Testing Docetaxel-Cetuximab or the Addition of an Immunotherapy Drug, Atezolizumab, to the Usual Chemotherapy and Radiation Therapy in High-Risk Head and Neck Cancer
Study Details
Study Description
Brief Summary
This phase II/III trial studies how well radiation therapy works when given together with cisplatin, docetaxel, cetuximab, and/or atezolizumab after surgery in treating patients with high-risk stage III-IV head and neck cancer the begins in the thin, flat cells (squamous cell). Specialized radiation therapy that delivers a high dose of radiation directly to the tumor may kill more tumor cells and cause less damage to normal tissue. Drugs used in chemotherapy, such as cisplatin and docetaxel, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Cetuximab is a monoclonal antibody that may interfere with the ability of tumor cells to grow and spread. Immunotherapy with monoclonal antibodies, such as atezolizumab, may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. The purpose of this study is to compare the usual treatment (radiation therapy with cisplatin chemotherapy) to using radiation therapy with docetaxel and cetuximab chemotherapy, and using the usual treatment plus an immunotherapy drug, atezolizumab.
Detailed Description
PRIMARY OBJECTIVES:
- To select the better docetaxel-based experimental arm to improve disease-free survival (DFS) over the control arm of radiation and cisplatin. (Phase II) (COMPLETE AS OF 20-MAR-2020) II. To determine if the combination of docetaxel-cetuximab and intensity-modulated radiation therapy (IMRT) is superior in terms of overall survival (OS) compared to standard cisplatin and IMRT in the adjuvant treatment of pathologic high risk, human papillomavirus (HPV)-negative head and neck squamous cell carcinoma (HNSCC). (Phase
-
- To determine if the combination of atezolizumab, cisplatin, and IMRT is superior in terms of OS compared to standard cisplatin and IMRT in the adjuvant treatment of pathologic high risk, HPV-negative HNSCC. (Phase III)
SECONDARY OBJECTIVES:
- To compare disease-free survival (DFS) between each experimental arm and the control arm. (Phase III) II. To determine whether each experimental arm improves local-regional disease control and the rate of distant metastasis. (Phase III) III. To compare acute toxicity profiles between each experimental arm and the control arm. (Phase III) IV. To compare late toxicity profiles at 1, 3, and 5 years after treatment. (Phase III) V. To assess long term DFS and OS between each experimental arm and the control arm. (Phase III) VI. To compare symptom burden, as measured by the MD Anderson Symptom Inventory - Head and Neck (MDASI-HN) (primary patient reported outcome [PRO]), and quality of life, as measured by the Functional Assessment of Cancer Therapy - Head and Neck (FACT-H&N) (secondary PRO), between each experimental arm and the control arm. (Phase III)
EXPLORATORY OBJECTIVE:
- To collect blood and tissue specimens for future translational research. (Phase III)
OUTLINE: Patients are randomized to 1 of 3 arms - Phase II (Arms 1, 2 or 3) and for Phase III (Arms 1, 3 or 4).
ARM 1: Patients undergo intensity modulated radiation therapy (IMRT) once daily (QD) five days a week for 6 weeks and receive concurrent cisplatin intravenously (IV) over 1-2 hours once weekly for 6 weeks.
ARM 2: Patients undergo IMRT as in Arm I and receive concurrent docetaxel IV over 60 minutes once weekly for 6 weeks. (CLOSED AS OF 20-MAR-2020)
ARM 3: Patients receive cetuximab IV over 120 minutes on week 1 and over 60 minutes once weekly on weeks 2-7. Patients undergo IMRT as in Arm I and concurrently receive docetaxel once weekly for 6 weeks.
ARM 4: Patients undergo IMRT QD five days a week for 6 weeks and receive concurrent cisplatin IV over 1-2 hours once weekly for 6 weeks. Starting 1 week before IMRT, patients also receive atezolizumab IV over 30-60 minutes every 3 weeks for up to 8 doses (weeks -1, 3, 6, 9, 12, 15, 18, and 21) in the absence of disease progression and unacceptable toxicity.
After completion of study treatment, patients are followed up at 1 and 3 months, every 3 months for 2 years, every 6 months for 3 years, and then annually thereafter.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: Arm 1 (IMRT, cisplatin) Patients undergo IMRT QD five days a week for 6 weeks and receive concurrent cisplatin IV over 1-2 hours once weekly for 6 weeks. |
Drug: Cisplatin
Given IV
Other Names:
Radiation: Intensity-Modulated Radiation Therapy
Undergo IMRT
Other Names:
Other: Laboratory Biomarker Analysis
Correlative studies
Other: Quality-of-Life Assessment
Ancillary studies
Other Names:
|
| Experimental: Arm 2 (IMRT, docetaxel) Patients undergo IMRT as in Arm I and receive concurrent docetaxel IV over 60 minutes once weekly for 6 weeks. (CLOSED AS OF 20-MAR-2020) |
Drug: Docetaxel
Given IV
Other Names:
Radiation: Intensity-Modulated Radiation Therapy
Undergo IMRT
Other Names:
Other: Laboratory Biomarker Analysis
Correlative studies
Other: Quality-of-Life Assessment
Ancillary studies
Other Names:
|
| Experimental: Arm 3 (IMRT, docetaxel, cetuximab) Patients receive cetuximab IV over 120 minutes on week 1 and over 60 minutes once weekly on weeks 2-7. Patients undergo IMRT as in Arm I and receive concurrent docetaxel once weekly for 6 weeks. |
Biological: Cetuximab
Given IV
Other Names:
Drug: Docetaxel
Given IV
Other Names:
Radiation: Intensity-Modulated Radiation Therapy
Undergo IMRT
Other Names:
Other: Laboratory Biomarker Analysis
Correlative studies
Other: Quality-of-Life Assessment
Ancillary studies
Other Names:
|
| Experimental: Arm 4 (IMRT, cisplatin, atezolizumab) Patients undergo IMRT QD five days a week for 6 weeks and receive concurrent cisplatin IV over 1-2 hours once weekly for 6 weeks. Starting 1 week before IMRT, patients also receive atezolizumab IV over 30-60 minutes every 3 weeks for up to 8 doses (weeks -1, 3, 6, 9, 12, 15, 18, and 21) in the absence of disease progression and unacceptable toxicity. |
Drug: Atezolizumab
Given IV
Other Names:
Drug: Cisplatin
Given IV
Other Names:
Radiation: Intensity-Modulated Radiation Therapy
Undergo IMRT
Other Names:
Other: Laboratory Biomarker Analysis
Correlative studies
Other: Quality-of-Life Assessment
Ancillary studies
Other Names:
|
Outcome Measures
Primary Outcome Measures
- Disease-free survival (DFS) (Phase II) [From date of randomization until date of local-regional recurrence, distant metastasis or death due to any cause, assessed up to 7 years]
Estimated using the Kaplan-Meier method for each arm. Their distributions will be compared between treatment arms with a one-sided log rank test.
- Overall survival (OS) (Phase III) [From date of randomization to death due to any cause, assessed up to 7 years]
Estimated using the Kaplan-Meier method for each arm. Their distributions will be compared between treatment arms with a one-sided log rank test. Multivariate analysis will be performed using the Cox proportional hazards model.
Secondary Outcome Measures
- Local-regional failure (LRF) [From date of randomization until date of local-regional recurrence, assessed up to 7 years]
The cumulative incidence method will be used to estimate rates, and the failure rates for the experimental arms will be compared against the control using a failure-specific log rank test.
- Distant metastasis (DM) [From date of randomization to date of distant metastasis, assessed up to 7 years]
The cumulative incidence method will be used to estimate rates, and the failure rates for the experimental arms will be compared against the control using a failure-specific log rank test.
- Toxicity [From start of treatment to death or last follow-up]
Adverse events (AEs) will be graded using Common Terminology Criteria for Adverse Events (CTCAE) version (v) 4.0. Rates of grade 3+ adverse events overall will be compared between arms by Chi-square test, or Fisher's exact test.
- Patient-reported outcome, symptom burden [Time from randomization to a first recovery within at least one MID unit of total symptom severity compared to the baseline (reference) score]
Time to recovery of baseline total symptom severity from the MD Anderson Symptom Inventory - Head and Neck (MDASI-HN). The cumulative incidence method will be used to estimate the event rates, and the event rates between arms will be compared using a cause-specific log rank test. The Fine-Gray subdistribution hazards model may be applied to further explore outcomes by treatment arm and other covariates.
- Quality of life [Baseline and 1 year post radiation therapy (RT)]
Quality of life change from baseline at 1-year post RT, as measured by the Functional Assessment of Cancer Therapy - Head and Neck (FACT-H&N) Trial Outcome Index (TOI). FACT TOI is a validated efficient summary index of physical/functional outcomes, and disease site-specific items, which is highly reliable and sensitive to change in performance status rating. A constrained longitudinal data analysis model will be fitted with all the time points (discrete), the treatment factor and its interaction. The secondary non-inferiority patient-reported outcome (PRO) hypothesis will be tested using a confidence interval approach.
Eligibility Criteria
Criteria
Inclusion Criteria:
-
PHASE II INCLUSION CRITERIA (COMPLETE AS OF 20-MAR-2020)
-
Pathologically (histologically or cytologically) proven diagnosis of head and neck squamous cell carcinoma (HNSCC) involving the oral cavity (excluding lips), oropharynx (p16 negative), larynx, or hypopharynx
-
Patients must have undergone gross total surgical resection of high-risk oral cavity, oropharynx (p16 negative), larynx, or hypopharynx within 63 days prior to registration; Note: patients may have biopsy under general anesthesia in an operating room followed by definitive ablative cancer surgery representing gross total resection; the gross total resection has to be done within 63 days prior to registration; if, however, patients have ablative resection but shortly recur or are determined to have persisting disease requiring re-resection to achieve gross total resection, then the patient is not eligible
-
Patients must have at least 1 of the following high-risk pathologic features: extracapsular nodal extension or invasive cancer at the primary tumor resection margin (tumor on ink)
-
Pathologic stage III or IV HNSCC, including no distant metastases, based upon the following minimum diagnostic workup:
-
General history and physical examination by a radiation oncologist and/or medical oncologist within 84 days prior to registration;
-
Examination by an ear nose throat (ENT) or head & neck surgeon prior to surgery; a laryngopharyngoscopy (mirror and/or fiber optic and/or direct procedure), if appropriate, is recommended but not required; intra-operative examination is acceptable documentation
-
Pre-operative (op) Imaging of the head and neck: A neck computed tomography (CT) (with contrast) or CT/positron emission tomography (PET) (with contrast) and/or an magnetic resonance imaging (MRI) of the neck (T1 with gadolinium and T2) within 84 days prior to surgery; Note: this imaging data (diagnostic pre-operative scan showing gross disease) is to be submitted in Digital Imaging and Communications in Medicine (DICOM) format via TRIAD; the report is to be uploaded into Rave
-
Chest CT scan (with or without contrast) or CT/PET that includes the chest (with or without contrast) either within 84 days prior to surgery or within 120 days prior to registration; Note: if the CT/PET with or without contrast is done within 84 days prior to surgery, it fulfills the chest imaging requirement
-
Zubrod performance status of 0-1 within 14 days prior to registration
-
Absolute granulocyte count (AGC) >= 1,500 cells/mm^3 (obtained within 14 days prior to registration on study)
-
Platelets >= 100,000 cells/mm^3 (obtained within 14 days prior to registration on study)
-
Hemoglobin >= 8.0 g/dl (Note: the use of transfusion or other intervention to achieve hemoglobin [Hgb] >= 8.0 g/dl is acceptable)
-
Total bilirubin < 2 x institutional upper limit of normal (ULN) within 14 days prior to registration
-
Aspartate aminotransferase (AST) or alanine aminotransferase (ALT) < 3 x institutional ULN within 14 days prior to registration
-
Serum creatinine institutional ULN within 14 days prior to registration or; creatinine clearance (CC) >= 50 ml/min within 14 days prior to registration determined by 24-hour collection or estimated by Cockcroft-Gault formula
-
Negative urine or serum pregnancy test within 14 days prior to registration for women of childbearing potential
-
The following assessments are required within 14 days prior to registration: sodium (Na), potassium (K), chloride (Cl), glucose, calcium (Ca), magnesium (Mg), and albumin; Note: patients with an initial magnesium < 0.5 mmol/L (1.2 mg/dl) may receive corrective magnesium supplementation but should continue to receive either prophylactic weekly infusion of magnesium and/or oral magnesium supplementation (e.g., magnesium oxide) at the investigator's discretion
-
Patients with feeding tubes are eligible for the study
-
Women of childbearing potential and male participants who are sexually active must agree to use a medically effective means of birth control
-
Patient must provide study specific informed consent prior to study entry, including consent for mandatory tissue submission for epidermal growth factor receptor (EGFR) analysis and for oropharyngeal cancer patients, human papilloma virus (HPV) analysis
-
PHASE III: Pathologically (histologically or cytologically) proven diagnosis of head and neck squamous cell carcinoma (HNSCC) involving the oral cavity (excluding lips), oropharynx (p16 negative), larynx, or hypopharynx
-
PHASE III: Patients with oropharyngeal cancer must have p16-negative based on central review prior to Step 2 registration; all patients with oropharyngeal primary must consent for mandatory tissue submission for central p16 confirmation
-
PHASE III: Patients must have undergone gross total surgical resection of high-risk oral cavity, oropharynx (p16 negative), larynx, or hypopharynx within 63 days prior to registration; note: patients may have biopsy under general anesthesia in an operating room followed by definitive ablative cancer surgery representing gross total resection; the gross total resection has to be done within 63 days prior to registration; if, however, patients have ablative resection but shortly recur or are determined to have persisting disease requiring re-resection to achieve gross total resection, then the patient is not eligible
-
PHASE III: Patients must have at least 1 of the following high-risk pathologic features: extracapsular nodal extension or invasive cancer at the primary tumor resection margin (tumor on ink or tumor in a final separately submitted margin)
-
PHASE III: Pathologic stage III or IV HNSCC (American Joint Committee on Cancer [AJCC] 7th edition), including no distant metastases, based upon the following minimum diagnostic workup:
-
General history and physical examination by a radiation oncologist or medical oncologist within 84 days prior to registration;
-
Examination by an ENT or head & neck surgeon prior to surgery; a laryngopharyngoscopy (mirror or fiberoptic or direct procedure), if appropriate, is recommended but not required. Intra-operative examination is acceptable documentation.
-
Pre-op Imaging of the head and neck: A neck CT (with contrast and of diagnostic quality) or PET/CT (with contrast and of diagnostic quality) and/or an MRI of the neck of diagnostic quality (T1 with gadolinium and T2) within 84 days prior to surgery; Note: this imaging data (diagnostic pre-operative scan showing gross disease) is to be submitted in DICOM format via TRIAD. The report is to be uploaded into Rave.
-
Chest CT scan (with or without contrast) or PET/CT that includes the chest (with or without contrast) either within 84 days prior to surgery or within 120 days prior to registration; Note: If the PET/CT with or without contrast is done within 84 days prior to surgery, it fulfills the chest imaging requirement
-
PHASE III: Zubrod performance status of 0-1 within 14 days prior to registration
-
PHASE III: Leukocytes >= 2,500 cells/mm^3 (obtained within 14 days prior to registration on study)
-
PHASE III: Absolute neutrophil count (ANC) >= 1,500 cells/mm^3 (obtained within 14 days prior to registration on study)
-
PHASE III: Platelets >= 100,000 cells/mm^3 (obtained within 14 days prior to registration on study)
-
PHASE III: Hemoglobin >= 8.0 g/dL (Note: The use of transfusion or other intervention to achieve Hgb >= 8.0 g/dL is acceptable) (obtained within 14 days prior to registration on study)
-
PHASE III: Total bilirubin =< 1.5 x institutional upper limit of normal (ULN) (however, patients with known Gilbert disease who have serum bilirubin level =< 3 x institutional ULN may be enrolled) (within 14 days prior to registration)
-
PHASE III: AST or ALT =< 3 x institutional ULN (within 14 days prior to registration)
-
PHASE III: Alkaline phosphatase =< 2.5 x institutional ULN (within 14 days prior to registration)
-
PHASE III: Creatinine clearance (CrCl) >= 50 mL/min within 14 days prior to registration determined by 24-hour collection or estimated by Cockcroft-Gault formula
-
PHASE III: Patients with feeding tubes are eligible for the study
-
PHASE III: Negative urine or serum pregnancy test within 14 days prior to registration for women of childbearing potential
-
PHASE III: All patients must provide study specific informed consent prior to study entry
-
PHASE III: Patients positive for human immunodeficiency virus (HIV) are allowed on study, but HIV-positive patients must have:
-
A stable regimen of highly active anti-retroviral therapy (HAART);
-
No requirement for concurrent antibiotics or antifungal agents for the prevention of opportunistic infections;
-
A CD4 count above 250 cells/mcL and an undetectable HIV viral load on standard polymerase chain reaction (PCR)-based tests
Exclusion Criteria:
-
PHASE II EXCLUSION CRITERIA (COMPLETE AS OF 20-MAR-2020)
-
Prior invasive malignancy (except non-melanomatous skin cancer) unless disease free for a minimum of 1095 days (3 years); noninvasive cancers (for example, carcinoma in situ of the breast, oral cavity, or cervix are all permissible) are permitted even if diagnosed and treated < 3 years ago
-
Patients with simultaneous primaries or bilateral tumors are excluded, with the exception of patients with bilateral tonsil cancers or patients with T1-2, N0, M0 resected differentiated thyroid carcinoma, who are eligible
-
Prior systemic chemotherapy or anti-epidermal growth factor (EGF) therapy for the study cancer; note that prior chemotherapy for a different cancer is allowable
-
Prior radiotherapy to the region of the study cancer that would result in overlap of radiation therapy fields
-
Severe, active co-morbidity, defined as follows:
-
Unstable angina and/or congestive heart failure requiring hospitalization within 6 months prior to registration
-
Transmural myocardial infarction within 6 months prior to registration
-
Acute bacterial or fungal infection requiring intravenous antibiotics at the time of registration
-
Chronic obstructive pulmonary disease exacerbation or other respiratory illness requiring hospitalization or precluding study therapy at the time of registration
-
Idiopathic pulmonary fibrosis or other severe interstitial lung disease that requires oxygen therapy or is thought to require oxygen therapy within 1 year prior to registration
-
Hepatic insufficiency resulting in clinical jaundice and/or coagulation defects; note, however, that laboratory tests for coagulation parameters are not required for entry into this protocol
-
Acquired immune deficiency syndrome (AIDS) based upon current Centers for Disease and Control and Prevention (CDC) definition; note: human immunodeficiency virus (HIV) testing is not required for entry into this protocol; the need to exclude patients with AIDS from this protocol is necessary because the treatments involved in this protocol may be significantly immunosuppressive; protocol-specific requirements may also exclude immuno-compromised patients.
-
Grade 3-4 electrolyte abnormalities (Common Terminology Criteria for Adverse Events [CTCAE], version [v.] 4):
-
Serum calcium (ionized or adjusted for albumin) < 7 mg/dl (1.75 mmol/L) or > 12.5 mg/dl (> 3.1 mmol/L) despite intervention to normalize levels
-
Glucose < 40 mg/dl (< 2.2 mmol/L) or > 250 mg/dl (> 14 mmol/L)
-
Magnesium < 0.9 mg/dl (< 0.4 mmol/L) or > 3 mg/dl (> 1.23 mmol/L) despite intervention to normalize levels
-
Potassium < 3.0 mmol/L or > 6 mmol/L despite intervention to normalize levels
-
Sodium < 130 mmol/L or > 155 mmol/L despite intervention to normalize levels
-
Pregnancy or women of childbearing potential and men who are sexually active and not willing/able to use medically acceptable forms of contraception; this exclusion is necessary because the treatment involved in this study may be significantly teratogenic
-
Prior allergic reaction to cetuximab
-
PHASE III: Prior invasive malignancy (except non-melanomatous skin cancer) unless disease free for a minimum of 1095 days (3 years) with the following exceptions: T1-2, N0, M0 resected differentiated thyroid carcinoma; Note that noninvasive cancers (For example, carcinoma in situ of the breast, oral cavity, or cervix) are permitted even if diagnosed and treated < 3 years ago
-
PHASE III: Patients with simultaneous primaries or bilateral tumors are excluded, with the exception of patients with bilateral tonsil cancers or patients with T1-2, N0, M0 resected differentiated thyroid carcinoma, who are eligible
-
PHASE III: Prior systemic therapy, including cytotoxic chemotherapy, biologic/targeted therapy (such as anti-EGF therapy), or immune therapy for the study cancer; note that prior chemotherapy for a different cancer is allowable, however, a prior anti-PD-1, anti-PD-L1, or anti-PD-L2 agent is not permitted
-
PHASE III: Prior radiotherapy to the region of the study cancer that would result in overlap of radiation therapy fields
-
PHASE III: Severe, active co-morbidity, defined as follows:
-
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 within 6 months prior to registration
-
Transmural myocardial infarction within 6 months prior to registration;
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Severe infections within 4 weeks prior to registration including, but not limited to, hospitalization for complications of infection, bacteremia, or severe pneumonia;
-
Acute bacterial or fungal infection requiring intravenous antibiotics at the time of registration; Note: Patients receiving prophylactic antibiotics (e.g., for prevention of a urinary tract infection or chronic obstructive pulmonary disease exacerbation) are eligible.
-
Chronic obstructive pulmonary disease exacerbation or other respiratory illness requiring hospitalization or precluding study therapy at the time of registration;
-
History of idiopathic pulmonary fibrosis, pneumonitis (including drug induced), organizing pneumonia (i.e., bronchiolitis obliterans, cryptogenic organizing pneumonia, etc.), or evidence of active pneumonitis on screening chest computed tomography (CT) scan. History of radiation pneumonitis in a prior radiation field (fibrosis) is permitted, provided that field does not overlap with the planned radiation field for the study cancer;
-
Patients with active tuberculosis (TB) are excluded;
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Known clinically significant liver disease, including active viral, alcoholic, or other hepatitis; cirrhosis; fatty liver; and inherited liver disease;
-
Patients with past or resolved hepatitis B infection (defined as having a negative hepatitis B surface ant
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | University of Alabama at Birmingham Cancer Center | Birmingham | Alabama | United States | 35233 |
| 2 | The Kirklin Clinic at Acton Road | Birmingham | Alabama | United States | 35243 |
| 3 | Banner University Medical Center - Tucson | Tucson | Arizona | United States | 85719 |
| 4 | University of Arizona Cancer Center-North Campus | Tucson | Arizona | United States | 85719 |
| 5 | University of Arkansas for Medical Sciences | Little Rock | Arkansas | United States | 72205 |
| 6 | Sutter Cancer Centers Radiation Oncology Services-Auburn | Auburn | California | United States | 95603 |
| 7 | Providence Saint Joseph Medical Center/Disney Family Cancer Center | Burbank | California | United States | 91505 |
| 8 | Sutter Cancer Centers Radiation Oncology Services-Cameron Park | Cameron Park | California | United States | 95682 |
| 9 | Mercy San Juan Medical Center | Carmichael | California | United States | 95608 |
| 10 | UC San Diego Moores Cancer Center | La Jolla | California | United States | 92093 |
| 11 | Cedars Sinai Medical Center | Los Angeles | California | United States | 90048 |
| 12 | Memorial Medical Center | Modesto | California | United States | 95355 |
| 13 | UC Irvine Health/Chao Family Comprehensive Cancer Center | Orange | California | United States | 92868 |
| 14 | Stanford Cancer Institute Palo Alto | Palo Alto | California | United States | 94304 |
| 15 | Sutter Cancer Centers Radiation Oncology Services-Roseville | Roseville | California | United States | 95661 |
| 16 | Sutter Medical Center Sacramento | Sacramento | California | United States | 95816 |
| 17 | University of California Davis Comprehensive Cancer Center | Sacramento | California | United States | 95817 |
| 18 | Saint Helena Hospital | Saint Helena | California | United States | 94574 |
| 19 | UCSF Medical Center-Mount Zion | San Francisco | California | United States | 94115 |
| 20 | UCSF Medical Center-Mission Bay | San Francisco | California | United States | 94158 |
| 21 | Sutter Cancer Centers Radiation Oncology Services-Vacaville | Vacaville | California | United States | 95687 |
| 22 | University of Colorado Hospital | Aurora | Colorado | United States | 80045 |
| 23 | Rocky Mountain Cancer Centers-Boulder | Boulder | Colorado | United States | 80304 |
| 24 | Penrose-Saint Francis Healthcare | Colorado Springs | Colorado | United States | 80907 |
| 25 | Porter Adventist Hospital | Denver | Colorado | United States | 80210 |
| 26 | Shaw Cancer Center | Edwards | Colorado | United States | 81632 |
| 27 | North Colorado Medical Center | Greeley | Colorado | United States | 80631 |
| 28 | Rocky Mountain Cancer Centers-Littleton | Littleton | Colorado | United States | 80120 |
| 29 | Longmont United Hospital | Longmont | Colorado | United States | 80501 |
| 30 | McKee Medical Center | Loveland | Colorado | United States | 80539 |
| 31 | Parker Adventist Hospital | Parker | Colorado | United States | 80138 |
| 32 | University of Connecticut | Farmington | Connecticut | United States | 06030 |
| 33 | Yale University | New Haven | Connecticut | United States | 06520 |
| 34 | Smilow Cancer Hospital Care Center - Waterford | Waterford | Connecticut | United States | 06385 |
| 35 | Helen F Graham Cancer Center | Newark | Delaware | United States | 19713 |
| 36 | Christiana Care Health System-Christiana Hospital | Newark | Delaware | United States | 19718 |
| 37 | George Washington University Medical Center | Washington | District of Columbia | United States | 20037 |
| 38 | UM Sylvester Comprehensive Cancer Center at Deerfield Beach | Deerfield Beach | Florida | United States | 33442 |
| 39 | University of Miami Miller School of Medicine-Sylvester Cancer Center | Miami | Florida | United States | 33136 |
| 40 | AdventHealth Orlando | Orlando | Florida | United States | 32803 |
| 41 | Orlando Health Cancer Institute | Orlando | Florida | United States | 32806 |
| 42 | Moffitt Cancer Center | Tampa | Florida | United States | 33612 |
| 43 | Emory University Hospital Midtown | Atlanta | Georgia | United States | 30308 |
| 44 | Emory University Hospital/Winship Cancer Institute | Atlanta | Georgia | United States | 30322 |
| 45 | Augusta University Medical Center | Augusta | Georgia | United States | 30912 |
| 46 | Memorial Health University Medical Center | Savannah | Georgia | United States | 31404 |
| 47 | Lewis Cancer and Research Pavilion at Saint Joseph's/Candler | Savannah | Georgia | United States | 31405 |
| 48 | Queen's Medical Center | Honolulu | Hawaii | United States | 96813 |
| 49 | The Cancer Center of Hawaii-Liliha | Honolulu | Hawaii | United States | 96817 |
| 50 | Saint Alphonsus Medical Center-Nampa | Nampa | Idaho | United States | 83686 |
| 51 | Northwestern University | Chicago | Illinois | United States | 60611 |
| 52 | John H Stroger Jr Hospital of Cook County | Chicago | Illinois | United States | 60612 |
| 53 | Rush University Medical Center | Chicago | Illinois | United States | 60612 |
| 54 | University of Illinois | Chicago | Illinois | United States | 60612 |
| 55 | Decatur Memorial Hospital | Decatur | Illinois | United States | 62526 |
| 56 | Crossroads Cancer Center | Effingham | Illinois | United States | 62401 |
| 57 | NorthShore University HealthSystem-Evanston Hospital | Evanston | Illinois | United States | 60201 |
| 58 | NorthShore University HealthSystem-Glenbrook Hospital | Glenview | Illinois | United States | 60026 |
| 59 | NorthShore University HealthSystem-Highland Park Hospital | Highland Park | Illinois | United States | 60035 |
| 60 | Advocate Christ Medical Center | Oak Lawn | Illinois | United States | 60453-2699 |
| 61 | OSF Saint Francis Radiation Oncology at Peoria Cancer Center | Peoria | Illinois | United States | 61615 |
| 62 | OSF Saint Francis Medical Center | Peoria | Illinois | United States | 61637 |
| 63 | SwedishAmerican Regional Cancer Center/ACT | Rockford | Illinois | United States | 61114 |
| 64 | Memorial Medical Center | Springfield | Illinois | United States | 62781 |
| 65 | Carle Cancer Center | Urbana | Illinois | United States | 61801 |
| 66 | Saint Vincent Anderson Regional Hospital/Cancer Center | Anderson | Indiana | United States | 46016 |
| 67 | Elkhart General Hospital | Elkhart | Indiana | United States | 46515 |
| 68 | Radiation Oncology Associates PC | Fort Wayne | Indiana | United States | 46804 |
| 69 | Parkview Hospital Randallia | Fort Wayne | Indiana | United States | 46805 |
| 70 | Parkview Regional Medical Center | Fort Wayne | Indiana | United States | 46845 |
| 71 | Goshen Center for Cancer Care | Goshen | Indiana | United States | 46526 |
| 72 | Indiana University/Melvin and Bren Simon Cancer Center | Indianapolis | Indiana | United States | 46202 |
| 73 | IU Health Methodist Hospital | Indianapolis | Indiana | United States | 46202 |
| 74 | IU Health Central Indiana Cancer Centers-East | Indianapolis | Indiana | United States | 46219 |
| 75 | Michiana Hematology Oncology PC-Mishawaka | Mishawaka | Indiana | United States | 46545 |
| 76 | Memorial Hospital of South Bend | South Bend | Indiana | United States | 46601 |
| 77 | McFarland Clinic PC - Ames | Ames | Iowa | United States | 50010 |
| 78 | Iowa Methodist Medical Center | Des Moines | Iowa | United States | 50309 |
| 79 | University of Kansas Cancer Center | Kansas City | Kansas | United States | 66160 |
| 80 | Olathe Health Cancer Center | Olathe | Kansas | United States | 66061 |
| 81 | University of Kansas Cancer Center-Overland Park | Overland Park | Kansas | United States | 66210 |
| 82 | Salina Regional Health Center | Salina | Kansas | United States | 67401 |
| 83 | University of Kentucky/Markey Cancer Center | Lexington | Kentucky | United States | 40536 |
| 84 | The James Graham Brown Cancer Center at University of Louisville | Louisville | Kentucky | United States | 40202 |
| 85 | Tulane University Health Sciences Center | New Orleans | Louisiana | United States | 70112 |
| 86 | Ochsner Medical Center Jefferson | New Orleans | Louisiana | United States | 70121 |
| 87 | University of Maryland/Greenebaum Cancer Center | Baltimore | Maryland | United States | 21201 |
| 88 | Greater Baltimore Medical Center | Baltimore | Maryland | United States | 21204 |
| 89 | Johns Hopkins University/Sidney Kimmel Cancer Center | Baltimore | Maryland | United States | 21287 |
| 90 | UM Upper Chesapeake Medical Center | Bel Air | Maryland | United States | 21014 |
| 91 | Central Maryland Radiation Oncology in Howard County | Columbia | Maryland | United States | 21044 |
| 92 | UM Baltimore Washington Medical Center/Tate Cancer Center | Glen Burnie | Maryland | United States | 21061 |
| 93 | Holy Cross Hospital | Silver Spring | Maryland | United States | 20910 |
| 94 | Boston Medical Center | Boston | Massachusetts | United States | 02118 |
| 95 | Saint Joseph Mercy Hospital | Ann Arbor | Michigan | United States | 48106 |
| 96 | University of Michigan Comprehensive Cancer Center | Ann Arbor | Michigan | United States | 48109 |
| 97 | Saint Joseph Mercy Brighton | Brighton | Michigan | United States | 48114 |
| 98 | University of Michigan - Brighton Center for Specialty Care | Brighton | Michigan | United States | 48116 |
| 99 | Henry Ford Cancer Institute-Downriver | Brownstown | Michigan | United States | 48183 |
| 100 | Henry Ford Macomb Hospital-Clinton Township | Clinton Township | Michigan | United States | 48038 |
| 101 | Henry Ford Hospital | Detroit | Michigan | United States | 48202 |
| 102 | West Michigan Cancer Center | Kalamazoo | Michigan | United States | 49007 |
| 103 | Trinity Health Saint Mary Mercy Livonia Hospital | Livonia | Michigan | United States | 48154 |
| 104 | William Beaumont Hospital-Royal Oak | Royal Oak | Michigan | United States | 48073 |
| 105 | Ascension Saint Mary's Hospital | Saginaw | Michigan | United States | 48601 |
| 106 | William Beaumont Hospital - Troy | Troy | Michigan | United States | 48085 |
| 107 | Henry Ford West Bloomfield Hospital | West Bloomfield | Michigan | United States | 48322 |
| 108 | Sanford Joe Lueken Cancer Center | Bemidji | Minnesota | United States | 56601 |
| 109 | Miller-Dwan Hospital | Duluth | Minnesota | United States | 55805 |
| 110 | Hennepin County Medical Center | Minneapolis | Minnesota | United States | 55415 |
| 111 | Mayo Clinic in Rochester | Rochester | Minnesota | United States | 55905 |
| 112 | University of Mississippi Medical Center | Jackson | Mississippi | United States | 39216 |
| 113 | Saint Francis Medical Center | Cape Girardeau | Missouri | United States | 63703 |
| 114 | University of Missouri - Ellis Fischel | Columbia | Missouri | United States | 65212 |
| 115 | Siteman Cancer Center at West County Hospital | Creve Coeur | Missouri | United States | 63141 |
| 116 | North Kansas City Hospital | Kansas City | Missouri | United States | 64116 |
| 117 | The University of Kansas Cancer Center-South | Kansas City | Missouri | United States | 64131 |
| 118 | University of Kansas Cancer Center - North | Kansas City | Missouri | United States | 64154 |
| 119 | University of Kansas Cancer Center - Lee's Summit | Lee's Summit | Missouri | United States | 64064 |
| 120 | Delbert Day Cancer Institute at PCRMC | Rolla | Missouri | United States | 65401 |
| 121 | Washington University School of Medicine | Saint Louis | Missouri | United States | 63110 |
| 122 | Siteman Cancer Center-South County | Saint Louis | Missouri | United States | 63129 |
| 123 | Missouri Baptist Medical Center | Saint Louis | Missouri | United States | 63131 |
| 124 | Mercy Hospital Saint Louis | Saint Louis | Missouri | United States | 63141 |
| 125 | Siteman Cancer Center at Saint Peters Hospital | Saint Peters | Missouri | United States | 63376 |
| 126 | Mercy Hospital Springfield | Springfield | Missouri | United States | 65804 |
| 127 | CoxHealth South Hospital | Springfield | Missouri | United States | 65807 |
| 128 | CHI Health Good Samaritan | Kearney | Nebraska | United States | 68847 |
| 129 | Nebraska Methodist Hospital | Omaha | Nebraska | United States | 68114 |
| 130 | Alegent Health Bergan Mercy Medical Center | Omaha | Nebraska | United States | 68124 |
| 131 | Memorial Sloan Kettering Basking Ridge | Basking Ridge | New Jersey | United States | 07920 |
| 132 | Memorial Sloan Kettering Monmouth | Middletown | New Jersey | United States | 07748 |
| 133 | Memorial Sloan Kettering Bergen | Montvale | New Jersey | United States | 07645 |
| 134 | Virtua Memorial | Mount Holly | New Jersey | United States | 08060 |
| 135 | Sparta Cancer Treatment Center | Sparta | New Jersey | United States | 07871 |
| 136 | Virtua Voorhees | Voorhees | New Jersey | United States | 08043 |
| 137 | University of New Mexico Cancer Center | Albuquerque | New Mexico | United States | 87102 |
| 138 | New Mexico Oncology Hematology Consultants | Albuquerque | New Mexico | United States | 87109 |
| 139 | South Shore University Hospital | Bay Shore | New York | United States | 11706 |
| 140 | New York-Presbyterian/Brooklyn Methodist Hospital | Brooklyn | New York | United States | 11215 |
| 141 | Roswell Park Cancer Institute | Buffalo | New York | United States | 14263 |
| 142 | Sands Cancer Center | Canandaigua | New York | United States | 14424 |
| 143 | Memorial Sloan Kettering Commack | Commack | New York | United States | 11725 |
| 144 | Arnot Ogden Medical Center/Falck Cancer Center | Elmira | New York | United States | 14905 |
| 145 | Memorial Sloan Kettering Westchester | Harrison | New York | United States | 10604 |
| 146 | Northwell Health/Center for Advanced Medicine | Lake Success | New York | United States | 11042 |
| 147 | Mount Sinai Union Square | New York | New York | United States | 10003 |
| 148 | Laura and Isaac Perlmutter Cancer Center at NYU Langone | New York | New York | United States | 10016 |
| 149 | NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center | New York | New York | United States | 10032 |
| 150 | Memorial Sloan Kettering Cancer Center | New York | New York | United States | 10065 |
| 151 | Wilmot Cancer Institute Radiation Oncology at Greece | Rochester | New York | United States | 14606 |
| 152 | Highland Hospital | Rochester | New York | United States | 14620 |
| 153 | University of Rochester | Rochester | New York | United States | 14642 |
| 154 | Memorial Sloan Kettering Sleepy Hollow | Sleepy Hollow | New York | United States | 10591 |
| 155 | State University of New York Upstate Medical University | Syracuse | New York | United States | 13210 |
| 156 | Memorial Sloan Kettering Nassau | Uniondale | New York | United States | 11553 |
| 157 | Atrium Health Stanly/LCI-Albemarle | Albemarle | North Carolina | United States | 28002 |
| 158 | UNC Lineberger Comprehensive Cancer Center | Chapel Hill | North Carolina | United States | 27599 |
| 159 | Carolinas Medical Center/Levine Cancer Institute | Charlotte | North Carolina | United States | 28203 |
| 160 | Atrium Health Pineville/LCI-Pineville | Charlotte | North Carolina | United States | 28210 |
| 161 | Atrium Health Cabarrus/LCI-Concord | Concord | North Carolina | United States | 28025 |
| 162 | East Carolina University | Greenville | North Carolina | United States | 27834 |
| 163 | Vidant Oncology-Kinston | Kinston | North Carolina | United States | 28501 |
| 164 | Atrium Health Union/LCI-Union | Monroe | North Carolina | United States | 28112 |
| 165 | Wake Forest University Health Sciences | Winston-Salem | North Carolina | United States | 27157 |
| 166 | Sanford Bismarck Medical Center | Bismarck | North Dakota | United States | 58501 |
| 167 | Sanford Roger Maris Cancer Center | Fargo | North Dakota | United States | 58122 |
| 168 | Summa Health System - Akron Campus | Akron | Ohio | United States | 44304 |
| 169 | Cleveland Clinic Akron General | Akron | Ohio | United States | 44307 |
| 170 | Summa Health System - Barberton Campus | Barberton | Ohio | United States | 44203 |
| 171 | UHHS-Chagrin Highlands Medical Center | Beachwood | Ohio | United States | 44122 |
| 172 | Geauga Hospital | Chardon | Ohio | United States | 44024 |
| 173 | Adena Regional Medical Center | Chillicothe | Ohio | United States | 45601 |
| 174 | University of Cincinnati Cancer Center-UC Medical Center | Cincinnati | Ohio | United States | 45219 |
| 175 | Case Western Reserve University | Cleveland | Ohio | United States | 44106 |
| 176 | Cleveland Clinic Cancer Center/Fairview Hospital | Cleveland | Ohio | United States | 44111 |
| 177 | Cleveland Clinic Foundation | Cleveland | Ohio | United States | 44195 |
| 178 | Ohio State University Comprehensive Cancer Center | Columbus | Ohio | United States | 43210 |
| 179 | Mercy Cancer Center-Elyria | Elyria | Ohio | United States | 44035 |
| 180 | Cleveland Clinic Cancer Center Independence | Independence | Ohio | United States | 44131 |
| 181 | OhioHealth Mansfield Hospital | Mansfield | Ohio | United States | 44903 |
| 182 | Hillcrest Hospital Cancer Center | Mayfield Heights | Ohio | United States | 44124 |
| 183 | Summa Health Medina Medical Center | Medina | Ohio | United States | 44256 |
| 184 | UH Seidman Cancer Center at Lake Health Mentor Campus | Mentor | Ohio | United States | 44060 |
| 185 | UH Seidman Cancer Center at Southwest General Hospital | Middleburg Heights | Ohio | United States | 44130 |
| 186 | University Hospitals Parma Medical Center | Parma | Ohio | United States | 44129 |
| 187 | Southern Ohio Medical Center | Portsmouth | Ohio | United States | 45662 |
| 188 | University Hospitals Portage Medical Center | Ravenna | Ohio | United States | 44266 |
| 189 | North Coast Cancer Care | Sandusky | Ohio | United States | 44870 |
| 190 | UH Seidman Cancer Center at Firelands Regional Medical Center | Sandusky | Ohio | United States | 44870 |
| 191 | Cleveland Clinic Cancer Center Strongsville | Strongsville | Ohio | United States | 44136 |
| 192 | University of Cincinnati Cancer Center-West Chester | West Chester | Ohio | United States | 45069 |
| 193 | UHHS-Westlake Medical Center | Westlake | Ohio | United States | 44145 |
| 194 | Cleveland Clinic Wooster Family Health and Surgery Center | Wooster | Ohio | United States | 44691 |
| 195 | University of Oklahoma Health Sciences Center | Oklahoma City | Oklahoma | United States | 73104 |
| 196 | Clackamas Radiation Oncology Center | Clackamas | Oregon | United States | 97015 |
| 197 | Providence Portland Medical Center | Portland | Oregon | United States | 97213 |
| 198 | Providence Saint Vincent Medical Center | Portland | Oregon | United States | 97225 |
| 199 | UPMC Altoona | Altoona | Pennsylvania | United States | 16601 |
| 200 | UPMC-Heritage Valley Health System Beaver | Beaver | Pennsylvania | United States | 15009 |
| 201 | Carlisle Regional Cancer Center | Carlisle | Pennsylvania | United States | 17015 |
| 202 | UPMC Hillman Cancer Center Erie | Erie | Pennsylvania | United States | 16505 |
| 203 | UPMC Cancer Center at UPMC Horizon | Farrell | Pennsylvania | United States | 16121 |
| 204 | UPMC Cancer Centers - Arnold Palmer Pavilion | Greensburg | Pennsylvania | United States | 15601 |
| 205 | UPMC Pinnacle Cancer Center/Community Osteopathic Campus | Harrisburg | Pennsylvania | United States | 17109 |
| 206 | Penn State Milton S Hershey Medical Center | Hershey | Pennsylvania | United States | 17033-0850 |
| 207 | UPMC-Johnstown/John P. Murtha Regional Cancer Center | Johnstown | Pennsylvania | United States | 15901 |
| 208 | UPMC Cancer Center at UPMC McKeesport | McKeesport | Pennsylvania | United States | 15132 |
| 209 | UPMC Hillman Cancer Center at Rocco And Nancy Ortenzio Cancer Pavilion | Mechanicsburg | Pennsylvania | United States | 17050 |
| 210 | UPMC Cancer Center - Monroeville | Monroeville | Pennsylvania | United States | 15146 |
| 211 | UPMC-Coraopolis/Heritage Valley Radiation Oncology | Moon | Pennsylvania | United States | 15108 |
| 212 | UPMC Cancer Center-Natrona Heights | Natrona Heights | Pennsylvania | United States | 15065 |
| 213 | UPMC Jameson | New Castle | Pennsylvania | United States | 16105 |
| 214 | Thomas Jefferson University Hospital | Philadelphia | Pennsylvania | United States | 19107 |
| 215 | Fox Chase Cancer Center | Philadelphia | Pennsylvania | United States | 19111 |
| 216 | Temple University Hospital | Philadelphia | Pennsylvania | United States | 19140 |
| 217 | Allegheny General Hospital | Pittsburgh | Pennsylvania | United States | 15212 |
| 218 | UPMC-Magee Womens Hospital | Pittsburgh | Pennsylvania | United States | 15213 |
| 219 | UPMC-Saint Margaret | Pittsburgh | Pennsylvania | United States | 15215 |
| 220 | UPMC-Shadyside Hospital | Pittsburgh | Pennsylvania | United States | 15232 |
| 221 | UPMC Jefferson Regional Radiation Oncology | Pittsburgh | Pennsylvania | United States | 15236 |
| 222 | UPMC-Passavant Hospital | Pittsburgh | Pennsylvania | United States | 15237 |
| 223 | UPMC-Saint Clair Hospital Cancer Center | Pittsburgh | Pennsylvania | United States | 15243 |
| 224 | UPMC Cancer Center at UPMC Northwest | Seneca | Pennsylvania | United States | 16346 |
| 225 | UPMC Uniontown Hospital Radiation Oncology | Uniontown | Pennsylvania | United States | 15401 |
| 226 | UPMC Washington Hospital Radiation Oncology | Washington | Pennsylvania | United States | 15301 |
| 227 | Reading Hospital | West Reading | Pennsylvania | United States | 19611 |
| 228 | Wexford Health and Wellness Pavilion | Wexford | Pennsylvania | United States | 15090 |
| 229 | AnMed Health Cancer Center | Anderson | South Carolina | United States | 29621 |
| 230 | Saint Joseph's/Candler - Bluffton Campus | Bluffton | South Carolina | United States | 29910 |
| 231 | Prisma Health Cancer Institute - Spartanburg | Boiling Springs | South Carolina | United States | 29316 |
| 232 | Prisma Health Cancer Institute - Faris | Greenville | South Carolina | United States | 29605 |
| 233 | Prisma Health Cancer Institute - Eastside | Greenville | South Carolina | United States | 29615 |
| 234 | Prisma Health Cancer Institute - Greer | Greer | South Carolina | United States | 29650 |
| 235 | Gibbs Cancer Center-Pelham | Greer | South Carolina | United States | 29651 |
| 236 | Prisma Health Cancer Institute - Seneca | Seneca | South Carolina | United States | 29672 |
| 237 | Spartanburg Medical Center | Spartanburg | South Carolina | United States | 29303 |
| 238 | Rapid City Regional Hospital | Rapid City | South Dakota | United States | 57701 |
| 239 | Sanford USD Medical Center - Sioux Falls | Sioux Falls | South Dakota | United States | 57117-5134 |
| 240 | Vanderbilt University/Ingram Cancer Center | Nashville | Tennessee | United States | 37232 |
| 241 | UT Southwestern/Simmons Cancer Center-Dallas | Dallas | Texas | United States | 75390 |
| 242 | University of Texas Medical Branch | Galveston | Texas | United States | 77555-0565 |
| 243 | M D Anderson Cancer Center | Houston | Texas | United States | 77030 |
| 244 | UTMB Cancer Center at Victory Lakes | League City | Texas | United States | 77573 |
| 245 | Covenant Medical Center-Lakeside | Lubbock | Texas | United States | 79410 |
| 246 | Intermountain Medical Center | Murray | Utah | United States | 84107 |
| 247 | Saint George Regional Medical Center | Saint George | Utah | United States | 84770 |
| 248 | Utah Cancer Specialists-Salt Lake City | Salt Lake City | Utah | United States | 84106 |
| 249 | Huntsman Cancer Institute/University of Utah | Salt Lake City | Utah | United States | 84112 |
| 250 | Inova Fairfax Hospital | Falls Church | Virginia | United States | 22042 |
| 251 | Sentara Cancer Institute at Sentara CarePlex Hospital | Hampton | Virginia | United States | 23666 |
| 252 | Sentara Norfolk General Hospital | Norfolk | Virginia | United States | 23507 |
| 253 | Virginia Commonwealth University/Massey Cancer Center | Richmond | Virginia | United States | 23298 |
| 254 | Sentara Virginia Beach General Hospital | Virginia Beach | Virginia | United States | 23454 |
| 255 | Saint Francis Hospital | Federal Way | Washington | United States | 98003 |
| 256 | Tri-Cities Cancer Center | Kennewick | Washington | United States | 99336 |
| 257 | PeaceHealth Saint John Medical Center | Longview | Washington | United States | 98632 |
| 258 | Skagit Regional Health Cancer Care Center | Mount Vernon | Washington | United States | 98274 |
| 259 | University of Washington Medical Center - Montlake | Seattle | Washington | United States | 98195 |
| 260 | Spokane Valley Cancer Center-Mayfair | Spokane | Washington | United States | 99208 |
| 261 | Spokane Valley Cancer Center-Mission | Spokane | Washington | United States | 99216 |
| 262 | Wenatchee Valley Hospital and Clinics | Wenatchee | Washington | United States | 98801 |
| 263 | West Virginia University Healthcare | Morgantown | West Virginia | United States | 26506 |
| 264 | Wheeling Hospital/Schiffler Cancer Center | Wheeling | West Virginia | United States | 26003 |
| 265 | Langlade Hospital and Cancer Center | Antigo | Wisconsin | United States | 54409 |
| 266 | Saint Vincent Hospital Cancer Center Green Bay | Green Bay | Wisconsin | United States | 54301 |
| 267 | Saint Vincent Hospital Cancer Center at Saint Mary's | Green Bay | Wisconsin | United States | 54303 |
| 268 | UW Cancer Center Johnson Creek | Johnson Creek | Wisconsin | United States | 53038 |
| 269 | Gundersen Lutheran Medical Center | La Crosse | Wisconsin | United States | 54601 |
| 270 | Mayo Clinic Health System-Franciscan Healthcare | La Crosse | Wisconsin | United States | 54601 |
| 271 | University of Wisconsin Carbone Cancer Center | Madison | Wisconsin | United States | 53792 |
| 272 | Bay Area Medical Center | Marinette | Wisconsin | United States | 54143 |
| 273 | Marshfield Medical Center | Marshfield | Wisconsin | United States | 54449 |
| 274 | Froedtert Menomonee Falls Hospital | Menomonee Falls | Wisconsin | United States | 53051 |
| 275 | Medical College of Wisconsin | Milwaukee | Wisconsin | United States | 53226 |
| 276 | Marshfield Clinic-Minocqua Center | Minocqua | Wisconsin | United States | 54548 |
| 277 | Drexel Town Square Health Center | Oak Creek | Wisconsin | United States | 53154 |
| 278 | Ascension Saint Michael's Hospital | Stevens Point | Wisconsin | United States | 54481 |
| 279 | Saint Vincent Hospital Cancer Center at Sturgeon Bay | Sturgeon Bay | Wisconsin | United States | 54235-1495 |
| 280 | Aspirus Regional Cancer Center | Wausau | Wisconsin | United States | 54401 |
| 281 | Froedtert West Bend Hospital/Kraemer Cancer Center | West Bend | Wisconsin | United States | 53095 |
| 282 | Aspirus Cancer Care - Wisconsin Rapids | Wisconsin Rapids | Wisconsin | United States | 54494 |
| 283 | Cross Cancer Institute | Edmonton | Alberta | Canada | T6G 1Z2 |
| 284 | Allan Blair Cancer Centre | Regina | Saskatchewan | Canada | S4T 7T1 |
| 285 | Saskatoon Cancer Centre | Saskatoon | Saskatchewan | Canada | S7N 4H4 |
| 286 | Chinese University of Hong Kong-Prince of Wales Hospital | Shatin | Hong Kong | China |
Sponsors and Collaborators
- National Cancer Institute (NCI)
- NRG Oncology
Investigators
- Principal Investigator: Paul M Harari, NRG Oncology
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- NCI-2013-00500
- NCI-2013-00500
- RTOG-1216
- RTOG-1216
- RTOG-1216
- U10CA180868
- U10CA021661
- NCT04411121