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Cabozantinib-s-malate eller Sunitinib Malate til behandling af patienter med tidligere ubehandlet lokalt avanceret eller metastatisk nyrekræft

28. januar 2021 opdateret af: National Cancer Institute (NCI)

Randomiseret fase II-studie, der sammenligner cabozantinib (NSC #761968) med kommercielt leveret sunitinib hos patienter med tidligere ubehandlet lokalt avanceret eller metastatisk nyrecellecarcinom

Dette randomiserede fase II-forsøg undersøger, hvor godt cabozantinib-s-malat virker sammenlignet med sunitinib-malat til behandling af patienter med tidligere ubehandlet nyrekræft, der har spredt sig fra det sted, hvor det startede, til nærliggende væv eller lymfeknuder eller til andre steder i kroppen. Cabozantinib-s-malat og sunitinib-malat kan stoppe væksten af ​​tumorceller ved at blokere nogle af de enzymer, der er nødvendige for cellevækst. Det vides endnu ikke, om cabozantinib-s-malat er mere effektivt end sunitinib-malat til behandling af patienter med nyrekræft.

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

PRIMÆRE MÅL:

I. At bestemme om patienter med nyrekræft behandlet med cabozantinib (cabozantinib-s-malat) vil have forbedret progressionsfri overlevelse sammenlignet med patienter behandlet med sunitinib (sunitinib malat).

SEKUNDÆRE MÅL:

I. At bestemme om responsraten for patienter med nyrekræft behandlet med cabozantinib vil være højere sammenlignet med patienter behandlet med sunitinib.

II. For at bestemme om patienter med nyrekræft behandlet med cabozantinib vil have en forbedret samlet overlevelse sammenlignet med patienter behandlet med sunitinib.

TERTIÆRE MÅL:

I. At bestemme om nyrekræftpatienter med høj MET-ekspression ved immunhistokemi (IHC) har en forbedring i progressionsfri overlevelse sammenlignet med patienter med lav MET-ekspression på begge arme af denne undersøgelse.

OVERSIGT: Patienterne randomiseres til 1 ud af 2 behandlingsarme.

ARM I: Patienter får cabozantinib-s-malat oralt (PO) én gang dagligt (QD) i 6 uger. Kurser gentages hver 6. uge i fravær af sygdomsprogression eller uacceptabel toksicitet.

ARM II: Patienter får sunitinib malat PO QD i 4 uger. Kurser gentages hver 6. uge i fravær af sygdomsprogression eller uacceptabel toksicitet.

Efter afsluttet undersøgelsesbehandling følges patienterne hver 6. måned i 5 år.

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

157

Fase

  • Fase 2

Kontakter og lokationer

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

Studiesteder

  • Forenede Stater
    • Alabama
      • Mobile, Alabama, Forenede Stater, 36608
        • Southern Cancer Center PC-Providence
    • Alaska
      • Anchorage, Alaska, Forenede Stater, 99508
        • Alaska Breast Care and Surgery 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
    • California
      • Burbank, California, Forenede Stater, 91505
        • Providence Saint Joseph Medical Center/Disney Family Cancer Center
      • Clovis, California, Forenede Stater, 93611
        • Community Cancer Institute
      • Clovis, California, Forenede Stater, 93611
        • University Oncology Associates
      • La Jolla, California, Forenede Stater, 92093
        • UC San Diego Moores Cancer Center
      • San Diego, California, Forenede Stater, 92161
        • San Diego VA Medical Center
      • San Francisco, California, Forenede Stater, 94115
        • UCSF Medical Center-Mount Zion
    • Colorado
      • 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, 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, 80218
        • Colorado Blood Cancer Institute
      • Denver, Colorado, Forenede Stater, 80222
        • Western States Cancer Research NCORP
      • Durango, Colorado, Forenede Stater, 81301
        • Mercy Medical Center
      • Englewood, Colorado, Forenede Stater, 80113
        • Mountain Blue Cancer Care Center - Swedish
      • Englewood, Colorado, Forenede Stater, 80113
        • Swedish Medical Center
      • Golden, Colorado, Forenede Stater, 80401
        • Mountain Blue Cancer Care Center
      • Greeley, Colorado, Forenede Stater, 80631
        • North Colorado Medical Center
      • Greenwood Village, Colorado, Forenede Stater, 80111
        • Rocky Mountain Cancer Centers-Greenwood Village
      • 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
      • Wheat Ridge, Colorado, Forenede Stater, 80033
        • SCL Health Lutheran Medical Center
    • Connecticut
      • Hartford, Connecticut, Forenede Stater, 06105
        • Smilow Cancer Hospital Care Center at Saint Francis
      • Middletown, Connecticut, Forenede Stater, 06457
        • Middlesex Hospital
    • 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
      • Rehoboth Beach, Delaware, Forenede Stater, 19971
        • Beebe Health Campus
      • Seaford, Delaware, Forenede Stater, 19973
        • TidalHealth Nanticoke / Allen Cancer Center
      • 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
      • Jacksonville, Florida, Forenede Stater, 32224-9980
        • Mayo Clinic in Florida
    • Georgia
      • Savannah, Georgia, Forenede Stater, 31404
        • Memorial Health University Medical Center
    • Hawaii
      • 'Aiea, Hawaii, Forenede Stater, 96701
        • Pali Momi Medical Center
      • 'Aiea, Hawaii, Forenede Stater, 96701
        • Queen's Cancer Center - Pearlridge
      • Honolulu, Hawaii, Forenede Stater, 96813
        • Queen's Medical Center
      • Honolulu, Hawaii, Forenede Stater, 96813
        • Hawaii Cancer Care Inc - Waterfront Plaza
      • 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
        • Queen's Cancer Center - Kuakini
      • Kailua, Hawaii, Forenede Stater, 96734
        • Castle Medical Center
      • Lihue, Hawaii, Forenede Stater, 96766
        • Wilcox Memorial Hospital and Kauai Medical Clinic
    • Idaho
      • Boise, Idaho, Forenede Stater, 83706
        • Saint Alphonsus Cancer Care Center-Boise
      • Coeur d'Alene, Idaho, Forenede Stater, 83814
        • Kootenai Medical Center
      • Post Falls, Idaho, Forenede Stater, 83854
        • Kootenai Cancer Center
      • Sandpoint, Idaho, Forenede Stater, 83864
        • Kootenai Cancer Clinic
    • 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
      • Carthage, Illinois, Forenede Stater, 62321
        • Illinois CancerCare-Carthage
      • Centralia, Illinois, Forenede Stater, 62801
        • Centralia Oncology Clinic
      • Chicago, Illinois, Forenede Stater, 60637
        • University of Chicago Comprehensive Cancer Center
      • Chicago, Illinois, Forenede Stater, 60640
        • Weiss Memorial Hospital
      • 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
      • Decatur, Illinois, Forenede Stater, 62526
        • Heartland Cancer Research NCORP
      • 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
      • Galesburg, Illinois, Forenede Stater, 61401
        • Western Illinois Cancer Treatment Center
      • Galesburg, Illinois, Forenede Stater, 61401
        • Illinois CancerCare-Galesburg
      • Kewanee, Illinois, Forenede Stater, 61443
        • Illinois CancerCare-Kewanee Clinic
      • Macomb, Illinois, Forenede Stater, 61455
        • Illinois CancerCare-Macomb
      • Mattoon, Illinois, Forenede Stater, 61938
        • Carle Physician Group-Mattoon/Charleston
      • 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
      • Monmouth, Illinois, Forenede Stater, 61462
        • Illinois CancerCare-Monmouth
      • Monmouth, Illinois, Forenede Stater, 61462
        • Holy Family Medical Center
      • Mount Vernon, Illinois, Forenede Stater, 62864
        • Good Samaritan Regional Health Center
      • Normal, Illinois, Forenede Stater, 61761
        • Community Cancer Center Foundation
      • Ottawa, Illinois, Forenede Stater, 61350
        • Illinois CancerCare-Ottawa Clinic
      • Ottawa, Illinois, Forenede Stater, 61350
        • Radiation Oncology of Northern Illinois
      • Ottawa, Illinois, Forenede Stater, 61350
        • Ottawa Regional Hospital and Healthcare Center
      • Pekin, Illinois, Forenede Stater, 61554
        • Illinois CancerCare-Pekin
      • Pekin, Illinois, Forenede Stater, 61554
        • OSF Saint Francis Radiation Oncology at Pekin Cancer Treatment Center
      • Peoria, Illinois, Forenede Stater, 61636
        • Methodist Medical Center of Illinois
      • Peoria, Illinois, Forenede Stater, 61637
        • OSF Saint Francis Medical Center
      • Peoria, Illinois, Forenede Stater, 61615
        • Illinois CancerCare-Peoria
      • Peoria, Illinois, Forenede Stater, 61615
        • OSF Saint Francis Radiation Oncology at Peoria Cancer Center
      • Peoria, Illinois, Forenede Stater, 61614
        • Proctor Hospital
      • Peru, Illinois, Forenede Stater, 61354
        • Illinois CancerCare-Peru
      • Peru, Illinois, Forenede Stater, 61354
        • Valley Radiation Oncology
      • Princeton, Illinois, Forenede Stater, 61356
        • Illinois CancerCare-Princeton
      • Springfield, Illinois, Forenede Stater, 62781
        • Memorial Medical Center
      • Urbana, Illinois, Forenede Stater, 61801
        • Carle Cancer Center
      • Urbana, Illinois, Forenede Stater, 61801
        • The Carle Foundation Hospital
      • Yorkville, Illinois, Forenede Stater, 60560
        • Rush-Copley Healthcare Center
    • Indiana
      • Elkhart, Indiana, Forenede Stater, 46515
        • Elkhart General Hospital
      • Elkhart, Indiana, Forenede Stater, 46514
        • Michiana Hematology Oncology PC-Elkhart
      • Elkhart, Indiana, Forenede Stater, 46514-2098
        • Elkhart Clinic
      • Fort Wayne, Indiana, Forenede Stater, 46845
        • Fort Wayne Medical Oncology and Hematology Inc-Parkview
      • 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
        • Franciscan Saint Anthony Health-Michigan City
      • 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
      • Plymouth, Indiana, Forenede Stater, 46563
        • Michiana Hematology Oncology PC-Plymouth
      • Richmond, Indiana, Forenede Stater, 47374
        • Reid Health
      • South Bend, Indiana, Forenede Stater, 46601
        • Memorial Hospital of South Bend
      • South Bend, Indiana, Forenede Stater, 46601
        • Michiana Hematology Oncology PC-South Bend
      • South Bend, Indiana, Forenede Stater, 46628
        • Northern Indiana Cancer Research Consortium
      • Westville, Indiana, Forenede Stater, 46391
        • Michiana Hematology Oncology PC-Westville
    • Iowa
      • Ames, Iowa, Forenede Stater, 50010
        • McFarland Clinic PC - Ames
      • Bettendorf, Iowa, Forenede Stater, 52722
        • Constantinou, Costas L MD (UIA Investigator)
      • Bettendorf, Iowa, Forenede Stater, 52722
        • University of Iowa Healthcare Cancer Services Quad Cities
      • Cedar Rapids, Iowa, Forenede Stater, 52403
        • Mercy Hospital
      • Cedar Rapids, Iowa, Forenede Stater, 52403
        • Oncology Associates at Mercy Medical Center
      • Clive, Iowa, Forenede Stater, 50325
        • Mercy Cancer Center-West Lakes
      • Clive, Iowa, Forenede Stater, 50325
        • Medical Oncology and Hematology Associates-West Des Moines
      • Des Moines, Iowa, Forenede Stater, 50309
        • Iowa Methodist Medical Center
      • Des Moines, Iowa, Forenede Stater, 50314
        • Mercy Medical Center - Des Moines
      • Des Moines, Iowa, Forenede Stater, 50309
        • Medical Oncology and Hematology Associates-Des Moines
      • Des Moines, Iowa, Forenede Stater, 50316
        • Iowa Lutheran Hospital
      • Des Moines, Iowa, Forenede Stater, 50309
        • Iowa-Wide Oncology Research Coalition NCORP
      • Des Moines, Iowa, Forenede Stater, 50314
        • Medical Oncology and Hematology Associates-Laurel
      • Iowa City, Iowa, Forenede Stater, 52242
        • University of Iowa/Holden Comprehensive Cancer Center
      • Iowa City, Iowa, Forenede Stater, 52246
        • Iowa City VA Healthcare System
      • Sioux City, Iowa, Forenede Stater, 51101
        • Siouxland Regional Cancer Center
      • Sioux City, Iowa, Forenede Stater, 51102
        • Mercy Medical Center-Sioux City
      • Sioux City, Iowa, Forenede Stater, 51104
        • Saint Luke's 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
      • Independence, Kansas, Forenede Stater, 67301
        • Cancer Center of Kansas-Independence
      • Kingman, Kansas, Forenede Stater, 67068
        • Cancer Center of Kansas-Kingman
      • Lawrence, Kansas, Forenede Stater, 66044
        • Lawrence Memorial 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
      • Parsons, Kansas, Forenede Stater, 67357
        • Cancer Center of Kansas - Parsons
      • Pratt, Kansas, Forenede Stater, 67124
        • Cancer Center of Kansas - Pratt
      • Salina, Kansas, Forenede Stater, 67401
        • Cancer Center of Kansas - Salina
      • Wellington, Kansas, Forenede Stater, 67152
        • Cancer Center of Kansas - Wellington
      • Wichita, Kansas, Forenede Stater, 67214
        • Ascension Via Christi Hospitals Wichita
      • 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
        • Wichita NCI Community Oncology Research Program
      • Winfield, Kansas, Forenede Stater, 67156
        • Cancer Center of Kansas - Winfield
    • Kentucky
      • Crestview Hills, Kentucky, Forenede Stater, 41017
        • Oncology Hematology Care Inc-Crestview
      • Lexington, Kentucky, Forenede Stater, 40536
        • University of Kentucky/Markey Cancer Center
    • Louisiana
      • New Orleans, Louisiana, Forenede Stater, 70121
        • Ochsner Medical Center Jefferson
    • Maine
      • Augusta, Maine, Forenede Stater, 04330
        • Harold Alfond Center for Cancer Care
      • Bangor, Maine, Forenede Stater, 04401
        • Eastern Maine Medical Center
      • Rockport, Maine, Forenede Stater, 04856
        • Penobscot Bay Medical Center
    • Maryland
      • Baltimore, Maryland, Forenede Stater, 21237
        • MedStar Franklin Square Medical Center/Weinberg Cancer Institute
      • Olney, Maryland, Forenede Stater, 20832
        • MedStar Montgomery Medical Center
    • Massachusetts
      • 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
    • Michigan
      • Adrian, Michigan, Forenede Stater, 49221
        • Bixby Medical Center
      • Adrian, Michigan, Forenede Stater, 49221
        • Hickman Cancer Center
      • Ann Arbor, Michigan, Forenede Stater, 48106
        • Saint Joseph Mercy Hospital
      • Ann Arbor, Michigan, Forenede Stater, 48106
        • Michigan Cancer Research Consortium NCORP
      • Dearborn, Michigan, Forenede Stater, 48124
        • Beaumont Hospital - Dearborn
      • Detroit, Michigan, Forenede Stater, 48202
        • Henry Ford Hospital
      • Detroit, Michigan, Forenede Stater, 48236
        • Ascension Saint John Hospital
      • Escanaba, Michigan, Forenede Stater, 49829
        • Green Bay Oncology - Escanaba
      • Flint, Michigan, Forenede Stater, 48503
        • Hurley Medical Center
      • Flint, Michigan, Forenede Stater, 48503
        • Genesys Hurley Cancer Institute
      • Iron Mountain, Michigan, Forenede Stater, 49801
        • Green Bay Oncology - Iron Mountain
      • 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
      • Monroe, Michigan, Forenede Stater, 48162
        • Mercy Memorial Hospital
      • Monroe, Michigan, Forenede Stater, 48162
        • Toledo Clinic Cancer Centers-Monroe
      • Pontiac, Michigan, Forenede Stater, 48341
        • Saint Joseph Mercy Oakland
      • Port Huron, Michigan, Forenede Stater, 48060
        • Lake Huron Medical Center
      • Saginaw, Michigan, Forenede Stater, 48601
        • Ascension Saint Mary's Hospital
      • Warren, Michigan, Forenede Stater, 48093
        • Saint John Macomb-Oakland Hospital
    • 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
      • 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
      • 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 in Rochester
      • Saint Cloud, Minnesota, Forenede Stater, 56303
        • Coborn Cancer Center at Saint Cloud Hospital
      • Saint Cloud, Minnesota, Forenede Stater, 56303
        • Saint Cloud Hospital
      • Saint Louis Park, Minnesota, Forenede Stater, 55416
        • Park Nicollet Clinic - Saint Louis Park
      • Saint Louis Park, Minnesota, Forenede Stater, 55416
        • Metro Minnesota Community Oncology Research Consortium
      • Saint Paul, Minnesota, Forenede Stater, 55101
        • Regions Hospital
      • Saint Paul, Minnesota, Forenede Stater, 55102
        • United Hospital
      • Shakopee, Minnesota, Forenede Stater, 55379
        • Saint Francis Regional Medical Center
      • Stillwater, Minnesota, Forenede Stater, 55082
        • Lakeview Hospital
      • Waconia, Minnesota, Forenede Stater, 55387
        • Ridgeview Medical Center
      • Willmar, Minnesota, Forenede Stater, 56201
        • Rice Memorial Hospital
      • Woodbury, Minnesota, Forenede Stater, 55125
        • Minnesota Oncology Hematology PA-Woodbury
    • Missouri
      • 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
      • Columbia, Missouri, Forenede Stater, 65201
        • Veterans Administration
      • 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
      • Rolla, Missouri, Forenede Stater, 65401
        • Delbert Day Cancer Institute at PCRMC
      • Rolla, Missouri, Forenede Stater, 65401
        • Mercy Clinic-Rolla-Cancer and Hematology
      • Saint Louis, Missouri, Forenede Stater, 63110
        • Washington University School of Medicine
      • Saint Louis, Missouri, Forenede Stater, 63131
        • Missouri Baptist Medical Center
      • Saint Louis, Missouri, Forenede Stater, 63141
        • Mercy Hospital Saint Louis
      • Saint Louis, Missouri, Forenede Stater, 63109
        • Saint Louis Cancer and Breast Institute-South City
      • Springfield, Missouri, Forenede Stater, 65804
        • Cancer Research for the Ozarks NCORP
      • Springfield, Missouri, Forenede Stater, 65807
        • CoxHealth South Hospital
      • Springfield, Missouri, Forenede Stater, 65804
        • Mercy Hospital Springfield
      • Sullivan, Missouri, Forenede Stater, 63080
        • Missouri Baptist Sullivan Hospital
      • Sunset Hills, Missouri, Forenede Stater, 63127
        • Missouri Baptist Outpatient Center-Sunset Hills
    • Montana
      • Billings, Montana, Forenede Stater, 59101
        • Billings Clinic Cancer Center
      • Billings, Montana, Forenede Stater, 59101
        • Saint Vincent Healthcare
      • Billings, Montana, Forenede Stater, 59102
        • Montana Cancer Consortium NCORP
      • 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
        • 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
      • Lincoln, Nebraska, Forenede Stater, 68506
        • Nebraska Hematology and Oncology
      • Lincoln, Nebraska, Forenede Stater, 68510
        • Nebraska Cancer Research Center
      • Norfolk, Nebraska, Forenede Stater, 68701
        • Faith Regional Health Services Carson Cancer Center
      • North Platte, Nebraska, Forenede Stater, 69101
        • Great Plains Health Callahan Cancer Center
      • Omaha, Nebraska, Forenede Stater, 68114
        • Nebraska Methodist Hospital
      • Omaha, Nebraska, Forenede Stater, 68124
        • Alegent Health Bergan Mercy Medical Center
      • 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, 68106
        • Missouri Valley Cancer Consortium
      • Omaha, Nebraska, Forenede Stater, 68124
        • Nebraska Cancer Specialists - Omaha
      • Omaha, Nebraska, Forenede Stater, 68130
        • Oncology Hematology West PC
      • Scottsbluff, Nebraska, Forenede Stater, 69361
        • Regional West Medical Center Cancer Center
    • Nevada
      • Henderson, Nevada, Forenede Stater, 89052
        • Comprehensive Cancer Centers of Nevada - Henderson
      • 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
      • 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, 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, 89169
        • Nevada Cancer Research Foundation NCORP
      • 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
    • New Hampshire
      • Concord, New Hampshire, Forenede Stater, 03301
        • New Hampshire Oncology Hematology PA-Concord
      • Laconia, New Hampshire, Forenede Stater, 03246
        • LRGHealthcare-Lakes Region General Hospital
      • Lebanon, New Hampshire, Forenede Stater, 03756
        • Dartmouth Hitchcock Medical Center
      • Manchester, New Hampshire, Forenede Stater, 03103
        • Solinsky Center for Cancer Care
    • 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
      • Hackensack, New Jersey, Forenede Stater, 07601
        • Hackensack University Medical Center
    • 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
      • Bronx, New York, Forenede Stater, 10461
        • Montefiore Medical Center-Einstein Campus
      • Bronx, New York, Forenede Stater, 10467
        • Montefiore Medical Center - Moses Campus
      • Bronx, New York, Forenede Stater, 10461
        • Montefiore Medical Center-Weiler Hospital
      • Brooklyn, New York, Forenede Stater, 11219
        • Maimonides Medical Center
      • Buffalo, New York, Forenede Stater, 14263
        • Roswell Park Cancer Institute
      • Buffalo, New York, Forenede Stater, 14215
        • Veterans Affairs Western New York Health Care System-Buffalo
      • 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
      • Glens Falls, New York, Forenede Stater, 12801
        • Glens Falls Hospital
      • Lake Success, New York, Forenede Stater, 11042
        • Northwell Health/Center for Advanced Medicine
      • Liverpool, New York, Forenede Stater, 13088
        • Hematology Oncology Associates of Central New York-Liverpool
      • Manhasset, New York, Forenede Stater, 11030
        • North Shore University Hospital
      • New Hyde Park, New York, Forenede Stater, 11040
        • Long Island Jewish Medical Center
      • New York, New York, Forenede Stater, 10065
        • Memorial Sloan Kettering Cancer Center
      • New York, New York, Forenede Stater, 10032
        • NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center
      • New York, New York, Forenede Stater, 10065
        • NYP/Weill Cornell Medical Center
      • Rome, New York, Forenede Stater, 13440
        • Hematology Oncology Associates of Central New York-Rome
      • Sleepy Hollow, New York, Forenede Stater, 10591
        • Memorial Sloan Kettering Sleepy Hollow
      • Syracuse, New York, Forenede Stater, 13210
        • State University of New York Upstate Medical University
      • Syracuse, New York, Forenede Stater, 13215
        • Hematology Oncology Associates of Central New York-Onondaga Hill
      • Uniondale, New York, Forenede Stater, 11553
        • Memorial Sloan Kettering Nassau
    • North Carolina
      • Charlotte, North Carolina, Forenede Stater, 28204
        • Novant Health Presbyterian Medical Center
      • Clinton, North Carolina, Forenede Stater, 28328
        • Southeastern Medical Oncology Center-Clinton
      • Durham, North Carolina, Forenede Stater, 27710
        • Duke University Medical Center
      • Goldsboro, North Carolina, Forenede Stater, 27534
        • Southeastern Medical Oncology Center-Goldsboro
      • Goldsboro, North Carolina, Forenede Stater, 27534
        • Wayne Memorial Hospital
      • Hendersonville, North Carolina, Forenede Stater, 28791
        • Hendersonville Hematology and Oncology at Pardee
      • Hendersonville, North Carolina, Forenede Stater, 28791
        • Margaret R Pardee Memorial Hospital
      • Hendersonville, North Carolina, Forenede Stater, 28792
        • AdventHealth Hendersonville
      • Jacksonville, North Carolina, Forenede Stater, 28546
        • Southeastern Medical Oncology Center-Jacksonville
      • Kinston, North Carolina, Forenede Stater, 28501
        • Vidant Oncology-Kinston
      • Pinehurst, North Carolina, Forenede Stater, 28374
        • FirstHealth of the Carolinas-Moore Regional Hospital
      • Statesville, North Carolina, Forenede Stater, 28677
        • Iredell Memorial Hospital
      • Winston-Salem, North Carolina, Forenede Stater, 27157
        • Wake Forest University Health Sciences
      • Winston-Salem, North Carolina, Forenede Stater, 27104
        • Southeast Clinical Oncology Research Consortium NCORP
    • North Dakota
      • Bismarck, North Dakota, Forenede Stater, 58501
        • Sanford Bismarck Medical Center
      • Fargo, North Dakota, Forenede Stater, 58122
        • Sanford Roger Maris Cancer Center
      • Fargo, North Dakota, Forenede Stater, 58122
        • Sanford Broadway Medical Center
      • Fargo, North Dakota, Forenede Stater, 58122
        • Sanford Clinic North-Fargo
      • Grand Forks, North Dakota, Forenede Stater, 58201
        • Altru Cancer Center
    • Ohio
      • Belpre, Ohio, Forenede Stater, 45714
        • Strecker Cancer Center-Belpre
      • Bowling Green, Ohio, Forenede Stater, 43402
        • Toledo Clinic Cancer Centers-Bowling Green
      • Chillicothe, Ohio, Forenede Stater, 45601
        • Adena Regional Medical Center
      • 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, 45230
        • Oncology Hematology Care Inc-Anderson
      • Cincinnati, Ohio, Forenede Stater, 45236
        • Oncology Hematology Care Inc-Kenwood
      • 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, 43215
        • Grant Medical Center
      • Columbus, Ohio, Forenede Stater, 43222
        • Mount Carmel Health Center West
      • Columbus, Ohio, Forenede Stater, 43215
        • Columbus NCI Community Oncology Research Program
      • Dayton, Ohio, Forenede Stater, 45406
        • Good Samaritan Hospital - Dayton
      • Dayton, Ohio, Forenede Stater, 45409
        • Miami Valley Hospital
      • Dayton, Ohio, Forenede Stater, 45415
        • Miami Valley Hospital North
      • Dayton, Ohio, Forenede Stater, 45459
        • Dayton NCI Community Oncology Research Program
      • 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
      • Franklin, Ohio, Forenede Stater, 45005-1066
        • Atrium Medical Center-Middletown Regional Hospital
      • Greenville, Ohio, Forenede Stater, 45331
        • Wayne Hospital
      • Kettering, Ohio, Forenede Stater, 45429
        • Kettering Medical Center
      • Lancaster, Ohio, Forenede Stater, 43130
        • Fairfield Medical Center
      • Lancaster, Ohio, Forenede Stater, 43130
        • Lancaster Radiation Oncology
      • Lima, Ohio, Forenede Stater, 45804
        • Lima Memorial Hospital
      • Marietta, Ohio, Forenede Stater, 45750
        • Marietta Memorial Hospital
      • Maumee, Ohio, Forenede Stater, 43537
        • Toledo Clinic Cancer Centers-Maumee
      • Maumee, Ohio, Forenede Stater, 43537
        • Toledo Radiation Oncology at Northwest Ohio Onocolgy Center
      • 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
      • Oregon, Ohio, Forenede Stater, 43616
        • Saint Charles Hospital
      • Oregon, Ohio, Forenede Stater, 43616
        • Toledo Clinic Cancer Centers-Oregon
      • Portsmouth, Ohio, Forenede Stater, 45662
        • Southern Ohio Medical Center
      • Springfield, Ohio, Forenede Stater, 45505
        • Springfield Regional Medical Center
      • Sylvania, Ohio, Forenede Stater, 43560
        • ProMedica Flower Hospital
      • Tiffin, Ohio, Forenede Stater, 44883
        • Mercy Hospital of Tiffin
      • Toledo, Ohio, Forenede Stater, 43606
        • ProMedica Toledo Hospital/Russell J Ebeid Children's Hospital
      • Toledo, Ohio, Forenede Stater, 43608
        • Saint Vincent Mercy Medical Center
      • Toledo, Ohio, Forenede Stater, 43623
        • Mercy Health - Saint Anne Hospital
      • Toledo, Ohio, Forenede Stater, 43623
        • Toledo Clinic Cancer Centers-Toledo
      • Toledo, Ohio, Forenede Stater, 43614
        • University of Toledo
      • Toledo, Ohio, Forenede Stater, 43617
        • Toledo Community Hospital Oncology Program CCOP
      • Troy, Ohio, Forenede Stater, 45373
        • Upper Valley Medical Center
      • Wauseon, Ohio, Forenede Stater, 43567
        • Fulton County Health Center
      • Westerville, Ohio, Forenede Stater, 43081
        • Saint Ann's 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
      • Tulsa, Oklahoma, Forenede Stater, 74146
        • Oklahoma Cancer Specialists and Research Institute-Tulsa
      • Tulsa, Oklahoma, Forenede Stater, 74136
        • Natalie Warren Bryant Cancer Center at Saint Francis
      • Tulsa, Oklahoma, Forenede Stater, 74146
        • Warren Clinic Oncology-Tulsa
    • Oregon
      • Clackamas, Oregon, Forenede Stater, 97015
        • Clackamas Radiation Oncology Center
      • Milwaukie, Oregon, Forenede Stater, 97222
        • Providence Milwaukie Hospital
      • Newberg, Oregon, Forenede Stater, 97132
        • Providence Newberg Medical Center
      • Oregon City, Oregon, Forenede Stater, 97045
        • Providence Willamette Falls Medical Center
      • Portland, Oregon, Forenede Stater, 97213
        • Providence Portland Medical Center
      • Portland, Oregon, Forenede Stater, 97225
        • Providence Saint Vincent Medical Center
    • Pennsylvania
      • Danville, Pennsylvania, Forenede Stater, 17822
        • Geisinger Medical Center
      • Hazleton, Pennsylvania, Forenede Stater, 18201
        • Geisinger Medical Center-Cancer Center Hazleton
      • Pottsville, Pennsylvania, Forenede Stater, 17901
        • Geisinger Cancer Services-Pottsville
      • Sayre, Pennsylvania, Forenede Stater, 18840
        • Guthrie Medical Group PC-Robert Packer Hospital
      • State College, Pennsylvania, Forenede Stater, 16801
        • Geisinger Medical Group
      • Wilkes-Barre, Pennsylvania, Forenede Stater, 18711
        • Geisinger Wyoming Valley/Henry Cancer Center
    • South Carolina
      • Anderson, South Carolina, Forenede Stater, 29621
        • AnMed Health Cancer Center
      • Boiling Springs, South Carolina, Forenede Stater, 29316
        • Prisma Health Cancer Institute - Spartanburg
      • Charleston, South Carolina, Forenede Stater, 29425
        • Medical University of South Carolina
      • Easley, South Carolina, Forenede Stater, 29640
        • Prisma Health Cancer Institute - Easley
      • Florence, South Carolina, Forenede Stater, 29506
        • McLeod Regional Medical Center
      • Greenville, South Carolina, Forenede Stater, 29605
        • Prisma Health Cancer Institute - Faris
      • Greenville, South Carolina, Forenede Stater, 29615
        • Prisma Health Cancer Institute - Eastside
      • Greenville, South Carolina, Forenede Stater, 29605
        • Prisma Health Cancer Institute - Butternut
      • Greenville, South Carolina, Forenede Stater, 29601
        • Saint Francis Hospital
      • Greenville, South Carolina, Forenede Stater, 29605
        • Prisma Health Greenville Memorial Hospital
      • Greenville, South Carolina, Forenede Stater, 29601
        • Greenville Health System Cancer Institute-Andrews
      • Greer, South Carolina, Forenede Stater, 29650
        • Prisma Health Cancer Institute - Greer
      • Greer, South Carolina, Forenede Stater, 29651
        • Gibbs Cancer Center-Pelham
      • Seneca, South Carolina, Forenede Stater, 29672
        • Prisma Health Cancer Institute - Seneca
      • Spartanburg, South Carolina, Forenede Stater, 29303
        • Spartanburg Medical Center
    • South Dakota
      • Rapid City, South Dakota, Forenede Stater, 57701
        • Rapid City Regional Hospital
      • Sioux Falls, South Dakota, Forenede Stater, 57105
        • Avera Cancer Institute
      • Sioux Falls, South Dakota, Forenede Stater, 57117-5134
        • Sanford USD Medical Center - Sioux Falls
      • Sioux Falls, South Dakota, Forenede Stater, 57104
        • Sanford Cancer Center Oncology Clinic
    • Tennessee
      • Bristol, Tennessee, Forenede Stater, 37620
        • Wellmont Medical Associates Oncology and Hematology-Bristol
      • Bristol, Tennessee, Forenede Stater, 37620
        • Wellmont Bristol Regional Medical Center
      • Kingsport, Tennessee, Forenede Stater, 37660
        • Wellmont Holston Valley Hospital and Medical Center
      • Kingsport, Tennessee, Forenede Stater, 37660
        • Regional Cancer Center at Indian Path Community Hospital
    • Virginia
      • Fredericksburg, Virginia, Forenede Stater, 22401
        • Fredericksburg Oncology Inc
      • Norton, Virginia, Forenede Stater, 24273
        • Southwest VA Regional Cancer Center
      • Richmond, Virginia, Forenede Stater, 23298
        • Virginia Commonwealth University/Massey Cancer Center
    • Washington
      • Longview, Washington, Forenede Stater, 98632
        • PeaceHealth Saint John Medical Center
      • Vancouver, Washington, Forenede Stater, 98664
        • PeaceHealth Southwest Medical Center
    • Wisconsin
      • Chippewa Falls, Wisconsin, Forenede Stater, 54729
        • Marshfield Clinic-Chippewa Center
      • Eau Claire, Wisconsin, Forenede Stater, 54701
        • Marshfield Clinic Cancer Center at Sacred Heart
      • Green Bay, Wisconsin, Forenede Stater, 54301
        • Saint Vincent Hospital Cancer Center Green Bay
      • Green Bay, Wisconsin, Forenede Stater, 54303
        • Saint Vincent Hospital Cancer Center at Saint Mary's
      • Green Bay, Wisconsin, Forenede Stater, 54303
        • Green Bay Oncology Limited at Saint Mary's Hospital
      • Green Bay, Wisconsin, Forenede Stater, 54301-3526
        • Green Bay Oncology at Saint Vincent Hospital
      • La Crosse, Wisconsin, Forenede Stater, 54601
        • Gundersen Lutheran Medical Center
      • Manitowoc, Wisconsin, Forenede Stater, 54221
        • Holy Family Memorial Hospital
      • Marinette, Wisconsin, Forenede Stater, 54143
        • Bay Area Medical Center
      • Marshfield, Wisconsin, Forenede Stater, 54449
        • Marshfield Medical Center-Marshfield
      • Milwaukee, Wisconsin, Forenede Stater, 53226
        • Medical College of Wisconsin
      • Minocqua, Wisconsin, Forenede Stater, 54548
        • Marshfield Clinic-Minocqua Center
      • Mukwonago, Wisconsin, Forenede Stater, 53149
        • ProHealth D N Greenwald Center
      • New Richmond, Wisconsin, Forenede Stater, 54017
        • Cancer Center of Western Wisconsin
      • Oconomowoc, Wisconsin, Forenede Stater, 53066
        • ProHealth Oconomowoc Memorial Hospital
      • Oconto Falls, Wisconsin, Forenede Stater, 54154
        • Saint Vincent Hospital Cancer Center at Oconto Falls
      • Rhinelander, Wisconsin, Forenede Stater, 54501
        • Ascension Saint Mary's Hospital
      • Rice Lake, Wisconsin, Forenede Stater, 54868
        • Marshfield Medical Center-Rice Lake
      • Sheboygan, Wisconsin, Forenede Stater, 53081
        • HSHS Saint Nicholas Hospital
      • Stevens Point, Wisconsin, Forenede Stater, 54481
        • Ascension Saint Michael's Hospital
      • Sturgeon Bay, Wisconsin, Forenede Stater, 54235
        • Green Bay Oncology - Sturgeon Bay
      • Waukesha, Wisconsin, Forenede Stater, 53188
        • ProHealth Waukesha Memorial Hospital
      • Wausau, Wisconsin, Forenede Stater, 54401
        • Marshfield Clinic-Wausau Center
      • Weston, Wisconsin, Forenede Stater, 54476
        • Marshfield Medical Center - Weston
      • Wisconsin Rapids, Wisconsin, Forenede Stater, 54494
        • Marshfield Clinic - Wisconsin Rapids 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

Deltagelseskriterier

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

Berettigelseskriterier

Aldre berettiget til at studere

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inklusionskriterier:

  • Nyrecellekarcinom med en komponent af klar celle histologi; histologisk dokumentation for metastatisk sygdom er ikke påkrævet
  • Lokalt avanceret (defineret som sygdom, der ikke er modtagelig for helbredende kirurgi eller strålebehandling) eller metastatisk nyrecellekarcinom (RCC) (svarende til fase IV RCC, ifølge American Joint Committee on Cancer [AJCC] iscenesættelse)

  • Kvalificerede patienter skal have mellem-/dårlig risiko i henhold til kriterierne for International Metastatic Renal Cell Carcinoma (mRCC) Database Consortium (Heng). patienter skal derfor have en eller flere af følgende seks faktorer:

    • Tid fra diagnose af RCC til systemisk behandling < 1 år

      • Bemærk: systemisk behandling refererer til påbegyndelse af A031203-protokolbehandling
    • Hæmoglobin < den nedre grænse for normal (LLN)
    • Korrigeret calcium > den øvre grænse for normal (ULN)
    • Karnofsky præstationsstatus < 80 %
    • Neutrofiltal > ULN
    • Blodpladetal > ULN
  • Ingen røntgenundersøgelser af kaviterende lungelæsioner
  • Ingen tumor invaderer de nedre vena cava (IVC) eller superior vena cava (SVC) blodkarrene
  • Ingen tegn på, at tumor invaderer mave-tarmkanalen (spiserør, mave, tynd- eller tyktarm, rektum eller anus), eller tegn på endotracheal eller endobronchial tumor inden for 28 dage før registrering
  • Ingen forudgående systemisk behandling for RCC; understøttende behandlinger såsom bisfosfonater (zoledronsyre) eller denosumab er tilladt
  • Patienter må ikke have haft et større kirurgisk indgreb eller væsentlig traumatisk skade inden for 6 uger før undersøgelsesregistrering, og de skal være helt restituerede efter en sådan procedure; dog kan patienter, der har fået en nefrektomi, blive indskrevet 4 uger efter operationen, forudsat at der ikke er nogen sårhelende komplikationer; Følgende anses ikke for at være større procedurer: thoracentese, paracentese, portplacering, laparoskopi, thoracoskopi, bronkoskopi, endoskopiske ultralydsprocedurer, mediastinoskopi, hudbiopsier, incisionsbiopsier, billeddiagnostik-guidet biopsi til diagnostiske formål og rutinemæssige tandbehandlinger

  • Stråling:

    • Til hjernen, thoraxhulen, maven eller bækkenet skal afsluttes mindst 90 dage før registreringen;
    • Ben skal udfyldes mindst 14 dage før registrering; og
    • Til andre steder skal afsluttes mindst 28 dage før registrering. I alle tilfælde skal der være fuldstændig bedring og ingen igangværende komplikationer fra tidligere strålebehandling
  • Ingen kronisk samtidig behandling af stærk cytochrom P450, familie 3, underfamilie A, polypeptid 4 (CYP3A4) inducere eller inhibitorer; patienter har muligvis ikke modtaget en stærk CYP3A4-inducer inden for 12 dage før registrering eller en stærk CYP3A4-hæmmer inden for 7 dage før registrering
  • Patienter skal have målbar sygdom ved responsevalueringskriterier i solide tumorer (RECIST) kriterier; læsioner, der kan måles nøjagtigt i mindst én dimension (længste diameter, der skal registreres) som >= 2 cm med konventionelle teknikker eller som >= 1 cm med spiral computertomografi (CT) scanning

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

    • Behandlede hjernemetastaser er defineret som at de ikke har noget løbende behov for steroider og ingen tegn på progression eller blødning efter behandling i mindst 3 måneder, som konstateret ved klinisk undersøgelse og hjernebilleddannelse (magnetisk resonansbilleddannelse [MRI] eller CT); (stabil dosis af antikonvulsiva er tilladt); behandling af hjernemetastaser kan omfatte strålebehandling af hele hjernen (WBRT), strålekirurgi (RS; Gamma Knife, lineær accelerator [LINAC] eller tilsvarende) eller en kombination, som den behandlende læge skønner passende; patienter med metastaser i centralnervesystemet (CNS) behandlet ved neurokirurgisk resektion eller hjernebiopsi udført inden for 3 måneder før registrering er ikke kvalificerede
    • Baseline hjernebilleddannelse (MRI/CT) er påkrævet
  • Ingen alvorlige ikke-helende sår, mavesår eller knoglebrud, der kræver intervention inden for 28 dage før registrering
  • Ingen arterielle trombotiske hændelser inden for 6 måneder før registrering, inklusive forbigående iskæmisk anfald (TIA), cerebrovaskulær ulykke (CVA), perifer arteriel trombose, ustabil angina eller angina, der kræver kirurgisk eller medicinsk intervention i de 6 måneder før registrering, eller myokardieinfarkt ( MI); patienter med klinisk signifikant perifer arteriesygdom (dvs. claudicatio på mindre end én blok), signifikant vaskulær sygdom (dvs. aortaaneurisme, aortadissektion) eller enhver anden arteriel trombotisk hændelse er ikke kvalificerede
  • Ingen historie med lungeemboli eller ubehandlet dyb venetrombose (DVT) inden for 6 måneder før registrering; bemærk: Patienter med nylig DVT, som er blevet behandlet med terapeutisk antikoagulering med lavmolekylær heparin i mindst 6 uger, er kvalificerede; patienter, der får terapeutisk warfarin (> 2 mg/dag), er ikke kvalificerede; patienter på warfarin kan skiftes til lavmolekylært heparin efter den behandlende læges skøn
  • Ingen utilstrækkeligt kontrolleret hypertension (defineret som et blodtryk på >= 150 mmHg systolisk og/eller >= 90 mmHg diastolisk), eller nogen tidligere historie med hypertensiv krise eller hypertensiv encefalopati
  • Ingen New York Heart Association (NYHA) klasse >= 2 kongestiv hjerteinsufficiens
  • Udstødningsfraktion på ekkokardiogram (Echo) eller multi-gated acquisition scan (MUGA) > 50 %
  • Intet korrigeret QT-interval beregnet ved Fridericia-formlen (QTcF) > 500 ms inden for 28 dage før randomisering; Bemærk: hvis initial QTcF viser sig at være > 500 ms, skal der udføres yderligere to elektrokardiogrammer (EKG'er) adskilt med mindst 3 minutter; hvis gennemsnittet af disse tre på hinanden følgende resultater for QTcF er =< 500 ms, opfylder emnet berettigelse i denne henseende
  • Ingen historie med medfødt QT-syndrom
  • Ingen ustabil hjertearytmi inden for 6 måneder før registrering

  • Intet bevis for nogen af ​​følgende:

    • Klinisk signifikant gastrointestinal blødning inden for 6 måneder før registrering; eller
    • Hæmoptyse af >= 0,5 teskefuld (2,5 ml) rødt blod inden for 3 måneder før registrering; eller
    • Eventuelle andre tegn på lungeblødning inden for 3 måneder før registrering
  • Ingen historie med abdominal fistel, gastrointestinal perforation, intraabdominal absces, tarmobstruktion eller maveudløbsobstruktion inden for 6 måneder før registrering og fuldstændig heling/opløsning før registrering; ingen perkutan endoskopisk gastrostomi (PEG) rørplacering inden for 3 måneder før registrering
  • Ingen aktiv mavesår, inden for 28 dage før registrering
  • Ingen inflammatorisk tarmsygdom (herunder colitis ulcerosa og Crohns sygdom), diverticulitis, cholecystitis, symptomatisk kolangitis eller blindtarmsbetændelse inden for 28 dage før registrering
  • Intet malabsorptionssyndrom inden for 28 dage før registrering
  • Ingen ukompenseret hypothyroidisme; patienter med hypothyroidisme i behandling skal have thyreoideastimulerende hormon (TSH) inden for normale grænser
  • Ingen radiologiske eller kliniske tegn på pancreatitis
  • Ingen historie med organtransplantation
  • Patienter med aktiv infektion, der kræver systemisk behandling inden for 28 dage før registrering, er ikke kvalificerede

  • Patienter, der er gravide eller ammer, er ikke berettigede; kvinder i den fødedygtige alder skal have en negativ serum- eller uringraviditetstest inden for 16 dage før registrering; kvinder i den fødedygtige alder omfatter:

    • Enhver kvinde, der har oplevet menarche, og som ikke har gennemgået kirurgisk sterilisation (hysterektomi, bilateral tubal ligering eller bilateral ooforektomi) eller ikke er postmenopausal (defineret som amenoré >= 12 på hinanden følgende måneder)
    • Kvinder i hormonsubstitutionsterapi (HRT) med dokumenteret serum follikelstimulerende hormon (FSH) niveau > 35m IE/ml
    • Kvinder, der bruger orale, implanterede eller injicerbare svangerskabsforebyggende hormoner eller mekaniske produkter, såsom en intrauterin enhed eller barrieremetoder (membran, kondomer, sæddræbende midler) for at forhindre graviditet eller praktisere afholdenhed, eller hvor partneren er steril (f.eks. vasektomi)
  • Præstationsstatus: Eastern Cooperative Oncology Group (ECOG) 0-2
  • Arkivvæv skal være tilgængeligt for indsendelse, selvom det er valgfrit for patienter at vælge at deltage i de korrelative delstudier
  • Absolut neutrofiltal (ANC) >= 1.500/uL
  • Blodpladetal >= 100.000/uL
  • Hæmoglobin >= 9 g/dL; patienter har muligvis ikke fået en transfusion inden for 7 dage før screeningsvurdering
  • Total bilirubin =< 1,5 x øvre normalgrænse
  • Aspartataminotransferase (AST)/alaninaminotransferase (ALT) =< 2,5 x ULN
  • Albumin >= 2,8 g/dL
  • Serumkreatinin =< 1,5 x ULN, ELLER beregnet kreatininclearance >= 30 ml/minut (modificeret Cockcroft og Gault-formel)
  • Urinprotein til kreatinin (UPC) forhold < 1,0; hvis UPC >= 1, så skal et 24-timers urinprotein vurderes; egnede patienter skal have en 24-timers urinproteinværdi < 1 g
  • Total serumcalcium < 12 mg/dL
  • Internationalt normaliseret forhold (INR) =< 1,2 x ULN; forsøgspersoner, der får antikoagulantbehandling, er kvalificerede, hvis deres INR er stabilt og inden for det anbefalede interval for det ønskede niveau af antikoagulering
  • TSH inden for normale grænser (WNL); TSH er kun påkrævet for patienter på skjoldbruskkirteltilskud

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)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Aktiv komparator: Arm I (cabozantinib-s-malat)
Patienterne får cabozantinib-s-malat PO QD i 6 uger. Kurser gentages hver 6. uge i fravær af sygdomsprogression eller uacceptabel toksicitet.
Andet: Laboratoriebiomarkøranalyse
Korrelative undersøgelser
Medicin: Cabozantinib S-malat
Givet PO
Andre navne:
  • BMS-907351
  • Cabometyx
  • Cometriq
  • XL-184
  • XL184
Aktiv komparator: Arm II (sunitinib malat)
Patienter får sunitinib malat PO QD i 4 uger. Kurser gentages hver 6. uge i fravær af sygdomsprogression eller uacceptabel toksicitet.
Andet: Laboratoriebiomarkøranalyse
Korrelative undersøgelser
Medicin: Sunitinib Malate
Givet PO
Andre navne:
  • Sutent
  • SU011248
  • SU11248
  • sunitinib

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Progressionsfri overlevelse (PFS)
Tidsramme: Op til 5 år
Progressionsfri overlevelse (PFS) blev undersøger vurderet og måles fra begyndelsen af ​​behandlingen til patientens progression eller død. Progression blev bestemt ved hjælp af RECIST 1.1-kriterier, progression er defineret som en stigning på mindst 20 % i summen af ​​diametrene af mållæsioner, idet man tager den mindste sum af undersøgelsen som reference (dette inkluderer baseline-summen, hvis den er den mindste i undersøgelsen) . Ud over den relative stigning på 20 % skal summen også vise en absolut stigning på mindst 5 mm. (Bemærk: forekomsten af ​​en eller flere nye læsioner betragtes også som progression). Den primære analyse vil være baseret på den stratificerede log-rang statistik for at sammenligne de to behandlingsarme på PFS. Kaplan-Meier-produktgrænseestimatoren vil blive brugt til at estimere PFS-fordelinger. Progressionsfri overlevelse blev vurderet pr. investigator, da dette var det protokol-specificerede endepunkt, og både investigator og uafhængige review-analyser af PFS-endepunktet er blevet offentliggjort.
Op til 5 år
Samlet overlevelse (OS)
Tidsramme: Op til 5 år
Den primære analyse vil være baseret på den stratificerede log-rang statistik for at sammenligne de to behandlingsarme på OS. Kaplan-Meier-produktgrænseestimatoren vil blive brugt til at estimere OS-distributioner.
Op til 5 år

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Objektive svarprocenter
Tidsramme: Op til 5 år
Objektive responsrater (ORR) blev efterforsker vurderet. ORR er frekvensen af ​​komplette eller delvise svar baseret på RECIST 1.1-kriterier. Et respons er defineret som et fald på mindst 30 % i summen af ​​diametrene af mållæsioner, idet der tages udgangspunkt i sumdiametrene ved baseline. Fishers eksakte test vil blive brugt til at sammenligne de to behandlingsarme.
Op til 5 år

Samarbejdspartnere og efterforskere

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

Sponsor

National Cancer Institute (NCI)

Efterforskere

  • Ledende efterforsker: Toni K Choueiri, Alliance for Clinical Trials in Oncology

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

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)

8. juli 2013

Primær færdiggørelse (Faktiske)

18. april 2016

Datoer for studieregistrering

Først indsendt

16. april 2013

Først indsendt, der opfyldte QC-kriterier

16. april 2013

Først opslået (Skøn)

18. april 2013

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

11. februar 2021

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

28. januar 2021

Sidst verificeret

1. december 2020

Mere information

Begreber relateret til denne undersøgelse

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • NCI-2013-00820 (Registry Identifier: CTRP (Clinical Trial Reporting Program))
  • U10CA180821 (U.S. NIH-bevilling/kontrakt)
  • U10CA031946 (U.S. NIH-bevilling/kontrakt)
  • A031203 (Anden identifikator: CTEP)

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

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