A Comparison of Three Chemotherapy Regimens for the Treatment of Patients With Newly Diagnosed Mantle Cell Lymphoma

• Sponsor: ECOG-ACRIN Cancer Research Group (Other)
• Overall Status: Recruiting
• CT.gov ID: NCT04115631
• Collaborator: National Cancer Institute (NCI) (NIH)
• Enrollment: 369
• Locations: 393
• Arms: 3
• Anticipated Duration (Months): 65.9
• Patients Per Site: 0.9
• Patients Per Site Per Month: 0

Study Details

Study Description

Brief Summary

This phase II trial compares three chemotherapy regimens consisting of bendamustine, rituximab, high dose cytarabine, and acalabrutinib and studies how well they work in treating patients with newly diagnosed mantle cell lymphoma. Drugs used in chemotherapy, such as bendamustine and cytarabine, work in different ways to stop the growth of cancer cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Monoclonal antibodies, such as rituximab, may interfere with the ability of cancer cells to grow and spread. Acalabrutinib may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. This study is being done to find out if one the drug combinations of bendamustine, rituximab, high dose cytarabine, and acalabrutinib is better or worse than the usual approach for mantle cell lymphoma.

Condition or Disease	Intervention/Treatment	Phase
Liver Lymphoma; Mantle Cell Lymphoma	Drug: Acalabrutinib; Drug: Bendamustine; Drug: Bendamustine Hydrochloride; Drug: Cytarabine; Biological: Rituximab	Phase 2

Detailed Description

PRIMARY OBJECTIVE:

1. Positron mission tomography (PET)/computed tomography (CT) complete response (CR)/peripheral blood minimal residual disease (MRD) negative rate.

SECONDARY OBJECTIVES:

1. Progression-free survival at 36 months. II. Toxicity rates (incidence of grade 3/4 infections, renal and neurologic toxicities, cumulative dose of cytarabine & acalabrutinib, dose reduction, and treatment discontinuation due to toxicity).

2. Objective response rate (ORR). IV. Overall survival at 36 months. V. Mobilization failure rate (defined as a yield < 2 x 10^6 CD34+ stem cells/kg with a maximum of 4 courses of apheresis).

3. To compare PET/CT negative rate between the three arms. VII. To evaluate the association between baseline PET quantitative assessment (qPET) and MRD status at end of treatment (EOT).

4. To evaluate the association between the change of qPET parameters from baseline to EOT and MRD, and compare this association across all 3 arms.

5. To determine the incremental prognostic value of baseline qPET to standard risk markers (Mantle Cell Lymphoma International Prognostic Index [MIPI]) in predicting MRD status at EOT.

6. To determine the prognostic value of baseline, interim and EOT PET in predicting progression-free survival (PFS).

EXPLORATORY IMAGING OBJECTIVES:

1. Interim PET status both qualitatively (Deauville) and quantitatively will be correlated with MRD status at EOT (end of induction).

2. Explore the incremental prognostic value of interim qPET to standard risk markers (MIPI) in predicting MRD status at EOT.

3. Explore the incremental prognostic value of interim qPET to Ki67 in predicting MRD status at EOT.

4. Explore the association of interim and EOT PET with overall survival (OS).

OUTLINE: Patients are randomized to 1 of 3 arms.

ARM A: Patients receive bendamustine intravenously (IV) on days 1 and 2 and rituximab IV on day 1 or 2. Treatment repeats every 28 days for up to 3 cycles in the absence of disease progression or unacceptable toxicity. Beginning cycle 4, patients receive rituximab IV on day 1 and cytarabine IV every 12 hours (Q12 hours) on days 1 and 2. Treatment repeats every 28 days for up to 3 cycles in the absence of disease progression or unacceptable toxicity.

ARM B: Patients receive acalabrutinib orally (PO) twice daily (BID) on days 1-28, bendamustine IV on days 1 and 2, and rituximab IV on day 1 or 2. Treatment repeats every 28 days for up to 3 cycles in the absence of disease progression or unacceptable toxicity. Beginning cycle 4, patients receive acalabrutinib PO BID on days 1-7 and 22-28, rituximab IV on day 1, and cytarabine IV Q12 hours on days 1 and 2. Treatment repeats every 28 days for up to 3 cycles in the absence of disease progression or unacceptable toxicity.

ARM C: Patients receive acalabrutinib PO BID on days 1-28, bendamustine IV on days 1 and 2, and rituximab IV on day 1 or 2. Treatment repeats every 28 days for up to 6 cycles in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed up every 3 months for 3 years, and then every 6 months until year 10.

Study Design

• Study Type: Interventional
• Anticipated Enrollment: 369 participants
• Allocation: Randomized
• Intervention Model: Parallel Assignment
• Masking: None (Open Label)
• Primary Purpose: Treatment
• Official Title: A Randomized 3-Arm Phase II Study Comparing 1.) Bendamustine, Rituximab and High Dose Cytarabine (BR/CR) 2.) Bendamustine, Rituximab, High Dose Cytarabine and Acalabrutinib (BR/CR-A), and 3.) Bendamustine, Rituximab and Acalabrutinib (BR-A) in Patients &lt;/= 70 Years Old With Untreated Mantle Cell Lymphoma
• Actual Study Start Date: Oct 3, 2019
• Anticipated Primary Completion Date: Mar 31, 2024
• Anticipated Study Completion Date: Mar 31, 2025

Arms and Interventions

Arm	Intervention/Treatment
Experimental: Arm A (bendamustine, rituximab, cytarabine) Patients receive bendamustine IV on days 1 and 2 and rituximab IV on day 1 or 2. Treatment repeats every 28 days for up to 3 cycles in the absence of disease progression or unacceptable toxicity. Beginning cycle 4, patients receive rituximab IV on day 1 and cytarabine IV every Q12 hours on days 1 and 2. Treatment repeats every 28 days for up to 3 cycles in the absence of disease progression or unacceptable toxicity.	Drug: Bendamustine; Given IV; Other Names: SDX-105 ; Drug: Bendamustine Hydrochloride; Given IV; Other Names: Bendamustin Hydrochloride Bendeka Cytostasan Hydrochloride Levact Ribomustin SyB L-0501 Treanda ; Drug: Cytarabine; Given IV; Other Names: .beta.-Cytosine arabinoside 1-.beta.-D-Arabinofuranosyl-4-amino-2(1H)pyrimidinone 1-.beta.-D-Arabinofuranosylcytosine 1-Beta-D-arabinofuranosyl-4-amino-2(1H)pyrimidinone 1-Beta-D-arabinofuranosylcytosine 1.beta.-D-Arabinofuranosylcytosine 2(1H)-Pyrimidinone, 4-Amino-1-beta-D-arabinofuranosyl- 2(1H)-Pyrimidinone, 4-amino-1.beta.-D-arabinofuranosyl- Alexan Ara-C ARA-cell Arabine Arabinofuranosylcytosine Arabinosylcytosine Aracytidine Aracytin Aracytine Beta-cytosine Arabinoside CHX-3311 Cytarabinum Cytarbel Cytosar Cytosine Arabinoside Cytosine-.beta.-arabinoside Cytosine-beta-arabinoside Erpalfa Starasid Tarabine PFS U 19920 U-19920 Udicil WR-28453 ; Biological: Rituximab; Given IV; Other Names: ABP 798 BI 695500 C2B8 Monoclonal Antibody Chimeric Anti-CD20 Antibody CT-P10 IDEC-102 IDEC-C2B8 IDEC-C2B8 Monoclonal Antibody MabThera Monoclonal Antibody IDEC-C2B8 PF-05280586 Rituxan Rituximab ABBS Rituximab Biosimilar ABP 798 Rituximab Biosimilar BI 695500 Rituximab Biosimilar CT-P10 Rituximab Biosimilar GB241 Rituximab Biosimilar IBI301 Rituximab Biosimilar JHL1101 Rituximab Biosimilar PF-05280586 Rituximab Biosimilar RTXM83 Rituximab Biosimilar SAIT101 rituximab biosimilar TQB2303 rituximab-abbs RTXM83 Truxima
Experimental: Arm B (acalabrutinib, bendamustine, rituximab, cytarabine) Patients receive PO BID on days 1-28, bendamustine IV on days 1 and 2, and rituximab IV on day 1 or 2. Treatment repeats every 28 days for up to 3 cycles in the absence of disease progression or unacceptable toxicity. Beginning cycle 4, patients receive acalabrutinib PO BID on days 1-7 and 22-28, rituximab IV on day 1, and cytarabine IV Q12 hours on days 1 and 2. Treatment repeats every 28 days for up to 3 cycles in the absence of disease progression or unacceptable toxicity.	Drug: Acalabrutinib; Given PO; Other Names: ACP-196 Bruton Tyrosine Kinase Inhibitor ACP-196 Calquence ; Drug: Bendamustine; Given IV; Other Names: SDX-105 ; Drug: Bendamustine Hydrochloride; Given IV; Other Names: Bendamustin Hydrochloride Bendeka Cytostasan Hydrochloride Levact Ribomustin SyB L-0501 Treanda ; Drug: Cytarabine; Given IV; Other Names: .beta.-Cytosine arabinoside 1-.beta.-D-Arabinofuranosyl-4-amino-2(1H)pyrimidinone 1-.beta.-D-Arabinofuranosylcytosine 1-Beta-D-arabinofuranosyl-4-amino-2(1H)pyrimidinone 1-Beta-D-arabinofuranosylcytosine 1.beta.-D-Arabinofuranosylcytosine 2(1H)-Pyrimidinone, 4-Amino-1-beta-D-arabinofuranosyl- 2(1H)-Pyrimidinone, 4-amino-1.beta.-D-arabinofuranosyl- Alexan Ara-C ARA-cell Arabine Arabinofuranosylcytosine Arabinosylcytosine Aracytidine Aracytin Aracytine Beta-cytosine Arabinoside CHX-3311 Cytarabinum Cytarbel Cytosar Cytosine Arabinoside Cytosine-.beta.-arabinoside Cytosine-beta-arabinoside Erpalfa Starasid Tarabine PFS U 19920 U-19920 Udicil WR-28453 ; Biological: Rituximab; Given IV; Other Names: ABP 798 BI 695500 C2B8 Monoclonal Antibody Chimeric Anti-CD20 Antibody CT-P10 IDEC-102 IDEC-C2B8 IDEC-C2B8 Monoclonal Antibody MabThera Monoclonal Antibody IDEC-C2B8 PF-05280586 Rituxan Rituximab ABBS Rituximab Biosimilar ABP 798 Rituximab Biosimilar BI 695500 Rituximab Biosimilar CT-P10 Rituximab Biosimilar GB241 Rituximab Biosimilar IBI301 Rituximab Biosimilar JHL1101 Rituximab Biosimilar PF-05280586 Rituximab Biosimilar RTXM83 Rituximab Biosimilar SAIT101 rituximab biosimilar TQB2303 rituximab-abbs RTXM83 Truxima
Experimental: Arm C (acalabrutinib, bendamustine, rituximab) Patients receive acalabrutinib PO BID on days 1-28, bendamustine IV on days 1 and 2, and rituximab IV on day 1 or 2. Treatment repeats every 28 days for up to 6 cycles in the absence of disease progression or unacceptable toxicity.	Drug: Acalabrutinib; Given PO; Other Names: ACP-196 Bruton Tyrosine Kinase Inhibitor ACP-196 Calquence ; Drug: Bendamustine; Given IV; Other Names: SDX-105 ; Drug: Bendamustine Hydrochloride; Given IV; Other Names: Bendamustin Hydrochloride Bendeka Cytostasan Hydrochloride Levact Ribomustin SyB L-0501 Treanda ; Biological: Rituximab; Given IV; Other Names: ABP 798 BI 695500 C2B8 Monoclonal Antibody Chimeric Anti-CD20 Antibody CT-P10 IDEC-102 IDEC-C2B8 IDEC-C2B8 Monoclonal Antibody MabThera Monoclonal Antibody IDEC-C2B8 PF-05280586 Rituxan Rituximab ABBS Rituximab Biosimilar ABP 798 Rituximab Biosimilar BI 695500 Rituximab Biosimilar CT-P10 Rituximab Biosimilar GB241 Rituximab Biosimilar IBI301 Rituximab Biosimilar JHL1101 Rituximab Biosimilar PF-05280586 Rituximab Biosimilar RTXM83 Rituximab Biosimilar SAIT101 rituximab biosimilar TQB2303 rituximab-abbs RTXM83 Truxima

Outcome Measures

Primary Outcome Measures

1. Composite of positron emission tomography (PET)/computed tomography (CT) complete response (CR) and peripheral blood (PB) minimal residual disease (MRD) negative rate [Up to 8 weeks post treatment]

   MRD status is defined as positive, negative, or indeterminate as measured from PB specimens following completion of treatment. Measures of frequencies and proportion, and location and dispersion will be used to describe categorical, and continuous variables respectively; 90% confidence intervals around these estimates will be computed. Kaplan-Meier method will be used to describe time-to-event endpoints and log-rank test to assess difference in time-to-event endpoints by levels of a categorical predictor. Cox proportional hazards (PH) regression model would be used to model the impact of baseline and other relevant variables on time-to-event endpoints.

Secondary Outcome Measures

1. Progression-free survival (PFS) [From randomization to earliest of disease progression or death, assessed at 36 months]

2. Incidence of adverse events [Up to 10 years post randomization]

   Assessed by Common Terminology Criteria for Adverse Events (CTCAE). The cumulative dose of high dose cytarabine and proportion of patients that discontinued treatment due to toxicity will be assessed.

3. Objective response rate (ORR) [Up to 10 years post randomization]

   ORR is defined as the proportion of patients achieving a best response to treatment of complete response (CR) or partial response (PR). ORR and PET/CT CR will be estimated in each treatment arm in the efficacy population, as well as among all treated patients, regardless of informative tissue status.

4. Overall survival (OS) [From randomization to death, assessed at 36 months]

   Patients that are alive will be censored at the time of last follow-up. OS will be described using the Kaplan-Meier method and log-rank test will be used to compare survival by treatment arm.

5. Mobilization failure rate [Up to 10 years post randomization]

   Defined as a yield < 2 x10^6 CD34+ stem cells/kg with a maximum of 4 course of apheresis will be summarized as a categorical variable, and compared, between treatment arms using Z- test.

Other Outcome Measures

1. PET/CT negative rate between the three arms [Up to 10 years post randomization]

2. PET quantitative assessment (qPET) [At end of treatment (within 6 months after the "8 weeks post treatment" timeframe)]

   Will evaluate the association between baseline qPET and MRD status.

3. Change of qPET parameters [Baseline to end of treatment (within 6 months after the "8 weeks post treatment" timeframe)]

   Will evaluate the association between the change of qPET parameters and MRD and compare this association across all 3 arms.

4. Incremental prognostic value of baseline qPET to standard risk markers (Mantle Cell Lymphoma International Prognostic Index [MIPI]) [At end of treatment (within 6 months after the "8 weeks post treatment" timeframe)]

   Will assess the incremental prognostic value of baseline to standard risk markers (MIPI) in predicting MRD status.

5. Interim PET status [At end of treatment (within 6 months after the "8 weeks post treatment" timeframe)]

   Interim PET status both qualitatively (Deauville) and quantitatively will be correlated with MRD status. Will fit a logistic regression model to evaluate this aim with binary MRD status at end of treatment (EOT) as the response variable and interim PET status as the predictor.

6. Incremental prognostic value of interim qPET to standard risk markers (MIPI) [At end of treatment (within 6 months after the "8 weeks post treatment" timeframe)]

   Will assess the incremental prognostic value of interim qPET to standard risk markers (MIPI) in predicting MRD status.

7. Incremental prognostic value of interim qPET to Ki67 [At end of treatment (within 6 months after the "8 weeks post treatment" timeframe)]

   Will assess the incremental prognostic value of interim qPET to Ki67 in predicting MRD status.

8. Incremental prognostic value of baseline qPET to Ki67 [At end of treatment (within 6 months after the "8 weeks post treatment" timeframe)]

   Will assess the incremental prognostic value of baseline qPET to Ki67 in predicting MRD status.

Eligibility Criteria

Criteria

• Ages Eligible for Study: 18 Years to 70 Years
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No

Inclusion Criteria:

• Baseline measurements and evaluations must be obtained within 6 weeks of randomization to the study. Abnormal PET or CT scans may constitute evaluable disease. Patient must have at least one objective measurable disease parameter. Measurable disease in the liver is required if the liver is the only site of lymphoma.

• MIPI score must be calculated and entered in Oncology Patient Enrollment Network (OPEN).

• Patients must have an Eastern Cooperative Oncology Group (ECOG) performance status score of 0-2.

• Patients must have untreated histologically confirmed mantle cell lymphoma, with cyclin D1 (BCL1) expression by immunohistochemical stains and/or t(11;14) by cytogenetics or fluorescent in situ hybridization (FISH). The diagnosis must be confirmed by formal hematopathology review at the enrolling center.

• Patients being treated with gastric reducing agents proton pump inhibitors must be switched to an alternative drug before starting acalabrutinib.

• Absolute neutrophil count (ANC) >= 1,000/mcL (obtained with 14 days of randomization). If disease includes marrow involvement or hypersplenism, please reference the below revised ANC requirement:

• ANC >= 500/mcL

• Platelets >= 75,000 mcL (obtained with 14 days of randomization). If disease includes involvement or hypersplenism, please reference the below revised platelet requirement:

• Platelets >= 25,000/mcL

• Total bilirubin =< 2 x institutional upper limit of normal (ULN) (obtained with 14 days of randomization). If disease includes hepatic infiltration or is causing biliary obstruction, or if elevated bilirubin is due to Gilbert's disease, please reference the below revised bilirubin requirements:

• Bilirubin =< 3 x institutional ULN

• Aspartate aminotransferase (AST) and alanine transaminase (ALT) =< 2.5 x institutional ULN (obtained with 14 days of randomization). If disease includes hepatic infiltration or is causing biliary obstruction, or if elevated bilirubin is due to Gilbert's disease, please reference the below revised AST/ALT requirements:

• AST/ALT =< 5 x institutional ULN

• Prothrombin time (PT)/international normalized ratio (INR) or partial thromboplastin time (aPTT) in the absence of lupus anticoagulant) < 2 x institutional ULN (obtained with 14 days of randomization). Patients receiving anticoagulant therapy (other than warfarin or equivalent vitamin K antagonists which are excluded), higher INR/aPTT may be permitted to enroll to this study after discussion with the primary investigator (PI).

• Creatinine =< institutional ULN, OR glomerular filtration rate (GFR) >= 40 mL/min/1.73 m^2 (obtained with 14 days of randomization).

• Human immunodeficiency virus (HIV)-infected patients on effective anti-retroviral therapy with undetectable viral load within 6 months are eligible for this trial.

• For patients with evidence of chronic hepatitis B virus (HBV) infection, the HBV viral load must be undetectable on suppressive therapy, if indicated.

• Patients with a history of hepatitis C virus (HCV) infection must have been treated and cured. For patients with HCV infection who are currently on treatment, they are eligible if they have an undetectable HCV viral load.

• Patients with a prior or concurrent malignancy whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen are eligible for this trial.

• Patients with known history or current symptoms of cardiac disease, or history of treatment with cardiotoxic agents, should have a clinical risk assessment of cardiac function using the New York Heart Association Functional classification. To be eligible for this trial, patients should be class 2B or better.

• Patients must have a QT interval (QTc) =< 480 msec obtained within 14 days of randomization.

• Women must not be pregnant or breast-feeding due to the potential harm to an unborn fetus and possible risk for adverse events in nursing infants with the treatment regimens being used. Patients must also not expect to conceive or father children from the time of registration, while on study treatment, and until 12 months after the last dose of study treatment. All females of childbearing potential must have a blood test or urine study within 2 weeks prior to randomization to rule out pregnancy. A female of childbearing potential is any woman, regardless of sexual orientation or whether they have undergone tubal ligation, who meets the following criteria: has achieved menarche at some point, has not undergone a hysterectomy or bilateral oophorectomy; or has not been naturally postmenopausal (amenorrhea following cancer therapy does not rule out childbearing potential) for at least 24 consecutive months (i.e., has had menses at any time in the preceding 24 consecutive months).

• Women of childbearing potential and sexually active males must agree to use accepted and effective method(s) of contraception or to abstain from sexual intercourse for the duration of their participation in the study and for 12 months after treatment ends.

• Patients are not eligible if they require treatment with a strong cytochrome P450 (CYP) 3A inhibitor.

• Patients may not have received the following within 7 days prior to the first dose of study drug:

• Strong and moderate CYP3A inhibitors

• Strong and moderate CYP3A inducers

• Patients are ineligible if they have any of the following:

• Malabsorption syndrome or disease significantly affecting gastrointestinal function.

• Active bleeding or history of bleeding diathesis (e.g. hemophilia or von Willebrand disease).

• Uncontrolled AIHA (autoimmune hemolytic anemia) or ITP (idiopathic thrombocytopenia purpura).

• Requires or receiving anticoagulation with warfarin or equivalent vitamin K antagonists (e.g. phenprocoumon) within 7 days of first dose of study drug.

• History of significant cerebrovascular disease/event, including stroke or intracranial hemorrhage, within 6 months before the first dose of study drug.

• Known active bacterial, viral, fungal, mycobacterial, parasitic, or other infections at study enrollment (defined as exhibiting ongoing signs/symptoms related to the infection and without improvement, despite appropriate antibiotics or other treatment).

• History of severe allergic reaction attributed to compounds of similar chemical or biologic composition to rituximab, bendamustine, cytarabine, or acalabrutinib.

• Patients must be able to fulfill one of the following eligibility requirements pertaining to biospecimen availability for submission following randomization:

• Archived formalin-fixed paraffin-embedded (FFPE) tumor tissue specimen from the original diagnostic biopsy is available for submission OR,

• If tumor tissue is not available, peripheral blood collected prior to initiation of protocol therapy will be submitted

• NOTE: Biospecimens must be submitted within 60 days following randomization to Adaptive Biotechnologies for ClonoSEQ ID molecular marker identification of unique clonal immunoglobulin deoxyribonucleic acid (DNA) sequence. If peripheral blood will be submitted, Adaptive Biotechnologies should be contacted prior to patient randomization for guidance pertaining to collection and submission requirements.

Contacts and Locations

Locations

	Site	City	State	Country	Postal Code
1	Anchorage Associates in Radiation Medicine	Anchorage	Alaska	United States	98508
2	Anchorage Radiation Therapy Center	Anchorage	Alaska	United States	99504
3	Alaska Breast Care and Surgery LLC	Anchorage	Alaska	United States	99508
4	Alaska Oncology and Hematology LLC	Anchorage	Alaska	United States	99508
5	Alaska Women's Cancer Care	Anchorage	Alaska	United States	99508
6	Anchorage Oncology Centre	Anchorage	Alaska	United States	99508
7	Katmai Oncology Group	Anchorage	Alaska	United States	99508
8	Providence Alaska Medical Center	Anchorage	Alaska	United States	99508
9	Fairbanks Memorial Hospital	Fairbanks	Alaska	United States	99701
10	Mercy Hospital Fort Smith	Fort Smith	Arkansas	United States	72903
11	CHI Saint Vincent Cancer Center Hot Springs	Hot Springs	Arkansas	United States	71913
12	Kaiser Permanente-Anaheim	Anaheim	California	United States	92806
13	Kaiser Permanente-Baldwin Park	Baldwin Park	California	United States	91706
14	Kaiser Permanente-Bellflower	Bellflower	California	United States	90706
15	Providence Saint Joseph Medical Center/Disney Family Cancer Center	Burbank	California	United States	91505
16	Kaiser Permanente-Fontana	Fontana	California	United States	92335
17	Kaiser Permanente - Harbor City	Harbor City	California	United States	90710
18	Kaiser Permanente-Irvine	Irvine	California	United States	92618
19	Kaiser Permanente Los Angeles Medical Center	Los Angeles	California	United States	90027
20	Kaiser Permanente-Cadillac	Los Angeles	California	United States	90034
21	Desert Regional Medical Center	Palm Springs	California	United States	92262
22	Kaiser Permanente - Panorama City	Panorama City	California	United States	91402
23	Kaiser Permanente-Riverside	Riverside	California	United States	92505
24	Kaiser Permanente-San Diego Mission	San Diego	California	United States	92108
25	Kaiser Permanente-San Diego Zion	San Diego	California	United States	92120
26	Kaiser Permanente-San Marcos	San Marcos	California	United States	92078
27	Kaiser Permanente-Woodland Hills	Woodland Hills	California	United States	91367
28	Rocky Mountain Cancer Centers-Aurora	Aurora	Colorado	United States	80012
29	The Medical Center of Aurora	Aurora	Colorado	United States	80012
30	Boulder Community Hospital	Boulder	Colorado	United States	80301
31	Rocky Mountain Cancer Centers-Boulder	Boulder	Colorado	United States	80304
32	Penrose-Saint Francis Healthcare	Colorado Springs	Colorado	United States	80907
33	Rocky Mountain Cancer Centers-Penrose	Colorado Springs	Colorado	United States	80907
34	Cancer Center of Colorado at Sloan's Lake	Denver	Colorado	United States	80204
35	National Jewish Health-Main Campus	Denver	Colorado	United States	80206
36	The Women's Imaging Center	Denver	Colorado	United States	80209
37	Porter Adventist Hospital	Denver	Colorado	United States	80210
38	Colorado Blood Cancer Institute	Denver	Colorado	United States	80218
39	Presbyterian - Saint Lukes Medical Center - Health One	Denver	Colorado	United States	80218
40	Rocky Mountain Cancer Centers-Midtown	Denver	Colorado	United States	80218
41	SCL Health Saint Joseph Hospital	Denver	Colorado	United States	80218
42	Rocky Mountain Cancer Centers-Rose	Denver	Colorado	United States	80220
43	Rose Medical Center	Denver	Colorado	United States	80220
44	Western Surgical Care	Denver	Colorado	United States	80220
45	Mercy Medical Center	Durango	Colorado	United States	81301
46	Southwest Oncology PC	Durango	Colorado	United States	81301
47	Mountain Blue Cancer Care Center - Swedish	Englewood	Colorado	United States	80113
48	Swedish Medical Center	Englewood	Colorado	United States	80113
49	National Jewish Health-Western Hematology Oncology	Golden	Colorado	United States	80401
50	Saint Mary's Hospital and Regional Medical Center	Grand Junction	Colorado	United States	81501
51	North Colorado Medical Center	Greeley	Colorado	United States	80631
52	Good Samaritan Medical Center	Lafayette	Colorado	United States	80026
53	Saint Anthony Hospital	Lakewood	Colorado	United States	80228
54	Rocky Mountain Cancer Centers-Littleton	Littleton	Colorado	United States	80120
55	Littleton Adventist Hospital	Littleton	Colorado	United States	80122
56	Rocky Mountain Cancer Centers-Sky Ridge	Lone Tree	Colorado	United States	80124
57	Sky Ridge Medical Center	Lone Tree	Colorado	United States	80124
58	Longmont United Hospital	Longmont	Colorado	United States	80501
59	Rocky Mountain Cancer Centers-Longmont	Longmont	Colorado	United States	80501
60	McKee Medical Center	Loveland	Colorado	United States	80539
61	Parker Adventist Hospital	Parker	Colorado	United States	80138
62	Saint Mary Corwin Medical Center	Pueblo	Colorado	United States	81004
63	National Jewish Health-Northern Hematology Oncology	Thornton	Colorado	United States	80260
64	SCL Health Lutheran Medical Center	Wheat Ridge	Colorado	United States	80033
65	Sibley Memorial Hospital	Washington	District of Columbia	United States	20016
66	Emory University Hospital/Winship Cancer Institute	Atlanta	Georgia	United States	30322
67	Emory Saint Joseph's Hospital	Atlanta	Georgia	United States	30342
68	Saint Alphonsus Cancer Care Center-Boise	Boise	Idaho	United States	83706
69	Saint Luke's Mountain States Tumor Institute	Boise	Idaho	United States	83712
70	Saint Alphonsus Cancer Care Center-Caldwell	Caldwell	Idaho	United States	83605
71	Kootenai Medical Center	Coeur d'Alene	Idaho	United States	83814
72	Walter Knox Memorial Hospital	Emmett	Idaho	United States	83617
73	Saint Luke's Mountain States Tumor Institute - Fruitland	Fruitland	Idaho	United States	83619
74	Idaho Urologic Institute-Meridian	Meridian	Idaho	United States	83642
75	Saint Luke's Mountain States Tumor Institute - Meridian	Meridian	Idaho	United States	83642
76	Saint Alphonsus Medical Center-Nampa	Nampa	Idaho	United States	83686
77	Saint Luke's Mountain States Tumor Institute - Nampa	Nampa	Idaho	United States	83686
78	Kootenai Cancer Center	Post Falls	Idaho	United States	83854
79	Kootenai Cancer Clinic	Sandpoint	Idaho	United States	83864
80	Saint Luke's Mountain States Tumor Institute-Twin Falls	Twin Falls	Idaho	United States	83301
81	Rush - Copley Medical Center	Aurora	Illinois	United States	60504
82	Illinois CancerCare-Bloomington	Bloomington	Illinois	United States	61704
83	Illinois CancerCare-Canton	Canton	Illinois	United States	61520
84	Memorial Hospital of Carbondale	Carbondale	Illinois	United States	62902
85	SIH Cancer Institute	Carterville	Illinois	United States	62918
86	Illinois CancerCare-Carthage	Carthage	Illinois	United States	62321
87	Centralia Oncology Clinic	Centralia	Illinois	United States	62801
88	Northwestern University	Chicago	Illinois	United States	60611
89	University of Chicago Comprehensive Cancer Center	Chicago	Illinois	United States	60637
90	Carle on Vermilion	Danville	Illinois	United States	61832
91	Cancer Care Specialists of Illinois - Decatur	Decatur	Illinois	United States	62526
92	Decatur Memorial Hospital	Decatur	Illinois	United States	62526
93	Northwestern Medicine Cancer Center Kishwaukee	DeKalb	Illinois	United States	60115
94	Illinois CancerCare-Dixon	Dixon	Illinois	United States	61021
95	Carle Physician Group-Effingham	Effingham	Illinois	United States	62401
96	Crossroads Cancer Center	Effingham	Illinois	United States	62401
97	Illinois CancerCare-Eureka	Eureka	Illinois	United States	61530
98	Illinois CancerCare-Galesburg	Galesburg	Illinois	United States	61401
99	Western Illinois Cancer Treatment Center	Galesburg	Illinois	United States	61401
100	Northwestern Medicine Cancer Center Delnor	Geneva	Illinois	United States	60134
101	Illinois CancerCare-Kewanee Clinic	Kewanee	Illinois	United States	61443
102	Northwestern Medicine Lake Forest Hospital	Lake Forest	Illinois	United States	60045
103	Illinois CancerCare-Macomb	Macomb	Illinois	United States	61455
104	Carle Physician Group-Mattoon/Charleston	Mattoon	Illinois	United States	61938
105	Good Samaritan Regional Health Center	Mount Vernon	Illinois	United States	62864
106	UC Comprehensive Cancer Center at Silver Cross	New Lenox	Illinois	United States	60451
107	Cancer Care Center of O'Fallon	O'Fallon	Illinois	United States	62269
108	University of Chicago Medicine-Orland Park	Orland Park	Illinois	United States	60462
109	Illinois CancerCare-Ottawa Clinic	Ottawa	Illinois	United States	61350
110	Illinois CancerCare-Pekin	Pekin	Illinois	United States	61554
111	OSF Saint Francis Radiation Oncology at Pekin Cancer Treatment Center	Pekin	Illinois	United States	61554
112	Illinois CancerCare-Peoria	Peoria	Illinois	United States	61615
113	OSF Saint Francis Radiation Oncology at Peoria Cancer Center	Peoria	Illinois	United States	61615
114	Methodist Medical Center of Illinois	Peoria	Illinois	United States	61636
115	OSF Saint Francis Medical Center	Peoria	Illinois	United States	61637
116	Illinois CancerCare-Peru	Peru	Illinois	United States	61354
117	Valley Radiation Oncology	Peru	Illinois	United States	61354
118	Illinois CancerCare-Princeton	Princeton	Illinois	United States	61356
119	Southern Illinois University School of Medicine	Springfield	Illinois	United States	62702
120	Springfield Clinic	Springfield	Illinois	United States	62702
121	Memorial Medical Center	Springfield	Illinois	United States	62781
122	Southwest Illinois Health Services LLP	Swansea	Illinois	United States	62226
123	Carle Cancer Center	Urbana	Illinois	United States	61801
124	The Carle Foundation Hospital	Urbana	Illinois	United States	61801
125	Northwestern Medicine Cancer Center Warrenville	Warrenville	Illinois	United States	60555
126	Rush-Copley Healthcare Center	Yorkville	Illinois	United States	60560
127	Mary Greeley Medical Center	Ames	Iowa	United States	50010
128	McFarland Clinic PC - Ames	Ames	Iowa	United States	50010
129	McFarland Clinic PC-Boone	Boone	Iowa	United States	50036
130	Medical Oncology and Hematology Associates-West Des Moines	Clive	Iowa	United States	50325
131	Mercy Cancer Center-West Lakes	Clive	Iowa	United States	50325
132	Alegent Health Mercy Hospital	Council Bluffs	Iowa	United States	51503
133	Greater Regional Medical Center	Creston	Iowa	United States	50801
134	Iowa Methodist Medical Center	Des Moines	Iowa	United States	50309
135	Medical Oncology and Hematology Associates-Des Moines	Des Moines	Iowa	United States	50309
136	Broadlawns Medical Center	Des Moines	Iowa	United States	50314
137	Medical Oncology and Hematology Associates-Laurel	Des Moines	Iowa	United States	50314
138	Mercy Medical Center - Des Moines	Des Moines	Iowa	United States	50314
139	Iowa Lutheran Hospital	Des Moines	Iowa	United States	50316
140	McFarland Clinic PC-Trinity Cancer Center	Fort Dodge	Iowa	United States	50501
141	Trinity Regional Medical Center	Fort Dodge	Iowa	United States	50501
142	McFarland Clinic PC-Jefferson	Jefferson	Iowa	United States	50129
143	McFarland Clinic PC-Marshalltown	Marshalltown	Iowa	United States	50158
144	Methodist West Hospital	West Des Moines	Iowa	United States	50266-7700
145	Mercy Medical Center-West Lakes	West Des Moines	Iowa	United States	50266
146	HaysMed University of Kansas Health System	Hays	Kansas	United States	67601
147	University of Kansas Cancer Center	Kansas City	Kansas	United States	66160
148	Olathe Health Cancer Center	Olathe	Kansas	United States	66061
149	University of Kansas Cancer Center-Overland Park	Overland Park	Kansas	United States	66210
150	Ascension Via Christi - Pittsburg	Pittsburg	Kansas	United States	66762
151	Salina Regional Health Center	Salina	Kansas	United States	67401
152	University of Kansas Health System Saint Francis Campus	Topeka	Kansas	United States	66606
153	University of Kansas Hospital-Westwood Cancer Center	Westwood	Kansas	United States	66205
154	Flaget Memorial Hospital	Bardstown	Kentucky	United States	40004
155	Commonwealth Cancer Center-Corbin	Corbin	Kentucky	United States	40701
156	Saint Joseph Radiation Oncology Resource Center	Lexington	Kentucky	United States	40504
157	Saint Joseph Hospital East	Lexington	Kentucky	United States	40509
158	Saint Joseph London	London	Kentucky	United States	40741
159	Jewish Hospital	Louisville	Kentucky	United States	40202
160	Saints Mary and Elizabeth Hospital	Louisville	Kentucky	United States	40215
161	Jewish Hospital Medical Center Northeast	Louisville	Kentucky	United States	40245
162	Jewish Hospital Medical Center South	Shepherdsville	Kentucky	United States	40165
163	Ochsner Medical Center Jefferson	New Orleans	Louisiana	United States	70121
164	Eastern Maine Medical Center	Bangor	Maine	United States	04401
165	Lafayette Family Cancer Center-EMMC	Brewer	Maine	United States	04412
166	Johns Hopkins University/Sidney Kimmel Cancer Center	Baltimore	Maryland	United States	21287
167	Hickman Cancer Center	Adrian	Michigan	United States	49221
168	Bronson Battle Creek	Battle Creek	Michigan	United States	49017
169	Wayne State University/Karmanos Cancer Institute	Detroit	Michigan	United States	48201
170	Weisberg Cancer Treatment Center	Farmington Hills	Michigan	United States	48334
171	Helen DeVos Children's Hospital at Spectrum Health	Grand Rapids	Michigan	United States	49503
172	Mercy Health Saint Mary's	Grand Rapids	Michigan	United States	49503
173	Spectrum Health at Butterworth Campus	Grand Rapids	Michigan	United States	49503
174	Bronson Methodist Hospital	Kalamazoo	Michigan	United States	49007
175	West Michigan Cancer Center	Kalamazoo	Michigan	United States	49007
176	Borgess Medical Center	Kalamazoo	Michigan	United States	49048
177	Toledo Clinic Cancer Centers-Monroe	Monroe	Michigan	United States	48162
178	Mercy Health Mercy Campus	Muskegon	Michigan	United States	49444
179	Lakeland Hospital Niles	Niles	Michigan	United States	49120
180	Cancer and Hematology Centers of Western Michigan - Norton Shores	Norton Shores	Michigan	United States	49444
181	Spectrum Health Reed City Hospital	Reed City	Michigan	United States	49677
182	Lakeland Medical Center Saint Joseph	Saint Joseph	Michigan	United States	49085
183	Marie Yeager Cancer Center	Saint Joseph	Michigan	United States	49085
184	Munson Medical Center	Traverse City	Michigan	United States	49684
185	Metro Health Hospital	Wyoming	Michigan	United States	49519
186	Riverwood Healthcare Center	Aitkin	Minnesota	United States	56431
187	Sanford Joe Lueken Cancer Center	Bemidji	Minnesota	United States	56601
188	Essentia Health Saint Joseph's Medical Center	Brainerd	Minnesota	United States	56401
189	Fairview Ridges Hospital	Burnsville	Minnesota	United States	55337
190	Cambridge Medical Center	Cambridge	Minnesota	United States	55008
191	Mercy Hospital	Coon Rapids	Minnesota	United States	55433
192	Essentia Health - Deer River Clinic	Deer River	Minnesota	United States	56636
193	Essentia Health Saint Mary's - Detroit Lakes Clinic	Detroit Lakes	Minnesota	United States	56501
194	Essentia Health Cancer Center	Duluth	Minnesota	United States	55805
195	Essentia Health Saint Mary's Medical Center	Duluth	Minnesota	United States	55805
196	Miller-Dwan Hospital	Duluth	Minnesota	United States	55805
197	Fairview Southdale Hospital	Edina	Minnesota	United States	55435
198	Lake Region Healthcare Corporation-Cancer Care	Fergus Falls	Minnesota	United States	56537
199	Essentia Health - Fosston	Fosston	Minnesota	United States	56542
200	Unity Hospital	Fridley	Minnesota	United States	55432
201	Essentia Health Hibbing Clinic	Hibbing	Minnesota	United States	55746
202	Fairview Clinics and Surgery Center Maple Grove	Maple Grove	Minnesota	United States	55369
203	Minnesota Oncology Hematology PA-Maplewood	Maplewood	Minnesota	United States	55109
204	Saint John's Hospital - Healtheast	Maplewood	Minnesota	United States	55109
205	Abbott-Northwestern Hospital	Minneapolis	Minnesota	United States	55407
206	Hennepin County Medical Center	Minneapolis	Minnesota	United States	55415
207	Health Partners Inc	Minneapolis	Minnesota	United States	55454
208	Monticello Cancer Center	Monticello	Minnesota	United States	55362
209	New Ulm Medical Center	New Ulm	Minnesota	United States	56073
210	Essentia Health - Park Rapids	Park Rapids	Minnesota	United States	56470
211	Fairview Northland Medical Center	Princeton	Minnesota	United States	55371
212	North Memorial Medical Health Center	Robbinsdale	Minnesota	United States	55422
213	Mayo Clinic	Rochester	Minnesota	United States	55905
214	Park Nicollet Clinic - Saint Louis Park	Saint Louis Park	Minnesota	United States	55416
215	Regions Hospital	Saint Paul	Minnesota	United States	55101
216	United Hospital	Saint Paul	Minnesota	United States	55102
217	Essentia Health Sandstone	Sandstone	Minnesota	United States	55072
218	Saint Francis Regional Medical Center	Shakopee	Minnesota	United States	55379
219	Lakeview Hospital	Stillwater	Minnesota	United States	55082
220	Sanford Thief River Falls Medical Center	Thief River Falls	Minnesota	United States	56701
221	Essentia Health Virginia Clinic	Virginia	Minnesota	United States	55792
222	Ridgeview Medical Center	Waconia	Minnesota	United States	55387
223	Rice Memorial Hospital	Willmar	Minnesota	United States	56201
224	Minnesota Oncology Hematology PA-Woodbury	Woodbury	Minnesota	United States	55125
225	Sanford Cancer Center Worthington	Worthington	Minnesota	United States	56187
226	Fairview Lakes Medical Center	Wyoming	Minnesota	United States	55092
227	Saint Louis Cancer and Breast Institute-Ballwin	Ballwin	Missouri	United States	63011
228	Parkland Health Center-Bonne Terre	Bonne Terre	Missouri	United States	63628
229	Cox Cancer Center Branson	Branson	Missouri	United States	65616
230	Saint Francis Medical Center	Cape Girardeau	Missouri	United States	63703
231	Southeast Cancer Center	Cape Girardeau	Missouri	United States	63703
232	Siteman Cancer Center at West County Hospital	Creve Coeur	Missouri	United States	63141
233	Parkland Health Center - Farmington	Farmington	Missouri	United States	63640
234	Capital Region Southwest Campus	Jefferson City	Missouri	United States	65109
235	Freeman Health System	Joplin	Missouri	United States	64804
236	Mercy Hospital Joplin	Joplin	Missouri	United States	64804
237	Truman Medical Centers	Kansas City	Missouri	United States	64108
238	University of Kansas Cancer Center - North	Kansas City	Missouri	United States	64154
239	Delbert Day Cancer Institute at PCRMC	Rolla	Missouri	United States	65401
240	Mercy Clinic-Rolla-Cancer and Hematology	Rolla	Missouri	United States	65401
241	Heartland Regional Medical Center	Saint Joseph	Missouri	United States	64506
242	Saint Louis Cancer and Breast Institute-South City	Saint Louis	Missouri	United States	63109
243	Washington University School of Medicine	Saint Louis	Missouri	United States	63110
244	Mercy Hospital South	Saint Louis	Missouri	United States	63128
245	Siteman Cancer Center-South County	Saint Louis	Missouri	United States	63129
246	Missouri Baptist Medical Center	Saint Louis	Missouri	United States	63131
247	Siteman Cancer Center at Christian Hospital	Saint Louis	Missouri	United States	63136
248	Mercy Hospital Saint Louis	Saint Louis	Missouri	United States	63141
249	Siteman Cancer Center at Saint Peters Hospital	Saint Peters	Missouri	United States	63376
250	Sainte Genevieve County Memorial Hospital	Sainte Genevieve	Missouri	United States	63670
251	Mercy Hospital Springfield	Springfield	Missouri	United States	65804
252	CoxHealth South Hospital	Springfield	Missouri	United States	65807
253	Missouri Baptist Sullivan Hospital	Sullivan	Missouri	United States	63080
254	Missouri Baptist Outpatient Center-Sunset Hills	Sunset Hills	Missouri	United States	63127
255	Mercy Hospital Washington	Washington	Missouri	United States	63090
256	Community Hospital of Anaconda	Anaconda	Montana	United States	59711
257	Billings Clinic Cancer Center	Billings	Montana	United States	59101
258	Saint Vincent Healthcare	Billings	Montana	United States	59101
259	Saint Vincent Frontier Cancer Center	Billings	Montana	United States	59102
260	Bozeman Deaconess Hospital	Bozeman	Montana	United States	59715
261	Saint James Community Hospital and Cancer Treatment Center	Butte	Montana	United States	59701
262	Benefis Healthcare- Sletten Cancer Institute	Great Falls	Montana	United States	59405
263	Great Falls Clinic	Great Falls	Montana	United States	59405
264	Kalispell Regional Medical Center	Kalispell	Montana	United States	59901
265	Saint Patrick Hospital - Community Hospital	Missoula	Montana	United States	59802
266	Community Medical Hospital	Missoula	Montana	United States	59804
267	CHI Health Saint Francis	Grand Island	Nebraska	United States	68803
268	CHI Health Good Samaritan	Kearney	Nebraska	United States	68847
269	Saint Elizabeth Regional Medical Center	Lincoln	Nebraska	United States	68510
270	Alegent Health Immanuel Medical Center	Omaha	Nebraska	United States	68122
271	Alegent Health Bergan Mercy Medical Center	Omaha	Nebraska	United States	68124
272	Alegent Health Lakeside Hospital	Omaha	Nebraska	United States	68130
273	Creighton University Medical Center	Omaha	Nebraska	United States	68131
274	Midlands Community Hospital	Papillion	Nebraska	United States	68046
275	Morristown Medical Center	Morristown	New Jersey	United States	07960
276	Roswell Park Cancer Institute	Buffalo	New York	United States	14263
277	University of Rochester	Rochester	New York	United States	14642
278	UNC Lineberger Comprehensive Cancer Center	Chapel Hill	North Carolina	United States	27599
279	Southeastern Medical Oncology Center-Clinton	Clinton	North Carolina	United States	28328
280	Southeastern Medical Oncology Center-Goldsboro	Goldsboro	North Carolina	United States	27534
281	Southeastern Medical Oncology Center-Jacksonville	Jacksonville	North Carolina	United States	28546
282	Vidant Oncology-Kenansville	Kenansville	North Carolina	United States	28349
283	Vidant Oncology-Kinston	Kinston	North Carolina	United States	28501
284	Vidant Oncology-Richlands	Richlands	North Carolina	United States	28574
285	Sanford Bismarck Medical Center	Bismarck	North Dakota	United States	58501
286	Essentia Health Cancer Center-South University Clinic	Fargo	North Dakota	United States	58103
287	Sanford South University Medical Center	Fargo	North Dakota	United States	58103
288	Southpointe-Sanford Medical Center Fargo	Fargo	North Dakota	United States	58103
289	Sanford Medical Center Fargo	Fargo	North Dakota	United States	58104
290	Sanford Broadway Medical Center	Fargo	North Dakota	United States	58122
291	Sanford Roger Maris Cancer Center	Fargo	North Dakota	United States	58122
292	Essentia Health - Jamestown Clinic	Jamestown	North Dakota	United States	58401
293	University of Cincinnati/Barrett Cancer Center	Cincinnati	Ohio	United States	45219
294	Good Samaritan Hospital - Cincinnati	Cincinnati	Ohio	United States	45220
295	Bethesda North Hospital	Cincinnati	Ohio	United States	45242
296	TriHealth Cancer Institute-Westside	Cincinnati	Ohio	United States	45247
297	TriHealth Cancer Institute-Anderson	Cincinnati	Ohio	United States	45255
298	Case Western Reserve University	Cleveland	Ohio	United States	44106
299	MetroHealth Medical Center	Cleveland	Ohio	United States	44109
300	Cleveland Clinic Foundation	Cleveland	Ohio	United States	44195
301	Ohio State University Comprehensive Cancer Center	Columbus	Ohio	United States	43210
302	Mercy Health Perrysburg Cancer Center	Perrysburg	Ohio	United States	43551
303	Mercy Saint Anne Hospital	Toledo	Ohio	United States	43623
304	Toledo Clinic Cancer Centers-Toledo	Toledo	Ohio	United States	43623
305	University Pointe	West Chester	Ohio	United States	45069
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	Oregon Health and Science University	Portland	Oregon	United States	97239
318	Saint Charles Health System-Redmond	Redmond	Oregon	United States	97756
319	Prisma Health Cancer Institute - Easley	Easley	South Carolina	United States	29640
320	Prisma Health Cancer Institute - Butternut	Greenville	South Carolina	United States	29605
321	Prisma Health Cancer Institute - Faris	Greenville	South Carolina	United States	29605
322	Prisma Health Cancer Institute - Eastside	Greenville	South Carolina	United States	29615
323	Prisma Health Cancer Institute - Greer	Greer	South Carolina	United States	29650
324	Prisma Health Cancer Institute - Seneca	Seneca	South Carolina	United States	29672
325	Prisma Health Cancer Institute - Spartanburg	Spartanburg	South Carolina	United States	29307
326	Sanford Cancer Center Oncology Clinic	Sioux Falls	South Dakota	United States	57104
327	Sanford USD Medical Center - Sioux Falls	Sioux Falls	South Dakota	United States	57117-5134
328	Saint Joseph Regional Cancer Center	Bryan	Texas	United States	77802
329	American Fork Hospital / Huntsman Intermountain Cancer Center	American Fork	Utah	United States	84003
330	Sandra L Maxwell Cancer Center	Cedar City	Utah	United States	84720
331	Logan Regional Hospital	Logan	Utah	United States	84321
332	Intermountain Medical Center	Murray	Utah	United States	84107
333	McKay-Dee Hospital Center	Ogden	Utah	United States	84403
334	Utah Valley Regional Medical Center	Provo	Utah	United States	84604
335	Riverton Hospital	Riverton	Utah	United States	84065
336	Dixie Medical Center Regional Cancer Center	Saint George	Utah	United States	84770
337	Utah Cancer Specialists-Salt Lake City	Salt Lake City	Utah	United States	84106
338	Huntsman Cancer Institute/University of Utah	Salt Lake City	Utah	United States	84112
339	LDS Hospital	Salt Lake City	Utah	United States	84143
340	University of Virginia Cancer Center	Charlottesville	Virginia	United States	22908
341	Providence Regional Cancer System-Aberdeen	Aberdeen	Washington	United States	98520
342	MultiCare Auburn Medical Center	Auburn	Washington	United States	98001
343	PeaceHealth Saint Joseph Medical Center	Bellingham	Washington	United States	98225
344	Harrison HealthPartners Hematology and Oncology-Bremerton	Bremerton	Washington	United States	98310
345	Harrison Medical Center	Bremerton	Washington	United States	98310
346	Highline Medical Center-Main Campus	Burien	Washington	United States	98166
347	Providence Regional Cancer System-Centralia	Centralia	Washington	United States	98531
348	Swedish Cancer Institute-Edmonds	Edmonds	Washington	United States	98026
349	Saint Elizabeth Hospital	Enumclaw	Washington	United States	98022
350	Providence Regional Cancer Partnership	Everett	Washington	United States	98201
351	Saint Francis Hospital	Federal Way	Washington	United States	98003
352	MultiCare Gig Harbor Medical Park	Gig Harbor	Washington	United States	98335
353	Swedish Cancer Institute-Issaquah	Issaquah	Washington	United States	98029
354	Kadlec Clinic Hematology and Oncology	Kennewick	Washington	United States	99336
355	Providence Regional Cancer System-Lacey	Lacey	Washington	United States	98503
356	Saint Clare Hospital	Lakewood	Washington	United States	98499
357	PeaceHealth Saint John Medical Center	Longview	Washington	United States	98632
358	Jefferson Healthcare	Port Townsend	Washington	United States	98368
359	Harrison HealthPartners Hematology and Oncology-Poulsbo	Poulsbo	Washington	United States	98370
360	MultiCare Good Samaritan Hospital	Puyallup	Washington	United States	98372
361	Pacific Gynecology Specialists	Seattle	Washington	United States	98104
362	Swedish Medical Center-Ballard Campus	Seattle	Washington	United States	98107
363	Swedish Medical Center-First Hill	Seattle	Washington	United States	98122-4307
364	Swedish Medical Center-Cherry Hill	Seattle	Washington	United States	98122-5711
365	PeaceHealth United General Medical Center	Sedro-Woolley	Washington	United States	98284
366	Providence Regional Cancer System-Shelton	Shelton	Washington	United States	98584
367	MultiCare Deaconess Cancer and Blood Specialty Center - Valley	Spokane Valley	Washington	United States	99216
368	MultiCare Deaconess Cancer and Blood Specialty Center - Downtown	Spokane	Washington	United States	99204
369	MultiCare Deaconess Cancer and Blood Specialty Center - North	Spokane	Washington	United States	99218
370	Franciscan Research Center-Northwest Medical Plaza	Tacoma	Washington	United States	98405
371	Mary Bridge Children's Hospital and Health Center	Tacoma	Washington	United States	98405
372	MultiCare Tacoma General Hospital	Tacoma	Washington	United States	98405
373	PeaceHealth Southwest Medical Center	Vancouver	Washington	United States	98664
374	Providence Saint Mary Regional Cancer Center	Walla Walla	Washington	United States	99362
375	Providence Regional Cancer System-Yelm	Yelm	Washington	United States	98597
376	Duluth Clinic Ashland	Ashland	Wisconsin	United States	54806
377	Northwest Wisconsin Cancer Center	Ashland	Wisconsin	United States	54806
378	Marshfield Medical Center-EC Cancer Center	Eau Claire	Wisconsin	United States	54701
379	Gundersen Lutheran Medical Center	La Crosse	Wisconsin	United States	54601
380	University of Wisconsin Hospital and Clinics	Madison	Wisconsin	United States	53792
381	Marshfield Medical Center-Marshfield	Marshfield	Wisconsin	United States	54449
382	Marshfield Clinic-Minocqua Center	Minocqua	Wisconsin	United States	54548
383	ProHealth D N Greenwald Center	Mukwonago	Wisconsin	United States	53149
384	Cancer Center of Western Wisconsin	New Richmond	Wisconsin	United States	54017
385	ProHealth Oconomowoc Memorial Hospital	Oconomowoc	Wisconsin	United States	53066
386	Marshfield Medical Center-Rice Lake	Rice Lake	Wisconsin	United States	54868
387	Marshfield Clinic Stevens Point Center	Stevens Point	Wisconsin	United States	54482
388	ProHealth Waukesha Memorial Hospital	Waukesha	Wisconsin	United States	53188
389	UW Cancer Center at ProHealth Care	Waukesha	Wisconsin	United States	53188
390	Marshfield Clinic - Weston Center	Weston	Wisconsin	United States	54476
391	Cheyenne Regional Medical Center-West	Cheyenne	Wyoming	United States	82001
392	Billings Clinic-Cody	Cody	Wyoming	United States	82414
393	Welch Cancer Center	Sheridan	Wyoming	United States	82801

Sponsors and Collaborators

• ECOG-ACRIN Cancer Research Group
• National Cancer Institute (NCI)

Investigators

• Principal Investigator: Nina D Wagner-Johnston, ECOG-ACRIN Cancer Research Group

Study Documents (Full-Text)

None provided.

More Information

Publications

None provided.

• Responsible Party: ECOG-ACRIN Cancer Research Group
• ClinicalTrials.gov Identifier: NCT04115631
• Other Study ID Numbers: EA4181; NCI-2019-05536; EA4181; EA4181; U10CA180820
• First Posted: Oct 4, 2019
• Last Update Posted: Aug 11, 2022
• Last Verified: Aug 1, 2022

• Studies a U.S. FDA-regulated Drug Product: Yes
• Studies a U.S. FDA-regulated Device Product: No
• Product Manufactured in and Exported from the U.S.: No
• Additional relevant MeSH terms: Lymphoma; Lymphoma, Mantle-Cell; Cytarabine; Rituximab; Antineoplastic Agents, Immunological; Bendamustine Hydrochloride; Acalabrutinib; Antibodies; Immunoglobulins; Antibodies, Monoclonal

Study Results

No Results Posted as of Aug 11, 2022