streets, providing a good starting point to explore outward.

You’ll also find the popular pedestrian only Nikolskaya Street connecting the Red Square to Lubyanka Square. This line of expensive shops includes plenty of activity, while also leading you to another popular square. Filled with history rivaling any city, the Red Square and surrounding areas are the heart and soul of Russia.

2. Patriarch’s Ponds

Patriarch’s Ponds is one of the most exclusive neighborhoods in Moscow. Despite the name being plural, there’s only one large pond, but it’s worth a visit with your camera. It’s a popular spot for locals and expats to come relax or take a stroll around the pond. You get an interesting mix of young and old too, from young love to “babushkas” feeding pigeons. It’s a very peaceful park atmosphere in one of the nicer areas within the city center, while bringing enough activity for street photography. 

The pond is shallow and in the winter becomes a popular spot for ice-skating too. The area is also well-known for the location in the famous Russian novel, The Master and Margarita. 

3. Old Arbat (Stary Arbat)

Old Arbat is the most famous pedestrian street in Moscow, and dating back to the 15th century, also one of its oldest. Originally, it was an area of trade, but soon became the most prestigious residential area in Moscow. During the 18th century, Arbat started attracting the city’s scholars and artists, including Alexander Pushkin. Cafes lined the streets and impressive homes filled the neighborhood. Since then, New Arbat street was created as a highway in the area, while Old Arbat was paved for a 1km pedestrian only walkway.

Due to the historic buildings, famous artists that lived here, and the bohemian atmosphere, Old Arbat has become a big attraction for tourists today. Now, there’s a mix of cafes, restaurants, souvenir shops, street performers, street merchants and other attractions for visitors, and some locals, to come enjoy. It can get really busy here and there’s usually something interesting going on so it’s a good street to come walk with your camera for guaranteed life.

4. Gorky Park

One of the most famous places in Moscow is Gorky Park. The official name is Maxim Gorky’s Central Park of Culture & Leisure, which gives you an idea of what goes on here. When built, it was the first of its kind in the Soviet Union. Divided into two parts, it stretches along Moscow River. One end contains fair rides, foods stands, tennis courts, a sports club, a lake for boat rides, and more. This end brings more active life due to its number of attractions, while the other end is more relaxed, where you’ll find gardens, trees, older buildings, and an outdoor amphitheater.

Gorky Park attracts mostly locals so it’s a good spot to capture the non-tourist side of Moscow life. Muscovites come here to escape the city and unwind in a picturesque setting. The park remains alive outside of the warmer months too, especially when the lake turns into the city’s largest outdoor skating rink. I’d recommend taking the metro out here to spend at least half a day exploring the massive park’s life with your camera.

5. Maroseyka Street

Maroseyka Street is a popular area not too far from the Red Square. The long, winding street turns into Pokrovka and is lined with restaurants, cafes, bars and places to stay. It’s actually where I like to stay when I’m in Moscow due to its location and solid street photography opportunities itself. You have Kitay-gorod station near and if you keep walking southwest, you’ll get to the Red Square. But if you walk northwest, as it changes to Pokrovka, you can find a long street of activity for photography with its own interesting atmosphere.

6. Tverskoy Boulevard

Tverskoy Boulevard is the oldest and longest boulevard in Moscow, beginning at the end of Nikitsky Boulevard, and finishing at Pushkin Square, a spot to come for activity itself. The boulevard is made up of two avenues, with pedestrian walkways in-between. You’ll find grass, shrubbery, trees, benches and more walking it’s almost kilometer length. Many people come here to enjoy some relaxation, walk their dog, or just to use it to walk wherever they’re going. Its center location also provides a nice place to walk with your camera near plenty of other spots you’ll want to check out anyway.

Sample Street Walk:

For a full day of Street Photography, covering some of the best spots, you can follow this sample street walk for Moscow:

• Start your morning walking around the Red Square (1), while exploring the surrounding area, including Nikolskaya Street
• Then walk northwest to Patriarch’s Ponds (2) and slowly walk the pond and surrounding area with your camera
• Next, walk east to the Pushkin Monument and stroll down Tverskoy Boulevard (6)
• Once Tverskoy Boulevard (6) ends, it will turn into Nikitsky Boulevard. Follow this down until you get to the start of Old Arbat Street (3), across from Arbatskaya station
• After you’re done walking down Old Arbat Street (3) for more street photography, spend some time checking out Moscow’s beautiful metro stations
• To finish off the day with more street photography, get off the metro near Red Square (1) again, Maroseyka Street (5) or wherever you’re staying for the night.

3 Things I’ll Remember about Shooting in Moscow:

1. museum metro.

The Moscow metro system was the first underground railway system in the Soviet Union and today includes 203 stations across 340km of routes. The elaborate system has some of the deepest stations in the world too, with escalators that seem to go on forever. None of this is what makes it so special, though. Many of its stations feel like stepping inside a museum, making it without a doubt the most interesting and beautiful metro system I’ve been in.

When built, Stalin wanted to make the metro stations “palaces for the people” with marble, chandeliers, and grand architecture. The best part is the variety of architecture and styles used, making many of the stations a completely different experience visually. You could easily spend a whole day traveling the stations and there are even tours available for people who wish to do just that. My advice, though, would be just to buy a ticket and hop on and off at different stations, while exploring different lines. The museum-like surrounding mixed with the crowds of characters can make for a great photography experience.

Since there are so many stations, here are some of my favorites to check out:

• Novoslobodskaya
• Mayakovskaya
• Elektrozavodskaya
• Komsomolskaya
• Ploschad Revolyutsii
• Dostoyevskaya
• Prospekt Mira

2. Moscow is Big

It’s no secret that Moscow is a big city, but it can feel even bigger with how spread out much of it is. This is especially true if you compare it to cities outside of Asia. If I compared it to cities in Europe, I’d probably say only Istanbul would warrant more time to really discover the depths of this city. Most only explore around the Red Square and surrounding area, but that is such a small part of the city. Although, that central area does give you plenty to see on its own.

Fortunately, I had a good friend living in the city to show me around, but it opened up my eyes even more to how much there is to discover in Moscow. It’s a big city with a variety of atmosphere that can take you from “east” to “west” and trendy to rugged depending on where you go. I’d imagine you’d have to live here a while to really know the city.

3. Cosmopolitan Mix of East meets West

Modern skyscrapers mixed with amazing architecture, a world-class metro system with museum-like beauty, trendy fashion and chic clubs, Moscow is a rich mix of Russian culture and history in a more western cosmopolitan package. There is a push to keep the Russian culture, while also pushing forward with a modern metropolis the whole world will envy. This comes with an impressive skyline, that continues to grow, and endless modernities, but with soviet nostalgia and atmosphere mixed in for good measure.

Mixed in with this grand western cosmopolitan atmosphere, is a strong national pride in Russia. This includes their famous leader, Vladimir Putin. Maybe no other place will you see a country’s leader more often. All over, from the pricey tourist shops to the underground walkway stalls, you’ll find goods with Putin’s likeness covering them. From t-shirts to magnets to Matryoshka dolls. There’s a strong national pride that can be seen around the city, which also extends to their leader. Moscow is many things. It’s East meets West, modernizations meets Soviet era, and a whole lot more.

What To Do For a Street Photography Break?:

Eat at a stolovaya.

Stolovayas are Russian cafeterias that became popular in the Soviet days. You grab a tray and walk down the line of freshly prepared local dishes, and select whatever you want from the chefs. They’re usually inexpensive and a much better value than restaurants, while giving you the opportunity to try from a wide selection of everyday Russian food. They’re also very tasty. I always include some borsch on my tray and go from there. The places themselves are all over Moscow and usually come with Soviet-era aesthetics to complete the experience.

Street Safety Score: 7

*As always, no place is completely safe! So when I talk about safety, I’m speaking in general comparison to other places. Always take precaution, be smart, observe your surroundings and trust your instincts anywhere you go!

Being the 2nd largest city in Europe with over 12 million people, you’re going to have your dangerous areas, but for the most part, it feels safe walking around. Russia is statistically higher in crime compared to most of Europe, but this generally doesn’t apply to tourists and visitors. Around the Red Square and surrounding city center, you should feel completely safe walking around. Pick pocketing can happen, but no more than other touristic places. I always explore Moscow freely without coming across too much to worry about. It’s a spread out city, though, so of course it matters where you are. Just use basic street smarts, know where you are and Moscow shouldn’t give you a problem. 

People’s Reaction Score: 7

Moscow is fast paced, big city life, which usually means people aren’t too concerned with you, or your camera. I don’t find people notice or pay much attention to me when I’m out taking photos in Moscow. For the most part, people just go about their day. You shouldn’t get too many looks or concern. But it can depend on the area you are in. The more you stick out, the more you might get noticed with suspicions. I’ve never had any problems in Moscow, or Russia, but just be careful who you’re taking a photo of if you get out of the city center. Other than that, it’s about average for reactions. 

Street Tips:

Learn the alphabet .

Much of Moscow, including the metro system, doesn’t use english. The Russian alphabet uses letters from the Cyrillic script, which if you aren’t familiar with it and don’t know the sounds, can be hard to decipher the words. This is most important for street names and metro stops when trying to get around. It can save confusion and make it easier getting around if you learn the basic alphabet. At the very least then, you can sound out the words to see which are similar in the english conversion, which can help matching them to maps. When out shooting street photography, getting around is as important as anything. So save yourself some time and frustration by learning the Russian Alphabet.

Use the metro

While Saint-Petersburg feels very walkable for a city its size, Moscow can feel very spread out, even for its bigger size. Outside of the Red Square area, you can have plenty of walking before getting anywhere very interesting, so you’ll need to take the metro a lot if you really want to explore the city. Maps are deceiving here too, it will always be further than it looks.

Another reason it’s less walkable than Saint-Petersburg is its completely different set-up. Moscow’s streets are mostly contstructed in rings with narrow, winding streets in-between. This is common with medieval city cities that used to be confined by walls, but you usually don’t have it in a city this massive. Saint-Petersburg has a more grid-like pattern that also uses the canals to help you know your way around. When it comes to navigating on foot in Moscow, it can be more difficult, so bring a map and take the metro when needed. It’s why Moscow’s metro carries more passengers per day than the London and Paris subways combined.

Explore other areas if you have time

Moscow is really big. While most people stay around the Red Square within the Boulevard Ring, there’s so much more to the city. I covered some other spots outside of this circle, but if you really want to see the city, you’ll need time. If you do have time, some other areas I’d check out first are Zamoskvarechye, along some of the south and western Moscow.

Inspiration:

For some more inspiration, you can look through the Street Photography of Moscow photographer Artem Zhitenev  and check out 33 of my photos taken in Moscow .

Conclusion:

Moscow’s name brings a certain mystique, but once you’re there it might bring a different atmosphere than you expect. It’s big and sprawling, but beautiful in many ways. It can feel like a European capital on a grand scale, but you can definitely find its Russian side in there.

The urban sprawl of Moscow can be intimidating, but give it enough time and you’ll be rewarded with plenty to discover. All with the world’s best metro system to take you around.

I hope this guide can help you start to experience some of what Moscow contains. So grab your camera and capture all that Moscow has to offer for Street Photography!

If you still have any questions about shooting in Moscow, feel free to comment below or email me!

(I want to make these guides as valuable as possible for all of you so add any ideas on improvements, including addition requests, in the comment section!)

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Venicci Carbo Lux 3 in 1 Travel System (9 Piece Bundle) – Light Grey

Description.

The  Venicci Carbo Lux 3 in 1 Travel System  will provide your baby with the highest level of comfort. Due to leatherette finish your baby will look stylish in the pram from day one – it is an absolute must-have Travel System! With an integrated 3-in-1 system, the Venicci Carbo will transform from Carry Cot to Seat Unit to Car Seat in no time at all, providing you and your baby with the very best in style and quality from the beginning.

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Aluminium alloy significantly reduce total weight and makes stroller unusually light-weighted and easy to drive.

UV 50+ fabric

Walk with no worries. We take care of your child’s protection. The sun UV 50+ filter is a special, permanent protection from the sun’s damaging radiation.

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Fabrics with a special water-repellent impregnation designed to keep your child safe in different weather conditions.

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Getting around Moscow

• 1 Travel tips
• 2 Getting to Moscow
• 3 Getting around Moscow
• 4 Money Matters
• 6 Info about Moscow & Russia

Official taxis can cost a bomb in Moscow, and after taking a ride in one you wouldn't be surprised to hear that your driver was called Boris Korruptikov. There's little point in insisting on using the meter as they can fix the amount per km. Instead look like you are prepared to take the bus and negotiate a price - plus have the right change or you will end up leaving a big tip. Alternatively wave down a comrade for a lift - see our page on citizen cabs !

Buses, trolleybuses and mini-buses offer a slightly less comfortable way of getting around town, and should be used when the metro won't take you where you need to go. Expect plenty of argy-bargy to get in, but once inside admire the reliability with which money changes hands as those at the back pass their roubles to the front for a ticket.

There are no trams in the epicentre of Moscow and they tend to be useful only for joining the outer districts of town with the metro system. You can buy a ticket on board or at a kiosk.

Renting a car isn't prohibitively expensive in Moscow, however the city's ring roads can make the most experienced driver break out into a cold sweat. Apart from dodgy manoeuvres from your fellow drivers, just heading in the right direction can be quite a headache...

The Moscow metro is a tourist attraction by itself! So unique!

Whats the best way to get from the airport to your hotel.

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Tinkoff C Cusack: Again Putin is destroying Ukraine for his own ends. Don't be fooled Hitler was evil but Putin is even worse. Marsupial is completely destroyed and the people left have no food he is starving them to death. Pass this on safely because we know a lot of Russians have been detained for expressing their views. If you receive this please let me know. Tinkoff John Hirst: Putin is causing genocide in Ukraine. He does this in YOUR name. Hard Rock Cafe Vladimir Putin: Putin is the reason Russia's economy is going down, because he has violated international order with an unprovoked attack on Ukraine. Meanwhile he lies to Russians that there are Nazis in Ukraine when the President Zelenskyy is Jewish. He said that Russians would be greeted with flowers and instead they are targeted with anti tank missiles. Putin is absolutely insane. Read the Washington Post and other REAL sources. Cafe Pushkin Vladimir Putin: Putin is the reason Russia's economy is going down, because he has violated international order with an unprovoked attack on Ukraine. Meanwhile he lies to Russians that there are Nazis in Ukraine when the President Zelenskyy is Jewish. He said that Russians would be greeted with flowers and instead they are targeted with anti tank missiles. Putin is absolutely insane. Read the Washington Post and other REAL sources.

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