Testing the Effectiveness of Two Immunotherapy Drugs (Nivolumab and Ipilimumab) With One Anti-cancer Targeted Drug (Cabozantinib) for Rare Genitourinary Tumors

Sponsor
National Cancer Institute (NCI) (NIH)
Overall Status
Recruiting
CT.gov ID
NCT03866382
Collaborator
(none)
224
564
1
46.6
0.4
0

Study Details

Study Description

Brief Summary

This phase II trial studies how well cabozantinib works in combination with nivolumab and ipilimumab in treating patients with rare genitourinary (GU) tumors that have spread to other places in the body. Cabozantinib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Immunotherapy with monoclonal antibodies, such as nivolumab and ipilimumab, may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. Giving cabozantinib, nivolumab, and ipilimumab may work better in treating patients with genitourinary tumors that have no treatment options compared to giving cabozantinib, nivolumab, or ipilimumab alone.

Condition or Disease Intervention/Treatment Phase
  • Drug: Cabozantinib S-malate
  • Biological: Ipilimumab
  • Biological: Nivolumab
Phase 2

Detailed Description

PRIMARY OBJECTIVE:
  1. To evaluate the efficacy of cabozantinib s-malate (cabozantinib) combined with nivolumab and ipilimumab in the first or second-line (and beyond) setting for patients within each of the rare genitourinary (GU) variant histology group of interest, as measured by objective response rate (ORR).
SECONDARY OBJECTIVES:
  1. To estimate the progression-free survival (PFS) for patients treated with cabozantinib combined with nivolumab and ipilimumab within each rare variant histology.

  2. To estimate the overall survival (OS) for patients treated with cabozantinib combined with nivolumab and ipilimumab within each rare variant histology.

  3. To estimate the clinical benefit rate (defined as complete response [CR] or partial response [PR] or stable disease [SD]) for patients treated with cabozantinib combined with nivolumab and ipilimumab within each rare variant histology.

  4. To assess the safety of treating patients with rare variant histologies with cabozantinib combined with nivolumab and ipilimumab.

  5. To support tissue banking and collection of clinical follow-up data for GU tract rare histological variants.

EXPLORATORY OBJECTIVES:
  1. To assess effects of treatment in patients with bone-only disease by bone scan.
OUTLINE:

Patients receive cabozantinib orally (PO) once daily (QD) on days 1-21 of cycles 1-4 and on days 1-28 of subsequent cycles. Patients also receive nivolumab intravenously (IV) over 30 minutes on day 1 and ipilimumab IV over 90 minutes on day 1 of cycles 1-4. Patients then receive nivolumab IV over 30 minutes on day 1 of subsequent cycles. Treatment repeats every 21 days for cycles 1-4 and every 28 days for subsequent cycles for 2 years in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed up every 2 months for 5 years.

Study Design

Study Type:
Interventional
Anticipated Enrollment :
224 participants
Allocation:
N/A
Intervention Model:
Single Group Assignment
Masking:
None (Open Label)
Primary Purpose:
Treatment
Official Title:
A Phase II Study of Ipilimumab, Cabozantinib, and Nivolumab in Rare Genitourinary Cancers (ICONIC)
Actual Study Start Date :
Apr 12, 2019
Anticipated Primary Completion Date :
Feb 28, 2023
Anticipated Study Completion Date :
Feb 28, 2023

Arms and Interventions

Arm Intervention/Treatment
Experimental: Treatment (cabozantinib, nivolumab, ipilimumab)

Patients receive cabozantinib PO QD on days 1-21 of cycles 1-4 and on days 1-28 of subsequent cycles. Patients also receive nivolumab IV over 30 minutes on day 1 and ipilimumab IV over 90 minutes on day 1 of cycles 1-4. Patients then receive nivolumab IV over 30 minutes on day 1 of subsequent cycles. Treatment repeats every 21 days for cycles 1-4 and every 28 days for subsequent cycles for 2 years in the absence of disease progression or unacceptable toxicity.

Drug: Cabozantinib S-malate
Given PO
Other Names:
  • BMS-907351
  • Cabometyx
  • Cometriq
  • XL-184
  • XL184
  • 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. Objective response rate (ORR) [Up to 5 years]

      An objective response is defined as a confirmed complete response (CR) or partial response (PR) as assessed by Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1. A confirmed tumor response is defined to be either a CR or PR noted as the objective status on 2 consecutive evaluations at least 4 weeks apart. Will be estimated by the number of confirmed objective responses divided by the total number of evaluable patients. Confidence intervals for the true ORR will be calculated.

    Secondary Outcome Measures

    1. Duration of response [From time measurement criteria are met for CR or PR (whichever is first recorded) until the first date that recurrent or progressive disease is objectively documented, assessed up to 5 years]

      Defined for all evaluable patients who have achieved an objective response as the date at which the patient's earliest best objective status is first noted to be either a CR or PR to the earliest date progression is documented.

    2. Progression-free survival (PFS) [From start of treatment to time of progression or death, whichever occurs first, assessed up to 5 years]

      The median its 95% confidence interval will be determined and will be summarized using the Kaplan-Meier estimator.

    3. Overall survival [Up to 5 years]

      The median its 95% confidence interval will be determined and will be summarized using the Kaplan-Meier estimator.

    4. Clinical benefit rate (CBR) [Up to 5 years]

      A confirmed clinical benefit is defined to be either a CR or PR noted as the objective status on 2 consecutive evaluations at least 4 weeks apart or a confirmed stable disease at two consecutive tumor assessments at least 3 months apart. The CBR will be estimated by the number of patients with confirmed clinical benefit divided by the total number of evaluable patients. Confidence intervals for the true CBR will be calculated using exact binomial confidence intervals.

    5. Incidence of adverse events (AE) [Up to 5 years]

      Will be assessed using Common Terminology Criteria for Adverse Events version 5.0. The maximum of a particular AE will be determined for each patient. Tables will summarize the number and relative frequency of patients observing an AE as well as the number and relative frequency of patients experiencing any AE of grade 3 or greater.

    Other Outcome Measures

    1. Effects of treatment in patients with bone-only disease [Up to 5 years]

      The bone-only tumor patients will be evaluated in an exploratory fashion (if no RECIST measurements are available). A maximum of 15 patients with bone-only disease will be enrolled and evaluated using PFS for a descriptive analysis of the effect of treatment.

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    18 Years and Older
    Sexes Eligible for Study:
    All
    Accepts Healthy Volunteers:
    No
    Inclusion Criteria:
    • Metastatic disease defined as new or progressive lesions on cross-sectional imaging or bone scan. Patients must have at least:

    • One measurable site of disease as per Response Evaluation Criteria in Solid Tumors (RECIST) version (v) 1.1

    • One bone lesion on bone scan (tec99 or sodium fluoride [NaF] positron emission tomography [PET]/computed tomography [CT], CT, or magnetic resonance imaging [MRI]) for the bone-only cohort

    • Histologically confirmed diagnosis of one of the following metastatic cohorts:

    • Small cell/ neuroendocrine carcinoma of the bladder - All urothelial carcinomas with any amount of neuroendocrine differentiation (including small cell differentiation) will be included. If the tumor is purely neuroendocrine, metastasis from another site of origin should be clinically excluded.

    • Adenocarcinoma of the bladder, or urachal adenocarcinoma, or bladder/urethra clear cell adenocarcinoma - must be pure (per World Health Organization [WHO] definition), (i.e. urothelial carcinoma with glandular differentiation is not considered a pure adenocarcinoma.

    • Squamous cell carcinoma of the bladder - must be pure (i.e. urothelial carcinoma with squamous differentiation is not considered a pure squamous cell carcinoma).

    • Plasmacytoid urothelial carcinoma - Tumor should show predominantly > or equal ~50% plasmacytoid histology (including all types of discohesive growth, such as tumors with signet-ring and/or rhabdoid features as well).

    • Any penile cancer

    • Sarcomatoid renal cell carcinoma - Tumor should be predominantly sarcomatoid ~50% (including rhabdoid differentiation) is also unclassified renal cell carcinomas (RCCs): all (assuming they are high grade with metastasis) malignant angiomyolipomas are allowed.

    • Sarcomatoid urothelial carcinoma - Tumor should show predominantly ~ 50% sarcomatoid differentiation.

    • Renal medullary carcinoma - Per WHO definition, ideally confirmed with immunostains.

    • Renal collecting duct carcinoma - Per WHO definition (medullary involvement, predominant tubular morphology, desmoplastic stromal reaction, high grade cytology, infiltrative growth pattern, and absence of other renal cell carcinoma subtype or urothelial carcinoma).

    • Bone only urothelial carcinoma or other non-prostate GU tumor

    • Urethra carcinoma - May be of any histology but if urothelial carcinoma then must be isolated to the urethra and not have metachronous or synchronous urothelial carcinoma of the bladder.

    • Other miscellaneous histologic variants of the urothelial carcinoma, such as, but not limited to: micropapillary (Tumor should show predominantly > or equal 50% micropapillary architecture), giant cell, lipid-rich, clear cell and nested variants (Tumor should predominantly > or equal 50% show these features), large cell neuroendocrine carcinoma, lymphoepithelioma-like carcinoma and mixed patterns will be considered, as well as small cell neuroendocrine prostate cancer (Only treatment-na├»ve primary small cell of prostate with any amount of small cell component allowed. Post-treatment small cell prostatic carcinomas are not allowed), Malignant testicular Sertoli or Leydig cell tumors, and papillary and chromophobe RCC.

    • Note: Translocation positive renal cell carcinoma patients are eligible. However, AREN1721 should be considered before this trial.

    • Hematoxylin and eosin (H&E) slides from diagnostic tumor tissue for retrospective central pathology review

    • Patients may have received up to 2 systemic anti-cancer treatments or be treatment naive. Patients with small cell carcinoma should have received a platinum-based combination regimen either as neoadjuvant, adjuvant or first-line treatment). Patients in the bone-only cohort may be urothelial carcinoma histology but must receive standard cisplatin-based chemotherapy (if cisplatin-eligible).

    • Patients must be able to swallow oral formulation of the tablets

    • Karnofsky performance status >= 80%

    • Absolute neutrophil count (ANC) >= 1,000/mcL

    • Platelet count >= 75,000/mcL

    • Total bilirubin =< 1.5 x upper limit of normal (ULN). For subjects with known Gilbert's disease or similar syndrome with slow conjugation of bilirubin, total bilirubin =< 3.0 mg/dL

    • Aspartate aminotransferase (AST)/alanine aminotransferase (ALT) =< 3.0 x institutional upper limit of normal (ULN) (or =< 5 x ULN for patients with liver metastases or Gilbert's disease)

    • Creatinine =< 1.5 x upper limit of normal (ULN) OR creatinine clearance >= 40 mL/min/1.73 m^2 (calculated using the Chronic Kidney Disease Epidemiology [CKD-EPI] equation or Cockcroft-Gault formula) for patients with creatinine levels above institutional normal

    • Hemoglobin >= 9 g/dL (transfusion of packed red blood cells [PRBCs] allowed)

    • Serum albumin >= 3.2 g/dL

    • Lipase and amylase =< 2.0 x ULN and no radiologic (on baseline anatomical imaging) or clinical evidence of pancreatitis

    • Prior treatment with MET or VEGFR inhibitors is allowed. However, prior cabozantinib will not be allowed. Also, patients that have received both prior MET or VEGF and prior PD-1/PD-L1/CTLA-4 (sequentially or in combination) are also not allowed

    • Prior treatment with any therapy on the PD-1/PD-L1 axis or anti- CTLA-4/CTLA-4 inhibitors is allowed, either in the perioperative or in the metastatic setting. However, patients that have received both prior MET or VEGF and prior PD-1/PD-L1/CTLA-4 (sequentially or in combination) are not allowed

    • Human immunodeficiency virus (HIV)-positive patients are eligible if on stable dose of highly active antiretroviral therapy (HAART), no clinically significant drug-drug interactions are anticipated with the current HAART regimen, CD4 counts are greater than 350 and viral load is undetectable

    • Patients with rheumatoid arthritis and other rheumatologic arthropathies, Sjogren's syndrome and psoriasis controlled with topical medication only and patients with positive serology, such as antinuclear antibodies (ANA), anti-thyroid antibodies etc. are eligible but should be considered for rheumatologic evaluation for the presence of target organ involvement and potential need for systemic treatment

    • Patients with vitiligo, endocrine deficiencies including thyroiditis managed with replacement hormones or medications (e.g. thyroiditis managed with propylthiouracil [PTU] or methimazole) including physiologic oral corticosteroids are eligible

    • Patients who have evidence of active or acute diverticulitis, intra-abdominal abscess, and gastrointestinal (GI) obstruction, within 12 months are not eligible

    • Women of childbearing potential must have a negative pregnancy test =< 7 days prior to registration

    • Women of childbearing potential include women who have experienced menarche and who have not undergone successful surgical sterilization (hysterectomy, bilateral tubal ligation, or bilateral oophorectomy) or are not postmenopausal. Post menopause is defined as amenorrhea >= 12 consecutive months. Note: women who have been amenorrheic for 12 or more months are still considered to be of childbearing potential if the amenorrhea is possibly due to prior chemotherapy, antiestrogens, ovarian suppression or any other reversible reason

    • Pregnant women may not participate in this study because with cabozantinib, nivolumab, and ipilimumab have potential for teratogenic or abortifacient effects. Because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with cabozantinib, nivolumab, and ipilimumab, breastfeeding should be discontinued if the mother is treated with these agents

    • The patient has received no cytotoxic chemotherapy (including investigational cytotoxic chemotherapy) or biologic agents (e.g., cytokines or antibodies) within 2 weeks before the first dose of study treatment

    • The patient has received no radiation therapy:

    • To the lungs and mediastinum or abdomen within 4 weeks before the first dose of study treatment, or has ongoing complications, or is healing from prior radiation therapy

    • To brain metastasis within 3 weeks for whole-brain radiotherapy (WBXRT), and 2 weeks for stereotactic body radiation therapy (SBRT) before the first dose of study treatment

    • To the abdomen within 4 weeks before the first dose of study treatment, or has ongoing complications, or is healing from prior radiation therapy

    • To any other site(s) within 2 weeks before the first dose of study treatment

    • The patient has received no radionuclide treatment within 6 weeks of the first dose of study treatment

    • The patient has received no prior treatment with a small molecule kinase inhibitor within 14 days or five half-lives of the compound or active metabolites, whichever is longer, before the first dose of study treatment

    • The patient has received no prior treatment with hormonal therapy within 14 days or five half-lives of the compound or active metabolites, whichever is longer, before the first dose of study treatment. Subjects receiving gonadotropin-releasing hormone (GnRH) agonists and antagonists are allowed to participate

    • The patient has not received any other type of investigational agent within 14 days before the first dose of study treatment

    • The patient must have recovered to baseline or Common Terminology Criteria for Adverse Events (CTCAE) =< grade 1 from toxicity due to all prior therapies except alopecia, neuropathy and other non-clinically significant adverse events (AEs) defined as lab elevation with no associated symptoms or sequelae

    • The patient may not have active brain metastases or epidural disease. Patients with brain metastases previously treated with whole brain radiation or radiosurgery who are asymptomatic and do not require steroid treatment for at least 2 weeks before starting study treatment are eligible. Neurosurgical resection of brain metastases or brain biopsy is permitted if completed at least 3 months before starting study treatment. Baseline brain imaging with contrast-enhanced computed tomography (CT) or magnetic resonance imaging (MRI) scans for subjects with known brain metastases is required to confirm eligibility

    • No concomitant treatment with warfarin. Aspirin (up to 325 mg/day), thrombin or factor Xa inhibitors, low-dose warfarin (=< 1 mg/day), prophylactic and therapeutic low molecular weight heparin (LMWH) are permitted

    • No chronic concomitant treatment with strong CYP3A4 inducers (e.g., dexamethasone, phenytoin, carbamazepine, rifampin, rifabutin, rifapentine, phenobarbital, and St. John's wort) or strong CYP3A4 inhibitors

    • Because the lists of these agents are constantly changing, it is important to regularly consult medical reference texts such as the Physicians' Desk Reference may also provide this information. As part of the enrollment/informed consent procedures, the patient will be counseled on the risk of interactions with other agents, and what to do if new medications need to be prescribed or if the patient is considering a new over-the-counter medicine or herbal product

    • The patient has not experienced any of the following:

    • Clinically-significant gastrointestinal bleeding within 6 months before the first dose of study treatment

    • Hemoptysis of >= 0.5 teaspoon (2.5 mL) of red blood per day within 1 months before the first dose of study treatment

    • Any other signs indicative of pulmonary hemorrhage within 3 months before the first dose of study treatment

    • The patient has no tumor invading any major blood vessels

    • The patient has no evidence of tumor invading the GI tract (esophagus, stomach, small or large bowel, rectum or anus), or any evidence of endotracheal or endobronchial tumor within 28 days before the first dose of cabozantinib. Patients with rectal tumor masses are not eligible.

    • The patient has no uncontrolled, significant intercurrent or recent illness including, but not limited to, the following conditions:

    • Cardiovascular disorders including:

    • Congestive heart failure (CHF): New York Heart Association (NYHA) class III (moderate) or class IV (severe) at the time of screening.

    • Concurrent uncontrolled hypertension defined as sustained blood pressure (BP) > 150 mm Hg systolic, or > 90 mm Hg diastolic despite optimal antihypertensive treatment within 7 days of the first dose of study treatment

    • The subject has a corrected QT interval calculated by the Fridericia formula (QTcF) > 500 ms within 28 days before randomization. Note: if initial QTcF is found to be > 500 ms, two additional electrocardiograms (EKGs) separated by at least 3 minutes should be performed. If the average of these three consecutive results for QTcF is =< 500 ms, the subject meets eligibility in this regard

    • Any history of congenital long QT syndrome

    • Any of the following within 6 months before registration of study treatment:

    • Unstable angina pectoris

    • Clinically-significant cardiac arrhythmias (patients with atrial fibrillation are eligible)

    • Stroke (including transient ischemic attack [TIA], or other ischemic event)

    • Myocardial infarction

    • Cardiomyopathy

    • No significant gastrointestinal disorders particularly those associated with a high risk of perforation or fistula formation including:

    • Any of the following that have not resolved within 28 days before the first dose of study treatment:

    • Active peptic ulcer disease

    • Acute diverticulitis, cholecystitis, symptomatic cholangitis or appendicitis, or malabsorption syndrome

    • None of the following within 2 years before the first dose of study treatment:

    • Abdominal fistula or genitourinary fistula

    • Gastrointestinal perforation

    • Bowel obstruction or gastric outlet obstruction

    • Intra-abdominal abscess. Note: Complete resolution of an intra-abdominal abscess must be confirmed prior to initiating treatment with cabozantinib even if the abscess occurred more than 2 years before the first dose of study treatment

    • Disorders associated with a high risk of fistula formation including percutaneous endoscopic gastrostomy (PEG) tube placement are not eligible

    • No other clinically significant disorders such as:

    • Severe active infection requiring IV systemic treatment within 14 days before the first dose of study treatment

    • Serious non-healing wound/ulcer/bone fracture within 28 days before the first dose of study treatment

    • History of organ or allogeneic stem cell transplant

    • Concurrent uncompensated hypothyroidism or thyroid dysfunction within 7 days before the first dose of study treatment (for asymptomatic patients with an elevated thyroid-stimulating hormone [TSH], thyroid replacement may be initiated if clinically indicated without delaying the start of study treatment)

    • No history of major surgery as follows:

    • Major surgery within 3 months of the first dose of ca

    Contacts and Locations

    Locations

    Site City State Country Postal Code
    1 University of Alabama at Birmingham Cancer Center Birmingham Alabama United States 35233
    2 Anchorage Associates in Radiation Medicine Anchorage Alaska United States 98508
    3 Anchorage Radiation Therapy Center Anchorage Alaska United States 99504
    4 Alaska Breast Care and Surgery LLC Anchorage Alaska United States 99508
    5 Alaska Oncology and Hematology LLC Anchorage Alaska United States 99508
    6 Alaska Women's Cancer Care Anchorage Alaska United States 99508
    7 Anchorage Oncology Centre Anchorage Alaska United States 99508
    8 Katmai Oncology Group Anchorage Alaska United States 99508
    9 Providence Alaska Medical Center Anchorage Alaska United States 99508
    10 Kingman Regional Medical Center Kingman Arizona United States 86401
    11 Cancer Center at Saint Joseph's Phoenix Arizona United States 85004
    12 Mayo Clinic Hospital in Arizona Phoenix Arizona United States 85054
    13 Mayo Clinic in Arizona Scottsdale Arizona United States 85259
    14 University of Arizona Cancer Center-Orange Grove Campus Tucson Arizona United States 85704
    15 Banner University Medical Center - Tucson Tucson Arizona United States 85719
    16 University of Arizona Cancer Center-North Campus Tucson Arizona United States 85719
    17 Mercy Hospital Fort Smith Fort Smith Arkansas United States 72903
    18 CHI Saint Vincent Cancer Center Hot Springs Hot Springs Arkansas United States 71913
    19 Mission Hope Medical Oncology - Arroyo Grande Arroyo Grande California United States 93420
    20 PCR Oncology Arroyo Grande California United States 93420
    21 Providence Saint Joseph Medical Center/Disney Family Cancer Center Burbank California United States 91505
    22 Community Cancer Institute Clovis California United States 93611
    23 University Oncology Associates Clovis California United States 93611
    24 Epic Care-Dublin Dublin California United States 94568
    25 Bay Area Breast Surgeons Inc Emeryville California United States 94608
    26 Epic Care Partners in Cancer Care Emeryville California United States 94608
    27 Marin Cancer Care Inc Greenbrae California United States 94904
    28 Los Angeles County-USC Medical Center Los Angeles California United States 90033
    29 USC / Norris Comprehensive Cancer Center Los Angeles California United States 90033
    30 UCLA / Jonsson Comprehensive Cancer Center Los Angeles California United States 90095
    31 Contra Costa Regional Medical Center Martinez California United States 94553-3156
    32 USC Norris Oncology/Hematology-Newport Beach Newport Beach California United States 92663
    33 Alta Bates Summit Medical Center - Summit Campus Oakland California United States 94609
    34 Bay Area Tumor Institute Oakland California United States 94609
    35 Pacific Central Coast Health Center-San Luis Obispo San Luis Obispo California United States 93401
    36 Mission Hope Medical Oncology - Santa Maria Santa Maria California United States 93444
    37 Epic Care Cyberknife Center Walnut Creek California United States 94597
    38 Penrose-Saint Francis Healthcare Colorado Springs Colorado United States 80907
    39 Rocky Mountain Cancer Centers-Penrose Colorado Springs Colorado United States 80907
    40 Porter Adventist Hospital Denver Colorado United States 80210
    41 Mercy Medical Center Durango Colorado United States 81301
    42 Southwest Oncology PC Durango Colorado United States 81301
    43 Saint Anthony Hospital Lakewood Colorado United States 80228
    44 Littleton Adventist Hospital Littleton Colorado United States 80122
    45 Longmont United Hospital Longmont Colorado United States 80501
    46 Rocky Mountain Cancer Centers-Longmont Longmont Colorado United States 80501
    47 Parker Adventist Hospital Parker Colorado United States 80138
    48 Saint Mary Corwin Medical Center Pueblo Colorado United States 81004
    49 MedStar Georgetown University Hospital Washington District of Columbia United States 20007
    50 Mount Sinai Comprehensive Cancer Center at Aventura Aventura Florida United States 33180
    51 Holy Cross Hospital Fort Lauderdale Florida United States 33308
    52 Mayo Clinic in Florida Jacksonville Florida United States 32224-9980
    53 Mount Sinai Medical Center Miami Beach Florida United States 33140
    54 Orlando Health Cancer Institute Orlando Florida United States 32806
    55 Emory University Hospital Midtown Atlanta Georgia United States 30308
    56 Emory University Hospital/Winship Cancer Institute Atlanta Georgia United States 30322
    57 Emory Saint Joseph's Hospital Atlanta Georgia United States 30342
    58 Emory Johns Creek Hospital Johns Creek Georgia United States 30097
    59 Saint Alphonsus Cancer Care Center-Boise Boise Idaho United States 83706
    60 Saint Luke's Cancer Institute - Boise Boise Idaho United States 83712
    61 Saint Alphonsus Cancer Care Center-Caldwell Caldwell Idaho United States 83605
    62 Kootenai Health - Coeur d'Alene Coeur d'Alene Idaho United States 83814
    63 Walter Knox Memorial Hospital Emmett Idaho United States 83617
    64 Saint Luke's Cancer Institute - Fruitland Fruitland Idaho United States 83619
    65 Idaho Urologic Institute-Meridian Meridian Idaho United States 83642
    66 Saint Luke's Cancer Institute - Meridian Meridian Idaho United States 83642
    67 Saint Alphonsus Medical Center-Nampa Nampa Idaho United States 83686
    68 Saint Luke's Cancer Institute - Nampa Nampa Idaho United States 83686
    69 Kootenai Clinic Cancer Services - Post Falls Post Falls Idaho United States 83854
    70 Kootenai Cancer Clinic Sandpoint Idaho United States 83864
    71 Saint Luke's Cancer Institute - Twin Falls Twin Falls Idaho United States 83301
    72 Saint Anthony's Health Alton Illinois United States 62002
    73 Rush - Copley Medical Center Aurora Illinois United States 60504
    74 Illinois CancerCare-Bloomington Bloomington Illinois United States 61704
    75 Loyola Center for Health at Burr Ridge Burr Ridge Illinois United States 60527
    76 Illinois CancerCare-Canton Canton Illinois United States 61520
    77 Memorial Hospital of Carbondale Carbondale Illinois United States 62902
    78 SIH Cancer Institute Carterville Illinois United States 62918
    79 Illinois CancerCare-Carthage Carthage Illinois United States 62321
    80 Northwestern University Chicago Illinois United States 60611
    81 Rush University Medical Center Chicago Illinois United States 60612
    82 University of Illinois Chicago Illinois United States 60612
    83 University of Chicago Comprehensive Cancer Center Chicago Illinois United States 60637
    84 Carle on Vermilion Danville Illinois United States 61832
    85 Cancer Care Specialists of Illinois - Decatur Decatur Illinois United States 62526
    86 Decatur Memorial Hospital Decatur Illinois United States 62526
    87 Illinois CancerCare-Dixon Dixon Illinois United States 61021
    88 Carle Physician Group-Effingham Effingham Illinois United States 62401
    89 Crossroads Cancer Center Effingham Illinois United States 62401
    90 Illinois CancerCare-Eureka Eureka Illinois United States 61530
    91 Illinois CancerCare-Galesburg Galesburg Illinois United States 61401
    92 Western Illinois Cancer Treatment Center Galesburg Illinois United States 61401
    93 Loyola Medicine Homer Glen Homer Glen Illinois United States 60491
    94 Illinois CancerCare-Kewanee Clinic Kewanee Illinois United States 61443
    95 Northwestern Medicine Lake Forest Hospital Lake Forest Illinois United States 60045
    96 Illinois CancerCare-Macomb Macomb Illinois United States 61455
    97 Carle Physician Group-Mattoon/Charleston Mattoon Illinois United States 61938
    98 Loyola University Medical Center Maywood Illinois United States 60153
    99 Marjorie Weinberg Cancer Center at Loyola-Gottlieb Melrose Park Illinois United States 60160
    100 Good Samaritan Regional Health Center Mount Vernon Illinois United States 62864
    101 UC Comprehensive Cancer Center at Silver Cross New Lenox Illinois United States 60451
    102 Cancer Care Center of O'Fallon O'Fallon Illinois United States 62269
    103 University of Chicago Medicine-Orland Park Orland Park Illinois United States 60462
    104 Illinois CancerCare-Ottawa Clinic Ottawa Illinois United States 61350
    105 Illinois CancerCare-Pekin Pekin Illinois United States 61554
    106 Illinois CancerCare-Peoria Peoria Illinois United States 61615
    107 Methodist Medical Center of Illinois Peoria Illinois United States 61636
    108 Illinois CancerCare-Peru Peru Illinois United States 61354
    109 Valley Radiation Oncology Peru Illinois United States 61354
    110 Illinois CancerCare-Princeton Princeton Illinois United States 61356
    111 Southern Illinois University School of Medicine Springfield Illinois United States 62702
    112 Springfield Clinic Springfield Illinois United States 62702
    113 Memorial Medical Center Springfield Illinois United States 62781
    114 Southwest Illinois Health Services LLP Swansea Illinois United States 62226
    115 Carle Cancer Center Urbana Illinois United States 61801
    116 The Carle Foundation Hospital Urbana Illinois United States 61801
    117 Illinois CancerCare - Washington Washington Illinois United States 61571
    118 Rush-Copley Healthcare Center Yorkville Illinois United States 60560
    119 Reid Health Richmond Indiana United States 47374
    120 Mary Greeley Medical Center Ames Iowa United States 50010
    121 McFarland Clinic PC - Ames Ames Iowa United States 50010
    122 McFarland Clinic PC-Boone Boone Iowa United States 50036
    123 Medical Oncology and Hematology Associates-West Des Moines Clive Iowa United States 50325
    124 Mercy Cancer Center-West Lakes Clive Iowa United States 50325
    125 Alegent Health Mercy Hospital Council Bluffs Iowa United States 51503
    126 Greater Regional Medical Center Creston Iowa United States 50801
    127 Medical Oncology and Hematology Associates-Laurel Des Moines Iowa United States 50314
    128 Mercy Medical Center - Des Moines Des Moines Iowa United States 50314
    129 McFarland Clinic PC-Trinity Cancer Center Fort Dodge Iowa United States 50501
    130 McFarland Clinic PC-Jefferson Jefferson Iowa United States 50129
    131 McFarland Clinic PC-Marshalltown Marshalltown Iowa United States 50158
    132 Mercy Medical Center-West Lakes West Des Moines Iowa United States 50266
    133 Cancer Center of Kansas - Chanute Chanute Kansas United States 66720
    134 Cancer Center of Kansas - Dodge City Dodge City Kansas United States 67801
    135 Cancer Center of Kansas - El Dorado El Dorado Kansas United States 67042
    136 University of Kansas Clinical Research Center Fairway Kansas United States 66205
    137 Central Care Cancer Center - Garden City Garden City Kansas United States 67846
    138 Central Care Cancer Center - Great Bend Great Bend Kansas United States 67530
    139 HaysMed University of Kansas Health System Hays Kansas United States 67601
    140 Cancer Center of Kansas-Independence Independence Kansas United States 67301
    141 Cancer Center of Kansas-Kingman Kingman Kansas United States 67068
    142 Lawrence Memorial Hospital Lawrence Kansas United States 66044
    143 Cancer Center of Kansas-Liberal Liberal Kansas United States 67905
    144 Cancer Center of Kansas-Manhattan Manhattan Kansas United States 66502
    145 Cancer Center of Kansas - McPherson McPherson Kansas United States 67460
    146 Cancer Center of Kansas - Newton Newton Kansas United States 67114
    147 Olathe Health Cancer Center Olathe Kansas United States 66061
    148 Cancer Center of Kansas - Parsons Parsons Kansas United States 67357
    149 Ascension Via Christi - Pittsburg Pittsburg Kansas United States 66762
    150 Cancer Center of Kansas - Pratt Pratt Kansas United States 67124
    151 Cancer Center of Kansas - Salina Salina Kansas United States 67401
    152 Salina Regional Health Center Salina Kansas United States 67401
    153 University of Kansas Health System Saint Francis Campus Topeka Kansas United States 66606
    154 Cancer Center of Kansas - Wellington Wellington Kansas United States 67152
    155 University of Kansas Hospital-Westwood Cancer Center Westwood Kansas United States 66205
    156 Cancer Center of Kansas-Wichita Medical Arts Tower Wichita Kansas United States 67208
    157 Ascension Via Christi Hospitals Wichita Wichita Kansas United States 67214
    158 Cancer Center of Kansas - Wichita Wichita Kansas United States 67214
    159 Cancer Center of Kansas - Winfield Winfield Kansas United States 67156
    160 Flaget Memorial Hospital Bardstown Kentucky United States 40004
    161 Commonwealth Cancer Center-Corbin Corbin Kentucky United States 40701
    162 Saint Joseph Radiation Oncology Resource Center Lexington Kentucky United States 40504
    163 Saint Joseph Hospital East Lexington Kentucky United States 40509
    164 University of Kentucky/Markey Cancer Center Lexington Kentucky United States 40536
    165 Saint Joseph London London Kentucky United States 40741
    166 Jewish Hospital Louisville Kentucky United States 40202
    167 Saints Mary and Elizabeth Hospital Louisville Kentucky United States 40215
    168 UofL Health Medical Center Northeast Louisville Kentucky United States 40245
    169 Jewish Hospital Medical Center South Shepherdsville Kentucky United States 40165
    170 Hematology/Oncology Clinic PLLC Baton Rouge Louisiana United States 70809
    171 Ochsner High Grove Baton Rouge Louisiana United States 70836
    172 Ochsner Medical Center Kenner Kenner Louisiana United States 70065
    173 East Jefferson General Hospital Metairie Louisiana United States 70006
    174 LSU Healthcare Network / Metairie Multi-Specialty Clinic Metairie Louisiana United States 70006
    175 Louisiana State University Health Science Center New Orleans Louisiana United States 70112
    176 Tulane University Health Sciences Center New Orleans Louisiana United States 70112
    177 Ochsner Medical Center Jefferson New Orleans Louisiana United States 70121
    178 Greater Baltimore Medical Center Baltimore Maryland United States 21204
    179 National Institutes of Health Clinical Center Bethesda Maryland United States 20892
    180 Lahey Hospital and Medical Center Burlington Massachusetts United States 01805
    181 Lahey Medical Center-Peabody Peabody Massachusetts United States 01960
    182 Mercy Medical Center Springfield Massachusetts United States 01104
    183 Winchester Hospital Winchester Massachusetts United States 01890
    184 Saint Joseph Mercy Hospital Ann Arbor Michigan United States 48106
    185 Saint Joseph Mercy Brighton Brighton Michigan United States 48114
    186 Trinity Health IHA Medical Group Hematology Oncology - Brighton Brighton Michigan United States 48114
    187 Henry Ford Cancer Institute-Downriver Brownstown Michigan United States 48183
    188 Saint Joseph Mercy Canton Canton Michigan United States 48188
    189 Trinity Health IHA Medical Group Hematology Oncology - Canton Canton Michigan United States 48188
    190 Caro Cancer Center Caro Michigan United States 48723
    191 Saint Joseph Mercy Chelsea Chelsea Michigan United States 48118
    192 Trinity Health IHA Medical Group Hematology Oncology - Chelsea Hospital Chelsea Michigan United States 48118
    193 Hematology Oncology Consultants-Clarkston Clarkston Michigan United States 48346
    194 Newland Medical Associates-Clarkston Clarkston Michigan United States 48346
    195 Henry Ford Macomb Hospital-Clinton Township Clinton Township Michigan United States 48038
    196 Henry Ford Medical Center-Fairlane Dearborn Michigan United States 48126
    197 Henry Ford Hospital Detroit Michigan United States 48202
    198 Ascension Saint John Hospital Detroit Michigan United States 48236
    199 Great Lakes Cancer Management Specialists-Doctors Park East China Township Michigan United States 48054
    200 Genesee Cancer and Blood Disease Treatment Center Flint Michigan United States 48503
    201 Genesee Hematology Oncology PC Flint Michigan United States 48503
    202 Genesys Hurley Cancer Institute Flint Michigan United States 48503
    203 Hurley Medical Center Flint Michigan United States 48503
    204 Academic Hematology Oncology Specialists Grosse Pointe Woods Michigan United States 48236
    205 Great Lakes Cancer Management Specialists-Van Elslander Cancer Center Grosse Pointe Woods Michigan United States 48236
    206 Michigan Breast Specialists-Grosse Pointe Woods Grosse Pointe Woods Michigan United States 48236
    207 Allegiance Health Jackson Michigan United States 49201
    208 Sparrow Hospital Lansing Michigan United States 48912
    209 Hope Cancer Clinic Livonia Michigan United States 48154
    210 Trinity Health Saint Mary Mercy Livonia Hospital Livonia Michigan United States 48154
    211 Great Lakes Cancer Management Specialists-Macomb Medical Campus Macomb Michigan United States 48044
    212 Michigan Breast Specialists-Macomb Township Macomb Michigan United States 48044
    213 Saint Mary's Oncology/Hematology Associates of Marlette Marlette Michigan United States 48453
    214 Henry Ford Medical Center-Columbus Novi Michigan United States 48377
    215 21st Century Oncology-Pontiac Pontiac Michigan United States 48341
    216 Hope Cancer Center Pontiac Michigan United States 48341
    217 Newland Medical Associates-Pontiac Pontiac Michigan United States 48341
    218 Saint Joseph Mercy Oakland Pontiac Michigan United States 48341
    219 Huron Medical Center PC Port Huron Michigan United States 48060
    220 Lake Huron Medical Center Port Huron Michigan United States 48060
    221 Great Lakes Cancer Management Specialists-Rochester Hills Rochester Hills Michigan United States 48309
    222 Ascension Saint Mary's Hospital Saginaw Michigan United States 48601
    223 Oncology Hematology Associates of Saginaw Valley PC Saginaw Michigan United States 48604
    224 Henry Ford Macomb Health Center - Shelby Township Shelby Michigan United States 48315
    225 Bhadresh Nayak MD PC-Sterling Heights Sterling Heights Michigan United States 48312
    226 Ascension Saint Joseph Hospital Tawas City Michigan United States 48764
    227 Advanced Breast Care Center PLLC Warren Michigan United States 48088
    228 Great Lakes Cancer Management Specialists-Macomb Professional Building Warren Michigan United States 48093
    229 Macomb Hematology Oncology PC Warren Michigan United States 48093
    230 Michigan Breast Specialists-Warren Warren Michigan United States 48093
    231 Saint John Macomb-Oakland Hospital Warren Michigan United States 48093
    232 Henry Ford West Bloomfield Hospital West Bloomfield Michigan United States 48322
    233 Saint Mary's Oncology/Hematology Associates of West Branch West Branch Michigan United States 48661
    234 Huron Gastroenterology PC Ypsilanti Michigan United States 48106
    235 Trinity Health IHA Medical Group Hematology Oncology Ann Arbor Campus Ypsilanti Michigan United States 48197
    236 Riverwood Healthcare Center Aitkin Minnesota United States 56431
    237 Essentia Health Saint Joseph's Medical Center Brainerd Minnesota United States 56401
    238 Fairview Ridges Hospital Burnsville Minnesota United States 55337
    239 Minnesota Oncology - Burnsville Burnsville Minnesota United States 55337
    240 Cambridge Medical Center Cambridge Minnesota United States 55008
    241 Mercy Hospital Coon Rapids Minnesota United States 55433
    242 Essentia Health - Deer River Clinic Deer River Minnesota United States 56636
    243 Essentia Health Saint Mary's - Detroit Lakes Clinic Detroit Lakes Minnesota United States 56501
    244 Essentia Health Cancer Center Duluth Minnesota United States 55805
    245 Essentia Health Saint Mary's Medical Center Duluth Minnesota United States 55805
    246 Miller-Dwan Hospital Duluth Minnesota United States 55805
    247 Fairview Southdale Hospital Edina Minnesota United States 55435
    248 Lake Region Healthcare Corporation-Cancer Care Fergus Falls Minnesota United States 56537
    249 Essentia Health - Fosston Fosston Minnesota United States 56542
    250 Unity Hospital Fridley Minnesota United States 55432
    251 Essentia Health Hibbing Clinic Hibbing Minnesota United States 55746
    252 Fairview Clinics and Surgery Center Maple Grove Maple Grove Minnesota United States 55369
    253 Minnesota Oncology Hematology PA-Maplewood Maplewood Minnesota United States 55109
    254 Saint John's Hospital - Healtheast Maplewood Minnesota United States 55109
    255 Abbott-Northwestern Hospital Minneapolis Minnesota United States 55407
    256 Hennepin County Medical Center Minneapolis Minnesota United States 55415
    257 Health Partners Inc Minneapolis Minnesota United States 55454
    258 Monticello Cancer Center Monticello Minnesota United States 55362
    259 New Ulm Medical Center New Ulm Minnesota United States 56073
    260 Essentia Health - Park Rapids Park Rapids Minnesota United States 56470
    261 Fairview Northland Medical Center Princeton Minnesota United States 55371
    262 North Memorial Medical Health Center Robbinsdale Minnesota United States 55422
    263 Mayo Clinic in Rochester Rochester Minnesota United States 55905
    264 Park Nicollet Clinic - Saint Louis Park Saint Louis Park Minnesota United States 55416
    265 Regions Hospital Saint Paul Minnesota United States 55101
    266 United Hospital Saint Paul Minnesota United States 55102
    267 Essentia Health Sandstone Sandstone Minnesota United States 55072
    268 Saint Francis Regional Medical Center Shakopee Minnesota United States 55379
    269 Lakeview Hospital Stillwater Minnesota United States 55082
    270 Essentia Health Virginia Clinic Virginia Minnesota United States 55792
    271 Ridgeview Medical Center Waconia Minnesota United States 55387
    272 Rice Memorial Hospital Willmar Minnesota United States 56201
    273 Minnesota Oncology Hematology PA-Woodbury Woodbury Minnesota United States 55125
    274 Fairview Lakes Medical Center Wyoming Minnesota United States 55092
    275 University of Mississippi Medical Center Jackson Mississippi United States 39216
    276 Saint Louis Cancer and Breast Institute-Ballwin Ballwin Missouri United States 63011
    277 Central Care Cancer Center - Bolivar Bolivar Missouri United States 65613
    278 Parkland Health Center-Bonne Terre Bonne Terre Missouri United States 63628
    279 Cox Cancer Center Branson Branson Missouri United States 65616
    280 Saint Francis Medical Center Cape Girardeau Missouri United States 63703
    281 Southeast Cancer Center Cape Girardeau Missouri United States 63703
    282 Siteman Cancer Center at West County Hospital Creve Coeur Missouri United States 63141
    283 Parkland Health Center - Farmington Farmington Missouri United States 63640
    284 Capital Region Southwest Campus Jefferson City Missouri United States 65109
    285 Freeman Health System Joplin Missouri United States 64804
    286 Mercy Hospital Joplin Joplin Missouri United States 64804
    287 Truman Medical Centers Kansas City Missouri United States 64108
    288 University of Kansas Cancer Center - Lee's Summit Lee's Summit Missouri United States 64064
    289 Delbert Day Cancer Institute at PCRMC Rolla Missouri United States 65401
    290 Mercy Clinic-Rolla-Cancer and Hematology Rolla Missouri United States 65401
    291 Heartland Regional Medical Center Saint Joseph Missouri United States 64506
    292 Saint Louis Cancer and Breast Institute-South City Saint Louis Missouri United States 63109
    293 Washington University School of Medicine Saint Louis Missouri United States 63110
    294 Mercy Hospital South Saint Louis Missouri United States 63128
    295 Siteman Cancer Center-South County Saint Louis Missouri United States 63129
    296 Missouri Baptist Medical Center Saint Louis Missouri United States 63131
    297 Siteman Cancer Center at Christian Hospital Saint Louis Missouri United States 63136
    298 Mercy Hospital Saint Louis Saint Louis Missouri United States 63141
    299 Siteman Cancer Center at Saint Peters Hospital Saint Peters Missouri United States 63376
    300 Sainte Genevieve County Memorial Hospital Sainte Genevieve Missouri United States 63670
    301 Mercy Hospital Springfield Springfield Missouri United States 65804
    302 CoxHealth South Hospital Springfield Missouri United States 65807
    303 Missouri Baptist Sullivan Hospital Sullivan Missouri United States 63080
    304 Missouri Baptist Outpatient Center-Sunset Hills Sunset Hills Missouri United States 63127
    305 Mercy Hospital Washington Washington Missouri United States 63090
    306 Community Hospital of Anaconda Anaconda Montana United States 59711
    307 Billings Clinic Cancer Center Billings Montana United States 59101
    308 Bozeman Deaconess Hospital Bozeman Montana United States 59715
    309 Benefis Healthcare- Sletten Cancer Institute Great Falls Montana United States 59405
    310 Great Falls Clinic Great Falls Montana United States 59405
    311 Saint Peter's Community Hospital Helena Montana United States 59601
    312 Kalispell Regional Medical Center Kalispell Montana United States 59901
    313 Saint Patrick Hospital - Community Hospital Missoula Montana United States 59802
    314 Community Medical Hospital Missoula Montana United States 59804
    315 Nebraska Medicine-Bellevue Bellevue Nebraska United States 68123
    316 CHI Health Saint Francis Grand Island Nebraska United States 68803
    317 CHI Health Good Samaritan Kearney Nebraska United States 68847
    318 Saint Elizabeth Regional Medical Center Lincoln Nebraska United States 68510
    319 Nebraska Methodist Hospital Omaha Nebraska United States 68114
    320 Nebraska Medicine-Village Pointe Omaha Nebraska United States 68118
    321 Alegent Health Immanuel Medical Center Omaha Nebraska United States 68122
    322 Alegent Health Bergan Mercy Medical Center Omaha Nebraska United States 68124
    323 Alegent Health Lakeside Hospital Omaha Nebraska United States 68130
    324 Creighton University Medical Center Omaha Nebraska United States 68131
    325 University of Nebraska Medical Center Omaha Nebraska United States 68198
    326 Midlands Community Hospital Papillion Nebraska United States 68046
    327 Carson Tahoe Regional Medical Center Carson City Nevada United States 89703
    328 Cancer and Blood Specialists-Henderson Henderson Nevada United States 89052
    329 Comprehensive Cancer Centers of Nevada - Henderson Henderson Nevada United States 89052
    330 Comprehensive Cancer Centers of Nevada-Horizon Ridge Henderson Nevada United States 89052
    331 Las Vegas Cancer Center-Henderson Henderson Nevada United States 89052
    332 OptumCare Cancer Care at Seven Hills Henderson Nevada United States 89052
    333 Comprehensive Cancer Centers of Nevada-Southeast Henderson Henderson Nevada United States 89074
    334 GenesisCare USA - Henderson Henderson Nevada United States 89074
    335 Las Vegas Urology - Green Valley Henderson Nevada United States 89074
    336 Las Vegas Urology - Pebble Henderson Nevada United States 89074
    337 Urology Specialists of Nevada - Green Valley Henderson Nevada United States 89074
    338 Las Vegas Urology - Pecos Las Vegas Nevada United States 89074
    339 Desert West Surgery Las Vegas Nevada United States 89102
    340 OptumCare Cancer Care at Charleston Las Vegas Nevada United States 89102
    341 University Medical Center of Southern Nevada Las Vegas Nevada United States 89102
    342 Hope Cancer Care of Nevada Las Vegas Nevada United States 89103
    343 Cancer and Blood Specialists-Shadow Las Vegas Nevada United States 89106
    344 Radiation Oncology Centers of Nevada Central Las Vegas Nevada United States 89106
    345 Urology Specialists of Nevada - Central Las Vegas Nevada United States 89106
    346 GenesisCare USA - Las Vegas Las Vegas Nevada United States 89109
    347 HealthCare Partners Medical Group Oncology/Hematology-Maryland Parkway Las Vegas Nevada United States 89109
    348 Sunrise Hospital and Medical Center Las Vegas Nevada United States 89109
    349 HealthCare Partners Medical Group Oncology/Hematology-San Martin Las Vegas Nevada United States 89113
    350 Las Vegas Prostate Cancer Center Las Vegas Nevada United States 89113
    351 Las Vegas Urology - Sunset Las Vegas Nevada United States 89113
    352 Urology Specialists of Nevada - Southwest Las Vegas Nevada United States 89113
    353 Radiation Oncology Centers of Nevada Southeast Las Vegas Nevada United States 89119
    354 Ann M Wierman MD LTD Las Vegas Nevada United States 89128
    355 Cancer and Blood Specialists-Tenaya Las Vegas Nevada United States 89128
    356 Comprehensive Cancer Centers of Nevada - Northwest Las Vegas Nevada United States 89128
    357 GenesisCare USA - Vegas Tenaya Las Vegas Nevada United States 89128
    358 HealthCare Partners Medical Group Oncology/Hematology-Tenaya Las Vegas Nevada United States 89128
    359 Las Vegas Urology - Cathedral Rock Las Vegas Nevada United States 89128
    360 Las Vegas Urology - Smoke Ranch Las Vegas Nevada United States 89128
    361 OptumCare Cancer Care at MountainView Las Vegas Nevada United States 89128
    362 Urology Specialists of Nevada - Northwest Las Vegas Nevada United States 89128
    363 Alliance for Childhood Diseases/Cure 4 the Kids Foundation Las Vegas Nevada United States 89135
    364 Comprehensive Cancer Centers of Nevada - Town Center Las Vegas Nevada United States 89144
    365 Comprehensive Cancer Centers of Nevada-Summerlin Las Vegas Nevada United States 89144
    366 Summerlin Hospital Medical Center Las Vegas Nevada United States 89144
    367 Las Vegas Cancer Center-Medical Center Las Vegas Nevada United States 89148-2405
    368 Comprehensive Cancer Centers of Nevada Las Vegas Nevada United States 89148
    369 GenesisCare USA - Fort Apache Las Vegas Nevada United States 89148
    370 OptumCare Cancer Care at Fort Apache Las Vegas Nevada United States 89148
    371 HealthCare Partners Medical Group Oncology/Hematology-Centennial Hills Las Vegas Nevada United States 89149
    372 Comprehensive Cancer Centers of Nevada - Central Valley Las Vegas Nevada United States 89169
    373 University Cancer Center Las Vegas Nevada United States 89169
    374 Hope Cancer Care of Nevada-Pahrump Pahrump Nevada United States 89048
    375 Renown Regional Medical Center Reno Nevada United States 89502
    376 Saint Mary's Regional Medical Center Reno Nevada United States 89503
    377 Radiation Oncology Associates Reno Nevada United States 89509
    378 Memorial Sloan Kettering Basking Ridge Basking Ridge New Jersey United States 07920
    379 Memorial Sloan Kettering Monmouth Middletown New Jersey United States 07748
    380 Memorial Sloan Kettering Bergen Montvale New Jersey United States 07645
    381 New York-Presbyterian/Brooklyn Methodist Hospital Brooklyn New York United States 11215
    382 Maimonides Medical Center Brooklyn New York United States 11219
    383 Roswell Park Cancer Institute Buffalo New York United States 14263
    384 Memorial Sloan Kettering Commack Commack New York United States 11725
    385 Memorial Sloan Kettering Westchester Harrison New York United States 10604
    386 Northwell Health/Center for Advanced Medicine Lake Success New York United States 11042
    387 NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center New York New York United States 10032
    388 Memorial Sloan Kettering Cancer Center New York New York United States 10065
    389 NYP/Weill Cornell Medical Center New York New York United States 10065
    390 University of Rochester Rochester New York United States 14642
    391 State University of New York Upstate Medical University Syracuse New York United States 13210
    392 Memorial Sloan Kettering Nassau Uniondale New York United States 11553
    393 UNC Lineberger Comprehensive Cancer Center Chapel Hill North Carolina United States 27599
    394 Margaret R Pardee Memorial Hospital Hendersonville North Carolina United States 28791
    395 Essentia Health Cancer Center-South University Clinic Fargo North Dakota United States 58103
    396 Essentia Health - Jamestown Clinic Jamestown North Dakota United States 58401
    397 Indu and Raj Soin Medical Center Beavercreek Ohio United States 45431
    398 Strecker Cancer Center-Belpre Belpre Ohio United States 45714
    399 Saint Elizabeth Boardman Hospital Boardman Ohio United States 44512
    400 Dayton Physicians LLC-Miami Valley South Centerville Ohio United States 45459
    401 Miami Valley Hospital South Centerville Ohio United States 45459
    402 Adena Regional Medical Center Chillicothe Ohio United States 45601
    403 University of Cincinnati Cancer Center-UC Medical Center Cincinnati Ohio United States 45219
    404 Good Samaritan Hospital - Cincinnati Cincinnati Ohio United States 45220
    405 Oncology Hematology Care Inc-Kenwood Cincinnati Ohio United States 45236
    406 Bethesda North Hospital Cincinnati Ohio United States 45242
    407 TriHealth Cancer Institute-Westside Cincinnati Ohio United States 45247
    408 TriHealth Cancer Institute-Anderson Cincinnati Ohio United States 45255
    409 Ohio State University Comprehensive Cancer Center Columbus Ohio United States 43210
    410 Mount Carmel East Hospital Columbus Ohio United States 43213
    411 Columbus Oncology and Hematology Associates Inc Columbus Ohio United States 43214
    412 Riverside Methodist Hospital Columbus Ohio United States 43214
    413 Grant Medical Center Columbus Ohio United States 43215
    414 The Mark H Zangmeister Center Columbus Ohio United States 43219
    415 Mount Carmel Health Center West Columbus Ohio United States 43222
    416 Doctors Hospital Columbus Ohio United States 43228
    417 Good Samaritan Hospital - Dayton Dayton Ohio United States 45406
    418 Miami Valley Hospital Dayton Ohio United States 45409
    419 Dayton Physician LLC-Miami Valley Hospital North Dayton Ohio United States 45415
    420 Miami Valley Hospital North Dayton Ohio United States 45415
    421 Delaware Health Center-Grady Cancer Center Delaware Ohio United States 43015
    422 Grady Memorial Hospital Delaware Ohio United States 43015
    423 Dublin Methodist Hospital Dublin Ohio United States 43016
    424 Armes Family Cancer Center Findlay Ohio United States 45840
    425 Blanchard Valley Hospital Findlay Ohio United States 45840
    426 Orion Cancer Care Findlay Ohio United States 45840
    427 Atrium Medical Center-Middletown Regional Hospital Franklin Ohio United States 45005-1066
    428 Dayton Physicians LLC-Atrium Franklin Ohio United States 45005
    429 Central Ohio Breast and Endocrine Surgery Gahanna Ohio United States 43230
    430 Dayton Physicians LLC-Wayne Greenville Ohio United States 45331
    431 Wayne Hospital Greenville Ohio United States 45331
    432 Mount Carmel Grove City Hospital Grove City Ohio United States 43123
    433 Greater Dayton Cancer Center Kettering Ohio United States 45409
    434 First Dayton Cancer Care Kettering Ohio United States 45420
    435 Kettering Medical Center Kettering Ohio United States 45429
    436 Fairfield Medical Center Lancaster Ohio United States 43130
    437 Saint Rita's Medical Center Lima Ohio United States 45801
    438 OhioHealth Mansfield Hospital Mansfield Ohio United States 44903
    439 Marietta Memorial Hospital Marietta Ohio United States 45750
    440 OhioHealth Marion General Hospital Marion Ohio United States 43302
    441 Knox Community Hospital Mount Vernon Ohio United States 43050
    442 Licking Memorial Hospital Newark Ohio United States 43055
    443 Newark Radiation Oncology Newark Ohio United States 43055
    444 Mercy Health Perrysburg Cancer Center Perrysburg Ohio United States 43551
    445 Southern Ohio Medical Center Portsmouth Ohio United States 45662
    446 Springfield Regional Cancer Center Springfield Ohio United States 45504
    447 Springfield Regional Medical Center Springfield Ohio United States 45505
    448 Saint Vincent Mercy Medical Center Toledo Ohio United States 43608
    449 Mercy Health - Saint Anne Hospital Toledo Ohio United States 43623
    450 Dayton Physicians LLC-Upper Valley Troy Ohio United States 45373
    451 Upper Valley Medical Center Troy Ohio United States 45373
    452 Saint Joseph Warren Hospital Warren Ohio United States 44484
    453 University of Cincinnati Cancer Center-West Chester West Chester Ohio United States 45069
    454 Saint Ann's Hospital Westerville Ohio United States 43081
    455 Saint Elizabeth Youngstown Hospital Youngstown Ohio United States 44501
    456 Genesis Healthcare System Cancer Care Center Zanesville Ohio United States 43701
    457 Cancer Centers of Southwest Oklahoma Research Lawton Oklahoma United States 73505
    458 University of Oklahoma Health Sciences Center Oklahoma City Oklahoma United States 73104
    459 Mercy Hospital Oklahoma City Oklahoma City Oklahoma United States 73120
    460 Oklahoma Cancer Specialists and Research Institute-Tulsa Tulsa Oklahoma United States 74146
    461 Saint Alphonsus Medical Center-Baker City Baker City Oregon United States 97814
    462 Saint Charles Health System Bend Oregon United States 97701
    463 Clackamas Radiation Oncology Center Clackamas Oregon United States 97015
    464 Providence Cancer Institute Clackamas Clinic Clackamas Oregon United States 97015
    465 Bay Area Hospital Coos Bay Oregon United States 97420
    466 Providence Newberg Medical Center Newberg Oregon United States 97132
    467 Saint Alphonsus Medical Center-Ontario Ontario Oregon United States 97914
    468 Providence Portland Medical Center Portland Oregon United States 97213
    469 Providence Saint Vincent Medical Center Portland Oregon United States 97225
    470 Oregon Health and Science University Portland Oregon United States 97239
    471 Saint Charles Health System-Redmond Redmond Oregon United States 97756
    472 Lehigh Valley Hospital-Cedar Crest Allentown Pennsylvania United States 18103
    473 Lehigh Valley Hospital - Muhlenberg Bethlehem Pennsylvania United States 18017
    474 Pocono Medical Center East Stroudsburg Pennsylvania United States 18301
    475 UPMC Hillman Cancer Center Erie Erie Pennsylvania United States 16505
    476 Saint Vincent Hospital Erie Pennsylvania United States 16544
    477 UPMC Cancer Centers - Arnold Palmer Pavilion Greensburg Pennsylvania United States 15601
    478 Lehigh Valley Hospital-Hazleton Hazleton Pennsylvania United States 18201
    479 Jefferson Hospital Jefferson Hills Pennsylvania United States 15025
    480 Forbes Hospital Monroeville Pennsylvania United States 15146
    481 UPMC Cancer Center - Monroeville Monroeville Pennsylvania United States 15146
    482 UPMC Hillman Cancer Center - Monroeville Monroeville Pennsylvania United States 15146
    483 Arnold Palmer Cancer Center Medical Oncology Norwin N. Huntingdon Pennsylvania United States 15642
    484 Allegheny Valley Hospital Natrona Heights Pennsylvania United States 15065
    485 Allegheny General Hospital Pittsburgh Pennsylvania United States 15212
    486 West Penn Hospital Pittsburgh Pennsylvania United States 15224
    487 University of Pittsburgh Cancer Institute (UPCI) Pittsburgh Pennsylvania United States 15232
    488 UPMC-Shadyside Hospital Pittsburgh Pennsylvania United States 15232
    489 UPMC-Passavant Hospital Pittsburgh Pennsylvania United States 15237
    490 UPMC-Saint Clair Hospital Cancer Center Pittsburgh Pennsylvania United States 15243
    491 Wexford Health and Wellness Pavilion Wexford Pennsylvania United States 15090
    492 Medical University of South Carolina Charleston South Carolina United States 29425
    493 Vanderbilt-Ingram Cancer Center Cool Springs Franklin Tennessee United States 37067
    494 University of Tennessee - Knoxville Knoxville Tennessee United States 37920
    495 Vanderbilt Breast Center at One Hundred Oaks Nashville Tennessee United States 37204
    496 Vanderbilt University/Ingram Cancer Center Nashville Tennessee United States 37232
    497 Saint Joseph Regional Cancer Center Bryan Texas United States 77802
    498 UT Southwestern/Simmons Cancer Center-Dallas Dallas Texas United States 75390
    499 UT Southwestern/Simmons Cancer Center-Fort Worth Fort Worth Texas United States 76104
    500 UT Southwestern Clinical Center at Richardson/Plano Richardson Texas United States 75080
    501 Providence Regional Cancer System-Aberdeen Aberdeen Washington United States 98520
    502 Overlake Medical Center Bellevue Washington United States 98004
    503 PeaceHealth Saint Joseph Medical Center Bellingham Washington United States 98225
    504 Harrison HealthPartners Hematology and Oncology-Bremerton Bremerton Washington United States 98310
    505 Harrison Medical Center Bremerton Washington United States 98310
    506 Highline Medical Center-Main Campus Burien Washington United States 98166
    507 Providence Regional Cancer System-Centralia Centralia Washington United States 98531
    508 Swedish Cancer Institute-Edmonds Edmonds Washington United States 98026
    509 Saint Elizabeth Hospital Enumclaw Washington United States 98022
    510 Providence Regional Cancer Partnership Everett Washington United States 98201
    511 Saint Francis Hospital Federal Way Washington United States 98003
    512 Swedish Cancer Institute-Issaquah Issaquah Washington United States 98029
    513 Kadlec Clinic Hematology and Oncology Kennewick Washington United States 99336
    514 Providence Regional Cancer System-Lacey Lacey Washington United States 98503
    515 Saint Clare Hospital Lakewood Washington United States 98499
    516 PeaceHealth Saint John Medical Center Longview Washington United States 98632
    517 Harrison HealthPartners Hematology and Oncology-Poulsbo Poulsbo Washington United States 98370
    518 Valley Medical Center Renton Washington United States 98055
    519 Pacific Gynecology Specialists Seattle Washington United States 98104
    520 Swedish Medical Center-Ballard Campus Seattle Washington United States 98107
    521 Swedish Medical Center-First Hill Seattle Washington United States 98122-4307
    522 Swedish Medical Center-Cherry Hill Seattle Washington United States 98122-5711
    523 PeaceHealth United General Medical Center Sedro-Woolley Washington United States 98284
    524 Providence Regional Cancer System-Shelton Shelton Washington United States 98584
    525 Franciscan Research Center-Northwest Medical Plaza Tacoma Washington United States 98405
    526 Northwest Medical Specialties PLLC Tacoma Washington United States 98405
    527 PeaceHealth Southwest Medical Center Vancouver Washington United States 98664
    528 Providence Saint Mary Regional Cancer Center Walla Walla Washington United States 99362
    529 North Star Lodge Cancer Center at Yakima Valley Memorial Hospital Yakima Washington United States 98902
    530 Providence Regional Cancer System-Yelm Yelm Washington United States 98597
    531 Duluth Clinic Ashland Ashland Wisconsin United States 54806
    532 Northwest Wisconsin Cancer Center Ashland Wisconsin United States 54806
    533 Aurora Cancer Care-Southern Lakes VLCC Burlington Wisconsin United States 53105
    534 Aurora Saint Luke's South Shore Cudahy Wisconsin United States 53110
    535 Marshfield Medical Center-EC Cancer Center Eau Claire Wisconsin United States 54701
    536 Mayo Clinic Health System-Eau Claire Clinic Eau Claire Wisconsin United States 54701
    537 Aurora Health Care Germantown Health Center Germantown Wisconsin United States 53022
    538 Aurora Cancer Care-Grafton Grafton Wisconsin United States 53024
    539 Aurora BayCare Medical Center Green Bay Wisconsin United States 54311
    540 Aurora Cancer Care-Kenosha South Kenosha Wisconsin United States 53142
    541 Aurora Bay Area Medical Group-Marinette Marinette Wisconsin United States 54143
    542 Marshfield Medical Center-Marshfield Marshfield Wisconsin United States 54449
    543 Aurora Cancer Care-Milwaukee Milwaukee Wisconsin United States 53209
    544 Aurora Saint Luke's Medical Center Milwaukee Wisconsin United States 53215
    545 Aurora Sinai Medical Center Milwaukee Wisconsin United States 53233
    546 Marshfield Clinic-Minocqua Center Minocqua Wisconsin United States 54548
    547 ProHealth D N Greenwald Center Mukwonago Wisconsin United States 53149
    548 Cancer Center of Western Wisconsin New Richmond Wisconsin United States 54017
    549 ProHealth Oconomowoc Memorial Hospital Oconomowoc Wisconsin United States 53066
    550 Vince Lombardi Cancer Clinic - Oshkosh Oshkosh Wisconsin United States 54904
    551 Aurora Cancer Care-Racine Racine Wisconsin United States 53406
    552 Marshfield Medical Center-Rice Lake Rice Lake Wisconsin United States 54868
    553 Vince Lombardi Cancer Clinic-Sheboygan Sheboygan Wisconsin United States 53081
    554 Marshfield Medical Center-River Region at Stevens Point Stevens Point Wisconsin United States 54482
    555 Aurora Medical Center in Summit Summit Wisconsin United States 53066
    556 Vince Lombardi Cancer Clinic-Two Rivers Two Rivers Wisconsin United States 54241
    557 ProHealth Waukesha Memorial Hospital Waukesha Wisconsin United States 53188
    558 UW Cancer Center at ProHealth Care Waukesha Wisconsin United States 53188
    559 Aurora Cancer Care-Milwaukee West Wauwatosa Wisconsin United States 53226
    560 Aurora West Allis Medical Center West Allis Wisconsin United States 53227
    561 Marshfield Medical Center - Weston Weston Wisconsin United States 54476
    562 Billings Clinic-Cody Cody Wyoming United States 82414
    563 Welch Cancer Center Sheridan Wyoming United States 82801
    564 Pan American Center for Oncology Trials LLC San Juan Puerto Rico 00902

    Sponsors and Collaborators

    • National Cancer Institute (NCI)

    Investigators

    • Principal Investigator: Andrea B Apolo, Alliance for Clinical Trials in Oncology

    Study Documents (Full-Text)

    None provided.

    More Information

    Publications

    None provided.
    Responsible Party:
    National Cancer Institute (NCI)
    ClinicalTrials.gov Identifier:
    NCT03866382
    Other Study ID Numbers:
    • NCI-2019-01266
    • NCI-2019-01266
    • A031702
    • A031702
    • U10CA180821
    First Posted:
    Mar 7, 2019
    Last Update Posted:
    Aug 25, 2022
    Last Verified:
    Apr 1, 2022

    Study Results

    No Results Posted as of Aug 25, 2022