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Everolimus med eller uden bevacizumab til behandling af patienter med avanceret nyrekræft, der udviklede sig efter førstelinjebehandling

5. marts 2019 opdateret af: National Cancer Institute (NCI)

Randomiseret fase III-forsøg, der sammenligner Everolimus versus Everolimus Plus Bevacizumab for avanceret nyrecellekarcinom, der skrider frem efter behandling med tyrosinkinasehæmmere

Dette randomiserede fase III-forsøg giver everolimus sammen med bevacizumab for at se, hvor godt det virker sammenlignet med everolimus alene til behandling af patienter med fremskreden nyrekræft, som udviklede sig efter førstelinjebehandling. Everolimus kan stoppe væksten af ​​tumorceller ved at blokere nogle af de enzymer, der er nødvendige for cellevækst. Monoklonale antistoffer, såsom bevacizumab, kan interferere med tumorvækst ved at blokere tumorcellernes evne til at vokse og sprede sig. Everolimus og bevacizumab kan også stoppe væksten af ​​nyrekræft ved at blokere blodtilførslen til tumoren. Det vides endnu ikke, om det er bedre at give everolimus sammen med bevacizumab end everolimus alene til behandling af patienter med fremskreden nyrekræft, som er udviklet efter førstelinjebehandling.

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

PRIMÆRE MÅL:

l. At sammenligne den samlede overlevelse af patienter, der får bevacizumab plus everolimus og everolimus alene, blandt patienter med fremskreden nyrecellekarcinom, der udvikler sig efter førstelinjebehandling af vaskulær epidermal vækstfaktorreceptor (VEGFR)-tyrosinkinasehæmmer (TKI).

SEKUNDÆRE MÅL:

I. At sammenligne den progressionsfrie overlevelse og andel, der oplever en objektiv respons (defineret som fuldstændig klinisk respons [cCR] + delvis respons [PR]) hos patienter med fremskreden nyrecellekarcinom, der får bevacizumab plus everolimus og everolimus alene.

II. For at sammenligne grad 3 eller højere toksicitet hos patienter, der får hvert behandlingsregime.

OVERSIGT: Patienterne randomiseres til 1 ud af 2 behandlingsarme.

ARM I: Patienter får everolimus oralt (PO) én gang dagligt (QD) på dag 1-28.

ARM II: Patienter får everolimus PO QD på dag 1-28 og bevacizumab intravenøst ​​(IV) over 30-90 minutter på dag 1 og 15.

I begge arme gentages kurser hver 28. dag i fravær af sygdomsprogression eller uacceptabel toksicitet.

Efter afslutning af undersøgelsesbehandlingen følges patienterne op hver 8. uge indtil sygdomsprogression og derefter hver 6. måned i op til 5,5 år.

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

77

Fase

  • Fase 3

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

  • Forenede Stater
    • Arizona
      • Scottsdale, Arizona, Forenede Stater, 85259
        • Mayo Clinic in Arizona
    • Arkansas
      • Jonesboro, Arkansas, Forenede Stater, 72401
        • Fowler Family Center for Cancer Care
      • Little Rock, Arkansas, Forenede Stater, 72205
        • University of Arkansas for Medical Sciences
    • California
      • Anaheim, California, Forenede Stater, 92806
        • Kaiser Permanente-Anaheim
      • Antioch, California, Forenede Stater, 94531
        • Kaiser Permanente-Deer Valley Medical Center
      • Arroyo Grande, California, Forenede Stater, 93420
        • PCR Oncology
      • Baldwin Park, California, Forenede Stater, 91706
        • Kaiser Permanente-Baldwin Park
      • Bellflower, California, Forenede Stater, 90706
        • Kaiser Permanente-Bellflower
      • Berkeley, California, Forenede Stater, 94704
        • Alta Bates Summit Medical Center-Herrick Campus
      • Burlingame, California, Forenede Stater, 94010
        • Mills-Peninsula Medical Center
      • Castro Valley, California, Forenede Stater, 94546
        • East Bay Radiation Oncology Center
      • Castro Valley, California, Forenede Stater, 94546
        • Valley Medical Oncology Consultants-Castro Valley
      • Emeryville, California, Forenede Stater, 94608
        • Bay Area Breast Surgeons Inc
      • Emeryville, California, Forenede Stater, 94608
        • Epic Care Partners in Cancer Care
      • Fontana, California, Forenede Stater, 92335
        • Kaiser Permanente-Fontana
      • Fremont, California, Forenede Stater, 94538
        • Kaiser Permanente-Fremont
      • Fremont, California, Forenede Stater, 94538
        • Valley Medical Oncology Consultants-Fremont
      • Fresno, California, Forenede Stater, 93720
        • Kaiser Permanente-Fresno
      • Harbor City, California, Forenede Stater, 90710
        • Kaiser Permanente - Harbor City
      • Irvine, California, Forenede Stater, 92618
        • Kaiser Permanente-Irvine
      • La Jolla, California, Forenede Stater, 92093
        • UC San Diego Moores Cancer Center
      • Los Angeles, California, Forenede Stater, 90027
        • Kaiser Permanente Los Angeles Medical Center
      • Los Angeles, California, Forenede Stater, 90034
        • Kaiser Permanente-Cadillac
      • Martinez, California, Forenede Stater, 94553-3156
        • Contra Costa Regional Medical Center
      • Modesto, California, Forenede Stater, 95355
        • Memorial Medical Center
      • Mountain View, California, Forenede Stater, 94040
        • El Camino Hospital
      • Novato, California, Forenede Stater, 94945
        • Sutter Cancer Research Consortium
      • Oakland, California, Forenede Stater, 94611
        • Kaiser Permanente-Oakland
      • Oakland, California, Forenede Stater, 94611
        • Kaiser Permanente Oakland-Broadway
      • Oakland, California, Forenede Stater, 94609
        • Alta Bates Summit Medical Center - Summit Campus
      • Oakland, California, Forenede Stater, 94609
        • Hematology and Oncology Associates-Oakland
      • Oakland, California, Forenede Stater, 94602
        • Highland General Hospital
      • Oakland, California, Forenede Stater, 94609
        • Tom K Lee Inc
      • Oakland, California, Forenede Stater, 94609
        • Bay Area Tumor Institute
      • Panorama City, California, Forenede Stater, 91402
        • Kaiser Permanente - Panorama City
      • Rancho Cordova, California, Forenede Stater, 95670
        • Kaiser Permanente-Rancho Cordova Cancer Center
      • Redwood City, California, Forenede Stater, 94063
        • Kaiser Permanente-Redwood City
      • Richmond, California, Forenede Stater, 94801
        • Kaiser Permanente-Richmond
      • Riverside, California, Forenede Stater, 92505
        • Kaiser Permanente-Riverside
      • Rohnert Park, California, Forenede Stater, 94928
        • Rohnert Park Cancer Center
      • Roseville, California, Forenede Stater, 95678
        • The Permanente Medical Group-Roseville Radiation Oncology
      • Roseville, California, Forenede Stater, 95661
        • Kaiser Permanente-Roseville
      • Sacramento, California, Forenede Stater, 95823
        • Kaiser Permanente-South Sacramento
      • Sacramento, California, Forenede Stater, 95823
        • South Sacramento Cancer Center
      • Sacramento, California, Forenede Stater, 95825
        • Kaiser Permanente - Sacramento
      • San Diego, California, Forenede Stater, 92120
        • Kaiser Permanente-San Diego Zion
      • San Diego, California, Forenede Stater, 92108
        • Kaiser Permanente-San Diego Mission
      • San Francisco, California, Forenede Stater, 94115
        • Kaiser Permanente-San Francisco
      • San Francisco, California, Forenede Stater, 94115
        • California Pacific Medical Center-Pacific Campus
      • San Francisco, California, Forenede Stater, 94115
        • UCSF Medical Center-Mount Zion
      • San Francisco, California, Forenede Stater, 94110
        • Zuckerberg San Francisco General Hospital
      • San Jose, California, Forenede Stater, 95119
        • Kaiser Permanente-Santa Teresa-San Jose
      • San Leandro, California, Forenede Stater, 94577
        • Kaiser Permanente San Leandro
      • San Marcos, California, Forenede Stater, 92078
        • Kaiser Permanente-San Marcos
      • San Pablo, California, Forenede Stater, 94806
        • Doctors Medical Center- JC Robinson Regional Cancer Center
      • San Rafael, California, Forenede Stater, 94903
        • Kaiser Permanente-San Rafael
      • Santa Clara, California, Forenede Stater, 95051
        • Kaiser Permanente Medical Center - Santa Clara
      • Santa Rosa, California, Forenede Stater, 95403
        • Kaiser Permanente-Santa Rosa
      • Santa Rosa, California, Forenede Stater, 95403
        • Sutter Pacific Medical Foundation
      • South San Francisco, California, Forenede Stater, 94080
        • Kaiser Permanente Cancer Treatment Center
      • South San Francisco, California, Forenede Stater, 94080
        • Kaiser Permanente-South San Francisco
      • Stockton, California, Forenede Stater, 95210
        • Kaiser Permanente-Stockton
      • Vacaville, California, Forenede Stater, 95688
        • Kaiser Permanente Medical Center-Vacaville
      • Vallejo, California, Forenede Stater, 94589
        • Kaiser Permanente-Vallejo
      • Vallejo, California, Forenede Stater, 94589
        • Sutter Solano Medical Center/Cancer Center
      • Walnut Creek, California, Forenede Stater, 94596
        • Kaiser Permanente-Walnut Creek
      • Woodland Hills, California, Forenede Stater, 91367
        • Kaiser Permanente-Woodland Hills
    • Colorado
      • Aurora, Colorado, Forenede Stater, 80012
        • The Medical Center of Aurora
      • Boulder, Colorado, Forenede Stater, 80301
        • Boulder Community Hospital
      • Colorado Springs, Colorado, Forenede Stater, 80907
        • Penrose-Saint Francis Healthcare
      • Denver, Colorado, Forenede Stater, 80210
        • Porter Adventist Hospital
      • Denver, Colorado, Forenede Stater, 80205
        • Kaiser Permanente-Franklin
      • Denver, Colorado, Forenede Stater, 80218
        • Presbyterian - Saint Lukes Medical Center - Health One
      • Denver, Colorado, Forenede Stater, 80218
        • SCL Health Saint Joseph Hospital
      • Denver, Colorado, Forenede Stater, 80220
        • Rose Medical Center
      • Denver, Colorado, Forenede Stater, 80222
        • Colorado Cancer Research Program NCORP
      • Englewood, Colorado, Forenede Stater, 80113
        • Swedish Medical Center
      • Fort Collins, Colorado, Forenede Stater, 80524
        • Poudre Valley Hospital
      • Grand Junction, Colorado, Forenede Stater, 81501
        • Saint Mary's Hospital and Regional Medical Center
      • Greeley, Colorado, Forenede Stater, 80631
        • North Colorado Medical Center
      • Lafayette, Colorado, Forenede Stater, 80026
        • Kaiser Permanente-Rock Creek
      • Lakewood, Colorado, Forenede Stater, 80228
        • Saint Anthony Hospital
      • Littleton, Colorado, Forenede Stater, 80122
        • Littleton Adventist Hospital
      • Lone Tree, Colorado, Forenede Stater, 80124
        • Sky Ridge Medical Center
      • Longmont, Colorado, Forenede Stater, 80501
        • Longmont United Hospital
      • Loveland, Colorado, Forenede Stater, 80539
        • McKee Medical Center
      • Parker, Colorado, Forenede Stater, 80138
        • Parker Adventist Hospital
      • Pueblo, Colorado, Forenede Stater, 81004
        • Saint Mary Corwin Medical Center
      • Thornton, Colorado, Forenede Stater, 80229
        • North Suburban Medical Center
      • Wheat Ridge, Colorado, Forenede Stater, 80033
        • SCL Health Lutheran Medical Center
    • Connecticut
      • Hartford, Connecticut, Forenede Stater, 06102
        • Hartford Hospital
      • New Britain, Connecticut, Forenede Stater, 06050
        • The Hospital of Central Connecticut
      • Norwich, Connecticut, Forenede Stater, 06360
        • Eastern Connecticut Hematology and Oncology Associates
      • Stamford, Connecticut, Forenede Stater, 06904
        • Stamford Hospital/Bennett Cancer Center
    • Delaware
      • Lewes, Delaware, Forenede Stater, 19958
        • Beebe Medical Center
      • Newark, Delaware, Forenede Stater, 19718
        • Christiana Care Health System-Christiana Hospital
    • District of Columbia
      • Washington, District of Columbia, Forenede Stater, 20010
        • Medstar Washington Hospital Center
      • Washington, District of Columbia, Forenede Stater, 20007
        • MedStar Georgetown University Hospital
      • Washington, District of Columbia, Forenede Stater, 20016
        • Sibley Memorial Hospital
    • Florida
      • Fort Lauderdale, Florida, Forenede Stater, 33308
        • Holy Cross Hospital
      • Jupiter, Florida, Forenede Stater, 33458
        • Jupiter Medical Center
      • Miami Beach, Florida, Forenede Stater, 33140
        • Mount Sinai Medical Center
      • Orange Park, Florida, Forenede Stater, 32073
        • 21st Century Oncology-Orange Park
      • Orlando, Florida, Forenede Stater, 32803
        • Florida Hospital Orlando
      • Orlando, Florida, Forenede Stater, 32806
        • UF Cancer Center at Orlando Health
      • Pensacola, Florida, Forenede Stater, 32504
        • Sacred Heart Hospital
      • Weston, Florida, Forenede Stater, 33331
        • Cleveland Clinic-Weston
    • Georgia
      • Albany, Georgia, Forenede Stater, 31701
        • Phoebe Putney Memorial Hospital
      • Macon, Georgia, Forenede Stater, 31201
        • Medical Center of Central Georgia
      • Savannah, Georgia, Forenede Stater, 31404
        • Memorial Health University Medical Center
    • Hawaii
      • 'Aiea, Hawaii, Forenede Stater, 96701
        • Pali Momi Medical Center
      • Honolulu, Hawaii, Forenede Stater, 96813
        • Queen's Medical Center
      • Honolulu, Hawaii, Forenede Stater, 96817
        • The Cancer Center of Hawaii-Liliha
      • Honolulu, Hawaii, Forenede Stater, 96813
        • Straub Clinic and Hospital
      • Honolulu, Hawaii, Forenede Stater, 96813
        • University of Hawaii Cancer Center
      • Honolulu, Hawaii, Forenede Stater, 96826
        • Kapiolani Medical Center for Women and Children
      • Honolulu, Hawaii, Forenede Stater, 96819
        • Kaiser Permanente Moanalua Medical Center
      • Honolulu, Hawaii, Forenede Stater, 96813
        • Hawaii Cancer Care Inc-POB II
      • Honolulu, Hawaii, Forenede Stater, 96817
        • Hawaii Oncology Inc-Kuakini
      • Kailua, Hawaii, Forenede Stater, 96734
        • Castle Medical Center
      • Lihue, Hawaii, Forenede Stater, 96766
        • Wilcox Memorial Hospital and Kauai Medical Clinic
      • Wailuku, Hawaii, Forenede Stater, 96793
        • Maui Memorial Medical Center
      • Wailuku, Hawaii, Forenede Stater, 96793
        • Pacific Cancer Institute of Maui
    • Idaho
      • Boise, Idaho, Forenede Stater, 83712
        • Saint Luke's Mountain States Tumor Institute
      • Fruitland, Idaho, Forenede Stater, 83619
        • Saint Luke's Mountain States Tumor Institute - Fruitland
      • Meridian, Idaho, Forenede Stater, 83642
        • Saint Luke's Mountain States Tumor Institute - Meridian
      • Nampa, Idaho, Forenede Stater, 83686
        • Saint Luke's Mountain States Tumor Institute - Nampa
      • Twin Falls, Idaho, Forenede Stater, 83301
        • Saint Luke's Mountain States Tumor Institute-Twin Falls
    • Illinois
      • Bloomington, Illinois, Forenede Stater, 61704
        • Illinois CancerCare-Bloomington
      • Bloomington, Illinois, Forenede Stater, 61701
        • Saint Joseph Medical Center
      • Canton, Illinois, Forenede Stater, 61520
        • Illinois CancerCare-Canton
      • Canton, Illinois, Forenede Stater, 61520
        • Graham Hospital Association
      • Carthage, Illinois, Forenede Stater, 62321
        • Illinois CancerCare-Carthage
      • Carthage, Illinois, Forenede Stater, 62321
        • Memorial Hospital
      • Chicago, Illinois, Forenede Stater, 60637
        • University of Chicago Comprehensive Cancer Center
      • Chicago, Illinois, Forenede Stater, 60612
        • University of Illinois
      • Chicago, Illinois, Forenede Stater, 60612
        • John H Stroger Jr Hospital of Cook County
      • Chicago, Illinois, Forenede Stater, 60631
        • Presence Resurrection Medical Center
      • Chicago, Illinois, Forenede Stater, 60640
        • Weiss Memorial Hospital
      • Chicago, Illinois, Forenede Stater, 60612
        • Jesse Brown Veterans Affairs Medical Center
      • Decatur, Illinois, Forenede Stater, 62526
        • Decatur Memorial Hospital
      • Decatur, Illinois, Forenede Stater, 62526
        • Heartland Cancer Research NCORP
      • Eureka, Illinois, Forenede Stater, 61530
        • Illinois CancerCare-Eureka
      • Eureka, Illinois, Forenede Stater, 61530
        • Eureka Hospital
      • Galesburg, Illinois, Forenede Stater, 61401
        • Illinois CancerCare-Galesburg
      • Havana, Illinois, Forenede Stater, 62644
        • Mason District Hospital
      • Havana, Illinois, Forenede Stater, 62644
        • Illinois CancerCare-Havana
      • Kankakee, Illinois, Forenede Stater, 60901
        • Presence Saint Mary's Hospital
      • Kewanee, Illinois, Forenede Stater, 61443
        • Illinois CancerCare-Kewanee Clinic
      • La Grange, Illinois, Forenede Stater, 60525
        • AMITA Health Adventist Medical Center
      • Macomb, Illinois, Forenede Stater, 61455
        • Illinois CancerCare-Macomb
      • Macomb, Illinois, Forenede Stater, 61455
        • Mcdonough District Hospital
      • Maywood, Illinois, Forenede Stater, 60153
        • Loyola University Medical Center
      • Monmouth, Illinois, Forenede Stater, 61462
        • Illinois CancerCare-Monmouth
      • Monmouth, Illinois, Forenede Stater, 61462
        • Holy Family Medical Center
      • Mount Vernon, Illinois, Forenede Stater, 62864
        • Good Samaritan Regional Health Center
      • Normal, Illinois, Forenede Stater, 61761
        • Community Cancer Center Foundation
      • Normal, Illinois, Forenede Stater, 61761
        • Bromenn Regional Medical Center
      • Normal, Illinois, Forenede Stater, 61761
        • Illinois CancerCare-Community Cancer Center
      • Oak Lawn, Illinois, Forenede Stater, 60453-2699
        • Advocate Christ Medical Center
      • Ottawa, Illinois, Forenede Stater, 61350
        • Illinois CancerCare-Ottawa Clinic
      • Ottawa, Illinois, Forenede Stater, 61350
        • Ottawa Regional Hospital and Healthcare Center
      • Pekin, Illinois, Forenede Stater, 61554
        • Illinois CancerCare-Pekin
      • Pekin, Illinois, Forenede Stater, 61554
        • OSF Saint Francis Radiation Oncology at Pekin Cancer Treatment Center
      • Peoria, Illinois, Forenede Stater, 61636
        • Methodist Medical Center of Illinois
      • Peoria, Illinois, Forenede Stater, 61637
        • OSF Saint Francis Medical Center
      • Peoria, Illinois, Forenede Stater, 61615
        • Illinois CancerCare-Peoria
      • Peoria, Illinois, Forenede Stater, 61614
        • Proctor Hospital
      • Peru, Illinois, Forenede Stater, 61354
        • Illinois CancerCare-Peru
      • Peru, Illinois, Forenede Stater, 61354
        • Illinois Valley Hospital
      • Princeton, Illinois, Forenede Stater, 61356
        • Illinois CancerCare-Princeton
      • Princeton, Illinois, Forenede Stater, 61356
        • Perry Memorial Hospital
      • River Forest, Illinois, Forenede Stater, 60305
        • West Suburban Medical Center
      • Rockford, Illinois, Forenede Stater, 61104
        • Swedish American Hospital
      • Spring Valley, Illinois, Forenede Stater, 61362
        • Illinois CancerCare-Spring Valley
      • Springfield, Illinois, Forenede Stater, 62781
        • Memorial Medical Center
      • Urbana, Illinois, Forenede Stater, 61801
        • Carle Cancer Center
    • Indiana
      • Beech Grove, Indiana, Forenede Stater, 46107
        • Franciscan Saint Francis Health-Beech Grove
      • Elkhart, Indiana, Forenede Stater, 46515
        • Elkhart General Hospital
      • Elkhart, Indiana, Forenede Stater, 46514
        • Michiana Hematology Oncology PC-Elkhart
      • Elkhart, Indiana, Forenede Stater, 46514-2098
        • Elkhart Clinic
      • Fort Wayne, Indiana, Forenede Stater, 46804
        • Radiation Oncology Associates PC
      • Fort Wayne, Indiana, Forenede Stater, 46845
        • Fort Wayne Medical Oncology and Hematology Inc-Parkview
      • Indianapolis, Indiana, Forenede Stater, 46237
        • Franciscan Health Indianapolis
      • Kokomo, Indiana, Forenede Stater, 46904
        • Community Howard Regional Health
      • La Porte, Indiana, Forenede Stater, 46350
        • IU Health La Porte Hospital
      • Merrillville, Indiana, Forenede Stater, 46410
        • Premier Oncology Hematology Associates
      • Mishawaka, Indiana, Forenede Stater, 46545
        • Michiana Hematology Oncology PC-Mishawaka
      • Mishawaka, Indiana, Forenede Stater, 46545
        • Saint Joseph Regional Medical Center-Mishawaka
      • Plymouth, Indiana, Forenede Stater, 46563
        • Michiana Hematology Oncology PC-Plymouth
      • Richmond, Indiana, Forenede Stater, 47374
        • Reid Health
      • South Bend, Indiana, Forenede Stater, 46601
        • Memorial Hospital of South Bend
      • South Bend, Indiana, Forenede Stater, 46601
        • Michiana Hematology Oncology PC-South Bend
      • South Bend, Indiana, Forenede Stater, 46628
        • Northern Indiana Cancer Research Consortium
      • South Bend, Indiana, Forenede Stater, 46617
        • South Bend Clinic
      • Westville, Indiana, Forenede Stater, 46391
        • Michiana Hematology Oncology PC-Westville
    • Iowa
      • Bettendorf, Iowa, Forenede Stater, 52722
        • University of Iowa Healthcare Cancer Services Quad Cities
      • Cedar Rapids, Iowa, Forenede Stater, 52403
        • Mercy Hospital
      • Cedar Rapids, Iowa, Forenede Stater, 52403
        • Oncology Associates at Mercy Medical Center
      • Cedar Rapids, Iowa, Forenede Stater, 52402
        • Saint Luke's Hospital
      • Cedar Rapids, Iowa, Forenede Stater, 52402
        • Physicians' Clinic of Iowa PC
      • Clive, Iowa, Forenede Stater, 50325
        • Mercy Cancer Center-West Lakes
      • Clive, Iowa, Forenede Stater, 50325
        • Medical Oncology and Hematology Associates-West Des Moines
      • Des Moines, Iowa, Forenede Stater, 50309
        • Iowa Methodist Medical Center
      • Des Moines, Iowa, Forenede Stater, 50314
        • Mercy Medical Center - Des Moines
      • Des Moines, Iowa, Forenede Stater, 50309
        • Medical Oncology and Hematology Associates-Des Moines
      • Des Moines, Iowa, Forenede Stater, 50316
        • Iowa Lutheran Hospital
      • Des Moines, Iowa, Forenede Stater, 50309
        • Iowa-Wide Oncology Research Coalition NCORP
      • Des Moines, Iowa, Forenede Stater, 50314
        • Medical Oncology and Hematology Associates-Laurel
      • Iowa City, Iowa, Forenede Stater, 52242
        • University of Iowa/Holden Comprehensive Cancer Center
      • Iowa City, Iowa, Forenede Stater, 52246
        • Iowa City VA Healthcare System
      • Sioux City, Iowa, Forenede Stater, 51101
        • Siouxland Regional Cancer Center
      • Sioux City, Iowa, Forenede Stater, 51104
        • Saint Luke's Regional Medical Center
      • Sioux City, Iowa, Forenede Stater, 51104
        • Mercy Medical Center-Sioux City
      • West Des Moines, Iowa, Forenede Stater, 50266-7700
        • Methodist West Hospital
      • West Des Moines, Iowa, Forenede Stater, 50266
        • Mercy Medical Center-West Lakes
    • Kansas
      • Kansas City, Kansas, Forenede Stater, 66112
        • Providence Medical Center
      • Overland Park, Kansas, Forenede Stater, 66209
        • Menorah Medical Center
      • Overland Park, Kansas, Forenede Stater, 66213
        • Saint Luke's South Hospital
      • Prairie Village, Kansas, Forenede Stater, 66208
        • Kansas City NCI Community Oncology Research Program
      • Shawnee Mission, Kansas, Forenede Stater, 66204
        • Shawnee Mission Medical Center-KCCC
      • Topeka, Kansas, Forenede Stater, 66606
        • Cotton O'Neil Cancer Center / Stormont Vail Health
    • Kentucky
      • Lexington, Kentucky, Forenede Stater, 40536
        • University of Kentucky/Markey Cancer Center
    • Louisiana
      • Baton Rouge, Louisiana, Forenede Stater, 70809
        • Mary Bird Perkins Cancer Center
      • Monroe, Louisiana, Forenede Stater, 71202
        • University Health-Conway
      • New Orleans, Louisiana, Forenede Stater, 70112
        • University Medical Center New Orleans
      • New Orleans, Louisiana, Forenede Stater, 70112
        • Louisiana State University Health Science Center
      • Shreveport, Louisiana, Forenede Stater, 71103
        • Louisiana State University Health Sciences Center Shreveport
      • Shreveport, Louisiana, Forenede Stater, 71105
        • Highland Clinic
    • Maine
      • Augusta, Maine, Forenede Stater, 04330
        • Harold Alfond Center for Cancer Care
      • Bangor, Maine, Forenede Stater, 04401
        • Eastern Maine Medical Center
    • Maryland
      • Baltimore, Maryland, Forenede Stater, 21237
        • MedStar Franklin Square Medical Center/Weinberg Cancer Institute
      • Baltimore, Maryland, Forenede Stater, 21287
        • Johns Hopkins University/Sidney Kimmel Cancer Center
      • Baltimore, Maryland, Forenede Stater, 21204
        • Greater Baltimore Medical Center
      • Bethesda, Maryland, Forenede Stater, 20889-5600
        • Walter Reed National Military Medical Center
      • Elkton, Maryland, Forenede Stater, 21921
        • Union Hospital of Cecil County
    • Massachusetts
      • Boston, Massachusetts, Forenede Stater, 02215
        • Dana-Farber Cancer Institute
      • Boston, Massachusetts, Forenede Stater, 02115
        • Brigham and Women's Hospital
      • Brighton, Massachusetts, Forenede Stater, 02135
        • Steward Saint Elizabeth's Medical Center
      • Burlington, Massachusetts, Forenede Stater, 01805
        • Lahey Hospital and Medical Center
      • Pittsfield, Massachusetts, Forenede Stater, 01201
        • Berkshire Hematology Oncology PC
      • Springfield, Massachusetts, Forenede Stater, 01199
        • Baystate Medical Center
      • Worcester, Massachusetts, Forenede Stater, 01655
        • University of Massachusetts Medical School
    • Michigan
      • Adrian, Michigan, Forenede Stater, 49221
        • Bixby Medical Center
      • Adrian, Michigan, Forenede Stater, 49221
        • Hickman Cancer Center
      • Battle Creek, Michigan, Forenede Stater, 49017
        • Bronson Battle Creek
      • Bay City, Michigan, Forenede Stater, 48706
        • McLaren Cancer Institute-Bay City
      • Big Rapids, Michigan, Forenede Stater, 49307
        • Spectrum Health Big Rapids Hospital
      • Detroit, Michigan, Forenede Stater, 48202
        • Henry Ford Hospital
      • Detroit, Michigan, Forenede Stater, 48201
        • Wayne State University/Karmanos Cancer Institute
      • Escanaba, Michigan, Forenede Stater, 49829
        • Green Bay Oncology - Escanaba
      • Flint, Michigan, Forenede Stater, 48532
        • McLaren Cancer Institute-Flint
      • Flint, Michigan, Forenede Stater, 48532
        • Singh and Arora Hematology Oncology PC
      • Grand Rapids, Michigan, Forenede Stater, 49503
        • Spectrum Health at Butterworth Campus
      • Grand Rapids, Michigan, Forenede Stater, 49503
        • Mercy Health Saint Mary's
      • Grand Rapids, Michigan, Forenede Stater, 49503
        • Cancer Research Consortium of West Michigan NCORP
      • Iron Mountain, Michigan, Forenede Stater, 49801
        • Green Bay Oncology - Iron Mountain
      • Kalamazoo, Michigan, Forenede Stater, 49007
        • West Michigan Cancer Center
      • Kalamazoo, Michigan, Forenede Stater, 49007
        • Bronson Methodist Hospital
      • Kalamazoo, Michigan, Forenede Stater, 49048
        • Borgess Medical Center
      • Lapeer, Michigan, Forenede Stater, 48446
        • McLaren Cancer Institute-Lapeer Region
      • Monroe, Michigan, Forenede Stater, 48162
        • Mercy Memorial Hospital
      • Monroe, Michigan, Forenede Stater, 48162
        • Toledo Clinic Cancer Centers-Monroe
      • Mount Clemens, Michigan, Forenede Stater, 48043
        • McLaren Cancer Institute-Macomb
      • Muskegon, Michigan, Forenede Stater, 49444
        • Mercy Health Mercy Campus
      • Niles, Michigan, Forenede Stater, 49120
        • Lakeland Hospital Niles
      • Petoskey, Michigan, Forenede Stater, 49770
        • McLaren Cancer Institute-Northern Michigan
      • Reed City, Michigan, Forenede Stater, 49677
        • Spectrum Health Reed City Hospital
      • Saint Joseph, Michigan, Forenede Stater, 49085
        • Lakeland Medical Center Saint Joseph
      • Saint Joseph, Michigan, Forenede Stater, 49085
        • Marie Yeager Cancer Center
      • Traverse City, Michigan, Forenede Stater, 49684
        • Munson Medical Center
      • Wyoming, Michigan, Forenede Stater, 49519
        • Metro Health Hospital
    • Minnesota
      • Alexandria, Minnesota, Forenede Stater, 56308
        • Medini, Eitan MD (UIA Investigator)
      • Burnsville, Minnesota, Forenede Stater, 55337
        • Fairview Ridges Hospital
      • Coon Rapids, Minnesota, Forenede Stater, 55433
        • Mercy Hospital
      • Edina, Minnesota, Forenede Stater, 55435
        • Fairview-Southdale Hospital
      • Fridley, Minnesota, Forenede Stater, 55432
        • Unity Hospital
      • Hutchinson, Minnesota, Forenede Stater, 55350
        • Hutchinson Area Health Care
      • Maplewood, Minnesota, Forenede Stater, 55109
        • Saint John's Hospital - Healtheast
      • Maplewood, Minnesota, Forenede Stater, 55109
        • Minnesota Oncology Hematology PA-Maplewood
      • Minneapolis, Minnesota, Forenede Stater, 55415
        • Hennepin County Medical Center
      • Minneapolis, Minnesota, Forenede Stater, 55407
        • Abbott-Northwestern Hospital
      • Minneapolis, Minnesota, Forenede Stater, 55417
        • Minneapolis Veterans Medical Center
      • New Ulm, Minnesota, Forenede Stater, 56073
        • New Ulm Medical Center
      • Robbinsdale, Minnesota, Forenede Stater, 55422
        • North Memorial Medical Health Center
      • Saint Cloud, Minnesota, Forenede Stater, 56303
        • Coborn Cancer Center at Saint Cloud Hospital
      • Saint Cloud, Minnesota, Forenede Stater, 56303
        • Saint Cloud Hospital
      • Saint Louis Park, Minnesota, Forenede Stater, 55416
        • Park Nicollet Clinic - Saint Louis Park
      • Saint Louis Park, Minnesota, Forenede Stater, 55416
        • Metro Minnesota Community Oncology Research Consortium
      • Saint Paul, Minnesota, Forenede Stater, 55101
        • Regions Hospital
      • Saint Paul, Minnesota, Forenede Stater, 55102
        • United Hospital
      • Shakopee, Minnesota, Forenede Stater, 55379
        • Saint Francis Regional Medical Center
      • Stillwater, Minnesota, Forenede Stater, 55082
        • Lakeview Hospital
      • Waconia, Minnesota, Forenede Stater, 55387
        • Ridgeview Medical Center
      • Willmar, Minnesota, Forenede Stater, 56201
        • Rice Memorial Hospital
      • Woodbury, Minnesota, Forenede Stater, 55125
        • Minnesota Oncology Hematology PA-Woodbury
    • Mississippi
      • Jackson, Mississippi, Forenede Stater, 39216
        • University of Mississippi Medical Center
    • Missouri
      • Bolivar, Missouri, Forenede Stater, 65613
        • Central Care Cancer Center - Bolivar
      • Branson, Missouri, Forenede Stater, 65616
        • Cox Cancer Center Branson
      • Cape Girardeau, Missouri, Forenede Stater, 63703
        • Saint Francis Medical Center
      • Cape Girardeau, Missouri, Forenede Stater, 63703
        • Southeast Cancer Center
      • Chesterfield, Missouri, Forenede Stater, 63017
        • Saint Luke's Hospital
      • Columbia, Missouri, Forenede Stater, 65212
        • University of Missouri - Ellis Fischel
      • Jefferson City, Missouri, Forenede Stater, 65109
        • Capital Region Southwest Campus
      • Joplin, Missouri, Forenede Stater, 64804
        • Freeman Health System
      • Joplin, Missouri, Forenede Stater, 64804
        • Mercy Hospital Joplin
      • Kansas City, Missouri, Forenede Stater, 64116
        • North Kansas City Hospital
      • Kansas City, Missouri, Forenede Stater, 64111
        • Saint Luke's Hospital of Kansas City
      • Kansas City, Missouri, Forenede Stater, 64132
        • Research Medical Center
      • Kansas City, Missouri, Forenede Stater, 64108
        • Truman Medical Center
      • Kansas City, Missouri, Forenede Stater, 64118
        • Heartland Hematology and Oncology Associates Incorporated
      • Kansas City, Missouri, Forenede Stater, 64114
        • Saint Joseph Health Center
      • Lee's Summit, Missouri, Forenede Stater, 64086
        • Saint Luke's East - Lee's Summit
      • Liberty, Missouri, Forenede Stater, 64068
        • Liberty Radiation Oncology Center
      • Rolla, Missouri, Forenede Stater, 65401
        • Delbert Day Cancer Institute at PCRMC
      • Rolla, Missouri, Forenede Stater, 65401
        • Mercy Clinic-Rolla-Cancer and Hematology
      • Saint Joseph, Missouri, Forenede Stater, 64507
        • Saint Joseph Oncology Inc
      • Saint Joseph, Missouri, Forenede Stater, 64507
        • Heartland Regional Medical Center
      • Saint Louis, Missouri, Forenede Stater, 63110
        • Washington University School of Medicine
      • Saint Louis, Missouri, Forenede Stater, 63131
        • Missouri Baptist Medical Center
      • Saint Louis, Missouri, Forenede Stater, 63141
        • Mercy Hospital Saint Louis
      • Saint Louis, Missouri, Forenede Stater, 63109
        • Saint Louis Cancer and Breast Institute-South City
      • Saint Louis, Missouri, Forenede Stater, 63141
        • Saint Louis-Cape Girardeau CCOP
      • Saint Louis, Missouri, Forenede Stater, 63141
        • Comprehensive Cancer Care PC
      • Springfield, Missouri, Forenede Stater, 65804
        • Cancer Research for the Ozarks NCORP
      • Springfield, Missouri, Forenede Stater, 65807
        • CoxHealth South Hospital
      • Springfield, Missouri, Forenede Stater, 65804
        • Mercy Hospital Springfield
    • Montana
      • Billings, Montana, Forenede Stater, 59101
        • Billings Clinic Cancer Center
      • Billings, Montana, Forenede Stater, 59101
        • Saint Vincent Healthcare
      • Billings, Montana, Forenede Stater, 59102
        • Montana Cancer Consortium NCORP
      • Billings, Montana, Forenede Stater, 59102
        • Saint Vincent Frontier Cancer Center
      • Bozeman, Montana, Forenede Stater, 59715
        • Bozeman Deaconess Hospital
      • Butte, Montana, Forenede Stater, 59701
        • Saint James Community Hospital and Cancer Treatment Center
      • Great Falls, Montana, Forenede Stater, 59405
        • Great Falls Clinic
      • Great Falls, Montana, Forenede Stater, 59405
        • Benefis Healthcare- Sletten Cancer Institute
      • Great Falls, Montana, Forenede Stater, 59405
        • Big Sky Oncology
      • Havre, Montana, Forenede Stater, 59501
        • Northern Montana Hospital
      • Helena, Montana, Forenede Stater, 59601
        • Saint Peter's Community Hospital
      • Kalispell, Montana, Forenede Stater, 59901
        • Kalispell Regional Medical Center
      • Kalispell, Montana, Forenede Stater, 59901
        • Glacier Oncology PLLC
      • Kalispell, Montana, Forenede Stater, 59901
        • Kalispell Medical Oncology
      • Missoula, Montana, Forenede Stater, 59802
        • Saint Patrick Hospital - Community Hospital
      • Missoula, Montana, Forenede Stater, 59802
        • Montana Cancer Specialists
    • Nebraska
      • Grand Island, Nebraska, Forenede Stater, 68803
        • CHI Health Saint Francis
      • Kearney, Nebraska, Forenede Stater, 68847
        • CHI Health Good Samaritan
      • North Platte, Nebraska, Forenede Stater, 69101
        • Great Plains Health Callahan Cancer Center
      • Omaha, Nebraska, Forenede Stater, 68198
        • University of Nebraska Medical Center
    • Nevada
      • Las Vegas, Nevada, Forenede Stater, 89102
        • University Medical Center of Southern Nevada
      • Las Vegas, Nevada, Forenede Stater, 89106
        • Nevada Cancer Research Foundation CCOP
    • New Jersey
      • Camden, New Jersey, Forenede Stater, 08103
        • Cooper Hospital University Medical Center
      • Mount Holly, New Jersey, Forenede Stater, 08060
        • Virtua Memorial
      • Voorhees, New Jersey, Forenede Stater, 08043
        • Virtua Voorhees
    • New York
      • Buffalo, New York, Forenede Stater, 14215
        • Veterans Affairs Western New York Health Care System-Buffalo
      • East Syracuse, New York, Forenede Stater, 13057
        • Hematology Oncology Associates of Central New York-East Syracuse
      • Glens Falls, New York, Forenede Stater, 12801
        • Glens Falls Hospital
      • Middletown, New York, Forenede Stater, 10940
        • Orange Regional Medical Center
      • New York, New York, Forenede Stater, 10065
        • Weill Medical College of Cornell University
      • Staten Island, New York, Forenede Stater, 10305
        • Staten Island University Hospital
      • Syracuse, New York, Forenede Stater, 13210
        • State University of New York Upstate Medical University
    • North Carolina
      • Asheville, North Carolina, Forenede Stater, 28801
        • Mission Hospital Inc-Memorial Campus
      • Chapel Hill, North Carolina, Forenede Stater, 27599
        • UNC Lineberger Comprehensive Cancer Center
      • Concord, North Carolina, Forenede Stater, 28025
        • Carolinas HealthCare System NorthEast
      • Durham, North Carolina, Forenede Stater, 27710
        • Duke University Medical Center
      • Goldsboro, North Carolina, Forenede Stater, 27534
        • Wayne Memorial Hospital
      • Hendersonville, North Carolina, Forenede Stater, 28791
        • Margaret R Pardee Memorial Hospital
      • Kinston, North Carolina, Forenede Stater, 28501
        • Vidant Oncology-Kinston
      • Washington, North Carolina, Forenede Stater, 27889
        • Marion L Shepard Cancer Center at Vidant Beaufort Hospital
    • North Dakota
      • Bismarck, North Dakota, Forenede Stater, 58501
        • Sanford Bismarck Medical Center
      • Bismarck, North Dakota, Forenede Stater, 58501
        • Mid Dakota Clinic
      • Bismarck, North Dakota, Forenede Stater, 58501
        • Saint Alexius Medical Center
    • Ohio
      • Akron, Ohio, Forenede Stater, 44307
        • Cleveland Clinic Akron General
      • Akron, Ohio, Forenede Stater, 44304
        • Summa Akron City Hospital/Cooper Cancer Center
      • Barberton, Ohio, Forenede Stater, 44203
        • Summa Barberton Hospital
      • Bowling Green, Ohio, Forenede Stater, 43402
        • Toledo Clinic Cancer Centers-Bowling Green
      • Canton, Ohio, Forenede Stater, 44708
        • Mercy Medical Center
      • Cincinnati, Ohio, Forenede Stater, 45219
        • University of Cincinnati/Barrett Cancer Center
      • Clyde, Ohio, Forenede Stater, 43410
        • North Coast Cancer Care-Clyde
      • Columbus, Ohio, Forenede Stater, 43210
        • Ohio State University Comprehensive Cancer Center
      • Dayton, Ohio, Forenede Stater, 45406
        • Good Samaritan Hospital - Dayton
      • Dayton, Ohio, Forenede Stater, 45409
        • Miami Valley Hospital
      • Dayton, Ohio, Forenede Stater, 45415
        • Samaritan North Health Center
      • Dayton, Ohio, Forenede Stater, 45420
        • Dayton NCI Community Oncology Research Program
      • Dayton, Ohio, Forenede Stater, 45405
        • Grandview Hospital
      • Elyria, Ohio, Forenede Stater, 44035
        • Mercy Cancer Center-Elyria
      • Elyria, Ohio, Forenede Stater, 44035
        • Hematology Oncology Center Incorporated
      • Findlay, Ohio, Forenede Stater, 45840
        • Blanchard Valley Hospital
      • Franklin, Ohio, Forenede Stater, 45005-1066
        • Atrium Medical Center-Middletown Regional Hospital
      • Greenville, Ohio, Forenede Stater, 45331
        • Wayne Hospital
      • Kettering, Ohio, Forenede Stater, 45429
        • Kettering Medical Center
      • Lima, Ohio, Forenede Stater, 45801
        • Saint Rita's Medical Center
      • Lima, Ohio, Forenede Stater, 45804
        • Lima Memorial Hospital
      • Maumee, Ohio, Forenede Stater, 43537
        • Toledo Clinic Cancer Centers-Maumee
      • Maumee, Ohio, Forenede Stater, 43537
        • Toledo Radiation Oncology at Northwest Ohio Onocolgy Center
      • Maumee, Ohio, Forenede Stater, 43537
        • Saint Luke's Hospital
      • Norwalk, Ohio, Forenede Stater, 44857
        • Fisher-Titus Medical Center
      • Oregon, Ohio, Forenede Stater, 43616
        • Saint Charles Hospital
      • Oregon, Ohio, Forenede Stater, 43616
        • Toledo Clinic Cancer Centers-Oregon
      • Sandusky, Ohio, Forenede Stater, 44870
        • North Coast Cancer Care
      • Sylvania, Ohio, Forenede Stater, 43560
        • ProMedica Flower Hospital
      • Tiffin, Ohio, Forenede Stater, 44883
        • Mercy Hospital of Tiffin
      • Toledo, Ohio, Forenede Stater, 43608
        • Saint Vincent Mercy Medical Center
      • Toledo, Ohio, Forenede Stater, 43623
        • Toledo Clinic Cancer Centers-Toledo
      • Toledo, Ohio, Forenede Stater, 43614
        • University of Toledo
      • Toledo, Ohio, Forenede Stater, 43617
        • Toledo Community Hospital Oncology Program CCOP
      • Toledo, Ohio, Forenede Stater, 43606
        • The Toledo Hospital/Toledo Children's Hospital
      • Toledo, Ohio, Forenede Stater, 43623
        • Mercy Saint Anne Hospital
      • Troy, Ohio, Forenede Stater, 45373
        • Upper Valley Medical Center
      • Wauseon, Ohio, Forenede Stater, 43567
        • Fulton County Health Center
      • Wilmington, Ohio, Forenede Stater, 45177
        • Clinton Memorial Hospital
      • Wright-Patterson Air Force Base, Ohio, Forenede Stater, 45433-5529
        • Wright-Patterson Medical Center
      • Xenia, Ohio, Forenede Stater, 45385
        • Greene Memorial Hospital
    • Oklahoma
      • Lawton, Oklahoma, Forenede Stater, 73505
        • Cancer Centers of Southwest Oklahoma Research
      • Norman, Oklahoma, Forenede Stater, 73071
        • Cancer Care Associates-Norman
      • Oklahoma City, Oklahoma, Forenede Stater, 73104
        • University of Oklahoma Health Sciences Center
      • Oklahoma City, Oklahoma, Forenede Stater, 73120
        • Mercy Hospital Oklahoma City
      • Oklahoma City, Oklahoma, Forenede Stater, 73120
        • Mercy Physicians of Oklahoma-Lakeside
    • Oregon
      • Clackamas, Oregon, Forenede Stater, 97015
        • Clackamas Radiation Oncology Center
      • Gresham, Oregon, Forenede Stater, 97030
        • Legacy Mount Hood Medical Center
      • Milwaukie, Oregon, Forenede Stater, 97222
        • Providence Milwaukie Hospital
      • Newberg, Oregon, Forenede Stater, 97132
        • Providence Newberg Medical Center
      • Oregon City, Oregon, Forenede Stater, 97045
        • Providence Willamette Falls Medical Center
      • Portland, Oregon, Forenede Stater, 97210
        • Legacy Good Samaritan Hospital and Medical Center
      • Portland, Oregon, Forenede Stater, 97213
        • Providence Portland Medical Center
      • Portland, Oregon, Forenede Stater, 97225
        • Providence Saint Vincent Medical Center
      • Portland, Oregon, Forenede Stater, 97227
        • Kaiser Permanente Northwest
      • Portland, Oregon, Forenede Stater, 97227
        • Legacy Emanuel Hospital and Health Center
      • Portland, Oregon, Forenede Stater, 97216
        • Adventist Medical Center
      • Portland, Oregon, Forenede Stater, 97227
        • Compass Oncology Rose Quarter
      • The Dalles, Oregon, Forenede Stater, 97058
        • Mid-Columbia Medical Center/Celilo Cancer Center
      • Tualatin, Oregon, Forenede Stater, 97062
        • Legacy Meridian Park Hospital
    • Pennsylvania
      • Abington, Pennsylvania, Forenede Stater, 19001
        • Abington Memorial Hospital
      • Allentown, Pennsylvania, Forenede Stater, 18103
        • Lehigh Valley Hospital-Cedar Crest
      • Bryn Mawr, Pennsylvania, Forenede Stater, 19010
        • Bryn Mawr Hospital
      • Butler, Pennsylvania, Forenede Stater, 16001
        • Butler Memorial Hospital
      • Danville, Pennsylvania, Forenede Stater, 17822
        • Geisinger Medical Center
      • Ephrata, Pennsylvania, Forenede Stater, 17522
        • Ephrata Cancer Center
      • Hazleton, Pennsylvania, Forenede Stater, 18201
        • Geisinger Medical Center-Cancer Center Hazleton
      • Hershey, Pennsylvania, Forenede Stater, 17033-0850
        • Penn State Milton S Hershey Medical Center
      • Lewistown, Pennsylvania, Forenede Stater, 17044
        • Lewistown Hospital
      • Media, Pennsylvania, Forenede Stater, 19063
        • Riddle Memorial Hospital
      • Paoli, Pennsylvania, Forenede Stater, 19301
        • Paoli Memorial Hospital
      • Sayre, Pennsylvania, Forenede Stater, 18840
        • Guthrie Medical Group PC-Robert Packer Hospital
      • Scranton, Pennsylvania, Forenede Stater, 18508
        • Hematology and Oncology Associates of North East Pennsylvania
      • State College, Pennsylvania, Forenede Stater, 16801
        • Geisinger Medical Group
      • State College, Pennsylvania, Forenede Stater, 16803
        • Mount Nittany Medical Center
      • Upland, Pennsylvania, Forenede Stater, 19013
        • Associates In Hematology Oncology PC-Upland
      • Wilkes-Barre, Pennsylvania, Forenede Stater, 18711
        • Geisinger Wyoming Valley/Henry Cancer Center
      • Williamsport, Pennsylvania, Forenede Stater, 17701
        • UPMC Susquehanna
      • Wynnewood, Pennsylvania, Forenede Stater, 19096
        • Lankenau Medical Center
      • Wynnewood, Pennsylvania, Forenede Stater, 19096
        • Main Line Health NCORP
    • South Carolina
      • Charleston, South Carolina, Forenede Stater, 29401
        • Roper Hospital
      • Easley, South Carolina, Forenede Stater, 29640
        • Greenville Health System Cancer Institute-Easley
      • Greenville, South Carolina, Forenede Stater, 29601
        • Saint Francis Hospital
      • Greenville, South Carolina, Forenede Stater, 29605
        • Greenville Health System Cancer Institute-Faris
      • Greenville, South Carolina, Forenede Stater, 29605
        • Greenville Memorial Hospital
      • Greenville, South Carolina, Forenede Stater, 29615
        • Greenville Health System Cancer Institute-Eastside
      • Greenville, South Carolina, Forenede Stater, 29605
        • Greenville Health System Cancer Institute-Butternut
      • Greenwood, South Carolina, Forenede Stater, 29646
        • Self Regional Healthcare
      • Greer, South Carolina, Forenede Stater, 29650
        • Greenville Health System Cancer Institute-Greer
      • Seneca, South Carolina, Forenede Stater, 29672
        • Greenville Health System Cancer Institute-Seneca
      • Spartanburg, South Carolina, Forenede Stater, 29307
        • Greenville Health System Cancer Institute-Spartanburg
    • South Dakota
      • Sioux Falls, South Dakota, Forenede Stater, 57105
        • Avera Cancer Institute
      • Sioux Falls, South Dakota, Forenede Stater, 57105
        • Avera McKennan Hospital and University Health Center
    • Tennessee
      • Kingsport, Tennessee, Forenede Stater, 37660
        • Wellmont Holston Valley Hospital and Medical Center
      • Knoxville, Tennessee, Forenede Stater, 37916
        • Thompson Cancer Survival Center
      • Knoxville, Tennessee, Forenede Stater, 37920
        • University of Tennessee - Knoxville
    • Utah
      • Salt Lake City, Utah, Forenede Stater, 84112
        • Huntsman Cancer Institute/University of Utah
    • Vermont
      • Berlin, Vermont, Forenede Stater, 05602
        • Central Vermont Medical Center/National Life Cancer Treatment
      • Burlington, Vermont, Forenede Stater, 05405
        • University of Vermont College of Medicine
      • White River Junction, Vermont, Forenede Stater, 05009
        • White River Junction Veteran Administration Medical Center
    • Virginia
      • Fredericksburg, Virginia, Forenede Stater, 22401
        • Fredericksburg Oncology Inc
      • Lynchburg, Virginia, Forenede Stater, 24501
        • Centra Lynchburg Hematology-Oncology Clinic Inc
      • Norton, Virginia, Forenede Stater, 24273
        • Southwest VA Regional Cancer Center
      • Richmond, Virginia, Forenede Stater, 23298
        • Virginia Commonwealth University/Massey Cancer Center
    • Washington
      • Centralia, Washington, Forenede Stater, 98531
        • Providence Regional Cancer System-Centralia
      • Federal Way, Washington, Forenede Stater, 98003
        • Saint Francis Hospital
      • Lakewood, Washington, Forenede Stater, 98499
        • Saint Clare Hospital
      • Olympia, Washington, Forenede Stater, 98506-5166
        • Providence - Saint Peter Hospital
      • Puyallup, Washington, Forenede Stater, 98372
        • MultiCare Good Samaritan Hospital
      • Spokane, Washington, Forenede Stater, 99220
        • Rockwood Clinic
      • Tacoma, Washington, Forenede Stater, 98405
        • MultiCare Tacoma General Hospital
      • Tacoma, Washington, Forenede Stater, 98405
        • MultiCare Allenmore Hospital
      • Tacoma, Washington, Forenede Stater, 98405
        • Northwest NCI Community Oncology Research Program
      • Tacoma, Washington, Forenede Stater, 98405
        • Saint Joseph Medical Center
      • Vancouver, Washington, Forenede Stater, 98686
        • Legacy Salmon Creek Hospital
      • Vancouver, Washington, Forenede Stater, 98664
        • PeaceHealth Southwest Medical Center
      • Vancouver, Washington, Forenede Stater, 98684
        • Compass Oncology Vancouver
    • West Virginia
      • Charleston, West Virginia, Forenede Stater, 25304
        • West Virginia University Charleston Division
      • Huntington, West Virginia, Forenede Stater, 25701
        • Edwards Comprehensive Cancer Center
    • Wisconsin
      • Antigo, Wisconsin, Forenede Stater, 54409
        • Langlade Hospital and Cancer Center
      • Appleton, Wisconsin, Forenede Stater, 54913
        • Fox Valley Hematology and Oncology SC-Appleton
      • Burlington, Wisconsin, Forenede Stater, 53105
        • Aurora Cancer Care-Southern Lakes VLCC
      • Chippewa Falls, Wisconsin, Forenede Stater, 54729
        • Marshfield Clinic-Chippewa Center
      • Eau Claire, Wisconsin, Forenede Stater, 54701
        • Marshfield Clinic Cancer Center at Sacred Heart
      • Franklin, Wisconsin, Forenede Stater, 53132
        • Aurora Cancer Care-Franklin
      • Germantown, Wisconsin, Forenede Stater, 53022
        • Aurora Health Care Germantown Health Center
      • Glendale, Wisconsin, Forenede Stater, 53212
        • Aurora Cancer Care-Glendale
      • Green Bay, Wisconsin, Forenede Stater, 54301
        • Saint Vincent Hospital Cancer Center Green Bay
      • Green Bay, Wisconsin, Forenede Stater, 54303
        • Saint Vincent Hospital Cancer Center at Saint Mary's
      • Green Bay, Wisconsin, Forenede Stater, 54303
        • Green Bay Oncology Limited at Saint Mary's Hospital
      • Green Bay, Wisconsin, Forenede Stater, 54301-3526
        • Green Bay Oncology at Saint Vincent Hospital
      • Kenosha, Wisconsin, Forenede Stater, 53142
        • Aurora Cancer Care-Kenosha South
      • La Crosse, Wisconsin, Forenede Stater, 54601
        • Gundersen Lutheran Medical Center
      • Manitowoc, Wisconsin, Forenede Stater, 54221
        • Holy Family Memorial Hospital
      • Marinette, Wisconsin, Forenede Stater, 54143
        • Bay Area Medical Center
      • Marshfield, Wisconsin, Forenede Stater, 54449
        • Marshfield Clinic
      • Milwaukee, Wisconsin, Forenede Stater, 53215
        • Aurora Saint Luke's Medical Center
      • Minocqua, Wisconsin, Forenede Stater, 54548
        • Marshfield Clinic-Minocqua Center
      • Oconto Falls, Wisconsin, Forenede Stater, 54154
        • Green Bay Oncology - Oconto Falls
      • Racine, Wisconsin, Forenede Stater, 53406
        • Aurora Cancer Care-Racine
      • Rhinelander, Wisconsin, Forenede Stater, 54501
        • Ascension Saint Mary's Hospital
      • Rice Lake, Wisconsin, Forenede Stater, 54868
        • Marshfield Clinic-Rice Lake Center
      • Sheboygan, Wisconsin, Forenede Stater, 53081
        • HSHS Saint Nicholas Hospital
      • Stevens Point, Wisconsin, Forenede Stater, 54481
        • Ascension Saint Michael's Hospital
      • Sturgeon Bay, Wisconsin, Forenede Stater, 54235
        • Green Bay Oncology - Sturgeon Bay
      • Waukesha, Wisconsin, Forenede Stater, 53188
        • Aurora Cancer Care-Waukesha
      • Wausau, Wisconsin, Forenede Stater, 54401
        • Aspirus Regional Cancer Center
      • Wauwatosa, Wisconsin, Forenede Stater, 53226
        • Aurora Cancer Care-Milwaukee West
      • Weston, Wisconsin, Forenede Stater, 54476
        • Diagnostic and Treatment Center
      • Weston, Wisconsin, Forenede Stater, 54476
        • Marshfield Clinic - Weston Center
      • Wisconsin Rapids, Wisconsin, Forenede Stater, 54494
        • Marshfield Clinic - Wisconsin Rapids Center
      • Wisconsin Rapids, Wisconsin, Forenede Stater, 54494
        • Aspirus UW Cancer Center
    • Wyoming
      • Casper, Wyoming, Forenede Stater, 82609
        • Rocky Mountain Oncology
      • Sheridan, Wyoming, Forenede Stater, 82801
        • Welch Cancer Center

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inklusionskriterier:

  • Nyrecellekarcinom med en komponent af klarcellehistologi
  • Metastatisk eller uoperabel sygdom
  • Skal have været behandlet med mindst 1 tidligere behandling med VEGFR tyrosinkinasehæmmer og have udviklet sig eller været intolerant over for behandling
  • Ingen tidligere systemisk behandling med et bindemiddel for vaskulær endotelvækstfaktor (VEGF) (f.eks. bevacizumab)
  • Ingen forudgående systemisk terapi med noget mekanistisk mål for rapamycin (mTOR) hæmmer (f.eks. sirolimus, temsirolimus, everolimus)
  • Forudgående cytokinbehandling er tilladt
  • Enhver systemisk behandling skal afsluttes mindst 4 uger før registrering
  • >= 2 uger siden nogen tidligere stråling (inklusive palliativ)

  • Patienter må ikke have haft et større kirurgisk indgreb, åben biopsi eller betydelig traumatisk skade inden for 4 uger før undersøgelsesregistrering, og de skal være helt restituerede efter en sådan procedure

    • Følgende anses ikke for at være større procedurer: thoracentese, paracentese, portplacering, laparoskopi, thoracoskopi, bronkoskopi, endoskopiske ultralydsprocedurer, mediastinoskopi, hudbiopsier, incisionsbiopsier og rutinemæssige tandprocedurer
  • Patienter skal have målbar sygdom efter RECIST-kriterier; læsioner, der kan måles nøjagtigt i mindst én dimension (længste diameter, der skal registreres) som >= 2 cm med konventionelle teknikker eller som >= 1 cm med spiral computertomografi (CT) scanning

  • Ingen aktive hjernemetastaser: Patienter med behandlede, stabile hjernemetastaser i mindst tre måneder er kvalificerede, så længe de opfylder følgende kriterier:

    • Behandlede hjernemetastaser er defineret som ikke at have noget løbende behov for steroider og ingen tegn på progression eller blødning efter behandling i mindst 3 måneder, som konstateret ved klinisk undersøgelse og hjernebilleddannelse (magnetisk resonansbilleddannelse [MRI] eller CT) (stabil dosis af antikonvulsiva midler er tilladt); behandling af hjernemetastaser kan omfatte strålebehandling af hele hjernen (WBRT), strålekirurgi (RS; Gamma Knife, lineær accelerator [LINAC] eller tilsvarende) eller en kombination, som den behandlende læge skønner passende; patienter med metastaser i centralnervesystemet (CNS) behandlet med neurokirurgisk resektion eller hjernebiopsi udført inden for 3 måneder før dag 1 er ikke kvalificerede
    • Baseline hjernebilleddannelse (MRI/CT) er påkrævet
  • Ingen alvorlige ikke-helende sår, mavesår eller knoglebrud

  • Ingen arterielle trombotiske hændelser inden for 6 måneder efter registrering:

    • Inklusive forbigående iskæmisk anfald (TIA), cerebrovaskulær ulykke (CVA), perifer arteriel trombe, ustabil angina eller angina, der kræver kirurgisk eller medicinsk intervention inden for de seneste 6 måneder, eller myokardieinfarkt (MI); patienter med klinisk signifikant perifer arteriesygdom (dvs. claudicatio på mindre end én blok), signifikant vaskulær sygdom (dvs. aortaaneurisme, aortadissektion) eller enhver anden arteriel trombotisk hændelse er ikke kvalificerede
  • Patienter, der har oplevet en dyb venetrombose eller lungeemboli inden for de seneste 6 måneder, skal have stabil terapeutisk antikoagulering for at blive optaget i denne undersøgelse
  • Patienter, der modtager trombocythæmmende midler og profylaktisk antikoagulering er kvalificerede
  • Ingen utilstrækkeligt kontrolleret hypertension: (defineret som et blodtryk på >= 160 mmHg systolisk og/eller >= 90 mmHg diastolisk på medicin), eller nogen tidligere historie med hypertensiv krise eller hypertensiv encefalopati

  • Ingen kendt alvorlig svækkelse af lungefunktionen, defineret som >= grad 2 dyspnø eller hoste, eller enten:

    • Behov for supplerende ilt, eller
    • I tilfælde, hvor der er opnået lungefunktions- eller pulsoximetritest, er forceret udåndingsvolumen af ​​lungen på et sekund (FEV1) eller forceret vitalkapacitet (FVC) < 50 % af forudsagt, eller enkeltåndediffunderende kapacitet i lungen for kulilte (DLCO) er < 35 % af forventet eller hvilerums iltmætning er mindre end 90 %
  • Ingen aktiv eller alvorlig leversygdom (f. akut eller kronisk hepatitis, skrumpelever)
  • Ingen positiv serologi for anti-hæmoglobin C (HBC) eller anti-hepatitis C virus (HCV) antistoffer; hepatitis B virus (HBV) seropositive patienter (hepatitis B overfladeantigen [HBsAg] positive) er kvalificerede, hvis de overvåges nøje for tegn på aktiv HBV infektion ved HBV deoxryribonukleinsyre (DNA) testning og accepterer at modtage suppressiv behandling med lamivudin eller anden HBV -suppressiv behandling indtil mindst 4 uger efter den sidste dosis everolimus
  • Ingen New York Heart Association (NYHA) klasse >= 2 kongestiv hjerteinsufficiens
  • Ingen aktiv blødning eller kronisk hæmoragisk diatese eller øget risiko for blødning: Inklusive men ikke begrænset til en historie med større blødninger inden for 6 måneder (f. gastrointestinale, lunge-, CNS-steder; eller nødvendig transfusionsstøtte)
  • Ingen anamnese med abdominal fistel, gastrointestinal perforation eller intraabdominal absces inden for 6 måneder før påbegyndelse af behandling
  • Ingen igangværende immunsuppressiv behandling: inklusive kronisk systemisk behandling med kortikosteroider (>= 10 mg/dag prednisonækvivalent)
  • Arkivvæv skal være tilgængeligt for indsendelse: selvom det er valgfrit for patienterne at vælge at deltage i de korrelative delstudier eller ej

  • Patienter, der er gravide eller ammende, er ikke berettigede

    • Kvinder i den fødedygtige alder skal have en negativ serum- eller uringraviditetstest inden for 16 dage før registrering

    • Kvinder i den fødedygtige alder omfatter:

      • Enhver kvinde, der har oplevet menarche, og som ikke har gennemgået kirurgisk sterilisation (hysterektomi, bilateral tubal ligering eller bilateral ooforektomi) eller ikke er postmenopausal (defineret som amenoré >= 12 på hinanden følgende måneder)
      • Kvinder i hormonsubstitutionsterapi (HRT) med dokumenteret serum follikelstimulerende hormon (FSH) niveau > 35m IE/ml
      • Kvinder, der bruger orale, implanterede eller injicerbare svangerskabsforebyggende hormoner eller mekaniske produkter, såsom en intrauterin enhed eller barrieremetoder (membran, kondomer, sæddræbende midler) for at forhindre graviditet eller praktisere afholdenhed, eller hvor partneren er steril (f.eks. vasektomi)
  • Præstationsstatus Eastern Cooperative Oncology Group (ECOG) 0-2 eller Karnofsky-score >= 60 %
  • Granulocytter >= 1.500/μL
  • Blodpladetal >= 100.000/μL
  • Beregnet kreatininclearance >= 30 ml/minut (modificeret Cockroft og Gault formel)
  • Bilirubin =< 1,5 x øvre normalgrænse
  • Aspartataminotransferase (AST) =< 2,5 x øvre normalgrænse (ULN)
  • Fastende serumtriglycerider =< 200 mg/dL
  • Serumkolesterol =< 300 mg/dL
  • Fastende serumglukose =< 1,5 x ULN
  • Urinprotein til kreatininforhold < 1,0 eller urinprotein =< 1+

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Dobbelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Aktiv komparator: Arm I (everolimus)
Patienter får everolimus PO QD på dag 1-28.
Andet: Laboratoriebiomarkøranalyse
Korrelative undersøgelser
Andet: Farmakologisk undersøgelse
Korrelative undersøgelser
Medicin: Everolimus
Givet PO
Andre navne:
  • 42-O-(2-Hydroxy)ethyl-rapamycin
  • Afinitor
  • Certican
  • RAD 001
  • RAD001
  • Votubia
  • Zorttress
Eksperimentel: Arm II (everolimus med bevacizumab)
Patienterne får everolimus PO QD på dag 1-28 og bevacizumab IV over 30-90 minutter på dag 1 og 15.
Andet: Laboratoriebiomarkøranalyse
Korrelative undersøgelser
Andet: Farmakologisk undersøgelse
Korrelative undersøgelser
Medicin: Everolimus
Givet PO
Andre navne:
  • 42-O-(2-Hydroxy)ethyl-rapamycin
  • Afinitor
  • Certican
  • RAD 001
  • RAD001
  • Votubia
  • Zorttress
Biologisk: Bevacizumab
Givet IV
Andre navne:
  • Avastin
  • Anti-VEGF
  • Anti-VEGF humaniseret monoklonalt antistof
  • Anti-VEGF rhuMAb
  • Bevacizumab Biosimilar BEVZ92
  • Bevacizumab Biosimilar BI 695502
  • Bevacizumab Biosimilar CBT 124
  • Bevacizumab Biosimilar FKB238
  • Bevacizumab Biosimilar MIL60
  • Bevacizumab Biosimilar QL 1101
  • Immunoglobulin G1 (human-mus monoklonal rhuMab-VEGF gammakæde anti-human vaskulær endotelvækstfaktor), disulfid med human-mus monoklonal rhuMab-VEGF let kæde, dimer
  • Rekombinant humaniseret anti-VEGF monoklonalt antistof
  • rhuMab-VEGF
  • BEVACIZUMAB, USPECIFICERET LICENSHOLDER

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Samlet overlevelse (OS)
Tidsramme: Tiden fra dato for randomisering til dato for død på grund af en hvilken som helst årsag, vurderet op til 5,5 år
Samlet overlevelsestid er defineret som tiden fra randomisering til død på grund af enhver årsag. Medianen og 95 % konfidensintervaller estimeres ved hjælp af Kaplan-Meier-estimatoren.
Tiden fra dato for randomisering til dato for død på grund af en hvilken som helst årsag, vurderet op til 5,5 år

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Progressionsfri overlevelse (PFS)
Tidsramme: Tiden fra randomisering til sygdomsprogression eller død uanset årsag, vurderet op til 5,5 år
Progressionsfri overlevelse (PFS) er defineret som tiden fra datoen for randomisering til datoen for sygdomsprogression eller død som følge af en hvilken som helst årsag, alt efter hvad der kommer først. Progression er defineret i henhold til Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1. Medianen og 95 % konfidensintervaller estimeres ved hjælp af Kaplan-Meier-estimatoren.
Tiden fra randomisering til sygdomsprogression eller død uanset årsag, vurderet op til 5,5 år
Objektiv responsrate (CR + PR)
Tidsramme: Op til 5,5 år
Responsraten (procent) er procentdelen af ​​patienter, hvis bedste respons var komplet respons (CR) eller delvis respons (PR) som defineret af RECIST 1.1-kriterier. Procentdelen af ​​succeser vil blive estimeret med 100 gange antallet af succeser divideret med det samlede antal evaluerbare patienter.
Op til 5,5 år
Toksiciteter, graderet i henhold til National Cancer Institute Common Terminology Criteria for Adverse Events Version 4.0
Tidsramme: Op til 30 dage efter afsluttet undersøgelsesbehandling
Antallet af patienter, der rapporterer uønskede hændelser af grad 3 eller højere som klassificeret efter NCI's Common Toxicity Criteria (CTCAE) Version 4, er rapporteret her. En komplet liste over alle rapporterede uønskede hændelser er rapporteret i afsnittet Bivirkninger i denne rapport.
Op til 30 dage efter afsluttet undersøgelsesbehandling

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

National Cancer Institute (NCI)

Efterforskere

  • Ledende efterforsker: George Philips, Alliance for Clinical Trials in Oncology

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

15. september 2010

Primær færdiggørelse (Faktiske)

15. december 2017

Studieafslutning (Faktiske)

16. december 2017

Datoer for studieregistrering

Først indsendt

8. september 2010

Først indsendt, der opfyldte QC-kriterier

8. september 2010

Først opslået (Skøn)

9. september 2010

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

6. marts 2019

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

5. marts 2019

Sidst verificeret

1. marts 2019

Mere information

Begreber relateret til denne undersøgelse

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • NCI-2011-02603 (Registry Identifier: CTRP (Clinical Trial Reporting Program))
  • U10CA180821 (U.S. NIH-bevilling/kontrakt)
  • U10CA031946 (U.S. NIH-bevilling/kontrakt)
  • CDR0000684313
  • CALGB 90802 (Anden identifikator: Alliance for Clinical Trials in Oncology)
  • CALGB-90802 (Anden identifikator: CTEP)

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .

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