Genetic Testing in Guiding Treatment for Patients With Brain Metastases
Study Details
Study Description
Brief Summary
This phase II trial studies how well genetic testing works in guiding treatment for patients with solid tumors that have spread to the brain. Several genes have been found to be altered or mutated in brain metastases such as NTRK, ROS1, CDK or PI3K. Medications that target these genes such as abemaciclib, paxalisib, and entrectinib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Genetic testing may help doctors tailor treatment for each mutation.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
Phase 2 |
Detailed Description
PRIMARY OBJECTIVES:
-
To determine the activity of a CDK inhibitor in patients with progressive brain metastases derived from lung cancer, breast cancer, and other cancers harboring actionable genetic alterations associated with sensitivity to CDK inhibitors as measured by response rate (Response Assessment in Neuro-Oncology [RANO] criteria).
-
To determine the activity of a PI3K inhibitor in patients with progressive brain metastases derived from lung cancer, breast cancer, and other cancers harboring actionable genetic alterations in the PI3K pathway as measured by response rate (RANO criteria).
III: To determine the activity of an NTRK/ROS1 inhibitor in patients with progressive brain metastases derived from lung cancer harboring actionable NTRK/ROS1 gene fusions as measured by response rate (RANO criteria).
SECONDARY OBJECTIVES:
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To evaluate the systemic response by Response Evaluation Criteria in Solid Tumors (RECIST) criteria in each of the cohorts determined by treatment and primary cancer type.
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To evaluate the clinical benefit rate (complete response [CR] + partial response [PR] + stable disease [SD]) by Brain Metastases (BM)-RANO for central nervous system (CNS) in each of the cohorts determined by treatment and primary cancer type.
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To evaluate the clinical benefit rate (CR + PR + SD) by RECIST for extracranial disease in each of the cohorts determined by treatment and primary cancer type.
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To evaluate the duration of response by BM-RANO in each of the cohorts determined by treatment and primary cancer type.
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To evaluate the duration of response by RECIST in each of the cohorts determined by treatment and primary cancer type.
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To evaluate the progression-free survival for intracranial disease in each of the cohorts determined by treatment and primary cancer type.
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To evaluate the progression-free survival for extracranial disease in each of the cohorts determined by treatment and primary cancer type.
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To evaluate the site of first progression (CNS versus [vs] non-CNS) in each of the cohorts determined by treatment and primary cancer type.
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To evaluate the overall survival in each of the cohorts determined by treatment and primary cancer type.
-
To evaluate the toxicity profile of agents in patients with brain metastases in each of the cohorts determined by treatment and primary cancer type.
OUTLINE: Patients are assigned to 1 of 3 arms.
ARM I (CDK GENE MUTATION): Patients receive abemaciclib orally (PO) twice daily (BID) on days 1-28. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity.
ARM II (PI3K GENE MUTATION): Patients receive PI3K inhibitor paxalisib PO once daily (QD) on days 1-28. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity.
ARM III (NTRK/ROS1 GENE MUTATION): Patients receive entrectinib PO QD on days 1-28. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity.
After completion of study treatment, patients are followed up every 8 weeks for 2 years, then every 3 months for years 3-4, and then every 6 months thereafter for up to 5 years after registration.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: Arm I (CDK gene mutation) Patients receive abemaciclib PO BID on days 1-28. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. |
Drug: Abemaciclib
Given PO
|
| Experimental: Arm II (PI3K gene mutation) Patients receive PI3K inhibitor paxalisib PO QD on days 1-28. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. |
Drug: PI3K Inhibitor paxalisib
Given PO
|
| Experimental: Arm III (NTRK/ROS1 gene mutation) Patients receive entrectinib PO QD on days 1-28. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. |
Drug: Entrectinib
Given PO
|
Outcome Measures
Primary Outcome Measures
- Objective response rate in the brain [Up to 5 years]
Assessed per Response Assessment in Neuro-Oncology (RANO) criteria for brain metastases. The response rate is defined as the number of patients who have achieved complete response (CR) or partial response (PR) per RANO for brain metastases criteria during treatment with CDK, PI3K, or NTRK/ROS inhibitors divided by total number of evaluable patients. The response rate and associated exact confidence interval will be estimated within each cohort defined by the targeted agent and histology.
Secondary Outcome Measures
- Systemic response for extracranial disease [Up to 5 years]
Assessed with Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 criteria. Will be estimated using the systemic response rate (SRR) - where SRR is defined as the number of evaluable patients achieving a response (PR or CR per RECIST 1.1) during treatment with study therapy divided by the total number of evaluable patients. Point estimates will be generated for systemic response rates within each cohort with corresponding 95% binomial confidence intervals.
- Clinical benefit rate for central nervous system (CNS) [Up to 5 years]
Evaluated by Response Assessment in Neuro-Oncology (RANO) criteria. Will be estimated as the number of evaluable patients achieving stable disease (SD), partial response (PR), or complete response (CR) as their best objective response during treatment with protocol therapy divided by the total number of evaluable patients. Point estimates will be generated for clinical benefit rates within each cohort with corresponding 95% binomial confidence intervals.
- Clinical benefit rate for extracranial disease [Up to 5 years]
Assessed by Response Evaluation Criteria in Solid Tumors (RECIST). Will be estimated as the number of evaluable patients achieving stable disease (SD), partial response (PR), or complete response (CR) as their best objective response (per RECIST for extracranial disease) during treatment with protocol therapy divided by the total number of evaluable patients. Point estimates will be generated for clinical benefit rates within each cohort with corresponding 95% binomial confidence intervals.
- Duration of response for brain metastases [From the time measurement criteria are met for CR or PR for brain metastases until the first date that progressive CNS disease or death is documented, assessed up to 5 years]
Duration of response for brain metastases is defined for all evaluable patients who have achieved a confirmed response as the time from the date at which the patient's objective status for brain metastases is first noted to be a CR or PR (per Response Assessment in Neuro-Oncology [RANO] for brain metastases) to the date of the earliest progressive CNS disease is documented or death. The median and 95% confidence intervals will be estimated using the Kaplan-Meier estimator. No formal comparison will be made among the cohorts.
- Duration of response for extracranial disease [From the time measurement criteria are met for CR or PR for extracranial disease until the first date that progressive disease for extracranial disease or death is documented, assessed up to 5 years]
Duration of response for extracranial disease is defined for all evaluable patients who have achieved a confirmed response as the time from the date at which the patient's objective status for extranial disease is first noted to be a CR or PR (per RECIST1.1) to the date of the earliest progression (PD) for extracranial disease is documented or death. The median and 95% confidence intervals will be estimated using the Kaplan-Meier estimator. No formal comparison will be made among the cohorts.
- Progression-free survival (PFS) - intracranial [From first day of study treatment to the earliest date documentation of intracranial disease progression or death from any cause, assessed up to 5 years]
Intracranial PFS is defined as the time from the first day of study treatment to the earliest date of intracranial disease progression (per RANO for brain metastases) or death from any cause, whichever comes first. The median and 95% confidence intervals will be estimated using the Kaplan-Meier estimator. No formal comparison will be made among the cohorts.
- Progression-free survival (PFS) - extracranial [From the first day of study treatment to the earliest date of documentation of extracranial disease progression or death from any cause, assessed up to 5 years]
Extracranial PFS is defined as the time from the first day of study treatment to the earliest date of extracranial disease progression (per RECIST1.1) or death from any cause, whichever comes first. The median and 95% confidence intervals will be estimated using the Kaplan-Meier estimator. No formal comparison will be made among the cohorts.
- Site of first progression [Up to 24 months]
The site of first progression will be estimated descriptively within each cohort within 12 and 24 months after starting protocol treatment. The first progression is defined as the first documented central nervous system (CNS) progression per Response Assessment in Neuro-Oncology (RANO) or extracranial progression per Response Evaluation Criteria in Solid Tumors (RECIST), whichever occurs first. The percentage of extracranial progression at first progression within 12 and 24 months after starting protocol treatment will be estimated as number of patients who experience the first progression which is extracranial progression divided by number of patients who are still at risk up to 12 and 24 months, respectively.
- Overall survival [From the first day of study treatment to death due to any cause, assessed up to 5 years]
Overall survival is defined as the time from the first day of study treatment to death due to any cause. The median and 95% confidence intervals are estimated using the Kaplan-Meier estimator. No formal comparison will be made among the cohorts.
- Incidence of adverse events [Up to 5 years]
Assessed per National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) version 5.0, toxicity is defined as adverse events that are classified as possibly, probably, or definitely related to study treatment. Toxicities will be evaluated via the ordinal CTCAE standard toxicity grading. Overall toxicity incidence as well as toxicity profiles by patient and treatment cohort will be explored and summarized. Frequency distributions, graphical techniques and other descriptive measures will form the basis of the analysis. No formal comparison will be made among the cohorts.
Eligibility Criteria
Criteria
Inclusion Criteria:
PRE-REGISTRATION ELIGIBILITY CRITERIA (ALL PATIENTS) • Tissue available for biomarker testing (any brain metastasis tissue and extracranial site from any prior resection or biopsy).
REGISTRATION ELIGIBILITY CRITERIA (ALL PATIENTS)
-
Participants must have histologically confirmed parenchymal metastatic disease to the brain from any solid tumor. Note: this includes patients that have controlled extracranial disease with progressive intracranial metastasis, as well as patients that have progressive intracranial and extracranial disease.
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New or progressive brain metastases are defined as any one of the following:
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Untreated measurable lesions in patients who have received surgery and/or stereotactic radiosurgery (SRS) to one or more other lesions.
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Progressive measurable lesions after radiation, surgery, or prior systemic therapy
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Residual or progressive lesions after surgery if asymptomatic.
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Patients who have had prior whole-brain radiotherapy (WBRT) and/or SRS and then whose lesions have progressed by BM-RANO criteria or there are new lesions, are eligible. Lesions treated with SRS may be eligible if there is unequivocal evidence of progression. For patients with NTRK or ROS1 mutations, entrectinib may be used for newly diagnosed brain metastases.
-
Patients who have not previously been treated with cranial radiation (e.g. WBRT or SRS) are eligible, but such patients must be asymptomatic or neurologically stable from their CNS metastases.
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Measurable CNS disease (=> 10 mm).
-
Ability to obtain magnetic resonance imaging (MRI)s with contrast
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No surgery within 2 weeks prior to or after registration.
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No chemotherapy within 14 days prior to registration (Note: for abemaciclib arm, a 21-day chemotherapy washout is required).
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For melanoma, patients must have progressed after prior immune checkpoint blockade or for BRAF positive melanoma, BRAF/MEK inhibitors.
-
For lung cancer, EGFR mutant patients must have failed EGFR therapies
-
For HER2-positive breast cancer patients (regardless of ER/PR status), patients must have received at least one prior HER-2 directed therapy in the metastatic setting.
-
For triple negative breast cancer (TNBC), patients must have received at least one chemotherapy in the metastatic setting.
-
For estrogen receptor (ER) and/or progesterone receptor (PR)+ HER2-negative breast cancer, patients must have received at least one endocrine therapy in the metastatic setting.
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Patients who have received prior treatment with any of the targeted treatments on this study are not eligible for that specific treatment arm(s), but could be eligible for other arms (e.g., a patient who has had prior treatment with abemaciclib would not be eligible for the abemaciclib arm, but could be eligible for another arm).
-
Presence of clinically actionable alteration in NTRK, ROS1, or CDK pathway or PI3K pathway in both a brain metastasis and extracranial site per central review.
-
Not pregnant and not nursing, because this study involves investigational agents whose genotoxic, mutagenic and teratogenic effects on the developing fetus and newborn are unknown. Therefore, for women of childbearing potential only, a negative pregnancy test done =< 14 days prior to registration is required (Note: for abemaciclib arm, pregnancy test is required =< 7 days prior to registration).
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No known current diffuse leptomeningeal involvement (diffuse defined as leptomeningeal involvement throughout the CNS axis; if there is documented positive CSF cytology, patient is ineligible).
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Eastern Cooperative Oncology Group (ECOG) performance status 0-2.
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Adequate organ function.
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Absolute neutrophil count (ANC) >= 1,500/mm^3.
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Platelet count >= 100,000/mm^3.
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Total bilirubin =< 1.5 x upper limit of normal (ULN) except in patients with Gilbert's disease. Patients with Gilbert's syndrome with a total bilirubin ≤2.0 times ULN and direct bilirubin within normal limits are permitted.
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Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) =< 2.5 x upper limit of normal (ULN).
-
Creatinine =< 1.5 mg/dL OR calculated (Calc.) creatinine clearance > 45 mL/min.
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No uncontrolled medical comorbidities per investigator discretion (e.g. interstitial lung disease, severe dyspnea at rest or requiring oxygen therapy, severe renal impairment [e.g. estimated creatinine clearance <30ml/min], history of major surgical resection involving the stomach or small bowel, or preexisting Crohn's disease or ulcerative colitis or a preexisting chronic condition resulting in baseline Grade 2 or higher diarrhea)
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Radiation to symptomatic non-target sites within neural axis is allowed prior to registration without washout (provided there is at least one untreated target lesion for measurement on study and radiation is completed prior to registration).
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Concurrent systemic corticosteroids are allowed if stable dose of dexamethasone for 7 days prior to registration. Baseline doses and changes in steroid dosing will be captured.
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No concurrent administration of anticancer therapies (except for endocrine therapy or continuation of hormonal therapy or trastuzumab in breast cancer patients). No chemotherapy, targeted therapy or immunotherapy within 14 days prior to entering the study (Note: For abemaciclib arm, a 21-day chemotherapy washout is required).
-
Chronic concomitant treatment with strong inhibitors of CYP3A4 is not allowed on this study. Patients on strong CYP3A4 inhibitors must discontinue the drug 14 days prior to registration on the study.
-
Chronic concomitant treatment with strong CYP3A4 inducers is not allowed. Patients must discontinue the drug 14 days prior to the start of study treatment.
ADDITIONAL REGISTRATION ELIGIBILITY CRITERIA FOR PAXALISIB ARM
-
Urine protein to creatinine (UPC) ratio < 1 or urine protein =< 1.
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Recent acute myocardial infarction in the last 6 months or current angina pectoris are excluded. Patients with symptomatic bradycardia should have an electrocardiogram at baseline. If QT interval > 470 msec, the patient is excluded.
-
Patients with uncontrolled type I or II diabetes mellitus should be excluded. Uncontrolled diabetes is defined as glycosylated hemoglobin (HbA1c) > 9% in addition to fasting glucose > 140 mg/dL on at least 2 occasions within 14 days prior to registration.
ADDITIONAL REGISTRATION ELIGIBILITY CRITERION FOR ENTRECTINIB ARM
• Concurrent use of H2 receptor antagonists, receptor antagonists, proton pump inhibitors (PPIs), and/or antacids are prohibited.
ADDITIONAL REGISTRATION ELIGIBILITY CRITERION FOR ABEMACICLIB ARM
-
Hemoglobin >= g/dL. Patients may receive erythrocyte transfusions to achieve this hemoglobin level at the discretion of the investigator. Initial treatment must not begin earlier than the day after the erythrocyte transfusion.
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Patients who received chemotherapy must have recovered (Common Terminology Criteria for Adverse Events [CTCAE] Grade ≤1) from the acute effects of chemotherapy except for residual alopecia or Grade 2 peripheral neuropathy prior to registration. A washout period of at least 21 days is required between last chemotherapy dose and registration (provided the patient did not receive radiotherapy).
-
Patients who received adjuvant radiotherapy must have completed and fully recovered from the acute effects of radiotherapy. A washout period of at least 14 days is required between end of radiotherapy and registration.
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Breast cancer patients who have received ribociclib or palbociclib are eligible as long as there is documentation of CDK4/6 pathway alteration on a biopsy or resection at the point of progression post-ribociclib or palbociclib.
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For females of childbearing potential: A female of childbearing potential, must have a negative serum pregnancy test within 7 days prior to registration and agree to use a highly effective contraception method during the treatment period and for 3 weeks following the last dose of abemaciclib. Contraceptive methods may include an intrauterine device [IUD] or barrier method. If condoms are used as a barrier method, a spermicidal agent should be added as a double barrier protection. Cases of pregnancy that occur during maternal exposures to abemaciclib should be reported. If a patient or spouse/partner is determined to be pregnant following abemaciclib initiation, she must discontinue treatment immediately. Data on fetal outcome and breast-feeding are to be collected for regulatory reporting and drug safety evaluation.
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Patients with active bacterial infection (requiring intravenous [IV] antibiotics at time of initiating study treatment), fungal infection, or detectable viral infection (such as known human immunodeficiency virus positivity or with known active hepatitis B or C [for example, hepatitis B surface antigen positive] are excluded. Screening is not required for enrollment.
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Patients with personal history of any of the following conditions: syncope of cardiovascular etiology, ventricular arrhythmia of pathological origin (including, but not limited to, ventricular tachycardia and ventricular fibrillation), or sudden cardiac arrest, are excluded.
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 | Cancer Center at Saint Joseph's | Phoenix | Arizona | United States | 85004 |
| 10 | Mayo Clinic Hospital in Arizona | Phoenix | Arizona | United States | 85054 |
| 11 | Mayo Clinic in Arizona | Scottsdale | Arizona | United States | 85259 |
| 12 | Mercy Hospital Fort Smith | Fort Smith | Arkansas | United States | 72903 |
| 13 | CHI Saint Vincent Cancer Center Hot Springs | Hot Springs | Arkansas | United States | 71913 |
| 14 | Mission Hope Medical Oncology - Arroyo Grande | Arroyo Grande | California | United States | 93420 |
| 15 | Providence Saint Joseph Medical Center/Disney Family Cancer Center | Burbank | California | United States | 91505 |
| 16 | Epic Care-Dublin | Dublin | California | United States | 94568 |
| 17 | Bay Area Breast Surgeons Inc | Emeryville | California | United States | 94608 |
| 18 | Epic Care Partners in Cancer Care | Emeryville | California | United States | 94608 |
| 19 | UC San Diego Moores Cancer Center | La Jolla | California | United States | 92093 |
| 20 | Cedars Sinai Medical Center | Los Angeles | California | United States | 90048 |
| 21 | Contra Costa Regional Medical Center | Martinez | California | United States | 94553-3156 |
| 22 | Alta Bates Summit Medical Center - Summit Campus | Oakland | California | United States | 94609 |
| 23 | Bay Area Tumor Institute | Oakland | California | United States | 94609 |
| 24 | UC Irvine Health/Chao Family Comprehensive Cancer Center | Orange | California | United States | 92868 |
| 25 | Sharp Memorial Hospital | San Diego | California | United States | 92123 |
| 26 | Pacific Central Coast Health Center-San Luis Obispo | San Luis Obispo | California | United States | 93401 |
| 27 | Mission Hope Medical Oncology - Santa Maria | Santa Maria | California | United States | 93444 |
| 28 | Torrance Memorial Physician Network - Cancer Care | Torrance | California | United States | 90505 |
| 29 | Torrance Memorial Medical Center | Torrance | California | United States | 90509 |
| 30 | Epic Care Cyberknife Center | Walnut Creek | California | United States | 94597 |
| 31 | Penrose-Saint Francis Healthcare | Colorado Springs | Colorado | United States | 80907 |
| 32 | Rocky Mountain Cancer Centers-Penrose | Colorado Springs | Colorado | United States | 80907 |
| 33 | Porter Adventist Hospital | Denver | Colorado | United States | 80210 |
| 34 | Mercy Medical Center | Durango | Colorado | United States | 81301 |
| 35 | Southwest Oncology PC | Durango | Colorado | United States | 81301 |
| 36 | Saint Anthony Hospital | Lakewood | Colorado | United States | 80228 |
| 37 | Littleton Adventist Hospital | Littleton | Colorado | United States | 80122 |
| 38 | Longmont United Hospital | Longmont | Colorado | United States | 80501 |
| 39 | Rocky Mountain Cancer Centers-Longmont | Longmont | Colorado | United States | 80501 |
| 40 | Parker Adventist Hospital | Parker | Colorado | United States | 80138 |
| 41 | Saint Mary Corwin Medical Center | Pueblo | Colorado | United States | 81004 |
| 42 | Smilow Cancer Center/Yale-New Haven Hospital | New Haven | Connecticut | United States | 06510 |
| 43 | Yale University | New Haven | Connecticut | United States | 06520 |
| 44 | Boca Raton Regional Hospital | Boca Raton | Florida | United States | 33486 |
| 45 | UM Sylvester Comprehensive Cancer Center at Coral Gables | Coral Gables | Florida | United States | 33146 |
| 46 | UM Sylvester Comprehensive Cancer Center at Deerfield Beach | Deerfield Beach | Florida | United States | 33442 |
| 47 | Holy Cross Hospital | Fort Lauderdale | Florida | United States | 33308 |
| 48 | Mayo Clinic in Florida | Jacksonville | Florida | United States | 32224-9980 |
| 49 | University of Miami Miller School of Medicine-Sylvester Cancer Center | Miami | Florida | United States | 33136 |
| 50 | Emory University Hospital Midtown | Atlanta | Georgia | United States | 30308 |
| 51 | Emory University Hospital/Winship Cancer Institute | Atlanta | Georgia | United States | 30322 |
| 52 | Emory Saint Joseph's Hospital | Atlanta | Georgia | United States | 30342 |
| 53 | Saint Alphonsus Cancer Care Center-Boise | Boise | Idaho | United States | 83706 |
| 54 | Saint Luke's Cancer Institute - Boise | Boise | Idaho | United States | 83712 |
| 55 | Saint Alphonsus Cancer Care Center-Caldwell | Caldwell | Idaho | United States | 83605 |
| 56 | Kootenai Health - Coeur d'Alene | Coeur d'Alene | Idaho | United States | 83814 |
| 57 | Walter Knox Memorial Hospital | Emmett | Idaho | United States | 83617 |
| 58 | Saint Luke's Cancer Institute - Fruitland | Fruitland | Idaho | United States | 83619 |
| 59 | Idaho Urologic Institute-Meridian | Meridian | Idaho | United States | 83642 |
| 60 | Saint Luke's Cancer Institute - Meridian | Meridian | Idaho | United States | 83642 |
| 61 | Saint Alphonsus Medical Center-Nampa | Nampa | Idaho | United States | 83686 |
| 62 | Saint Luke's Cancer Institute - Nampa | Nampa | Idaho | United States | 83686 |
| 63 | Kootenai Clinic Cancer Services - Post Falls | Post Falls | Idaho | United States | 83854 |
| 64 | Kootenai Cancer Clinic | Sandpoint | Idaho | United States | 83864 |
| 65 | Saint Luke's Cancer Institute - Twin Falls | Twin Falls | Idaho | United States | 83301 |
| 66 | Saint Anthony's Health | Alton | Illinois | United States | 62002 |
| 67 | Rush - Copley Medical Center | Aurora | Illinois | United States | 60504 |
| 68 | Northwestern University | Chicago | Illinois | United States | 60611 |
| 69 | Rush University Medical Center | Chicago | Illinois | United States | 60612 |
| 70 | University of Illinois | Chicago | Illinois | United States | 60612 |
| 71 | University of Chicago Comprehensive Cancer Center | Chicago | Illinois | United States | 60637 |
| 72 | Carle on Vermilion | Danville | Illinois | United States | 61832 |
| 73 | Carle Physician Group-Effingham | Effingham | Illinois | United States | 62401 |
| 74 | Northwestern Medicine Lake Forest Hospital | Lake Forest | Illinois | United States | 60045 |
| 75 | Carle Physician Group-Mattoon/Charleston | Mattoon | Illinois | United States | 61938 |
| 76 | Good Samaritan Regional Health Center | Mount Vernon | Illinois | United States | 62864 |
| 77 | Carle Cancer Center | Urbana | Illinois | United States | 61801 |
| 78 | The Carle Foundation Hospital | Urbana | Illinois | United States | 61801 |
| 79 | Rush-Copley Healthcare Center | Yorkville | Illinois | United States | 60560 |
| 80 | Mary Greeley Medical Center | Ames | Iowa | United States | 50010 |
| 81 | McFarland Clinic PC - Ames | Ames | Iowa | United States | 50010 |
| 82 | McFarland Clinic PC-Boone | Boone | Iowa | United States | 50036 |
| 83 | Saint Anthony Regional Hospital | Carroll | Iowa | United States | 51401 |
| 84 | Medical Oncology and Hematology Associates-West Des Moines | Clive | Iowa | United States | 50325 |
| 85 | Mercy Cancer Center-West Lakes | Clive | Iowa | United States | 50325 |
| 86 | Alegent Health Mercy Hospital | Council Bluffs | Iowa | United States | 51503 |
| 87 | Greater Regional Medical Center | Creston | Iowa | United States | 50801 |
| 88 | Iowa Methodist Medical Center | Des Moines | Iowa | United States | 50309 |
| 89 | Medical Oncology and Hematology Associates-Des Moines | Des Moines | Iowa | United States | 50309 |
| 90 | Broadlawns Medical Center | Des Moines | Iowa | United States | 50314 |
| 91 | Medical Oncology and Hematology Associates-Laurel | Des Moines | Iowa | United States | 50314 |
| 92 | Mercy Medical Center - Des Moines | Des Moines | Iowa | United States | 50314 |
| 93 | Iowa Lutheran Hospital | Des Moines | Iowa | United States | 50316 |
| 94 | McFarland Clinic PC-Trinity Cancer Center | Fort Dodge | Iowa | United States | 50501 |
| 95 | Trinity Regional Medical Center | Fort Dodge | Iowa | United States | 50501 |
| 96 | University of Iowa/Holden Comprehensive Cancer Center | Iowa City | Iowa | United States | 52242 |
| 97 | McFarland Clinic PC-Jefferson | Jefferson | Iowa | United States | 50129 |
| 98 | McFarland Clinic PC-Marshalltown | Marshalltown | Iowa | United States | 50158 |
| 99 | Methodist West Hospital | West Des Moines | Iowa | United States | 50266-7700 |
| 100 | Mercy Medical Center-West Lakes | West Des Moines | Iowa | United States | 50266 |
| 101 | Central Care Cancer Center - Garden City | Garden City | Kansas | United States | 67846 |
| 102 | Central Care Cancer Center - Great Bend | Great Bend | Kansas | United States | 67530 |
| 103 | HaysMed University of Kansas Health System | Hays | Kansas | United States | 67601 |
| 104 | University of Kansas Cancer Center | Kansas City | Kansas | United States | 66160 |
| 105 | University of Kansas Cancer Center-Overland Park | Overland Park | Kansas | United States | 66210 |
| 106 | University of Kansas Hospital-Westwood Cancer Center | Westwood | Kansas | United States | 66205 |
| 107 | Flaget Memorial Hospital | Bardstown | Kentucky | United States | 40004 |
| 108 | Commonwealth Cancer Center-Corbin | Corbin | Kentucky | United States | 40701 |
| 109 | Saint Joseph Radiation Oncology Resource Center | Lexington | Kentucky | United States | 40504 |
| 110 | Saint Joseph Hospital East | Lexington | Kentucky | United States | 40509 |
| 111 | University of Kentucky/Markey Cancer Center | Lexington | Kentucky | United States | 40536 |
| 112 | Saint Joseph London | London | Kentucky | United States | 40741 |
| 113 | Jewish Hospital | Louisville | Kentucky | United States | 40202 |
| 114 | Saints Mary and Elizabeth Hospital | Louisville | Kentucky | United States | 40215 |
| 115 | UofL Health Medical Center Northeast | Louisville | Kentucky | United States | 40245 |
| 116 | Jewish Hospital Medical Center South | Shepherdsville | Kentucky | United States | 40165 |
| 117 | Ochsner LSU Health Monroe Medical Center | Monroe | Louisiana | United States | 71202 |
| 118 | Louisiana State University Health Science Center | New Orleans | Louisiana | United States | 70112 |
| 119 | Tulane University Health Sciences Center | New Orleans | Louisiana | United States | 70112 |
| 120 | University Medical Center New Orleans | New Orleans | Louisiana | United States | 70112 |
| 121 | Ochsner LSU Health Saint Mary's Medical Center | Shreveport | Louisiana | United States | 71101 |
| 122 | LSU Health Sciences Center at Shreveport | Shreveport | Louisiana | United States | 71103 |
| 123 | Massachusetts General Hospital Cancer Center | Boston | Massachusetts | United States | 02114 |
| 124 | Dana-Farber Cancer Institute | Boston | Massachusetts | United States | 02215 |
| 125 | Mercy Medical Center | Springfield | Massachusetts | United States | 01104 |
| 126 | Hickman Cancer Center | Adrian | Michigan | United States | 49221 |
| 127 | Saint Joseph Mercy Hospital | Ann Arbor | Michigan | United States | 48106 |
| 128 | University of Michigan Comprehensive Cancer Center | Ann Arbor | Michigan | United States | 48109 |
| 129 | Bronson Battle Creek | Battle Creek | Michigan | United States | 49017 |
| 130 | IHA Hematology Oncology Consultants-Brighton | Brighton | Michigan | United States | 48114 |
| 131 | Saint Joseph Mercy Brighton | Brighton | Michigan | United States | 48114 |
| 132 | Henry Ford Cancer Institute-Downriver | Brownstown | Michigan | United States | 48183 |
| 133 | IHA Hematology Oncology Consultants-Canton | Canton | Michigan | United States | 48188 |
| 134 | Saint Joseph Mercy Canton | Canton | Michigan | United States | 48188 |
| 135 | Caro Cancer Center | Caro | Michigan | United States | 48723 |
| 136 | IHA Hematology Oncology Consultants-Chelsea | Chelsea | Michigan | United States | 48118 |
| 137 | Saint Joseph Mercy Chelsea | Chelsea | Michigan | United States | 48118 |
| 138 | Hematology Oncology Consultants-Clarkston | Clarkston | Michigan | United States | 48346 |
| 139 | Newland Medical Associates-Clarkston | Clarkston | Michigan | United States | 48346 |
| 140 | Henry Ford Macomb Hospital-Clinton Township | Clinton Township | Michigan | United States | 48038 |
| 141 | Henry Ford Medical Center-Fairlane | Dearborn | Michigan | United States | 48126 |
| 142 | Henry Ford Hospital | Detroit | Michigan | United States | 48202 |
| 143 | Ascension Saint John Hospital | Detroit | Michigan | United States | 48236 |
| 144 | Great Lakes Cancer Management Specialists-Doctors Park | East China Township | Michigan | United States | 48054 |
| 145 | Genesee Cancer and Blood Disease Treatment Center | Flint | Michigan | United States | 48503 |
| 146 | Genesee Hematology Oncology PC | Flint | Michigan | United States | 48503 |
| 147 | Genesys Hurley Cancer Institute | Flint | Michigan | United States | 48503 |
| 148 | Hurley Medical Center | Flint | Michigan | United States | 48503 |
| 149 | Helen DeVos Children's Hospital at Spectrum Health | Grand Rapids | Michigan | United States | 49503 |
| 150 | Mercy Health Saint Mary's | Grand Rapids | Michigan | United States | 49503 |
| 151 | Spectrum Health at Butterworth Campus | Grand Rapids | Michigan | United States | 49503 |
| 152 | Academic Hematology Oncology Specialists | Grosse Pointe Woods | Michigan | United States | 48236 |
| 153 | Great Lakes Cancer Management Specialists-Van Elslander Cancer Center | Grosse Pointe Woods | Michigan | United States | 48236 |
| 154 | Michigan Breast Specialists-Grosse Pointe Woods | Grosse Pointe Woods | Michigan | United States | 48236 |
| 155 | Allegiance Health | Jackson | Michigan | United States | 49201 |
| 156 | Bronson Methodist Hospital | Kalamazoo | Michigan | United States | 49007 |
| 157 | West Michigan Cancer Center | Kalamazoo | Michigan | United States | 49007 |
| 158 | Ascension Borgess Cancer Center | Kalamazoo | Michigan | United States | 49009 |
| 159 | Borgess Medical Center | Kalamazoo | Michigan | United States | 49048 |
| 160 | Sparrow Hospital | Lansing | Michigan | United States | 48912 |
| 161 | Hope Cancer Clinic | Livonia | Michigan | United States | 48154 |
| 162 | Saint Mary Mercy Hospital | Livonia | Michigan | United States | 48154 |
| 163 | Great Lakes Cancer Management Specialists-Macomb Medical Campus | Macomb | Michigan | United States | 48044 |
| 164 | Michigan Breast Specialists-Macomb Township | Macomb | Michigan | United States | 48044 |
| 165 | Saint Mary's Oncology/Hematology Associates of Marlette | Marlette | Michigan | United States | 48453 |
| 166 | Toledo Clinic Cancer Centers-Monroe | Monroe | Michigan | United States | 48162 |
| 167 | Mercy Health Mercy Campus | Muskegon | Michigan | United States | 49444 |
| 168 | Lakeland Hospital Niles | Niles | Michigan | United States | 49120 |
| 169 | Cancer and Hematology Centers of Western Michigan - Norton Shores | Norton Shores | Michigan | United States | 49444 |
| 170 | Ascension Providence Hospitals - Novi | Novi | Michigan | United States | 48374 |
| 171 | Henry Ford Medical Center-Columbus | Novi | Michigan | United States | 48377 |
| 172 | 21st Century Oncology-Pontiac | Pontiac | Michigan | United States | 48341 |
| 173 | Hope Cancer Center | Pontiac | Michigan | United States | 48341 |
| 174 | Newland Medical Associates-Pontiac | Pontiac | Michigan | United States | 48341 |
| 175 | Saint Joseph Mercy Oakland | Pontiac | Michigan | United States | 48341 |
| 176 | Spectrum Health Reed City Hospital | Reed City | Michigan | United States | 49677 |
| 177 | Great Lakes Cancer Management Specialists-Rochester Hills | Rochester Hills | Michigan | United States | 48309 |
| 178 | Ascension Saint Mary's Hospital | Saginaw | Michigan | United States | 48601 |
| 179 | Oncology Hematology Associates of Saginaw Valley PC | Saginaw | Michigan | United States | 48604 |
| 180 | Lakeland Medical Center Saint Joseph | Saint Joseph | Michigan | United States | 49085 |
| 181 | Marie Yeager Cancer Center | Saint Joseph | Michigan | United States | 49085 |
| 182 | Henry Ford Macomb Health Center - Shelby Township | Shelby | Michigan | United States | 48315 |
| 183 | Ascension Providence Hospitals - Southfield | Southfield | Michigan | United States | 48075 |
| 184 | Bhadresh Nayak MD PC-Sterling Heights | Sterling Heights | Michigan | United States | 48312 |
| 185 | Ascension Saint Joseph Hospital | Tawas City | Michigan | United States | 48764 |
| 186 | Munson Medical Center | Traverse City | Michigan | United States | 49684 |
| 187 | Advanced Breast Care Center PLLC | Warren | Michigan | United States | 48088 |
| 188 | Great Lakes Cancer Management Specialists-Macomb Professional Building | Warren | Michigan | United States | 48093 |
| 189 | Macomb Hematology Oncology PC | Warren | Michigan | United States | 48093 |
| 190 | Michigan Breast Specialists-Warren | Warren | Michigan | United States | 48093 |
| 191 | Saint John Macomb-Oakland Hospital | Warren | Michigan | United States | 48093 |
| 192 | Henry Ford West Bloomfield Hospital | West Bloomfield | Michigan | United States | 48322 |
| 193 | Saint Mary's Oncology/Hematology Associates of West Branch | West Branch | Michigan | United States | 48661 |
| 194 | Metro Health Hospital | Wyoming | Michigan | United States | 49519 |
| 195 | Huron Gastroenterology PC | Ypsilanti | Michigan | United States | 48106 |
| 196 | IHA Hematology Oncology Consultants-Ann Arbor | Ypsilanti | Michigan | United States | 48197 |
| 197 | Fairview Ridges Hospital | Burnsville | Minnesota | United States | 55337 |
| 198 | Minnesota Oncology - Burnsville | Burnsville | Minnesota | United States | 55337 |
| 199 | Cambridge Medical Center | Cambridge | Minnesota | United States | 55008 |
| 200 | Mercy Hospital | Coon Rapids | Minnesota | United States | 55433 |
| 201 | Fairview Southdale Hospital | Edina | Minnesota | United States | 55435 |
| 202 | Unity Hospital | Fridley | Minnesota | United States | 55432 |
| 203 | Fairview Clinics and Surgery Center Maple Grove | Maple Grove | Minnesota | United States | 55369 |
| 204 | Minnesota Oncology Hematology PA-Maplewood | Maplewood | Minnesota | United States | 55109 |
| 205 | Saint John's Hospital - Healtheast | Maplewood | Minnesota | United States | 55109 |
| 206 | Abbott-Northwestern Hospital | Minneapolis | Minnesota | United States | 55407 |
| 207 | Hennepin County Medical Center | Minneapolis | Minnesota | United States | 55415 |
| 208 | Health Partners Inc | Minneapolis | Minnesota | United States | 55454 |
| 209 | Monticello Cancer Center | Monticello | Minnesota | United States | 55362 |
| 210 | New Ulm Medical Center | New Ulm | Minnesota | United States | 56073 |
| 211 | Fairview Northland Medical Center | Princeton | Minnesota | United States | 55371 |
| 212 | North Memorial Medical Health Center | Robbinsdale | Minnesota | United States | 55422 |
| 213 | Mayo Clinic in Rochester | Rochester | Minnesota | United States | 55905 |
| 214 | Coborn Cancer Center at Saint Cloud Hospital | Saint Cloud | Minnesota | United States | 56303 |
| 215 | Park Nicollet Clinic - Saint Louis Park | Saint Louis Park | Minnesota | United States | 55416 |
| 216 | Regions Hospital | Saint Paul | Minnesota | United States | 55101 |
| 217 | United Hospital | Saint Paul | Minnesota | United States | 55102 |
| 218 | Saint Francis Regional Medical Center | Shakopee | Minnesota | United States | 55379 |
| 219 | Lakeview Hospital | Stillwater | Minnesota | United States | 55082 |
| 220 | Ridgeview Medical Center | Waconia | Minnesota | United States | 55387 |
| 221 | Rice Memorial Hospital | Willmar | Minnesota | United States | 56201 |
| 222 | Minnesota Oncology Hematology PA-Woodbury | Woodbury | Minnesota | United States | 55125 |
| 223 | Fairview Lakes Medical Center | Wyoming | Minnesota | United States | 55092 |
| 224 | University of Mississippi Medical Center | Jackson | Mississippi | United States | 39216 |
| 225 | Saint Louis Cancer and Breast Institute-Ballwin | Ballwin | Missouri | United States | 63011 |
| 226 | Central Care Cancer Center - Bolivar | Bolivar | Missouri | United States | 65613 |
| 227 | Cox Cancer Center Branson | Branson | Missouri | United States | 65616 |
| 228 | University of Missouri - Ellis Fischel | Columbia | Missouri | United States | 65212 |
| 229 | Siteman Cancer Center at West County Hospital | Creve Coeur | Missouri | United States | 63141 |
| 230 | Freeman Health System | Joplin | Missouri | United States | 64804 |
| 231 | Mercy Hospital Joplin | Joplin | Missouri | United States | 64804 |
| 232 | University of Kansas Cancer Center - North | Kansas City | Missouri | United States | 64154 |
| 233 | University of Kansas Cancer Center - Lee's Summit | Lee's Summit | Missouri | United States | 64064 |
| 234 | University of Kansas Cancer Center at North Kansas City Hospital | North Kansas City | Missouri | United States | 64116 |
| 235 | Delbert Day Cancer Institute at PCRMC | Rolla | Missouri | United States | 65401 |
| 236 | Mercy Clinic-Rolla-Cancer and Hematology | Rolla | Missouri | United States | 65401 |
| 237 | Heartland Regional Medical Center | Saint Joseph | Missouri | United States | 64506 |
| 238 | Saint Louis Cancer and Breast Institute-South City | Saint Louis | Missouri | United States | 63109 |
| 239 | Washington University School of Medicine | Saint Louis | Missouri | United States | 63110 |
| 240 | Mercy Hospital South | Saint Louis | Missouri | United States | 63128 |
| 241 | Siteman Cancer Center-South County | Saint Louis | Missouri | United States | 63129 |
| 242 | Siteman Cancer Center at Christian Hospital | Saint Louis | Missouri | United States | 63136 |
| 243 | Mercy Hospital Saint Louis | Saint Louis | Missouri | United States | 63141 |
| 244 | Siteman Cancer Center at Saint Peters Hospital | Saint Peters | Missouri | United States | 63376 |
| 245 | Mercy Hospital Springfield | Springfield | Missouri | United States | 65804 |
| 246 | CoxHealth South Hospital | Springfield | Missouri | United States | 65807 |
| 247 | Mercy Hospital Washington | Washington | Missouri | United States | 63090 |
| 248 | Community Hospital of Anaconda | Anaconda | Montana | United States | 59711 |
| 249 | Billings Clinic Cancer Center | Billings | Montana | United States | 59101 |
| 250 | Bozeman Deaconess Hospital | Bozeman | Montana | United States | 59715 |
| 251 | Benefis Healthcare- Sletten Cancer Institute | Great Falls | Montana | United States | 59405 |
| 252 | Great Falls Clinic | Great Falls | Montana | United States | 59405 |
| 253 | Kalispell Regional Medical Center | Kalispell | Montana | United States | 59901 |
| 254 | Saint Patrick Hospital - Community Hospital | Missoula | Montana | United States | 59802 |
| 255 | Community Medical Hospital | Missoula | Montana | United States | 59804 |
| 256 | CHI Health Saint Francis | Grand Island | Nebraska | United States | 68803 |
| 257 | CHI Health Good Samaritan | Kearney | Nebraska | United States | 68847 |
| 258 | Saint Elizabeth Regional Medical Center | Lincoln | Nebraska | United States | 68510 |
| 259 | Alegent Health Immanuel Medical Center | Omaha | Nebraska | United States | 68122 |
| 260 | Alegent Health Bergan Mercy Medical Center | Omaha | Nebraska | United States | 68124 |
| 261 | Alegent Health Lakeside Hospital | Omaha | Nebraska | United States | 68130 |
| 262 | Creighton University Medical Center | Omaha | Nebraska | United States | 68131 |
| 263 | Midlands Community Hospital | Papillion | Nebraska | United States | 68046 |
| 264 | Dartmouth Hitchcock Medical Center | Lebanon | New Hampshire | United States | 03756 |
| 265 | Morristown Medical Center | Morristown | New Jersey | United States | 07960 |
| 266 | Capital Health Medical Center-Hopewell | Pennington | New Jersey | United States | 08534 |
| 267 | Overlook Hospital | Summit | New Jersey | United States | 07902 |
| 268 | Lovelace Medical Center-Saint Joseph Square | Albuquerque | New Mexico | United States | 87102 |
| 269 | University of New Mexico Cancer Center | Albuquerque | New Mexico | United States | 87102 |
| 270 | Lovelace Radiation Oncology | Albuquerque | New Mexico | United States | 87109 |
| 271 | New York-Presbyterian/Brooklyn Methodist Hospital | Brooklyn | New York | United States | 11215 |
| 272 | Arnot Ogden Medical Center/Falck Cancer Center | Elmira | New York | United States | 14905 |
| 273 | Glens Falls Hospital | Glens Falls | New York | United States | 12801 |
| 274 | Laura and Isaac Perlmutter Cancer Center at NYU Langone | New York | New York | United States | 10016 |
| 275 | NYP/Weill Cornell Medical Center | New York | New York | United States | 10065 |
| 276 | Upstate Cancer Center at Oneida | Oneida | New York | United States | 13421 |
| 277 | University of Rochester | Rochester | New York | United States | 14642 |
| 278 | State University of New York Upstate Medical University | Syracuse | New York | United States | 13210 |
| 279 | UNC Lineberger Comprehensive Cancer Center | Chapel Hill | North Carolina | United States | 27599 |
| 280 | Carolinas Medical Center/Levine Cancer Institute | Charlotte | North Carolina | United States | 28203 |
| 281 | Atrium Health Pineville/LCI-Pineville | Charlotte | North Carolina | United States | 28210 |
| 282 | Atrium Health Cabarrus/LCI-Concord | Concord | North Carolina | United States | 28025 |
| 283 | Duke University Medical Center | Durham | North Carolina | United States | 27710 |
| 284 | Margaret R Pardee Memorial Hospital | Hendersonville | North Carolina | United States | 28791 |
| 285 | Vidant Oncology-Kenansville | Kenansville | North Carolina | United States | 28349 |
| 286 | Vidant Oncology-Kinston | Kinston | North Carolina | United States | 28501 |
| 287 | Vidant Oncology-Richlands | Richlands | North Carolina | United States | 28574 |
| 288 | UHHS-Chagrin Highlands Medical Center | Beachwood | Ohio | United States | 44122 |
| 289 | Geauga Hospital | Chardon | Ohio | United States | 44024 |
| 290 | Good Samaritan Hospital - Cincinnati | Cincinnati | Ohio | United States | 45220 |
| 291 | Bethesda North Hospital | Cincinnati | Ohio | United States | 45242 |
| 292 | TriHealth Cancer Institute-Westside | Cincinnati | Ohio | United States | 45247 |
| 293 | TriHealth Cancer Institute-Anderson | Cincinnati | Ohio | United States | 45255 |
| 294 | Case Western Reserve University | Cleveland | Ohio | United States | 44106 |
| 295 | Ohio State University Comprehensive Cancer Center | Columbus | Ohio | United States | 43210 |
| 296 | UH Seidman Cancer Center at Lake Health Mentor Campus | Mentor | Ohio | United States | 44060 |
| 297 | UH Seidman Cancer Center at Southwest General Hospital | Middleburg Heights | Ohio | United States | 44130 |
| 298 | University Hospitals Parma Medical Center | Parma | Ohio | United States | 44129 |
| 299 | Mercy Health Perrysburg Cancer Center | Perrysburg | Ohio | United States | 43551 |
| 300 | University Hospitals Portage Medical Center | Ravenna | Ohio | United States | 44266 |
| 301 | UH Seidman Cancer Center at Firelands Regional Medical Center | Sandusky | Ohio | United States | 44870 |
| 302 | Mercy Health - Saint Anne Hospital | Toledo | Ohio | United States | 43623 |
| 303 | Toledo Clinic Cancer Centers-Toledo | Toledo | Ohio | United States | 43623 |
| 304 | University Hospitals Sharon Health Center | Wadsworth | Ohio | United States | 44281 |
| 305 | UH Seidman Cancer Center at Saint John Medical Center | Westlake | Ohio | United States | 44145 |
| 306 | University of Oklahoma Health Sciences Center | Oklahoma City | Oklahoma | United States | 73104 |
| 307 | Mercy Hospital Oklahoma City | Oklahoma City | Oklahoma | United States | 73120 |
| 308 | Saint Alphonsus Medical Center-Baker City | Baker City | Oregon | United States | 97814 |
| 309 | Saint Charles Health System | Bend | Oregon | United States | 97701 |
| 310 | Clackamas Radiation Oncology Center | Clackamas | Oregon | United States | 97015 |
| 311 | Providence Cancer Institute Clackamas Clinic | Clackamas | Oregon | United States | 97015 |
| 312 | Bay Area Hospital | Coos Bay | Oregon | United States | 97420 |
| 313 | Providence Newberg Medical Center | Newberg | Oregon | United States | 97132 |
| 314 | Saint Alphonsus Medical Center-Ontario | Ontario | Oregon | United States | 97914 |
| 315 | Providence Portland Medical Center | Portland | Oregon | United States | 97213 |
| 316 | Providence Saint Vincent Medical Center | Portland | Oregon | United States | 97225 |
| 317 | Saint Charles Health System-Redmond | Redmond | Oregon | United States | 97756 |
| 318 | Lehigh Valley Hospital-Cedar Crest | Allentown | Pennsylvania | United States | 18103 |
| 319 | Lehigh Valley Hospital - Muhlenberg | Bethlehem | Pennsylvania | United States | 18017 |
| 320 | Pocono Medical Center | East Stroudsburg | Pennsylvania | United States | 18301 |
| 321 | Lehigh Valley Hospital-Hazleton | Hazleton | Pennsylvania | United States | 18201 |
| 322 | Pennsylvania Hospital | Philadelphia | Pennsylvania | United States | 19107 |
| 323 | Thomas Jefferson University Hospital | Philadelphia | Pennsylvania | United States | 19107 |
| 324 | UPMC-Magee Womens Hospital | Pittsburgh | Pennsylvania | United States | 15213 |
| 325 | University of Pittsburgh Cancer Institute (UPCI) | Pittsburgh | Pennsylvania | United States | 15232 |
| 326 | Saint Joseph Regional Cancer Center | Bryan | Texas | United States | 77802 |
| 327 | Parkland Memorial Hospital | Dallas | Texas | United States | 75235 |
| 328 | UT Southwestern/Simmons Cancer Center-Dallas | Dallas | Texas | United States | 75390 |
| 329 | UT Southwestern/Simmons Cancer Center-Fort Worth | Fort Worth | Texas | United States | 76104 |
| 330 | M D Anderson Cancer Center | Houston | Texas | United States | 77030 |
| 331 | Memorial Hermann Texas Medical Center | Houston | Texas | United States | 77030 |
| 332 | Memorial Hermann Northeast Hospital | Humble | Texas | United States | 77338 |
| 333 | Memorial Hermann The Woodlands Hospital | The Woodlands | Texas | United States | 77380 |
| 334 | Huntsman Cancer Institute/University of Utah | Salt Lake City | Utah | United States | 84112 |
| 335 | Central Vermont Medical Center/National Life Cancer Treatment | Berlin | Vermont | United States | 05602 |
| 336 | University of Vermont Medical Center | Burlington | Vermont | United States | 05401 |
| 337 | University of Vermont and State Agricultural College | Burlington | Vermont | United States | 05405 |
| 338 | Inova Schar Cancer Institute | Fairfax | Virginia | United States | 22031 |
| 339 | Inova Fair Oaks Hospital | Fairfax | Virginia | United States | 22033 |
| 340 | Providence Regional Cancer System-Aberdeen | Aberdeen | Washington | United States | 98520 |
| 341 | PeaceHealth Saint Joseph Medical Center | Bellingham | Washington | United States | 98225 |
| 342 | Harrison HealthPartners Hematology and Oncology-Bremerton | Bremerton | Washington | United States | 98310 |
| 343 | Harrison Medical Center | Bremerton | Washington | United States | 98310 |
| 344 | Highline Medical Center-Main Campus | Burien | Washington | United States | 98166 |
| 345 | Providence Regional Cancer System-Centralia | Centralia | Washington | United States | 98531 |
| 346 | Swedish Cancer Institute-Edmonds | Edmonds | Washington | United States | 98026 |
| 347 | Saint Elizabeth Hospital | Enumclaw | Washington | United States | 98022 |
| 348 | Providence Regional Cancer Partnership | Everett | Washington | United States | 98201 |
| 349 | Saint Francis Hospital | Federal Way | Washington | United States | 98003 |
| 350 | Swedish Cancer Institute-Issaquah | Issaquah | Washington | United States | 98029 |
| 351 | Kadlec Clinic Hematology and Oncology | Kennewick | Washington | United States | 99336 |
| 352 | Providence Regional Cancer System-Lacey | Lacey | Washington | United States | 98503 |
| 353 | Saint Clare Hospital | Lakewood | Washington | United States | 98499 |
| 354 | PeaceHealth Saint John Medical Center | Longview | Washington | United States | 98632 |
| 355 | Harrison HealthPartners Hematology and Oncology-Poulsbo | Poulsbo | Washington | United States | 98370 |
| 356 | Pacific Gynecology Specialists | Seattle | Washington | United States | 98104 |
| 357 | Swedish Medical Center-Ballard Campus | Seattle | Washington | United States | 98107 |
| 358 | Swedish Medical Center-First Hill | Seattle | Washington | United States | 98122-4307 |
| 359 | Swedish Medical Center-Cherry Hill | Seattle | Washington | United States | 98122-5711 |
| 360 | PeaceHealth United General Medical Center | Sedro-Woolley | Washington | United States | 98284 |
| 361 | Providence Regional Cancer System-Shelton | Shelton | Washington | United States | 98584 |
| 362 | Franciscan Research Center-Northwest Medical Plaza | Tacoma | Washington | United States | 98405 |
| 363 | Northwest Medical Specialties PLLC | Tacoma | Washington | United States | 98405 |
| 364 | PeaceHealth Southwest Medical Center | Vancouver | Washington | United States | 98664 |
| 365 | Providence Saint Mary Regional Cancer Center | Walla Walla | Washington | United States | 99362 |
| 366 | Providence Regional Cancer System-Yelm | Yelm | Washington | United States | 98597 |
| 367 | Aurora Cancer Care-Southern Lakes VLCC | Burlington | Wisconsin | United States | 53105 |
| 368 | Aurora Saint Luke's South Shore | Cudahy | Wisconsin | United States | 53110 |
| 369 | Aurora Health Care Germantown Health Center | Germantown | Wisconsin | United States | 53022 |
| 370 | Aurora Cancer Care-Grafton | Grafton | Wisconsin | United States | 53024 |
| 371 | Aurora BayCare Medical Center | Green Bay | Wisconsin | United States | 54311 |
| 372 | Aurora Cancer Care-Kenosha South | Kenosha | Wisconsin | United States | 53142 |
| 373 | Aurora Bay Area Medical Group-Marinette | Marinette | Wisconsin | United States | 54143 |
| 374 | Aurora Cancer Care-Milwaukee | Milwaukee | Wisconsin | United States | 53209 |
| 375 | Aurora Saint Luke's Medical Center | Milwaukee | Wisconsin | United States | 53215 |
| 376 | Medical College of Wisconsin | Milwaukee | Wisconsin | United States | 53226 |
| 377 | Aurora Sinai Medical Center | Milwaukee | Wisconsin | United States | 53233 |
| 378 | Cancer Center of Western Wisconsin | New Richmond | Wisconsin | United States | 54017 |
| 379 | Vince Lombardi Cancer Clinic - Oshkosh | Oshkosh | Wisconsin | United States | 54904 |
| 380 | Aurora Cancer Care-Racine | Racine | Wisconsin | United States | 53406 |
| 381 | Vince Lombardi Cancer Clinic-Sheboygan | Sheboygan | Wisconsin | United States | 53081 |
| 382 | Aurora Medical Center in Summit | Summit | Wisconsin | United States | 53066 |
| 383 | Vince Lombardi Cancer Clinic-Two Rivers | Two Rivers | Wisconsin | United States | 54241 |
| 384 | Aurora Cancer Care-Milwaukee West | Wauwatosa | Wisconsin | United States | 53226 |
| 385 | Aurora West Allis Medical Center | West Allis | Wisconsin | United States | 53227 |
| 386 | Billings Clinic-Cody | Cody | Wyoming | United States | 82414 |
| 387 | Welch Cancer Center | Sheridan | Wyoming | United States | 82801 |
Sponsors and Collaborators
- Alliance for Clinical Trials in Oncology
- National Cancer Institute (NCI)
- Genentech, Inc.
Investigators
- Study Chair: Priscilla Brastianos, MD, Massachusetts General Hospital
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- A071701
- NCI-2019-00744
- U10CA180821