Comparing Radiation Therapy to Usual Treatment for Patients With High-Risk Bone Metastases That Are Not Causing Pain, PREEMPT Trial (PREEMPT)

April 28, 2026 updated by: NRG Oncology

Radiation Therapy for High-Risk Asymptomatic Bone Metastases: A Pragmatic Multicenter Randomized Phase 3 Clinical Trial (PREEMPT)

This phase III trial compares the effect of adding radiation therapy to usual treatment on the occurrence of bone-related complications in cancer patients with high-risk bone metastases that are not causing symptoms, such as pain (asymptomatic). High-risk bone metastases are defined by their location (including hip, shoulder, long bones, and certain levels of the spine), or size (2 cm or larger). These bone metastases appear to be at higher risk of complications such as fracture, spinal cord compression, and/or pain warranting surgery or radiation treatment. Radiation therapy uses high energy x-rays to kill cancer cells and shrink tumors. The total dose of radiation can be delivered in a single day or divided in smaller doses for up to 5 days of total treatment. Usual treatment for asymptomatic bone metastases may include drugs that prevent bone loss, in addition to the treatment for the primary cancer or observation (which means no treatment until symptoms appear). Evidence has shown that preventative radiation therapy may be effective in lowering the number of bone metastases-related complications, however, it is not known if this approach is superior to usual care. Adding radiation therapy to usual treatment may be more effective in preventing bone-related complications than usual care alone in cancer patients with asymptomatic high-risk bone metastases.

Study Overview

Status

Active, not recruiting

Conditions

Intervention / Treatment

Detailed Description

PRIMARY OBJECTIVE:

I. To determine whether prophylactic radiation therapy (RT) to high-risk asymptomatic bone metastases decreases the occurrence of skeletal-related events (SREs), including pathologic fracture, spinal cord compression, and surgery to bone (not including palliative radiation for pain only), compared to standard of care (SOC).

SECONDARY OBJECTIVES:

I. To compare overall survival (OS) between study arms. II. To compare occurrence of any SREs (including RT for palliation of pain) among enrolled bone metastasis(es) between study arms.

III. To compare occurrence of hospitalizations related to any SREs in enrolled bone metastasis(es) between study arms.

IV. To compare pain-related quality of life (QOL) between study arms. V. To characterize adverse events of RT and compare to SOC.

EXPLORATORY OBJECTIVES:

I. To evaluate overall QOL, functional status, and quality-adjusted life years between study arms.

II. To evaluate any hospitalizations (from any cause) between study arms. III. To characterize differences in primary and secondary endpoints between study arms (a) among the represented racial and ethnic groups (e.g. Black, White, Hispanic/Latino, Asian/Pacific Islander, and Native American), (b) by sex, and (c) by health-related social needs.

IV. To evaluate the heterogeneity of radiation treatment effect based on cancer-related factors (histology, criteria indicating high-risk for SRE), treatment-related factors (bone modifying agent use, radiation dose/technique), and patient demographic factors (age, sex, race, ethnicity, and health-related social needs).

OUTLINE: Patients are randomized to 1 of 2 arms.

ARM I: Patients continue to receive SOC systemic anti-cancer therapy or observation and bone modifying agents as determined by the treating physician. Additionally, patients undergo optional blood sample collection on study.

ARM II: Patients continue SOC as in Arm I. Patients also undergo conventional RT or stereotactic body radiation therapy (SBRT) once daily (QD) for up to 5 days (5 fractions) in the absence of disease progression or unacceptable toxicity. Additionally, patients undergo computed tomography (CT) or magnetic resonance imaging (MRI) for RT planning and optional blood sample collection on study.

After completion of study treatment, patients are followed up at 3, 6, 12 and 24 months.

Study Type

Interventional

Enrollment (Estimated)

280

Phase

Phase 3

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

Canada
- Ontario
  - Toronto, Ontario, Canada, M5G 2M9
    - University Health Network-Princess Margaret Hospital
- Quebec
  - Montreal, Quebec, Canada, H3H 2R9
    - The Research Institute of the McGill University Health Centre (MUHC)
United States
- Alaska
  - Fairbanks, Alaska, United States, 99701
    - Fairbanks Memorial Hospital
- Arizona
  - Gilbert, Arizona, United States, 85234
    - Banner MD Anderson Cancer Center
  - Phoenix, Arizona, United States, 85004
    - Cancer Center at Saint Joseph's
  - Phoenix, Arizona, United States, 85006
    - Banner-University Medical Center Phoenix
  - Tucson, Arizona, United States, 85719
    - Banner University Medical Center - Tucson
  - Tucson, Arizona, United States, 85719
    - University of Arizona Cancer Center-North Campus
- California
  - Anaheim, California, United States, 92806
    - Kaiser Permanente-Anaheim
  - Antioch, California, United States, 94531
    - Kaiser Permanente-Deer Valley Medical Center
  - Arroyo Grande, California, United States, 93420
    - Mission Hope Medical Oncology - Arroyo Grande
  - Auburn, California, United States, 95602
    - Sutter Auburn Faith Hospital
  - Auburn, California, United States, 95603
    - Sutter Cancer Centers Radiation Oncology Services-Auburn
  - Bakersfield, California, United States, 93301
    - AIS Cancer Center at San Joaquin Community Hospital
  - Bellflower, California, United States, 90706
    - Kaiser Permanente-Bellflower
  - Berkeley, California, United States, 94704
    - Alta Bates Summit Medical Center-Herrick Campus
  - Burlingame, California, United States, 94010
    - Mills-Peninsula Medical Center
  - Cameron Park, California, United States, 95682
    - Sutter Cancer Centers Radiation Oncology Services-Cameron Park
  - Carmichael, California, United States, 95608
    - Mercy San Juan Medical Center
  - Carmichael, California, United States, 95608
    - Mercy Cancer Center - Carmichael
  - Castro Valley, California, United States, 94546
    - Eden Hospital Medical Center
  - Corona, California, United States, 92882
    - City of Hope Corona
  - Duarte, California, United States, 91010
    - City of Hope Comprehensive Cancer Center
  - Dublin, California, United States, 94568
    - Kaiser Permanente Dublin
  - Elk Grove, California, United States, 95758
    - Mercy Cancer Center - Elk Grove
  - Encinitas, California, United States, 92024
    - UC San Diego Health System - Encinitas
  - Fremont, California, United States, 94538
    - Kaiser Permanente-Fremont
  - Fremont, California, United States, 94538
    - Palo Alto Medical Foundation-Fremont
  - Fresno, California, United States, 93720
    - Kaiser Permanente-Fresno
  - Fresno, California, United States, 93720
    - Fresno Cancer Center
  - Fresno, California, United States, 93720
    - Kaiser Permanente Fresno Orchard Plaza
  - Irvine, California, United States, 92618
    - City of Hope at Irvine Lennar
  - Irvine, California, United States, 92612
    - UCI Health - Chao Family Comprehensive Cancer Center and Ambulatory Care
  - La Jolla, California, United States, 92093
    - UC San Diego Moores Cancer Center
  - Lancaster, California, United States, 93534
    - City of Hope Antelope Valley
  - Los Angeles, California, United States, 90027
    - Kaiser Permanente Los Angeles Medical Center
  - Martinez, California, United States, 94553-3156
    - Contra Costa Regional Medical Center
  - Modesto, California, United States, 95355
    - Memorial Medical Center
  - Modesto, California, United States, 95356
    - Kaiser Permanente-Modesto
  - Modesto, California, United States, 95356
    - Kaiser Permanente- Modesto MOB II
  - Mountain View, California, United States, 94040
    - Palo Alto Medical Foundation-Camino Division
  - Oakland, California, United States, 94611
    - Kaiser Permanente-Oakland
  - Oakland, California, United States, 94611
    - Kaiser Permanente Oakland-Broadway
  - Ontario, California, United States, 91761
    - Kaiser Permanente-Ontario
  - Orange, California, United States, 92868
    - UC Irvine Health/Chao Family Comprehensive Cancer Center
  - Palo Alto, California, United States, 94301
    - Palo Alto Medical Foundation Health Care
  - Rancho Cordova, California, United States, 95670
    - Kaiser Permanente-Rancho Cordova Cancer Center
  - Redwood City, California, United States, 94063
    - Kaiser Permanente- Marshall Medical Offices
  - Richmond, California, United States, 94801
    - Kaiser Permanente-Richmond
  - Rocklin, California, United States, 95765
    - Mercy Cancer Center - Rocklin
  - Rohnert Park, California, United States, 94928
    - Rohnert Park Cancer Center
  - Roseville, California, United States, 95661
    - Kaiser Permanente-Roseville
  - Roseville, California, United States, 95661
    - Sutter Cancer Centers Radiation Oncology Services-Roseville
  - Roseville, California, United States, 95661
    - Sutter Roseville Medical Center
  - Sacramento, California, United States, 95816
    - Sutter Medical Center Sacramento
  - Sacramento, California, United States, 95814
    - Kaiser Permanente Downtown Commons
  - Sacramento, California, United States, 95823
    - Kaiser Permanente-South Sacramento
  - Sacramento, California, United States, 95823
    - South Sacramento Cancer Center
  - Sacramento, California, United States, 95816
    - Mercy Cancer Center - Sacramento
  - San Diego, California, United States, 92103
    - UC San Diego Medical Center - Hillcrest
  - San Francisco, California, United States, 94115
    - Kaiser Permanente-San Francisco
  - San Francisco, California, United States, 94115
    - California Pacific Medical Center-Pacific Campus
  - San Jose, California, United States, 95119
    - Kaiser Permanente-Santa Teresa-San Jose
  - San Leandro, California, United States, 94577
    - Kaiser Permanente San Leandro
  - San Luis Obispo, California, United States, 93401
    - Pacific Central Coast Health Center-San Luis Obispo
  - San Mateo, California, United States, 94401
    - Mills Health Center
  - San Rafael, California, United States, 94903
    - Kaiser San Rafael-Gallinas
  - Santa Barbara, California, United States, 93105
    - Ridley-Tree Cancer Center
  - Santa Clara, California, United States, 95051
    - Kaiser Permanente Medical Center - Santa Clara
  - Santa Cruz, California, United States, 95065
    - Palo Alto Medical Foundation-Santa Cruz
  - Santa Maria, California, United States, 93444
    - Mission Hope Medical Oncology - Santa Maria
  - Santa Rosa, California, United States, 95403
    - Kaiser Permanente-Santa Rosa
  - Santa Rosa, California, United States, 95403
    - Sutter Pacific Medical Foundation
  - South Pasadena, California, United States, 91030
    - City of Hope South Pasadena
  - South San Francisco, California, United States, 94080
    - Kaiser Permanente Cancer Treatment Center
  - South San Francisco, California, United States, 94080
    - Kaiser Permanente-South San Francisco
  - Stockton, California, United States, 95210
    - Kaiser Permanente-Stockton
  - Stockton, California, United States, 95204
    - Saint Joseph's Medical Center
  - Sunnyvale, California, United States, 94086
    - Palo Alto Medical Foundation-Sunnyvale
  - Upland, California, United States, 91786
    - City of Hope Upland
  - Vacaville, California, United States, 95688
    - Kaiser Permanente Medical Center-Vacaville
  - Vallejo, California, United States, 94589
    - Kaiser Permanente-Vallejo
  - Vallejo, California, United States, 94589
    - Sutter Solano Medical Center/Cancer Center
  - Walnut Creek, California, United States, 94596
    - Kaiser Permanente-Walnut Creek
  - Walnut Creek, California, United States, 94598
    - John Muir Medical Center-Walnut Creek
  - Walnut Creek, California, United States, 94598
    - BASS Medical Group - Lennon
  - Woodland, California, United States, 95695
    - Woodland Memorial Hospital
- Colorado
  - Aurora, Colorado, United States, 80012
    - Rocky Mountain Cancer Centers-Aurora
  - Aurora, Colorado, United States, 80045
    - UCHealth University of Colorado Hospital
  - Boulder, Colorado, United States, 80304
    - Rocky Mountain Cancer Centers-Boulder
  - Colorado Springs, Colorado, United States, 80907
    - Penrose-Saint Francis Healthcare
  - Colorado Springs, Colorado, United States, 80909
    - UCHealth Memorial Hospital Central
  - Colorado Springs, Colorado, United States, 80907
    - Rocky Mountain Cancer Centers-Penrose
  - Colorado Springs, Colorado, United States, 80920
    - Memorial Hospital North
  - Colorado Springs, Colorado, United States, 80923
    - Saint Francis Cancer Center
  - Denver, Colorado, United States, 80218
    - Presbyterian - Saint Lukes Medical Center - Health One
  - Denver, Colorado, United States, 80206
    - UCHealth - Cherry Creek
  - Denver, Colorado, United States, 80210
    - AdventHealth Porter
  - Englewood, Colorado, United States, 80113
    - The Melanoma and Skin Cancer Institute
  - Greeley, Colorado, United States, 80631
    - Banner North Colorado Medical Center
  - Highlands Ranch, Colorado, United States, 80129
    - UCHealth Highlands Ranch Hospital
  - Lakewood, Colorado, United States, 80228
    - Saint Anthony Hospital
  - Littleton, Colorado, United States, 80120
    - Rocky Mountain Cancer Centers-Littleton
  - Littleton, Colorado, United States, 80122
    - AdventHealth Littleton
  - Longmont, Colorado, United States, 80501
    - Longmont United Hospital
  - Loveland, Colorado, United States, 80539
    - Banner North Colorado Medical Center - Loveland Campus
  - Parker, Colorado, United States, 80138
    - AdventHealth Parker
  - Pueblo, Colorado, United States, 81004
    - Saint Mary Corwin Medical Center
  - Thornton, Colorado, United States, 80260
    - Rocky Mountain Cancer Centers-Thornton
  - Westminster, Colorado, United States, 80023
    - Saint Anthony North Hospital
- Connecticut
  - Danbury, Connecticut, United States, 06810
    - Danbury Hospital
  - Norwalk, Connecticut, United States, 06856
    - Norwalk Hospital
- Delaware
  - Lewes, Delaware, United States, 19958
    - Beebe Medical Center
  - Millville, Delaware, United States, 19967
    - Beebe South Coastal Health Campus
  - Newark, Delaware, United States, 19713
    - Helen F Graham Cancer Center
  - Newark, Delaware, United States, 19713
    - Medical Oncology Hematology Consultants PA
  - Newark, Delaware, United States, 19718
    - Christiana Care Health System-Christiana Hospital
  - Rehoboth Beach, Delaware, United States, 19971
    - Beebe Health Campus
  - Wilmington, Delaware, United States, 19801
    - Christiana Care Health System-Wilmington Hospital
- District of Columbia
  - Washington D.C., District of Columbia, United States, 20037
    - George Washington University Medical Center
- Florida
  - Aventura, Florida, United States, 33180
    - UM Sylvester Comprehensive Cancer Center at Aventura
  - Bay Pines, Florida, United States, 33744
    - Bay Pines VA Healthcare System
  - Coral Gables, Florida, United States, 33146
    - UM Sylvester Comprehensive Cancer Center at Coral Gables
  - Daytona Beach, Florida, United States, 32117
    - AdventHealth Daytona Beach
  - Deerfield Beach, Florida, United States, 33442
    - UM Sylvester Comprehensive Cancer Center at Deerfield Beach
  - Doral, Florida, United States, 33166
    - UM Sylvester Comprehensive Cancer Center at Doral
  - Fort Lauderdale, Florida, United States, 33308
    - Holy Cross Hospital
  - Hollywood, Florida, United States, 33021
    - Memorial Regional Hospital/Joe DiMaggio Children's Hospital
  - Miami, Florida, United States, 33136
    - University of Miami Miller School of Medicine-Sylvester Cancer Center
  - Miami, Florida, United States, 33176
    - Miami Cancer Institute
  - Miami, Florida, United States, 33176
    - UM Sylvester Comprehensive Cancer Center at Kendall
  - Pembroke Pines, Florida, United States, 33028
    - Memorial Hospital West
  - Plantation, Florida, United States, 33324
    - UM Sylvester Comprehensive Cancer Center at Plantation
  - Ruskin, Florida, United States, 33570
    - Moffitt Cancer Center at SouthShore
  - Tampa, Florida, United States, 33612
    - Moffitt Cancer Center
  - Tampa, Florida, United States, 33607
    - Moffitt Cancer Center-International Plaza
  - Tampa, Florida, United States, 33612
    - Moffitt Cancer Center - McKinley Campus
  - Wesley Chapel, Florida, United States, 33544
    - Moffitt Cancer Center at Wesley Chapel
- Georgia
  - Atlanta, Georgia, United States, 30308
    - Emory University Hospital Midtown
  - Atlanta, Georgia, United States, 30322
    - Emory University Hospital/Winship Cancer Institute
  - Atlanta, Georgia, United States, 30342
    - Emory Saint Joseph's Hospital
  - Atlanta, Georgia, United States, 30303
    - Grady Health System
  - Decatur, Georgia, United States, 30033
    - Emory Decatur Hospital
- Hawaii
  - Honolulu, Hawaii, United States, 96813
    - Queen's Medical Center
  - Honolulu, Hawaii, United States, 96817
    - The Cancer Center of Hawaii-Liliha
  - Honolulu, Hawaii, United States, 96813
    - Hawaii Cancer Care Inc - Waterfront Plaza
  - Honolulu, Hawaii, United States, 96813
    - Queen's Cancer Cenrer - POB I
  - Honolulu, Hawaii, United States, 96813
    - Straub Clinic and Hospital
  - Honolulu, Hawaii, United States, 96813
    - University of Hawaii Cancer Center
  - Honolulu, Hawaii, United States, 96817
    - Kuakini Medical Center
  - Honolulu, Hawaii, United States, 96817
    - Queen's Cancer Center - Kuakini
  - Honolulu, Hawaii, United States, 96826
    - Kapiolani Medical Center for Women and Children
  - Honolulu, Hawaii, United States, 96819
    - Kaiser Permanente Moanalua Medical Center
  - Kailua, Hawaii, United States, 96734
    - Castle Medical Center
  - Lihue, Hawaii, United States, 96766
    - Wilcox Memorial Hospital and Kauai Medical Clinic
  - ‘Aiea, Hawaii, United States, 96701
    - Hawaii Cancer Care - Westridge
  - ‘Aiea, Hawaii, United States, 96701
    - Pali Momi Medical Center
  - ‘Aiea, Hawaii, United States, 96701
    - Queen's Cancer Center - Pearlridge
  - ‘Aiea, Hawaii, United States, 96701
    - The Cancer Center of Hawaii-Pali Momi
  - ‘Ewa Beach, Hawaii, United States, 96706
    - The Queen's Medical Center - West Oahu
- Idaho
  - Boise, Idaho, United States, 83706
    - Saint Alphonsus Cancer Care Center-Boise
  - Caldwell, Idaho, United States, 83605
    - Saint Alphonsus Cancer Care Center-Caldwell
  - Coeur d'Alene, Idaho, United States, 83814
    - Kootenai Health - Coeur d'Alene
  - Meridian, Idaho, United States, 83642
    - Idaho Urologic Institute-Meridian
  - Nampa, Idaho, United States, 83687
    - Saint Alphonsus Cancer Care Center-Nampa
  - Post Falls, Idaho, United States, 83854
    - Kootenai Clinic Cancer Services - Post Falls
- Illinois
  - Alton, Illinois, United States, 62002
    - Alton Memorial Hospital
  - Aurora, Illinois, United States, 60504
    - Rush-Copley Medical Center
  - Aurora, Illinois, United States, 60506
    - Advocate Outpatient Center - Aurora
  - Barrington, Illinois, United States, 60010
    - Advocate Good Shepherd Hospital
  - Bloomington, Illinois, United States, 61704
    - Illinois CancerCare-Bloomington
  - Bloomington, Illinois, United States, 61701
    - OSF Saint Joseph Medical Center
  - Canton, Illinois, United States, 61520
    - Illinois CancerCare-Canton
  - Carbondale, Illinois, United States, 62902
    - Memorial Hospital of Carbondale
  - Carterville, Illinois, United States, 62918
    - SIH Cancer Institute
  - Carthage, Illinois, United States, 62321
    - Illinois CancerCare-Carthage
  - Centralia, Illinois, United States, 62801
    - Centralia Oncology Clinic
  - Chicago, Illinois, United States, 60611
    - Northwestern University
  - Chicago, Illinois, United States, 60657
    - Advocate Illinois Masonic Medical Center
  - Chicago, Illinois, United States, 60612
    - Rush MD Anderson Cancer Center
  - Crystal Lake, Illinois, United States, 60014
    - AMG Crystal Lake - Oncology
  - Danville, Illinois, United States, 61832
    - Carle at The Riverfront
  - DeKalb, Illinois, United States, 60115
    - Northwestern Medicine Cancer Center Kishwaukee
  - Decatur, Illinois, United States, 62526
    - Decatur Memorial Hospital
  - Decatur, Illinois, United States, 62526
    - Cancer Care Specialists of Illinois - Decatur
  - Dixon, Illinois, United States, 61021
    - Illinois CancerCare-Dixon
  - Downers Grove, Illinois, United States, 60515
    - Advocate Good Samaritan Hospital
  - Effingham, Illinois, United States, 62401
    - Crossroads Cancer Center
  - Effingham, Illinois, United States, 62401
    - Carle Physician Group-Effingham
  - Elgin, Illinois, United States, 60123
    - Advocate Sherman Hospital
  - Elmhurst, Illinois, United States, 60126
    - Elmhurst Memorial Hospital
  - Eureka, Illinois, United States, 61530
    - Illinois CancerCare-Eureka
  - Galesburg, Illinois, United States, 61401
    - Illinois CancerCare-Galesburg
  - Geneva, Illinois, United States, 60134
    - Northwestern Medicine Cancer Center Delnor
  - Hazel Crest, Illinois, United States, 60429
    - Advocate South Suburban Hospital
  - Kewanee, Illinois, United States, 61443
    - Illinois CancerCare-Kewanee Clinic
  - Libertyville, Illinois, United States, 60048
    - Condell Memorial Hospital
  - Libertyville, Illinois, United States, 60048
    - AMG Libertyville - Oncology
  - Macomb, Illinois, United States, 61455
    - Illinois CancerCare-Macomb
  - Mattoon, Illinois, United States, 61938
    - Carle Physician Group-Mattoon/Charleston
  - Maywood, Illinois, United States, 60153
    - Loyola University Medical Center
  - Naperville, Illinois, United States, 60540
    - Edward Hospital/Cancer Center
  - Normal, Illinois, United States, 61761
    - Carle Cancer Institute Normal
  - Normal, Illinois, United States, 61761
    - Carle BroMenn Medical Center
  - O'Fallon, Illinois, United States, 62269
    - Cancer Care Center of O'Fallon
  - O'Fallon, Illinois, United States, 62269
    - HSHS Saint Elizabeth's Hospital
  - Oak Brook, Illinois, United States, 60523
    - Northwestern Medicine Oak Brook
  - Oak Lawn, Illinois, United States, 60453-2699
    - Advocate Christ Medical Center
  - Oak Park, Illinois, United States, 60304
    - Rush MD Anderson Cancer Center at Rush Oak Park
  - Orland Park, Illinois, United States, 60462
    - Northwestern Medicine Orland Park
  - Ottawa, Illinois, United States, 61350
    - Illinois CancerCare-Ottawa Clinic
  - Palos Heights, Illinois, United States, 60463
    - Advocate High Tech Medical Park
  - Park Ridge, Illinois, United States, 60068
    - Advocate Lutheran General Hospital
  - Pekin, Illinois, United States, 61554
    - Illinois CancerCare-Pekin
  - Pekin, Illinois, United States, 61554
    - OSF Saint Francis Radiation Oncology at Pekin
  - Peoria, Illinois, United States, 61636
    - Methodist Medical Center of Illinois
  - Peoria, Illinois, United States, 61637
    - OSF Saint Francis Medical Center
  - Peoria, Illinois, United States, 61615
    - Illinois CancerCare-Peoria
  - Peoria, Illinois, United States, 61615
    - OSF Saint Francis Radiation Oncology at Peoria Cancer Center
  - Peru, Illinois, United States, 61354
    - Illinois CancerCare-Peru
  - Peru, Illinois, United States, 61354
    - Valley Radiation Oncology
  - Princeton, Illinois, United States, 61356
    - Illinois CancerCare-Princeton
  - Rockford, Illinois, United States, 61114
    - UW Health Carbone Cancer Center Rockford
  - Shiloh, Illinois, United States, 62269
    - Memorial Hospital East
  - Springfield, Illinois, United States, 62702
    - Southern Illinois University School of Medicine
  - Springfield, Illinois, United States, 62702
    - Springfield Clinic
  - Springfield, Illinois, United States, 62781
    - Springfield Memorial Hospital
  - Urbana, Illinois, United States, 61801
    - Carle Cancer Center
  - Warrenville, Illinois, United States, 60555
    - Northwestern Medicine Cancer Center Warrenville
  - Washington, Illinois, United States, 61571
    - Illinois CancerCare - Washington
  - Zion, Illinois, United States, 60099
    - Midwestern Regional Medical Center
- Indiana
  - Avon, Indiana, United States, 46123
    - IU Health West Hospital
  - Carmel, Indiana, United States, 46032
    - IU Health North Hospital
  - Crown Point, Indiana, United States, 46307
    - Northwest Cancer Center - Main Campus
  - Dyer, Indiana, United States, 46311
    - Northwest Oncology LLC
  - Goshen, Indiana, United States, 46526
    - Goshen Center for Cancer Care
  - Hobart, Indiana, United States, 46342
    - Northwest Cancer Center - Hobart
  - Hobart, Indiana, United States, 46342
    - Saint Mary Medical Center
  - Indianapolis, Indiana, United States, 46202
    - Indiana University/Melvin and Bren Simon Cancer Center
  - Indianapolis, Indiana, United States, 46202
    - IU Health Methodist Hospital
  - Munster, Indiana, United States, 46321
    - The Community Hospital
  - Munster, Indiana, United States, 46321
    - Women's Diagnostic Center - Munster
  - Richmond, Indiana, United States, 47374
    - Reid Health
  - Valparaiso, Indiana, United States, 46383
    - Northwest Cancer Center - Valparaiso
- Iowa
  - Ames, Iowa, United States, 50010
    - Mary Greeley Medical Center
  - Ames, Iowa, United States, 50010
    - McFarland Clinic - Ames
  - Ankeny, Iowa, United States, 50023
    - UI Health Care Mission Cancer and Blood - Ankeny Clinic
  - Cedar Rapids, Iowa, United States, 52402
    - Saint Luke's Hospital
  - Clive, Iowa, United States, 50325
    - Mercy Cancer Center-West Lakes
  - Clive, Iowa, United States, 50325
    - UI Health Care Mission Cancer and Blood - West Des Moines Clinic
  - Creston, Iowa, United States, 50801
    - Greater Regional Medical Center
  - Des Moines, Iowa, United States, 50309
    - Iowa Methodist Medical Center
  - Des Moines, Iowa, United States, 50314
    - Mercy Medical Center - Des Moines
  - Des Moines, Iowa, United States, 50309
    - UI Health Care Mission Cancer and Blood - Des Moines Clinic
  - Des Moines, Iowa, United States, 50314
    - UI Health Care Mission Cancer and Blood - Laurel Clinic
  - Waukee, Iowa, United States, 50263
    - UI Health Care Mission Cancer and Blood - Waukee Clinic
  - West Des Moines, Iowa, United States, 50266
    - Mercy Medical Center-West Lakes
- Kansas
  - Kansas City, Kansas, United States, 66160
    - University of Kansas Cancer Center
  - Lawrence, Kansas, United States, 66044
    - Lawrence Memorial Hospital
  - Olathe, Kansas, United States, 66061
    - The University of Kansas Cancer Center - Olathe
  - Overland Park, Kansas, United States, 66210
    - University of Kansas Cancer Center-Overland Park
  - Overland Park, Kansas, United States, 66211
    - University of Kansas Hospital-Indian Creek Campus
  - Salina, Kansas, United States, 67401
    - Salina Regional Health Center
  - Topeka, Kansas, United States, 66606
    - University of Kansas Health System Saint Francis Campus
  - Westwood, Kansas, United States, 66205
    - University of Kansas Hospital-Westwood Cancer Center
- Kentucky
  - Lexington, Kentucky, United States, 40504
    - Saint Joseph Radiation Oncology Resource Center
  - Lexington, Kentucky, United States, 40509
    - Saint Joseph Hospital East
  - Lexington, Kentucky, United States, 40504
    - Saint Joseph Hospital
  - Louisville, Kentucky, United States, 40202
    - Norton Hospital Pavilion and Medical Campus
  - Louisville, Kentucky, United States, 40241
    - Norton Brownsboro Hospital and Medical Campus
  - Louisville, Kentucky, United States, 40207
    - Norton Suburban Hospital and Medical Campus
  - Louisville, Kentucky, United States, 40217
    - Norton Audubon Hospital and Medical Campus
- Maine
  - Bath, Maine, United States, 04530
    - MaineHealth Coastal Cancer Treatment Center
  - Belfast, Maine, United States, 04915
    - MaineHealth Waldo Hospital
  - Damariscotta, Maine, United States, 04543
    - MaineHealth LincolnHealth Hospital
  - Portland, Maine, United States, 04102
    - MaineHealth Maine Medical Center - Portland
  - Rockport, Maine, United States, 04856
    - Penobscot Bay Medical Center
  - Sanford, Maine, United States, 04073
    - MaineHealth Cancer Care Center of York County
  - Scarborough, Maine, United States, 04074
    - MaineHealth Maine Medical Center- Scarborough
  - South Portland, Maine, United States, 04106
    - MaineHealth Cancer Care and IV Therapy - South Portland
- Maryland
  - Baltimore, Maryland, United States, 21215
    - Sinai Hospital of Baltimore
  - Baltimore, Maryland, United States, 21201
    - University of Maryland/Greenebaum Cancer Center
  - Baltimore, Maryland, United States, 21201
    - Maryland Proton Treatment Center
  - Bel Air, Maryland, United States, 21014
    - UM Upper Chesapeake Medical Center
  - Columbia, Maryland, United States, 21044
    - Central Maryland Radiation Oncology in Howard County
  - Cumberland, Maryland, United States, 21502
    - UPMC Western Maryland
  - Easton, Maryland, United States, 21601
    - University of Maryland Shore Medical Center at Easton
  - Glen Burnie, Maryland, United States, 21061
    - UM Baltimore Washington Medical Center/Tate Cancer Center
  - Largo, Maryland, United States, 20774
    - UM Capital Region Medical Center
  - Towson, Maryland, United States, 21204
    - UM Saint Joseph Medical Center
  - Westminster, Maryland, United States, 21157
    - William E Kahlert Regional Cancer Center/Sinai Hospital
- Massachusetts
  - Boston, Massachusetts, United States, 02111
    - Tufts Medical Center
- Michigan
  - Alma, Michigan, United States, 48801
    - MyMichigan Medical Center Gratiot
  - Ann Arbor, Michigan, United States, 48106
    - Trinity Health Saint Joseph Mercy Hospital Ann Arbor
  - Bay City, Michigan, United States, 48706
    - McLaren Cancer Institute-Bay City
  - Brighton, Michigan, United States, 48114
    - Trinity Health IHA Medical Group Hematology Oncology - Brighton
  - Brighton, Michigan, United States, 48114
    - Trinity Health Medical Center - Brighton
  - Canton, Michigan, United States, 48188
    - Trinity Health IHA Medical Group Hematology Oncology - Canton
  - Canton, Michigan, United States, 48188
    - Trinity Health Medical Center - Canton
  - Chelsea, Michigan, United States, 48118
    - Trinity Health IHA Medical Group Hematology Oncology - Chelsea Hospital
  - Chelsea, Michigan, United States, 48118
    - Chelsea Hospital
  - Clarkston, Michigan, United States, 48346
    - McLaren Cancer Institute-Clarkston
  - Detroit, Michigan, United States, 48201
    - Wayne State University/Karmanos Cancer Institute
  - Detroit, Michigan, United States, 48236
    - Henry Ford Health Saint John Hospital
  - Farmington Hills, Michigan, United States, 48334
    - Weisberg Cancer Treatment Center
  - Flint, Michigan, United States, 48532
    - McLaren Cancer Institute-Flint
  - Flint, Michigan, United States, 48503
    - Hurley Medical Center
  - Flint, Michigan, United States, 48503
    - Genesys Hurley Cancer Institute
  - Grosse Pointe Woods, Michigan, United States, 48236
    - Henry Ford Saint John Hospital - Van Elslander
  - Lansing, Michigan, United States, 48910
    - Karmanos Cancer Institute at McLaren Greater Lansing
  - Lansing, Michigan, United States, 48912
    - University of Michigan Health - Sparrow Lansing
  - Lapeer, Michigan, United States, 48446
    - McLaren Cancer Institute-Lapeer Region
  - Livonia, Michigan, United States, 48154
    - Trinity Health Saint Mary Mercy Livonia Hospital
  - Macomb, Michigan, United States, 48044
    - Henry Ford Saint John Hospital - Macomb Medical
  - Midland, Michigan, United States, 48670
    - MyMichigan Medical Center Midland
  - Mount Clemens, Michigan, United States, 48043
    - McLaren Cancer Institute-Macomb
  - Mount Pleasant, Michigan, United States, 48858
    - McLaren Cancer Institute-Central Michigan
  - Petoskey, Michigan, United States, 49770
    - McLaren Cancer Institute-Northern Michigan
  - Pontiac, Michigan, United States, 48341
    - Trinity Health Saint Joseph Mercy Oakland Hospital
  - Pontiac, Michigan, United States, 48341
    - Michigan Healthcare Professionals Pontiac
  - Port Huron, Michigan, United States, 48060
    - McLaren-Port Huron
  - Saginaw, Michigan, United States, 48601
    - MyMichigan Medical Center Saginaw
  - Tawas City, Michigan, United States, 48764
    - MyMichigan Medical Center Tawas
  - Warren, Michigan, United States, 48093
    - Henry Ford Health Warren Hospital
  - Ypsilanti, Michigan, United States, 48197
    - Trinity Health IHA Medical Group Hematology Oncology Ann Arbor Campus
- Minnesota
  - Brainerd, Minnesota, United States, 56401
    - Essentia Health Saint Joseph's Medical Center
  - Burnsville, Minnesota, United States, 55337
    - Minnesota Oncology - Burnsville
  - Coon Rapids, Minnesota, United States, 55433
    - Mercy Hospital
  - Deer River, Minnesota, United States, 56636
    - Essentia Health - Deer River Clinic
  - Detroit Lakes, Minnesota, United States, 56501
    - Essentia Health Saint Mary's - Detroit Lakes Clinic
  - Duluth, Minnesota, United States, 55805
    - Essentia Health Cancer Center
  - Duluth, Minnesota, United States, 55805
    - Essentia Health Saint Mary's Medical Center
  - Duluth, Minnesota, United States, 55805
    - Miller-Dwan Hospital
  - Edina, Minnesota, United States, 55435
    - Fairview Southdale Hospital
  - Fosston, Minnesota, United States, 56542
    - Essentia Health - Fosston
  - Hibbing, Minnesota, United States, 55746
    - Essentia Health Hibbing Clinic
  - Maple Grove, Minnesota, United States, 55369
    - Fairview Clinics and Surgery Center Maple Grove
  - Maplewood, Minnesota, United States, 55109
    - Saint John's Hospital - Healtheast
  - Maplewood, Minnesota, United States, 55109
    - Minnesota Oncology Hematology PA-Maplewood
  - Minneapolis, Minnesota, United States, 55415
    - Hennepin County Medical Center
  - Minneapolis, Minnesota, United States, 55407
    - Abbott-Northwestern Hospital
  - Monticello, Minnesota, United States, 55362
    - Monticello Cancer Center
  - Park Rapids, Minnesota, United States, 56470
    - Essentia Health - Park Rapids
  - Robbinsdale, Minnesota, United States, 55422
    - North Memorial Medical Health Center
  - Saint Cloud, Minnesota, United States, 56303
    - Coborn Cancer Center at Saint Cloud Hospital
  - Saint Louis Park, Minnesota, United States, 55416
    - Park Nicollet Clinic - Saint Louis Park
  - Saint Paul, Minnesota, United States, 55101
    - Regions Hospital
  - Saint Paul, Minnesota, United States, 55102
    - United Hospital
  - Sandstone, Minnesota, United States, 55072
    - Essentia Health Sandstone
  - Shakopee, Minnesota, United States, 55379
    - Saint Francis Regional Medical Center
  - Stillwater, Minnesota, United States, 55082
    - Lakeview Hospital
  - Virginia, Minnesota, United States, 55792
    - Essentia Health Virginia Clinic
  - Waconia, Minnesota, United States, 55387
    - Ridgeview Medical Center
  - Willmar, Minnesota, United States, 56201
    - Rice Memorial Hospital
  - Woodbury, Minnesota, United States, 55125
    - Minnesota Oncology Hematology PA-Woodbury
- Missouri
  - Cape Girardeau, Missouri, United States, 63703
    - Saint Francis Medical Center
  - City of Saint Peters, Missouri, United States, 63376
    - Siteman Cancer Center at Saint Peters Hospital
  - Columbia, Missouri, United States, 65212
    - MU Health - University Hospital/Ellis Fischel Cancer Center
  - Creve Coeur, Missouri, United States, 63141
    - Siteman Cancer Center at West County Hospital
  - Farmington, Missouri, United States, 63640
    - Parkland Health Center - Farmington
  - Kansas City, Missouri, United States, 64154
    - University of Kansas Cancer Center - North
  - Kansas City, Missouri, United States, 64116
    - University of Kansas Cancer Center - Briarcliff
  - Lee's Summit, Missouri, United States, 64064
    - University of Kansas Cancer Center - Lee's Summit
  - Sainte Genevieve, Missouri, United States, 63670
    - Sainte Genevieve County Memorial Hospital
  - St Louis, Missouri, United States, 63110
    - Washington University School of Medicine
  - St Louis, Missouri, United States, 63129
    - Siteman Cancer Center-South County
  - St Louis, Missouri, United States, 63131
    - Missouri Baptist Medical Center
  - Sullivan, Missouri, United States, 63080
    - Missouri Baptist Sullivan Hospital
  - Sunset Hills, Missouri, United States, 63127
    - BJC Outpatient Center at Sunset Hills
- Montana
  - Billings, Montana, United States, 59101
    - Billings Clinic Cancer Center
  - Bozeman, Montana, United States, 59715
    - Bozeman Health Deaconess Hospital
  - Great Falls, Montana, United States, 59405
    - Great Falls Clinic
  - Great Falls, Montana, United States, 59405
    - Benefis Sletten Cancer Institute
  - Havre, Montana, United States, 59501
    - Hi-Line Sletten Cancer Center
  - Kalispell, Montana, United States, 59901
    - Logan Health Medical Center
  - Missoula, Montana, United States, 59804
    - Community Medical Center
- Nebraska
  - Bellevue, Nebraska, United States, 68123
    - Nebraska Medicine-Bellevue
  - Kearney, Nebraska, United States, 68847
    - CHI Health Good Samaritan
  - Omaha, Nebraska, United States, 68198
    - University of Nebraska Medical Center
  - Omaha, Nebraska, United States, 68124
    - Alegent Health Bergan Mercy Medical Center
  - Omaha, Nebraska, United States, 68118
    - Nebraska Medicine-Village Pointe
  - Omaha, Nebraska, United States, 68122
    - Alegent Health Immanuel Medical Center
  - Omaha, Nebraska, United States, 68130
    - Alegent Health Lakeside Hospital
  - Omaha, Nebraska, United States, 68131
    - Creighton University Medical Center
- New Hampshire
  - Lebanon, New Hampshire, United States, 03756
    - Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center
  - Manchester, New Hampshire, United States, 03104
    - Dartmouth Cancer Center - Manchester/ DCC Manchester
  - Nashua, New Hampshire, United States, 03063
    - Dartmouth Cancer Center - Nashua
- New Jersey
  - Camden, New Jersey, United States, 08103
    - Cooper Hospital University Medical Center
  - Cherry Hill, New Jersey, United States, 08002
    - Jefferson Cherry Hill Hospital
  - Mount Laurel, New Jersey, United States, 08054
    - Cooper CyberKnife Center
  - New Brunswick, New Jersey, United States, 08901
    - Saint Peter's University Hospital
  - Paramus, New Jersey, United States, 07652
    - The Valley Hospital - Luckow Pavilion
  - Sewell, New Jersey, United States, 08080
    - Sidney Kimmel Cancer Center Washington Township
  - Voorhees Township, New Jersey, United States, 08043
    - MD Anderson Cancer Center at Cooper-Voorhees
- New Mexico
  - Albuquerque, New Mexico, United States, 87106
    - University of New Mexico Cancer Center
  - Las Cruces, New Mexico, United States, 88011
    - Memorial Medical Center-Las Cruces
- New York
  - Astoria, New York, United States, 11102
    - Mount Sinai Queens
  - Bay Shore, New York, United States, 11706
    - Northwell Health Imbert Cancer Center
  - Bronxville, New York, United States, 10708
    - New York-Presbyterian Westchester Hospital
  - Brooklyn, New York, United States, 11220
    - NYU Langone Hospital - Brooklyn
  - Buffalo, New York, United States, 14263
    - Roswell Park Cancer Institute
  - Canandiaqua, New York, United States, 14424
    - Sands Cancer Center
  - Dansville, New York, United States, 14437
    - Noyes Memorial Hospital/Myers Cancer Center
  - Forest Hills, New York, United States, 11375
    - Northwell Health Physicians Partners Radiation Medicine at Queens
  - Glens Falls, New York, United States, 12801
    - Glens Falls Hospital
  - Greenlawn, New York, United States, 11740
    - Northwell Health Cancer Institute at Huntington
  - Lake Success, New York, United States, 11042
    - Northwell Health/Center for Advanced Medicine
  - Mineola, New York, United States, 11501
    - NYU Langone Hospital - Long Island
  - New York, New York, United States, 10019
    - Mount Sinai West
  - New York, New York, United States, 10029
    - Mount Sinai Hospital
  - New York, New York, United States, 10032
    - NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center
  - New York, New York, United States, 10011
    - Mount Sinai Chelsea
  - New York, New York, United States, 10016
    - Laura and Isaac Perlmutter Cancer Center at NYU Langone
  - New York, New York, United States, 10075
    - Lenox Hill Hospital
  - New York, New York, United States, 10065
    - Manhattan Eye Ear and Throat Hospital
  - New York, New York, United States, 10003
    - Mount Sinai Union Square
  - Rego Park, New York, United States, 11374
    - Queens Cancer Center
  - Rochester, New York, United States, 14642
    - University of Rochester
  - Rochester, New York, United States, 14620
    - Highland Hospital
  - Rochester, New York, United States, 14606
    - Wilmot Cancer Institute Radiation Oncology at Greece
  - Rochester, New York, United States, 14623
    - Pluta Cancer Center
  - Stony Brook, New York, United States, 11794
    - Stony Brook University Medical Center
  - The Bronx, New York, United States, 10461
    - Montefiore Medical Center-Einstein Campus
  - The Bronx, New York, United States, 10467
    - Montefiore Medical Center - Moses Campus
  - The Bronx, New York, United States, 10468
    - James J Peters VA Medical Center
  - Webster, New York, United States, 14580
    - Wilmot Cancer Institute at Webster
- North Carolina
  - Albemarle, North Carolina, United States, 28002
    - Atrium Health Stanly/LCI-Albemarle
  - Burlington, North Carolina, United States, 27215
    - Cone Health Cancer Center at Alamance Regional
  - Chapel Hill, North Carolina, United States, 27599
    - UNC Lineberger Comprehensive Cancer Center
  - Charlotte, North Carolina, United States, 28203
    - Carolinas Medical Center/Levine Cancer Institute
  - Charlotte, North Carolina, United States, 28210
    - Atrium Health Pineville/LCI-Pineville
  - Charlotte, North Carolina, United States, 28262
    - Atrium Health University City/LCI-University
  - Clemmons, North Carolina, United States, 27012
    - Wake Forest University at Clemmons
  - Concord, North Carolina, United States, 28025
    - Atrium Health Cabarrus/LCI-Concord
  - Gastonia, North Carolina, United States, 28054
    - CaroMont Regional Medical Center
  - Greensboro, North Carolina, United States, 27403
    - Cone Health Cancer Center
  - High Point, North Carolina, United States, 27262
    - Hayworth Cancer Center
  - Lincolnton, North Carolina, United States, 28092
    - CaroMont Health - Lincoln Cancer Center
  - Monroe, North Carolina, United States, 28112
    - Atrium Health Union/LCI-Union
  - Reidsville, North Carolina, United States, 27320
    - Annie Penn Memorial Hospital
  - Shelby, North Carolina, United States, 28150
    - Atrium Health Cleveland/LCI-Cleveland
  - Statesville, North Carolina, United States, 28677
    - Wake Forest Baptist Health - Hematology Oncology - Statesville
  - Wilkesboro, North Carolina, United States, 28659
    - Wake Forest Baptist Health - Wilkes Medical Center
  - Winston-Salem, North Carolina, United States, 27157
    - Wake Forest University Health Sciences
- North Dakota
  - Fargo, North Dakota, United States, 58103
    - Essentia Health Cancer Center-South University Clinic
  - Jamestown, North Dakota, United States, 58401
    - Essentia Health - Jamestown Clinic
- Ohio
  - Akron, Ohio, United States, 44307
    - Cleveland Clinic Akron General
  - Beavercreek, Ohio, United States, 45431
    - Indu and Raj Soin Medical Center
  - Boardman, Ohio, United States, 44512
    - Saint Elizabeth Boardman Hospital
  - Canton, Ohio, United States, 44708
    - Cleveland Clinic Mercy Hospital
  - Centerville, Ohio, United States, 45459
    - Dayton Physicians LLC-Miami Valley South
  - Cincinnati, Ohio, United States, 45219
    - University of Cincinnati Cancer Center-UC Medical Center
  - Cincinnati, Ohio, United States, 45220
    - Good Samaritan Hospital - Cincinnati
  - Cincinnati, Ohio, United States, 45242
    - Bethesda North Hospital
  - Cincinnati, Ohio, United States, 45236
    - Oncology Hematology Care Inc-Kenwood
  - Cleveland, Ohio, United States, 44195
    - Cleveland Clinic Foundation
  - Cleveland, Ohio, United States, 44111
    - Cleveland Clinic Cancer Center/Fairview Hospital
  - Columbus, Ohio, United States, 43214
    - Riverside Methodist Hospital
  - Columbus, Ohio, United States, 43210
    - Ohio State University Comprehensive Cancer Center
  - Columbus, Ohio, United States, 43228
    - Doctors Hospital
  - Columbus, Ohio, United States, 43215
    - Grant Medical Center
  - Dayton, Ohio, United States, 45415
    - Dayton Physician LLC - Englewood
  - Delaware, Ohio, United States, 43015
    - Delaware Health Center-Grady Cancer Center
  - Delaware, Ohio, United States, 43015
    - Grady Memorial Hospital
  - Dublin, Ohio, United States, 43016
    - Dublin Methodist Hospital
  - Findlay, Ohio, United States, 45840
    - Blanchard Valley Hospital
  - Findlay, Ohio, United States, 45840
    - Armes Family Cancer Center
  - Findlay, Ohio, United States, 45840
    - Orion Cancer Care
  - Franklin, Ohio, United States, 45005
    - Dayton Physicians LLC-Atrium
  - Greenville, Ohio, United States, 45331
    - Wayne Hospital
  - Greenville, Ohio, United States, 45331
    - Dayton Physicians LLC-Wayne
  - Independence, Ohio, United States, 44131
    - Cleveland Clinic Cancer Center Independence
  - Kettering, Ohio, United States, 45429
    - Kettering Medical Center
  - Kettering, Ohio, United States, 45409
    - Greater Dayton Cancer Center
  - Mansfield, Ohio, United States, 44906
    - Cleveland Clinic Cancer Center Mansfield
  - Mansfield, Ohio, United States, 44903
    - OhioHealth Mansfield Hospital
  - Marion, Ohio, United States, 43302
    - OhioHealth Marion General Hospital
  - Mayfield Heights, Ohio, United States, 44124
    - Hillcrest Hospital Cancer Center
  - Sandusky, Ohio, United States, 44870
    - North Coast Cancer Care
  - Strongsville, Ohio, United States, 44136
    - Cleveland Clinic Cancer Center Strongsville
  - Troy, Ohio, United States, 45373
    - Dayton Physicians LLC - Troy
  - Warren, Ohio, United States, 44484
    - Saint Joseph Warren Hospital
  - West Chester, Ohio, United States, 45069
    - University of Cincinnati Cancer Center-West Chester
  - Youngstown, Ohio, United States, 44501
    - Saint Elizabeth Youngstown Hospital
- Oregon
  - Portland, Oregon, United States, 97227
    - Kaiser Permanente Northwest
- Pennsylvania
  - Allentown, Pennsylvania, United States, 18103
    - Lehigh Valley Hospital-Cedar Crest
  - Allentown, Pennsylvania, United States, 18104
    - Saint Luke's Cancer Center - Allentown
  - Beaver, Pennsylvania, United States, 15009
    - UPMC-Heritage Valley Health System Beaver
  - Bethlehem, Pennsylvania, United States, 18017
    - Lehigh Valley Hospital - Muhlenberg
  - Bethlehem, Pennsylvania, United States, 18015
    - Saint Luke's University Hospital-Bethlehem Campus
  - Bryn Mawr, Pennsylvania, United States, 19010
    - Bryn Mawr Hospital
  - Chadds Ford, Pennsylvania, United States, 19317
    - Christiana Care Health System-Concord Health Center
  - Chambersburg, Pennsylvania, United States, 17201
    - Chambersburg Hospital
  - Danville, Pennsylvania, United States, 17822
    - Geisinger Medical Center
  - East Norriton, Pennsylvania, United States, 19401
    - Fox Chase Cancer Center - East Norriton Hospital Outpatient Center
  - East Stroudsburg, Pennsylvania, United States, 18301
    - Pocono Medical Center
  - Easton, Pennsylvania, United States, 18045
    - Saint Luke's Hospital-Anderson Campus
  - Ephrata, Pennsylvania, United States, 17522
    - Ephrata Cancer Center
  - Erie, Pennsylvania, United States, 16505
    - UPMC Hillman Cancer Center Erie
  - Farrell, Pennsylvania, United States, 16121
    - UPMC Cancer Center at UPMC Horizon
  - Furlong, Pennsylvania, United States, 18925
    - Fox Chase Cancer Center Buckingham
  - Gettysburg, Pennsylvania, United States, 17325
    - Adams Cancer Center
  - Greensburg, Pennsylvania, United States, 15601
    - UPMC Cancer Centers - Arnold Palmer Pavilion
  - Hershey, Pennsylvania, United States, 17033-0850
    - Penn State Milton S Hershey Medical Center
  - Indiana, Pennsylvania, United States, 15701
    - IRMC Cancer Center
  - Johnstown, Pennsylvania, United States, 15901
    - UPMC-Johnstown/John P. Murtha Regional Cancer Center
  - Lebanon, Pennsylvania, United States, 17042
    - Sechler Family Cancer Center
  - Lewisburg, Pennsylvania, United States, 17837
    - Geisinger Medical Oncology-Lewisburg
  - Meadowbrook, Pennsylvania, United States, 19046
    - Redeemer Health
  - Mechanicsburg, Pennsylvania, United States, 17050
    - UPMC Hillman Cancer Center at Rocco And Nancy Ortenzio Cancer Pavilion
  - Media, Pennsylvania, United States, 19063
    - Riddle Memorial Hospital
  - Monroeville, Pennsylvania, United States, 15146
    - UPMC Cancer Center - Monroeville
  - New Castle, Pennsylvania, United States, 16105
    - UPMC Hillman Cancer Center - New Castle
  - Paoli, Pennsylvania, United States, 19301
    - Paoli Memorial Hospital
  - Philadelphia, Pennsylvania, United States, 19111
    - Fox Chase Cancer Center
  - Philadelphia, Pennsylvania, United States, 19107
    - Thomas Jefferson University Hospital
  - Philadelphia, Pennsylvania, United States, 19114
    - Jefferson Torresdale Hospital
  - Philadelphia, Pennsylvania, United States, 19140
    - Temple University Hospital
  - Philadelphia, Pennsylvania, United States, 19141
    - Einstein Medical Center Philadelphia
  - Pittsburgh, Pennsylvania, United States, 15213
    - UPMC-Magee Womens Hospital
  - Pittsburgh, Pennsylvania, United States, 15232
    - UPMC-Shadyside Hospital
  - Pittsburgh, Pennsylvania, United States, 15215
    - UPMC-Saint Margaret
  - Pittsburgh, Pennsylvania, United States, 15243
    - UPMC-Saint Clair Hospital Cancer Center
  - Pottsville, Pennsylvania, United States, 17901
    - Geisinger Cancer Services-Pottsville
  - Quakertown, Pennsylvania, United States, 18951
    - Saint Luke's Hospital - Upper Bucks Campus
  - Stroudsburg, Pennsylvania, United States, 18360
    - Saint Luke's Hospital - Monroe Campus
  - Washington, Pennsylvania, United States, 15301
    - UPMC Washington Hospital Radiation Oncology
  - Washington, Pennsylvania, United States, 15301
    - UPMC Cancer Center-Washington
  - West Chester, Pennsylvania, United States, 19380
    - Chester County Hospital
  - Wilkes-Barre, Pennsylvania, United States, 18711
    - Geisinger Wyoming Valley/Henry Cancer Center
  - Willow Grove, Pennsylvania, United States, 19090
    - Asplundh Cancer Pavilion
  - Wynnewood, Pennsylvania, United States, 19096
    - Lankenau Medical Center
  - York, Pennsylvania, United States, 17403
    - WellSpan Health-York Cancer Center
  - York, Pennsylvania, United States, 17403
    - WellSpan Health-York Hospital
- South Carolina
  - Charleston, South Carolina, United States, 29425
    - Medical University of South Carolina
  - Greenville, South Carolina, United States, 29607
    - Saint Francis Cancer Center
  - Greenville, South Carolina, United States, 29601
    - Saint Francis Hospital
  - Greenwood, South Carolina, United States, 29646
    - Self Regional Healthcare
  - Rock Hill, South Carolina, United States, 29730
    - Rock Hill Radiation Therapy Center
- Tennessee
  - Nashville, Tennessee, United States, 37203
    - Sarah Cannon Cancer Center
- Texas
  - Dallas, Texas, United States, 75235
    - Parkland Memorial Hospital
  - Dallas, Texas, United States, 75390
    - UT Southwestern/Simmons Cancer Center-Dallas
  - Houston, Texas, United States, 77030
    - Memorial Hermann Texas Medical Center
  - San Antonio, Texas, United States, 78229
    - University of Texas Health Science Center at San Antonio
- Vermont
  - Berlin Corners, Vermont, United States, 05602
    - Central Vermont Medical Center/National Life Cancer Treatment
  - Burlington, Vermont, United States, 05401
    - University of Vermont Medical Center
  - Burlington, Vermont, United States, 05405
    - University of Vermont and State Agricultural College
  - Saint Johnsbury, Vermont, United States, 05819
    - Dartmouth Cancer Center - North
- Virginia
  - Alexandria, Virginia, United States, 22304
    - Inova Alexandria Hospital
  - Fairfax, Virginia, United States, 22031
    - Inova Schar Cancer Institute
  - Fairfax, Virginia, United States, 22033
    - Inova Fair Oaks Hospital
  - Harrisonburg, Virginia, United States, 22801
    - Sentara Rockingham Memorial Hospital Hahn Cancer Center
  - Leesburg, Virginia, United States, 20176
    - Inova Loudoun Hospital
  - Mechanicsville, Virginia, United States, 23116
    - Bon Secours Memorial Regional Medical Center
  - Mechanicsville, Virginia, United States, 23116
    - VCU Massey Cancer Center at Hanover Medical Park
  - Midlothian, Virginia, United States, 23114
    - Bon Secours Saint Francis Medical Center
  - Richmond, Virginia, United States, 23235
    - VCU Massey Cancer Center at Stony Point
  - Richmond, Virginia, United States, 23226
    - Bon Secours Saint Mary's Hospital
  - Richmond, Virginia, United States, 23230
    - Bon Secours Cancer Institute at Reynolds Crossing
  - Richmond, Virginia, United States, 23298
    - VCU Massey Comprehensive Cancer Center
- Washington
  - Seattle, Washington, United States, 98195
    - University of Washington Medical Center - Montlake
  - Seattle, Washington, United States, 98109
    - Fred Hutchinson Cancer Center
  - Seattle, Washington, United States, 98133
    - FHCC at Northwest Hospital
  - Silverdale, Washington, United States, 98383
    - Saint Michael Cancer Center
- West Virginia
  - Bridgeport, West Virginia, United States, 26330
    - United Hospital Center
  - Morgantown, West Virginia, United States, 26506
    - West Virginia University Healthcare
  - Parkersburg, West Virginia, United States, 26101
    - Camden Clark Medical Center
  - Princeton, West Virginia, United States, 24740
    - Princeton Community Hospital
  - Wheeling, West Virginia, United States, 26003
    - Wheeling Hospital/Schiffler Cancer Center
- Wisconsin
  - Antigo, Wisconsin, United States, 54409
    - Langlade Hospital and Cancer Center
  - Appleton, Wisconsin, United States, 54915
    - Ascension Saint Elizabeth Hospital
  - Ashland, Wisconsin, United States, 54806
    - Duluth Clinic Ashland
  - Ashland, Wisconsin, United States, 54806
    - Northwest Wisconsin Cancer Center
  - Brookfield, Wisconsin, United States, 53045
    - Ascension Southeast Wisconsin Hospital - Elmbrook Campus
  - Burlington, Wisconsin, United States, 53105
    - Aurora Cancer Care-Southern Lakes VLCC
  - Chilton, Wisconsin, United States, 53014
    - Ascension Calumet Hospital
  - Eau Claire, Wisconsin, United States, 54701
    - Marshfield Medical Center-EC Cancer Center
  - Franklin, Wisconsin, United States, 53132
    - Ascension Saint Francis - Reiman Cancer Center
  - Franklin, Wisconsin, United States, 53132
    - Ascension Southeast Wisconsin Hospital - Franklin
  - Germantown, Wisconsin, United States, 53022
    - Aurora Health Care Germantown Health Center
  - Grafton, Wisconsin, United States, 53024
    - Aurora Cancer Care-Grafton
  - Green Bay, Wisconsin, United States, 54311
    - Aurora BayCare Medical Center
  - Green Bay, Wisconsin, United States, 54301
    - Saint Vincent Hospital Cancer Center Green Bay
  - Green Bay, Wisconsin, United States, 54303
    - Saint Vincent Hospital Cancer Center at Saint Mary's
  - Hayward, Wisconsin, United States, 54843
    - Essentia Health-Hayward Clinic
  - Johnson Creek, Wisconsin, United States, 53038
    - University of Wisconsin Carbone Cancer Center - Johnson Creek
  - Kenosha, Wisconsin, United States, 53142
    - Aurora Cancer Care-Kenosha South
  - Madison, Wisconsin, United States, 53705
    - William S Middleton VA Medical Center
  - Madison, Wisconsin, United States, 53792
    - University of Wisconsin Carbone Cancer Center - University Hospital
  - Madison, Wisconsin, United States, 53718
    - University of Wisconsin Carbone Cancer Center - Eastpark Medical Center
  - Marinette, Wisconsin, United States, 54143
    - Aurora Bay Area Medical Group-Marinette
  - Marshfield, Wisconsin, United States, 54449
    - Marshfield Medical Center-Marshfield
  - Medford, Wisconsin, United States, 54451
    - Aspirus Medford Hospital
  - Mequon, Wisconsin, United States, 53097
    - Ascension Columbia Saint Mary's Hospital Ozaukee
  - Milwaukee, Wisconsin, United States, 53209
    - Aurora Cancer Care-Milwaukee
  - Milwaukee, Wisconsin, United States, 53215
    - Aurora Saint Luke's Medical Center
  - Milwaukee, Wisconsin, United States, 53233
    - Aurora Sinai Medical Center
  - Milwaukee, Wisconsin, United States, 53210
    - Ascension Southeast Wisconsin Hospital - Saint Joseph Campus
  - Milwaukee, Wisconsin, United States, 53211
    - Ascension Columbia Saint Mary's Hospital - Milwaukee
  - Milwaukee, Wisconsin, United States, 53215
    - Ascension Saint Francis Hospital
  - Milwaukee, Wisconsin, United States, 53295
    - Zablocki Veterans Administration Medical Center
  - Mukwonago, Wisconsin, United States, 53149
    - ProHealth D N Greenwald Center
  - New Richmond, Wisconsin, United States, 54017
    - Cancer Center of Western Wisconsin
  - Oconomowoc, Wisconsin, United States, 53066
    - ProHealth Oconomowoc Memorial Hospital
  - Oshkosh, Wisconsin, United States, 54904
    - Ascension Mercy Hospital
  - Oshkosh, Wisconsin, United States, 54904
    - Vince Lombardi Cancer Clinic - Oshkosh
  - Racine, Wisconsin, United States, 53406
    - Aurora Cancer Care-Racine
  - Racine, Wisconsin, United States, 53405
    - Ascension All Saints Hospital
  - Rhinelander, Wisconsin, United States, 54501
    - Aspirus Cancer Care - James Beck Cancer Center
  - Rice Lake, Wisconsin, United States, 54868
    - Marshfield Medical Center-Rice Lake
  - Sheboygan, Wisconsin, United States, 53081
    - Vince Lombardi Cancer Clinic-Sheboygan
  - Sheboygan, Wisconsin, United States, 53081
    - Saint Vincent Hospital Cancer Center at Sheboygan
  - Spooner, Wisconsin, United States, 54801
    - Essentia Health-Spooner Clinic
  - Stevens Point, Wisconsin, United States, 54482
    - Marshfield Medical Center-River Region at Stevens Point
  - Stevens Point, Wisconsin, United States, 54481
    - Aspirus Cancer Care - Stevens Point
  - Sturgeon Bay, Wisconsin, United States, 54235-1495
    - Saint Vincent Hospital Cancer Center at Sturgeon Bay
  - Summit, Wisconsin, United States, 53066
    - Aurora Medical Center in Summit
  - Superior, Wisconsin, United States, 54880
    - Essentia Health Saint Mary's Hospital - Superior
  - Two Rivers, Wisconsin, United States, 54241
    - Vince Lombardi Cancer Clinic-Two Rivers
  - Waukesha, Wisconsin, United States, 53188
    - UW Cancer Center at ProHealth Care
  - Wausau, Wisconsin, United States, 54401
    - Aspirus Regional Cancer Center
  - Wauwatosa, Wisconsin, United States, 53226
    - Aurora Cancer Care-Milwaukee West
  - Wauwatosa, Wisconsin, United States, 53226
    - Ascension Medical Group Southeast Wisconsin - Mayfair Road
  - West Allis, Wisconsin, United States, 53227
    - Aurora West Allis Medical Center
  - Weston, Wisconsin, United States, 54476
    - Marshfield Medical Center - Weston
  - Wisconsin Rapids, Wisconsin, United States, 54494
    - Aspirus Cancer Care - Wisconsin Rapids
- Wyoming
  - Cheyenne, Wyoming, United States, 82001
    - Memorial Hospital of Laramie County

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

Adult
Older Adult

Accepts Healthy Volunteers

Description

Inclusion Criteria:

Patients with polymetastatic cancer defined as more than 5 sites of radiographically-evident systemic metastatic disease (excluding intracranial disease)
"High-risk" asymptomatic bone metastasis(es) (defined as pain score of < 5 on a 0-10 scale using question #3 from the Brief Pain Inventory [BPI]) defined as fulfilling at least one of the following four high-risk criteria:
- Bulky site of disease in bone (>= 2 cm);
- Disease involving the hip (acetabulum, femoral head, femoral neck), shoulder (acromion, glenoid, humeral head), or sacroiliac joints;
- Disease in long bones occupying up to 2/3 of the cortical thickness (humerus, radius, ulna, clavicle, femur, tibia, fibula, metacarpals, phalanges); and/or
- Disease in junctional spine (C7-T1, T12-L1, L5-S1) and/or disease with posterolateral element (pedicles and/or facet joints) involvement.

NOTES:

Patients may have up to 3 individual high-risk bone metastases enrolled in the study. Sternum, rib, and scapula are defined as flat bones so lesions in these locations would only be included if bulky (per high-risk criteria #1)
Question #3 from the Brief Pain Inventory (BPI): "On a scale of 0-10, 0 being no or least amount of pain, and 10 being the worst pain imaginable, what score would you rate your worst pain in the last 24 hours."
- The pain score can be lesion-specific and does not need to refer to overall pain.
- The remaining questions on the BPI are not required to confirm eligibility
  - Patients with any solid tumor type (excluding multiple myeloma and lymphoma)
  - Patients must have systemic disease evaluation through standard of care diagnostic imaging, including either CT chest/abdomen/pelvis or body positron emission tomography (PET)/CT, with radiology report available
  - Patients with treated brain metastases and no known leptomeningeal disease are eligible if these lesions have been treated prior to enrollment
  - Age ≥ 18
  - Performance status: Eastern Cooperative Oncology Group (ECOG) 0-2 or Karnofsky performance status (KPS) ≥ 60
  - No previous radiotherapy to the intended enrolled sites of disease
  - No epidural spinal cord compression (ESCC) ≥ grade 1c (defined as deformation of the thecal sac with spinal cord abutment) at the enrolled bone metastasis(es)
  - No prior fracture at the enrolled bone metastasis(es)

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Interventional Model: Parallel Assignment
Masking: None (Open Label)

Number of Arms

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Arm II (RT, SOC) Patients continue SOC as in Arm I. Patients also undergo conventional RT or SBRT QD for up to 5 days (5 fractions) in the absence of disease progression or unacceptable toxicity. Additionally, patients undergo CT or MRI for RT planning and optional blood sample collection on study.	Other: Questionnaire Administration Ancillary studies Procedure: Magnetic Resonance Imaging Undergo MRI Other Names: MRI Magnetic Resonance Magnetic Resonance Imaging Scan Medical Imaging, Magnetic Resonance / Nuclear Magnetic Resonance MR MR Imaging MRI Scan NMR Imaging NMRI Nuclear Magnetic Resonance Imaging Magnetic Resonance Imaging (MRI) sMRI Magnetic resonance imaging (procedure) MRIs Structural MRI Procedure: Computed Tomography Undergo CT Other Names: CT CAT CAT Scan Computed Axial Tomography Computerized Axial Tomography Computerized Tomography CT Scan tomography Computerized axial tomography (procedure) Computerized Tomography (CT) scan Diagnostic CAT Scan Diagnostic CAT Scan Service Type Procedure: Biospecimen Collection Undergo blood sample collection Other Names: Biological Sample Collection Biospecimen Collected Specimen Collection Radiation: Stereotactic Body Radiation Therapy Undergo SBRT Other Names: SBRT SABR Stereotactic Ablative Body Radiation Therapy Other: Best Practice Given SOC systemic anti-cancer therapy Other Names: standard of care standard therapy Other: Patient Observation Undergo SOC observation Other Names: Observation Active Surveillance deferred therapy expectant management Watchful Waiting Other: Bone Metastases Treatment Given bone modifying agent Procedure: Conventional Radiotherapy Undergo conventional RT Other Names: 2-Dimensional Conventional Radiation Therapy 2D Conventional Radiotherapy 2D Radiotherapy 2D-RT Radiation, 2D Conventional
Active Comparator: Arm I (standard of care) Patients continue to receive SOC systemic anti-cancer therapy or observation and bone modifying agents as determined by the treating physician. Additionally, patients undergo optional blood sample collection on study.	Other: Questionnaire Administration Ancillary studies Procedure: Biospecimen Collection Undergo blood sample collection Other Names: Biological Sample Collection Biospecimen Collected Specimen Collection Other: Best Practice Given SOC systemic anti-cancer therapy Other Names: standard of care standard therapy Other: Patient Observation Undergo SOC observation Other Names: Observation Active Surveillance deferred therapy expectant management Watchful Waiting Other: Bone Metastases Treatment Given bone modifying agent

Participant Group / Arm

Intervention / Treatment

Experimental: Arm II (RT, SOC)

Patients continue SOC as in Arm I. Patients also undergo conventional RT or SBRT QD for up to 5 days (5 fractions) in the absence of disease progression or unacceptable toxicity. Additionally, patients undergo CT or MRI for RT planning and optional blood sample collection on study.

Other: Questionnaire Administration

Ancillary studies

Procedure: Magnetic Resonance Imaging

Undergo MRI

Other Names:

MRI
Magnetic Resonance
Magnetic Resonance Imaging Scan
Medical Imaging, Magnetic Resonance / Nuclear Magnetic Resonance
MR
MR Imaging
MRI Scan
NMR Imaging
NMRI
Nuclear Magnetic Resonance Imaging
Magnetic Resonance Imaging (MRI)
sMRI
Magnetic resonance imaging (procedure)
MRIs
Structural MRI

Procedure: Computed Tomography

Undergo CT

Other Names:

CT
CAT
CAT Scan
Computed Axial Tomography
Computerized Axial Tomography
Computerized Tomography
CT Scan
tomography
Computerized axial tomography (procedure)
Computerized Tomography (CT) scan
Diagnostic CAT Scan
Diagnostic CAT Scan Service Type

Procedure: Biospecimen Collection

Undergo blood sample collection

Other Names:

Biological Sample Collection
Biospecimen Collected
Specimen Collection

Radiation: Stereotactic Body Radiation Therapy

Undergo SBRT

Other Names:

SBRT
SABR
Stereotactic Ablative Body Radiation Therapy

Other: Best Practice

Given SOC systemic anti-cancer therapy

Other Names:

standard of care
standard therapy

Other: Patient Observation

Undergo SOC observation

Other Names:

Observation
Active Surveillance
deferred therapy
expectant management
Watchful Waiting

Other: Bone Metastases Treatment

Given bone modifying agent

Procedure: Conventional Radiotherapy

Undergo conventional RT

Other Names:

2-Dimensional Conventional Radiation Therapy
2D Conventional Radiotherapy
2D Radiotherapy
2D-RT
Radiation, 2D Conventional

Active Comparator: Arm I (standard of care)

Patients continue to receive SOC systemic anti-cancer therapy or observation and bone modifying agents as determined by the treating physician. Additionally, patients undergo optional blood sample collection on study.

Other: Questionnaire Administration

Ancillary studies

Procedure: Biospecimen Collection

Undergo blood sample collection

Other Names:

Biological Sample Collection
Biospecimen Collected
Specimen Collection

Other: Best Practice

Given SOC systemic anti-cancer therapy

Other Names:

standard of care
standard therapy

Other: Patient Observation

Undergo SOC observation

Other Names:

Observation
Active Surveillance
deferred therapy
expectant management
Watchful Waiting

Other: Bone Metastases Treatment

Given bone modifying agent

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Incidence of skeletal-related events (SREs) (Excluding palliative radiation for pain) Time Frame: From randomization until first SRE up to 24 months	Gray's test will be used to test for statistically significant difference in the distribution of SRE failure times (Gray 1988), accounting for death as a competing risk. The cause specific Cox proportional hazards model will be used to evaluate the treatment effect and stratification variables (Cox 1972). The analysis will be conducted on an intent-to-treat basis using all randomized patients. Analyses of treatment effect will be performed using the Cox proportional hazard model with the stratification factors as fixed covariates. The adjusted estimate of the treatment hazard ratio with a 95% confidence interval will be provided.	From randomization until first SRE up to 24 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Overall survival (OS) Time Frame: From the time of study entry until death up to 24 months	OS will be compared between the two treatment arms. A stratified Cox proportional hazards model will be used to evaluate the treatment effect and stratification variables (Cox 1972). The analysis will be conducted on an intent-to-treat basis using all randomized patients. The adjusted estimate of the treatment hazard ratio with a 95% confidence interval will be provided.	From the time of study entry until death up to 24 months
Hospitalizations for SRE Time Frame: Up to 24 months	Hospitalization for SRE as an event will be analyzed with a logistic regression model by treatment status, adjusted for stratification factors. The adjusted estimate of the treatment odds ratio with a 95% confidence interval will be provided.	Up to 24 months
Brief Pain Inventory (BPI) scores Time Frame: At baseline and up to 24 months	The mean BPI scores at each collected time point (and their 95% confidence intervals) by treatment arm will be estimated. A mixed-effects model will be used to estimate and compare the mean BPI worst pain scores for the treatment arms. Model covariates will include the patients' randomly assigned study treatment, stratification factors, baseline BPI worst pain score, any opioid use, and a treatment-by-assessment time interaction term.	At baseline and up to 24 months
Incidence of adverse events (AEs) Time Frame: Up to 42 days from registration (Arm I) and up to 30 days from end of treatment (Arm II)	AEs will be collected using the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. Descriptive statistics will be used to summarize AEs. These analyses will focus on individuals who initiated their assigned treatment and will summarize maximum grade of AEs occurring during treatment and follow-up classified by CTCAE category. The primary summary of AEs will present counts and percentages, regardless of whether the AE was attributed to any of the study agents.	Up to 42 days from registration (Arm I) and up to 30 days from end of treatment (Arm II)

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Overall quality of life, functional status, and quality-adjusted life years Time Frame: At baseline and up to 24 months	Comparison of overall quality of life between the arms will be evaluated using the European Quality of Life Five Dimension Five Level (EQ-5D-5L) scale. Analyses of the EQ-5D-5L is primarily descriptive and involves estimating differences in mean scores for each treatment group with confidence intervals. A mixed-effects model will be used to estimate and compare the mean scores for the treatment groups across time. Model adjustment covariates will include the patients' randomly assigned study treatment, stratification factors, baseline EQ-5D-5L score and assessment time.	At baseline and up to 24 months
Hospitalizations (from any cause) Time Frame: Up to 24 months	Hospitalizations from any cause as an event will be analyzed with a logistic regression model by treatment status, adjusted for stratification factors. The adjusted estimate of the treatment odds ratio with a 95% confidence interval will be provided.	Up to 24 months
Heterogeneity of radiation treatment effects Time Frame: Up to 24 months	Sociodemographic variables collected at baseline will be evaluated for potential interaction with radiation treatment.	Up to 24 months
Treatment differences by race and ethnicity, sex, and health-related social needs Time Frame: Up to 24 months	Differences in primary and secondary endpoints will be characterized descriptively only. Estimates of the primary outcome treatment effect and the corresponding 95% confidence interval will be provided by sex, race, and ethnicity.	Up to 24 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

NRG Oncology

Investigators

Principal Investigator: Erin F Gillespie, NRG Oncology

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Lapen K, Zhang Z, White C, Barker CA, Kotecha R, McIntosh AF, Nipp RD, Iyengar P, Yang JT, Yerramilli D, Gillespie EF. Predictors of Skeletal-Related Events and Quality-of-Life Dimensions Among Patients With High-Risk Asymptomatic Bone Metastases With or Without Early Radiation Therapy: Secondary Analysis of a Multicenter Randomized Phase II Clinical Trial. J Natl Compr Canc Netw. 2026 Mar 9;24(4):e257126. doi: 10.6004/jnccn.2025.7126.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

May 7, 2025

Primary Completion (Estimated)

February 1, 2029

Study Completion (Estimated)

February 1, 2029

Study Registration Dates

First Submitted

December 17, 2024

First Submitted That Met QC Criteria

December 17, 2024

First Posted (Actual)

December 20, 2024

Study Record Updates

Last Update Posted (Actual)

May 4, 2026

Last Update Submitted That Met QC Criteria

April 28, 2026

Last Verified

April 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

NRG-CC014 (Other Identifier: CTEP)
UG1CA189867 (U.S. NIH Grant/Contract)
NCI-2024-08199 (Registry Identifier: CTRP (Clinical Trial Reporting Program))

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

NCI is committed to sharing data in accordance with NIH policy. For more details on how clinical trial data is shared, access the link to the NIH data sharing policy page.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

Studies a U.S. FDA-regulated device product

product manufactured in and exported from the U.S.

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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Study Overview

Status

Conditions

Intervention / Treatment

Detailed Description

Study Type

Enrollment (Estimated)

Phase

Contacts and Locations

Study Locations

Participation Criteria

Eligibility Criteria

Ages Eligible for Study

Accepts Healthy Volunteers

Description

Study Plan

How is the study designed?

Design Details

Number of Arms

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

What is the study measuring?

Primary Outcome Measures

Outcome Measure

Measure Description

Time Frame

Secondary Outcome Measures

Outcome Measure

Measure Description

Time Frame

Other Outcome Measures

Outcome Measure

Measure Description

Time Frame

Collaborators and Investigators

Sponsor

Investigators

Publications and helpful links

General Publications

Study record dates

Study Major Dates

Study Start (Actual)

Primary Completion (Estimated)

Study Completion (Estimated)

Study Registration Dates

First Submitted

First Submitted That Met QC Criteria

First Posted (Actual)

Study Record Updates

Last Update Posted (Actual)

Last Update Submitted That Met QC Criteria

Last Verified

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

IPD Plan Description

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

Studies a U.S. FDA-regulated device product

product manufactured in and exported from the U.S.

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