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Testing Treatment With Ipilimumab and Nivolumab Compared to Treatment With Ipilimumab Alone in Advanced Melanoma

Sponsor
National Cancer Institute (NCI) (NIH)
Overall Status
Active, not recruiting
CT.gov ID
NCT03033576
Collaborator
(none)
94
Enrollment
639
Locations
2
Arms
67.9
Anticipated Duration (Months)
0.1
Patients Per Site
0
Patients Per Site Per Month

Study Details

Study Description

Brief Summary

This phase II trial studies how well ipilimumab with or without nivolumab work in treating patients with melanoma that is stage IV or stage III and cannot be removed by surgery. Immunotherapy with monoclonal antibodies, such as ipilimumab and nivolumab, may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread.

Condition or Disease Intervention/Treatment Phase
  • Biological: Ipilimumab
  • Biological: Nivolumab
 Phase 2

Detailed Description

PRIMARY OBJECTIVE:
  1. To compare progression free survival (PFS) of patients with advanced melanoma refractory to an anti-PD-1 or anti-PD-L1 agent, treated with combination therapy ipilimumab plus nivolumab versus ipilimumab alone.
SECONDARY OBJECTIVES:

  1. To estimate difference in T-cell infiltrate between on-study biopsy samples of patients who respond to combination therapy (including confirmed and unconfirmed, complete and partial response per Response Evaluation Criteria in Solid Tumors [RECIST] 1.1, in each treatment arm).

  2. To evaluate the objective response rate (ORR), defined as confirmed complete or partial response per RECIST 1.1, in each treatment arm.

  3. To evaluate the overall survival (OS) of patients in each treatment arm. IV. To evaluate the toxicity profile of patients in each treatment arm.

TRANSLATIONAL OBJECTIVES:

  1. To assess the marginal prognostic value of baseline T-cell density, T-cell receptor (TCR) clonality, mutational load, messenger ribonucleic acid (mRNA) and other phenotypical expression levels, and circulating tumor deoxyribonucleic acid (DNA) in terms of response.

  2. To assess the joint prognostic value of T-cell density, TCR clonality, and mutational load, mRNA and other phenotypical expression levels, and circulating tumor DNA in terms of response.

  3. To identify T-cell poor subtype(s) that are associated with response.

OUTLINE: Patients are randomized to 1 of 2 arms.

ARM I: Patients receive ipilimumab intravenously (IV) over 90 minutes on day 1. Treatment repeats every 21 days for up to 4 cycles in the absence of disease progression or unacceptable toxicity.

ARM II: Patients receive nivolumab IV over 30 minutes and ipilimumab IV over 90 minutes on day 1. Treatment repeats every 21 days for up to 4 cycles in the absence of disease progression or unacceptable toxicity. Patients then receive nivolumab IV over 30 minutes on day 1. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed up every 6 months for 2 years and then annually for 1 year.

Study Design

Study Type:
Interventional
Anticipated Enrollment :
94 participants
Allocation:
Randomized
Intervention Model:
Parallel Assignment
Masking:
None (Open Label)
Primary Purpose:
Treatment
Official Title:
A Phase II Randomized Study of Nivolumab (NSC-748726) With Ipilimumab (NSC-732442) or Ipilimumab Alone in Advanced Melanoma Patients Refractory to an Anti-PD1 or Anti-PD-L1 Agent
Actual Study Start Date :
Jul 17, 2017
Anticipated Primary Completion Date :
Mar 15, 2023
Anticipated Study Completion Date :
Mar 15, 2023

Arms and Interventions

Arm Intervention/Treatment
Active Comparator: Arm I (ipilimumab)

Patients receive ipilimumab IV over 90 minutes on day 1. Treatment repeats every 21 days for up to 4 cycles in the absence of disease progression or unacceptable toxicity.

Biological: Ipilimumab
Given IV
Other Names:
  • Anti-Cytotoxic T-Lymphocyte-Associated Antigen-4 Monoclonal Antibody
  • BMS-734016
  • Ipilimumab Biosimilar CS1002
  • MDX-010
  • MDX-CTLA4
  • Yervoy

    		•
    Experimental: Arm II (nivolumab, ipilimumab)

    Patients receive nivolumab IV over 30 minutes and ipilimumab IV over 90 minutes on day 1. Treatment repeats every 21 days for up to 4 cycles in the absence of disease progression or unacceptable toxicity. Patients then receive nivolumab IV over 30 minutes on day 1. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity.

    Biological: Ipilimumab
    Given IV
    Other Names:
  • Anti-Cytotoxic T-Lymphocyte-Associated Antigen-4 Monoclonal Antibody
  • BMS-734016
  • Ipilimumab Biosimilar CS1002
  • MDX-010
  • MDX-CTLA4
  • Yervoy

    • Biological: Nivolumab
    Given IV
    Other Names:
  • BMS-936558
  • CMAB819
  • MDX-1106
  • NIVO
  • Nivolumab Biosimilar CMAB819
  • ONO-4538
  • Opdivo

    		•

    Outcome Measures

    Primary Outcome Measures

    1. Progression free survival (PFS) [From date of registration to date of first documentation of progression or symptomatic deterioration, or death due to any cause, assessed up to 3 years]

      Will be compared between arms using a log-rank test. Kaplan-Meier plots will be constructed and median PFS for each arm with corresponding 95% Brookmeyer-Crowley confidence intervals will be estimated.

    Secondary Outcome Measures

    1. CD8+ expression levels [Up to 3 years]

      Will evaluate by comparing the quantitative CD8+ expression levels between patients who eventually respond and patients who do not respond using a two-sample t-test and control the type I error at the two-sided 0.05 level. Assuming that the trial accrues to completion, 90% compliance in tissue and biopsy submission, and that 25% of patients respond, then we anticipate 80% power to detect a mean difference in CD8+ expression of 0.875 standard deviations.

    2. Response rate (confirmed and unconfirmed, complete and partial responses) [Up to 3 years]

      Will estimate the response rate in each arm and construct 95% binomial confidence intervals. All randomized patients will be included in the analysis of response. Patients who cannot have their exact response determined due to inadequate disease assessments will be counted in the denominator as non-responders.

    3. Overall survival (OS) [Up to 3 years]

      Will construct Kaplan-Meier plots and estimate the median OS and construct 95% Brookmeyer-Crowley confidence intervals. We will be able to estimate the objective response rate (ORR) or the OS rates at a particular time point (e.g. 13 weeks) to within 12.3% (95% confidence interval [CI]) and 21.4% in the combination therapy and ipilimumab alone arms, respectively. Waterfall plots will be constructed to represent each patient's best change in tumor burden.

    4. Incidence of adverse events [Up to 3 years]

      Assessed by National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0 (version 5.0 will be utilized for serious adverse events reporting only). Toxicity will be assessed in each arm separately. Any toxicity with at least 5% chance of occurring has 93.7% and 60.3% chance of being observed at least once in the combination therapy and ipilimumab alone arms, respectively. We will be able to estimate the rate of occurrence of any particular toxicity to within 12.3% (95% CI) and 21.4% in the combination therapy and ipilimumab alone arms, respectively.

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    18 Years and Older
    Sexes Eligible for Study:
    All
    Accepts Healthy Volunteers:
    No
    Inclusion Criteria:

    • Patients must have pathologically confirmed melanoma that is either stage IV or unresectable stage III; patients may have primaries of cutaneous, mucosal or unknown origin; patients with uveal (ocular) primary are not eligible

    • Patients must have measurable disease per RECIST 1.1; all measurable lesions must be assessed by physical examination, computed tomography (CT) scans or magnetic resonance imaging (MRI)s within 28 days prior to registration; if the only measurable disease is cutaneous or subcutaneous, lesions must be at least 10 mm in greatest dimension and able to be serially recorded using calipers and photographs; tests used to assess non-measurable disease must have been performed within 42 days prior to registration; all disease must be assessed and documented on the Baseline Tumor Assessment Form

    • Patients with central nervous system (CNS) metastases must have all lesions adequately treated with stereotactic radiation therapy, craniotomy, gamma knife therapy, or whole brain radiotherapy, with no subsequent evidence of CNS progression; patients must not have required steroids for at least 14 days prior to registration; patients with a history of central nervous system metastases must have MRI of the brain within 42 days prior to registration

    • Patients must have had prior treatment with anti-PD1 or anti-PD-L1 agents and had documented disease progression per the treating physician either while on these agents or after stopping therapy with these agents without intervening therapy; patients who received adjuvant therapy for previously resected disease with PD-1 or PD-L1 agents may also be eligible if disease recurrence occurred while still receiving the PD-1 or PD-L1 therapy and no intervening therapy was received; patients must have discontinued anti-PD-1 or anti-PD-L1 therapy at least 21 days prior to registration

    • Patients must have Zubrod performance status of =< 2

    • Patients must have complete history and physical examination within 28 days prior to registration

    • Absolute neutrophil count (ANC) >= 1,500/mcL (within 28 days prior to registration)

    • Hemoglobin >= 8 g/dL (within 28 days prior to registration)

    • Platelets >= 100,000/mcL (within 28 days prior to registration)

    • Total bilirubin =< 2.5 x institutional upper limit of normal (IULN) (except patients with Gilbert's syndrome) (within 28 days prior to registration)

    • Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) both =< 5 x IULN (within 28 days prior to registration)

    • Serum creatinine =< 2.0 x IULN within 28 days prior to registration

    • Patients with a known history of human immunodeficiency virus (HIV) must have CD4 count >= institutional lower limit of normal within 28 days prior to registration

    • Patients with a known history of congestive heart failure (CHF), cardiomyopathy, myocarditis, myocardial infarction (MI), exposure to cardiotoxic medications, or with a clinical history suggestive of the above must have an electrocardiography (EKG) and echocardiogram (ECHO) performed within 42 days prior to registration and as clinically indicated while on treatment

    • Patients with new symptoms of congestive heart failure (CHF), cardiomyopathy, myocarditis, myocardial infarction (MI), or exposure to cardiotoxic medications must have a cardiology consultation, creatinine phosphokinase (CPK), and troponin testing at prestudy and as clinically indicated

    • Males who are sexually active with women of reproductive potential must have agreed to use birth control throughout the study and for 7 months after completion of protocol treatment; in addition to routine contraceptive methods, "effective contraception" also includes heterosexual celibacy and surgery intended to prevent pregnancy (vasectomy); if at any point a previously celibate patient chooses to become heterosexually active during or within 7 months after completion of protocol treatment, he is responsible for beginning effective contraceptive measures

    • Patients must submit archival tissue (if available) for translational medicine; patients must also be willing to undergo biopsies and submit tissue and blood for translational medicine

    • Patients must be offered the opportunity to participate in specimen banking of leftover tissue for future research

    • Patients must be informed of the investigational nature of this study and must sign and give written informed consent in accordance with institutional and federal guidelines

    • As a part of the Oncology Patient Enrollment Network (OPEN) registration process the treating institution's identity is provided in order to ensure that the current (within 365 days) date of institutional review board approval for this study has been entered in the system

    Exclusion Criteria:

    • Patients must not have achieved a partial or complete response to the anti-PD-1 or anti-PD-L1 agents prior to progression per the treating physician

    • Patients must not have had any systemic therapy, including anti-PD-1 or anti-PD-L1 agents, within 21 days prior to registration

    • Patients must not have had prior radiation therapy within 14 days prior to registration

    • Patients must not have had:

    • Prior treatment with ipilimumab or other CTLA-4 antagonists

    • Systemic therapy between progression on the anti-PD-1 or anti-PD-L1 agents and registration

    • Note: Systemic therapy (including BRAF-targeting agents) prior to anti-PD-1 or anti-PD-L1 therapy is allowed

    • Patients must not be planning to require any additional form of systemic anti-tumor therapy while on protocol treatment

    • Patients must not have known active hepatitis B virus (HBV) or hepatitis C virus (HCV) infection prior to registration

    • Patients must not have an active infection requiring systemic therapy at time of registration

    • Patients must not have organ allografts

    • Patients must not have received systemic treatment with corticosteroids (> 10 mg daily prednisone or equivalent) or other immunosuppressive medications within 14 days prior to registration; inhaled or topical steroids, and adrenal replacement doses =< 10 mg daily prednisone or equivalent are permitted in the absence of active autoimmune disease

    • Patients must not have a history of immune-mediated pneumonitis or colitis that required interruption of therapy or treatment of steroids

    • No other prior malignancy is allowed except for the following: adequately treated basal cell or squamous cell skin cancer, in situ cervical cancer, adequately treated stage 0, I or II cancer from which the patient is currently in complete remission, or any other cancer from which the patient has been disease free for two years

    • Patients must not be pregnant or nursing due to risk of fetal or nursing infant harm; females of reproductive potential must have negative serum pregnancy test within 2 days prior to registration and agree to use an effective contraceptive method throughout the study and for 5 months after completion of protocol treatment; a woman is considered to be of "reproductive potential" if she has had menses at any time in the preceding 12 consecutive months; in addition to routine contraceptive methods, "effective contraception" also includes heterosexual celibacy and surgery intended to prevent pregnancy (or with a side-effect of pregnancy prevention) defined as a hysterectomy, bilateral oophorectomy or bilateral tubal ligation; if at any point a previously celibate patient chooses to become heterosexually active during or within 5 months after protocol treatment, she is responsible for beginning effective contraceptive measures

    Contacts and Locations

    Locations

    Site City State Country Postal Code
    1 Anchorage Associates in Radiation Medicine Anchorage Alaska United States 98508
    2 Anchorage Radiation Therapy Center Anchorage Alaska United States 99504
    3 Alaska Breast Care and Surgery LLC Anchorage Alaska United States 99508
    4 Alaska Oncology and Hematology LLC Anchorage Alaska United States 99508
    5 Alaska Women's Cancer Care Anchorage Alaska United States 99508
    6 Anchorage Oncology Centre Anchorage Alaska United States 99508
    7 Katmai Oncology Group Anchorage Alaska United States 99508
    8 Providence Alaska Medical Center Anchorage Alaska United States 99508
    9 Fairbanks Memorial Hospital Fairbanks Alaska United States 99701
    10 Kingman Regional Medical Center Kingman Arizona United States 86401
    11 University of Arizona Cancer Center-Orange Grove Campus Tucson Arizona United States 85704
    12 Banner University Medical Center - Tucson Tucson Arizona United States 85719
    13 University of Arizona Cancer Center-North Campus Tucson Arizona United States 85719
    14 Mercy Hospital Fort Smith Fort Smith Arkansas United States 72903
    15 CHI Saint Vincent Cancer Center Hot Springs Hot Springs Arkansas United States 71913
    16 NEA Baptist Memorial Hospital and Fowler Family Cancer Center - Jonesboro Jonesboro Arkansas United States 72401
    17 John L McClellan Memorial Veterans Hospital Little Rock Arkansas United States 72205
    18 Kaiser Permanente-Anaheim Anaheim California United States 92806
    19 Kaiser Permanente-Deer Valley Medical Center Antioch California United States 94531
    20 Mission Hope Medical Oncology - Arroyo Grande Arroyo Grande California United States 93420
    21 PCR Oncology Arroyo Grande California United States 93420
    22 Sutter Auburn Faith Hospital Auburn California United States 95602
    23 Sutter Cancer Centers Radiation Oncology Services-Auburn Auburn California United States 95603
    24 Kaiser Permanente-Baldwin Park Baldwin Park California United States 91706
    25 Kaiser Permanente-Bellflower Bellflower California United States 90706
    26 Alta Bates Summit Medical Center-Herrick Campus Berkeley California United States 94704
    27 Providence Saint Joseph Medical Center/Disney Family Cancer Center Burbank California United States 91505
    28 Mills-Peninsula Medical Center Burlingame California United States 94010
    29 Sutter Cancer Centers Radiation Oncology Services-Cameron Park Cameron Park California United States 95682
    30 Eden Hospital Medical Center Castro Valley California United States 94546
    31 Sutter Davis Hospital Davis California United States 95616
    32 City of Hope Comprehensive Cancer Center Duarte California United States 91010
    33 Epic Care-Dublin Dublin California United States 94568
    34 Kaiser Permanente Dublin Dublin California United States 94568
    35 Bay Area Breast Surgeons Inc Emeryville California United States 94608
    36 Epic Care Partners in Cancer Care Emeryville California United States 94608
    37 Kaiser Permanente-Fontana Fontana California United States 92335
    38 Kaiser Permanente-Fremont Fremont California United States 94538
    39 Palo Alto Medical Foundation-Fremont Fremont California United States 94538
    40 Fresno Cancer Center Fresno California United States 93720
    41 Kaiser Permanente-Fresno Fresno California United States 93720
    42 Kaiser Permanente - Harbor City Harbor City California United States 90710
    43 Kaiser Permanente-Irvine Irvine California United States 92618
    44 City of Hope Antelope Valley Lancaster California United States 93534
    45 Kaiser Permanente Los Angeles Medical Center Los Angeles California United States 90027
    46 Kaiser Permanente West Los Angeles Los Angeles California United States 90034
    47 UCLA / Jonsson Comprehensive Cancer Center Los Angeles California United States 90095
    48 Contra Costa Regional Medical Center Martinez California United States 94553-3156
    49 Memorial Medical Center Modesto California United States 95355
    50 Kaiser Permanente-Modesto Modesto California United States 95356
    51 Palo Alto Medical Foundation-Camino Division Mountain View California United States 94040
    52 Palo Alto Medical Foundation-Gynecologic Oncology Mountain View California United States 94040
    53 Sutter Cancer Research Consortium Novato California United States 94945
    54 Alta Bates Summit Medical Center - Summit Campus Oakland California United States 94609
    55 Bay Area Tumor Institute Oakland California United States 94609
    56 Kaiser Permanente Oakland-Broadway Oakland California United States 94611
    57 Kaiser Permanente-Oakland Oakland California United States 94611
    58 Saint Joseph Hospital - Orange Orange California United States 92868
    59 UC Irvine Health/Chao Family Comprehensive Cancer Center Orange California United States 92868
    60 Palo Alto Medical Foundation Health Care Palo Alto California United States 94301
    61 VA Palo Alto Health Care System Palo Alto California United States 94304
    62 Kaiser Permanente - Panorama City Panorama City California United States 91402
    63 Kaiser Permanente-Rancho Cordova Cancer Center Rancho Cordova California United States 95670
    64 Eisenhower Medical Center Rancho Mirage California United States 92270
    65 Kaiser Permanente-Redwood City Redwood City California United States 94063
    66 Kaiser Permanente-Richmond Richmond California United States 94801
    67 Kaiser Permanente-Riverside Riverside California United States 92505
    68 Rohnert Park Cancer Center Rohnert Park California United States 94928
    69 Kaiser Permanente-Roseville Roseville California United States 95661
    70 Sutter Cancer Centers Radiation Oncology Services-Roseville Roseville California United States 95661
    71 Sutter Roseville Medical Center Roseville California United States 95661
    72 The Permanente Medical Group-Roseville Radiation Oncology Roseville California United States 95678
    73 Kaiser Permanente Downtown Commons Sacramento California United States 95814
    74 Sutter Medical Center Sacramento Sacramento California United States 95816
    75 Kaiser Permanente-South Sacramento Sacramento California United States 95823
    76 South Sacramento Cancer Center Sacramento California United States 95823
    77 Kaiser Permanente - Sacramento Sacramento California United States 95825
    78 Kaiser Permanente-San Diego Mission San Diego California United States 92108
    79 Kaiser Permanente-San Diego Zion San Diego California United States 92120
    80 California Pacific Medical Center-Pacific Campus San Francisco California United States 94115
    81 Kaiser Permanente-San Francisco San Francisco California United States 94115
    82 Kaiser Permanente-Santa Teresa-San Jose San Jose California United States 95119
    83 Kaiser Permanente San Leandro San Leandro California United States 94577
    84 Kaiser Permanente-San Marcos San Marcos California United States 92078
    85 Kaiser Permanente-San Rafael San Rafael California United States 94903
    86 Kaiser San Rafael-Gallinas San Rafael California United States 94903
    87 Kaiser Permanente Medical Center - Santa Clara Santa Clara California United States 95051
    88 Palo Alto Medical Foundation-Santa Cruz Santa Cruz California United States 95065
    89 Mission Hope Medical Oncology - Santa Maria Santa Maria California United States 93444
    90 Kaiser Permanente-Santa Rosa Santa Rosa California United States 95403
    91 Sutter Pacific Medical Foundation Santa Rosa California United States 95403
    92 City of Hope South Pasadena South Pasadena California United States 91030
    93 Kaiser Permanente Cancer Treatment Center South San Francisco California United States 94080
    94 Kaiser Permanente-South San Francisco South San Francisco California United States 94080
    95 Kaiser Permanente-Stockton Stockton California United States 95210
    96 Palo Alto Medical Foundation-Sunnyvale Sunnyvale California United States 94086
    97 City of Hope Upland Upland California United States 91786
    98 Sutter Cancer Centers Radiation Oncology Services-Vacaville Vacaville California United States 95687
    99 Kaiser Permanente Medical Center-Vacaville Vacaville California United States 95688
    100 Kaiser Permanente-Vallejo Vallejo California United States 94589
    101 Sutter Solano Medical Center/Cancer Center Vallejo California United States 94589
    102 Kaiser Permanente-Walnut Creek Walnut Creek California United States 94596
    103 Epic Care Cyberknife Center Walnut Creek California United States 94597
    104 Kaiser Permanente-Woodland Hills Woodland Hills California United States 91367
    105 Rocky Mountain Cancer Centers-Aurora Aurora Colorado United States 80012
    106 The Medical Center of Aurora Aurora Colorado United States 80012
    107 University of Colorado Hospital Aurora Colorado United States 80045
    108 Boulder Community Hospital Boulder Colorado United States 80301
    109 Rocky Mountain Cancer Centers-Boulder Boulder Colorado United States 80304
    110 Penrose-Saint Francis Healthcare Colorado Springs Colorado United States 80907
    111 Rocky Mountain Cancer Centers-Penrose Colorado Springs Colorado United States 80907
    112 UCHealth Memorial Hospital Central Colorado Springs Colorado United States 80909
    113 Memorial Hospital North Colorado Springs Colorado United States 80920
    114 Cancer Center of Colorado at Sloan's Lake Denver Colorado United States 80204
    115 Denver Health Medical Center Denver Colorado United States 80204
    116 National Jewish Health-Main Campus Denver Colorado United States 80206
    117 The Women's Imaging Center Denver Colorado United States 80209
    118 Porter Adventist Hospital Denver Colorado United States 80210
    119 Colorado Blood Cancer Institute Denver Colorado United States 80218
    120 Presbyterian - Saint Lukes Medical Center - Health One Denver Colorado United States 80218
    121 Rocky Mountain Cancer Centers-Midtown Denver Colorado United States 80218
    122 SCL Health Saint Joseph Hospital Denver Colorado United States 80218
    123 Rocky Mountain Cancer Centers-Rose Denver Colorado United States 80220
    124 Rose Medical Center Denver Colorado United States 80220
    125 Mercy Medical Center Durango Colorado United States 81301
    126 Southwest Oncology PC Durango Colorado United States 81301
    127 Mountain Blue Cancer Care Center - Swedish Englewood Colorado United States 80113
    128 Swedish Medical Center Englewood Colorado United States 80113
    129 Poudre Valley Hospital Fort Collins Colorado United States 80524
    130 Cancer Care and Hematology-Fort Collins Fort Collins Colorado United States 80528
    131 Mountain Blue Cancer Care Center Golden Colorado United States 80401
    132 National Jewish Health-Western Hematology Oncology Golden Colorado United States 80401
    133 Saint Mary's Hospital and Regional Medical Center Grand Junction Colorado United States 81501
    134 North Colorado Medical Center Greeley Colorado United States 80631
    135 UCHealth Greeley Hospital Greeley Colorado United States 80631
    136 Rocky Mountain Cancer Centers-Greenwood Village Greenwood Village Colorado United States 80111
    137 Good Samaritan Medical Center Lafayette Colorado United States 80026
    138 Rocky Mountain Cancer Centers-Lakewood Lakewood Colorado United States 80228
    139 Saint Anthony Hospital Lakewood Colorado United States 80228
    140 Rocky Mountain Cancer Centers-Littleton Littleton Colorado United States 80120
    141 Littleton Adventist Hospital Littleton Colorado United States 80122
    142 Rocky Mountain Cancer Centers-Sky Ridge Lone Tree Colorado United States 80124
    143 Sky Ridge Medical Center Lone Tree Colorado United States 80124
    144 Longmont United Hospital Longmont Colorado United States 80501
    145 Rocky Mountain Cancer Centers-Longmont Longmont Colorado United States 80501
    146 Medical Center of the Rockies Loveland Colorado United States 80538
    147 McKee Medical Center Loveland Colorado United States 80539
    148 Parker Adventist Hospital Parker Colorado United States 80138
    149 Rocky Mountain Cancer Centers-Parker Parker Colorado United States 80138
    150 Saint Mary Corwin Medical Center Pueblo Colorado United States 81004
    151 Rocky Mountain Cancer Centers - Pueblo Pueblo Colorado United States 81008
    152 National Jewish Health-Northern Hematology Oncology Thornton Colorado United States 80260
    153 Rocky Mountain Cancer Centers-Thornton Thornton Colorado United States 80260
    154 SCL Health Lutheran Medical Center Wheat Ridge Colorado United States 80033
    155 Mount Sinai Comprehensive Cancer Center at Aventura Aventura Florida United States 33180
    156 Holy Cross Hospital Fort Lauderdale Florida United States 33308
    157 Memorial Regional Hospital/Joe DiMaggio Children's Hospital Hollywood Florida United States 33021
    158 Mount Sinai Medical Center Miami Beach Florida United States 33140
    159 University of Miami Miller School of Medicine-Sylvester Cancer Center Miami Florida United States 33136
    160 Orlando Health Cancer Institute Orlando Florida United States 32806
    161 Memorial Hospital West Pembroke Pines Florida United States 33028
    162 Moffitt Cancer Center-International Plaza Tampa Florida United States 33607
    163 Moffitt Cancer Center - McKinley Campus Tampa Florida United States 33612
    164 Moffitt Cancer Center Tampa Florida United States 33612
    165 Hawaii Cancer Care - Savio 'Aiea Hawaii United States 96701
    166 Pali Momi Medical Center 'Aiea Hawaii United States 96701
    167 Queen's Cancer Center - Pearlridge 'Aiea Hawaii United States 96701
    168 The Cancer Center of Hawaii-Pali Momi 'Aiea Hawaii United States 96701
    169 Hawaii Cancer Care Inc - Waterfront Plaza Honolulu Hawaii United States 96813
    170 Island Urology Honolulu Hawaii United States 96813
    171 Queen's Cancer Cenrer - POB I Honolulu Hawaii United States 96813
    172 Queen's Medical Center Honolulu Hawaii United States 96813
    173 Straub Clinic and Hospital Honolulu Hawaii United States 96813
    174 University of Hawaii Cancer Center Honolulu Hawaii United States 96813
    175 Hawaii Cancer Care Inc-Liliha Honolulu Hawaii United States 96817
    176 Kuakini Medical Center Honolulu Hawaii United States 96817
    177 Queen's Cancer Center - Kuakini Honolulu Hawaii United States 96817
    178 The Cancer Center of Hawaii-Liliha Honolulu Hawaii United States 96817
    179 Kaiser Permanente Moanalua Medical Center Honolulu Hawaii United States 96819
    180 Kapiolani Medical Center for Women and Children Honolulu Hawaii United States 96826
    181 Wilcox Memorial Hospital and Kauai Medical Clinic Lihue Hawaii United States 96766
    182 Saint Alphonsus Cancer Care Center-Boise Boise Idaho United States 83706
    183 Saint Luke's Cancer Institute - Boise Boise Idaho United States 83712
    184 Saint Alphonsus Cancer Care Center-Caldwell Caldwell Idaho United States 83605
    185 Kootenai Health - Coeur d'Alene Coeur d'Alene Idaho United States 83814
    186 Walter Knox Memorial Hospital Emmett Idaho United States 83617
    187 Saint Luke's Cancer Institute - Fruitland Fruitland Idaho United States 83619
    188 Idaho Urologic Institute-Meridian Meridian Idaho United States 83642
    189 Saint Luke's Cancer Institute - Meridian Meridian Idaho United States 83642
    190 Saint Alphonsus Medical Center-Nampa Nampa Idaho United States 83686
    191 Saint Luke's Cancer Institute - Nampa Nampa Idaho United States 83686
    192 Kootenai Clinic Cancer Services - Post Falls Post Falls Idaho United States 83854
    193 Kootenai Cancer Clinic Sandpoint Idaho United States 83864
    194 Saint Luke's Cancer Institute - Twin Falls Twin Falls Idaho United States 83301
    195 Rush - Copley Medical Center Aurora Illinois United States 60504
    196 Northwestern University Chicago Illinois United States 60611
    197 Carle on Vermilion Danville Illinois United States 61832
    198 Carle Physician Group-Effingham Effingham Illinois United States 62401
    199 Northwestern Medicine Lake Forest Hospital Lake Forest Illinois United States 60045
    200 Carle Physician Group-Mattoon/Charleston Mattoon Illinois United States 61938
    201 Good Samaritan Regional Health Center Mount Vernon Illinois United States 62864
    202 Advocate Lutheran General Hospital Park Ridge Illinois United States 60068
    203 Carle Cancer Center Urbana Illinois United States 61801
    204 The Carle Foundation Hospital Urbana Illinois United States 61801
    205 Rush-Copley Healthcare Center Yorkville Illinois United States 60560
    206 Memorial Regional Cancer Center Day Road Mishawaka Indiana United States 46545
    207 Reid Health Richmond Indiana United States 47374
    208 Memorial Hospital of South Bend South Bend Indiana United States 46601
    209 Physicians' Clinic of Iowa PC Cedar Rapids Iowa United States 52402
    210 Medical Oncology and Hematology Associates-West Des Moines Clive Iowa United States 50325
    211 Mercy Cancer Center-West Lakes Clive Iowa United States 50325
    212 Alegent Health Mercy Hospital Council Bluffs Iowa United States 51503
    213 Greater Regional Medical Center Creston Iowa United States 50801
    214 Iowa Methodist Medical Center Des Moines Iowa United States 50309
    215 Medical Oncology and Hematology Associates-Des Moines Des Moines Iowa United States 50309
    216 Broadlawns Medical Center Des Moines Iowa United States 50314
    217 Medical Oncology and Hematology Associates-Laurel Des Moines Iowa United States 50314
    218 Mercy Medical Center - Des Moines Des Moines Iowa United States 50314
    219 Iowa Lutheran Hospital Des Moines Iowa United States 50316
    220 Trinity Regional Medical Center Fort Dodge Iowa United States 50501
    221 Siouxland Regional Cancer Center Sioux City Iowa United States 51101
    222 Methodist West Hospital West Des Moines Iowa United States 50266-7700
    223 Mercy Medical Center-West Lakes West Des Moines Iowa United States 50266
    224 Coffeyville Regional Medical Center Coffeyville Kansas United States 67337
    225 HaysMed University of Kansas Health System Hays Kansas United States 67601
    226 University of Kansas Cancer Center Kansas City Kansas United States 66160
    227 Olathe Health Cancer Center Olathe Kansas United States 66061
    228 University of Kansas Cancer Center-Overland Park Overland Park Kansas United States 66210
    229 Ascension Via Christi - Pittsburg Pittsburg Kansas United States 66762
    230 Salina Regional Health Center Salina Kansas United States 67401
    231 Cotton O'Neil Cancer Center / Stormont Vail Health Topeka Kansas United States 66606
    232 University of Kansas Health System Saint Francis Campus Topeka Kansas United States 66606
    233 University of Kansas Hospital-Westwood Cancer Center Westwood Kansas United States 66205
    234 Flaget Memorial Hospital Bardstown Kentucky United States 40004
    235 Commonwealth Cancer Center-Corbin Corbin Kentucky United States 40701
    236 Saint Joseph Radiation Oncology Resource Center Lexington Kentucky United States 40504
    237 Saint Joseph Hospital East Lexington Kentucky United States 40509
    238 Saint Joseph London London Kentucky United States 40741
    239 Jewish Hospital Louisville Kentucky United States 40202
    240 Saints Mary and Elizabeth Hospital Louisville Kentucky United States 40215
    241 UofL Health Medical Center Northeast Louisville Kentucky United States 40245
    242 Jewish Hospital Medical Center South Shepherdsville Kentucky United States 40165
    243 Harold Alfond Center for Cancer Care Augusta Maine United States 04330
    244 Waldo County General Hospital Belfast Maine United States 04915
    245 MaineHealth/SMHC Cancer Care and Blood Disorders-Biddeford Biddeford Maine United States 04005
    246 Stephens Memorial Hospital Norway Maine United States 04268
    247 MaineHealth/SMHC Cancer Care and Blood Disorders-Sanford Sanford Maine United States 04073
    248 Massachusetts General Hospital Cancer Center Boston Massachusetts United States 02114
    249 Dana-Farber Cancer Institute Boston Massachusetts United States 02215
    250 Lahey Hospital and Medical Center Burlington Massachusetts United States 01805
    251 Winchester Hospital Winchester Massachusetts United States 01890
    252 Hickman Cancer Center Adrian Michigan United States 49221
    253 Bronson Battle Creek Battle Creek Michigan United States 49017
    254 Henry Ford Cancer Institute-Downriver Brownstown Michigan United States 48183
    255 Henry Ford Macomb Hospital-Clinton Township Clinton Township Michigan United States 48038
    256 Henry Ford Medical Center-Fairlane Dearborn Michigan United States 48126
    257 Henry Ford Hospital Detroit Michigan United States 48202
    258 Helen DeVos Children's Hospital at Spectrum Health Grand Rapids Michigan United States 49503
    259 Mercy Health Saint Mary's Grand Rapids Michigan United States 49503
    260 Spectrum Health at Butterworth Campus Grand Rapids Michigan United States 49503
    261 Allegiance Health Jackson Michigan United States 49201
    262 Bronson Methodist Hospital Kalamazoo Michigan United States 49007
    263 West Michigan Cancer Center Kalamazoo Michigan United States 49007
    264 Borgess Medical Center Kalamazoo Michigan United States 49048
    265 Toledo Clinic Cancer Centers-Monroe Monroe Michigan United States 48162
    266 Mercy Health Mercy Campus Muskegon Michigan United States 49444
    267 Lakeland Hospital Niles Niles Michigan United States 49120
    268 Cancer and Hematology Centers of Western Michigan - Norton Shores Norton Shores Michigan United States 49444
    269 Henry Ford Medical Center-Columbus Novi Michigan United States 48377
    270 Huron Medical Center PC Port Huron Michigan United States 48060
    271 Lake Huron Medical Center Port Huron Michigan United States 48060
    272 Spectrum Health Reed City Hospital Reed City Michigan United States 49677
    273 Lakeland Medical Center Saint Joseph Saint Joseph Michigan United States 49085
    274 Marie Yeager Cancer Center Saint Joseph Michigan United States 49085
    275 Henry Ford Macomb Health Center - Shelby Township Shelby Michigan United States 48315
    276 Munson Medical Center Traverse City Michigan United States 49684
    277 Henry Ford West Bloomfield Hospital West Bloomfield Michigan United States 48322
    278 Metro Health Hospital Wyoming Michigan United States 49519
    279 Riverwood Healthcare Center Aitkin Minnesota United States 56431
    280 Essentia Health Saint Joseph's Medical Center Brainerd Minnesota United States 56401
    281 Fairview Ridges Hospital Burnsville Minnesota United States 55337
    282 Cambridge Medical Center Cambridge Minnesota United States 55008
    283 Mercy Hospital Coon Rapids Minnesota United States 55433
    284 Essentia Health - Deer River Clinic Deer River Minnesota United States 56636
    285 Essentia Health Saint Mary's - Detroit Lakes Clinic Detroit Lakes Minnesota United States 56501
    286 Essentia Health Cancer Center Duluth Minnesota United States 55805
    287 Essentia Health Saint Mary's Medical Center Duluth Minnesota United States 55805
    288 Miller-Dwan Hospital Duluth Minnesota United States 55805
    289 Fairview Southdale Hospital Edina Minnesota United States 55435
    290 Lake Region Healthcare Corporation-Cancer Care Fergus Falls Minnesota United States 56537
    291 Essentia Health - Fosston Fosston Minnesota United States 56542
    292 Unity Hospital Fridley Minnesota United States 55432
    293 Essentia Health Hibbing Clinic Hibbing Minnesota United States 55746
    294 Fairview Clinics and Surgery Center Maple Grove Maple Grove Minnesota United States 55369
    295 Minnesota Oncology Hematology PA-Maplewood Maplewood Minnesota United States 55109
    296 Saint John's Hospital - Healtheast Maplewood Minnesota United States 55109
    297 Abbott-Northwestern Hospital Minneapolis Minnesota United States 55407
    298 Hennepin County Medical Center Minneapolis Minnesota United States 55415
    299 Health Partners Inc Minneapolis Minnesota United States 55454
    300 Monticello Cancer Center Monticello Minnesota United States 55362
    301 New Ulm Medical Center New Ulm Minnesota United States 56073
    302 Essentia Health - Park Rapids Park Rapids Minnesota United States 56470
    303 Fairview Northland Medical Center Princeton Minnesota United States 55371
    304 North Memorial Medical Health Center Robbinsdale Minnesota United States 55422
    305 Park Nicollet Clinic - Saint Louis Park Saint Louis Park Minnesota United States 55416
    306 Regions Hospital Saint Paul Minnesota United States 55101
    307 United Hospital Saint Paul Minnesota United States 55102
    308 Essentia Health Sandstone Sandstone Minnesota United States 55072
    309 Saint Francis Regional Medical Center Shakopee Minnesota United States 55379
    310 Lakeview Hospital Stillwater Minnesota United States 55082
    311 Essentia Health Virginia Clinic Virginia Minnesota United States 55792
    312 Ridgeview Medical Center Waconia Minnesota United States 55387
    313 Rice Memorial Hospital Willmar Minnesota United States 56201
    314 Minnesota Oncology Hematology PA-Woodbury Woodbury Minnesota United States 55125
    315 Fairview Lakes Medical Center Wyoming Minnesota United States 55092
    316 The West Clinic - Corinth Corinth Mississippi United States 38834
    317 Saint Louis Cancer and Breast Institute-Ballwin Ballwin Missouri United States 63011
    318 Central Care Cancer Center - Bolivar Bolivar Missouri United States 65613
    319 Cox Cancer Center Branson Branson Missouri United States 65616
    320 Siteman Cancer Center at West County Hospital Creve Coeur Missouri United States 63141
    321 Freeman Health System Joplin Missouri United States 64804
    322 Mercy Hospital Joplin Joplin Missouri United States 64804
    323 Truman Medical Centers Kansas City Missouri United States 64108
    324 Kansas City Veterans Affairs Medical Center Kansas City Missouri United States 64128
    325 University of Kansas Cancer Center - North Kansas City Missouri United States 64154
    326 University of Kansas Cancer Center - Lee's Summit Lee's Summit Missouri United States 64064
    327 Saint Luke's East - Lee's Summit Lee's Summit Missouri United States 64086
    328 Delbert Day Cancer Institute at PCRMC Rolla Missouri United States 65401
    329 Mercy Clinic-Rolla-Cancer and Hematology Rolla Missouri United States 65401
    330 Heartland Regional Medical Center Saint Joseph Missouri United States 64506
    331 Saint Louis Cancer and Breast Institute-South City Saint Louis Missouri United States 63109
    332 Washington University School of Medicine Saint Louis Missouri United States 63110
    333 Mercy Hospital South Saint Louis Missouri United States 63128
    334 Siteman Cancer Center-South County Saint Louis Missouri United States 63129
    335 Mercy Hospital Saint Louis Saint Louis Missouri United States 63141
    336 Mercy Hospital Springfield Springfield Missouri United States 65804
    337 CoxHealth South Hospital Springfield Missouri United States 65807
    338 Mercy Hospital Washington Washington Missouri United States 63090
    339 Community Hospital of Anaconda Anaconda Montana United States 59711
    340 Billings Clinic Cancer Center Billings Montana United States 59101
    341 Saint Vincent Healthcare Billings Montana United States 59101
    342 Saint Vincent Frontier Cancer Center Billings Montana United States 59102
    343 Bozeman Deaconess Hospital Bozeman Montana United States 59715
    344 Saint James Community Hospital and Cancer Treatment Center Butte Montana United States 59701
    345 Benefis Healthcare- Sletten Cancer Institute Great Falls Montana United States 59405
    346 Great Falls Clinic Great Falls Montana United States 59405
    347 Saint Peter's Community Hospital Helena Montana United States 59601
    348 Kalispell Regional Medical Center Kalispell Montana United States 59901
    349 Saint Patrick Hospital - Community Hospital Missoula Montana United States 59802
    350 Community Medical Hospital Missoula Montana United States 59804
    351 CHI Health Saint Francis Grand Island Nebraska United States 68803
    352 Heartland Hematology and Oncology Kearney Nebraska United States 68845
    353 CHI Health Good Samaritan Kearney Nebraska United States 68847
    354 Saint Elizabeth Regional Medical Center Lincoln Nebraska United States 68510
    355 Nebraska Methodist Hospital Omaha Nebraska United States 68114
    356 Alegent Health Immanuel Medical Center Omaha Nebraska United States 68122
    357 Hematology and Oncology Consultants PC Omaha Nebraska United States 68122
    358 Alegent Health Bergan Mercy Medical Center Omaha Nebraska United States 68124
    359 Alegent Health Lakeside Hospital Omaha Nebraska United States 68130
    360 Creighton University Medical Center Omaha Nebraska United States 68131
    361 Midlands Community Hospital Papillion Nebraska United States 68046
    362 Carson Tahoe Regional Medical Center Carson City Nevada United States 89703
    363 Cancer and Blood Specialists-Henderson Henderson Nevada United States 89052
    364 Comprehensive Cancer Centers of Nevada - Henderson Henderson Nevada United States 89052
    365 Comprehensive Cancer Centers of Nevada-Horizon Ridge Henderson Nevada United States 89052
    366 Las Vegas Cancer Center-Henderson Henderson Nevada United States 89052
    367 OptumCare Cancer Care at Seven Hills Henderson Nevada United States 89052
    368 Comprehensive Cancer Centers of Nevada-Southeast Henderson Henderson Nevada United States 89074
    369 GenesisCare USA - Henderson Henderson Nevada United States 89074
    370 Las Vegas Urology - Green Valley Henderson Nevada United States 89074
    371 Las Vegas Urology - Pebble Henderson Nevada United States 89074
    372 Urology Specialists of Nevada - Green Valley Henderson Nevada United States 89074
    373 Las Vegas Urology - Pecos Las Vegas Nevada United States 89074
    374 Desert West Surgery Las Vegas Nevada United States 89102
    375 OptumCare Cancer Care at Charleston Las Vegas Nevada United States 89102
    376 University Medical Center of Southern Nevada Las Vegas Nevada United States 89102
    377 Hope Cancer Care of Nevada Las Vegas Nevada United States 89103
    378 Cancer and Blood Specialists-Shadow Las Vegas Nevada United States 89106
    379 Radiation Oncology Centers of Nevada Central Las Vegas Nevada United States 89106
    380 Urology Specialists of Nevada - Central Las Vegas Nevada United States 89106
    381 GenesisCare USA - Las Vegas Las Vegas Nevada United States 89109
    382 HealthCare Partners Medical Group Oncology/Hematology-Maryland Parkway Las Vegas Nevada United States 89109
    383 Sunrise Hospital and Medical Center Las Vegas Nevada United States 89109
    384 HealthCare Partners Medical Group Oncology/Hematology-San Martin Las Vegas Nevada United States 89113
    385 Las Vegas Prostate Cancer Center Las Vegas Nevada United States 89113
    386 Las Vegas Urology - Sunset Las Vegas Nevada United States 89113
    387 Urology Specialists of Nevada - Southwest Las Vegas Nevada United States 89113
    388 Radiation Oncology Centers of Nevada Southeast Las Vegas Nevada United States 89119
    389 Cancer Therapy and Integrative Medicine Las Vegas Nevada United States 89121
    390 Ann M Wierman MD LTD Las Vegas Nevada United States 89128
    391 Cancer and Blood Specialists-Tenaya Las Vegas Nevada United States 89128
    392 Comprehensive Cancer Centers of Nevada - Northwest Las Vegas Nevada United States 89128
    393 GenesisCare USA - Vegas Tenaya Las Vegas Nevada United States 89128
    394 HealthCare Partners Medical Group Oncology/Hematology-Tenaya Las Vegas Nevada United States 89128
    395 Las Vegas Urology - Cathedral Rock Las Vegas Nevada United States 89128
    396 Las Vegas Urology - Smoke Ranch Las Vegas Nevada United States 89128
    397 OptumCare Cancer Care at MountainView Las Vegas Nevada United States 89128
    398 Urology Specialists of Nevada - Northwest Las Vegas Nevada United States 89128
    399 Alliance for Childhood Diseases/Cure 4 the Kids Foundation Las Vegas Nevada United States 89135
    400 Comprehensive Cancer Centers of Nevada - Town Center Las Vegas Nevada United States 89144
    401 Comprehensive Cancer Centers of Nevada-Summerlin Las Vegas Nevada United States 89144
    402 Summerlin Hospital Medical Center Las Vegas Nevada United States 89144
    403 Las Vegas Cancer Center-Medical Center Las Vegas Nevada United States 89148-2405
    404 Comprehensive Cancer Centers of Nevada Las Vegas Nevada United States 89148
    405 GenesisCare USA - Fort Apache Las Vegas Nevada United States 89148
    406 OptumCare Cancer Care at Fort Apache Las Vegas Nevada United States 89148
    407 HealthCare Partners Medical Group Oncology/Hematology-Centennial Hills Las Vegas Nevada United States 89149
    408 Comprehensive Cancer Centers of Nevada - Central Valley Las Vegas Nevada United States 89169
    409 University Cancer Center Las Vegas Nevada United States 89169
    410 Hope Cancer Care of Nevada-Pahrump Pahrump Nevada United States 89048
    411 Renown Regional Medical Center Reno Nevada United States 89502
    412 Saint Mary's Regional Medical Center Reno Nevada United States 89503
    413 Radiation Oncology Associates Reno Nevada United States 89509
    414 Cooper Hospital University Medical Center Camden New Jersey United States 08103
    415 Hackensack University Medical Center Hackensack New Jersey United States 07601
    416 Rutgers Cancer Institute of New Jersey New Brunswick New Jersey United States 08903
    417 MD Anderson Cancer Center at Cooper-Voorhees Voorhees New Jersey United States 08043
    418 Lovelace Medical Center-Saint Joseph Square Albuquerque New Mexico United States 87102
    419 University of New Mexico Cancer Center Albuquerque New Mexico United States 87102
    420 Roswell Park Cancer Institute Buffalo New York United States 14263
    421 University of Rochester Rochester New York United States 14642
    422 UNC Lineberger Comprehensive Cancer Center Chapel Hill North Carolina United States 27599
    423 Southeastern Medical Oncology Center-Clinton Clinton North Carolina United States 28328
    424 Southeastern Medical Oncology Center-Goldsboro Goldsboro North Carolina United States 27534
    425 Wayne Memorial Hospital Goldsboro North Carolina United States 27534
    426 Onslow Memorial Hospital Jacksonville North Carolina United States 28546
    427 Southeastern Medical Oncology Center-Jacksonville Jacksonville North Carolina United States 28546
    428 Wake Forest University Health Sciences Winston-Salem North Carolina United States 27157
    429 Essentia Health Cancer Center-South University Clinic Fargo North Dakota United States 58103
    430 Altru Cancer Center Grand Forks North Dakota United States 58201
    431 Essentia Health - Jamestown Clinic Jamestown North Dakota United States 58401
    432 Indu and Raj Soin Medical Center Beavercreek Ohio United States 45431
    433 Strecker Cancer Center-Belpre Belpre Ohio United States 45714
    434 Saint Elizabeth Boardman Hospital Boardman Ohio United States 44512
    435 Dayton Physicians LLC-Miami Valley South Centerville Ohio United States 45459
    436 Miami Valley Hospital South Centerville Ohio United States 45459
    437 Adena Regional Medical Center Chillicothe Ohio United States 45601
    438 University of Cincinnati Cancer Center-UC Medical Center Cincinnati Ohio United States 45219
    439 Good Samaritan Hospital - Cincinnati Cincinnati Ohio United States 45220
    440 Oncology Hematology Care Inc-Kenwood Cincinnati Ohio United States 45236
    441 Bethesda North Hospital Cincinnati Ohio United States 45242
    442 TriHealth Cancer Institute-Westside Cincinnati Ohio United States 45247
    443 TriHealth Cancer Institute-Anderson Cincinnati Ohio United States 45255
    444 Ohio State University Comprehensive Cancer Center Columbus Ohio United States 43210
    445 Mount Carmel East Hospital Columbus Ohio United States 43213
    446 Columbus Oncology and Hematology Associates Inc Columbus Ohio United States 43214
    447 Riverside Methodist Hospital Columbus Ohio United States 43214
    448 Grant Medical Center Columbus Ohio United States 43215
    449 The Mark H Zangmeister Center Columbus Ohio United States 43219
    450 Mount Carmel Health Center West Columbus Ohio United States 43222
    451 Doctors Hospital Columbus Ohio United States 43228
    452 Good Samaritan Hospital - Dayton Dayton Ohio United States 45406
    453 Miami Valley Hospital Dayton Ohio United States 45409
    454 Dayton Physician LLC-Miami Valley Hospital North Dayton Ohio United States 45415
    455 Miami Valley Hospital North Dayton Ohio United States 45415
    456 Delaware Health Center-Grady Cancer Center Delaware Ohio United States 43015
    457 Delaware Radiation Oncology Delaware Ohio United States 43015
    458 Grady Memorial Hospital Delaware Ohio United States 43015
    459 Dublin Methodist Hospital Dublin Ohio United States 43016
    460 Armes Family Cancer Center Findlay Ohio United States 45840
    461 Blanchard Valley Hospital Findlay Ohio United States 45840
    462 Orion Cancer Care Findlay Ohio United States 45840
    463 Atrium Medical Center-Middletown Regional Hospital Franklin Ohio United States 45005-1066
    464 Dayton Physicians LLC-Atrium Franklin Ohio United States 45005
    465 Dayton Physicians LLC-Wayne Greenville Ohio United States 45331
    466 Wayne Hospital Greenville Ohio United States 45331
    467 Mount Carmel Grove City Hospital Grove City Ohio United States 43123
    468 Greater Dayton Cancer Center Kettering Ohio United States 45409
    469 First Dayton Cancer Care Kettering Ohio United States 45420
    470 Kettering Medical Center Kettering Ohio United States 45429
    471 Fairfield Medical Center Lancaster Ohio United States 43130
    472 OhioHealth Mansfield Hospital Mansfield Ohio United States 44903
    473 Marietta Memorial Hospital Marietta Ohio United States 45750
    474 OhioHealth Marion General Hospital Marion Ohio United States 43302
    475 Toledo Clinic Cancer Centers-Maumee Maumee Ohio United States 43537
    476 Toledo Radiation Oncology at Northwest Ohio Onocolgy Center Maumee Ohio United States 43537
    477 Dayton Physicians LLC-Signal Point Middletown Ohio United States 45042
    478 Knox Community Hospital Mount Vernon Ohio United States 43050
    479 Licking Memorial Hospital Newark Ohio United States 43055
    480 Newark Radiation Oncology Newark Ohio United States 43055
    481 Mercy Health Perrysburg Cancer Center Perrysburg Ohio United States 43551
    482 Southern Ohio Medical Center Portsmouth Ohio United States 45662
    483 Dayton Physicians LLC-Wilson Sidney Ohio United States 45365
    484 Springfield Regional Cancer Center Springfield Ohio United States 45504
    485 Springfield Regional Medical Center Springfield Ohio United States 45505
    486 ProMedica Flower Hospital Sylvania Ohio United States 43560
    487 ProMedica Toledo Hospital/Russell J Ebeid Children's Hospital Toledo Ohio United States 43606
    488 Mercy Health - Saint Anne Hospital Toledo Ohio United States 43623
    489 Toledo Clinic Cancer Centers-Toledo Toledo Ohio United States 43623
    490 Dayton Physicians LLC-Upper Valley Troy Ohio United States 45373
    491 Upper Valley Medical Center Troy Ohio United States 45373
    492 Saint Joseph Warren Hospital Warren Ohio United States 44484
    493 University of Cincinnati Cancer Center-West Chester West Chester Ohio United States 45069
    494 Saint Ann's Hospital Westerville Ohio United States 43081
    495 Saint Elizabeth Youngstown Hospital Youngstown Ohio United States 44501
    496 Genesis Healthcare System Cancer Care Center Zanesville Ohio United States 43701
    497 University of Oklahoma Health Sciences Center Oklahoma City Oklahoma United States 73104
    498 Mercy Hospital Oklahoma City Oklahoma City Oklahoma United States 73120
    499 Oklahoma Cancer Specialists and Research Institute-Tulsa Tulsa Oklahoma United States 74146
    500 Saint Alphonsus Medical Center-Baker City Baker City Oregon United States 97814
    501 Saint Charles Health System Bend Oregon United States 97701
    502 Clackamas Radiation Oncology Center Clackamas Oregon United States 97015
    503 Providence Cancer Institute Clackamas Clinic Clackamas Oregon United States 97015
    504 Bay Area Hospital Coos Bay Oregon United States 97420
    505 Providence Newberg Medical Center Newberg Oregon United States 97132
    506 Saint Alphonsus Medical Center-Ontario Ontario Oregon United States 97914
    507 Providence Portland Medical Center Portland Oregon United States 97213
    508 Providence Saint Vincent Medical Center Portland Oregon United States 97225
    509 Saint Charles Health System-Redmond Redmond Oregon United States 97756
    510 Jefferson Abington Hospital Abington Pennsylvania United States 19001
    511 Reading Hospital West Reading Pennsylvania United States 19611
    512 Asplundh Cancer Pavilion Willow Grove Pennsylvania United States 19090
    513 Saint Francis Hospital Greenville South Carolina United States 29601
    514 Saint Francis Cancer Center Greenville South Carolina United States 29607
    515 Rapid City Regional Hospital Rapid City South Dakota United States 57701
    516 Memorial Hospital Chattanooga Tennessee United States 37404
    517 Vanderbilt-Ingram Cancer Center Cool Springs Franklin Tennessee United States 37067
    518 The West Clinic - Wolf River Germantown Tennessee United States 38138
    519 Pulmonary Medicine Center of Chattanooga-Hixson Hixson Tennessee United States 37343
    520 The West Clinic - Mid-Town Memphis Tennessee United States 38104
    521 University of Tennessee Health Science Center Memphis Tennessee United States 38163
    522 Vanderbilt Breast Center at One Hundred Oaks Nashville Tennessee United States 37204
    523 Vanderbilt University/Ingram Cancer Center Nashville Tennessee United States 37232
    524 Memorial GYN Plus Ooltewah Tennessee United States 37363
    525 Saint Joseph Regional Cancer Center Bryan Texas United States 77802
    526 Parkland Memorial Hospital Dallas Texas United States 75235
    527 UT Southwestern/Simmons Cancer Center-Dallas Dallas Texas United States 75390
    528 UT Southwestern/Simmons Cancer Center-Fort Worth Fort Worth Texas United States 76104
    529 Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center Houston Texas United States 77030
    530 Ben Taub General Hospital Houston Texas United States 77030
    531 UT Southwestern Clinical Center at Richardson/Plano Richardson Texas United States 75080
    532 American Fork Hospital / Huntsman Intermountain Cancer Center American Fork Utah United States 84003
    533 Sandra L Maxwell Cancer Center Cedar City Utah United States 84720
    534 Logan Regional Hospital Logan Utah United States 84321
    535 Intermountain Medical Center Murray Utah United States 84107
    536 McKay-Dee Hospital Center Ogden Utah United States 84403
    537 Utah Valley Regional Medical Center Provo Utah United States 84604
    538 Riverton Hospital Riverton Utah United States 84065
    539 Saint George Regional Medical Center Saint George Utah United States 84770
    540 Utah Cancer Specialists-Salt Lake City Salt Lake City Utah United States 84106
    541 Huntsman Cancer Institute/University of Utah Salt Lake City Utah United States 84112
    542 LDS Hospital Salt Lake City Utah United States 84143
    543 Providence Regional Cancer System-Aberdeen Aberdeen Washington United States 98520
    544 MultiCare Auburn Medical Center Auburn Washington United States 98001
    545 Virginia Mason Bainbridge Island Medical Center Bainbridge Island Washington United States 98110
    546 Overlake Medical Center Bellevue Washington United States 98004
    547 PeaceHealth Saint Joseph Medical Center Bellingham Washington United States 98225
    548 Harrison HealthPartners Hematology and Oncology-Bremerton Bremerton Washington United States 98310
    549 Harrison Medical Center Bremerton Washington United States 98310
    550 Highline Medical Center-Main Campus Burien Washington United States 98166
    551 Providence Regional Cancer System-Centralia Centralia Washington United States 98531
    552 Swedish Cancer Institute-Edmonds Edmonds Washington United States 98026
    553 Saint Elizabeth Hospital Enumclaw Washington United States 98022
    554 Providence Regional Cancer Partnership Everett Washington United States 98201
    555 Virginia Mason Federal Way Medical Center Federal Way Washington United States 98002
    556 Saint Francis Hospital Federal Way Washington United States 98003
    557 Tacoma/Valley Radiation Oncology Centers-Gig Harbor Gig Harbor Washington United States 98332
    558 MultiCare Gig Harbor Medical Park Gig Harbor Washington United States 98335
    559 Swedish Cancer Institute-Issaquah Issaquah Washington United States 98029
    560 Kadlec Clinic Hematology and Oncology Kennewick Washington United States 99336
    561 Northwest Cancer Clinic Kennewick Washington United States 99336
    562 Providence Regional Cancer System-Lacey Lacey Washington United States 98503
    563 Saint Clare Hospital Lakewood Washington United States 98499
    564 PeaceHealth Saint John Medical Center Longview Washington United States 98632
    565 Virginia Mason Lynnwood Medical Center Lynnwood Washington United States 98036
    566 Jefferson Healthcare Port Townsend Washington United States 98368
    567 Harrison HealthPartners Hematology and Oncology-Poulsbo Poulsbo Washington United States 98370
    568 Peninsula Cancer Center Poulsbo Washington United States 98370
    569 MultiCare Good Samaritan Hospital Puyallup Washington United States 98372
    570 Tacoma/Valley Radiation Oncology Centers-Puyallup Puyallup Washington United States 98372
    571 Valley Medical Center Renton Washington United States 98055
    572 Virginia Mason Medical Center Seattle Washington United States 98101
    573 Pacific Gynecology Specialists Seattle Washington United States 98104
    574 Swedish Medical Center-Ballard Campus Seattle Washington United States 98107
    575 Kaiser Permanente Washington Seattle Washington United States 98112
    576 Swedish Medical Center-First Hill Seattle Washington United States 98122-4307
    577 Swedish Medical Center-Cherry Hill Seattle Washington United States 98122-5711
    578 PeaceHealth United General Medical Center Sedro-Woolley Washington United States 98284
    579 Providence Regional Cancer System-Shelton Shelton Washington United States 98584
    580 MultiCare Deaconess Cancer and Blood Specialty Center - Valley Spokane Valley Washington United States 99216
    581 MultiCare Deaconess Cancer and Blood Specialty Center - Downtown Spokane Washington United States 99204
    582 MultiCare Deaconess Cancer and Blood Specialty Center - North Spokane Washington United States 99218
    583 Tacoma/Valley Radiation Oncology Centers-Jackson Hall Tacoma Washington United States 97405
    584 Franciscan Research Center-Northwest Medical Plaza Tacoma Washington United States 98405
    585 Mary Bridge Children's Hospital and Health Center Tacoma Washington United States 98405
    586 MultiCare Tacoma General Hospital Tacoma Washington United States 98405
    587 Northwest Medical Specialties PLLC Tacoma Washington United States 98405
    588 Tacoma/Valley Radiation Oncology Centers-Saint Joe's Tacoma Washington United States 98405
    589 PeaceHealth Southwest Medical Center Vancouver Washington United States 98664
    590 Providence Saint Mary Regional Cancer Center Walla Walla Washington United States 99362
    591 North Star Lodge Cancer Center at Yakima Valley Memorial Hospital Yakima Washington United States 98902
    592 Providence Regional Cancer System-Yelm Yelm Washington United States 98597
    593 United Hospital Center Bridgeport West Virginia United States 26330
    594 West Virginia University Charleston Division Charleston West Virginia United States 25304
    595 Edwards Comprehensive Cancer Center Huntington West Virginia United States 25701
    596 WVUH-Berkely Medical Center Martinsburg West Virginia United States 25401
    597 West Virginia University Healthcare Morgantown West Virginia United States 26506
    598 Camden Clark Medical Center Parkersburg West Virginia United States 26101
    599 Duluth Clinic Ashland Ashland Wisconsin United States 54806
    600 Northwest Wisconsin Cancer Center Ashland Wisconsin United States 54806
    601 Aurora Cancer Care-Southern Lakes VLCC Burlington Wisconsin United States 53105
    602 Marshfield Clinic-Chippewa Center Chippewa Falls Wisconsin United States 54729
    603 Marshfield Medical Center-EC Cancer Center Eau Claire Wisconsin United States 54701
    604 Aurora Health Center-Fond du Lac Fond Du Lac Wisconsin United States 54937
    605 Aurora Health Care Germantown Health Center Germantown Wisconsin United States 53022
    606 Aurora Cancer Care-Grafton Grafton Wisconsin United States 53024
    607 Saint Vincent Hospital Cancer Center Green Bay Green Bay Wisconsin United States 54301
    608 Saint Vincent Hospital Cancer Center at Saint Mary's Green Bay Wisconsin United States 54303
    609 Aurora BayCare Medical Center Green Bay Wisconsin United States 54311
    610 UW Cancer Center Johnson Creek Johnson Creek Wisconsin United States 53038
    611 Aurora Cancer Care-Kenosha South Kenosha Wisconsin United States 53142
    612 Gundersen Lutheran Medical Center La Crosse Wisconsin United States 54601
    613 Marshfield Clinic - Ladysmith Center Ladysmith Wisconsin United States 54848
    614 University of Wisconsin Carbone Cancer Center Madison Wisconsin United States 53792
    615 Aurora Bay Area Medical Group-Marinette Marinette Wisconsin United States 54143
    616 Marshfield Medical Center-Marshfield Marshfield Wisconsin United States 54449
    617 Aurora Cancer Care-Milwaukee Milwaukee Wisconsin United States 53209
    618 Aurora Saint Luke's Medical Center Milwaukee Wisconsin United States 53215
    619 Medical College of Wisconsin Milwaukee Wisconsin United States 53226
    620 Aurora Sinai Medical Center Milwaukee Wisconsin United States 53233
    621 Marshfield Clinic-Minocqua Center Minocqua Wisconsin United States 54548
    622 Cancer Center of Western Wisconsin New Richmond Wisconsin United States 54017
    623 Saint Vincent Hospital Cancer Center at Oconto Falls Oconto Falls Wisconsin United States 54154
    624 Vince Lombardi Cancer Clinic - Oshkosh Oshkosh Wisconsin United States 54904
    625 Aurora Cancer Care-Racine Racine Wisconsin United States 53406
    626 Marshfield Medical Center-Rice Lake Rice Lake Wisconsin United States 54868
    627 Vince Lombardi Cancer Clinic-Sheboygan Sheboygan Wisconsin United States 53081
    628 Marshfield Medical Center-River Region at Stevens Point Stevens Point Wisconsin United States 54482
    629 Saint Vincent Hospital Cancer Center at Sturgeon Bay Sturgeon Bay Wisconsin United States 54235-1495
    630 Aurora Medical Center in Summit Summit Wisconsin United States 53066
    631 Vince Lombardi Cancer Clinic-Two Rivers Two Rivers Wisconsin United States 54241
    632 Marshfield Clinic-Wausau Center Wausau Wisconsin United States 54401
    633 Aurora Cancer Care-Milwaukee West Wauwatosa Wisconsin United States 53226
    634 Aurora West Allis Medical Center West Allis Wisconsin United States 53227
    635 Marshfield Medical Center - Weston Weston Wisconsin United States 54476
    636 Marshfield Clinic - Wisconsin Rapids Center Wisconsin Rapids Wisconsin United States 54494
    637 Cheyenne Regional Medical Center-West Cheyenne Wyoming United States 82001
    638 Billings Clinic-Cody Cody Wyoming United States 82414
    639 Welch Cancer Center Sheridan Wyoming United States 82801

    Sponsors and Collaborators

    • National Cancer Institute (NCI)

    Investigators

    • Principal Investigator: Ari M Vanderwalde, Southwest Oncology Group

    Study Documents (Full-Text)

    None provided.

    More Information

    Publications

    None provided.
    Responsible Party:
    National Cancer Institute (NCI)
    ClinicalTrials.gov Identifier:
    NCT03033576
    Other Study ID Numbers:
    • NCI-2017-00105
    • NCI-2017-00105
    • S1616
    • S1616
    • S1616
    • U10CA180888
    First Posted:
    Jan 27, 2017
    Last Update Posted:
    Aug 8, 2022
    Last Verified:
    Mar 1, 2022
    Studies a U.S. FDA-regulated Drug Product:
    Yes
    Studies a U.S. FDA-regulated Device Product:
    No
    Additional relevant MeSH terms:
    Melanoma
    Skin Neoplasms
    Nivolumab
    Ipilimumab

    Study Results

    No Results Posted as of Aug 8, 2022