Imunoterapie nivolumabem a ipilimumabem následovaná nivolumabem nebo nivolumabem kabozantinibem pro pacienty s pokročilou rakovinou ledvin, studie PDIGREE
PD-inhibitor (nivolumab) a ipilimumab s následným nivolumabem vs. VEGF TKI Cabozantinib s nivolumabem: Studie fáze III u metastatického neléčeného karcinomu ledvinových buněk [PDIGREE]
This phase III trial compares the usual treatment (treatment with ipilimumab and nivolumab followed by nivolumab alone) to treatment with ipilimumab and nivolumab, followed by nivolumab with cabozantinib in patients with untreated renal cell carcinoma that has spread to other parts of the body. The addition of cabozantinib to the usual treatment may make it work better. Immunotherapy with monoclonal antibodies, such as nivolumab and ipilimumab, may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. Cabozantinib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. It is not yet known how well the combination of cabozantinib and nivolumab after initial treatment with ipilimumab and nivolumab works in treating patients with renal cell cancer that has spread to other parts of the body.
Přehled studie
Postavení
Postavení
Podmínky
Podmínky
- Clear Cell Renal Cell Carcinoma
- Stádium III rakoviny ledvinových buněk AJCC v8
- Stádium IV rakoviny ledvinových buněk AJCC v8
- Metastatický maligní novotvar v kosti
- Metastatický maligní novotvar v lymfatických uzlinách
- Metastatický maligní novotvar ve vnitřních orgánech
- Sarkomatoidní renální buněčný karcinom
- Rhabdoidní nádor ledviny
- Metastatická maligní novotvar v měkké tkáni
Intervence / Léčba
Intervence / Léčba
Detailní popis
PRIMARY OBJECTIVE:
I. To compare the overall survival (OS) in patients with metastatic renal cell cancer (RCC) treated with ipilimumab-nivolumab followed by either nivolumab versus cabozantinib-nivolumab.
SECONDARY OBJECTIVES:
I. To determine progression free survival (PFS) of patients treated with nivolumab versus nivolumab-cabozantinib.
II. To evaluate the 12-month complete response rate in patients treated with ipilimumab-nivolumab followed by cabozantinib-nivolumab versus ipilimumab-nivolumab followed by nivolumab (patients who have complete response [CR] and relapse before 12 months will not be counted as a CR at 12-months).
III. To evaluate the rates of discontinuing therapy at 1 year. IV. To compare objective response rates (ORR, assessed by Response Evaluation Criteria in Solid Tumors [RECIST] 1.1 and Immune Response Evaluation Criteria in Solid Tumors [iRECIST] criteria) for patients treated with ipilimumab-nivolumab followed by cabozantinib-nivolumab versus ipilimumab-nivolumab followed by nivolumab.
V. To document the adverse event profile of ipilimumab-nivolumab followed by cabozantinib-nivolumab.
BIOMARKER OBJECTIVES:
I. To evaluate biomarkers associated with exceptional responses in both arms (exceptional responses defined as CRs with treatment discontinuation at 12 months or 24 months).
II. To evaluate whether baseline IL-6 is predictive of outcome in patients treated with cabozantinib-containing regimen.
QUALITY OF LIFE (QOL) OBJECTIVES:
I. To compare health-related quality of life at 18 months post-registration as assessed by the Functional Assessment of Cancer Therapy (FACT)-Kidney Symptom Index 19 (FKSI-19) between patients randomized to nivolumab (nivo) versus (vs) cabozantinib (cabo)/nivo.
II. To compare health-related quality of life as assessed by the FKSI-19 between patients randomized to nivo vs cabo/nivo at other time points.
III. To compare patient-reported fatigue using Patient-Reported Outcomes Measurement Information System (PROMIS)-Fatigue between patients randomized to nivo vs cabo/nivo.
IV. To compare quality-adjusted survival (overall survival x utility score assessed by EuroQol five-dimensional questionnaire [EQ5D-5L]) between patients randomized to nivo vs cabo/nivo.
OUTLINE:
INDUCTION: Patients receive nivolumab intravenously (IV) over 30 minutes and ipilimumab IV over 30 minutes on day 1. Treatment repeats every 21 days for up to 4 cycles in the absence of disease progression or unacceptable toxicity.
TREATMENT:
Patients with unconfirmed but clinical progression of disease (iuPD) with clinical instability receive cabozantinib orally (PO) daily on days 1-28. Treatment repeats every 28 days until further disease progression or unacceptable toxicity.
Patients with unconfirmed CR (iCR) receive nivolumab IV between 30-60 minutes on day 1. Treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity.
Patients with non-CR/non-PD or iuPD with clinical stability are randomized to 1 of 2 arms.
ARM A: Patients receive nivolumab IV between 30-60 minutes on day 1. Treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity.
ARM B: Patients receive nivolumab IV between 30-60 minutes on day 1 and cabozantinib PO daily on days 1-28. Treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity.
Patients undergo computed tomography (CT) scan, magnetic resonance imaging (MRI) and blood and urine sample collection, and may also undergo a bone scan as clinically indicated throughout the study.
Typ studie
Typ studie
Zápis (Odhadovaný)
Zápis
Fáze
Fáze
- Fáze 3
Kontakty a umístění
Studijní místa
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San Juan, Portoriko, 00902
- Pan American Center for Oncology Trials LLC
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Alabama
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Mobile, Alabama, Spojené státy, 36688
- University of South Alabama Mitchell Cancer Institute
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Alaska
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Anchorage, Alaska, Spojené státy, 98508
- Anchorage Associates in Radiation Medicine
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Anchorage, Alaska, Spojené státy, 99508
- Alaska Breast Care and Surgery LLC
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Anchorage, Alaska, Spojené státy, 99508
- Alaska Oncology and Hematology LLC
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Anchorage, Alaska, Spojené státy, 99508
- Alaska Women's Cancer Care
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Anchorage, Alaska, Spojené státy, 99508
- Anchorage Oncology Centre
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Anchorage, Alaska, Spojené státy, 99508
- Katmai Oncology Group
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Anchorage, Alaska, Spojené státy, 99508
- Providence Alaska Medical Center
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Anchorage, Alaska, Spojené státy, 99504
- Anchorage Radiation Therapy Center
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Fairbanks, Alaska, Spojené státy, 99701
- Fairbanks Memorial Hospital
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Arizona
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Kingman, Arizona, Spojené státy, 86401
- Kingman Regional Medical Center
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Phoenix, Arizona, Spojené státy, 85004
- Cancer Center at Saint Joseph's
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Arkansas
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Fayetteville, Arkansas, Spojené státy, 72703
- Highlands Oncology Group - Fayetteville
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Fort Smith, Arkansas, Spojené státy, 72903
- Mercy Hospital Fort Smith
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Hot Springs, Arkansas, Spojené státy, 71913
- CHI Saint Vincent Cancer Center Hot Springs
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Rogers, Arkansas, Spojené státy, 72758
- Highlands Oncology Group - Rogers
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Springdale, Arkansas, Spojené státy, 72762
- Highlands Oncology Group
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California
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Anaheim, California, Spojené státy, 92806
- Kaiser Permanente-Anaheim
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Arroyo Grande, California, Spojené státy, 93420
- PCR Oncology
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Arroyo Grande, California, Spojené státy, 93420
- Mission Hope Medical Oncology - Arroyo Grande
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Baldwin Park, California, Spojené státy, 91706
- Kaiser Permanente-Baldwin Park
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Bellflower, California, Spojené státy, 90706
- Kaiser Permanente-Bellflower
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Burbank, California, Spojené státy, 91505
- Providence Saint Joseph Medical Center/Disney Family Cancer Center
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Clovis, California, Spojené státy, 93611
- Community Cancer Institute
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Clovis, California, Spojené státy, 93611
- University Oncology Associates
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Fontana, California, Spojené státy, 92335
- Kaiser Permanente-Fontana
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Harbor City, California, Spojené státy, 90710
- Kaiser Permanente South Bay
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Irvine, California, Spojené státy, 92618
- Kaiser Permanente-Irvine
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La Jolla, California, Spojené státy, 92093
- UC San Diego Moores Cancer Center
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Los Angeles, California, Spojené státy, 90027
- Kaiser Permanente Los Angeles Medical Center
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Los Angeles, California, Spojené státy, 90034
- Kaiser Permanente West Los Angeles
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Ontario, California, Spojené státy, 91761
- Kaiser Permanente-Ontario
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Panorama City, California, Spojené státy, 91402
- Kaiser Permanente - Panorama City
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Riverside, California, Spojené státy, 92505
- Kaiser Permanente-Riverside
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Sacramento, California, Spojené státy, 95817
- University of California Davis Comprehensive Cancer Center
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San Diego, California, Spojené státy, 92120
- Kaiser Permanente-San Diego Zion
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San Diego, California, Spojené státy, 92134
- Naval Medical Center -San Diego
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San Diego, California, Spojené státy, 92123
- Sharp Memorial Hospital
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San Diego, California, Spojené státy, 92108
- Kaiser Permanente-Rio San Diego
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San Francisco, California, Spojené státy, 94158
- UCSF Medical Center-Mission Bay
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San Luis Obispo, California, Spojené státy, 93401
- Pacific Central Coast Health Center-San Luis Obispo
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San Marcos, California, Spojené státy, 92078
- Kaiser Permanente-San Marcos
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Santa Maria, California, Spojené státy, 93444
- Mission Hope Medical Oncology - Santa Maria
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Woodland Hills, California, Spojené státy, 91367
- Kaiser Permanente-Woodland Hills
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Colorado
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Aurora, Colorado, Spojené státy, 80012
- Rocky Mountain Cancer Centers-Aurora
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Aurora, Colorado, Spojené státy, 80012
- The Medical Center of Aurora
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Aurora, Colorado, Spojené státy, 80045
- UCHealth University of Colorado Hospital
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Boulder, Colorado, Spojené státy, 80303
- Boulder Community Foothills Hospital
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Boulder, Colorado, Spojené státy, 80304
- Rocky Mountain Cancer Centers-Boulder
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Centennial, Colorado, Spojené státy, 80112
- Rocky Mountain Cancer Centers - Centennial
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Colorado Springs, Colorado, Spojené státy, 80907
- Penrose-Saint Francis Healthcare
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Colorado Springs, Colorado, Spojené státy, 80909
- UCHealth Memorial Hospital Central
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Colorado Springs, Colorado, Spojené státy, 80907
- Rocky Mountain Cancer Centers-Penrose
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Colorado Springs, Colorado, Spojené státy, 80920
- Memorial Hospital North
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Denver, Colorado, Spojené státy, 80205
- Kaiser Permanente-Franklin
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Denver, Colorado, Spojené státy, 80218
- Presbyterian - Saint Lukes Medical Center - Health One
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Denver, Colorado, Spojené státy, 80220
- Rose Medical Center
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Denver, Colorado, Spojené státy, 80218
- Rocky Mountain Cancer Centers-Midtown
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Denver, Colorado, Spojené státy, 80220
- Rocky Mountain Cancer Centers-Rose
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Denver, Colorado, Spojené státy, 80218
- Colorado Blood Cancer Institute
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Denver, Colorado, Spojené státy, 80204
- Cancer Center of Colorado at Sloan's Lake
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Denver, Colorado, Spojené státy, 80209
- The Women's Imaging Center
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Denver, Colorado, Spojené státy, 80206
- National Jewish Health-Main Campus
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Denver, Colorado, Spojené státy, 80220
- Western Surgical Care
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Denver, Colorado, Spojené státy, 80206
- UCHealth - Cherry Creek
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Denver, Colorado, Spojené státy, 80218
- Saint Joseph Hospital - Cancer Centers of Colorado
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Denver, Colorado, Spojené státy, 80210
- AdventHealth Porter
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Durango, Colorado, Spojené státy, 81301
- Mercy Medical Center
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Durango, Colorado, Spojené státy, 81301
- CommonSpirit Cancer Center Mercy
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Englewood, Colorado, Spojené státy, 80113
- Mountain Blue Cancer Care Center - Swedish
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Englewood, Colorado, Spojené státy, 80113
- Swedish Medical Center
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Englewood, Colorado, Spojené státy, 80113
- Rocky Mountain Cancer Centers - Swedish
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Englewood, Colorado, Spojené státy, 80113
- The Melanoma and Skin Cancer Institute
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Fort Collins, Colorado, Spojené státy, 80524
- Poudre Valley Hospital
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Fort Collins, Colorado, Spojené státy, 80528
- Cancer Care and Hematology-Fort Collins
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Golden, Colorado, Spojené státy, 80401
- National Jewish Health-Western Hematology Oncology
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Grand Junction, Colorado, Spojené státy, 81501
- Saint Mary's Hospital and Regional Medical Center
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Greeley, Colorado, Spojené státy, 80631
- UCHealth Greeley Hospital
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Greeley, Colorado, Spojené státy, 80631
- Banner North Colorado Medical Center
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Highlands Ranch, Colorado, Spojené státy, 80129
- UCHealth Highlands Ranch Hospital
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Lafayette, Colorado, Spojené státy, 80026
- Kaiser Permanente-Rock Creek
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Lafayette, Colorado, Spojené státy, 80026
- Good Samaritan Hospital - Cancer Centers of Colorado
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Lakewood, Colorado, Spojené státy, 80228
- Rocky Mountain Cancer Centers-Lakewood
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Lakewood, Colorado, Spojené státy, 80228
- CommonSpirit Saint Anthony Hospital Cancer Center
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Littleton, Colorado, Spojené státy, 80120
- Rocky Mountain Cancer Centers-Littleton
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Littleton, Colorado, Spojené státy, 80122
- AdventHealth Littleton
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Lone Tree, Colorado, Spojené státy, 80124
- Kaiser Permanente-Lone Tree
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Lone Tree, Colorado, Spojené státy, 80124
- Sky Ridge Medical Center
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Lone Tree, Colorado, Spojené státy, 80124
- Rocky Mountain Cancer Centers-Sky Ridge
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Lone Tree, Colorado, Spojené státy, 80124
- UCHealth Lone Tree Health Center
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Longmont, Colorado, Spojené státy, 80501
- Longmont United Hospital
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Longmont, Colorado, Spojené státy, 80501
- Rocky Mountain Cancer Centers-Longmont
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Loveland, Colorado, Spojené státy, 80538
- Medical Center of the Rockies
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Loveland, Colorado, Spojené státy, 80539
- Banner North Colorado Medical Center - Loveland Campus
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Parker, Colorado, Spojené státy, 80138
- AdventHealth Parker
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Pueblo, Colorado, Spojené státy, 81004
- Saint Mary Corwin Medical Center
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Thornton, Colorado, Spojené státy, 80260
- Rocky Mountain Cancer Centers-Thornton
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Thornton, Colorado, Spojené státy, 80260
- National Jewish Health-Northern Hematology Oncology
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Wheat Ridge, Colorado, Spojené státy, 80401
- Intermountain Health Lutheran Hospital
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Connecticut
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Stamford, Connecticut, Spojené státy, 06904
- Stamford Hospital/Bennett Cancer Center
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Delaware
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Lewes, Delaware, Spojené státy, 19958
- Beebe Medical Center
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Millville, Delaware, Spojené státy, 19967
- Beebe South Coastal Health Campus
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Newark, Delaware, Spojené státy, 19713
- Helen F Graham Cancer Center
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Newark, Delaware, Spojené státy, 19713
- Delaware Clinical and Laboratory Physicians PA
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Newark, Delaware, Spojené státy, 19713
- Medical Oncology Hematology Consultants PA
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Newark, Delaware, Spojené státy, 19718
- Christiana Care Health System-Christiana Hospital
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Rehoboth Beach, Delaware, Spojené státy, 19971
- Beebe Health Campus
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Seaford, Delaware, Spojené státy, 19973
- TidalHealth Nanticoke / Allen Cancer Center
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Wilmington, Delaware, Spojené státy, 19801
- Christiana Care Health System-Wilmington Hospital
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District of Columbia
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Washington D.C., District of Columbia, Spojené státy, 20037
- George Washington University Medical Center
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Washington D.C., District of Columbia, Spojené státy, 20010
- MedStar Washington Hospital Center
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Washington D.C., District of Columbia, Spojené státy, 20007
- MedStar Georgetown University Hospital
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Florida
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Coral Gables, Florida, Spojené státy, 33146
- UM Sylvester Comprehensive Cancer Center at Coral Gables
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Deerfield Beach, Florida, Spojené státy, 33442
- UM Sylvester Comprehensive Cancer Center at Deerfield Beach
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Fort Lauderdale, Florida, Spojené státy, 33308
- Holy Cross Hospital
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Gainesville, Florida, Spojené státy, 32610
- UF Health Cancer Institute - Gainesville
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Miami, Florida, Spojené státy, 33136
- University of Miami Miller School of Medicine-Sylvester Cancer Center
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Miami, Florida, Spojené státy, 33176
- UM Sylvester Comprehensive Cancer Center at Kendall
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Orlando, Florida, Spojené státy, 32806
- Orlando Health Cancer Institute
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Plantation, Florida, Spojené státy, 33324
- UM Sylvester Comprehensive Cancer Center at Plantation
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Georgia
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Atlanta, Georgia, Spojené státy, 30342
- Northside Hospital
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Duluth, Georgia, Spojené státy, 30096
- Northside Hospital - Duluth
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Lawrenceville, Georgia, Spojené státy, 30046
- Northside Hospital - Gwinnett
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Savannah, Georgia, Spojené státy, 31405
- Lewis Cancer and Research Pavilion at Saint Joseph's/Candler
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Snellville, Georgia, Spojené státy, 30078
- Suburban Hematology Oncology Associates - Snellville
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Hawaii
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Honolulu, Hawaii, Spojené státy, 96813
- Queen's Medical Center
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Honolulu, Hawaii, Spojené státy, 96817
- The Cancer Center of Hawaii-Liliha
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Honolulu, Hawaii, Spojené státy, 96813
- Hawaii Cancer Care Inc - Waterfront Plaza
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Honolulu, Hawaii, Spojené státy, 96813
- Queen's Cancer Cenrer - POB I
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Honolulu, Hawaii, Spojené státy, 96813
- Straub Clinic and Hospital
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Honolulu, Hawaii, Spojené státy, 96813
- University of Hawaii Cancer Center
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Honolulu, Hawaii, Spojené státy, 96817
- Queen's Cancer Center - Kuakini
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Honolulu, Hawaii, Spojené státy, 96826
- Kapiolani Medical Center for Women and Children
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Honolulu, Hawaii, Spojené státy, 96813
- Island Urology
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Lihue, Hawaii, Spojené státy, 96766
- Wilcox Memorial Hospital and Kauai Medical Clinic
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‘Aiea, Hawaii, Spojené státy, 96701
- Hawaii Cancer Care - Westridge
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‘Aiea, Hawaii, Spojené státy, 96701
- Pali Momi Medical Center
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‘Aiea, Hawaii, Spojené státy, 96701
- Queen's Cancer Center - Pearlridge
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‘Aiea, Hawaii, Spojené státy, 96701
- The Cancer Center of Hawaii-Pali Momi
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Idaho
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Boise, Idaho, Spojené státy, 83706
- Saint Alphonsus Cancer Care Center-Boise
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Boise, Idaho, Spojené státy, 83712
- Saint Luke's Cancer Institute - Boise
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Caldwell, Idaho, Spojené státy, 83605
- Saint Alphonsus Cancer Care Center-Caldwell
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Coeur d'Alene, Idaho, Spojené státy, 83814
- Kootenai Health - Coeur d'Alene
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Emmett, Idaho, Spojené státy, 83617
- Walter Knox Memorial Hospital
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Fruitland, Idaho, Spojené státy, 83619
- Saint Luke's Cancer Institute - Fruitland
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Meridian, Idaho, Spojené státy, 83642
- Idaho Urologic Institute-Meridian
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Meridian, Idaho, Spojené státy, 83642
- Saint Luke's Cancer Institute - Meridian
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Nampa, Idaho, Spojené státy, 83687
- Saint Alphonsus Cancer Care Center-Nampa
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Nampa, Idaho, Spojené státy, 83687
- Saint Luke's Cancer Institute - Nampa
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Post Falls, Idaho, Spojené státy, 83854
- Kootenai Clinic Cancer Services - Post Falls
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Sandpoint, Idaho, Spojené státy, 83864
- Kootenai Clinic Cancer Services - Sandpoint
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Twin Falls, Idaho, Spojené státy, 83301
- Saint Luke's Cancer Institute - Twin Falls
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Illinois
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Alton, Illinois, Spojené státy, 62002
- OSF Saint Anthony's Health Center
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Aurora, Illinois, Spojené státy, 60504
- Rush-Copley Medical Center
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Bloomington, Illinois, Spojené státy, 61704
- Illinois CancerCare-Bloomington
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Burr Ridge, Illinois, Spojené státy, 60527
- Loyola Center for Health at Burr Ridge
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Canton, Illinois, Spojené státy, 61520
- Illinois CancerCare-Canton
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Carbondale, Illinois, Spojené státy, 62902
- Memorial Hospital of Carbondale
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Carterville, Illinois, Spojené státy, 62918
- SIH Cancer Institute
-
Carthage, Illinois, Spojené státy, 62321
- Illinois CancerCare-Carthage
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Centralia, Illinois, Spojené státy, 62801
- Centralia Oncology Clinic
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Chicago, Illinois, Spojené státy, 60611
- Northwestern University
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Chicago, Illinois, Spojené státy, 60637
- University of Chicago Comprehensive Cancer Center
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Chicago, Illinois, Spojené státy, 60612
- John H Stroger Jr Hospital of Cook County
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Chicago, Illinois, Spojené státy, 60612
- Rush MD Anderson Cancer Center
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Danville, Illinois, Spojené státy, 61832
- Carle at The Riverfront
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DeKalb, Illinois, Spojené státy, 60115
- Northwestern Medicine Cancer Center Kishwaukee
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Decatur, Illinois, Spojené státy, 62526
- Decatur Memorial Hospital
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Decatur, Illinois, Spojené státy, 62526
- Cancer Care Specialists of Illinois - Decatur
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Dixon, Illinois, Spojené státy, 61021
- Illinois CancerCare-Dixon
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Effingham, Illinois, Spojené státy, 62401
- Crossroads Cancer Center
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Effingham, Illinois, Spojené státy, 62401
- Carle Physician Group-Effingham
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Elmhurst, Illinois, Spojené státy, 60126
- Elmhurst Memorial Hospital
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Eureka, Illinois, Spojené státy, 61530
- Illinois CancerCare-Eureka
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Galesburg, Illinois, Spojené státy, 61401
- Western Illinois Cancer Treatment Center
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Galesburg, Illinois, Spojené státy, 61401
- Illinois CancerCare-Galesburg
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Geneva, Illinois, Spojené státy, 60134
- Northwestern Medicine Cancer Center Delnor
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Harvey, Illinois, Spojené státy, 60426
- Ingalls Memorial Hospital
-
Homer Glen, Illinois, Spojené státy, 60491
- Loyola Medicine Homer Glen
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Joliet, Illinois, Spojené státy, 60435
- Duly Health and Care Joliet
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Kewanee, Illinois, Spojené státy, 61443
- Illinois CancerCare-Kewanee Clinic
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Lake Forest, Illinois, Spojené státy, 60045
- Northwestern Medicine Lake Forest Hospital
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Macomb, Illinois, Spojené státy, 61455
- Illinois CancerCare-Macomb
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Mattoon, Illinois, Spojené státy, 61938
- Carle Physician Group-Mattoon/Charleston
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Maywood, Illinois, Spojené státy, 60153
- Loyola University Medical Center
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Melrose Park, Illinois, Spojené státy, 60160
- Marjorie Weinberg Cancer Center at Loyola-Gottlieb
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Mount Vernon, Illinois, Spojené státy, 62864
- SSM Health Good Samaritan
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Naperville, Illinois, Spojené státy, 60540
- Edward Hospital/Cancer Center
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New Lenox, Illinois, Spojené státy, 60451
- UC Comprehensive Cancer Center at Silver Cross
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O'Fallon, Illinois, Spojené státy, 62269
- Cancer Care Center of O'Fallon
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Orland Park, Illinois, Spojené státy, 60462
- University of Chicago Medicine-Orland Park
-
Orland Park, Illinois, Spojené státy, 60462
- Northwestern Medicine Orland Park
-
Ottawa, Illinois, Spojené státy, 61350
- Illinois CancerCare-Ottawa Clinic
-
Pekin, Illinois, Spojené státy, 61554
- Illinois CancerCare-Pekin
-
Peoria, Illinois, Spojené státy, 61636
- Methodist Medical Center of Illinois
-
Peoria, Illinois, Spojené státy, 61615
- Illinois CancerCare-Peoria
-
Peru, Illinois, Spojené státy, 61354
- Illinois CancerCare-Peru
-
Peru, Illinois, Spojené státy, 61354
- Valley Radiation Oncology
-
Plainfield, Illinois, Spojené státy, 60585
- Edward Hospital/Cancer Center?Plainfield
-
Princeton, Illinois, Spojené státy, 61356
- Illinois CancerCare-Princeton
-
Rockford, Illinois, Spojené státy, 61114
- UW Health Carbone Cancer Center Rockford
-
Shiloh, Illinois, Spojené státy, 62269
- Memorial Hospital East
-
Springfield, Illinois, Spojené státy, 62702
- Southern Illinois University School of Medicine
-
Springfield, Illinois, Spojené státy, 62702
- Springfield Clinic
-
Springfield, Illinois, Spojené státy, 62781
- Springfield Memorial Hospital
-
Swansea, Illinois, Spojené státy, 62226
- Southwest Illinois Health Services LLP
-
Urbana, Illinois, Spojené státy, 61801
- Carle Cancer Center
-
Urbana, Illinois, Spojené státy, 61801
- The Carle Foundation Hospital
-
Warrenville, Illinois, Spojené státy, 60555
- Northwestern Medicine Cancer Center Warrenville
-
Washington, Illinois, Spojené státy, 61571
- Illinois CancerCare - Washington
-
Yorkville, Illinois, Spojené státy, 60560
- Rush-Copley Healthcare Center
-
-
Indiana
-
Indianapolis, Indiana, Spojené státy, 46237
- Franciscan Health Indianapolis
-
Indianapolis, Indiana, Spojené státy, 46202
- Indiana University/Melvin and Bren Simon Cancer Center
-
Indianapolis, Indiana, Spojené státy, 46202
- Sidney and Lois Eskenazi Hospital
-
Michigan City, Indiana, Spojené státy, 46360
- Woodland Cancer Care Center
-
Mooresville, Indiana, Spojené státy, 46158
- Franciscan Health Mooresville
-
Richmond, Indiana, Spojené státy, 47374
- Reid Health
-
-
Iowa
-
Ames, Iowa, Spojené státy, 50010
- Mary Greeley Medical Center
-
Ames, Iowa, Spojené státy, 50010
- McFarland Clinic - Ames
-
Ankeny, Iowa, Spojené státy, 50023
- UI Health Care Mission Cancer and Blood - Ankeny Clinic
-
Boone, Iowa, Spojené státy, 50036
- McFarland Clinic - Boone
-
Carroll, Iowa, Spojené státy, 51401
- Saint Anthony Regional Hospital
-
Clive, Iowa, Spojené státy, 50325
- Mercy Cancer Center-West Lakes
-
Clive, Iowa, Spojené státy, 50325
- UI Health Care Mission Cancer and Blood - West Des Moines Clinic
-
Council Bluffs, Iowa, Spojené státy, 51503
- Alegent Health Mercy Hospital
-
Creston, Iowa, Spojené státy, 50801
- Greater Regional Medical Center
-
Des Moines, Iowa, Spojené státy, 50309
- Iowa Methodist Medical Center
-
Des Moines, Iowa, Spojené státy, 50314
- Mercy Medical Center - Des Moines
-
Des Moines, Iowa, Spojené státy, 50314
- Broadlawns Medical Center
-
Des Moines, Iowa, Spojené státy, 50316
- Iowa Lutheran Hospital
-
Des Moines, Iowa, Spojené státy, 50309
- UI Health Care Mission Cancer and Blood - Des Moines Clinic
-
Des Moines, Iowa, Spojené státy, 50314
- UI Health Care Mission Cancer and Blood - Laurel Clinic
-
Fort Dodge, Iowa, Spojené státy, 50501
- McFarland Clinic - Trinity Cancer Center
-
Fort Dodge, Iowa, Spojené státy, 50501
- UI Healthcare Mission Cancer and Blood - Fort Dodge
-
Jefferson, Iowa, Spojené státy, 50129
- McFarland Clinic - Jefferson
-
Marshalltown, Iowa, Spojené státy, 50158
- McFarland Clinic - Marshalltown
-
Sioux City, Iowa, Spojené státy, 51101
- Siouxland Regional Cancer Center
-
West Des Moines, Iowa, Spojené státy, 50266-7700
- Methodist West Hospital
-
West Des Moines, Iowa, Spojené státy, 50266
- Mercy Medical Center-West Lakes
-
-
Kansas
-
Fairway, Kansas, Spojené státy, 66205
- University of Kansas Clinical Research Center
-
Garden City, Kansas, Spojené státy, 67846
- Central Care Cancer Center - Garden City
-
Great Bend, Kansas, Spojené státy, 67530
- Central Care Cancer Center - Great Bend
-
Hays, Kansas, Spojené státy, 67601
- HaysMed
-
Lawrence, Kansas, Spojené státy, 66044
- Lawrence Memorial Hospital
-
Lenexa, Kansas, Spojené státy, 66219
- Kansas Institute of Medicine Cancer and Blood Center
-
Lenexa, Kansas, Spojené státy, 66219
- Minimally Invasive Surgery Hospital
-
Olathe, Kansas, Spojené státy, 66061
- The University of Kansas Cancer Center - Olathe
-
Overland Park, Kansas, Spojené státy, 66210
- University of Kansas Cancer Center-Overland Park
-
Overland Park, Kansas, Spojené státy, 66209
- Menorah Medical Center
-
Parsons, Kansas, Spojené státy, 67357
- Cancer Center of Kansas - Parsons
-
Pittsburg, Kansas, Spojené státy, 66762
- Freeman Physician Group of Pittsburg
-
Pittsburg, Kansas, Spojené státy, 66762
- Mercy Hospital Pittsburg
-
Salina, Kansas, Spojené státy, 67401
- Salina Regional Health Center
-
Topeka, Kansas, Spojené státy, 66606
- University of Kansas Health System Saint Francis Campus
-
Westwood, Kansas, Spojené státy, 66205
- University of Kansas Hospital-Westwood Cancer Center
-
Wichita, Kansas, Spojené státy, 67214
- Ascension Via Christi Hospitals Wichita
-
Wichita, Kansas, Spojené státy, 67208
- Cancer Center of Kansas-Wichita Medical Arts Tower
-
Wichita, Kansas, Spojené státy, 67214
- Cancer Center of Kansas - Wichita
-
-
Kentucky
-
Bardstown, Kentucky, Spojené státy, 40004
- CommonSpirit Saint Joseph Hospital - Bardstown
-
Corbin, Kentucky, Spojené státy, 40701
- Commonwealth Cancer Center-Corbin
-
Lexington, Kentucky, Spojené státy, 40536
- University of Kentucky/Markey Cancer Center
-
Lexington, Kentucky, Spojené státy, 40504
- Saint Joseph Radiation Oncology Resource Center
-
Lexington, Kentucky, Spojené státy, 40509
- CommonSpirit Saint Joseph Medical Center - East Lexington
-
London, Kentucky, Spojené státy, 40741
- CommonSpirit Saint Joseph Hospital London
-
Louisville, Kentucky, Spojené státy, 40202
- Jewish Hospital
-
Louisville, Kentucky, Spojené státy, 40245
- UofL Health Medical Center Northeast
-
Louisville, Kentucky, Spojené státy, 40207
- Baptist Health Louisville
-
Louisville, Kentucky, Spojené státy, 40215
- Saints Mary and Elizabeth Hospital
-
Shepherdsville, Kentucky, Spojené státy, 40165
- Jewish Hospital Medical Center South
-
-
Louisiana
-
Baton Rouge, Louisiana, Spojené státy, 70805
- LSU Health Baton Rouge-North Clinic
-
Baton Rouge, Louisiana, Spojené státy, 70809
- Louisiana Hematology Oncology Associates LLC
-
Baton Rouge, Louisiana, Spojené státy, 70809
- Mary Bird Perkins Cancer Center
-
Baton Rouge, Louisiana, Spojené státy, 70836
- Ochsner High Grove
-
Baton Rouge, Louisiana, Spojené státy, 70809
- Hematology/Oncology Clinic PLLC
-
Baton Rouge, Louisiana, Spojené státy, 70808
- Our Lady of The Lake
-
Baton Rouge, Louisiana, Spojené státy, 70808
- Our Lady of the Lake Physician Group
-
Covington, Louisiana, Spojené státy, 70433
- Northshore Oncology Associates-Covington
-
Covington, Louisiana, Spojené státy, 70433
- Ochsner Hematology Oncology North Shore - Covington (West Region)
-
Houma, Louisiana, Spojené státy, 70360
- Terrebonne General Medical Center
-
Houma, Louisiana, Spojené státy, 70360
- Oncology Center of The South Incorporated
-
Metairie, Louisiana, Spojené státy, 70006
- East Jefferson General Hospital
-
Metairie, Louisiana, Spojené státy, 70006
- LSU Healthcare Network / Metairie Multi-Specialty Clinic
-
Monroe, Louisiana, Spojené státy, 71202
- Ochsner LSU Health Monroe Medical Center
-
New Orleans, Louisiana, Spojené státy, 70112
- Tulane University School of Medicine
-
New Orleans, Louisiana, Spojené státy, 70121
- Ochsner Medical Center Jefferson
-
New Orleans, Louisiana, Spojené státy, 70112
- University Medical Center New Orleans
-
New Orleans, Louisiana, Spojené státy, 70112
- Louisiana State University Health Science Center
-
New Orleans, Louisiana, Spojené státy, 70115
- Touro Infirmary
-
Shreveport, Louisiana, Spojené státy, 71103
- LSU Health Sciences Center at Shreveport
-
-
Maine
-
Augusta, Maine, Spojené státy, 04330
- Harold Alfond Center for Cancer Care
-
Belfast, Maine, Spojené státy, 04915
- MaineHealth Waldo Hospital
-
Biddeford, Maine, Spojené státy, 04005
- MaineHealth Maine Medical Center - Biddeford
-
Brewer, Maine, Spojené státy, 04412
- Lafayette Family Cancer Center-EMMC
-
Norway, Maine, Spojené státy, 04268
- MaineHealth Stephens Hospital
-
Rockport, Maine, Spojené státy, 04856
- Penobscot Bay Medical Center
-
Sanford, Maine, Spojené státy, 04073
- MaineHealth Cancer Care and IV Therapy - Sanford
-
South Portland, Maine, Spojené státy, 04106
- MaineHealth Cancer Care and IV Therapy - South Portland
-
-
Maryland
-
Baltimore, Maryland, Spojené státy, 21204
- Greater Baltimore Medical Center
-
-
Massachusetts
-
Boston, Massachusetts, Spojené státy, 02215
- Dana-Farber Cancer Institute
-
Newton, Massachusetts, Spojené státy, 02467
- Dana-Farber Cancer Institute - Chestnut Hill
-
Springfield, Massachusetts, Spojené státy, 01104
- Mercy Medical Center
-
-
Michigan
-
Adrian, Michigan, Spojené státy, 49221
- Hickman Cancer Center
-
Ann Arbor, Michigan, Spojené státy, 48106
- Trinity Health Saint Joseph Mercy Hospital Ann Arbor
-
Battle Creek, Michigan, Spojené státy, 49017
- Bronson Battle Creek
-
Brighton, Michigan, Spojené státy, 48114
- Trinity Health IHA Medical Group Hematology Oncology - Brighton
-
Brighton, Michigan, Spojené státy, 48114
- Trinity Health Medical Center - Brighton
-
Brownstown, Michigan, Spojené státy, 48183
- Henry Ford Cancer Institute-Downriver
-
Canton, Michigan, Spojené státy, 48188
- Trinity Health IHA Medical Group Hematology Oncology - Canton
-
Canton, Michigan, Spojené státy, 48188
- Trinity Health Medical Center - Canton
-
Caro, Michigan, Spojené státy, 48723
- Caro Cancer Center
-
Chelsea, Michigan, Spojené státy, 48118
- Trinity Health IHA Medical Group Hematology Oncology - Chelsea Hospital
-
Chelsea, Michigan, Spojené státy, 48118
- Chelsea Hospital
-
Clarkston, Michigan, Spojené státy, 48346
- Hematology Oncology Consultants-Clarkston
-
Clarkston, Michigan, Spojené státy, 48346
- Newland Medical Associates-Clarkston
-
Clinton Township, Michigan, Spojené státy, 48038
- Henry Ford Macomb Hospital-Clinton Township
-
Dearborn, Michigan, Spojené státy, 48126
- Henry Ford Medical Center-Fairlane
-
Detroit, Michigan, Spojené státy, 48202
- Henry Ford Hospital
-
Detroit, Michigan, Spojené státy, 48236
- Henry Ford Health Saint John Hospital
-
East China Township, Michigan, Spojené státy, 48054
- Henry Ford River District Hospital
-
Escanaba, Michigan, Spojené státy, 49829
- OSF Saint Francis Hospital and Medical Group
-
Flint, Michigan, Spojené státy, 48503
- Hurley Medical Center
-
Flint, Michigan, Spojené státy, 48503
- Genesee Hematology Oncology PC
-
Flint, Michigan, Spojené státy, 48503
- Genesys Hurley Cancer Institute
-
Flint, Michigan, Spojené státy, 48503
- Cancer Hematology Centers - Flint
-
Grand Rapids, Michigan, Spojené státy, 49503
- Trinity Health Grand Rapids Hospital
-
Grand Rapids, Michigan, Spojené státy, 49503
- Corewell Health Grand Rapids Hospitals - Butterworth Hospital
-
Grand Rapids, Michigan, Spojené státy, 49503
- Corewell Health Grand Rapids Hospitals - Helen DeVos Children's Hospital
-
Grosse Pointe Woods, Michigan, Spojené státy, 48236
- Henry Ford Saint John Hospital - Academic
-
Grosse Pointe Woods, Michigan, Spojené státy, 48236
- Henry Ford Saint John Hospital - Breast
-
Grosse Pointe Woods, Michigan, Spojené státy, 48236
- Henry Ford Saint John Hospital - Van Elslander
-
Jackson, Michigan, Spojené státy, 49201
- Allegiance Health
-
Kalamazoo, Michigan, Spojené státy, 49007
- West Michigan Cancer Center
-
Kalamazoo, Michigan, Spojené státy, 49007
- Bronson Methodist Hospital
-
Kalamazoo, Michigan, Spojené státy, 49009
- Beacon Kalamazoo Cancer Center
-
Kalamazoo, Michigan, Spojené státy, 49048
- Beacon Kalamazoo
-
Lansing, Michigan, Spojené státy, 48912
- University of Michigan Health - Sparrow Lansing
-
Livonia, Michigan, Spojené státy, 48154
- Trinity Health Saint Mary Mercy Livonia Hospital
-
Livonia, Michigan, Spojené státy, 48154
- Hope Cancer Clinic
-
Macomb, Michigan, Spojené státy, 48044
- Henry Ford Warren Hospital - Breast Macomb
-
Macomb, Michigan, Spojené státy, 48044
- Henry Ford Saint John Hospital - Macomb Medical
-
Marlette, Michigan, Spojené státy, 48453
- Saint Mary's Oncology/Hematology Associates of Marlette
-
Monroe, Michigan, Spojené státy, 48162
- Toledo Clinic Cancer Centers-Monroe
-
Muskegon, Michigan, Spojené státy, 49444
- Trinity Health Muskegon Hospital
-
Niles, Michigan, Spojené státy, 49120
- Corewell Health Lakeland Hospitals - Niles Hospital
-
Norton Shores, Michigan, Spojené státy, 49444
- Cancer and Hematology Centers of Western Michigan - Norton Shores
-
Novi, Michigan, Spojené státy, 48377
- Henry Ford Medical Center-Columbus
-
Novi, Michigan, Spojené státy, 48374
- Henry Ford Health Providence Novi Hospital
-
Pontiac, Michigan, Spojené státy, 48341
- Hope Cancer Center
-
Pontiac, Michigan, Spojené státy, 48341
- Trinity Health Saint Joseph Mercy Oakland Hospital
-
Pontiac, Michigan, Spojené státy, 48341
- Michigan Healthcare Professionals Pontiac
-
Pontiac, Michigan, Spojené státy, 48341
- Trinity Health IHA Medical Group-Alice Gustafson Center
-
Port Huron, Michigan, Spojené státy, 48060
- Lake Huron Medical Center
-
Port Huron, Michigan, Spojené státy, 48060
- Huron Medical Center PC
-
Reed City, Michigan, Spojené státy, 49677
- Corewell Health Reed City Hospital
-
Rochester Hills, Michigan, Spojené státy, 48309
- Henry Ford Rochester Hospital
-
Saginaw, Michigan, Spojené státy, 48604
- Oncology Hematology Associates of Saginaw Valley PC
-
Saginaw, Michigan, Spojené státy, 48601
- MyMichigan Medical Center Saginaw
-
Saint Joseph, Michigan, Spojené státy, 49085
- Corewell Health Lakeland Hospitals - Marie Yeager Cancer Center
-
Saint Joseph, Michigan, Spojené státy, 49085
- Corewell Health Lakeland Hospitals - Saint Joseph Hospital
-
Shelby, Michigan, Spojené státy, 48315
- Henry Ford Macomb Health Center - Shelby Township
-
Southfield, Michigan, Spojené státy, 48075
- Henry Ford Health Providence Southfield Hospital
-
Sterling Heights, Michigan, Spojené státy, 48312
- Bhadresh Nayak MD PC-Sterling Heights
-
Tawas City, Michigan, Spojené státy, 48764
- MyMichigan Medical Center Tawas
-
Traverse City, Michigan, Spojené státy, 49684
- Munson Medical Center
-
Warren, Michigan, Spojené státy, 48088
- Advanced Breast Care Center PLLC
-
Warren, Michigan, Spojené státy, 48093
- Macomb Hematology Oncology PC
-
Warren, Michigan, Spojené státy, 48093
- Henry Ford Madison Heights Hospital - Breast
-
Warren, Michigan, Spojené státy, 48093
- Henry Ford Health Warren Hospital
-
Warren, Michigan, Spojené státy, 48093
- Henry Ford Warren Hospital - GLCMS
-
West Bloomfield, Michigan, Spojené státy, 48322
- Henry Ford West Bloomfield Hospital
-
West Branch, Michigan, Spojené státy, 48661
- Saint Mary's Oncology/Hematology Associates of West Branch
-
Wyoming, Michigan, Spojené státy, 49519
- University of Michigan Health - West
-
Ypsilanti, Michigan, Spojené státy, 48197
- Trinity Health IHA Medical Group Hematology Oncology Ann Arbor Campus
-
Ypsilanti, Michigan, Spojené státy, 48106
- Huron Gastroenterology PC
-
-
Minnesota
-
Aitkin, Minnesota, Spojené státy, 56431
- Riverwood Healthcare Center
-
Bemidji, Minnesota, Spojené státy, 56601
- Sanford Joe Lueken Cancer Center
-
Brainerd, Minnesota, Spojené státy, 56401
- Essentia Health Saint Joseph's Medical Center
-
Burnsville, Minnesota, Spojené státy, 55337
- Fairview Ridges Hospital
-
Burnsville, Minnesota, Spojené státy, 55337
- Minnesota Oncology - Burnsville
-
Cambridge, Minnesota, Spojené státy, 55008
- Cambridge Medical Center
-
Coon Rapids, Minnesota, Spojené státy, 55433
- Mercy Hospital
-
Deer River, Minnesota, Spojené státy, 56636
- Essentia Health - Deer River Clinic
-
Detroit Lakes, Minnesota, Spojené státy, 56501
- Essentia Health Saint Mary's - Detroit Lakes Clinic
-
Duluth, Minnesota, Spojené státy, 55805
- Essentia Health Cancer Center
-
Duluth, Minnesota, Spojené státy, 55805
- Essentia Health Saint Mary's Medical Center
-
Duluth, Minnesota, Spojené státy, 55805
- Miller-Dwan Hospital
-
Edina, Minnesota, Spojené státy, 55435
- Fairview Southdale Hospital
-
Fergus Falls, Minnesota, Spojené státy, 56537
- Lake Region Healthcare Corporation-Cancer Care
-
Fosston, Minnesota, Spojené státy, 56542
- Essentia Health - Fosston
-
Fridley, Minnesota, Spojené státy, 55432
- Unity Hospital
-
Hibbing, Minnesota, Spojené státy, 55746
- Essentia Health Hibbing Clinic
-
Maple Grove, Minnesota, Spojené státy, 55369
- Fairview Clinics and Surgery Center Maple Grove
-
Maplewood, Minnesota, Spojené státy, 55109
- Saint John's Hospital - Healtheast
-
Maplewood, Minnesota, Spojené státy, 55109
- Minnesota Oncology Hematology PA-Maplewood
-
Minneapolis, Minnesota, Spojené státy, 55415
- Hennepin County Medical Center
-
Minneapolis, Minnesota, Spojené státy, 55407
- Abbott-Northwestern Hospital
-
Minneapolis, Minnesota, Spojené státy, 55454
- Health Partners Inc
-
Minneapolis, Minnesota, Spojené státy, 55417
- Minneapolis VA Medical Center
-
Monticello, Minnesota, Spojené státy, 55362
- Monticello Cancer Center
-
New Ulm, Minnesota, Spojené státy, 56073
- New Ulm Medical Center
-
Park Rapids, Minnesota, Spojené státy, 56470
- Essentia Health - Park Rapids
-
Princeton, Minnesota, Spojené státy, 55371
- Fairview Northland Medical Center
-
Robbinsdale, Minnesota, Spojené státy, 55422
- North Memorial Medical Health Center
-
Saint Cloud, Minnesota, Spojené státy, 56303
- Coborn Cancer Center at Saint Cloud Hospital
-
Saint Louis Park, Minnesota, Spojené státy, 55416
- Park Nicollet Clinic - Saint Louis Park
-
Saint Paul, Minnesota, Spojené státy, 55101
- Regions Hospital
-
Saint Paul, Minnesota, Spojené státy, 55102
- United Hospital
-
Sandstone, Minnesota, Spojené státy, 55072
- Essentia Health Sandstone
-
Shakopee, Minnesota, Spojené státy, 55379
- Saint Francis Regional Medical Center
-
Stillwater, Minnesota, Spojené státy, 55082
- Lakeview Hospital
-
Thief River Falls, Minnesota, Spojené státy, 56701
- Sanford Thief River Falls Medical Center
-
Virginia, Minnesota, Spojené státy, 55792
- Essentia Health Virginia Clinic
-
Waconia, Minnesota, Spojené státy, 55387
- Ridgeview Medical Center
-
Willmar, Minnesota, Spojené státy, 56201
- Rice Memorial Hospital
-
Woodbury, Minnesota, Spojené státy, 55125
- Minnesota Oncology Hematology PA-Woodbury
-
Worthington, Minnesota, Spojené státy, 56187
- Sanford Cancer Center Worthington
-
Wyoming, Minnesota, Spojené státy, 55092
- Fairview Lakes Medical Center
-
-
Mississippi
-
Columbus, Mississippi, Spojené státy, 39705
- Baptist Memorial Hospital and Cancer Center-Golden Triangle
-
Grenada, Mississippi, Spojené státy, 38901
- Baptist Cancer Center-Grenada
-
Gulfport, Mississippi, Spojené státy, 39502
- Gulfport Memorial Hospital
-
Jackson, Mississippi, Spojené státy, 39216
- University of Mississippi Medical Center
-
New Albany, Mississippi, Spojené státy, 38652
- Baptist Memorial Hospital and Cancer Center-Union County
-
Oxford, Mississippi, Spojené státy, 38655
- Baptist Memorial Hospital and Cancer Center-Oxford
-
Southhaven, Mississippi, Spojené státy, 38671
- Baptist Memorial Hospital and Cancer Center-Desoto
-
-
Missouri
-
Ballwin, Missouri, Spojené státy, 63011
- Mercy Oncology and Hematology - Clayton-Clarkson
-
Bolivar, Missouri, Spojené státy, 65613
- Central Care Cancer Center - Bolivar
-
Bonne Terre, Missouri, Spojené státy, 63628
- Parkland Health Center-Bonne Terre
-
Branson, Missouri, Spojené státy, 65616
- Cox Cancer Center Branson
-
Cape Girardeau, Missouri, Spojené státy, 63703
- Saint Francis Medical Center
-
Cape Girardeau, Missouri, Spojené státy, 63703
- Mercy Cancer Center - Cape Girardeau
-
Chesterfield, Missouri, Spojené státy, 63017
- Saint Luke's Hospital
-
City of Saint Peters, Missouri, Spojené státy, 63376
- Siteman Cancer Center at Saint Peters Hospital
-
Columbia, Missouri, Spojené státy, 65212
- MU Health - University Hospital/Ellis Fischel Cancer Center
-
Creve Coeur, Missouri, Spojené státy, 63141
- Siteman Cancer Center at West County Hospital
-
Farmington, Missouri, Spojené státy, 63640
- Parkland Health Center - Farmington
-
Independence, Missouri, Spojené státy, 64057
- Centerpoint Medical Center LLC
-
Jefferson City, Missouri, Spojené státy, 65109
- MU Health Care Goldschmidt Cancer Center
-
Joplin, Missouri, Spojené státy, 64804
- Freeman Health System
-
Joplin, Missouri, Spojené státy, 64804
- Mercy Hospital Joplin
-
Kansas City, Missouri, Spojené státy, 64154
- University of Kansas Cancer Center - North
-
Kansas City, Missouri, Spojené státy, 64132
- Research Medical Center
-
Kansas City, Missouri, Spojené státy, 64108
- University Health Truman Medical Center
-
Lee's Summit, Missouri, Spojené státy, 64064
- University of Kansas Cancer Center - Lee's Summit
-
North Kansas City, Missouri, Spojené státy, 64116
- University of Kansas Cancer Center at North Kansas City Hospital
-
Rolla, Missouri, Spojené státy, 65401
- Mercy Clinic-Rolla-Cancer and Hematology
-
Rolla, Missouri, Spojené státy, 65401
- Phelps Health Delbert Day Cancer Institute
-
Saint Joseph, Missouri, Spojené státy, 64506
- Heartland Regional Medical Center
-
Sainte Genevieve, Missouri, Spojené státy, 63670
- Sainte Genevieve County Memorial Hospital
-
Springfield, Missouri, Spojené státy, 65807
- CoxHealth South Hospital
-
Springfield, Missouri, Spojené státy, 65804
- Mercy Hospital Springfield
-
St Louis, Missouri, Spojené státy, 63110
- Washington University School of Medicine
-
St Louis, Missouri, Spojené státy, 63129
- Siteman Cancer Center-South County
-
St Louis, Missouri, Spojené státy, 63136
- Siteman Cancer Center at Christian Hospital
-
St Louis, Missouri, Spojené státy, 63131
- Missouri Baptist Medical Center
-
St Louis, Missouri, Spojené státy, 63109
- Mercy Infusion Center - Chippewa
-
St Louis, Missouri, Spojené státy, 63141
- Mercy Hospital Saint Louis
-
St Louis, Missouri, Spojené státy, 63128
- Mercy Hospital South
-
Sullivan, Missouri, Spojené státy, 63080
- Missouri Baptist Sullivan Hospital
-
Washington, Missouri, Spojené státy, 63090
- Mercy Hospital Washington
-
-
Montana
-
Anaconda, Montana, Spojené státy, 59711
- Community Hospital of Anaconda
-
Billings, Montana, Spojené státy, 59101
- Billings Clinic Cancer Center
-
Billings, Montana, Spojené státy, 59101
- Saint Vincent Healthcare
-
Billings, Montana, Spojené státy, 59102
- Saint Vincent Frontier Cancer Center
-
Bozeman, Montana, Spojené státy, 59715
- Bozeman Health Deaconess Hospital
-
Butte, Montana, Spojené státy, 59701
- Saint James Community Hospital and Cancer Treatment Center
-
Great Falls, Montana, Spojené státy, 59405
- Great Falls Clinic
-
Great Falls, Montana, Spojené státy, 59405
- Benefis Sletten Cancer Institute
-
Helena, Montana, Spojené státy, 59601
- Saint Peter's Community Hospital
-
Kalispell, Montana, Spojené státy, 59901
- Logan Health Medical Center
-
Missoula, Montana, Spojené státy, 59802
- Saint Patrick Hospital - Community Hospital
-
Missoula, Montana, Spojené státy, 59804
- Community Medical Center
-
-
Nebraska
-
Bellevue, Nebraska, Spojené státy, 68123
- Nebraska Medicine-Bellevue
-
Grand Island, Nebraska, Spojené státy, 68803
- Nebraska Cancer Specialists/Oncology Hematology West PC
-
Kearney, Nebraska, Spojené státy, 68847
- CHI Health Good Samaritan
-
Lincoln, Nebraska, Spojené státy, 68510
- Saint Elizabeth Regional Medical Center
-
Lincoln, Nebraska, Spojené státy, 68516
- Cancer Partners of Nebraska
-
Omaha, Nebraska, Spojené státy, 68114
- Nebraska Methodist Hospital
-
Omaha, Nebraska, Spojené státy, 68198
- University of Nebraska Medical Center
-
Omaha, Nebraska, Spojené státy, 68124
- Alegent Health Bergan Mercy Medical Center
-
Omaha, Nebraska, Spojené státy, 68118
- Nebraska Medicine-Village Pointe
-
Omaha, Nebraska, Spojené státy, 68122
- Alegent Health Immanuel Medical Center
-
Omaha, Nebraska, Spojené státy, 68130
- Alegent Health Lakeside Hospital
-
Omaha, Nebraska, Spojené státy, 68114
- Oncology Associates PC
-
Omaha, Nebraska, Spojené státy, 68114
- Nebraska Cancer Specialists/Oncology Hematology West PC - MECC
-
Papillion, Nebraska, Spojené státy, 68046
- Midlands Community Hospital
-
-
Nevada
-
Carson City, Nevada, Spojené státy, 89703
- Carson Tahoe Regional Medical Center
-
Henderson, Nevada, Spojené státy, 89052
- Comprehensive Cancer Centers of Nevada - Henderson
-
Henderson, Nevada, Spojené státy, 89052
- Cancer and Blood Specialists-Henderson
-
Henderson, Nevada, Spojené státy, 89052
- Las Vegas Cancer Center-Henderson
-
Henderson, Nevada, Spojené státy, 89074
- Comprehensive Cancer Centers of Nevada-Southeast Henderson
-
Henderson, Nevada, Spojené státy, 89052
- Comprehensive Cancer Centers of Nevada-Horizon Ridge
-
Henderson, Nevada, Spojené státy, 89074
- Las Vegas Urology - Green Valley
-
Henderson, Nevada, Spojené státy, 89074
- Las Vegas Urology - Pebble
-
Henderson, Nevada, Spojené státy, 89074
- Urology Specialists of Nevada - Green Valley
-
Henderson, Nevada, Spojené státy, 89074
- Oncology Las Vegas - Henderson
-
Las Vegas, Nevada, Spojené státy, 89144
- Summerlin Hospital Medical Center
-
Las Vegas, Nevada, Spojené státy, 89109
- Sunrise Hospital and Medical Center
-
Las Vegas, Nevada, Spojené státy, 89102
- OptumCare Cancer Care at Charleston
-
Las Vegas, Nevada, Spojené státy, 89106
- Radiation Oncology Centers of Nevada Central
-
Las Vegas, Nevada, Spojené státy, 89119
- Radiation Oncology Centers of Nevada Southeast
-
Las Vegas, Nevada, Spojené státy, 89128
- Comprehensive Cancer Centers of Nevada - Northwest
-
Las Vegas, Nevada, Spojené státy, 89128
- OptumCare Cancer Care at MountainView
-
Las Vegas, Nevada, Spojené státy, 89135
- Alliance for Childhood Diseases/Cure 4 the Kids Foundation
-
Las Vegas, Nevada, Spojené státy, 89144
- Comprehensive Cancer Centers of Nevada - Town Center
-
Las Vegas, Nevada, Spojené státy, 89144
- Comprehensive Cancer Centers of Nevada-Summerlin
-
Las Vegas, Nevada, Spojené státy, 89148
- Comprehensive Cancer Centers of Nevada
-
Las Vegas, Nevada, Spojené státy, 89169
- Comprehensive Cancer Centers of Nevada - Central Valley
-
Las Vegas, Nevada, Spojené státy, 89102
- University Medical Center of Southern Nevada
-
Las Vegas, Nevada, Spojené státy, 89106
- Cancer and Blood Specialists-Shadow
-
Las Vegas, Nevada, Spojené státy, 89109
- HealthCare Partners Medical Group Oncology/Hematology-Maryland Parkway
-
Las Vegas, Nevada, Spojené státy, 89113
- HealthCare Partners Medical Group Oncology/Hematology-San Martin
-
Las Vegas, Nevada, Spojené státy, 89128
- Cancer and Blood Specialists-Tenaya
-
Las Vegas, Nevada, Spojené státy, 89128
- HealthCare Partners Medical Group Oncology/Hematology-Tenaya
-
Las Vegas, Nevada, Spojené státy, 89148-2405
- Las Vegas Cancer Center-Medical Center
-
Las Vegas, Nevada, Spojené státy, 89149
- HealthCare Partners Medical Group Oncology/Hematology-Centennial Hills
-
Las Vegas, Nevada, Spojené státy, 89128
- Ann M Wierman MD LTD
-
Las Vegas, Nevada, Spojené státy, 89074
- Las Vegas Urology - Pecos
-
Las Vegas, Nevada, Spojené státy, 89102
- Desert West Surgery
-
Las Vegas, Nevada, Spojené státy, 89103
- Hope Cancer Care of Nevada
-
Las Vegas, Nevada, Spojené státy, 89106
- Urology Specialists of Nevada - Central
-
Las Vegas, Nevada, Spojené státy, 89113
- Las Vegas Prostate Cancer Center
-
Las Vegas, Nevada, Spojené státy, 89113
- Las Vegas Urology - Sunset
-
Las Vegas, Nevada, Spojené státy, 89128
- Las Vegas Urology - Cathedral Rock
-
Las Vegas, Nevada, Spojené státy, 89128
- Las Vegas Urology - Smoke Ranch
-
Las Vegas, Nevada, Spojené státy, 89128
- Urology Specialists of Nevada - Northwest
-
Las Vegas, Nevada, Spojené státy, 89169
- University Cancer Center
-
Las Vegas, Nevada, Spojené státy, 89113
- Urology Specialists of Nevada - Southwest
-
Las Vegas, Nevada, Spojené státy, 89128
- Oncology Las Vegas - Tenaya
-
Las Vegas, Nevada, Spojené státy, 89183
- OptumCare Cancer Care at Fort Apache
-
Pahrump, Nevada, Spojené státy, 89048
- Hope Cancer Care of Nevada-Pahrump
-
Reno, Nevada, Spojené státy, 89502
- Renown Regional Medical Center
-
Reno, Nevada, Spojené státy, 89503
- Saint Mary's Regional Medical Center
-
Reno, Nevada, Spojené státy, 89509
- Radiation Oncology Associates
-
-
New Hampshire
-
Concord, New Hampshire, Spojené státy, 03301
- New Hampshire Oncology Hematology PA-Concord
-
Manchester, New Hampshire, Spojené státy, 03103
- Solinsky Center for Cancer Care
-
Manchester, New Hampshire, Spojené státy, 03103
- Elliot Hospital
-
-
New Jersey
-
Brick, New Jersey, Spojené státy, 08724
- Ocean University Medical Center
-
Cape May Court House, New Jersey, Spojené státy, 08210
- AtlantiCare Health Park-Cape May Court House
-
Egg Harbor, New Jersey, Spojené státy, 08234
- AtlantiCare Surgery Center
-
Hackensack, New Jersey, Spojené státy, 07601
- Hackensack University Medical Center
-
Livingston, New Jersey, Spojené státy, 07039
- Cooperman Barnabas Medical Center
-
Manahawkin, New Jersey, Spojené státy, 08050
- Southern Ocean County Medical Center
-
Mullica Hill, New Jersey, Spojené státy, 08062
- Inspira Medical Center Mullica Hill
-
Neptune City, New Jersey, Spojené státy, 07753
- Jersey Shore Medical Center
-
New Brunswick, New Jersey, Spojené státy, 08903
- Rutgers Cancer Institute of New Jersey
-
Red Bank, New Jersey, Spojené státy, 07701
- Riverview Medical Center/Booker Cancer Center
-
-
New Mexico
-
Albuquerque, New Mexico, Spojené státy, 87106
- University of New Mexico Cancer Center
-
-
New York
-
Auburn, New York, Spojené státy, 13021
- Hematology Oncology Associates of Central New York-Auburn
-
Camillus, New York, Spojené státy, 13031
- Hematology Oncology Associates of CNY at Camillus
-
Cooperstown, New York, Spojené státy, 13326
- Mary Imogene Bassett Hospital
-
East Syracuse, New York, Spojené státy, 13057
- Hematology Oncology Associates of Central New York-East Syracuse
-
Glens Falls, New York, Spojené státy, 12801
- Glens Falls Hospital
-
Lake Success, New York, Spojené státy, 11042
- Northwell Health/Center for Advanced Medicine
-
New York, New York, Spojené státy, 10065
- NYP/Weill Cornell Medical Center
-
Rochester, New York, Spojené státy, 14642
- University of Rochester
-
Stony Brook, New York, Spojené státy, 11794
- Stony Brook University Medical Center
-
The Bronx, New York, Spojené státy, 10461
- Montefiore Medical Center-Einstein Campus
-
The Bronx, New York, Spojené státy, 10467
- Montefiore Medical Center - Moses Campus
-
The Bronx, New York, Spojené státy, 10461
- Montefiore Medical Center-Weiler Hospital
-
-
North Carolina
-
Asheville, North Carolina, Spojené státy, 28803
- AdventHealth Infusion Center Asheville
-
Chapel Hill, North Carolina, Spojené státy, 27599
- UNC Lineberger Comprehensive Cancer Center
-
Charlotte, North Carolina, Spojené státy, 28204
- Novant Health Presbyterian Medical Center
-
Clemmons, North Carolina, Spojené státy, 27012
- Wake Forest University at Clemmons
-
Clinton, North Carolina, Spojené státy, 28328
- Southeastern Medical Oncology Center-Clinton
-
Clyde, North Carolina, Spojené státy, 28721
- AdventHealth Infusion Center Haywood
-
Durham, North Carolina, Spojené státy, 27710
- Duke University Medical Center
-
Durham, North Carolina, Spojené státy, 27705
- Durham VA Medical Center
-
Goldsboro, North Carolina, Spojené státy, 27534
- Southeastern Medical Oncology Center-Goldsboro
-
Greenville, North Carolina, Spojené státy, 27834
- ECU Health Medical Center
-
Hendersonville, North Carolina, Spojené státy, 28791
- Margaret R Pardee Memorial Hospital
-
Hendersonville, North Carolina, Spojené státy, 28792
- AdventHealth Hendersonville
-
Huntersville, North Carolina, Spojené státy, 28078
- Novant Health Cancer Institute - Huntersville
-
Huntersville, North Carolina, Spojené státy, 28078
- Novant Health Presbyterian Medical Center Huntersville
-
Jacksonville, North Carolina, Spojené státy, 28546
- Southeastern Medical Oncology Center-Jacksonville
-
Kenansville, North Carolina, Spojené státy, 28349
- ECU Health Oncology Kenansville
-
Kernersville, North Carolina, Spojené státy, 27284
- Novant Health Cancer Institute - Kernersville
-
Kinston, North Carolina, Spojené státy, 28501
- ECU Health Oncology Kinston
-
Matthews, North Carolina, Spojené státy, 28105
- Novant Health Cancer Institute - Matthews
-
Mooresville, North Carolina, Spojené státy, 28117
- Novant Health Cancer Institute - Mooresville
-
Mount Airy, North Carolina, Spojené státy, 27030
- Novant Health Cancer Institute - Mount Airy
-
North Wilkesboro, North Carolina, Spojené státy, 28659
- Novant Health Cancer Institute - Wilkesboro
-
Richlands, North Carolina, Spojené státy, 28574
- ECU Health Oncology Richlands
-
Statesville, North Carolina, Spojené státy, 28625
- Novant Health Cancer Institute - Statesville
-
Statesville, North Carolina, Spojené státy, 28677
- Wake Forest Baptist Health - Hematology Oncology - Statesville
-
Thomasville, North Carolina, Spojené státy, 27360
- Novant Health Cancer Institute - Thomasville
-
Weaverville, North Carolina, Spojené státy, 28787
- AdventHealth Infusion Center Weaverville
-
Wilkesboro, North Carolina, Spojené státy, 28659
- Wake Forest Baptist Health - Wilkes Medical Center
-
Winston-Salem, North Carolina, Spojené státy, 27157
- Wake Forest University Health Sciences
-
Winston-Salem, North Carolina, Spojené státy, 27103
- Novant Health Forsyth Medical Center
-
-
North Dakota
-
Bismarck, North Dakota, Spojené státy, 58501
- Sanford Bismarck Medical Center
-
Fargo, North Dakota, Spojené státy, 58122
- Sanford Roger Maris Cancer Center
-
Fargo, North Dakota, Spojené státy, 58103
- Essentia Health Cancer Center-South University Clinic
-
Fargo, North Dakota, Spojené státy, 58122
- Sanford Broadway Medical Center
-
Fargo, North Dakota, Spojené státy, 58103
- Sanford South University Medical Center
-
Fargo, North Dakota, Spojené státy, 58103
- Southpointe-Sanford Medical Center Fargo
-
Fargo, North Dakota, Spojené státy, 58104
- Sanford Medical Center Fargo
-
Grand Forks, North Dakota, Spojené státy, 58201
- Altru Cancer Center
-
Jamestown, North Dakota, Spojené státy, 58401
- Essentia Health - Jamestown Clinic
-
Minot, North Dakota, Spojené státy, 58701
- Trinity Cancer Care Center
-
-
Ohio
-
Beavercreek, Ohio, Spojené státy, 45431
- Indu and Raj Soin Medical Center
-
Belpre, Ohio, Spojené státy, 45714
- Strecker Cancer Center-Belpre
-
Boardman, Ohio, Spojené státy, 44512
- Saint Elizabeth Boardman Hospital
-
Centerville, Ohio, Spojené státy, 45459
- Miami Valley Hospital South
-
Centerville, Ohio, Spojené státy, 45459
- Dayton Physicians LLC-Miami Valley South
-
Chillicothe, Ohio, Spojené státy, 45601
- Adena Regional Medical Center
-
Cincinnati, Ohio, Spojené státy, 45219
- University of Cincinnati Cancer Center-UC Medical Center
-
Cincinnati, Ohio, Spojené státy, 45220
- Good Samaritan Hospital - Cincinnati
-
Cincinnati, Ohio, Spojené státy, 45242
- Bethesda North Hospital
-
Cincinnati, Ohio, Spojené státy, 45236
- Oncology Hematology Care Inc-Kenwood
-
Cincinnati, Ohio, Spojené státy, 45247
- TriHealth Cancer Institute-Westside
-
Cincinnati, Ohio, Spojené státy, 45255
- TriHealth Cancer Institute-Anderson
-
Cleveland, Ohio, Spojené státy, 44109
- MetroHealth Medical Center
-
Columbus, Ohio, Spojené státy, 43214
- Riverside Methodist Hospital
-
Columbus, Ohio, Spojené státy, 43210
- Ohio State University Comprehensive Cancer Center
-
Columbus, Ohio, Spojené státy, 43219
- The Mark H Zangmeister Center
-
Columbus, Ohio, Spojené státy, 43214
- Columbus Oncology and Hematology Associates Inc
-
Columbus, Ohio, Spojené státy, 43228
- Doctors Hospital
-
Columbus, Ohio, Spojené státy, 43213
- Mount Carmel East Hospital
-
Columbus, Ohio, Spojené státy, 43215
- Grant Medical Center
-
Columbus, Ohio, Spojené státy, 43222
- Mount Carmel Health Center West
-
Dayton, Ohio, Spojené státy, 45406
- Good Samaritan Hospital - Dayton
-
Dayton, Ohio, Spojené státy, 45409
- Miami Valley Hospital
-
Dayton, Ohio, Spojené státy, 45415
- Miami Valley Hospital North
-
Dayton, Ohio, Spojené státy, 45415
- Dayton Physician LLC - Englewood
-
Dayton, Ohio, Spojené státy, 45409
- Premier Blood and Cancer Center
-
Delaware, Ohio, Spojené státy, 43015
- Delaware Health Center-Grady Cancer Center
-
Delaware, Ohio, Spojené státy, 43015
- Grady Memorial Hospital
-
Dublin, Ohio, Spojené státy, 43016
- Dublin Methodist Hospital
-
Dublin, Ohio, Spojené státy, 43016
- Columbus Oncology and Hematology Associates
-
Findlay, Ohio, Spojené státy, 45840
- Blanchard Valley Hospital
-
Findlay, Ohio, Spojené státy, 45840
- Armes Family Cancer Center
-
Findlay, Ohio, Spojené státy, 45840
- Orion Cancer Care
-
Franklin, Ohio, Spojené státy, 45005-1066
- Atrium Medical Center-Middletown Regional Hospital
-
Franklin, Ohio, Spojené státy, 45005
- Dayton Physicians LLC-Atrium
-
Gahanna, Ohio, Spojené státy, 43230
- Central Ohio Breast and Endocrine Surgery
-
Greenville, Ohio, Spojené státy, 45331
- Wayne Hospital
-
Greenville, Ohio, Spojené státy, 45331
- Dayton Physicians LLC-Wayne
-
Greenville, Ohio, Spojené státy, 45331
- Miami Valley Cancer Care and Infusion
-
Grove City, Ohio, Spojené státy, 43123
- Mount Carmel Grove City Hospital
-
Kettering, Ohio, Spojené státy, 45429
- Kettering Medical Center
-
Kettering, Ohio, Spojené státy, 45409
- Greater Dayton Cancer Center
-
Kettering, Ohio, Spojené státy, 45420
- First Dayton Cancer Care
-
Lancaster, Ohio, Spojené státy, 43130
- Fairfield Medical Center
-
Lima, Ohio, Spojené státy, 45801
- Saint Rita's Medical Center
-
Mansfield, Ohio, Spojené státy, 44903
- OhioHealth Mansfield Hospital
-
Marietta, Ohio, Spojené státy, 45750
- Marietta Memorial Hospital
-
Marion, Ohio, Spojené státy, 43302
- OhioHealth Marion General Hospital
-
Marysville, Ohio, Spojené státy, 43040
- Memorial Hospital
-
Mount Vernon, Ohio, Spojené státy, 43050
- Knox Community Hospital
-
Newark, Ohio, Spojené státy, 43055
- Licking Memorial Hospital
-
Newark, Ohio, Spojené státy, 43055
- Newark Radiation Oncology
-
Perrysburg, Ohio, Spojené státy, 43551
- Mercy Health - Perrysburg Hospital
-
Portsmouth, Ohio, Spojené státy, 45662
- Southern Ohio Medical Center
-
Springfield, Ohio, Spojené státy, 45504
- Springfield Regional Cancer Center
-
Springfield, Ohio, Spojené státy, 45504
- Springfield Regional Medical Center
-
Toledo, Ohio, Spojené státy, 43623
- Mercy Health - Saint Anne Hospital
-
Toledo, Ohio, Spojené státy, 43623
- Toledo Clinic Cancer Centers-Toledo
-
Toledo, Ohio, Spojené státy, 43608
- Mercy Health - Saint Vincent Hospital
-
Troy, Ohio, Spojené státy, 45373
- Upper Valley Medical Center
-
Troy, Ohio, Spojené státy, 45373
- Dayton Physicians LLC - Troy
-
Warren, Ohio, Spojené státy, 44484
- Saint Joseph Warren Hospital
-
West Chester, Ohio, Spojené státy, 45069
- University of Cincinnati Cancer Center-West Chester
-
Westerville, Ohio, Spojené státy, 43081
- Saint Ann's Hospital
-
Youngstown, Ohio, Spojené státy, 44501
- Saint Elizabeth Youngstown Hospital
-
Zanesville, Ohio, Spojené státy, 43701
- Genesis Healthcare System Cancer Care Center
-
-
Oklahoma
-
Lawton, Oklahoma, Spojené státy, 73505
- Cancer Centers of Southwest Oklahoma Research
-
Oklahoma City, Oklahoma, Spojené státy, 73104
- University of Oklahoma Health Sciences Center
-
Oklahoma City, Oklahoma, Spojené státy, 73120
- Mercy Hospital Oklahoma City
-
Tulsa, Oklahoma, Spojené státy, 74146
- Oklahoma Cancer Specialists and Research Institute-Tulsa
-
-
Oregon
-
Baker City, Oregon, Spojené státy, 97814
- Saint Alphonsus Cancer Care Center-Baker City
-
Bend, Oregon, Spojené státy, 97701
- Saint Charles Health System
-
Clackamas, Oregon, Spojené státy, 97015
- Clackamas Radiation Oncology Center
-
Clackamas, Oregon, Spojené státy, 97015
- Providence Cancer Institute Clackamas Clinic
-
Coos Bay, Oregon, Spojené státy, 97420
- Bay Area Hospital
-
Gresham, Oregon, Spojené státy, 97030
- Legacy Mount Hood Medical Center
-
Newberg, Oregon, Spojené státy, 97132
- Providence Newberg Medical Center
-
Ontario, Oregon, Spojené státy, 97914
- Saint Alphonsus Cancer Care Center-Ontario
-
Oregon City, Oregon, Spojené státy, 97045
- Providence Willamette Falls Medical Center
-
Portland, Oregon, Spojené státy, 97239
- Oregon Health and Science University
-
Portland, Oregon, Spojené státy, 97210
- Legacy Good Samaritan Hospital and Medical Center
-
Portland, Oregon, Spojené státy, 97213
- Providence Portland Medical Center
-
Portland, Oregon, Spojené státy, 97225
- Providence Saint Vincent Medical Center
-
Redmond, Oregon, Spojené státy, 97756
- Saint Charles Health System-Redmond
-
Tualatin, Oregon, Spojené státy, 97062
- Legacy Meridian Park Hospital
-
-
Pennsylvania
-
Allentown, Pennsylvania, Spojené státy, 18103
- Lehigh Valley Hospital-Cedar Crest
-
Bethlehem, Pennsylvania, Spojené státy, 18017
- Lehigh Valley Hospital - Muhlenberg
-
Bryn Mawr, Pennsylvania, Spojené státy, 19010
- Bryn Mawr Hospital
-
Chadds Ford, Pennsylvania, Spojené státy, 19317
- Christiana Care Health System-Concord Health Center
-
Collegeville, Pennsylvania, Spojené státy, 19426
- Main Line Health Center-Collegeville
-
Danville, Pennsylvania, Spojené státy, 17822
- Geisinger Medical Center
-
East Stroudsburg, Pennsylvania, Spojené státy, 18301
- Pocono Medical Center
-
Exton, Pennsylvania, Spojené státy, 19341
- Main Line Health Center-Exton
-
Hazleton, Pennsylvania, Spojené státy, 18201
- Geisinger Medical Center-Cancer Center Hazleton
-
Hazleton, Pennsylvania, Spojené státy, 18201
- Lehigh Valley Hospital-Hazleton
-
Hershey, Pennsylvania, Spojené státy, 17033-0850
- Penn State Milton S Hershey Medical Center
-
Lewisburg, Pennsylvania, Spojené státy, 17837
- Geisinger Medical Oncology-Lewisburg
-
Lewistown, Pennsylvania, Spojené státy, 17044
- Lewistown Hospital
-
Media, Pennsylvania, Spojené státy, 19063
- Riddle Memorial Hospital
-
Newtown Square, Pennsylvania, Spojené státy, 19073
- Bryn Mawr Health Center
-
Paoli, Pennsylvania, Spojené státy, 19301
- Paoli Memorial Hospital
-
Philadelphia, Pennsylvania, Spojené státy, 19107
- Thomas Jefferson University Hospital
-
Philadelphia, Pennsylvania, Spojené státy, 19148
- Jefferson Methodist Hospital
-
Pottsville, Pennsylvania, Spojené státy, 17901
- Geisinger Cancer Services-Pottsville
-
Sayre, Pennsylvania, Spojené státy, 18840
- Guthrie Medical Group PC-Robert Packer Hospital
-
Scranton, Pennsylvania, Spojené státy, 18510
- Community Medical Center
-
Selinsgrove, Pennsylvania, Spojené státy, 17870
- Geisinger Medical Oncology-Selinsgrove
-
State College, Pennsylvania, Spojené státy, 16801
- Geisinger Medical Group
-
Wilkes-Barre, Pennsylvania, Spojené státy, 18711
- Geisinger Wyoming Valley/Henry Cancer Center
-
Wynnewood, Pennsylvania, Spojené státy, 19096
- Lankenau Medical Center
-
-
South Carolina
-
Boiling Springs, South Carolina, Spojené státy, 29316
- Prisma Health Cancer Institute - Spartanburg
-
Charleston, South Carolina, Spojené státy, 29425
- Medical University of South Carolina
-
Easley, South Carolina, Spojené státy, 29640
- Prisma Health Cancer Institute - Easley
-
Gaffney, South Carolina, Spojené státy, 29341
- Gibbs Cancer Center-Gaffney
-
Greenville, South Carolina, Spojené státy, 29605
- Prisma Health Cancer Institute - Faris
-
Greenville, South Carolina, Spojené státy, 29607
- Saint Francis Cancer Center
-
Greenville, South Carolina, Spojené státy, 29615
- Prisma Health Cancer Institute - Eastside
-
Greenville, South Carolina, Spojené státy, 29605
- Prisma Health Cancer Institute - Butternut
-
Greenville, South Carolina, Spojené státy, 29601
- Saint Francis Hospital
-
Greenville, South Carolina, Spojené státy, 29605
- Prisma Health Greenville Memorial Hospital
-
Greer, South Carolina, Spojené státy, 29650
- Prisma Health Cancer Institute - Greer
-
Greer, South Carolina, Spojené státy, 29651
- Gibbs Cancer Center-Pelham
-
Seneca, South Carolina, Spojené státy, 29672
- Prisma Health Cancer Institute - Seneca
-
Spartanburg, South Carolina, Spojené státy, 29303
- Spartanburg Medical Center
-
Spartanburg, South Carolina, Spojené státy, 29307
- Spartanburg Medical Center - Mary Black Campus
-
Spartanburg, South Carolina, Spojené státy, 29303
- North Grove Medical Park
-
Union, South Carolina, Spojené státy, 29379
- SMC Center for Hematology Oncology Union
-
-
South Dakota
-
Aberdeen, South Dakota, Spojené státy, 57401
- Avera Cancer Institute-Aberdeen
-
Rapid City, South Dakota, Spojené státy, 57701
- Rapid City Regional Hospital
-
Sioux Falls, South Dakota, Spojené státy, 57105
- Avera Cancer Institute
-
Sioux Falls, South Dakota, Spojené státy, 57117-5134
- Sanford USD Medical Center - Sioux Falls
-
Sioux Falls, South Dakota, Spojené státy, 57104
- Sanford Cancer Center Oncology Clinic
-
-
Tennessee
-
Alcoa, Tennessee, Spojené státy, 37701
- University Cancer Specialists - Alcoa
-
Bristol, Tennessee, Spojené státy, 37620
- Bristol Regional Medical Center
-
Collierville, Tennessee, Spojené státy, 38017
- Baptist Memorial Hospital and Cancer Center-Collierville
-
Cookeville, Tennessee, Spojené státy, 38501
- Cookeville Regional Medical Center
-
Kingsport, Tennessee, Spojené státy, 37660
- Ballad Health Cancer Care - Kingsport
-
Kingsport, Tennessee, Spojené státy, 37660
- Wellmont Holston Valley Hospital and Medical Center
-
Knoxville, Tennessee, Spojené státy, 37920
- University of Tennessee - Knoxville
-
Memphis, Tennessee, Spojené státy, 38120
- Baptist Memorial Hospital and Cancer Center-Memphis
-
-
Texas
-
Austin, Texas, Spojené státy, 78701
- Dell Seton Medical Center at The University of Texas
-
Bryan, Texas, Spojené státy, 77802
- Saint Joseph Regional Cancer Center
-
Dallas, Texas, Spojené státy, 75235
- Parkland Memorial Hospital
-
Dallas, Texas, Spojené státy, 75390
- UT Southwestern/Simmons Cancer Center-Dallas
-
Dallas, Texas, Spojené státy, 75237
- UT Southwestern Simmons Cancer Center - RedBird
-
Fort Worth, Texas, Spojené státy, 76104
- UT Southwestern/Simmons Cancer Center-Fort Worth
-
Galveston, Texas, Spojené státy, 77555-0565
- University of Texas Medical Branch
-
Houston, Texas, Spojené státy, 77030
- Memorial Hermann Texas Medical Center
-
Laredo, Texas, Spojené státy, 78041
- Doctor's Hospital of Laredo
-
Richardson, Texas, Spojené státy, 75080
- UT Southwestern Clinical Center at Richardson/Plano
-
-
Utah
-
American Fork, Utah, Spojené státy, 84003
- American Fork Hospital / Huntsman Intermountain Cancer Center
-
Cedar City, Utah, Spojené státy, 84720
- Sandra L Maxwell Cancer Center
-
Logan, Utah, Spojené státy, 84321
- Logan Regional Hospital
-
Murray, Utah, Spojené státy, 84107
- Intermountain Medical Center
-
Ogden, Utah, Spojené státy, 84403
- McKay-Dee Hospital Center
-
Provo, Utah, Spojené státy, 84604
- Utah Valley Regional Medical Center
-
Riverton, Utah, Spojené státy, 84065
- Riverton Hospital
-
Salt Lake City, Utah, Spojené státy, 84106
- Utah Cancer Specialists-Salt Lake City
-
Salt Lake City, Utah, Spojené státy, 84143
- LDS Hospital
-
St. George, Utah, Spojené státy, 84770
- Saint George Regional Medical Center
-
-
Vermont
-
Berlin Corners, Vermont, Spojené státy, 05602
- Central Vermont Medical Center/National Life Cancer Treatment
-
Burlington, Vermont, Spojené státy, 05401
- University of Vermont Medical Center
-
Burlington, Vermont, Spojené státy, 05405
- University of Vermont and State Agricultural College
-
-
Virginia
-
Bristol, Virginia, Spojené státy, 24201
- Ballad Health Cancer Care - Bristol
-
Fishersville, Virginia, Spojené státy, 22939
- Augusta Health Center for Cancer and Blood Disorders
-
Lynchburg, Virginia, Spojené státy, 24501
- Centra Alan B Pearson Regional Cancer Center
-
Mechanicsville, Virginia, Spojené státy, 23116
- Bon Secours Memorial Regional Medical Center
-
Midlothian, Virginia, Spojené státy, 23114
- Bon Secours Saint Francis Medical Center
-
Midlothian, Virginia, Spojené státy, 23113
- Bon Secours Westchester Emergency Center
-
Norfolk, Virginia, Spojené státy, 23505
- Bon Secours DePaul Medical Center
-
Norton, Virginia, Spojené státy, 24273
- Ballad Health Cancer Care - Norton
-
Portsmouth, Virginia, Spojené státy, 23707
- Bon Secours Maryview Medical Center
-
Richmond, Virginia, Spojené státy, 23226
- Bon Secours Saint Mary's Hospital
-
Richmond, Virginia, Spojené státy, 23230
- Bon Secours Cancer Institute at Reynolds Crossing
-
Richmond, Virginia, Spojené státy, 23298
- VCU Massey Comprehensive Cancer Center
-
South Hill, Virginia, Spojené státy, 23970
- VCU Community Memorial Health Center
-
Suffolk, Virginia, Spojené státy, 23435
- Bon Secours Health Center at Harbour View
-
-
Washington
-
Aberdeen, Washington, Spojené státy, 98520
- Providence Regional Cancer System-Aberdeen
-
Auburn, Washington, Spojené státy, 98001
- MultiCare Auburn Medical Center
-
Bellevue, Washington, Spojené státy, 98004
- Overlake Medical Center
-
Bellingham, Washington, Spojené státy, 98225
- PeaceHealth Saint Joseph Medical Center
-
Burien, Washington, Spojené státy, 98166
- Saint Anne Hospital
-
Centralia, Washington, Spojené státy, 98531
- Providence Regional Cancer System-Centralia
-
Edmonds, Washington, Spojené státy, 98026
- Swedish Cancer Institute-Edmonds
-
Enumclaw, Washington, Spojené státy, 98022
- Saint Elizabeth Hospital
-
Everett, Washington, Spojené státy, 98201
- Providence Regional Cancer Partnership
-
Federal Way, Washington, Spojené státy, 98003
- Saint Francis Hospital
-
Gig Harbor, Washington, Spojené státy, 98335
- MultiCare Gig Harbor Medical Park
-
Issaquah, Washington, Spojené státy, 98029
- Swedish Cancer Institute-Issaquah
-
Kennewick, Washington, Spojené státy, 99336
- Kadlec Clinic Hematology and Oncology
-
Lacey, Washington, Spojené státy, 98503
- Providence Regional Cancer System-Lacey
-
Lakewood, Washington, Spojené státy, 98499
- Saint Clare Hospital
-
Longview, Washington, Spojené státy, 98632
- PeaceHealth Saint John Medical Center
-
Port Townsend, Washington, Spojené státy, 98368
- Jefferson Healthcare
-
Poulsbo, Washington, Spojené státy, 98370
- Harrison HealthPartners Hematology and Oncology-Poulsbo
-
Puyallup, Washington, Spojené státy, 98372
- MultiCare Good Samaritan Hospital
-
Renton, Washington, Spojené státy, 98055
- Valley Medical Center
-
Seattle, Washington, Spojené státy, 98107
- Swedish Medical Center-Ballard Campus
-
Seattle, Washington, Spojené státy, 98122
- Swedish Medical Center-First Hill
-
Seattle, Washington, Spojené státy, 98104
- Pacific Gynecology Specialists
-
Seattle, Washington, Spojené státy, 98122-5711
- Swedish Medical Center-Cherry Hill
-
Sedro-Woolley, Washington, Spojené státy, 98284
- PeaceHealth United General Medical Center
-
Shelton, Washington, Spojené státy, 98584
- Providence Regional Cancer System-Shelton
-
Silverdale, Washington, Spojené státy, 98383
- Saint Joseph Medical Center Hematology and Oncology - Silverdale
-
Spokane, Washington, Spojené státy, 99204
- MultiCare Deaconess Cancer and Blood Specialty Center - Downtown
-
Spokane, Washington, Spojené státy, 99218
- MultiCare Deaconess Cancer and Blood Specialty Center - North
-
Spokane Valley, Washington, Spojené státy, 99216
- MultiCare Deaconess Cancer and Blood Specialty Center - Valley
-
Tacoma, Washington, Spojené státy, 98405
- Mary Bridge Children's Hospital and Health Center
-
Tacoma, Washington, Spojené státy, 98405
- Northwest Medical Specialties PLLC
-
Tacoma, Washington, Spojené státy, 98405
- MultiCare Tacoma General Hospital
-
Tacoma, Washington, Spojené státy, 98405
- Franciscan Research Center-Northwest Medical Plaza
-
Vancouver, Washington, Spojené státy, 98686
- Legacy Salmon Creek Hospital
-
Vancouver, Washington, Spojené státy, 98664
- PeaceHealth Southwest Medical Center
-
Vancouver, Washington, Spojené státy, 98684
- Legacy Cancer Institute Medical Oncology and Day Treatment
-
Walla Walla, Washington, Spojené státy, 99362
- Providence Saint Mary Regional Cancer Center
-
Yakima, Washington, Spojené státy, 98902
- North Star Lodge Cancer Center at Yakima Valley Memorial Hospital
-
Yelm, Washington, Spojené státy, 98597
- Providence Regional Cancer System-Yelm
-
-
West Virginia
-
Bridgeport, West Virginia, Spojené státy, 26330
- United Hospital Center
-
Charleston, West Virginia, Spojené státy, 25304
- Vandalia Health/CAMC Institute for Academic Medicine
-
Huntington, West Virginia, Spojené státy, 25701
- Edwards Comprehensive Cancer Center
-
Martinsburg, West Virginia, Spojené státy, 25401
- WVUH-Berkely Medical Center
-
Morgantown, West Virginia, Spojené státy, 26506
- West Virginia University Healthcare
-
Parkersburg, West Virginia, Spojené státy, 26101
- Camden Clark Medical Center
-
-
Wisconsin
-
Antigo, Wisconsin, Spojené státy, 54409
- Aspirus Cancer Care-Antigo-Volm Cancer Center
-
Appleton, Wisconsin, Spojené státy, 54911
- ThedaCare Regional Cancer Center
-
Ashland, Wisconsin, Spojené státy, 54806
- Duluth Clinic Ashland
-
Ashland, Wisconsin, Spojené státy, 54806
- Northwest Wisconsin Cancer Center
-
Eau Claire, Wisconsin, Spojené státy, 54701
- Marshfield Medical Center-EC Cancer Center
-
Eau Claire, Wisconsin, Spojené státy, 54701
- HSHS Sacred Heart Hospital
-
Green Bay, Wisconsin, Spojené státy, 54301
- Saint Vincent Hospital Cancer Center Green Bay
-
Green Bay, Wisconsin, Spojené státy, 54303
- Saint Vincent Hospital Cancer Center at Saint Mary's
-
Green Bay, Wisconsin, Spojené státy, 54301
- Bellin Memorial Hospital
-
Madison, Wisconsin, Spojené státy, 53792
- University of Wisconsin Carbone Cancer Center - University Hospital
-
Madison, Wisconsin, Spojené státy, 53715
- SSM Health Dean Medical Group - South Madison Campus
-
Manitowoc, Wisconsin, Spojené státy, 54221
- Holy Family Memorial Hospital
-
Marshfield, Wisconsin, Spojené státy, 54449
- Marshfield Medical Center-Marshfield
-
Medford, Wisconsin, Spojené státy, 54451
- Aspirus Medford Hospital
-
Menomonee Falls, Wisconsin, Spojené státy, 53051
- Froedtert Menomonee Falls Hospital
-
Milwaukee, Wisconsin, Spojené státy, 53226
- Medical College of Wisconsin
-
Minocqua, Wisconsin, Spojené státy, 54548
- Marshfield Medical Center - Minocqua
-
Mukwonago, Wisconsin, Spojené státy, 53149
- ProHealth D N Greenwald Center
-
New Richmond, Wisconsin, Spojené státy, 54017
- Cancer Center of Western Wisconsin
-
Oconomowoc, Wisconsin, Spojené státy, 53066
- ProHealth Oconomowoc Memorial Hospital
-
Oconto Falls, Wisconsin, Spojené státy, 54154
- Saint Vincent Hospital Cancer Center at Oconto Falls
-
Rhinelander, Wisconsin, Spojené státy, 54501
- Aspirus Cancer Care-Rhinelander-James Beck Cancer Center
-
Rice Lake, Wisconsin, Spojené státy, 54868
- Marshfield Medical Center-Rice Lake
-
Sheboygan, Wisconsin, Spojené státy, 53081
- HSHS Saint Nicholas Hospital
-
Stevens Point, Wisconsin, Spojené státy, 54482
- Marshfield Medical Center-River Region at Stevens Point
-
Stevens Point, Wisconsin, Spojené státy, 54481
- Aspirus Cancer Care - Stevens Point
-
Sturgeon Bay, Wisconsin, Spojené státy, 54235-1495
- Saint Vincent Hospital Cancer Center at Sturgeon Bay
-
Waukesha, Wisconsin, Spojené státy, 53188
- UW Cancer Center at ProHealth Care
-
Waukesha, Wisconsin, Spojené státy, 53188
- ProHealth Waukesha Memorial Hospital
-
Wausau, Wisconsin, Spojené státy, 54401
- Aspirus Cancer Care-Wausau
-
West Bend, Wisconsin, Spojené státy, 53095
- Froedtert West Bend Hospital/Kraemer Cancer Center
-
Weston, Wisconsin, Spojené státy, 54476
- Marshfield Medical Center - Weston
-
Wisconsin Rapids, Wisconsin, Spojené státy, 54494
- Aspirus Cancer Care - Wisconsin Rapids
-
-
Wyoming
-
Cheyenne, Wyoming, Spojené státy, 82001
- Cheyenne Regional Medical Center-West
-
Cody, Wyoming, Spojené státy, 82414
- Billings Clinic-Cody
-
Sheridan, Wyoming, Spojené státy, 82801
- Welch Cancer Center
-
-
Kritéria účasti
Kritéria způsobilosti
Kritéria způsobilosti
Věk způsobilý ke studiu
Přijímá zdravé dobrovolníky
Pohlaví způsobilá ke studiu
Popis
Inclusion Criteria:
-
STEP I REGISTRATION CRITERIA
-
Histologically documented renal cell carcinoma with clear cell component, including patients who have sarcomatoid or rhabdoid features
-
Any metastatic disease, including visceral, lymph node, other soft tissue and bone, measurable per RECIST 1.1
-
Measurable disease as defined in the protocol
-
Must be intermediate or poor risk patient per International Metastatic Renal Cell Carcinoma Database (IMDC) criteria (1 or more of the following): Karnofsky performance status [KPS] < 80, < 1 year from diagnosis [including initial nephrectomy] to systemic treatment for metastatic disease, hemoglobin less than lower limit of normal [LLN], corrected calcium concentration greater than upper limit of normal [ULN], absolute neutrophil count greater than ULN, platelet count > ULN)
-
Central nervous system (CNS) disease permitted, if stable and not otherwise causing symptoms or needing active treatment
-
Karnofsky performance status >= 70%
-
No prior treatment with PD-1, PD-L1, or CTLA-4 targeting agents (including but not limited to nivolumab, pembrolizumab, pidilizumab, durvalumab, atezolizumab, tremelimumab, and ipilimumab), or any other drug or antibody specifically targeting T-cell co-stimulation or checkpoint pathways. The only exception is for prior treatment with nivolumab or other PD-1/PD-L1/CTLA-4 targeting therapy on pre- or post-operative trials, as long as > 1 year since completion of systemic therapy
-
No prior previous systemic therapy for renal cell carcinoma (prior HD IL-2 [>28 days]. Prior adjuvant sunitinib >180 days since completion and prior immunotherapy as above are allowed).
-
No systemic cancer therapy less than 28 days prior to registration; no radiation therapy less than 14 days prior to registration. There must be a complete recovery and no ongoing complications from radiotherapy
-
Not pregnant and not nursing, because this study involves an agent that has known genotoxic, mutagenic and teratogenic effects. Therefore, for women of childbearing potential only, a negative serum or urine pregnancy test done =< 14 days prior to registration is required
-
Age >= 18 years
-
None of the following:
- Active autoimmune disease requiring ongoing therapy
- Ongoing acute toxicity > grade 2 from previous treatment
- History of severe allergic, anaphylactic or other hypersensitivity reactions to chimeric or humanized antibodies
- Active hepatitis B/C, or active tuberculosis (purified protein derivative [PPD] response without active tuberculosis [TB] is allowed)
- HIV-infected patients with detectable viral load within 6 months prior to registration. Patients on effective anti-retroviral therapy with undetectable viral load within 6 months prior to registration are eligible
- Concurrent use of immunosuppressive medication including prednisone above 10 mg daily
- Uncontrolled adrenal insufficiency
- Uncontrolled hypertension (systolic blood pressure [BP] > 150mmHg or diastolic BP > 90mmHg)
- Major surgery less than 28 days prior to registration
- Any serious non-healing wound, ulcer, or bone fracture within 28 days prior to registration
- Any arterial thrombotic events within 180 days prior to registration
- Clinically significant hematuria, hematemesis, or hemoptysis within 12 weeks prior to registration
- Cavitating pulmonary lesions or known endotracheal or endobronchial disease manifestations
- Lesions encasing or invading any major blood vessels (this does not include tumor thrombus extending into/through renal vein/inferior vena cava [IVC]). Patients with tumor thrombus extending into/through renal vein are considered eligible
- Moderate of severe hepatic impairment (child-Pugh B or C)
- Any history of untreated pulmonary embolism or deep venous thrombosis (DVT) in the 180 days prior to registration. (Any asymptomatic, treated pulmonary embolism or asymptomatic, treated deep venous thrombosis > 30 days prior to registration allowed)
- Corrected QT interval calculated by the Fridericia formula (QTcF) > 500 ms
- Unstable cardiac arrhythmia within 6 months prior to registration
- Any gastrointestinal (GI) bleeding =< 180 days, hemoptysis, or other signs of pulmonary hemorrhage =< 90 days prior to registration
- History of abdominal fistula, gastrointestinal perforation, intra-abdominal abscess, bowel obstruction, or gastric outlet obstruction within 180 days prior to registration
- Active peptic ulcer disease, inflammatory bowel disease, or malabsorption syndrome within 28 days prior to registration
- Untreated hypothyroidism (treated hypothyroidism on thyroid replacement therapy is allowed. Abnormal thyroid-stimulating hormone [TSH] is acceptable with normal T3/free T4 if treated on thyroid replacement therapy)
- Evidence of pancreatitis, history of organ transplant, or history of congenital QT syndrome
- Active treatment with coumarin agents (e.g., warfarin), direct thrombin inhibitors (e.g., dabigatran), direct Xa inhibitor betrixaban or platelet inhibitors (e.g., clopidogrel) within 5 days of registration Allowed anticoagulants include: prophylactic use of low-dose aspirin for cardio-protection (per local applicable guidelines) and low-dose low molecular weight heparins (LMWH), therapeutic doses of LMWH or anticoagulation with direct factor Xa inhibitors rivaroxaban, edoxaban, apixaban. Allowed also in patients with known brain metastases who are on a stable dose of the anticoagulant for at least 1 week prior to registration without clinically significant hemorrhagic complications from the anticoagulation regimen or the tumor
- Significant cardiac ischemia events (ST elevation myocardial infarction [STEMI] or non-ST-elevation myocardial infarction [NSTEMI]) within 6 months or active New York (NY) Heart Association class 3-4 heart failure symptoms
-
Absolute neutrophil count (ANC) >= 1,500/mm^3
-
Platelet count >= 100,000/mm^3
-
Hemoglobin >= 8 g/dL
-
Calculated (Calc.) creatinine clearance >= 30 mL/min
-
Urine protein =< 1+ or urine protein to creatinine (UPC) ratio < 1
-
Total bilirubin =< 1.5 x upper limit of normal (ULN) (except for patients with known or likely Gilbert's syndrome, for whom total bilirubin up to 3 mg/dL is allowed with direct bilirubin =< 20% total bilirubin)
-
Aspartate aminotransferase/alanine aminotransferase (AST/ALT) =< 2.5 x upper limit of normal (ULN) or < 5 x ULN if hepatic metastases present
-
STEP 2 REGISTRATION ELIGIBILITY CRITERIA
-
Successful completion of at least 1 cycle of ipilimumab/nivolumab
-
Resolution of any treatment-related adverse events to grade 1 or less per dose modification section (this criteria does not include any adverse events [AEs] not attributable to treatment which are present due to disease), with prednisone-equivalent dosing at 10 mg daily or less. Exceptions for this criteria include patients receiving replacement hormone treatments (such as levothyroxine for treatment-related hypothyroidism or glucocorticoid replacement for adrenal insufficiency). Please contact study chair if further discussion is needed
-
No more than 80 days from last dose of ipilimumab/nivolumab
Studijní plán
Jak je studie koncipována?
Detaily designu
- Primární účel: Léčba
- Přidělení: Randomizované
- Intervenční model: Paralelní přiřazení
- Maskování: Žádné (otevřený štítek)
Počet zbraní
Zbraně a zásahy
Skupina účastníků / ArmSkupina účastníků / Arm |
Intervence / LéčbaIntervence / Léčba |
|---|---|
|
Aktivní komparátor: Arm A (nivolumab)
INDUCTION: Patients receive nivolumab IV over 30 minutes and ipilimumab IV over 30 minutes on day 1. Treatment repeats every 21 days for up to 4 cycles in the absence of disease progression or unacceptable toxicity. TREATMENT: Patients with iuPD with clinical instability receive cabozantinib PO daily on days 1-28. Treatment repeats every 28 days until further disease progression or unacceptable toxicity Patients with iCR receive nivolumab IV over 30 minutes on day 1. Treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity. Patients with non-CR/non-PD with clinical stability receive nivolumab IV over 30 minutes on day 1. Treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity. Patients undergo CT scan, MRI and blood and urine sample collection, and may also undergo a bone scan as clinically indicated throughout the study. |
Ancillary studies
Ostatní jména:
Given IV
Ostatní jména:
Undergo MRI
Ostatní jména:
Ancillary studies Given IV
Ostatní jména:
Undergo CT scan
Ostatní jména:
Undergo bone scan
Ostatní jména:
Undergo blood and urine sample collection
Ostatní jména:
|
|
Experimentální: Arm B (nivolumab, cabozantinib)
INDUCTION: Patients receive nivolumab IV over 30 minutes and ipilimumab IV over 30 minutes on day 1. Treatment repeats every 21 days for up to 4 cycles in the absence of disease progression or unacceptable toxicity. TREATMENT: Patients with iuPD with clinical instability receive cabozantinib PO daily on days 1-28. Treatment repeats every 28 days until further disease progression or unacceptable toxicity. Patients with iCR receive nivolumab IV over 30 minutes on day 1. Treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity. Patients with non-CR/non-PD rwith clinical stability eceive nivolumab IV over 30 minutes on day 1 and cabozantinib PO daily on days 1-28. Treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity. Patients undergo CT scan, MRI and blood and urine sample collection, and may also undergo a bone scan as clinically indicated throughout the study. |
Ancillary studies
Ostatní jména:
Given IV
Ostatní jména:
Undergo MRI
Ostatní jména:
Ancillary studies Given IV
Ostatní jména:
Undergo CT scan
Ostatní jména:
Undergo blood and urine sample collection
Ostatní jména:
Given PO |
Co je měření studie?
Primární výstupní opatření
Primární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
|
Overall survival (OS)
Časové okno: From registration to date of death from any cause for non-randomized patients, from time of randomization until death from any cause for randomized patients, assessed up to 5 years
|
OS of patients who achieve complete response (CR) and progressive disease (PD) from ipilimumab-nivolumab induction phase will be summarized. The stratified log-rank statistic will be the primary analysis to compare the hypothesis on OS with the stratification factors (presence of bone metastases and IMDC risk criteria). The Kaplan-Meier product-limit estimator will be used to estimate the OS. A stratified proportional hazards model will be used to generate estimates for the OS hazard ratio. For the randomized patients, OS will be calculated and compared from the time of randomization until the time of an OS event or time of last-follow-up, whatever occurs first. For the patients who were initially CR or PD, OS will be measured from the time of study registration. A comparison of OS will be made across the patient groups (randomized patients, patients initially CR, and patients initially PD). |
From registration to date of death from any cause for non-randomized patients, from time of randomization until death from any cause for randomized patients, assessed up to 5 years
|
Sekundární výstupní opatření
Sekundární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
|
Progression-free survival (PFS)
Časové okno: From date of registration to date of progression (or disease recurrence) or death due to any cause, whichever occurs first, assessed up to 5 years
|
Progression will be defined using the Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 criteria. PFS of patients who achieve CR and PD from ipilimumab-nivolumab induction phase will be summarized (secondary analysis). The Kaplan-Meier product-limit estimator will be used to estimate the PFS distribution. A stratified proportional hazards model will be used to generate estimates for the PFS hazard ratio. For the randomized patients, PFS will be calculated and compared from the time of randomization until the time of a PFS event or time of last-follow-up, whatever occurs first. For the patients who were initially CR or PD, PFS will be measured from the time of study registration. A comparison of PFS will be made across the patient groups (randomized patients, patients initially CR, and patients initially PD). For this comparison, PFS will be measured from time of study registration all the patients, regardless of whether they were randomized or not. |
From date of registration to date of progression (or disease recurrence) or death due to any cause, whichever occurs first, assessed up to 5 years
|
|
Complete response (CR) (randomized patients)
Časové okno: At 12 months from date of randomization
|
Patients who had a CR prior to 12 months but have experienced a disease recurrence prior to 12 months, will not be considered to be a CR at 12 months. The Cochran-Mantel-Haenszel test will be used to compare the two arms on the proportion of patients who have a 12-month CR adjusting on the stratification factors. |
At 12 months from date of randomization
|
|
Objective response
Časové okno: Up to 5 years
|
Defined as the best response observed that has been confirmed by a scan performed 4 or more weeks after the observation of the initial response. The objective response will be confirmed using RECIST 1.1. In addition, objective responses will also be confirmed using Immune Response Evaluation Criteria in Solid Tumors (iRECIST). |
Up to 5 years
|
|
Proportion of patients who discontinue protocol-directed treatment prior to 1 year from date of study registration
Časové okno: Up to 5 years
|
Patients who stop their protocol directed treatment for any reason prior to one year from study registration will be considered to have discontinued their treatment. The Cochran-Mantel-Haenszel test will also be used to compare the proportion of patients who discontinue their treatment prior to one-year after study registration. |
Up to 5 years
|
|
Incidence of adverse events
Časové okno: Up to 5 years
|
Assessed with National Cancer Institute Common Terminology Criteria for Adverse Events version 5.0. A Fisher's exact test will be used to compare the two treatment arms on the proportion of patient with a grade 3 or higher adverse event. |
Up to 5 years
|
Další výstupní opatření
Další výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
|
Estimates of OS by sex
Časové okno: From registration to date of death from any cause for non-randomized patients, from time of randomization until death from any cause for randomized patients, assessed up to 5 years
|
Estimates of OS and the corresponding 95% confidence intervals (CIs) by sex will be provided (with an understanding that sometimes the CI or estimate will not be computable because of scant data). |
From registration to date of death from any cause for non-randomized patients, from time of randomization until death from any cause for randomized patients, assessed up to 5 years
|
|
Estimates of OS by race
Časové okno: From registration to date of death from any cause for non-randomized patients, from time of randomization until death from any cause for randomized patients, assessed up to 5 years
|
Estimates of OS and the corresponding 95% CIs by race will be provided (with an understanding that sometimes the CI or estimate will not be computable because of scant data). |
From registration to date of death from any cause for non-randomized patients, from time of randomization until death from any cause for randomized patients, assessed up to 5 years
|
|
Estimates of OS by ethnicity
Časové okno: From registration to date of death from any cause for non-randomized patients, from time of randomization until death from any cause for randomized patients, assessed up to 5 years
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Estimates of OS and the corresponding 95% CIs by ethnicity will be provided (with an understanding that sometimes the CI or estimate will not be computable because of scant data). |
From registration to date of death from any cause for non-randomized patients, from time of randomization until death from any cause for randomized patients, assessed up to 5 years
|
Spolupracovníci a vyšetřovatelé
Sponzor
Sponzor
Vyšetřovatelé
Vyšetřovatelé
- Vrchní vyšetřovatel: Tian Zhang, Alliance for Clinical Trials in Oncology
Publikace a užitečné odkazy
Obecné publikace
- Yang Y, Psutka SP, Parikh AB, Li M, Collier K, Miah A, Mori SV, Hinkley M, Tykodi SS, Hall E, Thompson JA, Yin M. Combining immune checkpoint inhibition plus tyrosine kinase inhibition as first and subsequent treatments for metastatic renal cell carcinoma. Cancer Med. 2022 Aug;11(16):3106-3114. doi: 10.1002/cam4.4679. Epub 2022 Mar 18.
- Labriola MK, George DJ. Setting a new standard for long-term survival in metastatic kidney cancer. Cancer. 2022 Jun 1;128(11):2058-2060. doi: 10.1002/cncr.34177. Epub 2022 Apr 5. No abstract available.
Termíny studijních záznamů
Hlavní termíny studia
Začátek studia (Aktuální)
Začátek studia
Primární dokončení (Odhadovaný)
Primární dokončení
Dokončení studie (Odhadovaný)
Dokončení studie
Termíny zápisu do studia
První předloženo
První předloženo
První předloženo, které splnilo kritéria kontroly kvality
První předloženo, které splnilo kritéria kontroly kvality
První zveřejněno (Aktuální)
První zveřejněno
Aktualizace studijních záznamů
Poslední zveřejněná aktualizace (Aktuální)
Poslední zveřejněná aktualizace
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Naposledy ověřeno
Naposledy ověřeno
Více informací
Termíny související s touto studií
Další relevantní podmínky MeSH
- Urogenitální onemocnění
- Patologické procesy
- Urogenitální novotvary
- Novotvary podle místa
- Novotvary
- Mužská urogenitální onemocnění
- Onemocnění ledvin
- Urologická onemocnění
- Ženské urogenitální onemocnění
- Ženské urogenitální onemocnění a těhotenské komplikace
- Novotvary podle histologického typu
- Novotvary, žlázové a epiteliální
- Adenokarcinom
- Neoplastické procesy
- Urologické novotvary
- Karcinom
- Novotvary ledvin
- Metastáza novotvaru
- Patologické stavy, příznaky a symptomy
- Karcinom, renální buňka
- Lymfatické metastázy
- Aminokyseliny, peptidy a proteiny
- Proteiny
- Vyšetřovací techniky
- Klinické laboratorní techniky
- Diagnostické techniky a postupy
- Diagnóza
- Biologické faktory
- Protilátky, monoklonální, humanizované
- Protilátky, monoklonální
- Protilátky
- Imunoglobuliny
- Imunoproteiny
- Krevní proteiny
- Sérové globuliny
- Globuliny
- Techniky chemie, analytické
- Analýza spektra
- Receptory, buněčný povrch
- Membránové proteiny
- Antigeny
- Antigeny, povrch
- Biomarkery
- Receptory, imunologické
- Antigeny, diferenciace, t-lymfocyt
- Antigeny, diferenciace
- Proteiny imunitního kontrolního bodu
- Kostimulační a inhibiční receptory T-buněk
- Nivolumab
- Ipilimumab
- Manipulace se vzorkem
- Magnetická rezonanční spektroskopie
- Cabozantinib
- Antigen CTLA-4
Další identifikační čísla studie
Další identifikační čísla studie
- NCI-2018-03694
- U10CA180821 (Grant/smlouva NIH USA)
- NCI-2018-03694 (Identifikátor registru: CTRP (Clinical Trial Reporting Program))
- A031704 (Jiný identifikátor: CTEP)
- A031704 (Jiný identifikátor: Alliance for Clinical Trials in Oncology)
Plán pro data jednotlivých účastníků (IPD)
Plánujete sdílet data jednotlivých účastníků (IPD)?
Popis plánu IPD
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
Informace o lécích a zařízeních, studijní dokumenty
Studuje lékový produkt regulovaný americkým FDA
Studuje produkt zařízení regulovaný americkým úřadem FDA
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