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UDSIGT: Kemoterapi alene eller kemoterapi plus strålebehandling til behandling af patienter med lokalt avanceret endetarmskræft, der gennemgår kirurgi

5. januar 2024 opdateret af: Alliance for Clinical Trials in Oncology

Et fase II/III forsøg med neoadjuverende FOLFOX med selektiv brug af kombineret modalitet kemoradiation versus præoperativ kombineret modalitet kemoradiation til lokalt avancerede rektalcancerpatienter, der gennemgår lav anterior resektion med total mesorektal excision (PROSPECT)

Standardbehandlingen for lokalt fremskreden endetarmskræft involverer kemoterapi og stråling, kendt som 5FUCMT, (kemoterapipræparaterne 5-fluorouracil/capecitabin og strålebehandling) før operationen. Selvom strålebehandling af bækkenet har været en standard og vigtig del af behandlingen af endetarmskræft og har vist sig at mindske risikoen for, at kræften vender tilbage i det samme område i bækkenet, oplever nogle patienter uønskede bivirkninger fra strålingen og har været vigtige fremskridt inden for kemoterapi, kirurgi og stråling, som kan være til gavn. Formålet med denne undersøgelse er at sammenligne virkningerne, både gode og dårlige, af standardbehandlingen af kemoterapi og stråling med kemoterapi ved brug af et kombinationsregime kendt som FOLFOX, (stofferne 5-fluorouracil (5-FU), oxaliplatin og leucovorin) og selektiv brug af standardbehandlingen, afhængig af respons på FOLFOX. Lægemidlerne i FOLFOX-kuren er alle godkendt af FDA (Food and Drug Administration) og er blevet brugt rutinemæssigt til behandling af patienter med fremskreden tyktarmskræft.

Studieoversigt

Status

Aktiv, ikke rekrutterende

Betingelser

Kolorektal cancer

Intervention / Behandling

Detaljeret beskrivelse

OVERSIGT: Dette er et multicenter, fase II/III-studie. Patienterne stratificeres i henhold til ECOG-præstationsstatus (0 eller 1 mod 2) og randomiseres til 1 ud af 2 behandlingsregimer. Patienterne vil modtage fuld støttende behandling under denne undersøgelse.

MÅL:

Primær

Fase II komponent: For at sikre, at neoadjuverende FOLFOX efterfulgt af selektiv brug af 5FUCMT gruppe (Gruppe 1) opretholder den nuværende høje frekvens af bækken R0 resektion og er i overensstemmelse med non-inferiority for tid til lokalt tilbagefald (TLR).
Fase III-komponent: At sammenligne neoadjuverende FOLFOX efterfulgt af selektiv brug af 5FUCMT (Gruppe 1) med standard 5FUCMT (Gruppe 2) med hensyn til det primære endepunkt for sygdomsfri overlevelse (DFS).

Sekundær

For at bestemme, om den neoadjuvante FOLFOX efterfulgt af selektiv brug af 5FUCMT (Gruppe 1) ikke er ringere end standardgruppen 5FUCMT (Gruppe 2) med hensyn til andelen af patienter, der opnår et patologisk komplet respons (pCR) på tidspunktet for kirurgisk indgreb resektion.
For at bestemme, om den neoadjuvante FOLFOX efterfulgt af selektiv brug af 5FUCMT (Gruppe 1) ikke er ringere end standard 5FUCMT (Gruppe 2) med hensyn til samlet overlevelse.
At evaluere og sammenligne bivirkningsprofilen og kirurgiske komplikationer mellem to grupper.
At estimere andelen af patienter i den selektive gruppe (Gruppe 1), som modtager: 1) præoperativ 5FUCMT; 2) postoperativ 5FUCMT; 3) enten præ- eller postoperativ 5FUCMT.
For at bestemme, om den neoadjuvante FOLFOX efterfulgt af selektiv brug af 5FUCMT (Gruppe 1) ikke er ringere end standarden 5FUCMT (Gruppe 2) med hensyn til lokalt tilbagefald (TLR)
For at bestemme, om den neoadjuvante FOLFOX efterfulgt af selektiv brug af 5FUCMT (Gruppe 1) ikke er ringere end standarden 5FUCMT (Gruppe 2) med hensyn til Neoadjuvant Response Score (NAR)

Hændelsesovervågning af patienter vil fortsætte op til 8 år efter randomisering.

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

1194

Fase

Fase 2
Fase 3

Kontakter og lokationer

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

Studiesteder

Canada
- Alberta
  - Calgary, Alberta, Canada, T2N 4N2
    - Tom Baker Cancer Centre
  - Edmonton, Alberta, Canada, T6G 1Z2
    - Cross Cancer Institute
- British Columbia
  - Kelowna, British Columbia, Canada, V1Y 5L3
    - BCCA-Cancer Centre for the Southern Interior
  - Vancouver, British Columbia, Canada, V5Z 4E6
    - BCCA-Vancouver Cancer Centre
- Manitoba
  - Winnipeg, Manitoba, Canada, R3E 0V9
    - CancerCare Manitoba
- New Brunswick
  - Saint John, New Brunswick, Canada, E2L 4L2
    - Atlantic Health Sciences Corporation-Saint John Regional Hospital
- Ontario
  - London, Ontario, Canada, N6A 4L6
    - London Regional Cancer Program
  - Oshawa, Ontario, Canada, L1G 2B9
    - Lakeridge Health Oshawa
  - Ottawa, Ontario, Canada, K1H 8L6
    - Ottawa Hospital and Cancer Center-General Campus
  - Saint Catharines, Ontario, Canada, L2S 0A9
    - Niagara Health System-Saint Catharines General
  - Toronto, Ontario, Canada, M4N 3M5
    - Odette Cancer Centre- Sunnybrook Health Sciences Centre
- Prince Edward Island
  - Charlottetown, Prince Edward Island, Canada, C1A 8T5
    - PEI Cancer Treatment Centre-Queen Elizabeth Hospital
- Quebec
  - Montreal, Quebec, Canada, H3H 2R9
    - The Research Institute of the McGill University Health Centre (MUHC)
  - Montreal, Quebec, Canada, H2W 1S6
    - McGill University Department of Oncology
- Saskatchewan
  - Regina, Saskatchewan, Canada, S4T 7T1
    - Allan Blair Cancer Centre
  - Saskatoon, Saskatchewan, Canada, S7N 4H4
    - Saskatoon Cancer Centre
Forenede Stater
- Alabama
  - Birmingham, Alabama, Forenede Stater, 35233
    - University of Alabama at Birmingham Cancer Center
  - Daphne, Alabama, Forenede Stater, 36526
    - Southern Cancer Center PC-Daphne
  - Mobile, Alabama, Forenede Stater, 36688
    - University of South Alabama Mitchell Cancer Institute
  - Mobile, Alabama, Forenede Stater, 36607
    - Southern Cancer Center PC-Mobile
  - Mobile, Alabama, Forenede Stater, 36608
    - Southern Cancer Center PC-Providence
  - Mobile, Alabama, Forenede Stater, 36608
    - Southern Cancer Center PC-Springhill
- Alaska
  - Anchorage, Alaska, Forenede Stater, 98508
    - Anchorage Associates in Radiation Medicine
  - Anchorage, Alaska, Forenede Stater, 99508
    - Alaska Breast Care and Surgery LLC
  - Anchorage, Alaska, Forenede Stater, 99508
    - Alaska Oncology and Hematology LLC
  - Anchorage, Alaska, Forenede Stater, 99508
    - Alaska Women's Cancer Care
  - Anchorage, Alaska, Forenede Stater, 99508
    - Anchorage Oncology Centre
  - Anchorage, Alaska, Forenede Stater, 99508
    - Katmai Oncology Group
  - Anchorage, Alaska, Forenede Stater, 99508
    - Providence Alaska Medical Center
  - Anchorage, Alaska, Forenede Stater, 99504
    - Anchorage Radiation Therapy Center
  - Anchorage, Alaska, Forenede Stater, 99508
    - Alaska Regional Hospital
  - Fairbanks, Alaska, Forenede Stater, 99701
    - Fairbanks Memorial Hospital
- Arizona
  - Phoenix, Arizona, Forenede Stater, 85054
    - Mayo Clinic Hospital
  - Scottsdale, Arizona, Forenede Stater, 85259
    - Mayo Clinic in Arizona
  - Tucson, Arizona, Forenede Stater, 85704
    - University of Arizona Cancer Center-Orange Grove Campus
  - Tucson, Arizona, Forenede Stater, 85719
    - University of Arizona Cancer Center-North Campus
  - Tucson, Arizona, Forenede Stater, 85724
    - The University of Arizona Medical Center-University Campus
  - Yuma, Arizona, Forenede Stater, 85364
    - Yuma Cancer Center
- Arkansas
  - Hot Springs, Arkansas, Forenede Stater, 71913
    - CHI Saint Vincent Cancer Center Hot Springs
  - Jonesboro, Arkansas, Forenede Stater, 72401
    - Baptist Memorial Hospital and Fowler Family Cancer Center - Jonesboro
  - Rogers, Arkansas, Forenede Stater, 72758
    - Highlands Oncology Group-Rogers
- 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
  - Auburn, California, Forenede Stater, 95602
    - Sutter Auburn Faith Hospital
  - Auburn, California, Forenede Stater, 95603
    - Sutter Cancer Centers Radiation Oncology Services-Auburn
  - 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
  - Burbank, California, Forenede Stater, 91505
    - Providence Saint Joseph Medical Center/Disney Family Cancer Center
  - Burlingame, California, Forenede Stater, 94010
    - Mills-Peninsula Medical Center
  - Cameron Park, California, Forenede Stater, 95682
    - Sutter Cancer Centers Radiation Oncology Services-Cameron Park
  - Castro Valley, California, Forenede Stater, 94546
    - Eden Hospital Medical Center
  - Castro Valley, California, Forenede Stater, 94546
    - East Bay Radiation Oncology Center
  - Chico, California, Forenede Stater, 95928
    - Feather River Cancer Center
  - Clovis, California, Forenede Stater, 93611
    - Community Cancer Institute
  - Clovis, California, Forenede Stater, 93611
    - University Oncology Associates
  - Concord, California, Forenede Stater, 94520
    - John Muir Medical Center-Concord Campus
  - Costa Mesa, California, Forenede Stater, 92627
    - UC Irvine Health Cancer Center-Newport
  - Davis, California, Forenede Stater, 95616
    - Sutter Davis Hospital
  - Dublin, California, Forenede Stater, 94568
    - Epic Care-Dublin
  - Emeryville, California, Forenede Stater, 94608
    - Bay Area Breast Surgeons Inc
  - Emeryville, California, Forenede Stater, 94608
    - Epic Care Partners in Cancer Care
  - Fremont, California, Forenede Stater, 94538
    - Kaiser Permanente-Fremont
  - Fremont, California, Forenede Stater, 94538
    - Palo Alto Medical Foundation-Fremont
  - Fresno, California, Forenede Stater, 93720
    - Kaiser Permanente-Fresno
  - Fresno, California, Forenede Stater, 93720
    - Fresno Cancer Center
  - Greenbrae, California, Forenede Stater, 94904
    - Marin Cancer Care Inc
  - Greenbrae, California, Forenede Stater, 94904
    - Marin General Hospital
  - La Jolla, California, Forenede Stater, 92093
    - UC San Diego Moores Cancer Center
  - Los Angeles, California, Forenede Stater, 90033
    - USC / Norris Comprehensive Cancer Center
  - Los Angeles, California, Forenede Stater, 90033
    - Los Angeles County-USC Medical Center
  - Los Angeles, California, Forenede Stater, 90027
    - Kaiser Permanente Los Angeles Medical Center
  - Los Angeles, California, Forenede Stater, 90048
    - Cedars Sinai Medical Center
  - Martinez, California, Forenede Stater, 94553-3156
    - Contra Costa Regional Medical Center
  - Modesto, California, Forenede Stater, 95355
    - Memorial Medical Center
  - Modesto, California, Forenede Stater, 95356
    - Kaiser Permanente-Modesto
  - Mountain View, California, Forenede Stater, 94040
    - El Camino Hospital
  - Mountain View, California, Forenede Stater, 94040
    - Palo Alto Medical Foundation-Camino Division
  - Mountain View, California, Forenede Stater, 94040
    - Palo Alto Medical Foundation-Gynecologic Oncology
  - Newport Beach, California, Forenede Stater, 92663
    - USC Norris Oncology/Hematology-Newport Beach
  - Novato, California, Forenede Stater, 94945
    - Sutter Cancer Research Consortium
  - Oakland, California, Forenede Stater, 94611
    - Kaiser Permanente-Oakland
  - 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
    - Bay Area Tumor Institute
  - Orange, California, Forenede Stater, 92868
    - UC Irvine Health/Chao Family Comprehensive Cancer Center
  - Orange, California, Forenede Stater, 92868
    - Saint Joseph Hospital - Orange
  - Palo Alto, California, Forenede Stater, 94304
    - Stanford Cancer Institute Palo Alto
  - Palo Alto, California, Forenede Stater, 94301
    - Palo Alto Medical Foundation Health Care
  - Pasadena, California, Forenede Stater, 91105
    - Keck Medical Center of USC Pasadena
  - Pleasanton, California, Forenede Stater, 94588
    - Valley Medical Oncology Consultants
  - 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
  - Roseville, California, Forenede Stater, 95661
    - Kaiser Permanente-Roseville
  - Roseville, California, Forenede Stater, 95661
    - Sutter Cancer Centers Radiation Oncology Services-Roseville
  - Roseville, California, Forenede Stater, 95661
    - Sutter Roseville Medical Center
  - Sacramento, California, Forenede Stater, 95816
    - Sutter Medical Center Sacramento
  - Sacramento, California, Forenede Stater, 95817
    - University of California Davis Comprehensive Cancer Center
  - Sacramento, California, Forenede Stater, 95814
    - Kaiser Permanente Downtown Commons
  - Sacramento, California, Forenede Stater, 95823
    - Kaiser Permanente-South Sacramento
  - Sacramento, California, Forenede Stater, 95825
    - Kaiser Permanente - Sacramento
  - Saint Helena, California, Forenede Stater, 94574
    - Saint Helena Hospital
  - San Diego, California, Forenede Stater, 92120
    - Kaiser Permanente-San Diego Zion
  - San Diego, California, Forenede Stater, 92134
    - Naval Medical Center -San Diego
  - 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, 94158
    - UCSF Medical Center-Mission Bay
  - San Francisco, California, Forenede Stater, 94115
    - California Pacific Medical Center-Pacific Campus
  - San Francisco, California, Forenede Stater, 94115
    - UCSF Medical Center-Mount Zion
  - 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 San Rafael-Gallinas
  - San Rafael, California, Forenede Stater, 94903
    - Kaiser Permanente-San Rafael
  - Santa Clara, California, Forenede Stater, 95051
    - Kaiser Permanente Medical Center - Santa Clara
  - Santa Cruz, California, Forenede Stater, 95065
    - Palo Alto Medical Foundation-Santa Cruz
  - 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-South San Francisco
  - Stockton, California, Forenede Stater, 95210
    - Kaiser Permanente-Stockton
  - Sunnyvale, California, Forenede Stater, 94086
    - Palo Alto Medical Foundation-Sunnyvale
  - Vacaville, California, Forenede Stater, 95688
    - Kaiser Permanente Medical Center-Vacaville
  - Vacaville, California, Forenede Stater, 95687
    - Northbay Cancer Center
  - Vacaville, California, Forenede Stater, 95687
    - Sutter Cancer Centers Radiation Oncology Services-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
  - Walnut Creek, California, Forenede Stater, 94598
    - John Muir Medical Center-Walnut Creek
  - Walnut Creek, California, Forenede Stater, 94597
    - Epic Care Cyberknife Center
- Colorado
  - Aurora, Colorado, Forenede Stater, 80045
    - University of Colorado Hospital
  - Aurora, Colorado, Forenede Stater, 80012
    - Rocky Mountain Cancer Centers-Aurora
  - Aurora, Colorado, Forenede Stater, 80012
    - The Medical Center of Aurora
  - Boulder, Colorado, Forenede Stater, 80301
    - Boulder Community Hospital
  - Boulder, Colorado, Forenede Stater, 80304
    - Rocky Mountain Cancer Centers-Boulder
  - Colorado Springs, Colorado, Forenede Stater, 80907
    - Penrose-Saint Francis Healthcare
  - Colorado Springs, Colorado, Forenede Stater, 80909
    - UCHealth Memorial Hospital Central
  - Colorado Springs, Colorado, Forenede Stater, 80907
    - Rocky Mountain Cancer Centers-Penrose
  - Denver, Colorado, Forenede Stater, 80210
    - Porter Adventist Hospital
  - 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, 80218
    - Rocky Mountain Cancer Centers-Midtown
  - Denver, Colorado, Forenede Stater, 80220
    - Rocky Mountain Cancer Centers-Rose
  - Denver, Colorado, Forenede Stater, 80204
    - Denver Health Medical Center
  - Denver, Colorado, Forenede Stater, 80218
    - Colorado Blood Cancer Institute
  - Denver, Colorado, Forenede Stater, 80209
    - The Women's Imaging Center
  - Denver, Colorado, Forenede Stater, 80206
    - National Jewish Health-Main Campus
  - Durango, Colorado, Forenede Stater, 81301
    - Mercy Medical Center
  - Durango, Colorado, Forenede Stater, 81301
    - Southwest Oncology PC
  - Englewood, Colorado, Forenede Stater, 80113
    - Swedish Medical Center
  - Englewood, Colorado, Forenede Stater, 80113
    - Comprehensive Cancer Care and Research Institute of Colorado LLC
  - Fort Collins, Colorado, Forenede Stater, 80524
    - Poudre Valley Hospital
  - Golden, Colorado, Forenede Stater, 80401
    - Mountain Blue Cancer Care Center
  - Golden, Colorado, Forenede Stater, 80401
    - National Jewish Health-Western Hematology Oncology
  - Grand Junction, Colorado, Forenede Stater, 81501
    - Saint Mary's Hospital and Regional Medical Center
  - Greeley, Colorado, Forenede Stater, 80631
    - North Colorado Medical Center
  - Greenwood Village, Colorado, Forenede Stater, 80111
    - Rocky Mountain Cancer Centers-Greenwood Village
  - Lafayette, Colorado, Forenede Stater, 80026
    - Good Samaritan Medical Center
  - Lakewood, Colorado, Forenede Stater, 80228
    - Saint Anthony Hospital
  - Lakewood, Colorado, Forenede Stater, 80228
    - Rocky Mountain Cancer Centers-Lakewood
  - Littleton, Colorado, Forenede Stater, 80120
    - Rocky Mountain Cancer Centers-Littleton
  - Littleton, Colorado, Forenede Stater, 80122
    - Littleton Adventist Hospital
  - Lone Tree, Colorado, Forenede Stater, 80124
    - Sky Ridge Medical Center
  - Lone Tree, Colorado, Forenede Stater, 80124
    - Rocky Mountain Cancer Centers-Sky Ridge
  - Longmont, Colorado, Forenede Stater, 80501
    - Longmont United Hospital
  - Longmont, Colorado, Forenede Stater, 80501
    - Rocky Mountain Cancer Centers-Longmont
  - Loveland, Colorado, Forenede Stater, 80539
    - McKee Medical Center
  - Parker, Colorado, Forenede Stater, 80138
    - Parker Adventist Hospital
  - Parker, Colorado, Forenede Stater, 80138
    - Rocky Mountain Cancer Centers-Parker
  - Pueblo, Colorado, Forenede Stater, 81004
    - Saint Mary Corwin Medical Center
  - Pueblo, Colorado, Forenede Stater, 81008
    - Rocky Mountain Cancer Centers - Pueblo
  - Thornton, Colorado, Forenede Stater, 80260
    - Rocky Mountain Cancer Centers-Thornton
  - Thornton, Colorado, Forenede Stater, 80260
    - National Jewish Health-Northern Hematology Oncology
  - Wheat Ridge, Colorado, Forenede Stater, 80033
    - SCL Health Lutheran Medical Center
- Connecticut
  - Guilford, Connecticut, Forenede Stater, 06437
    - Yale-New Haven Shoreline Medical Center
  - Hartford, Connecticut, Forenede Stater, 06105
    - Smilow Cancer Hospital Care Center at Saint Francis
  - Hartford, Connecticut, Forenede Stater, 06102
    - Hartford Hospital
  - Meriden, Connecticut, Forenede Stater, 06451
    - Midstate Medical Center
  - New Britain, Connecticut, Forenede Stater, 06050
    - The Hospital of Central Connecticut
  - New Haven, Connecticut, Forenede Stater, 06520
    - Yale University
  - New Haven, Connecticut, Forenede Stater, 06510
    - Smilow Cancer Center/Yale-New Haven Hospital
  - North Haven, Connecticut, Forenede Stater, 06473
    - Yale-New Haven Hospital North Haven Medical Center
  - Norwalk, Connecticut, Forenede Stater, 06856
    - Norwalk Hospital
  - Norwich, Connecticut, Forenede Stater, 06360
    - Eastern Connecticut Hematology and Oncology Associates
  - Trumbull, Connecticut, Forenede Stater, 06611
    - Smilow Cancer Hospital Care Center-Trumbull
  - Waterford, Connecticut, Forenede Stater, 06385
    - Lawrence and Memorial Cancer Center
- Delaware
  - Lewes, Delaware, Forenede Stater, 19958
    - Beebe Medical Center
  - Newark, Delaware, Forenede Stater, 19713
    - Helen F Graham Cancer Center
  - Newark, Delaware, Forenede Stater, 19713
    - Delaware Clinical and Laboratory Physicians PA
  - Newark, Delaware, Forenede Stater, 19713
    - Medical Oncology Hematology Consultants PA
  - Newark, Delaware, Forenede Stater, 19718
    - Christiana Care Health System-Christiana Hospital
  - Newark, Delaware, Forenede Stater, 19713
    - Christiana Gynecologic Oncology LLC
  - Newark, Delaware, Forenede Stater, 19713
    - Regional Hematology and Oncology PA
  - Rehoboth Beach, Delaware, Forenede Stater, 19971
    - Beebe Health Campus
  - Seaford, Delaware, Forenede Stater, 19973
    - Nanticoke Memorial Hospital
  - Wilmington, Delaware, Forenede Stater, 19801
    - Christiana Care Health System-Wilmington 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
- Florida
  - Altamonte Springs, Florida, Forenede Stater, 32701
    - Florida Hospital Cancer Institute Altamonte
  - Aventura, Florida, Forenede Stater, 33180
    - Mount Sinai Comprehensive Cancer Center at Aventura
  - Coral Gables, Florida, Forenede Stater, 33146
    - UM Sylvester Comprehensive Cancer Center at Coral Gables
  - Deerfield Beach, Florida, Forenede Stater, 33442
    - UM Sylvester Comprehensive Cancer Center at Deerfield Beach
  - Fort Lauderdale, Florida, Forenede Stater, 33308
    - Holy Cross Hospital
  - Gainesville, Florida, Forenede Stater, 32610
    - University of Florida Health Science Center - Gainesville
  - Hollywood, Florida, Forenede Stater, 33021
    - Memorial Regional Hospital/Joe DiMaggio Children's Hospital
  - Jacksonville, Florida, Forenede Stater, 32207
    - Baptist MD Anderson Cancer Center
  - Jacksonville, Florida, Forenede Stater, 32224-9980
    - Mayo Clinic in Florida
  - Jacksonville, Florida, Forenede Stater, 32258
    - Baptist Medical Center South
  - Jacksonville, Florida, Forenede Stater, 32207
    - Integrated Community Oncology Network-Southside Cancer Center
  - Jacksonville Beach, Florida, Forenede Stater, 32250
    - Integrated Community Oncology Network-Florida Cancer Center Beaches
  - Jupiter, Florida, Forenede Stater, 33458
    - Jupiter Medical Center
  - Kissimmee, Florida, Forenede Stater, 34744
    - Florida Hospital Kissimmee
  - Lakeland, Florida, Forenede Stater, 33805
    - Lakeland Regional Health Hollis Cancer Center
  - Lakeland, Florida, Forenede Stater, 33805
    - The Watson Clinic
  - Miami, Florida, Forenede Stater, 33136
    - University of Miami Miller School of Medicine-Sylvester Cancer 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, 32803
    - Florida Urology Associates-Orlando
  - Orlando, Florida, Forenede Stater, 32822
    - Florida Hospital East Orlando
  - Palatka, Florida, Forenede Stater, 32177
    - 21st Century Oncology-Palatka
  - Pembroke Pines, Florida, Forenede Stater, 33028
    - Memorial Hospital West
  - Plantation, Florida, Forenede Stater, 33324
    - UM Sylvester Comprehensive Cancer Center at Plantation
  - Saint Augustine, Florida, Forenede Stater, 32086
    - Integrated Community Oncology Network-Flager Cancer Center
  - Tampa, Florida, Forenede Stater, 33606
    - Tampa General Hospital
  - Winter Park, Florida, Forenede Stater, 32792
    - Florida Hospital Cancer Institute Winter Park
- Georgia
  - Atlanta, Georgia, Forenede Stater, 30308
    - Emory University Hospital Midtown
  - Atlanta, Georgia, Forenede Stater, 30322
    - Emory University Hospital/Winship Cancer Institute
  - Atlanta, Georgia, Forenede Stater, 30342
    - Emory Saint Joseph's Hospital
  - Columbus, Georgia, Forenede Stater, 31904
    - John B Amos Cancer Center
  - Decatur, Georgia, Forenede Stater, 30033
    - Atlanta VA Medical Center
  - Savannah, Georgia, Forenede Stater, 31404
    - Memorial Health University Medical Center
  - Savannah, Georgia, Forenede Stater, 31404
    - Summit Cancer Care-Memorial
  - Savannah, Georgia, Forenede Stater, 31405
    - Low Country Cancer Care Associates PC
  - Thomasville, Georgia, Forenede Stater, 31792
    - Lewis Hall Singletary Oncology Center
- Hawaii
  - 'Aiea, Hawaii, Forenede Stater, 96701
    - Pali Momi Medical Center
  - 'Aiea, Hawaii, Forenede Stater, 96701
    - The Cancer Center of Hawaii-Pali Momi
  - 'Aiea, Hawaii, Forenede Stater, 96701
    - Hawaii Oncology Inc-Pali Momi
  - 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, 96817
    - Hawaii Cancer Care Inc-Liliha
  - Honolulu, Hawaii, Forenede Stater, 96817
    - Kuakini Medical Center
  - Honolulu, Hawaii, Forenede Stater, 96826
    - Kapiolani Medical Center for Women and Children
  - Honolulu, Hawaii, Forenede Stater, 96813
    - Island Urology
  - 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, 96813
    - Hawaii Oncology Inc-POB I
  - Honolulu, Hawaii, Forenede Stater, 96817
    - Hawaii Oncology Inc-Kuakini
  - Lihue, Hawaii, Forenede Stater, 96766
    - Wilcox Memorial Hospital and Kauai Medical Clinic
- Idaho
  - Boise, Idaho, Forenede Stater, 83706
    - Saint Alphonsus Cancer Care Center-Boise
  - Boise, Idaho, Forenede Stater, 83712
    - Saint Luke's Mountain States Tumor Institute
  - Caldwell, Idaho, Forenede Stater, 83605
    - Saint Alphonsus Cancer Care Center-Caldwell
  - Coeur d'Alene, Idaho, Forenede Stater, 83814
    - Kootenai Medical Center
  - Emmett, Idaho, Forenede Stater, 83617
    - Walter Knox Memorial Hospital
  - Fruitland, Idaho, Forenede Stater, 83619
    - Saint Luke's Mountain States Tumor Institute - Fruitland
  - Lewiston, Idaho, Forenede Stater, 83501
    - Saint Joseph Regional Medical Center
  - Meridian, Idaho, Forenede Stater, 83642
    - Idaho Urologic Institute-Meridian
  - Meridian, Idaho, Forenede Stater, 83642
    - Saint Luke's Mountain States Tumor Institute - Meridian
  - Nampa, Idaho, Forenede Stater, 83686
    - Saint Alphonsus Medical Center-Nampa
  - Nampa, Idaho, Forenede Stater, 83686
    - Saint Luke's Mountain States Tumor Institute - Nampa
  - Post Falls, Idaho, Forenede Stater, 83854
    - Kootenai Cancer Center
  - Sandpoint, Idaho, Forenede Stater, 83864
    - Kootenai Cancer Clinic
  - Twin Falls, Idaho, Forenede Stater, 83301
    - Saint Luke's Mountain States Tumor Institute-Twin Falls
- Illinois
  - Aurora, Illinois, Forenede Stater, 60504
    - Rush - Copley Medical Center
  - 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
  - Carbondale, Illinois, Forenede Stater, 62902
    - Memorial Hospital of Carbondale
  - Carterville, Illinois, Forenede Stater, 62918
    - SIH Cancer Institute
  - Carthage, Illinois, Forenede Stater, 62321
    - Illinois CancerCare-Carthage
  - Centralia, Illinois, Forenede Stater, 62801
    - Centralia Oncology Clinic
  - Chicago, Illinois, Forenede Stater, 60611
    - Northwestern University
  - Chicago, Illinois, Forenede Stater, 60612
    - Rush University Medical Center
  - 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, 60608
    - Mount Sinai Hospital Medical Center
  - Chicago, Illinois, Forenede Stater, 60625
    - Swedish Covenant Hospital
  - Chicago, Illinois, Forenede Stater, 60611
    - Hematology and Oncology Associates
  - Chicago, Illinois, Forenede Stater, 60631
    - Presence Resurrection Medical Center
  - Chicago, Illinois, Forenede Stater, 60657
    - Presence Saint Joseph Hospital-Chicago
  - Danville, Illinois, Forenede Stater, 61832
    - Carle on Vermilion
  - Decatur, Illinois, Forenede Stater, 62526
    - Decatur Memorial Hospital
  - Decatur, Illinois, Forenede Stater, 62526
    - Cancer Care Specialists of Illinois - Decatur
  - Effingham, Illinois, Forenede Stater, 62401
    - Crossroads Cancer Center
  - Effingham, Illinois, Forenede Stater, 62401
    - Carle Physician Group-Effingham
  - Eureka, Illinois, Forenede Stater, 61530
    - Illinois CancerCare-Eureka
  - Evanston, Illinois, Forenede Stater, 60201
    - NorthShore University HealthSystem-Evanston Hospital
  - Galesburg, Illinois, Forenede Stater, 61401
    - Western Illinois Cancer Treatment Center
  - Galesburg, Illinois, Forenede Stater, 61401
    - Illinois CancerCare-Galesburg
  - Geneva, Illinois, Forenede Stater, 60134
    - Northwestern Medicine Cancer Center Delnor
  - Glenview, Illinois, Forenede Stater, 60026
    - NorthShore University HealthSystem-Glenbrook Hospital
  - Harvey, Illinois, Forenede Stater, 60426
    - Ingalls Memorial Hospital
  - Highland Park, Illinois, Forenede Stater, 60035
    - NorthShore University HealthSystem-Highland Park Hospital
  - Highland Park, Illinois, Forenede Stater, 60035
    - Hematology Oncology Associates of Illinois-Highland Park
  - Hines, Illinois, Forenede Stater, 60141
    - Edward Hines Jr VA Hospital
  - Kankakee, Illinois, Forenede Stater, 60901
    - Presence Saint Mary's Hospital
  - Kewanee, Illinois, Forenede Stater, 61443
    - Illinois CancerCare-Kewanee Clinic
  - Libertyville, Illinois, Forenede Stater, 60048
    - NorthShore Hematology Oncology-Libertyville
  - Macomb, Illinois, Forenede Stater, 61455
    - Illinois CancerCare-Macomb
  - Mattoon, Illinois, Forenede Stater, 61938
    - Carle Physician Group-Mattoon/Charleston
  - Maywood, Illinois, Forenede Stater, 60153
    - Loyola University Medical Center
  - Moline, Illinois, Forenede Stater, 61265
    - Garneau, Stewart C MD (UIA Investigator)
  - Moline, Illinois, Forenede Stater, 61265
    - Porubcin, Michael MD (UIA Investigator)
  - Moline, Illinois, Forenede Stater, 61265
    - Spector, David MD (UIA Investigator)
  - Moline, Illinois, Forenede Stater, 61265
    - Trinity Medical Center
  - Mount Vernon, Illinois, Forenede Stater, 62864
    - Good Samaritan Regional Health Center
  - New Lenox, Illinois, Forenede Stater, 60451
    - UC Comprehensive Cancer Center at Silver Cross
  - Niles, Illinois, Forenede Stater, 60714
    - Illinois Cancer Specialists-Niles
  - Orland Park, Illinois, Forenede Stater, 60462
    - University of Chicago Medicine-Orland Park
  - Ottawa, Illinois, Forenede Stater, 61350
    - Illinois CancerCare-Ottawa Clinic
  - Ottawa, Illinois, Forenede Stater, 61350
    - Radiation Oncology of Northern Illinois
  - Park Ridge, Illinois, Forenede Stater, 60068
    - Advocate Lutheran General Hospital
  - 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, 61615
    - OSF Saint Francis Radiation Oncology at Peoria Cancer Center
  - Peru, Illinois, Forenede Stater, 61354
    - Illinois CancerCare-Peru
  - Peru, Illinois, Forenede Stater, 61354
    - Valley Radiation Oncology
  - Princeton, Illinois, Forenede Stater, 61356
    - Illinois CancerCare-Princeton
  - Rockford, Illinois, Forenede Stater, 61114
    - SwedishAmerican Regional Cancer Center/ACT
  - Rockford, Illinois, Forenede Stater, 61104
    - Swedish American Hospital
  - Skokie, Illinois, Forenede Stater, 60076
    - Hematology Oncology Associates of Illinois - Skokie
  - Springfield, Illinois, Forenede Stater, 62781
    - Memorial Medical Center
  - Springfield, Illinois, Forenede Stater, 62702
    - Southern Illinois University School of Medicine
  - Springfield, Illinois, Forenede Stater, 62702
    - Springfield Clinic
  - Springfield, Illinois, Forenede Stater, 62702
    - Central Illinois Hematology Oncology Center
  - Swansea, Illinois, Forenede Stater, 62226
    - Southwest Illinois Health Services LLP
  - Swansea, Illinois, Forenede Stater, 62226
    - Cancer Care Specialists of Illinois-Swansea
  - Urbana, Illinois, Forenede Stater, 61801
    - Carle Cancer Center
  - Urbana, Illinois, Forenede Stater, 61801
    - The Carle Foundation Hospital
  - Warrenville, Illinois, Forenede Stater, 60555
    - Northwestern Medicine Cancer Center Warrenville
  - Yorkville, Illinois, Forenede Stater, 60560
    - Rush-Copley Healthcare Center
- Indiana
  - Carmel, Indiana, Forenede Stater, 46032
    - IU Health North Hospital
  - 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
  - Evansville, Indiana, Forenede Stater, 47713
    - Deaconess Clinic Downtown
  - Fort Wayne, Indiana, Forenede Stater, 46805
    - Parkview Hospital Randallia
  - 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
  - Indianapolis, Indiana, Forenede Stater, 46202
    - Indiana University/Melvin and Bren Simon Cancer Center
  - Indianapolis, Indiana, Forenede Stater, 46202
    - Sidney and Lois Eskenazi Hospital
  - Indianapolis, Indiana, Forenede Stater, 46290
    - Springmill Medical Center
  - Indianapolis, Indiana, Forenede Stater, 46237
    - Kendrick Colon and Rectal Center-Indianapolis
  - Kokomo, Indiana, Forenede Stater, 46904
    - Community Howard Regional Health
  - La Porte, Indiana, Forenede Stater, 46350
    - IU Health La Porte Hospital
  - Michigan City, Indiana, Forenede Stater, 46360
    - Woodland Cancer Care Center
  - Mishawaka, Indiana, Forenede Stater, 46545
    - Memorial Regional Cancer Center Day Road
  - Mishawaka, Indiana, Forenede Stater, 46545
    - Michiana Hematology Oncology PC-Mishawaka
  - Mishawaka, Indiana, Forenede Stater, 46545
    - Saint Joseph Regional Medical Center-Mishawaka
  - Mooresville, Indiana, Forenede Stater, 46158
    - Franciscan Health Mooresville
  - Newburgh, Indiana, Forenede Stater, 47630
    - Chancellor Center for Oncology
  - 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, 46617
    - South Bend Clinic
  - Terre Haute, Indiana, Forenede Stater, 47804
    - Union Hospital
  - Westville, Indiana, Forenede Stater, 46391
    - Michiana Hematology Oncology PC-Westville
- Iowa
  - Bettendorf, Iowa, Forenede Stater, 52722
    - Constantinou, Costas L MD (UIA Investigator)
  - Cedar Rapids, Iowa, Forenede Stater, 52403
    - Mercy Hospital
  - Cedar Rapids, Iowa, Forenede Stater, 52403
    - Oncology Associates at Mercy Medical Center
  - Clive, Iowa, Forenede Stater, 50325
    - Mercy Cancer Center-West Lakes
  - Clive, Iowa, Forenede Stater, 50325
    - Medical Oncology and Hematology Associates-West Des Moines
  - Council Bluffs, Iowa, Forenede Stater, 51503
    - Alegent Health Mercy Hospital
  - Creston, Iowa, Forenede Stater, 50801
    - Greater Regional Medical Center
  - 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, 50314
    - Broadlawns Medical Center
  - Des Moines, Iowa, Forenede Stater, 50316
    - Iowa Lutheran Hospital
  - Des Moines, Iowa, Forenede Stater, 50314
    - Medical Oncology and Hematology Associates-Laurel
  - Fort Dodge, Iowa, Forenede Stater, 50501
    - Trinity Regional Medical Center
  - West Des Moines, Iowa, Forenede Stater, 50266-7700
    - Methodist West Hospital
  - West Des Moines, Iowa, Forenede Stater, 50266
    - Mercy Medical Center-West Lakes
- Kansas
  - Chanute, Kansas, Forenede Stater, 66720
    - Cancer Center of Kansas - Chanute
  - Dodge City, Kansas, Forenede Stater, 67801
    - Cancer Center of Kansas - Dodge City
  - El Dorado, Kansas, Forenede Stater, 67042
    - Cancer Center of Kansas - El Dorado
  - Fort Scott, Kansas, Forenede Stater, 66701
    - Cancer Center of Kansas - Fort Scott
  - Garden City, Kansas, Forenede Stater, 67846
    - Central Care Cancer Center - Garden City
  - Garden City, Kansas, Forenede Stater, 67846
    - Saint Catherine Hospital
  - Great Bend, Kansas, Forenede Stater, 67530
    - Central Care Cancer Center - Great Bend
  - Independence, Kansas, Forenede Stater, 67301
    - Cancer Center of Kansas-Independence
  - Kansas City, Kansas, Forenede Stater, 66160
    - University of Kansas Cancer Center
  - Kingman, Kansas, Forenede Stater, 67068
    - Cancer Center of Kansas-Kingman
  - Lawrence, Kansas, Forenede Stater, 66044
    - Lawrence Memorial Hospital
  - Lenexa, Kansas, Forenede Stater, 66219
    - Kansas Institute of Medicine Cancer and Blood Center
  - Lenexa, Kansas, Forenede Stater, 66219
    - Minimally Invasive Surgery Hospital
  - Liberal, Kansas, Forenede Stater, 67905
    - Cancer Center of Kansas-Liberal
  - Manhattan, Kansas, Forenede Stater, 66502
    - Cancer Center of Kansas-Manhattan
  - McPherson, Kansas, Forenede Stater, 67460
    - Cancer Center of Kansas - McPherson
  - Newton, Kansas, Forenede Stater, 67114
    - Cancer Center of Kansas - Newton
  - Olathe, Kansas, Forenede Stater, 66061
    - Olathe Medical Center
  - Overland Park, Kansas, Forenede Stater, 66210
    - University of Kansas Cancer Center-Overland Park
  - Overland Park, Kansas, Forenede Stater, 66209
    - Menorah Medical Center
  - Overland Park, Kansas, Forenede Stater, 66213
    - Saint Luke's South Hospital
  - Parsons, Kansas, Forenede Stater, 67357
    - Cancer Center of Kansas - Parsons
  - Pittsburg, Kansas, Forenede Stater, 66762
    - Via Christi Hospital-Pittsburg
  - Pratt, Kansas, Forenede Stater, 67124
    - Cancer Center of Kansas - Pratt
  - Salina, Kansas, Forenede Stater, 67401
    - Salina Regional Health Center
  - Salina, Kansas, Forenede Stater, 67401
    - Cancer Center of Kansas - Salina
  - Topeka, Kansas, Forenede Stater, 66606
    - Cotton O'Neil Cancer Center / Stormont Vail Health
  - Topeka, Kansas, Forenede Stater, 66606
    - Saint Francis Hospital and Medical Center - Topeka
  - Wellington, Kansas, Forenede Stater, 67152
    - Cancer Center of Kansas - Wellington
  - Westwood, Kansas, Forenede Stater, 66205
    - University of Kansas Hospital-Westwood Cancer Center
  - Wichita, Kansas, Forenede Stater, 67208
    - Cancer Center of Kansas-Wichita Medical Arts Tower
  - Wichita, Kansas, Forenede Stater, 67214
    - Cancer Center of Kansas - Wichita
  - Wichita, Kansas, Forenede Stater, 67208
    - Associates In Womens Health
  - Wichita, Kansas, Forenede Stater, 67214
    - Via Christi Regional Medical Center
  - Wichita, Kansas, Forenede Stater, 67214
    - Wesley Medical Center
  - Winfield, Kansas, Forenede Stater, 67156
    - Cancer Center of Kansas - Winfield
- Kentucky
  - Bardstown, Kentucky, Forenede Stater, 40004
    - Flaget Memorial Hospital
  - Corbin, Kentucky, Forenede Stater, 40701
    - Baptist Health Corbin
  - Corbin, Kentucky, Forenede Stater, 40701
    - Commonwealth Cancer Center-Corbin
  - Crestview Hills, Kentucky, Forenede Stater, 41017
    - Oncology Hematology Care Inc-Crestview
  - Lexington, Kentucky, Forenede Stater, 40536
    - University of Kentucky/Markey Cancer Center
  - Lexington, Kentucky, Forenede Stater, 40504
    - Saint Joseph Radiation Oncology Resource Center
  - Lexington, Kentucky, Forenede Stater, 40509
    - Saint Joseph Hospital East
  - Lexington, Kentucky, Forenede Stater, 40503
    - Baptist Health Lexington
  - London, Kentucky, Forenede Stater, 40741
    - Saint Joseph London
  - Louisville, Kentucky, Forenede Stater, 40202
    - Jewish Hospital
  - Louisville, Kentucky, Forenede Stater, 40207
    - Baptist Health Louisville
  - Louisville, Kentucky, Forenede Stater, 40215
    - Saints Mary and Elizabeth Hospital
  - Louisville, Kentucky, Forenede Stater, 40245
    - Jewish Hospital Medical Center Northeast
  - Madisonville, Kentucky, Forenede Stater, 42431
    - Baptist Health Madisonville/Merle Mahr Cancer Center
  - Paducah, Kentucky, Forenede Stater, 42003
    - Baptist Health Paducah
  - Shepherdsville, Kentucky, Forenede Stater, 40165
    - Jewish Hospital Medical Center South
- Louisiana
  - Baton Rouge, Louisiana, Forenede Stater, 70805
    - LSU Health Baton Rouge-North Clinic
  - Baton Rouge, Louisiana, Forenede Stater, 70809
    - Louisiana Hematology Oncology Associates LLC
  - Baton Rouge, Louisiana, Forenede Stater, 70809
    - Mary Bird Perkins Cancer Center
  - Baton Rouge, Louisiana, Forenede Stater, 70809
    - Our Lady of the Lake Physicians Group - Medical Oncology
  - New Orleans, Louisiana, Forenede Stater, 70121
    - Ochsner Medical Center Jefferson
  - New Orleans, Louisiana, Forenede Stater, 70112
    - University Medical Center New Orleans
  - New Orleans, Louisiana, Forenede Stater, 70112
    - Louisiana State University Health Science Center
- Maine
  - Bangor, Maine, Forenede Stater, 04401
    - Eastern Maine Medical Center
  - Brewer, Maine, Forenede Stater, 04412
    - Lafayette Family Cancer Center-EMMC
- Maryland
  - Baltimore, Maryland, Forenede Stater, 21287
    - Johns Hopkins University/Sidney Kimmel Cancer Center
  - Baltimore, Maryland, Forenede Stater, 21215
    - Sinai Hospital of Baltimore
  - Baltimore, Maryland, Forenede Stater, 21201
    - University of Maryland/Greenebaum Cancer Center
  - Baltimore, Maryland, Forenede Stater, 21218
    - MedStar Union Memorial Hospital
  - Baltimore, Maryland, Forenede Stater, 21239
    - MedStar Good Samaritan Hospital
  - Bel Air, Maryland, Forenede Stater, 21014
    - UM Upper Chesapeake Medical Center
  - Glen Burnie, Maryland, Forenede Stater, 21061
    - UM Baltimore Washington Medical Center/Tate Cancer Center
  - Salisbury, Maryland, Forenede Stater, 21801
    - Peninsula Regional Medical Center
- Massachusetts
  - Beverly, Massachusetts, Forenede Stater, 01915
    - Beverly Hospital
  - Boston, Massachusetts, Forenede Stater, 02215
    - Beth Israel Deaconess Medical Center
  - Boston, Massachusetts, Forenede Stater, 02215
    - Dana-Farber Cancer Institute
  - Boston, Massachusetts, Forenede Stater, 02115
    - Brigham and Women's Hospital
  - Boston, Massachusetts, Forenede Stater, 02118
    - Boston Medical Center
  - Boston, Massachusetts, Forenede Stater, 02114
    - Massachusetts General Hospital Cancer Center
  - Burlington, Massachusetts, Forenede Stater, 01805
    - Lahey Hospital and Medical Center
  - Gloucester, Massachusetts, Forenede Stater, 01930
    - Addison Gilbert Hospital
  - Milford, Massachusetts, Forenede Stater, 01757
    - Dana-Farber/Brigham and Women's Cancer Center at Milford Regional
  - Pittsfield, Massachusetts, Forenede Stater, 01201
    - Berkshire Hematology Oncology PC
  - South Weymouth, Massachusetts, Forenede Stater, 02190
    - Dana-Farber/Brigham and Women's Cancer Center at South Shore
  - Springfield, Massachusetts, Forenede Stater, 01199
    - Baystate Medical Center
  - Springfield, Massachusetts, Forenede Stater, 01104
    - Mercy Medical Center
  - Winchester, Massachusetts, Forenede Stater, 01890
    - Winchester Hospital
- Michigan
  - Ann Arbor, Michigan, Forenede Stater, 48109
    - University of Michigan Comprehensive Cancer Center
  - Ann Arbor, Michigan, Forenede Stater, 48106
    - Saint Joseph Mercy Hospital
  - Brighton, Michigan, Forenede Stater, 48114
    - Saint Joseph Mercy Brighton
  - Brighton, Michigan, Forenede Stater, 48114
    - IHA Hematology Oncology Consultants-Brighton
  - Brownstown, Michigan, Forenede Stater, 48183
    - Henry Ford Cancer Institute-Downriver
  - Canton, Michigan, Forenede Stater, 48188
    - Saint Joseph Mercy Canton
  - Canton, Michigan, Forenede Stater, 48188
    - IHA Hematology Oncology Consultants-Canton
  - Caro, Michigan, Forenede Stater, 48723
    - Caro Cancer Center
  - Chelsea, Michigan, Forenede Stater, 48118
    - Saint Joseph Mercy Chelsea
  - Chelsea, Michigan, Forenede Stater, 48118
    - IHA Hematology Oncology Consultants-Chelsea
  - Clarkston, Michigan, Forenede Stater, 48346
    - Hematology Oncology Consultants-Clarkston
  - Clarkston, Michigan, Forenede Stater, 48346
    - Newland Medical Associates-Clarkston
  - Clinton Township, Michigan, Forenede Stater, 48038
    - Henry Ford Macomb Hospital-Clinton Township
  - Dearborn, Michigan, Forenede Stater, 48126
    - Henry Ford Medical Center-Fairlane
  - Dearborn, Michigan, Forenede Stater, 48124
    - Beaumont Hospital-Dearborn
  - Detroit, Michigan, Forenede Stater, 48202
    - Henry Ford Hospital
  - Detroit, Michigan, Forenede Stater, 48201
    - Wayne State University/Karmanos Cancer Institute
  - Detroit, Michigan, Forenede Stater, 48236
    - Ascension Saint John Hospital
  - East China Township, Michigan, Forenede Stater, 48054
    - Great Lakes Cancer Management Specialists-Doctors Park
  - Farmington Hills, Michigan, Forenede Stater, 48336
    - Beaumont Hospital - Farmington Hills
  - Flint, Michigan, Forenede Stater, 48503
    - Hurley Medical Center
  - Flint, Michigan, Forenede Stater, 48503
    - Genesee Cancer and Blood Disease Treatment Center
  - Flint, Michigan, Forenede Stater, 48503
    - Genesee Hematology Oncology PC
  - Flint, Michigan, Forenede Stater, 48503
    - Genesys Hurley Cancer Institute
  - Grosse Pointe, Michigan, Forenede Stater, 48230
    - William Beaumont Hospital-Grosse Point
  - Grosse Pointe Woods, Michigan, Forenede Stater, 48236
    - Great Lakes Cancer Management Specialists-Van Elslander Cancer Center
  - Grosse Pointe Woods, Michigan, Forenede Stater, 48236
    - Michigan Breast Specialists-Grosse Pointe Woods
  - Grosse Pointe Woods, Michigan, Forenede Stater, 48236
    - Lymphoma Clinic of Michigan
  - Jackson, Michigan, Forenede Stater, 49201
    - Allegiance Health
  - 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
  - Lansing, Michigan, Forenede Stater, 48912
    - Sparrow Hospital
  - Livonia, Michigan, Forenede Stater, 48154
    - Saint Mary Mercy Hospital
  - Livonia, Michigan, Forenede Stater, 48154
    - Hope Cancer Clinic
  - Macomb, Michigan, Forenede Stater, 48044
    - Great Lakes Cancer Management Specialists-Macomb Medical Campus
  - Macomb, Michigan, Forenede Stater, 48044
    - Michigan Breast Specialists-Macomb Township
  - Marlette, Michigan, Forenede Stater, 48453
    - Saint Mary's Oncology/Hematology Associates of Marlette
  - Midland, Michigan, Forenede Stater, 48670
    - Mid-Michigan Medical Center - Midland
  - Monroe, Michigan, Forenede Stater, 48162
    - Monroe Cancer Center
  - Niles, Michigan, Forenede Stater, 49120
    - Lakeland Hospital Niles
  - Novi, Michigan, Forenede Stater, 48377
    - Henry Ford Medical Center-Columbus
  - Pontiac, Michigan, Forenede Stater, 48341
    - Saint Joseph Mercy Oakland
  - Pontiac, Michigan, Forenede Stater, 48341
    - 21st Century Oncology-Pontiac
  - Pontiac, Michigan, Forenede Stater, 48341
    - Hope Cancer Center
  - Pontiac, Michigan, Forenede Stater, 48341
    - Newland Medical Associates-Pontiac
  - Port Huron, Michigan, Forenede Stater, 48060
    - Lake Huron Medical Center
  - Port Huron, Michigan, Forenede Stater, 48060
    - Huron Medical Center PC
  - Rochester Hills, Michigan, Forenede Stater, 48309
    - Great Lakes Cancer Management Specialists-Rochester Hills
  - Roseville, Michigan, Forenede Stater, 48066
    - Michigan Cancer Specialists
  - Royal Oak, Michigan, Forenede Stater, 48073
    - William Beaumont Hospital-Royal Oak
  - Royal Oak, Michigan, Forenede Stater, 48067
    - Oakland Colon and Rectal Association
  - Royal Oak, Michigan, Forenede Stater, 48073
    - Cancer Care Associates PC
  - Royal Oak, Michigan, Forenede Stater, 48073
    - Comprehensive Medical Center PLLC
  - Royal Oak, Michigan, Forenede Stater, 48073
    - Hematology Oncology Consultants PC
  - Royal Oak, Michigan, Forenede Stater, 48073
    - Oakland Medical Group
  - Saginaw, Michigan, Forenede Stater, 48601
    - Saint Mary's of Michigan
  - Saginaw, Michigan, Forenede Stater, 48604
    - Oncology Hematology Associates of Saginaw Valley PC
  - Saint Joseph, Michigan, Forenede Stater, 49085
    - Lakeland Medical Center Saint Joseph
  - Saint Joseph, Michigan, Forenede Stater, 49085
    - Marie Yeager Cancer Center
  - Sterling Heights, Michigan, Forenede Stater, 48312
    - Bhadresh Nayak MD PC-Sterling Heights
  - Sterling Heights, Michigan, Forenede Stater, 48312
    - Premier Hematology Oncology Care
  - Sterling Heights, Michigan, Forenede Stater, 48314
    - Mitchell Folbe MD PC
  - Tawas City, Michigan, Forenede Stater, 48764
    - Saint Joseph Health System-Tawas City
  - Troy, Michigan, Forenede Stater, 48085
    - William Beaumont Hospital - Troy
  - Troy, Michigan, Forenede Stater, 48084
    - Michigan Institute of Urology-Town Center
  - Troy, Michigan, Forenede Stater, 48085
    - Claudia BR Herke MD PC
  - Troy, Michigan, Forenede Stater, 48098
    - Hematology Oncology Consultants PC-Troy
  - Warren, Michigan, Forenede Stater, 48093
    - Saint John Macomb-Oakland Hospital
  - Warren, Michigan, Forenede Stater, 48088
    - Advanced Breast Care Center PLLC
  - Warren, Michigan, Forenede Stater, 48093
    - Great Lakes Cancer Management Specialists-Macomb Professional Building
  - Warren, Michigan, Forenede Stater, 48093
    - Macomb Hematology Oncology PC
  - Warren, Michigan, Forenede Stater, 48093
    - Michigan Breast Specialists-Warren
  - Warren, Michigan, Forenede Stater, 48093
    - Bhadresh Nayak MD PC-Warren
  - West Bloomfield, Michigan, Forenede Stater, 48322
    - Henry Ford West Bloomfield Hospital
  - West Branch, Michigan, Forenede Stater, 48661
    - Saint Mary's Oncology/Hematology Associates of West Branch
  - Ypsilanti, Michigan, Forenede Stater, 48106
    - Huron Gastroenterology PC
  - Ypsilanti, Michigan, Forenede Stater, 48197
    - IHA Hematology Oncology Consultants-Ann Arbor
- Minnesota
  - Bemidji, Minnesota, Forenede Stater, 56601
    - Sanford Joe Lueken Cancer Center
  - 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
  - Mankato, Minnesota, Forenede Stater, 56001
    - Mayo Clinic Health Systems-Mankato
  - Maple Grove, Minnesota, Forenede Stater, 55369
    - Fairview Maple Grove Medical Center
  - 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, 55454
    - Health Partners Inc
  - Minneapolis, Minnesota, Forenede Stater, 55417
    - Minneapolis VA Medical Center
  - Monticello, Minnesota, Forenede Stater, 55362
    - Monticello Cancer Center
  - New Ulm, Minnesota, Forenede Stater, 56073
    - New Ulm Medical Center
  - Robbinsdale, Minnesota, Forenede Stater, 55422
    - North Memorial Medical Health Center
  - Rochester, Minnesota, Forenede Stater, 55905
    - Mayo Clinic
  - 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 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
  - Worthington, Minnesota, Forenede Stater, 56187
    - Sanford Cancer Center Worthington
  - Wyoming, Minnesota, Forenede Stater, 55092
    - Fairview Lakes Medical Center
- Mississippi
  - Gulfport, Mississippi, Forenede Stater, 39502
    - Gulfport Memorial Hospital
- Missouri
  - Bolivar, Missouri, Forenede Stater, 65613
    - Central Care Cancer Center - Bolivar
  - Bonne Terre, Missouri, Forenede Stater, 63628
    - Parkland Health Center-Bonne Terre
  - 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
  - Creve Coeur, Missouri, Forenede Stater, 63141
    - Siteman Cancer Center at West County Hospital
  - Independence, Missouri, Forenede Stater, 64057
    - Centerpoint Medical Center LLC
  - 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, 64131
    - The University of Kansas Cancer Center-South
  - 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, 64118
    - Heartland Hematology and Oncology Associates Incorporated
  - Kansas City, Missouri, Forenede Stater, 64154
    - The University of Kansas Cancer Center-North
  - Lee's Summit, Missouri, Forenede Stater, 64086
    - Saint Luke's East - Lee's Summit
  - Lee's Summit, Missouri, Forenede Stater, 64064
    - The University of Kansas Cancer Center-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, 63128
    - Mercy Hospital South
  - Saint Louis, Missouri, Forenede Stater, 63129
    - Siteman Cancer Center-South County
  - Saint Louis, Missouri, Forenede Stater, 63136
    - Siteman Cancer Center at Christian Hospital
  - Saint Louis, Missouri, Forenede Stater, 63109
    - Saint Louis Cancer and Breast Institute-South City
  - Saint Peters, Missouri, Forenede Stater, 63376
    - Siteman Cancer Center at Saint Peters Hospital
  - Sainte Genevieve, Missouri, Forenede Stater, 63670
    - Sainte Genevieve County Memorial Hospital
  - Springfield, Missouri, Forenede Stater, 65807
    - CoxHealth South Hospital
  - Springfield, Missouri, Forenede Stater, 65804
    - Mercy Hospital Springfield
  - Sullivan, Missouri, Forenede Stater, 63080
    - Missouri Baptist Sullivan Hospital
  - Sunset Hills, Missouri, Forenede Stater, 63127
    - Missouri Baptist Outpatient Center-Sunset Hills
- Montana
  - Anaconda, Montana, Forenede Stater, 59711
    - Community Hospital of Anaconda
  - Billings, Montana, Forenede Stater, 59101
    - Billings Clinic Cancer Center
  - Billings, Montana, Forenede Stater, 59101
    - Saint Vincent Healthcare
  - 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
  - Helena, Montana, Forenede Stater, 59601
    - Saint Peter's Community Hospital
  - Kalispell, Montana, Forenede Stater, 59901
    - Kalispell Regional Medical Center
  - Missoula, Montana, Forenede Stater, 59804
    - Community Medical Hospital
  - Missoula, Montana, Forenede Stater, 59802
    - Saint Patrick Hospital - Community Hospital
  - Missoula, Montana, Forenede Stater, 59802
    - Montana Cancer Specialists
- Nebraska
  - Bellevue, Nebraska, Forenede Stater, 68123
    - Nebraska Medicine-Bellevue
  - Grand Island, Nebraska, Forenede Stater, 68803
    - CHI Health Saint Francis
  - Kearney, Nebraska, Forenede Stater, 68847
    - CHI Health Good Samaritan
  - Kearney, Nebraska, Forenede Stater, 68845
    - Heartland Hematology and Oncology
  - Lincoln, Nebraska, Forenede Stater, 68510
    - Saint Elizabeth Regional Medical Center
  - Omaha, Nebraska, Forenede Stater, 68198
    - University of Nebraska Medical Center
  - Omaha, Nebraska, Forenede Stater, 68124
    - Alegent Health Bergan Mercy Medical Center
  - Omaha, Nebraska, Forenede Stater, 68118
    - Nebraska Medicine-Village Pointe
  - Omaha, Nebraska, Forenede Stater, 68122
    - Alegent Health Immanuel Medical Center
  - Omaha, Nebraska, Forenede Stater, 68130
    - Alegent Health Lakeside Hospital
  - Omaha, Nebraska, Forenede Stater, 68131
    - Creighton University Medical Center
  - Omaha, Nebraska, Forenede Stater, 68122
    - Hematology and Oncology Consultants PC
  - Papillion, Nebraska, Forenede Stater, 68046
    - Midlands Community Hospital
- Nevada
  - Carson City, Nevada, Forenede Stater, 89703
    - Carson Tahoe Regional Medical Center
  - Henderson, Nevada, Forenede Stater, 89052
    - Comprehensive Cancer Centers of Nevada - Henderson
  - Henderson, Nevada, Forenede Stater, 89052
    - OptumCare Cancer Care at Seven Hills
  - Henderson, Nevada, Forenede Stater, 89052
    - Cancer and Blood Specialists-Henderson
  - Henderson, Nevada, Forenede Stater, 89052
    - Las Vegas Cancer Center-Henderson
  - Henderson, Nevada, Forenede Stater, 89074
    - Comprehensive Cancer Centers of Nevada-Southeast Henderson
  - Henderson, Nevada, Forenede Stater, 89074
    - 21st Century Oncology-Henderson
  - Henderson, Nevada, Forenede Stater, 89052
    - Comprehensive Cancer Centers of Nevada-Horizon Ridge
  - Las Vegas, Nevada, Forenede Stater, 89144
    - Summerlin Hospital Medical Center
  - Las Vegas, Nevada, Forenede Stater, 89106
    - Radiation Oncology Centers of Nevada Central
  - Las Vegas, Nevada, Forenede Stater, 89119
    - Radiation Oncology Centers of Nevada Southeast
  - Las Vegas, Nevada, Forenede Stater, 89128
    - Comprehensive Cancer Centers of Nevada - Northwest
  - Las Vegas, Nevada, Forenede Stater, 89128
    - OptumCare Cancer Care at MountainView
  - Las Vegas, Nevada, Forenede Stater, 89144
    - Comprehensive Cancer Centers of Nevada-Summerlin
  - Las Vegas, Nevada, Forenede Stater, 89148
    - Comprehensive Cancer Centers of Nevada
  - Las Vegas, Nevada, Forenede Stater, 89148
    - OptumCare Cancer Care at Fort Apache
  - Las Vegas, Nevada, Forenede Stater, 89169
    - Comprehensive Cancer Centers of Nevada - Central Valley
  - Las Vegas, Nevada, Forenede Stater, 89102
    - University Medical Center of Southern Nevada
  - Las Vegas, Nevada, Forenede Stater, 89106
    - Cancer and Blood Specialists-Shadow
  - Las Vegas, Nevada, Forenede Stater, 89109
    - HealthCare Partners Medical Group Oncology/Hematology-Maryland Parkway
  - Las Vegas, Nevada, Forenede Stater, 89113
    - HealthCare Partners Medical Group Oncology/Hematology-San Martin
  - Las Vegas, Nevada, Forenede Stater, 89121
    - Cancer Therapy and Integrative Medicine
  - Las Vegas, Nevada, Forenede Stater, 89128
    - Cancer and Blood Specialists-Tenaya
  - Las Vegas, Nevada, Forenede Stater, 89128
    - HealthCare Partners Medical Group Oncology/Hematology-Tenaya
  - Las Vegas, Nevada, Forenede Stater, 89148-2405
    - Las Vegas Cancer Center-Medical Center
  - Las Vegas, Nevada, Forenede Stater, 89149
    - HealthCare Partners Medical Group Oncology/Hematology-Centennial Hills
  - Las Vegas, Nevada, Forenede Stater, 89109
    - 21st Century Oncology
  - Las Vegas, Nevada, Forenede Stater, 89128
    - 21st Century Oncology-Vegas Tenaya
  - Las Vegas, Nevada, Forenede Stater, 89148
    - 21st Century Oncology-Fort Apache
  - Las Vegas, Nevada, Forenede Stater, 89128
    - Ann M Wierman MD LTD
  - Las Vegas, Nevada, Forenede Stater, 89102
    - Desert West Surgery
  - Las Vegas, Nevada, Forenede Stater, 89169
    - University Cancer Center
  - Las Vegas, Nevada, Forenede Stater, 89106
    - OptumCare Cancer Care at Oakey
  - Pahrump, Nevada, Forenede Stater, 89048
    - Hope Cancer Care of Nevada-Pahrump
  - Reno, Nevada, Forenede Stater, 89502
    - Renown Regional Medical Center
  - Reno, Nevada, Forenede Stater, 89503
    - Saint Mary's Regional Medical Center
  - Reno, Nevada, Forenede Stater, 89509
    - Radiation Oncology Associates
  - Reno, Nevada, Forenede Stater, 89511
    - Cancer Care Specialists - Reno
  - Reno, Nevada, Forenede Stater, 89503
    - Alpine Hematology-Oncology
- New Hampshire
  - Lebanon, New Hampshire, Forenede Stater, 03756
    - Dartmouth Hitchcock Medical Center
  - Nashua, New Hampshire, Forenede Stater, 03060
    - Saint Joseph Hospital
- New Jersey
  - Basking Ridge, New Jersey, Forenede Stater, 07920
    - Memorial Sloan Kettering Basking Ridge
  - Camden, New Jersey, Forenede Stater, 08103
    - Cooper Hospital University Medical Center
  - Englewood, New Jersey, Forenede Stater, 07631
    - Englewood Hospital and Medical Center
  - Lakewood, New Jersey, Forenede Stater, 08701
    - Monmouth Medical Center Southern Campus
  - Long Branch, New Jersey, Forenede Stater, 07740
    - Monmouth Medical Center
  - Middletown, New Jersey, Forenede Stater, 07748
    - Memorial Sloan Kettering Monmouth
  - Morristown, New Jersey, Forenede Stater, 07960
    - Morristown Medical Center
  - Mount Holly, New Jersey, Forenede Stater, 08060
    - Virtua Memorial
  - New Brunswick, New Jersey, Forenede Stater, 08901
    - Saint Peter's University Hospital
  - Summit, New Jersey, Forenede Stater, 07902
    - Overlook Hospital
  - Voorhees, New Jersey, Forenede Stater, 08043
    - Virtua Voorhees
- New Mexico
  - Albuquerque, New Mexico, Forenede Stater, 87102
    - University of New Mexico Cancer Center
- New York
  - Auburn, New York, Forenede Stater, 13021
    - Hematology Oncology Associates of Central New York-Auburn
  - Bay Shore, New York, Forenede Stater, 11706
    - Southside Hospital
  - Bronx, New York, Forenede Stater, 10461
    - Montefiore Medical Center-Einstein Campus
  - Bronx, New York, Forenede Stater, 10467
    - Montefiore Medical Center - Moses Campus
  - Brooklyn, New York, Forenede Stater, 11219
    - Maimonides Medical Center
  - Buffalo, New York, Forenede Stater, 14263
    - Roswell Park Cancer Institute
  - Commack, New York, Forenede Stater, 11725
    - Memorial Sloan Kettering Commack
  - East Syracuse, New York, Forenede Stater, 13057
    - Hematology Oncology Associates of Central New York-East Syracuse
  - Elmira, New York, Forenede Stater, 14905
    - Arnot Ogden Medical Center/Falck Cancer Center
  - Glens Falls, New York, Forenede Stater, 12801
    - Glens Falls Hospital
  - Harrison, New York, Forenede Stater, 10604
    - Memorial Sloan Kettering Westchester
  - Huntington, New York, Forenede Stater, 11743
    - Huntington Hospital
  - Lake Success, New York, Forenede Stater, 11042
    - Northwell Health/Center for Advanced Medicine
  - Manhasset, New York, Forenede Stater, 11030
    - North Shore University Hospital
  - Middletown, New York, Forenede Stater, 10940
    - Orange Regional Medical Center
  - Mineola, New York, Forenede Stater, 11501
    - NYU Winthrop Hospital
  - New York, New York, Forenede Stater, 10065
    - Memorial Sloan Kettering Cancer Center
  - New York, New York, Forenede Stater, 10065
    - Weill Medical College of Cornell University
  - New York, New York, Forenede Stater, 10019
    - Mount Sinai West
  - New York, New York, Forenede Stater, 10029
    - Mount Sinai Hospital
  - New York, New York, Forenede Stater, 10016
    - Laura and Isaac Perlmutter Cancer Center at NYU Langone
  - New York, New York, Forenede Stater, 10003
    - Mount Sinai Union Square
  - Poughkeepsie, New York, Forenede Stater, 12601
    - Vassar Brothers Medical Center
  - Rochester, New York, Forenede Stater, 14642
    - University of Rochester
  - Rockville Centre, New York, Forenede Stater, 11570
    - Memorial Sloan Kettering Rockville Centre
  - Sleepy Hollow, New York, Forenede Stater, 10591
    - Memorial Sloan Kettering Sleepy Hollow
  - Stony Brook, New York, Forenede Stater, 11794
    - Stony Brook University Medical Center
  - Syracuse, New York, Forenede Stater, 13215
    - Hematology Oncology Associates of Central New York-Onondaga Hill
- North Carolina
  - Asheville, North Carolina, Forenede Stater, 28803
    - AdventHealth Infusion Center Asheville
  - Chapel Hill, North Carolina, Forenede Stater, 27599
    - UNC Lineberger Comprehensive Cancer Center
  - Charlotte, North Carolina, Forenede Stater, 28204
    - Novant Health Presbyterian Medical Center
  - Charlotte, North Carolina, Forenede Stater, 28207
    - Oncology Specialists of Charlotte
  - Charlotte, North Carolina, Forenede Stater, 28207
    - Carolina Surgical Clinic of Charlotte PA
  - Charlotte, North Carolina, Forenede Stater, 28262
    - Southern Oncology Specialists-Charlotte
  - Clinton, North Carolina, Forenede Stater, 28328
    - Southeastern Medical Oncology Center-Clinton
  - Clinton, North Carolina, Forenede Stater, 28328
    - Sampson Radiation Oncology
  - Clyde, North Carolina, Forenede Stater, 28721
    - AdventHealth Infusion Center Haywood
  - Goldsboro, North Carolina, Forenede Stater, 27534
    - Southeastern Medical Oncology Center-Goldsboro
  - Goldsboro, North Carolina, Forenede Stater, 27534
    - Wayne Memorial Hospital
  - Goldsboro, North Carolina, Forenede Stater, 27534
    - Wayne Radiation Oncology
  - Greenville, North Carolina, Forenede Stater, 27834
    - East Carolina University
  - Hendersonville, North Carolina, Forenede Stater, 28792
    - AdventHealth Hendersonville
  - Huntersville, North Carolina, Forenede Stater, 28078
    - Southern Oncology Specialists-Huntersville
  - Huntersville, North Carolina, Forenede Stater, 28078
    - Lake Norman Hematology Oncology Specialists-Huntersville
  - Jacksonville, North Carolina, Forenede Stater, 28546
    - Southeastern Medical Oncology Center-Jacksonville
  - Jacksonville, North Carolina, Forenede Stater, 28546
    - Onslow Memorial Hospital
  - Kenansville, North Carolina, Forenede Stater, 28349
    - Vidant Oncology-Kenansville
  - Kinston, North Carolina, Forenede Stater, 28501
    - Vidant Oncology-Kinston
  - Matthews, North Carolina, Forenede Stater, 28105
    - Novant Health Cancer Specialists-Matthews
  - Matthews, North Carolina, Forenede Stater, 28105
    - Matthews Radiation Oncology Center
  - Mooresville, North Carolina, Forenede Stater, 28117
    - Lake Norman Hematology Oncology Specialists-Mooresville
  - Richlands, North Carolina, Forenede Stater, 28574
    - Vidant Oncology-Richlands
  - Salisbury, North Carolina, Forenede Stater, 28144
    - Carolina Oncology Associates PA
  - Wilson, North Carolina, Forenede Stater, 27893
    - Southeastern Medical Oncology Center-Wilson
  - Winston-Salem, North Carolina, Forenede Stater, 27157
    - Wake Forest University Health Sciences
  - Winston-Salem, North Carolina, Forenede Stater, 27103
    - Novant Health Forsyth Medical Center
- North Dakota
  - Fargo, North Dakota, Forenede Stater, 58122
    - Sanford Broadway Medical Center
  - Fargo, North Dakota, Forenede Stater, 58122
    - Sanford Clinic North-Fargo
  - Fargo, North Dakota, Forenede Stater, 58122
    - Roger Maris Cancer Center
  - Grand Forks, North Dakota, Forenede Stater, 58201
    - Altru Cancer Center
- Ohio
  - Akron, Ohio, Forenede Stater, 44304
    - Summa Akron City Hospital/Cooper Cancer Center
  - Barberton, Ohio, Forenede Stater, 44203
    - Summa Barberton Hospital
  - Beachwood, Ohio, Forenede Stater, 44122
    - UHHS-Chagrin Highlands Medical Center
  - Beavercreek, Ohio, Forenede Stater, 45431
    - Indu and Raj Soin Medical Center
  - Belpre, Ohio, Forenede Stater, 45714
    - Strecker Cancer Center-Belpre
  - Canton, Ohio, Forenede Stater, 44710
    - Aultman Health Foundation
  - Canton, Ohio, Forenede Stater, 44708
    - Mercy Medical Center
  - Centerville, Ohio, Forenede Stater, 45459
    - Miami Valley Hospital South
  - Centerville, Ohio, Forenede Stater, 45459
    - Dayton Physicians LLC-Miami Valley South
  - Chillicothe, Ohio, Forenede Stater, 45601
    - Adena Regional Medical Center
  - Cincinnati, Ohio, Forenede Stater, 45220
    - Good Samaritan Hospital - Cincinnati
  - Cincinnati, Ohio, Forenede Stater, 45242
    - Bethesda North Hospital
  - Cincinnati, Ohio, Forenede Stater, 45242
    - Oncology Hematology Care Inc-Blue Ash
  - Cincinnati, Ohio, Forenede Stater, 45202
    - Oncology Hematology Care Inc-Eden Park
  - Cincinnati, Ohio, Forenede Stater, 45211
    - Oncology Hematology Care Inc-Mercy West
  - Cincinnati, Ohio, Forenede Stater, 45236
    - Oncology Hematology Care Inc-Kenwood
  - Cincinnati, Ohio, Forenede Stater, 45219
    - University of Cincinnati/Barrett Cancer Center
  - Cincinnati, Ohio, Forenede Stater, 45230
    - Oncology Hematology Care Inc - Anderson
  - Cincinnati, Ohio, Forenede Stater, 45247
    - TriHealth Cancer Institute-Westside
  - Cincinnati, Ohio, Forenede Stater, 45255
    - TriHealth Cancer Institute-Anderson
  - Cleveland, Ohio, Forenede Stater, 44106
    - Case Western Reserve University
  - Cleveland, Ohio, Forenede Stater, 44109
    - MetroHealth Medical Center
  - Columbus, Ohio, Forenede Stater, 43214
    - Riverside Methodist Hospital
  - Columbus, Ohio, Forenede Stater, 43210
    - Ohio State University Comprehensive Cancer Center
  - Columbus, Ohio, Forenede Stater, 43219
    - The Mark H Zangmeister Center
  - Columbus, Ohio, Forenede Stater, 43214
    - Columbus Oncology and Hematology Associates Inc
  - Columbus, Ohio, Forenede Stater, 43228
    - Doctors Hospital
  - Columbus, Ohio, Forenede Stater, 43213
    - Mount Carmel East Hospital
  - Columbus, Ohio, Forenede Stater, 43215
    - Grant Medical Center
  - Columbus, Ohio, Forenede Stater, 43222
    - Mount Carmel Health Center West
  - Dayton, Ohio, Forenede Stater, 45406
    - Good Samaritan Hospital - Dayton
  - Dayton, Ohio, Forenede Stater, 45409
    - Miami Valley Hospital
  - Dayton, Ohio, Forenede Stater, 45415
    - Dayton Physician LLC-Miami Valley Hospital North
  - Dayton, Ohio, Forenede Stater, 45415
    - Miami Valley Hospital North
  - Dayton, Ohio, Forenede Stater, 45405
    - Grandview Hospital
  - Delaware, Ohio, Forenede Stater, 43015
    - Delaware Health Center-Grady Cancer Center
  - Delaware, Ohio, Forenede Stater, 43015
    - Delaware Radiation Oncology
  - Delaware, Ohio, Forenede Stater, 43015
    - Grady Memorial Hospital
  - Fairfield, Ohio, Forenede Stater, 45014
    - Oncology Hematology Care Inc-Healthplex
  - Findlay, Ohio, Forenede Stater, 45840
    - Blanchard Valley Hospital
  - Findlay, Ohio, Forenede Stater, 45840
    - Armes Family Cancer Center
  - Findlay, Ohio, Forenede Stater, 45840
    - Orion Cancer Care
  - Franklin, Ohio, Forenede Stater, 45005-1066
    - Atrium Medical Center-Middletown Regional Hospital
  - Franklin, Ohio, Forenede Stater, 45005
    - Dayton Physicians LLC-Atrium
  - Greenville, Ohio, Forenede Stater, 45331
    - Wayne Hospital
  - Greenville, Ohio, Forenede Stater, 45331
    - Dayton Physicians LLC-Wayne
  - Kettering, Ohio, Forenede Stater, 45429
    - Kettering Medical Center
  - Kettering, Ohio, Forenede Stater, 45409
    - Greater Dayton Cancer Center
  - Kettering, Ohio, Forenede Stater, 45420
    - First Dayton Cancer Care
  - Lancaster, Ohio, Forenede Stater, 43130
    - Fairfield Medical Center
  - Lancaster, Ohio, Forenede Stater, 43130
    - Lancaster Radiation Oncology
  - Mansfield, Ohio, Forenede Stater, 44903
    - OhioHealth Mansfield Hospital
  - Marietta, Ohio, Forenede Stater, 45750
    - Marietta Memorial Hospital
  - Marion, Ohio, Forenede Stater, 43302
    - OhioHealth Marion General Hospital
  - Middletown, Ohio, Forenede Stater, 45042
    - Dayton Physicians LLC-Signal Point
  - Mount Vernon, Ohio, Forenede Stater, 43050
    - Knox Community Hospital
  - Newark, Ohio, Forenede Stater, 43055
    - Licking Memorial Hospital
  - Newark, Ohio, Forenede Stater, 43055
    - Newark Radiation Oncology
  - Portsmouth, Ohio, Forenede Stater, 45662
    - Southern Ohio Medical Center
  - Sidney, Ohio, Forenede Stater, 45365
    - Dayton Physicians LLC-Wilson
  - Springfield, Ohio, Forenede Stater, 45505
    - Springfield Regional Medical Center
  - Springfield, Ohio, Forenede Stater, 45504
    - Springfield Regional Cancer Center
  - Sylvania, Ohio, Forenede Stater, 43560
    - ProMedica Flower Hospital
  - Toledo, Ohio, Forenede Stater, 43606
    - The Toledo Hospital/Toledo Children's Hospital
  - Troy, Ohio, Forenede Stater, 45373
    - Upper Valley Medical Center
  - Troy, Ohio, Forenede Stater, 45373
    - Dayton Physicians LLC-Upper Valley
  - West Chester, Ohio, Forenede Stater, 45069
    - University Pointe
  - Westerville, Ohio, Forenede Stater, 43081
    - Saint Ann's Hospital
  - Westlake, Ohio, Forenede Stater, 44145
    - UHHS-Westlake Medical Center
  - Wright-Patterson Air Force Base, Ohio, Forenede Stater, 45433-5529
    - Wright-Patterson Medical Center
  - Xenia, Ohio, Forenede Stater, 45385
    - Greene Memorial Hospital
  - Zanesville, Ohio, Forenede Stater, 43701
    - Genesis Healthcare System Cancer Care Center
- Oklahoma
  - Lawton, Oklahoma, Forenede Stater, 73505
    - Cancer Centers of Southwest Oklahoma Research
  - 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, 73142
    - Integris Cancer Institute of Oklahoma
- Oregon
  - Baker City, Oregon, Forenede Stater, 97814
    - Saint Alphonsus Medical Center-Baker City
  - Bend, Oregon, Forenede Stater, 97701
    - Saint Charles Health System
  - Clackamas, Oregon, Forenede Stater, 97015
    - Clackamas Radiation Oncology Center
  - Clackamas, Oregon, Forenede Stater, 97015
    - Providence Oncology and Hematology Care Southeast
  - Coos Bay, Oregon, Forenede Stater, 97420
    - Bay Area Hospital
  - Milwaukie, Oregon, Forenede Stater, 97222
    - Providence Milwaukie Hospital
  - Newberg, Oregon, Forenede Stater, 97132
    - Providence Newberg Medical Center
  - Ontario, Oregon, Forenede Stater, 97914
    - Saint Alphonsus Medical Center-Ontario
  - Oregon City, Oregon, Forenede Stater, 97045
    - Providence Willamette Falls 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
  - Redmond, Oregon, Forenede Stater, 97756
    - Saint Charles Health System-Redmond
- Pennsylvania
  - Abington, Pennsylvania, Forenede Stater, 19001
    - Abington Memorial Hospital
  - Allentown, Pennsylvania, Forenede Stater, 18103
    - Lehigh Valley Hospital-Cedar Crest
  - Beaver, Pennsylvania, Forenede Stater, 15009
    - UPMC-Heritage Valley Health System Beaver
  - Bethlehem, Pennsylvania, Forenede Stater, 18017
    - Lehigh Valley Hospital - Muhlenberg
  - Danville, Pennsylvania, Forenede Stater, 17822
    - Geisinger Medical Center
  - Easton, Pennsylvania, Forenede Stater, 18042
    - Easton Hospital
  - Erie, Pennsylvania, Forenede Stater, 16544
    - Saint Vincent Hospital
  - Erie, Pennsylvania, Forenede Stater, 16505
    - The Regional Cancer Center
  - Furlong, Pennsylvania, Forenede Stater, 18925
    - Fox Chase Cancer Center Buckingham
  - Greensburg, Pennsylvania, Forenede Stater, 15601
    - UPMC Cancer Centers - Arnold Palmer Pavilion
  - Hershey, Pennsylvania, Forenede Stater, 17033-0850
    - Penn State Milton S Hershey Medical Center
  - Jefferson Hills, Pennsylvania, Forenede Stater, 15025
    - Jefferson Hospital
  - Johnstown, Pennsylvania, Forenede Stater, 15901
    - UPMC-Johnstown/John P. Murtha Regional Cancer Center
  - Kittanning, Pennsylvania, Forenede Stater, 16201
    - Armstrong Center for Medicine and Health
  - Lewisburg, Pennsylvania, Forenede Stater, 17837
    - Geisinger Medical Oncology-Lewisburg
  - Lewistown, Pennsylvania, Forenede Stater, 17044
    - Lewistown Hospital
  - McKeesport, Pennsylvania, Forenede Stater, 15132
    - UPMC Cancer Center at UPMC McKeesport
  - Monroeville, Pennsylvania, Forenede Stater, 15146
    - Forbes Hospital
  - Moon, Pennsylvania, Forenede Stater, 15108
    - UPMC-Coraopolis/Heritage Valley Radiation Oncology
  - Philadelphia, Pennsylvania, Forenede Stater, 19111
    - Fox Chase Cancer Center
  - Philadelphia, Pennsylvania, Forenede Stater, 19107
    - Thomas Jefferson University Hospital
  - Philadelphia, Pennsylvania, Forenede Stater, 19140
    - Temple University Hospital
  - Philadelphia, Pennsylvania, Forenede Stater, 19102
    - Drexel University School of Medicine
  - Pittsburgh, Pennsylvania, Forenede Stater, 15212
    - Allegheny General Hospital
  - Pittsburgh, Pennsylvania, Forenede Stater, 15213
    - UPMC-Magee Womens Hospital
  - Pittsburgh, Pennsylvania, Forenede Stater, 15232
    - University of Pittsburgh Cancer Institute (UPCI)
  - Pittsburgh, Pennsylvania, Forenede Stater, 15232
    - UPMC-Shadyside Hospital
  - Pittsburgh, Pennsylvania, Forenede Stater, 15213
    - UPMC-Presbyterian Hospital
  - Pittsburgh, Pennsylvania, Forenede Stater, 15215
    - UPMC-Saint Margaret
  - Pittsburgh, Pennsylvania, Forenede Stater, 15236
    - UPMC Jefferson Regional Radiation Oncology
  - Pittsburgh, Pennsylvania, Forenede Stater, 15237
    - UPMC-Passavant Hospital
  - Pittsburgh, Pennsylvania, Forenede Stater, 15243
    - UPMC-Saint Clair Hospital Cancer Center
  - Pottstown, Pennsylvania, Forenede Stater, 19464
    - Pottstown Hospital
  - Seneca, Pennsylvania, Forenede Stater, 16346
    - UPMC Cancer Center at UPMC Northwest
  - Uniontown, Pennsylvania, Forenede Stater, 15401
    - UPMC Uniontown Hospital Radiation Oncology
  - Washington, Pennsylvania, Forenede Stater, 15301
    - UPMC Washington Hospital Radiation Oncology
  - Wilkes-Barre, Pennsylvania, Forenede Stater, 18711
    - Geisinger Wyoming Valley/Henry Cancer Center
  - Willow Grove, Pennsylvania, Forenede Stater, 19090
    - Abington Memorial Hospital-Asplundh Cancer Pavilion
- South Carolina
  - Clinton, South Carolina, Forenede Stater, 29325
    - Greenville Health System Cancer Institute-Laurens
  - Easley, South Carolina, Forenede Stater, 29640
    - Greenville Health System Cancer Institute-Easley
  - 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
  - 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
- Tennessee
  - Chattanooga, Tennessee, Forenede Stater, 37404
    - Memorial Hospital
  - Hixson, Tennessee, Forenede Stater, 37343
    - Pulmonary Medicine Center of Chattanooga-Hixson
  - Nashville, Tennessee, Forenede Stater, 37208
    - Meharry Medical College
  - Ooltewah, Tennessee, Forenede Stater, 37363
    - Memorial GYN Plus
- Texas
  - Amarillo, Texas, Forenede Stater, 79106
    - The Don and Sybil Harrington Cancer Center
  - Austin, Texas, Forenede Stater, 78701
    - Dell Seton Medical Center at The University of Texas
  - Bryan, Texas, Forenede Stater, 77802
    - Saint Joseph Regional Cancer Center
  - Dallas, Texas, Forenede Stater, 75246
    - Baylor University Medical Center
  - Houston, Texas, Forenede Stater, 77030
    - M D Anderson Cancer Center
  - Houston, Texas, Forenede Stater, 77026-1967
    - Lyndon Baines Johnson General Hospital
  - Houston, Texas, Forenede Stater, 77030
    - Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center
  - Houston, Texas, Forenede Stater, 77070
    - Methodist Willowbrook Hospital
  - Houston, Texas, Forenede Stater, 77030
    - Michael E DeBakey VA Medical Center
  - Houston, Texas, Forenede Stater, 77030
    - The Methodist Hospital System
  - Houston, Texas, Forenede Stater, 77094
    - MD Anderson Regional Care Center-Katy
  - Houston, Texas, Forenede Stater, 77030
    - Ben Taub General Hospital
  - Nassau Bay, Texas, Forenede Stater, 77058
    - MD Anderson Regional Care Center-Bay Area
  - Sugar Land, Texas, Forenede Stater, 77479
    - Houston Methodist Sugar Land Hospital
  - Sugar Land, Texas, Forenede Stater, 77478
    - MD Anderson Regional Care Center-Sugar Land
  - Temple, Texas, Forenede Stater, 76508
    - Scott and White Memorial Hospital
  - The Woodlands, Texas, Forenede Stater, 77384
    - MD Anderson Regional Care Center-The Woodlands
- Utah
  - American Fork, Utah, Forenede Stater, 84003
    - American Fork Hospital / Huntsman Intermountain Cancer Center
  - Cedar City, Utah, Forenede Stater, 84720
    - Sandra L Maxwell Cancer Center
  - Logan, Utah, Forenede Stater, 84321
    - Logan Regional Hospital
  - Murray, Utah, Forenede Stater, 84107
    - Intermountain Medical Center
  - Ogden, Utah, Forenede Stater, 84403
    - McKay-Dee Hospital Center
  - Provo, Utah, Forenede Stater, 84604
    - Utah Valley Regional Medical Center
  - Riverton, Utah, Forenede Stater, 84065
    - Riverton Hospital
  - Saint George, Utah, Forenede Stater, 84770
    - Dixie Medical Center Regional Cancer Center
  - Salt Lake City, Utah, Forenede Stater, 84112
    - Huntsman Cancer Institute/University of Utah
  - Salt Lake City, Utah, Forenede Stater, 84106
    - Utah Cancer Specialists-Salt Lake City
  - Salt Lake City, Utah, Forenede Stater, 84143
    - LDS Hospital
- Vermont
  - Berlin, Vermont, Forenede Stater, 05602
    - Central Vermont Medical Center/National Life Cancer Treatment
  - Burlington, Vermont, Forenede Stater, 05401
    - University of Vermont Medical Center
  - Burlington, Vermont, Forenede Stater, 05405
    - University of Vermont College of Medicine
  - Saint Johnsbury, Vermont, Forenede Stater, 05819
    - Norris Cotton Cancer Center-North
- Virginia
  - Charlottesville, Virginia, Forenede Stater, 22908
    - University of Virginia Cancer Center
  - Charlottesville, Virginia, Forenede Stater, 22901
    - Sentara Martha Jefferson Hospital
  - Falls Church, Virginia, Forenede Stater, 22042
    - Inova Fairfax Hospital
  - Fredericksburg, Virginia, Forenede Stater, 22408
    - Hematology Oncology Associates of Fredericksburg Inc
  - Hampton, Virginia, Forenede Stater, 23666
    - Sentara Cancer Institute at Sentara CarePlex Hospital
  - Lynchburg, Virginia, Forenede Stater, 24501
    - Centra Lynchburg Hematology-Oncology Clinic Inc
  - Midlothian, Virginia, Forenede Stater, 23114
    - Bon Secours Saint Francis Medical Center
  - Norfolk, Virginia, Forenede Stater, 23507
    - Sentara Norfolk General Hospital
  - Norfolk, Virginia, Forenede Stater, 23502
    - Sentara Leigh Hospital
  - Richmond, Virginia, Forenede Stater, 23298
    - Virginia Commonwealth University/Massey Cancer Center
  - Richmond, Virginia, Forenede Stater, 23226
    - Bon Secours Saint Mary's Hospital
  - South Hill, Virginia, Forenede Stater, 23970
    - VCU Community Memorial Health Center
  - Winchester, Virginia, Forenede Stater, 22601
    - Shenandoah Oncology PC
- Washington
  - Aberdeen, Washington, Forenede Stater, 98520
    - Providence Regional Cancer System-Aberdeen
  - Anacortes, Washington, Forenede Stater, 98221
    - Cancer Care Center at Island Hospital
  - Auburn, Washington, Forenede Stater, 98001
    - MultiCare Auburn Medical Center
  - Bainbridge Island, Washington, Forenede Stater, 98110
    - Virginia Mason Bainbridge Island Medical Center
  - Bellevue, Washington, Forenede Stater, 98005
    - Swedish Cancer Institute-Eastside Oncology Hematology
  - Bellevue, Washington, Forenede Stater, 98004
    - Overlake Hospital Medical Center
  - Bellingham, Washington, Forenede Stater, 98225
    - PeaceHealth Saint Joseph Medical Center
  - Bremerton, Washington, Forenede Stater, 98310
    - Harrison HealthPartners Hematology and Oncology-Bremerton
  - Bremerton, Washington, Forenede Stater, 98310
    - Harrison Medical Center
  - Burien, Washington, Forenede Stater, 98166
    - Highline Medical Center-Main Campus
  - Centralia, Washington, Forenede Stater, 98531
    - Providence Regional Cancer System-Centralia
  - Edmonds, Washington, Forenede Stater, 98026
    - Swedish Medical Center-Edmonds
  - Enumclaw, Washington, Forenede Stater, 98022
    - Saint Elizabeth Hospital
  - Everett, Washington, Forenede Stater, 98201
    - Providence Regional Cancer Partnership
  - Federal Way, Washington, Forenede Stater, 98002
    - Virginia Mason Federal Way Medical Center
  - Federal Way, Washington, Forenede Stater, 98003
    - Saint Francis Hospital
  - Gig Harbor, Washington, Forenede Stater, 98332
    - Tacoma/Valley Radiation Oncology Centers-Gig Harbor
  - Gig Harbor, Washington, Forenede Stater, 98335
    - MultiCare Gig Harbor Medical Park
  - Issaquah, Washington, Forenede Stater, 98029
    - Swedish Cancer Institute-Issaquah
  - Kennewick, Washington, Forenede Stater, 99336
    - Kadlec Clinic Hematology and Oncology
  - Kennewick, Washington, Forenede Stater, 99336
    - Northwest Cancer Clinic
  - Kennewick, Washington, Forenede Stater, 99336
    - Tri-Cities Cancer Center
  - Kirkland, Washington, Forenede Stater, 98034
    - Seattle Cancer Care Alliance at EvergreenHealth
  - Kirkland, Washington, Forenede Stater, 98033
    - EvergreenHealth Medical Center
  - Lacey, Washington, Forenede Stater, 98503
    - Providence Regional Cancer System-Lacey
  - Lakewood, Washington, Forenede Stater, 98499
    - Saint Clare Hospital
  - Longview, Washington, Forenede Stater, 98632
    - PeaceHealth Saint John Medical Center
  - Lynnwood, Washington, Forenede Stater, 98036
    - Virginia Mason Lynnwood Medical Center
  - Mount Vernon, Washington, Forenede Stater, 98274
    - Skagit Valley Hospital
  - Mount Vernon, Washington, Forenede Stater, 98274
    - Skagit Valley Hospital Regional Cancer Care Center
  - Port Townsend, Washington, Forenede Stater, 98368
    - Jefferson Healthcare
  - Poulsbo, Washington, Forenede Stater, 98370
    - Harrison HealthPartners Hematology and Oncology-Poulsbo
  - Poulsbo, Washington, Forenede Stater, 98370
    - Peninsula Cancer Center
  - Puyallup, Washington, Forenede Stater, 98372
    - MultiCare Good Samaritan Hospital
  - Puyallup, Washington, Forenede Stater, 98372
    - Tacoma/Valley Radiation Oncology Centers-Puyallup
  - Renton, Washington, Forenede Stater, 98055
    - Valley Medical Center
  - Seattle, Washington, Forenede Stater, 98109
    - Fred Hutchinson Cancer Research Center
  - Seattle, Washington, Forenede Stater, 98109
    - Seattle Cancer Care Alliance
  - Seattle, Washington, Forenede Stater, 98195
    - University of Washington Medical Center
  - Seattle, Washington, Forenede Stater, 98101
    - Virginia Mason Medical Center
  - Seattle, Washington, Forenede Stater, 98107
    - Swedish Medical Center-Ballard Campus
  - Seattle, Washington, Forenede Stater, 98112
    - Kaiser Permanente Washington
  - Seattle, Washington, Forenede Stater, 98104
    - Minor and James Medical PLLC
  - Seattle, Washington, Forenede Stater, 98104
    - Pacific Gynecology Specialists
  - Seattle, Washington, Forenede Stater, 98122-4307
    - Swedish Medical Center-First Hill
  - Seattle, Washington, Forenede Stater, 98133
    - Seattle Cancer Care Alliance at Northwest Hospital
  - Seattle, Washington, Forenede Stater, 98122-5711
    - Swedish Medical Center-Cherry Hill
  - Sedro-Woolley, Washington, Forenede Stater, 98284
    - PeaceHealth United General Medical Center
  - Shelton, Washington, Forenede Stater, 98584
    - Providence Regional Cancer System-Shelton
  - Spokane, Washington, Forenede Stater, 99204
    - Rockwood Cancer Treatment Center-DHEC-Downtown
  - Spokane, Washington, Forenede Stater, 99218
    - Evergreen Hematology and Oncology PS
  - Spokane, Washington, Forenede Stater, 99202
    - Cancer Care Northwest - Spokane South
  - Spokane, Washington, Forenede Stater, 99208
    - Spokane Valley Cancer Center-Mayfair
  - Spokane, Washington, Forenede Stater, 99216
    - Cancer Care Northwest-Valley
  - Spokane, Washington, Forenede Stater, 99218
    - Cancer Care Northwest-North Spokane
  - Spokane, Washington, Forenede Stater, 99216
    - Spokane Valley Cancer Center-Mission
  - Spokane, Washington, Forenede Stater, 99218
    - Rockwood North Cancer Treatment Center
  - Spokane Valley, Washington, Forenede Stater, 99216
    - Rockwood Clinic Cancer Treatment Center-Valley
  - Tacoma, Washington, Forenede Stater, 98405
    - Northwest Medical Specialties PLLC
  - Tacoma, Washington, Forenede Stater, 98405
    - MultiCare Tacoma General Hospital
  - Tacoma, Washington, Forenede Stater, 98405
    - Tacoma/Valley Radiation Oncology Centers-Saint Joe's
  - Tacoma, Washington, Forenede Stater, 97405
    - Tacoma/Valley Radiation Oncology Centers-Jackson Hall
  - Tacoma, Washington, Forenede Stater, 98405
    - Franciscan Research Center-Northwest Medical Plaza
  - Tacoma, Washington, Forenede Stater, 98405
    - Saint Joseph Medical Center
  - Vancouver, Washington, Forenede Stater, 98664
    - PeaceHealth Southwest Medical Center
  - Vancouver, Washington, Forenede Stater, 98684
    - Compass Oncology Vancouver
  - Walla Walla, Washington, Forenede Stater, 99362
    - Providence Saint Mary Regional Cancer Center
  - Wenatchee, Washington, Forenede Stater, 98801
    - Wenatchee Valley Hospital and Clinics
  - Yakima, Washington, Forenede Stater, 98902
    - North Star Lodge Cancer Center at Yakima Valley Memorial Hospital
  - Yelm, Washington, Forenede Stater, 98597
    - Providence Regional Cancer System-Yelm
- West Virginia
  - Bridgeport, West Virginia, Forenede Stater, 26330
    - United Hospital Center
  - Huntington, West Virginia, Forenede Stater, 25701
    - Edwards Comprehensive Cancer Center
  - Martinsburg, West Virginia, Forenede Stater, 25401
    - WVUH-Berkely Medical Center
  - Morgantown, West Virginia, Forenede Stater, 26506
    - West Virginia University Healthcare
  - Parkersburg, West Virginia, Forenede Stater, 26101
    - Camden Clark Medical Center
- Wisconsin
  - Antigo, Wisconsin, Forenede Stater, 54409
    - Langlade Hospital and Cancer Center
  - 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
    - HSHS Sacred Heart Hospital
  - Eau Claire, Wisconsin, Forenede Stater, 54701
    - Mayo Clinic Health System-Eau Claire Clinic
  - Eau Claire, Wisconsin, Forenede Stater, 54703
    - Mayo Clinic Health System Eau Claire Hospital-Luther Campus
  - Eau Claire, Wisconsin, Forenede Stater, 54701
    - Marshfield Clinic Cancer Center at Sacred Heart
  - Eau Claire, Wisconsin, Forenede Stater, 54701
    - Marshfield Clinic Cancer Center - Eau Claire
  - Fond Du Lac, Wisconsin, Forenede Stater, 54937
    - Aurora Health Center-Fond du Lac
  - Germantown, Wisconsin, Forenede Stater, 53022
    - Aurora Health Care Germantown Health Center
  - Grafton, Wisconsin, Forenede Stater, 53024
    - Aurora Cancer Care-Grafton
  - Green Bay, Wisconsin, Forenede Stater, 54311
    - Aurora BayCare Medical Center
  - Kenosha, Wisconsin, Forenede Stater, 53142
    - Aurora Cancer Care-Kenosha South
  - Madison, Wisconsin, Forenede Stater, 53792
    - University of Wisconsin Hospital and Clinics
  - Marinette, Wisconsin, Forenede Stater, 54143
    - Aurora Bay Area Medical Group-Marinette
  - Marinette, Wisconsin, Forenede Stater, 54143
    - Bay Area Medical Center
  - Marshfield, Wisconsin, Forenede Stater, 54449
    - Marshfield Medical Center-Marshfield
  - Marshfield, Wisconsin, Forenede Stater, 54449
    - Marshfield Medical Center
  - Milwaukee, Wisconsin, Forenede Stater, 53226
    - Froedtert and The Medical College of Wisconsin
  - Milwaukee, Wisconsin, Forenede Stater, 53209
    - Aurora Cancer Care-Milwaukee
  - Milwaukee, Wisconsin, Forenede Stater, 53215
    - Aurora Saint Luke's Medical Center
  - Milwaukee, Wisconsin, Forenede Stater, 53233
    - Aurora Sinai Medical Center
  - Minocqua, Wisconsin, Forenede Stater, 54548
    - Marshfield Clinic-Minocqua Center
  - New Richmond, Wisconsin, Forenede Stater, 54017
    - Cancer Center of Western Wisconsin
  - Oshkosh, Wisconsin, Forenede Stater, 54904
    - Vince Lombardi Cancer Clinic - Oshkosh
  - Racine, Wisconsin, Forenede Stater, 53406
    - Aurora Cancer Care-Racine
  - Rhinelander, Wisconsin, Forenede Stater, 54501
    - Ascension Saint Mary's Hospital
  - Rhinelander, Wisconsin, Forenede Stater, 54501
    - Saint Mary's Hospital
  - Rice Lake, Wisconsin, Forenede Stater, 54868
    - Marshfield Medical Center-Rice Lake
  - Sheboygan, Wisconsin, Forenede Stater, 53081
    - Vince Lombardi Cancer Clinic-Sheboygan
  - Stevens Point, Wisconsin, Forenede Stater, 54482
    - Marshfield Clinic Stevens Point Center
  - Stevens Point, Wisconsin, Forenede Stater, 54481
    - Ascension Saint Michael's Hospital
  - Stevens Point, Wisconsin, Forenede Stater, 54481
    - Saint Michael's Hospital
  - Summit, Wisconsin, Forenede Stater, 53066
    - Aurora Medical Center in Summit
  - Two Rivers, Wisconsin, Forenede Stater, 54241
    - Vince Lombardi Cancer Clinic-Two Rivers
  - Waukesha, Wisconsin, Forenede Stater, 53188
    - Aurora Cancer Care-Waukesha
  - Wausau, Wisconsin, Forenede Stater, 54401
    - Aspirus Regional Cancer Center
  - Wausau, Wisconsin, Forenede Stater, 54401
    - Marshfield Clinic-Wausau Center
  - Wauwatosa, Wisconsin, Forenede Stater, 53226
    - Aurora Cancer Care-Milwaukee West
  - West Allis, Wisconsin, Forenede Stater, 53227
    - Aurora West Allis Medical Center
  - Weston, Wisconsin, Forenede Stater, 54476
    - Diagnostic and Treatment Center
  - Weston, Wisconsin, Forenede Stater, 54476
    - Marshfield Clinic - Weston Center
  - Weston, Wisconsin, Forenede Stater, 54476
    - Saint Clare's Hospital
  - 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
  - Cheyenne, Wyoming, Forenede Stater, 82001
    - Cheyenne Regional Medical Center-West
  - Cody, Wyoming, Forenede Stater, 82414
    - Big Horn Basin Cancer Center
  - Cody, Wyoming, Forenede Stater, 82414
    - Billings Clinic-Cody
  - Sheridan, Wyoming, Forenede Stater, 82801
    - Welch Cancer Center
Israel
- - Jerusalem, Israel, 91031
    - Shaare Zedek Medical Center
Schweiz
- - Aarau, Schweiz, 5001
    - Kantonsspital Aarau
  - Basel, Schweiz, 4031
    - University Hospital Basel
  - Bellinzona, Schweiz, CH-6500
    - Oncology Institute of Southern Switzerland
  - Chur, Schweiz, 7000
    - Kantonsspital Graubünden
  - Lausanne, Schweiz, CH 1011
    - University Hospital of Lausanne
  - Winterthur, Schweiz, 8401
    - Kantonsspital Winterthur
  - Zurich, Schweiz, 8027
    - Zurich Im Park
  - Zurich, Schweiz, 8032
    - Zurich Hirslanden Klinik

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

Beskrivelse

Registreringsinkluderingskriterier:

Alder ≥ 18 år ved diagnose
Diagnose af rektal adenokarcinom
Radiologisk målbar eller klinisk evaluerbar sygdom som defineret i protokollen
ECOG Performance Status (PS): 0, 1 eller 2
For denne patient vil standardbehandlingsanbefalingen i mangel af et klinisk forsøg være kombineret modalitet neoadjuverende kemoradiation efterfulgt af kurativ intention kirurgisk resektion
Kandidat til lukkemuskelbesparende kirurgisk resektion forud for neoadjuverende terapi ifølge den primære kirurg
Primærkirurg har legitimation eller er villig til at blive godkendt i Total Mesorectal Excision (TME), hvilket indebærer indsendelse af fotos af en enkelt TME-prøve enten før indskrivning af den første patient eller ved at bruge kirurgens 1. påløbne tilfælde.
Klinisk fase: T2N1, T3N0, T3N1.
- N2 sygdom skal estimeres som fire eller flere lymfeknuder, der er ≥ 10 mm.
- Klinisk stadieinddeling bør estimeres baseret på kombinationen af følgende vurderinger: fysisk undersøgelse foretaget af den primære kirurg, CT- eller PET/CT-skanning af bryst/mave/bækken og enten en bækken-MR eller en ultralyd (ERUS). Hvis der udføres en bækken-MR, er det acceptabelt at udføre CT af brystet/abdomen, uden at CT-billede af bækkenet.
Følgende laboratorieværdier opnået ≤ 28 dage før registrering:
- Absolut neutrofiltal (ANC) ≥ 1500/mm^3
- Blodpladeantal ≥ 100.000/mm^3
- Hæmoglobin > 8,0 g/dL
- Total bilirubin ≤ 1,5 x øvre normalgrænse (ULN)
- SGOT (AST) ≤ 3 x ULN
- SGPT (ALT) ≤ 3 x ULN
- Kreatinin ≤1,5 x ULN
Negativ graviditetstest udført ≤ 7 dage før registrering, kun for kvinder i den fødedygtige alder
Patienter i den fødedygtige alder er villig til at anvende passende prævention
Giv informeret skriftligt samtykke
Villig til at vende tilbage til tilmeldingsmedicinsk websted for alle undersøgelsesvurderinger

Udelukkelseskriterier for registrering:

Kliniske T4-tumorer
Primærkirurg indikerer behov for abdominoperineal (APR) ved baseline
Bevis for, at tumoren klæber til eller invaderer den mesorektale fascia på billeddiagnostiske undersøgelser, således at kirurgen ikke ville være i stand til at udføre en R0-resektion (en med negative marginer)
Tumor forårsager symptomatisk tarmobstruktion (patienter, der har haft en midlertidig omdirigerende stomi er berettiget).
Kemoterapi inden for 5 år før registrering. Hormonbehandling er tilladt, hvis det sygdomsfrie interval er ≥ 5 år.
Enhver tidligere bækkenstråling
Anden invasiv malignitet ≤ 5 år før registrering. Undtagelser er colonpolypper, non-melanom hudkræft, duktalt carcinom in situ, blærecarcinom in situ eller carcinoma-in-situ af livmoderhalsen.
Enhver af følgende, fordi denne undersøgelse involverer et middel, der har kendt genotoksiske, mutagene og teratogene virkninger.
- Gravid kvinde
- Sygeplejerske kvinder
- Mænd eller kvinder i den fødedygtige alder, som ikke er villige til at anvende passende prævention
Komorbide sygdomme eller anden samtidig sygdom, som efter klinikerens vurdering, der opnår informeret samtykke, ville gøre patienten uegnet til at deltage i denne undersøgelse eller væsentligt forstyrre den korrekte vurdering af sikkerhed og toksicitet af de ordinerede regimer.

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: Ingen (Åben etiket)

Antal våben

Våben og indgreb

Deltagergruppe / Arm	Intervention / Behandling
Eksperimentel: Gruppe 1 Patienterne vil modtage FOLFOX kemoterapi en gang hver anden uge i 6 cyklusser i alt over en periode på 12 uger. Efter endt FOLFOX-kemoterapi skal patienten have en MR-scanning eller endorektal ultralyd (ERUS) for at undersøge tumoren. Hvis tumoren ikke er mindsket i størrelse med mindst 20 %, vil patienten modtage 5FUCMT (stråling med kemoterapi). Hvis tumoren er faldet i størrelse med 20%, vil patienten gå direkte til operationen. Hvis alle kanter af tumoren er normale efter operationen, modtager patienten seks yderligere cyklusser med FOLFOX-kemoterapi. Hvis alle kanter af tumoren ikke er normale, modtager patienten kemoradiationsbehandling i 5,5 uger efter operationen. Efter kemoradiation vil yderligere cyklusser af FOLFOX eller lignende kemoterapi blive anbefalet i 4 cyklusser eller 8 uger. Patientobservation med opfølgende evalueringer og hændelsesmonitorering vil forekomme op til 8 år efter randomisering.	Medicin: FOLFOX (kemoterapi) Oxaliplatin 85 mg/m^2 IV over 2 timer på dag 1, leucovorin 400 mg/m^2 bolus IV over 2 timer på dag 1 og 5-fluorouracil 400 mg/m^2 bolus over 5-15 minutter derefter 2400 mg/ m^2 kontinuerlig over 46-48 timer total dosis IV på dag 1-2. Behandlingsskemaet gentages baseret på gruppen. Dosisændringer er tilladt baseret på bivirkninger. Andet: 5 FUCMT (kemoradiation) 5-fluorouracil 225 mg/m^2 per dag kontinuerlig IV-infusion administreret samtidig med strålebehandling i 5 eller 7 dage om ugen ELLER capecitabin 825 mg/m^2 to gange dagligt administreret oralt og samtidig med strålebehandling i 5 dage om ugen. Dosisændringer er tilladt baseret på bivirkninger. Procedure: kirurgi lav anterior resektion med total mesorektal excision Procedure: magnetisk resonansbilleddannelse eller endorektal ultralyd
Aktiv komparator: Gruppe 2 Patienterne modtager 5FUCMT inklusive kemoterapi og strålebehandling i 5,5 uger. Patienterne vil få enten 5-fluorouracil eller capecitabin og strålebehandling. Efter at kemoradiationsbehandlingen er afsluttet, vil patienterne gå direkte til operationen. Efter operationen vil patienter modtage FOLFOX kemoterapi en gang hver anden uge i 8 cyklusser i alt over en periode på 16 uger. Patientobservation med opfølgende evalueringer og hændelsesmonitorering vil forekomme op til 8 år efter randomisering.	Medicin: FOLFOX (kemoterapi) Oxaliplatin 85 mg/m^2 IV over 2 timer på dag 1, leucovorin 400 mg/m^2 bolus IV over 2 timer på dag 1 og 5-fluorouracil 400 mg/m^2 bolus over 5-15 minutter derefter 2400 mg/ m^2 kontinuerlig over 46-48 timer total dosis IV på dag 1-2. Behandlingsskemaet gentages baseret på gruppen. Dosisændringer er tilladt baseret på bivirkninger. Andet: 5 FUCMT (kemoradiation) 5-fluorouracil 225 mg/m^2 per dag kontinuerlig IV-infusion administreret samtidig med strålebehandling i 5 eller 7 dage om ugen ELLER capecitabin 825 mg/m^2 to gange dagligt administreret oralt og samtidig med strålebehandling i 5 dage om ugen. Dosisændringer er tilladt baseret på bivirkninger. Procedure: kirurgi lav anterior resektion med total mesorektal excision

Deltagergruppe / Arm

Intervention / Behandling

Eksperimentel: Gruppe 1

Patienterne vil modtage FOLFOX kemoterapi en gang hver anden uge i 6 cyklusser i alt over en periode på 12 uger. Efter endt FOLFOX-kemoterapi skal patienten have en MR-scanning eller endorektal ultralyd (ERUS) for at undersøge tumoren. Hvis tumoren ikke er mindsket i størrelse med mindst 20 %, vil patienten modtage 5FUCMT (stråling med kemoterapi). Hvis tumoren er faldet i størrelse med 20%, vil patienten gå direkte til operationen.

Hvis alle kanter af tumoren er normale efter operationen, modtager patienten seks yderligere cyklusser med FOLFOX-kemoterapi. Hvis alle kanter af tumoren ikke er normale, modtager patienten kemoradiationsbehandling i 5,5 uger efter operationen. Efter kemoradiation vil yderligere cyklusser af FOLFOX eller lignende kemoterapi blive anbefalet i 4 cyklusser eller 8 uger. Patientobservation med opfølgende evalueringer og hændelsesmonitorering vil forekomme op til 8 år efter randomisering.

Medicin: FOLFOX (kemoterapi)

Oxaliplatin 85 mg/m^2 IV over 2 timer på dag 1, leucovorin 400 mg/m^2 bolus IV over 2 timer på dag 1 og 5-fluorouracil 400 mg/m^2 bolus over 5-15 minutter derefter 2400 mg/ m^2 kontinuerlig over 46-48 timer total dosis IV på dag 1-2. Behandlingsskemaet gentages baseret på gruppen. Dosisændringer er tilladt baseret på bivirkninger.

Andet: 5 FUCMT (kemoradiation)

5-fluorouracil 225 mg/m^2 per dag kontinuerlig IV-infusion administreret samtidig med strålebehandling i 5 eller 7 dage om ugen ELLER capecitabin 825 mg/m^2 to gange dagligt administreret oralt og samtidig med strålebehandling i 5 dage om ugen. Dosisændringer er tilladt baseret på bivirkninger.

Procedure: kirurgi

lav anterior resektion med total mesorektal excision

Procedure: magnetisk resonansbilleddannelse eller endorektal ultralyd

Aktiv komparator: Gruppe 2

Patienterne modtager 5FUCMT inklusive kemoterapi og strålebehandling i 5,5 uger. Patienterne vil få enten 5-fluorouracil eller capecitabin og strålebehandling. Efter at kemoradiationsbehandlingen er afsluttet, vil patienterne gå direkte til operationen. Efter operationen vil patienter modtage FOLFOX kemoterapi en gang hver anden uge i 8 cyklusser i alt over en periode på 16 uger. Patientobservation med opfølgende evalueringer og hændelsesmonitorering vil forekomme op til 8 år efter randomisering.

Medicin: FOLFOX (kemoterapi)

Andet: 5 FUCMT (kemoradiation)

Procedure: kirurgi

lav anterior resektion med total mesorektal excision

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål	Foranstaltningsbeskrivelse	Tidsramme
Bækken R0 Resektionsfrekvens Tidsramme: Op til 5 år	Antal deltagere med bækken R0 resektion	Op til 5 år
DFS Tidsramme: Op til 5 år	Sygdomsfri overlevelse (DFS): Fordelingen af DFS efter gruppe vil blive estimeret ved hjælp af metoden fra Kaplan-Meier. 5 års sygdomsfri rater efter behandlingsgruppe med konfidensintervaller baseret på Kaplan-Meier kurver vil blive rapporteret. Log-rank test vil blive brugt til at sammenligne DFS mellem to behandlingsgrupper. Hazard ratio med konfidensinterval vil blive estimeret baseret på Cox proportional hazard model. Cox proportional hazard model vil blive brugt til multivariat analyse.	Op til 5 år

Sekundære resultatmål

Resultatmål	Foranstaltningsbeskrivelse	Tidsramme
Patologisk komplet respons Tidsramme: Op til 8 år	Patologisk komplet respons (pCR): pCR-hastigheden er defineret som antallet af patienter, der opnår pCR divideret med det samlede antal patienter inkluderet i analysepopulationen (se definition i afsnit 16.3.3.1) i hver gruppe. Patienter, der ikke blev opereret, vil blive klassificeret som ikke-pCR. Punktestimat og konfidensinterval (ifølge Duffy og Santners tilgang) vil blive beregnet af behandlingsgrupper. Chi-square test vil blive brugt til at sammenligne pCR-hastighederne mellem grupper.	Op til 8 år
Samlet overlevelse Tidsramme: Op til 5 år	Samlet overlevelse (OS): OS er defineret som tiden fra randomisering til dødsdatoen på grund af alle årsager. Fordelingen af OS efter gruppe vil blive estimeret ved hjælp af metoden fra Kaplan-Meier. Fem års overlevelsesrater efter behandlingsgruppe med konfidensintervaller baseret på Kaplan-Meier-kurver vil blive rapporteret. Logrank test vil blive brugt til at sammenligne OS mellem to behandlingsgrupper. Hazard ratio med konfidensinterval vil blive estimeret baseret på Cox proportional hazard model. Cox proportional hazard model vil blive brugt til multivariat analyse.	Op til 5 år
Satser for modtagelse af præ- eller postoperativ 5FUCMT Tidsramme: Op til 5 år	Frekvenser for modtagelse af 5FUCMT: For selektive gruppepatienter, andelen af patienter, der modtog 1) præoperativ 5FUCMT, 2) postoperativ 5FUCMT, 3) enten præ- eller postoperativ 5FUCMT, og konfidensintervaller (i henhold til tilgang af Duffy og Santner) vil blive rapporteret.	Op til 5 år
Lokal gentagelse (TLR): Tidsramme: Op til 5 år	Tid til lokal gentagelse (TLR): Fordelingen af TLR efter gruppe vil blive estimeret ved hjælp af metoden fra Kaplan-Meier. 5 års lokale recidivfrie rater efter behandlingsgruppe med konfidensintervaller baseret på Kaplan-Meier-kurver vil blive rapporteret. Sammenligningen af den kumulative forekomst af lokalt tilbagefald mellem grupper, idet fjernt tilbagefald og død behandles som konkurrerende risici ved hjælp af testen af Gray (Annals of Statistics, 1988) vil blive udført.	Op til 5 år
Neoadjuvant rektal score Tidsramme: Op til 5 år	neoadjuvant rektal (NAR) score =[5 * pN - 3(cT - pT) + 12]^2/9,61. cT er et element i mængden {1, 2, 3, 4}, pT er i {0, 1, 2, 3, 4}, og pN er i {0, 1, 2}. cT klinisk tumorstadium, pT patologisk tumorstadium, pN patologisk nodalstadium. Lav (NAR <8), mellem (NAR = 8-16) og høj (NAR >16). Lav er bedre og høj er værre.	Op til 5 år

Samarbejdspartnere og efterforskere

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

Sponsor

Alliance for Clinical Trials in Oncology

Samarbejdspartnere

National Cancer Institute (NCI)

Canadian Cancer Trials Group

Efterforskere

Studiestol: Deborah Schrag, MD, Dana-Farber Cancer Institute

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

Schrag D, Weiser M, Saltz L, Mamon H, Gollub M, Basch E, Venook A, Shi Q. Challenges and solutions in the design and execution of the PROSPECT Phase II/III neoadjuvant rectal cancer trial (NCCTG N1048/Alliance). Clin Trials. 2019 Apr;16(2):165-175. doi: 10.1177/1740774518824539. Epub 2019 Jan 28.

Hjælpsomme links

Clinical trial summary from the National Cancer Institute's PDQ® database

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)

12. juni 2012

Primær færdiggørelse (Faktiske)

31. december 2022

Studieafslutning (Anslået)

30. juni 2024

Datoer for studieregistrering

Først indsendt

18. januar 2012

Først indsendt, der opfyldte QC-kriterier

18. januar 2012

Først opslået (Anslået)

24. januar 2012

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Anslået)

2. februar 2024

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

5. januar 2024

Sidst verificeret

1. januar 2024

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

N1048
U10CA031946 (U.S. NIH-bevilling/kontrakt)
CDR0000715321 (Registry Identifier: PDQ (Physician Data Query))
NCI-2012-00234 (Registry Identifier: CTRP (Clinical Trials Reporting System))

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 .

Kliniske forsøg med Kolorektal cancer

University of Arkansas

Rekruttering

Virkningen af det forbedrede restitution efter kirurgi-system til kolorektal kirurgi

Colorectal cancer og inflammatorisk tarmsygdom

Forenede Stater
University Health Network, Toronto
AstraZeneca

Aktiv, ikke rekrutterende

Kurvkombinationsundersøgelse af hæmmere af DNA-skaderespons, angiogenese og programmeret dødsligand 1 hos patienter med avancerede solide tumorer (DAPPER)

Adenocarcinom i bugspytkirtlen | Leiomyosarkom | Mismatch Reparation Proficient Colorectal Cancer

Canada
Stingray Therapeutics

Rekruttering

Fase 2-studie af SR-8541A i kombination med Botensilimab og Balstilimab i forsøgspersoner med refraktær metastatisk mikrosatellitstabil kolorektal cancer (MSS-CRC)

Refractory Metastatic Microsatellite Stabil Colorectal Cancer (MSS-CRC)

Forenede Stater
IRCCS Azienda Ospedaliero-Universitaria di Bologna

Ikke rekrutterer endnu

Hugo RAS Kolorektalkirurgisk Samarbejde (HRCC)

Kolorektal kirurgi | Robotkirurgi | Colorectal cancer og inflammatorisk tarmsygdom
Tianjin Medical University Cancer Institute and...

Rekruttering

PD-1-hæmmer kombineret med Bevacizumab og FOLFIRI-regimen i andenlinjebehandlingen af avanceret kolorektal cancer

MSI-H Advanced Colorectal Cancer

Kina
Bristol-Myers Squibb

Afsluttet

En undersøgelse af Nivolumab alene eller Nivolumab kombinationsterapi ved tyktarmskræft, der er vendt tilbage eller har spredt sig (CheckMate142)

Mikrosatellit stabil kolorektal cancer | Mismatch Reparation Proficient Colorectal Cancer | Mikrosatellit ustabil kolorektal cancer | Mismatch Reparation Manglende tyktarmskræft

Forenede Stater, Australien, Belgien, Canada, Irland, Italien, Spanien, Frankrig
Syndax Pharmaceuticals
Merck Sharp & Dohme LLC

Afsluttet

Ph1b/2 dosis-eskaleringsundersøgelse af entinostat med Pembrolizumab i NSCLC med ekspansionskohorter i NSCLC, melanom og kolorektal cancer

Melanom | Ikke-småcellet lungekræft | Mismatch Reparation-Proficient Colorectal Cancer

Forenede Stater

Kliniske forsøg med FOLFOX (kemoterapi)

Tongji Hospital
Akesobio

Aktiv, ikke rekrutterende

Kombineret HAIC, Lenvatinib og Cadonilimab som konverteringsterapi for ikke-operabelt hepatocellulært karcinom (CCGLC-011)

Hepatocellulært karcinom Ikke-operabelt

Kina
Fox Chase Cancer Center

Aktiv, ikke rekrutterende

Organkonservering hos patienter med tidlig rektalcancer

Endetarmskræft

Forenede Stater
Canadian Cancer Trials Group

Afsluttet

NEO: Neoadjuverende kemoterapi, excision og observation for tidlig rektalcancer

Endetarmskræft

Forenede Stater, Canada
University of Rochester

Aktiv, ikke rekrutterende

Neoadjuverende FOLFOX-terapi med kortvarig stråling og aktiv overvågning ved lokalt fremskreden rektalcancer

Avanceret endetarmskræft

Forenede Stater
Shanghai Zhongshan Hospital

Rekruttering

NALIRIFOX plus målrettet terapi versus FOLFOX plus målrettet terapi som første-linjesbehandling for metastatisk kolorektalkræft

Metastatisk kolorektal cancer (CRC)

Kina
Jules Bordet Institute

Afsluttet

Præoperativ kemosensitivitetstest for at forudsige behandlingsfordele ved adjuverende trin III tyktarmskræft (PePiTA)

Tyktarmskræft

Belgien
University of Saskatchewan

Afsluttet

FOLFIRI veksler med FOLFOX ved ubehandlet metastatisk gastrisk og esophagealt adenokarcinom (LOGIC)

Metastatisk gastroøsofagealt adenokarcinom

Canada
UNICANCER
Summit Therapeutics; Cancer Research UK & UCL Cancer Trials Centre; Belgian...

Rekruttering

Test af Ivonescimab versus FOLFOX hos patienter med avanceret galdevejskræft (SEVILLA)

Galdevejskræft

Frankrig, Det Forenede Kongerige
Sun Yat-sen University

Rekruttering

Neoadjuverende HAIC for resektabelt hepatocellulært karcinom ud over Milanos kriterier

Hepatocellulært karcinom

Kina
UNICANCER

Rekruttering

Dosisindividualisering af kemoterapi hos patienter med gastrointestinale kræftformer, der mangler et specifikt leverenzym (FUDOSE)

Kolorektal cancer | Fordøjelseskræft

Frankrig

UDSIGT: Kemoterapi alene eller kemoterapi plus strålebehandling til behandling af patienter med lokalt avanceret endetarmskræft, der gennemgår kirurgi

Et fase II/III forsøg med neoadjuverende FOLFOX med selektiv brug af kombineret modalitet kemoradiation versus præoperativ kombineret modalitet kemoradiation til lokalt avancerede rektalcancerpatienter, der gennemgår lav anterior resektion med total mesorektal excision (PROSPECT)

Studieoversigt

Status

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Undersøgelsestype

Tilmelding (Faktiske)

Fase

Kontakter og lokationer

Studiesteder

Deltagelseskriterier

Berettigelseskriterier

Aldre berettiget til at studere

Tager imod sunde frivillige

Beskrivelse

Studieplan

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

Antal våben

Våben og indgreb

Deltagergruppe / Arm

Intervention / Behandling

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål

Foranstaltningsbeskrivelse

Tidsramme

Sekundære resultatmål

Resultatmål

Foranstaltningsbeskrivelse

Tidsramme

Samarbejdspartnere og efterforskere

Sponsor

Samarbejdspartnere

Efterforskere

Publikationer og nyttige links

Generelle publikationer

Hjælpsomme links

Datoer for undersøgelser

Studer store datoer

Studiestart (Faktiske)

Primær færdiggørelse (Faktiske)

Studieafslutning (Anslået)

Datoer for studieregistrering

Først indsendt

Først indsendt, der opfyldte QC-kriterier

Først opslået (Anslået)

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Anslået)

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

Sidst verificeret

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

Kliniske forsøg med Kolorektal cancer

Kliniske forsøg med FOLFOX (kemoterapi)

Søg i lignende forsøg

Sponsorer og samarbejdspartnere

Medicinske tilstande

Narkotikainterventioner

CROs by country

CROs in Mexico

Betingelser

Sjældne sygdomme

Narkotikainterventioner

Kosttilskud

Sponsor / samarbejdspartnere

Placeringer