High-Dose Recombinant Interferon Alfa-2B, Ipilimumab, or Pembrolizumab in Treating Patients With Stage III-IV High Risk Melanoma That Has Been Removed by Surgery

• Sponsor: National Cancer Institute (NCI) (NIH)
• Overall Status: Active, not recruiting
• CT.gov ID: NCT02506153
• Collaborator: (none)
• Enrollment: 1,378
• Locations: 583
• Arms: 2
• Patients Per Site: 2.4

Study Details

Study Description

Brief Summary

This randomized phase III trial studies how well high-dose recombinant interferon alfa-2B or ipilimumab works compared with pembrolizumab in treating patients with stage III-IV melanoma that has been removed by surgery but is likely to come back or spread. High-dose recombinant interferon alfa-2B may help shrink or slow the growth of melanoma. Immunotherapy with monoclonal antibodies, such as ipilimumab and pembrolizumab, may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. It is not yet known whether high-dose recombinant interferon alfa-2B or ipilimumab is more effective than pembrolizumab in treating patients with melanoma.

Condition or Disease	Intervention/Treatment	Phase
Metastatic Cutaneous Melanoma; Metastatic Mucosal Melanoma; Metastatic Non-Cutaneous Melanoma; Non-Cutaneous Melanoma; Recurrent Cutaneous Melanoma; Recurrent Mucosal Melanoma; Recurrent Non-Cutaneous Melanoma; Stage III Cutaneous Melanoma AJCC v7; Stage III Mucosal Melanoma of the Head and Neck AJCC v7; Stage IIIA Cutaneous Melanoma AJCC v7; Stage IIIB Cutaneous Melanoma AJCC v7; Stage IIIC Cutaneous Melanoma AJCC v7; Stage IV Cutaneous Melanoma AJCC v6 and v7; Stage IVA Mucosal Melanoma of the Head and Neck AJCC v7; Stage IVB Mucosal Melanoma of the Head and Neck AJCC v7; Stage IVC Mucosal Melanoma of the Head and Neck AJCC v7	Biological: Ipilimumab; Biological: Pembrolizumab; Other: Quality-of-Life Assessment; Biological: Recombinant Interferon Alfa-2b	Phase 3

Detailed Description

PRIMARY OBJECTIVES:

1. To compare overall survival (OS) of patients with resected stage III and IV melanoma treated with physician/patient choice of either high dose interferon recombinant interferon alfa-2b (alfa-2b) or ipilimumab versus MK-3475 (pembrolizumab).

2. Among patients who are PD-L1 positive, to compare OS of patients with resected stage III and IV melanoma treated with physician/patient choice of either high dose interferon alfa-2b or ipilimumab versus MK-3475 (pembrolizumab).

3. To compare relapse-free survival (RFS) of patients with resected stage III and IV melanoma treated with physician/patient choice of either high dose interferon alfa-2b or ipilimumab to MK-3475 (pembrolizumab).

SECONDARY OBJECTIVES:

1. To estimate OS and RFS for patients who are PD-L1 negative or PD-L1 indeterminate in this population.

2. To compare OS and RFS of patients between the two arms within PD-L1 positive and negative subgroups and to look at the interaction between PD-L1 (positive versus negative) and treatment arm.

3. To assess the safety and tolerability of the regimens.

ADDITIONAL OBJECTIVES:

1. To bank tissue and whole blood in anticipation of future correlative studies in this patient population.

2. To evaluate PD-L1 expression through immunohistochemistry assay. III. To evaluate the effect of treatment-related side effects that may have an impact on the health-related domains of quality of life (QOL) using the Functional Assessment of Cancer Therapy (FACT)-Biological Response Modifiers (BRM), European Quality of Life Five Dimension Three Level Scale (EQ-5D-3L), and Functional Assessment of Chronic Illness Therapy Diarrhea (FACIT-D) between patients treated with physician/patient choice of either high-dose interferon alfa-2b or ipilimumab and MK-3475 (pembrolizumab).

3. Pharmacokinetic (PK) and anti-drug antibody (ADA) testing will be performed on all patients receiving MK-3475 (pembrolizumab).

TRANSLATIONAL OBJECTIVES RELATED TO T-CELL RECEPTOR BETA CHAIN SEQUENCING:

1. To evaluate the association between TCR beta variable gene (TRBV) haplotype and grade 3-4 immune-related adverse events (irAEs) among stage III melanoma patients treated with adjuvant ipilimumab or pembrolizumab.

2. To describe the TRBV haplotype distribution among this cohort of patients studied.

TRANSLATIONAL MEDICINAL OBJECTIVE RELATED TO ASSOCIATION OF CIRCULATING TUMOR DNA (ctDNA) WITH RELAPSE-FREE SURVIVAL IN HIGH-RISK, RESECTED MELANOMA PATIENTS.

1. To evaluate associations between pretreatment ctDNA (present versus absent) and relapse within 2 years of randomization in a case-control analysis across treatment arms.

2. To evaluate associations between pretreatment ctDNA (present versus absent) and relapse within 2 years of randomization in a case-control analysis across treatment arms.

3. To evaluate associations between pretreatment ctDNA and relapse within 2 years of randomization in a case-control analysis within each treatment arm (after treatment arm data are unblinded to investigators).

4. To evaluate associations between "early-on treatment" ctDNA levels and relapse within 2 years of randomization.

5. To describe ctDNA levels at end of therapy and time of relapse.

OUTLINE: Patients are randomized to 1 of 2 treatment arms.

ARM I:

INDUCTION THERAPY: Patients receive high-dose recombinant interferon alfa-2B intravenously (IV) over 20 minutes on days 1-5. Treatment repeats weekly for 4 weeks in the absence of disease progression or unacceptable toxicity. Or patients receive ipilimumab IV over 90 minutes on day 1. Treatment repeats every 3 weeks for a total of 4 cycles in the absence of disease progression or unacceptable toxicity.

MAINTENANCE THERAPY: Patients receive high-dose recombinant interferon alfa-2B subcutaneously (SC) on days 1, 3, and 5. Treatment repeats every 6 weeks for up to 48 weeks in the absence of disease progression or unacceptable toxicity. Or patients receive ipilimumab IV over 90 minutes on day 1. Treatment repeats every 12 weeks for 3 years in the absence of disease progression or unacceptable toxicity.

ARM II: Patients receive pembrolizumab IV over 30 minutes on day 1. Treatment repeats every 3 weeks for up to 52 weeks in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed up at 30 days, 6 and 12 weeks, every 3 months for 2 years, every 6 months for 3 years, and then every 12 months for 5 years.

Study Design

• Study Type: Interventional
• Anticipated Enrollment: 1378 participants
• Allocation: Randomized
• Intervention Model: Parallel Assignment
• Masking: Double (Participant, Investigator)
• Primary Purpose: Treatment
• Official Title: A Phase III Randomized Trial Comparing Physician/Patient Choice of Either High Dose Interferon or Ipilimumab to MK-3475 (Pembrolizumab) in Patients With High Risk Resected Melanoma
• Actual Study Start Date: Oct 15, 2015
• Anticipated Primary Completion Date: Sep 15, 2023

Arms and Interventions

Arm	Intervention/Treatment
Active Comparator: Arm I (high-dose recombinant interferon alfa-2B, ipilimumab) INDUCTION THERAPY: Patients receive high-dose recombinant interferon alfa-2B intravenously (IV) over 20 minutes on days 1-5. Treatment repeats weekly for 4 weeks in the absence of disease progression or unacceptable toxicity. Or patients receive ipilimumab IV over 90 minutes on day 1. Treatment repeats every 3 weeks for a total of 4 cycles in the absence of disease progression or unacceptable toxicity. MAINTENANCE THERAPY: Patients receive high-dose recombinant interferon alfa-2B subcutaneously (SC) on days 1, 3, and 5. Treatment repeats every 6 weeks for up to 48 weeks in the absence of disease progression or unacceptable toxicity. Or patients receive ipilimumab IV over 90 minutes on day 1. Treatment repeats every 12 weeks for 3 years in the absence of disease progression or unacceptable toxicity.	Biological: Ipilimumab; Given IV; Other Names: Anti-Cytotoxic T-Lymphocyte-Associated Antigen-4 Monoclonal Antibody BMS-734016 Ipilimumab Biosimilar CS1002 MDX-010 MDX-CTLA4 Yervoy ; Other: Quality-of-Life Assessment; Ancillary studies; Other Names: Quality of Life Assessment ; Biological: Recombinant Interferon Alfa-2b; Given IV and SC; Other Names: Alfatronol Glucoferon Heberon Alfa IFN alpha-2B Interferon alfa 2b Interferon Alfa-2B Interferon Alpha-2b Intron A Sch 30500 Urifron Viraferon
Experimental: Arm II (pembrolizumab) Patients receive pembrolizumab IV over 30 minutes on day 1. Treatment repeats every 3 weeks for up to 52 weeks in the absence of disease progression or unacceptable toxicity.	Biological: Pembrolizumab; Given IV; Other Names: Keytruda Lambrolizumab MK-3475 SCH 900475 ; Other: Quality-of-Life Assessment; Ancillary studies; Other Names: Quality of Life Assessment

Outcome Measures

Primary Outcome Measures

1. Overall survival (OS) [From date of randomization to date of death due to any cause, assessed up to 5 years]

   Cox regression models will be used to estimate hazard ratios and calculate confidence intervals to compare treatment arms in the PD-L1 negative subgroup. In addition, Cox regression models for OS will be used to estimate interaction terms between PD-L1 status and treatment arm. A restricted mean survival time analysis will be done as a supportive analysis.

2. Relapse-free survival (RFS) [From date of randomization to date of first documentation of progression or death due to any cause, assessed up to 5 years]

   Cox regression models will be used to estimate hazard ratios and calculate confidence intervals to compare treatment arms in the PD-L1 negative subgroup. In addition, Cox regression models for RFS will be used to estimate interaction terms between PD-L1 status and treatment arm. A restricted mean survival time analysis will be done as a supportive analysis.

3. PD-L1 status [Baseline]

   Cox regression models will be used to estimate hazard ratios and calculate confidence intervals to compare treatment arms in the PD-L1 negative subgroup. In addition, Cox regression models for OS and RFS will be used to estimate interaction terms between PD-L1 status and treatment arm.

Secondary Outcome Measures

1. Incidence of toxicity [Up to 30 days after the last study drug administration]

   Will be assessed using the National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0 (CTCAE version 5.0 beginning April 1, 2018). Toxicity rates will be estimated with a 95% confidence interval.

2. Post-relapse therapy [Up to 10 years]

   Data on therapy after relapse will be collected for three years after relapse (or until 10 years after registration maximum). Therapies will be categorized into one of two categories: systemic or local. Specific therapies after relapse will be tabulated and summarized. Therapy after relapse will be analyzed as a time-dependent variable in Cox regression analyses for the endpoint of OS after relapse.

3. BRAF mutation status [Baseline]

   Pre-study BRAF mutation status on patients will be collected. BRAF mutation will be analyzed as a prognostic value as a covariate in Cox regression analyses and exponential-logistic cure regression models. In addition, BRAF mutation will be analyzed as a predictive factor by analyzing the interaction between mutation status and treatment in Cox regression models and in exponential-logistic cure regression model.

4. Long-term survival [Up to 10 years]

   Exponential-logistic cure regression models will be used to examine the association between known prognostic factors, including stage, and long-term survivor/cure status, and survival for patients who are not long-term survivors/cured.

5. Change in quality of life [Baseline to up to 5 years]

   The European Quality of Life Five Dimension Three Level Scale, Functional Assessment of Cancer Therapy-Biological Response Modifiers, Functional Assessment of Chronic Illness Therapy Diarrhea, and Trial Outcome Index will be assessed at multiple time points. Longitudinal regression models (using mixed-effects models) will be used to evaluate changes over time.

Eligibility Criteria

Criteria

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

Inclusion Criteria:

• STEP 1 REGISTRATION:

• Patients must have completely resected melanoma of cutaneous origin or of unknown primary in order to be eligible for this study; patients must be classified as stage IIIA (N2a), IIIB, IIIC, or stage IV melanoma; patients with non-ulcerated T1b N1a disease are not eligible; patients with melanoma of mucosal or other non-cutaneous origin are eligible; patients with melanoma of ocular origin are not eligible; patients with a history of brain metastases are ineligible

• Patients are eligible for this trial either at initial presentation of their melanoma or at the time of the first detected nodal, satellite/in-transit, distant metastases, or recurrent disease in prior lymphadenectomy basin or distant site; nodal, satellite/in-transit metastasis, distant metastases or disease in a prior complete lymphadenectomy basin must have been confirmed histologically by hematoxylin and eosin (H & E) stained slides

• Patients with multiple regional nodal basin involvement are eligible; gross or microscopic extracapsular nodal extension is permitted

• Patients at initial presentation of melanoma must undergo an adequate wide excision of the primary lesion, if present; patients with previously diagnosed melanoma must have had all current disease resected with pathologically negative margins and must have no evidence of disease at the primary site or must undergo re-resection of the primary site; a full lymphadenectomy meeting the criteria outlined is required for all node-positive patients including those with positive sentinel nodes; patients with recurrent disease who have had a prior complete lymphadenectomy fulfill this requirement as long as all recurrent disease has been resected; for all patients, all disease must have been resected with negative pathological margins and no clinical, radiologic, or pathological evidence of any incompletely resected melanoma; patients must be registered within 98 days of the last surgery performed to render the patient free of disease

• Patients must have available and be willing to submit a minimum of five unstained slides from primary, lymph node, or metastatic site to determine PD-L1 expression; the tumor tissue must be adequate for PD-L1 testing (defined as >= 100 tumor cells as confirmed by the treating institution's local pathologist); this must be documented by having a pathologist sign the S1404 Local Pathology Review form prior to step 1 registration; the specimens may come from an archived block but must be submitted within 20 days from cutting the slides

• Patients must be offered the opportunity to participate in specimen banking as outlined

• Patients must be willing to have blood draws for PK/ADA analysis as outlined, should the patient be randomized to the MK-3475 arm

• Patients may have received prior radiation therapy, including after the surgical resection; all adverse events associated with prior surgery and radiation therapy must have resolved to =< grade 1 prior to registration

• Patients must not have received neoadjuvant treatment for their melanoma; patients must not have had prior immunotherapy including, but not limited to ipilimumab, interferon alfa-2b, high dose IL-2, pegylated (PEG)-IFN, anti-PD-1, anti-PD-L1 intra-tumoral, or vaccine therapies; patients must not be planning to receive any of the prohibited therapies during the screening or treatment phases of the study

• Patients must not be planning to receive concomitant other biologic therapy, radiation therapy, hormonal therapy, other chemotherapy, surgery or other therapy after step 2 registration

• All patients must have disease-free status documented by a complete physical examination and imaging studies within 42 days prior to registration; imaging studies must include a total body positron emission tomography (PET)-computed tomography (CT) scan that is of diagnostic quality (with or without brain) or a CT of the chest, abdomen and pelvis; for patients with melanoma arising from the head and neck, dedicated neck imaging (CT with IV contrast or PET-CT through the region) is required; if the patient has had unknown primary with disease in the axilla, neck imaging is required to assure region is clear of cancer; CT imaging should be done with intravenous contrast if there are no contraindications for it; any other clinically-indicated imaging studies if performed (e.g. bone scan) must show no evidence of disease

• All patients must have a CT or magnetic resonance imaging (MRI) of the brain within 90 days prior to registration; the brain CT or MRI should be performed with intravenous contrast (unless contraindicated)

• Absolute neutrophil count (ANC) >= 1,500 microliter (mcL) (within 42 days prior to registration)

• Platelets >= 100,000 mcL (within 42 days prior to registration)

• Hemoglobin >= 10 g/dL (within 42 days prior to registration)

• Total bilirubin =< 1.5 x institutional upper limit of normal (IULN) (except Gilbert's syndrome, who must have a total bilirubin < 3.0 mg/dL) (within 42 days prior to registration)

• Serum glutamic oxaloacetic transaminase (SGOT) (aspartate aminotransferase [AST]) and serum glutamate pyruvate transaminase (SGPT) (alanine aminotransferase [ALT]) =< 2 x IULN (within 42 days prior to registration)

• Alkaline phosphatase =< 2 x IULN (within 42 days prior to registration)

• Serum creatinine =< IULN OR measured or calculated creatinine clearance >= 60 mL/min (within 42 days prior to registration)

• Patients must have lactate dehydrogenase (LDH) performed within 42 days prior to registration

• Patients must have Zubrod performance status =< 1

• Patients must have a baseline electrocardiogram (ECG) performed within 42 days of registration that is normal or considered not clinically significant by the site investigator

• Patients must not have a history of (non-infectious) pneumonitis that required steroids or current pneumonitis

• Patients must not have an active infection requiring systemic therapy

• Patients must not have active autoimmune disease that has required systemic treatment in past 2 years (i.e., with use of disease modifying agents, corticosteroids or immunosuppressive drugs); replacement therapy (e.g., thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency, etc.) is not considered a form of systemic treatment

• Patients must not have received live vaccines within 42 days prior to registration; examples of live vaccines include, but are not limited to, the following: measles, mumps, rubella, chicken pox, shingles, yellow fever, rabies, bacillus Calmette-Guerin (BCG), and typhoid (oral) vaccine; seasonal influenza vaccines for injection are generally killed virus vaccines and are allowed; however, intranasal influenza vaccines (e.g., Flu-Mist) are live attenuated vaccines, and are not allowed

• Patients known to be human immunodeficiency virus (HIV) positive are eligible if they meet the following criteria within 30 days prior to registration: stable and adequate cluster of differentiation 4 (CD4) counts (>= 350 mm^3), and serum HIV viral load of < 25,000 IU/ml; patients may be on or off anti-viral therapy so long as they meet the CD4 count criteria

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

• Patients must not have a history or current evidence of any condition, therapy or laboratory abnormality that might confound the trial results, interfere with the patient's participation for the full duration of the trial, or indicate that participation in the trial is not in the patient's best interests, in the opinion of the treating investigator

• No other prior malignancy is allowed except for the following: adequately treated basal cell or squamous cell skin cancer, in situ cervical cancer, lobular carcinoma of the breast in situ, atypical melanocytic hyperplasia or melanoma in situ, adequately treated stage I or II cancer (including multiple primary melanomas) from which the patient is currently in complete remission, or any other cancer from which the patient has been disease free for three years

• Women of childbearing potential must have a negative urine or serum pregnancy test within 28 days prior to registration; women/men of reproductive potential must have agreed to use an effective contraceptive method for the course of the study through 120 days after the last dose of study medication; should a woman become pregnant or suspect she is pregnant while she or her partner is participating in this study, she should inform her treating physician immediately; a woman is considered to be of "reproductive potential" if she has had menses at any time in the preceding 12 consecutive months; in addition to routine contraceptive methods, "effective contraception" also includes heterosexual celibacy and surgery intended to prevent pregnancy (or with a side-effect of pregnancy prevention) defined as a hysterectomy, bilateral oophorectomy, or bilateral tubal ligation; however, if at any point a previously celibate patient chooses to become heterosexually active during the time period for use of contraceptive measures, he/she is responsible for beginning contraceptive measures; patients must not be pregnant or nursing due to unknown teratogenic side effects

• Patients who are able to complete questionnaires in English, Spanish or French must participate in the quality of life assessments; (those patients who cannot complete the quality of life questionnaires in English, Spanish or French can be registered to S1404 without contributing to the quality of life studies)

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

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

• STEP 2 REGISTRATION (RANDOMIZATION CRITERIA):

• Patients must not be registered until receiving confirmation from the Southwest Oncology Group (SWOG) Statistical Center that the patient's tissue specimen was adequate for PD-L1 testing; patients must be registered within 7 working days of receiving the e-mail notification

• Women of childbearing potential must plan to have a urine or serum pregnancy test within 72 hours prior to receiving the first dose of study medication; if the urine test is positive or cannot be confirmed as negative, a negative serum pregnancy test will be required

• No tests or exams are required to be repeated for step 2 registration (randomization); however, patients who are known to have a change in eligibility status after step 1 registration are not eligible for step 2 registration; for example, ANC is not required to be repeated between step 1 and step 2 registration, but the most recent ANC performed before step 2 registration is required to be >= 1,500 mcL

Contacts and Locations

Locations

	Site	City	State	Country	Postal Code
1	University of Alabama at Birmingham Cancer Center	Birmingham	Alabama	United States	35233
2	Cancer Center at Saint Joseph's	Phoenix	Arizona	United States	85004
3	Virginia G Piper Cancer Care-Del Camino	Scottsdale	Arizona	United States	85258
4	Banner University Medical Center - Tucson	Tucson	Arizona	United States	85719
5	University of Arizona Cancer Center-North Campus	Tucson	Arizona	United States	85719
6	University of Arkansas for Medical Sciences	Little Rock	Arkansas	United States	72205
7	Highlands Oncology Group - Rogers	Rogers	Arkansas	United States	72758
8	Kaiser Permanente-Anaheim	Anaheim	California	United States	92806
9	Sutter Auburn Faith Hospital	Auburn	California	United States	95602
10	Kaiser Permanente-Baldwin Park	Baldwin Park	California	United States	91706
11	Kaiser Permanente-Bellflower	Bellflower	California	United States	90706
12	UC Irvine Health Cancer Center-Newport	Costa Mesa	California	United States	92627
13	City of Hope Comprehensive Cancer Center	Duarte	California	United States	91010
14	Kaiser Permanente-Fontana	Fontana	California	United States	92335
15	Kaiser Permanente-Fremont	Fremont	California	United States	94538
16	Palo Alto Medical Foundation-Fremont	Fremont	California	United States	94538
17	Kaiser Permanente-Fresno	Fresno	California	United States	93720
18	Kaiser Permanente - Harbor City	Harbor City	California	United States	90710
19	Kaiser Permanente-Irvine	Irvine	California	United States	92618
20	UC San Diego Moores Cancer Center	La Jolla	California	United States	92093
21	Kaiser Permanente Los Angeles Medical Center	Los Angeles	California	United States	90027
22	Los Angeles County-USC Medical Center	Los Angeles	California	United States	90033
23	USC / Norris Comprehensive Cancer Center	Los Angeles	California	United States	90033
24	Kaiser Permanente West Los Angeles	Los Angeles	California	United States	90034
25	Cedars Sinai Medical Center	Los Angeles	California	United States	90048
26	UCLA / Jonsson Comprehensive Cancer Center	Los Angeles	California	United States	90095
27	Fremont - Rideout Cancer Center	Marysville	California	United States	95901
28	Memorial Medical Center	Modesto	California	United States	95355
29	Kaiser Permanente-Modesto	Modesto	California	United States	95356
30	Palo Alto Medical Foundation-Camino Division	Mountain View	California	United States	94040
31	USC Norris Oncology/Hematology-Newport Beach	Newport Beach	California	United States	92663
32	Sutter Cancer Research Consortium	Novato	California	United States	94945
33	Kaiser Permanente-Oakland	Oakland	California	United States	94611
34	Saint Joseph Hospital - Orange	Orange	California	United States	92868
35	UC Irvine Health/Chao Family Comprehensive Cancer Center	Orange	California	United States	92868
36	Palo Alto Medical Foundation Health Care	Palo Alto	California	United States	94301
37	Stanford Cancer Institute Palo Alto	Palo Alto	California	United States	94304
38	Kaiser Permanente - Panorama City	Panorama City	California	United States	91402
39	Kaiser Permanente-Redwood City	Redwood City	California	United States	94063
40	Kaiser Permanente-Richmond	Richmond	California	United States	94801
41	Kaiser Permanente-Riverside	Riverside	California	United States	92505
42	Kaiser Permanente-Roseville	Roseville	California	United States	95661
43	Sutter Roseville Medical Center	Roseville	California	United States	95661
44	Sutter Medical Center Sacramento	Sacramento	California	United States	95816
45	University of California Davis Comprehensive Cancer Center	Sacramento	California	United States	95817
46	Kaiser Permanente-South Sacramento	Sacramento	California	United States	95823
47	Kaiser Permanente - Sacramento	Sacramento	California	United States	95825
48	Kaiser Permanente-San Diego Mission	San Diego	California	United States	92108
49	Kaiser Permanente-San Diego Zion	San Diego	California	United States	92120
50	California Pacific Medical Center-Pacific Campus	San Francisco	California	United States	94115
51	Kaiser Permanente-San Francisco	San Francisco	California	United States	94115
52	Kaiser Permanente-Santa Teresa-San Jose	San Jose	California	United States	95119
53	Kaiser Permanente San Leandro	San Leandro	California	United States	94577
54	Kaiser Permanente-San Marcos	San Marcos	California	United States	92078
55	Kaiser Permanente-San Rafael	San Rafael	California	United States	94903
56	Kaiser Permanente Medical Center - Santa Clara	Santa Clara	California	United States	95051
57	Palo Alto Medical Foundation-Santa Cruz	Santa Cruz	California	United States	95065
58	Kaiser Permanente-Santa Rosa	Santa Rosa	California	United States	95403
59	Sutter Pacific Medical Foundation	Santa Rosa	California	United States	95403
60	Kaiser Permanente-South San Francisco	South San Francisco	California	United States	94080
61	Kaiser Permanente-Stockton	Stockton	California	United States	95210
62	Palo Alto Medical Foundation-Sunnyvale	Sunnyvale	California	United States	94086
63	Gene Upshaw Memorial Tahoe Forest Cancer Center	Truckee	California	United States	96161
64	Kaiser Permanente Medical Center-Vacaville	Vacaville	California	United States	95688
65	Kaiser Permanente-Vallejo	Vallejo	California	United States	94589
66	Kaiser Permanente-Walnut Creek	Walnut Creek	California	United States	94596
67	Kaiser Permanente-Woodland Hills	Woodland Hills	California	United States	91367
68	University of Colorado Hospital	Aurora	Colorado	United States	80045
69	Penrose-Saint Francis Healthcare	Colorado Springs	Colorado	United States	80907
70	UCHealth Memorial Hospital Central	Colorado Springs	Colorado	United States	80909
71	Kaiser Permanente-Franklin	Denver	Colorado	United States	80205
72	Porter Adventist Hospital	Denver	Colorado	United States	80210
73	SCL Health Saint Joseph Hospital	Denver	Colorado	United States	80218
74	Poudre Valley Hospital	Fort Collins	Colorado	United States	80524
75	North Colorado Medical Center	Greeley	Colorado	United States	80631
76	Kaiser Permanente-Rock Creek	Lafayette	Colorado	United States	80026
77	Littleton Adventist Hospital	Littleton	Colorado	United States	80122
78	Kaiser Permanente-Lone Tree	Lone Tree	Colorado	United States	80124
79	Parker Adventist Hospital	Parker	Colorado	United States	80138
80	Smilow Cancer Hospital Care Center-Fairfield	Fairfield	Connecticut	United States	06824
81	Smilow Cancer Hospital Care Center at Saint Francis	Hartford	Connecticut	United States	06105
82	Yale University	New Haven	Connecticut	United States	06520
83	Stamford Hospital/Bennett Cancer Center	Stamford	Connecticut	United States	06904
84	Smilow Cancer Hospital Care Center-Trumbull	Trumbull	Connecticut	United States	06611
85	Helen F Graham Cancer Center	Newark	Delaware	United States	19713
86	Medical Oncology Hematology Consultants PA	Newark	Delaware	United States	19713
87	Christiana Care Health System-Christiana Hospital	Newark	Delaware	United States	19718
88	Beebe Health Campus	Rehoboth Beach	Delaware	United States	19971
89	MedStar Georgetown University Hospital	Washington	District of Columbia	United States	20007
90	MedStar Washington Hospital Center	Washington	District of Columbia	United States	20010
91	Lakeland Regional Health Hollis Cancer Center	Lakeland	Florida	United States	33805
92	Mount Sinai Medical Center	Miami Beach	Florida	United States	33140
93	University of Miami Miller School of Medicine-Sylvester Cancer Center	Miami	Florida	United States	33136
94	Orlando Health Cancer Institute	Orlando	Florida	United States	32806
95	Moffitt Cancer Center	Tampa	Florida	United States	33612
96	Cleveland Clinic-Weston	Weston	Florida	United States	33331
97	Emory University Hospital/Winship Cancer Institute	Atlanta	Georgia	United States	30322
98	Northside Hospital	Atlanta	Georgia	United States	30342
99	Northside Hospital-Forsyth	Cumming	Georgia	United States	30041
100	Memorial Health University Medical Center	Savannah	Georgia	United States	31404
101	Lewis Cancer and Research Pavilion at Saint Joseph's/Candler	Savannah	Georgia	United States	31405
102	South Georgia Medical Center/Pearlman Cancer Center	Valdosta	Georgia	United States	31602
103	Hawaii Cancer Care Inc - Waterfront Plaza	Honolulu	Hawaii	United States	96813
104	Island Urology	Honolulu	Hawaii	United States	96813
105	Queen's Cancer Cenrer - POB I	Honolulu	Hawaii	United States	96813
106	Queen's Medical Center	Honolulu	Hawaii	United States	96813
107	Straub Clinic and Hospital	Honolulu	Hawaii	United States	96813
108	University of Hawaii Cancer Center	Honolulu	Hawaii	United States	96813
109	Hawaii Cancer Care Inc-Liliha	Honolulu	Hawaii	United States	96817
110	Queen's Cancer Center - Kuakini	Honolulu	Hawaii	United States	96817
111	Tripler Army Medical Center	Honolulu	Hawaii	United States	96859
112	Saint Alphonsus Cancer Care Center-Boise	Boise	Idaho	United States	83706
113	Saint Luke's Cancer Institute - Boise	Boise	Idaho	United States	83712
114	Kootenai Health - Coeur d'Alene	Coeur d'Alene	Idaho	United States	83814
115	Saint Luke's Cancer Institute - Fruitland	Fruitland	Idaho	United States	83619
116	Saint Luke's Cancer Institute - Meridian	Meridian	Idaho	United States	83642
117	Saint Luke's Cancer Institute - Nampa	Nampa	Idaho	United States	83686
118	Kootenai Clinic Cancer Services - Post Falls	Post Falls	Idaho	United States	83854
119	Kootenai Cancer Clinic	Sandpoint	Idaho	United States	83864
120	Saint Luke's Cancer Institute - Twin Falls	Twin Falls	Idaho	United States	83301
121	Rush - Copley Medical Center	Aurora	Illinois	United States	60504
122	Illinois CancerCare-Bloomington	Bloomington	Illinois	United States	61704
123	Illinois CancerCare-Canton	Canton	Illinois	United States	61520
124	Centralia Oncology Clinic	Centralia	Illinois	United States	62801
125	Northwestern University	Chicago	Illinois	United States	60611
126	Rush University Medical Center	Chicago	Illinois	United States	60612
127	University of Chicago Comprehensive Cancer Center	Chicago	Illinois	United States	60637
128	Carle on Vermilion	Danville	Illinois	United States	61832
129	Cancer Care Specialists of Illinois - Decatur	Decatur	Illinois	United States	62526
130	Decatur Memorial Hospital	Decatur	Illinois	United States	62526
131	Carle Physician Group-Effingham	Effingham	Illinois	United States	62401
132	Crossroads Cancer Center	Effingham	Illinois	United States	62401
133	Elmhurst Memorial Hospital	Elmhurst	Illinois	United States	60126
134	Illinois CancerCare-Eureka	Eureka	Illinois	United States	61530
135	NorthShore University HealthSystem-Evanston Hospital	Evanston	Illinois	United States	60201
136	Illinois CancerCare-Galesburg	Galesburg	Illinois	United States	61401
137	Northwestern Medicine Cancer Center Delnor	Geneva	Illinois	United States	60134
138	NorthShore University HealthSystem-Glenbrook Hospital	Glenview	Illinois	United States	60026
139	NorthShore University HealthSystem-Highland Park Hospital	Highland Park	Illinois	United States	60035
140	Illinois CancerCare-Kewanee Clinic	Kewanee	Illinois	United States	61443
141	Illinois CancerCare-Macomb	Macomb	Illinois	United States	61455
142	Carle Physician Group-Mattoon/Charleston	Mattoon	Illinois	United States	61938
143	Loyola University Medical Center	Maywood	Illinois	United States	60153
144	Edward Hospital/Cancer Center	Naperville	Illinois	United States	60540
145	UC Comprehensive Cancer Center at Silver Cross	New Lenox	Illinois	United States	60451
146	Cancer Care Center of O'Fallon	O'Fallon	Illinois	United States	62269
147	University of Chicago Medicine-Orland Park	Orland Park	Illinois	United States	60462
148	Illinois CancerCare-Ottawa Clinic	Ottawa	Illinois	United States	61350
149	Illinois CancerCare-Pekin	Pekin	Illinois	United States	61554
150	Illinois CancerCare-Peoria	Peoria	Illinois	United States	61615
151	Illinois CancerCare-Peru	Peru	Illinois	United States	61354
152	Edward Hospital/Cancer Center?Plainfield	Plainfield	Illinois	United States	60585
153	Illinois CancerCare-Princeton	Princeton	Illinois	United States	61356
154	SwedishAmerican Regional Cancer Center/ACT	Rockford	Illinois	United States	61114
155	Central Illinois Hematology Oncology Center	Springfield	Illinois	United States	62702
156	Southern Illinois University School of Medicine	Springfield	Illinois	United States	62702
157	Springfield Clinic	Springfield	Illinois	United States	62702
158	Memorial Medical Center	Springfield	Illinois	United States	62781
159	Carle Cancer Center	Urbana	Illinois	United States	61801
160	The Carle Foundation Hospital	Urbana	Illinois	United States	61801
161	Northwestern Medicine Cancer Center Warrenville	Warrenville	Illinois	United States	60555
162	Rush-Copley Healthcare Center	Yorkville	Illinois	United States	60560
163	Indiana University/Melvin and Bren Simon Cancer Center	Indianapolis	Indiana	United States	46202
164	Community Cancer Center East	Indianapolis	Indiana	United States	46219
165	Community Cancer Center South	Indianapolis	Indiana	United States	46227
166	Franciscan Health Indianapolis	Indianapolis	Indiana	United States	46237
167	Community Cancer Center North	Indianapolis	Indiana	United States	46256
168	Franciscan Health Mooresville	Mooresville	Indiana	United States	46158
169	Reid Health	Richmond	Indiana	United States	47374
170	Mary Greeley Medical Center	Ames	Iowa	United States	50010
171	McFarland Clinic PC - Ames	Ames	Iowa	United States	50010
172	McFarland Clinic PC-Boone	Boone	Iowa	United States	50036
173	Physicians' Clinic of Iowa PC	Cedar Rapids	Iowa	United States	52402
174	Medical Oncology and Hematology Associates-West Des Moines	Clive	Iowa	United States	50325
175	Mercy Cancer Center-West Lakes	Clive	Iowa	United States	50325
176	Iowa Methodist Medical Center	Des Moines	Iowa	United States	50309
177	Medical Oncology and Hematology Associates-Des Moines	Des Moines	Iowa	United States	50309
178	Medical Oncology and Hematology Associates-Laurel	Des Moines	Iowa	United States	50314
179	Mercy Medical Center - Des Moines	Des Moines	Iowa	United States	50314
180	McFarland Clinic PC-Trinity Cancer Center	Fort Dodge	Iowa	United States	50501
181	University of Iowa/Holden Comprehensive Cancer Center	Iowa City	Iowa	United States	52242
182	McFarland Clinic PC-Jefferson	Jefferson	Iowa	United States	50129
183	McFarland Clinic PC-Marshalltown	Marshalltown	Iowa	United States	50158
184	Mercy Medical Center-West Lakes	West Des Moines	Iowa	United States	50266
185	Cancer Center of Kansas - Chanute	Chanute	Kansas	United States	66720
186	Cancer Center of Kansas - Dodge City	Dodge City	Kansas	United States	67801
187	Cancer Center of Kansas - El Dorado	El Dorado	Kansas	United States	67042
188	Saint Catherine Hospital	Garden City	Kansas	United States	67846
189	Central Care Cancer Center - Great Bend	Great Bend	Kansas	United States	67530
190	Saint Rose Ambulatory and Surgery Center	Great Bend	Kansas	United States	67530
191	HaysMed University of Kansas Health System	Hays	Kansas	United States	67601
192	University of Kansas Cancer Center-West	Kansas City	Kansas	United States	66112
193	University of Kansas Cancer Center	Kansas City	Kansas	United States	66160
194	Lawrence Memorial Hospital	Lawrence	Kansas	United States	66044
195	Kansas Institute of Medicine Cancer and Blood Center	Lenexa	Kansas	United States	66219
196	Minimally Invasive Surgery Hospital	Lenexa	Kansas	United States	66219
197	Cancer Center of Kansas-Liberal	Liberal	Kansas	United States	67905
198	Cancer Center of Kansas - McPherson	McPherson	Kansas	United States	67460
199	Cancer Center of Kansas - Newton	Newton	Kansas	United States	67114
200	Olathe Health Cancer Center	Olathe	Kansas	United States	66061
201	Menorah Medical Center	Overland Park	Kansas	United States	66209
202	University of Kansas Cancer Center-Overland Park	Overland Park	Kansas	United States	66210
203	Saint Luke's South Hospital	Overland Park	Kansas	United States	66213
204	Cancer Center of Kansas - Parsons	Parsons	Kansas	United States	67357
205	Ascension Via Christi - Pittsburg	Pittsburg	Kansas	United States	66762
206	Cancer Center of Kansas - Salina	Salina	Kansas	United States	67401
207	Salina Regional Health Center	Salina	Kansas	United States	67401
208	University of Kansas Health System Saint Francis Campus	Topeka	Kansas	United States	66606
209	Cancer Center of Kansas - Wellington	Wellington	Kansas	United States	67152
210	Cancer Center of Kansas-Wichita Medical Arts Tower	Wichita	Kansas	United States	67208
211	Ascension Via Christi Hospitals Wichita	Wichita	Kansas	United States	67214
212	Cancer Center of Kansas - Wichita	Wichita	Kansas	United States	67214
213	Cancer Center of Kansas - Winfield	Winfield	Kansas	United States	67156
214	Flaget Memorial Hospital	Bardstown	Kentucky	United States	40004
215	Saint Joseph Radiation Oncology Resource Center	Lexington	Kentucky	United States	40504
216	Saint Joseph Hospital East	Lexington	Kentucky	United States	40509
217	Saints Mary and Elizabeth Hospital	Louisville	Kentucky	United States	40215
218	UofL Health Medical Center Northeast	Louisville	Kentucky	United States	40245
219	Owensboro Health Mitchell Memorial Cancer Center	Owensboro	Kentucky	United States	42303
220	LSU Health Baton Rouge-North Clinic	Baton Rouge	Louisiana	United States	70805
221	Louisiana Hematology Oncology Associates LLC	Baton Rouge	Louisiana	United States	70809
222	Mary Bird Perkins Cancer Center	Baton Rouge	Louisiana	United States	70809
223	Our Lady of the Lake Physicians Group - Medical Oncology	Baton Rouge	Louisiana	United States	70809
224	Northshore Oncology Associates-Covington	Covington	Louisiana	United States	70433
225	Ochsner LSU Health Monroe Medical Center	Monroe	Louisiana	United States	71202
226	LSU Health Sciences Center at Shreveport	Shreveport	Louisiana	United States	71103
227	Harold Alfond Center for Cancer Care	Augusta	Maine	United States	04330
228	Eastern Maine Medical Center	Bangor	Maine	United States	04401
229	Lafayette Family Cancer Center-EMMC	Brewer	Maine	United States	04412
230	Maine Center for Cancer Medicine-Scarborough	Scarborough	Maine	United States	04074
231	Mercy Medical Center	Baltimore	Maryland	United States	21202
232	MedStar Franklin Square Medical Center/Weinberg Cancer Institute	Baltimore	Maryland	United States	21237
233	Frederick Memorial Hospital	Frederick	Maryland	United States	21701
234	Beverly Hospital	Beverly	Massachusetts	United States	01915
235	Massachusetts General Hospital Cancer Center	Boston	Massachusetts	United States	02114
236	Boston Medical Center	Boston	Massachusetts	United States	02118
237	Beth Israel Deaconess Medical Center	Boston	Massachusetts	United States	02215
238	Dana-Farber Cancer Institute	Boston	Massachusetts	United States	02215
239	Lahey Hospital and Medical Center	Burlington	Massachusetts	United States	01805
240	Addison Gilbert Hospital	Gloucester	Massachusetts	United States	01930
241	Baystate Medical Center	Springfield	Massachusetts	United States	01199
242	University of Michigan Comprehensive Cancer Center	Ann Arbor	Michigan	United States	48109
243	Wayne State University/Karmanos Cancer Institute	Detroit	Michigan	United States	48201
244	Henry Ford Hospital	Detroit	Michigan	United States	48202
245	Ascension Saint John Hospital	Detroit	Michigan	United States	48236
246	Great Lakes Cancer Management Specialists-Doctors Park	East China Township	Michigan	United States	48054
247	Green Bay Oncology - Escanaba	Escanaba	Michigan	United States	49829
248	Genesys Hurley Cancer Institute	Flint	Michigan	United States	48503
249	Hurley Medical Center	Flint	Michigan	United States	48503
250	Mercy Health Saint Mary's	Grand Rapids	Michigan	United States	49503
251	Spectrum Health at Butterworth Campus	Grand Rapids	Michigan	United States	49503
252	Academic Hematology Oncology Specialists	Grosse Pointe Woods	Michigan	United States	48236
253	Great Lakes Cancer Management Specialists-Van Elslander Cancer Center	Grosse Pointe Woods	Michigan	United States	48236
254	Michigan Breast Specialists-Grosse Pointe Woods	Grosse Pointe Woods	Michigan	United States	48236
255	Green Bay Oncology - Iron Mountain	Iron Mountain	Michigan	United States	49801
256	Allegiance Health	Jackson	Michigan	United States	49201
257	West Michigan Cancer Center	Kalamazoo	Michigan	United States	49007
258	Sparrow Hospital	Lansing	Michigan	United States	48912
259	Great Lakes Cancer Management Specialists-Macomb Medical Campus	Macomb	Michigan	United States	48044
260	Michigan Breast Specialists-Macomb Township	Macomb	Michigan	United States	48044
261	Mercy Health Mercy Campus	Muskegon	Michigan	United States	49444
262	Spectrum Health Reed City Hospital	Reed City	Michigan	United States	49677
263	Great Lakes Cancer Management Specialists-Rochester Hills	Rochester Hills	Michigan	United States	48309
264	Ascension Saint Mary's Hospital	Saginaw	Michigan	United States	48601
265	Munson Medical Center	Traverse City	Michigan	United States	49684
266	Great Lakes Cancer Management Specialists-Macomb Professional Building	Warren	Michigan	United States	48093
267	Saint John Macomb-Oakland Hospital	Warren	Michigan	United States	48093
268	Metro Health Hospital	Wyoming	Michigan	United States	49519
269	Sanford Joe Lueken Cancer Center	Bemidji	Minnesota	United States	56601
270	Fairview Ridges Hospital	Burnsville	Minnesota	United States	55337
271	Mercy Hospital	Coon Rapids	Minnesota	United States	55433
272	Essentia Health Cancer Center	Duluth	Minnesota	United States	55805
273	Essentia Health Saint Mary's Medical Center	Duluth	Minnesota	United States	55805
274	Miller-Dwan Hospital	Duluth	Minnesota	United States	55805
275	Fairview Southdale Hospital	Edina	Minnesota	United States	55435
276	Lake Region Healthcare Corporation-Cancer Care	Fergus Falls	Minnesota	United States	56537
277	Unity Hospital	Fridley	Minnesota	United States	55432
278	Minnesota Oncology Hematology PA-Maplewood	Maplewood	Minnesota	United States	55109
279	Saint John's Hospital - Healtheast	Maplewood	Minnesota	United States	55109
280	Abbott-Northwestern Hospital	Minneapolis	Minnesota	United States	55407
281	Hennepin County Medical Center	Minneapolis	Minnesota	United States	55415
282	Park Nicollet Clinic - Saint Louis Park	Saint Louis Park	Minnesota	United States	55416
283	Regions Hospital	Saint Paul	Minnesota	United States	55101
284	United Hospital	Saint Paul	Minnesota	United States	55102
285	Ridgeview Medical Center	Waconia	Minnesota	United States	55387
286	Minnesota Oncology Hematology PA-Woodbury	Woodbury	Minnesota	United States	55125
287	University of Mississippi Medical Center	Jackson	Mississippi	United States	39216
288	Parkland Health Center-Bonne Terre	Bonne Terre	Missouri	United States	63628
289	Saint Francis Medical Center	Cape Girardeau	Missouri	United States	63703
290	Southeast Cancer Center	Cape Girardeau	Missouri	United States	63703
291	Centerpoint Medical Center LLC	Independence	Missouri	United States	64057
292	Capital Region Southwest Campus	Jefferson City	Missouri	United States	65109
293	Truman Medical Centers	Kansas City	Missouri	United States	64108
294	Saint Luke's Hospital of Kansas City	Kansas City	Missouri	United States	64111
295	Heartland Hematology and Oncology Associates Incorporated	Kansas City	Missouri	United States	64118
296	Kansas City Veterans Affairs Medical Center	Kansas City	Missouri	United States	64128
297	The University of Kansas Cancer Center-South	Kansas City	Missouri	United States	64131
298	Research Medical Center	Kansas City	Missouri	United States	64132
299	University of Kansas Cancer Center - North	Kansas City	Missouri	United States	64154
300	University of Kansas Cancer Center - Lee's Summit	Lee's Summit	Missouri	United States	64064
301	Saint Luke's East - Lee's Summit	Lee's Summit	Missouri	United States	64086
302	Liberty Radiation Oncology Center	Liberty	Missouri	United States	64068
303	Heartland Regional Medical Center	Saint Joseph	Missouri	United States	64506
304	Missouri Baptist Medical Center	Saint Louis	Missouri	United States	63131
305	Sainte Genevieve County Memorial Hospital	Sainte Genevieve	Missouri	United States	63670
306	Mercy Hospital Springfield	Springfield	Missouri	United States	65804
307	CoxHealth South Hospital	Springfield	Missouri	United States	65807
308	Missouri Baptist Sullivan Hospital	Sullivan	Missouri	United States	63080
309	Community Hospital of Anaconda	Anaconda	Montana	United States	59711
310	Billings Clinic Cancer Center	Billings	Montana	United States	59101
311	Saint Vincent Healthcare	Billings	Montana	United States	59101
312	Bozeman Deaconess Hospital	Bozeman	Montana	United States	59715
313	Saint James Community Hospital and Cancer Treatment Center	Butte	Montana	United States	59701
314	Benefis Healthcare- Sletten Cancer Institute	Great Falls	Montana	United States	59405
315	Great Falls Clinic	Great Falls	Montana	United States	59405
316	Saint Peter's Community Hospital	Helena	Montana	United States	59601
317	Kalispell Regional Medical Center	Kalispell	Montana	United States	59901
318	Saint Patrick Hospital - Community Hospital	Missoula	Montana	United States	59802
319	Community Medical Hospital	Missoula	Montana	United States	59804
320	CHI Health Saint Francis	Grand Island	Nebraska	United States	68803
321	Nebraska Hematology and Oncology	Lincoln	Nebraska	United States	68506
322	Southeast Nebraska Cancer Center - 68th Street Place	Lincoln	Nebraska	United States	68516
323	Faith Regional Health Services Carson Cancer Center	Norfolk	Nebraska	United States	68701
324	Nebraska Methodist Hospital	Omaha	Nebraska	United States	68114
325	Alegent Health Immanuel Medical Center	Omaha	Nebraska	United States	68122
326	Alegent Health Bergan Mercy Medical Center	Omaha	Nebraska	United States	68124
327	Nebraska Cancer Specialists - Omaha	Omaha	Nebraska	United States	68124
328	Alegent Health Lakeside Hospital	Omaha	Nebraska	United States	68130
329	Creighton University Medical Center	Omaha	Nebraska	United States	68131
330	Regional West Medical Center Cancer Center	Scottsbluff	Nebraska	United States	69361
331	Cancer and Blood Specialists-Henderson	Henderson	Nevada	United States	89052
332	Comprehensive Cancer Centers of Nevada - Henderson	Henderson	Nevada	United States	89052
333	Las Vegas Cancer Center-Henderson	Henderson	Nevada	United States	89052
334	Comprehensive Cancer Centers of Nevada-Southeast Henderson	Henderson	Nevada	United States	89074
335	GenesisCare USA - Henderson	Henderson	Nevada	United States	89074
336	University Medical Center of Southern Nevada	Las Vegas	Nevada	United States	89102
337	GenesisCare USA - Las Vegas	Las Vegas	Nevada	United States	89109
338	Cancer Therapy and Integrative Medicine	Las Vegas	Nevada	United States	89121
339	Ann M Wierman MD LTD	Las Vegas	Nevada	United States	89128
340	Comprehensive Cancer Centers of Nevada - Northwest	Las Vegas	Nevada	United States	89128
341	Las Vegas Cancer Center-Medical Center	Las Vegas	Nevada	United States	89148-2405
342	Comprehensive Cancer Centers of Nevada	Las Vegas	Nevada	United States	89148
343	OptumCare Cancer Care at Fort Apache	Las Vegas	Nevada	United States	89148
344	Comprehensive Cancer Centers of Nevada - Central Valley	Las Vegas	Nevada	United States	89169
345	University Cancer Center	Las Vegas	Nevada	United States	89169
346	Wentworth-Douglass Hospital	Dover	New Hampshire	United States	03820
347	Dartmouth Hitchcock Medical Center	Lebanon	New Hampshire	United States	03756
348	Norris Cotton Cancer Center-Manchester	Manchester	New Hampshire	United States	03102
349	Saint Joseph Hospital	Nashua	New Hampshire	United States	03060
350	Norris Cotton Cancer Center-Nashua	Nashua	New Hampshire	United States	03063
351	Veterans Adminstration New Jersey Health Care System	East Orange	New Jersey	United States	07018-1095
352	Hackensack University Medical Center	Hackensack	New Jersey	United States	07601
353	Saint Barnabas Medical Center	Livingston	New Jersey	United States	07039
354	Rutgers Cancer Institute of New Jersey	New Brunswick	New Jersey	United States	08903
355	Lovelace Medical Center-Saint Joseph Square	Albuquerque	New Mexico	United States	87102
356	University of New Mexico Cancer Center	Albuquerque	New Mexico	United States	87102
357	Southwest Gynecologic Oncology Associates Inc	Albuquerque	New Mexico	United States	87106
358	Hematology Oncology Associates of Central New York-Auburn	Auburn	New York	United States	13021
359	Roswell Park Cancer Institute	Buffalo	New York	United States	14263
360	Hematology Oncology Associates of Central New York-East Syracuse	East Syracuse	New York	United States	13057
361	Glens Falls Hospital	Glens Falls	New York	United States	12801
362	NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center	New York	New York	United States	10032
363	Rochester General Hospital	Rochester	New York	United States	14621
364	University of Rochester	Rochester	New York	United States	14642
365	Stony Brook University Medical Center	Stony Brook	New York	United States	11794
366	State University of New York Upstate Medical University	Syracuse	New York	United States	13210
367	Hematology Oncology Associates of Central New York-Onondaga Hill	Syracuse	New York	United States	13215
368	UNC Lineberger Comprehensive Cancer Center	Chapel Hill	North Carolina	United States	27599
369	Southeastern Medical Oncology Center-Clinton	Clinton	North Carolina	United States	28328
370	Duke University Medical Center	Durham	North Carolina	United States	27710
371	Southeastern Medical Oncology Center-Goldsboro	Goldsboro	North Carolina	United States	27534
372	Wayne Memorial Hospital	Goldsboro	North Carolina	United States	27534
373	Hendersonville Hematology and Oncology at Pardee	Hendersonville	North Carolina	United States	28791
374	Margaret R Pardee Memorial Hospital	Hendersonville	North Carolina	United States	28791
375	Southeastern Medical Oncology Center-Jacksonville	Jacksonville	North Carolina	United States	28546
376	Sanford Bismarck Medical Center	Bismarck	North Dakota	United States	58501
377	Sanford Broadway Medical Center	Fargo	North Dakota	United States	58122
378	Sanford Clinic North-Fargo	Fargo	North Dakota	United States	58122
379	Sanford Roger Maris Cancer Center	Fargo	North Dakota	United States	58122
380	Altru Cancer Center	Grand Forks	North Dakota	United States	58201
381	UHHS-Chagrin Highlands Medical Center	Beachwood	Ohio	United States	44122
382	Strecker Cancer Center-Belpre	Belpre	Ohio	United States	45714
383	Dayton Physicians LLC-Miami Valley South	Centerville	Ohio	United States	45459
384	Miami Valley Hospital South	Centerville	Ohio	United States	45459
385	Adena Regional Medical Center	Chillicothe	Ohio	United States	45601
386	University of Cincinnati Cancer Center-UC Medical Center	Cincinnati	Ohio	United States	45219
387	Case Western Reserve University	Cleveland	Ohio	United States	44106
388	MetroHealth Medical Center	Cleveland	Ohio	United States	44109
389	Cleveland Clinic Cancer Center/Fairview Hospital	Cleveland	Ohio	United States	44111
390	Cleveland Clinic Foundation	Cleveland	Ohio	United States	44195
391	Ohio State University Comprehensive Cancer Center	Columbus	Ohio	United States	43210
392	Mount Carmel East Hospital	Columbus	Ohio	United States	43213
393	Columbus Oncology and Hematology Associates Inc	Columbus	Ohio	United States	43214
394	Riverside Methodist Hospital	Columbus	Ohio	United States	43214
395	Grant Medical Center	Columbus	Ohio	United States	43215
396	The Mark H Zangmeister Center	Columbus	Ohio	United States	43219
397	Mount Carmel Health Center West	Columbus	Ohio	United States	43222
398	Doctors Hospital	Columbus	Ohio	United States	43228
399	Good Samaritan Hospital - Dayton	Dayton	Ohio	United States	45406
400	Miami Valley Hospital	Dayton	Ohio	United States	45409
401	Dayton Physician LLC-Miami Valley Hospital North	Dayton	Ohio	United States	45415
402	Miami Valley Hospital North	Dayton	Ohio	United States	45415
403	Delaware Health Center-Grady Cancer Center	Delaware	Ohio	United States	43015
404	Grady Memorial Hospital	Delaware	Ohio	United States	43015
405	Armes Family Cancer Center	Findlay	Ohio	United States	45840
406	Blanchard Valley Hospital	Findlay	Ohio	United States	45840
407	Orion Cancer Care	Findlay	Ohio	United States	45840
408	Cleveland Clinic Cancer Center Independence	Independence	Ohio	United States	44131
409	Greater Dayton Cancer Center	Kettering	Ohio	United States	45409
410	Kettering Medical Center	Kettering	Ohio	United States	45429
411	OhioHealth Mansfield Hospital	Mansfield	Ohio	United States	44903
412	Cleveland Clinic Cancer Center Mansfield	Mansfield	Ohio	United States	44906
413	Marietta Memorial Hospital	Marietta	Ohio	United States	45750
414	OhioHealth Marion General Hospital	Marion	Ohio	United States	43302
415	Hillcrest Hospital Cancer Center	Mayfield Heights	Ohio	United States	44124
416	Knox Community Hospital	Mount Vernon	Ohio	United States	43050
417	Licking Memorial Hospital	Newark	Ohio	United States	43055
418	University Hospitals Parma Medical Center	Parma	Ohio	United States	44129
419	Southern Ohio Medical Center	Portsmouth	Ohio	United States	45662
420	North Coast Cancer Care	Sandusky	Ohio	United States	44870
421	UH Seidman Cancer Center at Firelands Regional Medical Center	Sandusky	Ohio	United States	44870
422	Cleveland Clinic Cancer Center Strongsville	Strongsville	Ohio	United States	44136
423	ProMedica Flower Hospital	Sylvania	Ohio	United States	43560
424	University of Toledo	Toledo	Ohio	United States	43614
425	South Pointe Hospital	Warrensville Heights	Ohio	United States	44122
426	Saint Ann's Hospital	Westerville	Ohio	United States	43081
427	Cleveland Clinic Wooster Family Health and Surgery Center	Wooster	Ohio	United States	44691
428	Genesis Healthcare System Cancer Care Center	Zanesville	Ohio	United States	43701
429	University of Oklahoma Health Sciences Center	Oklahoma City	Oklahoma	United States	73104
430	Mercy Hospital Oklahoma City	Oklahoma City	Oklahoma	United States	73120
431	Providence Portland Medical Center	Portland	Oregon	United States	97213
432	Kaiser Permanente Northwest	Portland	Oregon	United States	97227
433	Oregon Health and Science University	Portland	Oregon	United States	97239
434	Jefferson Abington Hospital	Abington	Pennsylvania	United States	19001
435	Lehigh Valley Hospital-Cedar Crest	Allentown	Pennsylvania	United States	18103
436	Saint Luke's University Hospital-Bethlehem Campus	Bethlehem	Pennsylvania	United States	18015
437	Geisinger Medical Center	Danville	Pennsylvania	United States	17822
438	Ephrata Cancer Center	Ephrata	Pennsylvania	United States	17522
439	Ephrata Community Hospital	Ephrata	Pennsylvania	United States	17522
440	UPMC Hillman Cancer Center Erie	Erie	Pennsylvania	United States	16505
441	Adams Cancer Center	Gettysburg	Pennsylvania	United States	17325
442	Cherry Tree Cancer Center	Hanover	Pennsylvania	United States	17331
443	Geisinger Medical Center-Cancer Center Hazleton	Hazleton	Pennsylvania	United States	18201
444	Penn State Milton S Hershey Medical Center	Hershey	Pennsylvania	United States	17033-0850
445	Fox Chase Cancer Center	Philadelphia	Pennsylvania	United States	19111
446	Allegheny General Hospital	Pittsburgh	Pennsylvania	United States	15212
447	West Penn Hospital	Pittsburgh	Pennsylvania	United States	15224
448	University of Pittsburgh Cancer Institute (UPCI)	Pittsburgh	Pennsylvania	United States	15232
449	Geisinger Cancer Services-Pottsville	Pottsville	Pennsylvania	United States	17901
450	Reading Hospital	West Reading	Pennsylvania	United States	19611
451	Wexford Health and Wellness Pavilion	Wexford	Pennsylvania	United States	15090
452	Geisinger Wyoming Valley/Henry Cancer Center	Wilkes-Barre	Pennsylvania	United States	18711
453	UPMC Susquehanna	Williamsport	Pennsylvania	United States	17701
454	WellSpan Health-York Cancer Center	York	Pennsylvania	United States	17403
455	WellSpan Health-York Hospital	York	Pennsylvania	United States	17403
456	Newport Hospital	Newport	Rhode Island	United States	02840
457	Rhode Island Hospital	Providence	Rhode Island	United States	02903
458	Miriam Hospital	Providence	Rhode Island	United States	02906
459	AnMed Health Cancer Center	Anderson	South Carolina	United States	29621
460	Roper Hospital	Charleston	South Carolina	United States	29401
461	Charleston Oncology - Roper	Charleston	South Carolina	United States	29403
462	Lowcountry Hematology Oncology PA-North Charleston	Charleston	South Carolina	United States	29406
463	Bon Secours Saint Francis Hospital	Charleston	South Carolina	United States	29414
464	Charleston Oncology - Saint Francis	Charleston	South Carolina	United States	29414
465	Lowcountry Hematology Oncology PA-West Ashley	Charleston	South Carolina	United States	29414
466	Saint Francis Cancer Center	Greenville	South Carolina	United States	29607
467	Lowcountry Hematology Oncology PA-Mount Pleasant	Mount Pleasant	South Carolina	United States	29464
468	Rapid City Regional Hospital	Rapid City	South Dakota	United States	57701
469	Sanford Cancer Center Oncology Clinic	Sioux Falls	South Dakota	United States	57104
470	Sanford USD Medical Center - Sioux Falls	Sioux Falls	South Dakota	United States	57117-5134
471	The West Clinic - Wolf River	Germantown	Tennessee	United States	38138
472	The West Clinic - Mid-Town	Memphis	Tennessee	United States	38104
473	University of Tennessee Health Science Center	Memphis	Tennessee	United States	38163
474	Vanderbilt University/Ingram Cancer Center	Nashville	Tennessee	United States	37232
475	Texas Oncology - Central Austin Cancer Center	Austin	Texas	United States	78731
476	Baylor University Medical Center	Dallas	Texas	United States	75246
477	M D Anderson Cancer Center	Houston	Texas	United States	77030
478	American Fork Hospital / Huntsman Intermountain Cancer Center	American Fork	Utah	United States	84003
479	Sandra L Maxwell Cancer Center	Cedar City	Utah	United States	84720
480	Logan Regional Hospital	Logan	Utah	United States	84321
481	Intermountain Medical Center	Murray	Utah	United States	84107
482	McKay-Dee Hospital Center	Ogden	Utah	United States	84403
483	Utah Valley Regional Medical Center	Provo	Utah	United States	84604
484	Saint George Regional Medical Center	Saint George	Utah	United States	84770
485	Utah Cancer Specialists-Salt Lake City	Salt Lake City	Utah	United States	84106
486	Huntsman Cancer Institute/University of Utah	Salt Lake City	Utah	United States	84112
487	LDS Hospital	Salt Lake City	Utah	United States	84143
488	South Jordan Health Center	South Jordan	Utah	United States	84009
489	Central Vermont Medical Center/National Life Cancer Treatment	Berlin	Vermont	United States	05602
490	University of Vermont Medical Center	Burlington	Vermont	United States	05401
491	University of Vermont and State Agricultural College	Burlington	Vermont	United States	05405
492	Centra Lynchburg Hematology-Oncology Clinic Inc	Lynchburg	Virginia	United States	24501
493	Virginia Cancer Institute	Richmond	Virginia	United States	23229
494	Virginia Commonwealth University/Massey Cancer Center	Richmond	Virginia	United States	23298
495	VCU Community Memorial Health Center	South Hill	Virginia	United States	23970
496	Providence Regional Cancer System-Aberdeen	Aberdeen	Washington	United States	98520
497	Providence Regional Cancer System-Centralia	Centralia	Washington	United States	98531
498	Providence Regional Cancer Partnership	Everett	Washington	United States	98201
499	Providence Regional Cancer System-Lacey	Lacey	Washington	United States	98503
500	PeaceHealth Saint John Medical Center	Longview	Washington	United States	98632
501	Kaiser Permanente Washington	Seattle	Washington	United States	98112
502	Swedish Medical Center-First Hill	Seattle	Washington	United States	98122-4307
503	Providence Regional Cancer System-Shelton	Shelton	Washington	United States	98584
504	PeaceHealth Southwest Medical Center	Vancouver	Washington	United States	98664
505	Providence Saint Mary Regional Cancer Center	Walla Walla	Washington	United States	99362
506	Providence Regional Cancer System-Yelm	Yelm	Washington	United States	98597
507	United Hospital Center	Bridgeport	West Virginia	United States	26330
508	West Virginia University Charleston Division	Charleston	West Virginia	United States	25304
509	West Virginia University Healthcare	Morgantown	West Virginia	United States	26506
510	Camden Clark Medical Center	Parkersburg	West Virginia	United States	26101
511	Langlade Hospital and Cancer Center	Antigo	Wisconsin	United States	54409
512	Aurora Cancer Care-Southern Lakes VLCC	Burlington	Wisconsin	United States	53105
513	Marshfield Clinic-Chippewa Center	Chippewa Falls	Wisconsin	United States	54729
514	Marshfield Clinic Cancer Center at Sacred Heart	Eau Claire	Wisconsin	United States	54701
515	Saint Agnes Hospital/Agnesian Cancer Center	Fond Du Lac	Wisconsin	United States	54935
516	Aurora Health Center-Fond du Lac	Fond Du Lac	Wisconsin	United States	54937
517	Aurora Health Care Germantown Health Center	Germantown	Wisconsin	United States	53022
518	Aurora Cancer Care-Grafton	Grafton	Wisconsin	United States	53024
519	Green Bay Oncology at Saint Vincent Hospital	Green Bay	Wisconsin	United States	54301-3526
520	Saint Vincent Hospital Cancer Center Green Bay	Green Bay	Wisconsin	United States	54301
521	Green Bay Oncology Limited at Saint Mary's Hospital	Green Bay	Wisconsin	United States	54303
522	Saint Vincent Hospital Cancer Center at Saint Mary's	Green Bay	Wisconsin	United States	54303
523	Aurora BayCare Medical Center	Green Bay	Wisconsin	United States	54311
524	Aurora Cancer Care-Kenosha South	Kenosha	Wisconsin	United States	53142
525	Gundersen Lutheran Medical Center	La Crosse	Wisconsin	United States	54601
526	University of Wisconsin Carbone Cancer Center	Madison	Wisconsin	United States	53792
527	Aurora Bay Area Medical Group-Marinette	Marinette	Wisconsin	United States	54143
528	Bay Area Medical Center	Marinette	Wisconsin	United States	54143
529	Marshfield Medical Center-Marshfield	Marshfield	Wisconsin	United States	54449
530	Froedtert Menomonee Falls Hospital	Menomonee Falls	Wisconsin	United States	53051
531	Aurora Cancer Care-Milwaukee	Milwaukee	Wisconsin	United States	53209
532	Ascension Southeast Wisconsin Hospital - Saint Joseph Campus	Milwaukee	Wisconsin	United States	53210
533	Aurora Saint Luke's Medical Center	Milwaukee	Wisconsin	United States	53215
534	Medical College of Wisconsin	Milwaukee	Wisconsin	United States	53226
535	Aurora Sinai Medical Center	Milwaukee	Wisconsin	United States	53233
536	Marshfield Clinic-Minocqua Center	Minocqua	Wisconsin	United States	54548
537	Cancer Center of Western Wisconsin	New Richmond	Wisconsin	United States	54017
538	Saint Vincent Hospital Cancer Center at Oconto Falls	Oconto Falls	Wisconsin	United States	54154
539	Vince Lombardi Cancer Clinic - Oshkosh	Oshkosh	Wisconsin	United States	54904
540	Aurora Cancer Care-Racine	Racine	Wisconsin	United States	53406
541	Lakeview Medical Center-Marshfield Clinic	Rice Lake	Wisconsin	United States	54868
542	Marshfield Medical Center-Rice Lake	Rice Lake	Wisconsin	United States	54868
543	HSHS Saint Nicholas Hospital	Sheboygan	Wisconsin	United States	53081
544	Vince Lombardi Cancer Clinic-Sheboygan	Sheboygan	Wisconsin	United States	53081
545	Ascension Saint Michael's Hospital	Stevens Point	Wisconsin	United States	54481
546	Saint Vincent Hospital Cancer Center at Sturgeon Bay	Sturgeon Bay	Wisconsin	United States	54235-1495
547	Green Bay Oncology - Sturgeon Bay	Sturgeon Bay	Wisconsin	United States	54235
548	Aurora Medical Center in Summit	Summit	Wisconsin	United States	53066
549	Vince Lombardi Cancer Clinic-Two Rivers	Two Rivers	Wisconsin	United States	54241
550	Aspirus Regional Cancer Center	Wausau	Wisconsin	United States	54401
551	Marshfield Clinic-Wausau Center	Wausau	Wisconsin	United States	54401
552	Aurora Cancer Care-Milwaukee West	Wauwatosa	Wisconsin	United States	53226
553	Aurora West Allis Medical Center	West Allis	Wisconsin	United States	53227
554	Marshfield Medical Center - Weston	Weston	Wisconsin	United States	54476
555	Aspirus Cancer Care - Wisconsin Rapids	Wisconsin Rapids	Wisconsin	United States	54494
556	Marshfield Clinic - Wisconsin Rapids Center	Wisconsin Rapids	Wisconsin	United States	54494
557	Big Horn Basin Cancer Center	Cody	Wyoming	United States	82414
558	Billings Clinic-Cody	Cody	Wyoming	United States	82414
559	Welch Cancer Center	Sheridan	Wyoming	United States	82801
560	BCCA-Vancouver Cancer Centre	Vancouver	British Columbia	Canada	V5Z 4E6
561	The Vitalite Health Network - Dr Leon Richard Oncology Centre	Moncton	New Brunswick	Canada	E1C 8X3
562	Royal Victoria Regional Health Centre	Barrie	Ontario	Canada	L4M 6M2
563	Juravinski Cancer Centre at Hamilton Health Sciences	Hamilton	Ontario	Canada	L8V 5C2
564	Kingston Health Sciences Centre	Kingston	Ontario	Canada	K7L 2V7
565	Grand River Regional Cancer Centre at Grand River Hospital	Kitchener	Ontario	Canada	N2G 1G3
566	London Regional Cancer Program	London	Ontario	Canada	N6A 4L6
567	Trillium Health Partners - Credit Valley Hospital	Mississauga	Ontario	Canada	L5M 2N1
568	Lakeridge Health Oshawa	Oshawa	Ontario	Canada	L1G 2B9
569	Ottawa Hospital and Cancer Center-General Campus	Ottawa	Ontario	Canada	K1H 8L6
570	Algoma District Cancer Program Sault Area Hospital	Sault Ste Marie	Ontario	Canada	P6B 0A8
571	Thunder Bay Regional Health Science Centre	Thunder Bay	Ontario	Canada	P7B 6V4
572	Odette Cancer Centre- Sunnybrook Health Sciences Centre	Toronto	Ontario	Canada	M4N 3M5
573	University Health Network-Princess Margaret Hospital	Toronto	Ontario	Canada	M5G 2M9
574	Windsor Regional Cancer Centre	Windsor	Ontario	Canada	N8W 2X3
575	Hopital de la Cite-de-la-Sante	Laval	Quebec	Canada	H7M 3L9
576	The Research Institute of the McGill University Health Centre (MUHC)	Montreal	Quebec	Canada	H3H 2R9
577	CHU de Quebec-L'Hotel-Dieu de Quebec (HDQ)	Quebec City	Quebec	Canada	G1R 2J6
578	Centre Hospitalier Universitaire de Sherbrooke-Fleurimont	Sherbrooke	Quebec	Canada	J1H 5N4
579	Allan Blair Cancer Centre	Regina	Saskatchewan	Canada	S4T 7T1
580	Saskatoon Cancer Centre	Saskatoon	Saskatchewan	Canada	S7N 4H4
581	Saint Vincent's University Hospital	Dublin	Co Dublin	Ireland	4
582	University College Hospital Galway	Galway	Co Galway	Ireland
583	University Hospital Waterford	Waterford	Co Waterford	Ireland	9

Sponsors and Collaborators

• National Cancer Institute (NCI)

Investigators

• Principal Investigator: Kenneth F Grossmann, Southwest Oncology Group

Study Documents (Full-Text)

None provided.

More Information

Publications

None provided.

• Responsible Party: National Cancer Institute (NCI)
• ClinicalTrials.gov Identifier: NCT02506153
• Other Study ID Numbers: NCI-2014-02676; NCI-2014-02676; S1404; S1404; S1404; U10CA180888
• First Posted: Jul 23, 2015
• Last Update Posted: Jul 28, 2022
• Last Verified: Jan 1, 2022

• Additional relevant MeSH terms: Melanoma; Skin Neoplasms; Recurrence; Interferons; Interferon-alpha; Interferon alpha-2; Pembrolizumab; Ipilimumab

Study Results

No Results Posted as of Jul 28, 2022